Bacteriological

Am J Obstet Gynecol, 1985 Jul 1, 152(5), 569 - 70
Bartholin's cyst: marsupialization or aspiration?
Cheetham DR.
Of 34 patients with bartholinitis, two thirds had abscesses and one third had cysts . Aspiration provided not only relief but also material for bacteriologic culture . Ninety-five percent of the abscesses, half of them caused by gonorrhea, could be treated with penicillin and metronidazole . Cysts were not treated with chemotherapy . Cure rate was 85%.

Urology, 1985 Jul, 26(1 Suppl), 27 - 33
Prevention and treatment of postoperative infection; Harrison LH et al.; Strategies for the prevention, early recognition, and management of postoperative infections in urologic patients are described . It is suggested that clinicians consider the extent of the patient's exposure to hospital pathogens as well as the hospital's unique bacteriology when devising antibiotic strategies for postoperative infections.

Acta Leprol, 1985 Jul-Sep, 3(3), 239 - 48
{Integration of leprosy polychemotherapy into general health services}; Daumerie D et al.; The actual control of leprosy must conciliate difficulties of multidrug therapy (MDT) application and integration of general health services . The getting up of multidrug therapy needs a logistic with clinical and bacteriological track off, patient categorisation, supervision of treatment, follow up of the drug compliance and control of the disease evolution . The management of such system must be perfectly mastered in order to avoid the uncontroled circulation of rifampicine . Solutions are proposed in order to increase specialized teams efficiency and integration of non specialized officers incumbent tasks.

Radiologe, 1985 Jul, 25(7), 291 - 8
{Spondylitis--spondylodiscitis . Pathologico-anatomical morphology and diagnostic problems}; Adler CP; Inflammatory disorders of the spine usually develop in the medullary space of the vertebral bodies, and this clinical picture is identified as spondylitis . If the inflammation involves the intervertebral disk as well as adjacent vertebrae, this lesion is defined as spondylodiscitis . Spondylitis may be brought about by several causes which should be diagnostically clearly defined in order to introduce a suitable therapy . In many cases, no conclusions can be drawn from the radiological structures alone with respect to the underlying disease, an additional biopsy investigation (e.g., by a needle puncture) is therefore required . Most infections conditions of spondylitis represent histologically either an acute, purulent or a chronic, unspecific osteomyelitis . The causative germs are determined by simultaneous bacteriological investigation . The biopsy material of specific spondylitis shows typical histological granulomas which, together with the bacteriological findings, will allow a precise diagnosis to be established . Both spondylitis and spondylodiscitis may also be produced by fungi that can be histologically identified . Parasites (e.g., Echinococci) may also be recognized histologically . In spondylitis of unknown etiology the histological structures do not have a pathognomonic appearance, and therefore clinical and radiological findings should be included in the diagnosis . Diagnostic problems will only be solved by considering a synthesis of all findings.

Nord Vet Med, 1985 Jul-Aug, 37(4), 228 - 33
A field trial evaluating the use of cefoperazone in the treatment of bovine clinical mastitis; Holmgren N et al.; A field trial was designed to investigate the efficacy of a single intramammary infusion of cefoperazone in the treatment of clinical bovine mastitis . 110 cases of naturally occurring mastitis were treated and the clinical and bacteriological cure rates at day 14 after treatment were recorded.

Monatsschr Kinderheilkd, 1985 Jul, 133(7), 483 - 6
{Bacterial growth in breast milk under various storage conditions}; Knoop U et al.; To find the best temperature for storing human breast milk in the first test series, bacterial growth was determined and recorded at refrigerator temperatures of 8 to 10 degrees C and at 4 degrees C respectively . During a 3-day observation period, there was a slight decrease in bacterial count (b.c.) at higher temperature whereas the b.c . decrease at the lower temperature was more significant . In another test 72 samples of milk were kept for one month at a temperature of -20 degrees C; the b.c . observed after thawing was substantially smaller than that recorded before freezing . Pasteurized milk samples were found sterile with the method we used (in 0.1 ml) . In a third test a measured quantity of specific bacteria was added to the milk samples which were first deep-frozen, thereafter pasteurized and finally stored in a refrigerator for 3 days at 4 degrees C . During this process, a decrease was observed in all the bacteria involved . In our opinion, breast milk is best stored at a constant temperature of 4 degrees C . Pasteurization and freezing are also recommended from a bacteriological point of view.

Vet Clin North Am Small Anim Pract, 1985 Jul, 15(4), 827 - 34
Surgery in hematopoietic tumors; Brown NO; The role of surgery in the diagnosis of hematopoietic malignancies is undisputed . Many techniques to procure and examine representative tissue samples are recognized in identifying dogs and cats with these diseases . More sophisticated cytologic techniques not yet readily available would be helpful in implementing appropriate diagnostic, prognostic, and therapeutic approaches . Surgery has a limited role in the management of primary disease . The greatest limitation to surgical intervention is the systemic nature of most hematopoietic malignancies . Other limitations that can more realistically be overcome include early recognition of patients with extranodal lymphomas in Stage I disease, the increased use of surgery and radiation as adjunctive therapies for patients with regional disease, a more aggressive approach to the treatment of disease complications, and the implementation of promising experimental therapies in clinical patients of the future . The surgeon treating dogs and cats with hematopoietic malignancies must, as always, practice accepted principles of bacteriologic and oncologic asepsis and await further advances in veterinary medicine to integrate this discipline more completely with other modalities of therapy.

Radiologe, 1985 Jul, 25(7), 329 - 38
{X-ray guided punch biopsy of the spinal column}; Rau WS; Roentgenographically visible lesions of the skeleton are subjects for microscopy if the nature of the lesion is uncertain . In particular, the vertebral column, as it lies so deeply, needs a major surgical intervention if an excision has to be performed . The radiologically guided trephine biopsy, in contrast, is a great simplification for the patient . Using the Jamshidi-needle, 57 bone biopsies were performed . In 53 cases a reliable pathologic diagnosis was obtained by microscopy . Bacteriology, however, was positive in only 5 out of 23 cases with spondylitis or spondylodiscitis . No complications were observed.

Indian J Lepr, 1985 Jul-Sep, 57(3), 483 - 90
Multi-drug therapy in bacilliferous leprosy--two years experience; Kaur S et al.; The data of thirty patients who completed two years of multi-drug therapy (MDT) is analysed in regard to clinical improvement, occurrence of reactions, bacteriological response and compliance to therapy.

Schweiz Med Wochenschr, 1985 Jun 29, 115(26), 903 - 6
{Bacteriological safety of enteral nutrition with continuous delivery}; Bengoa JM et al.; Enteral nutrition can be administered as bolus feedings or by pump-assisted continuous drip . We have compared these two techniques in regard to bacterial contamination of nutritional solutions for given periods of administration set utilisation . A total of 103 patients were treated for 3 months . Bacterial contamination of nutritional solutions was important, but clinical complications, particularly diarrhea, were seen only in 11% . In several cases osmotic diarrhea was produced by too rapid administration . Factors associated with a high level of bacterial growth included utilisation time of administration sets, hanging time of feeding formula, and, mainly, maintenance of the connection between the administration set and the nasogastric tube during pump-assisted continuous drip . Retrograde colonisation of the nasogastric feeding tube is likely in view of the bacterial flora identified . The absence of relationship between microbial contamination of nutritional solutions and infectious diarrhea, as demonstrated in this study, is indicative of the appropriate bacterial safety of continuous drip or bolus enteral nutrition.

Jpn J Antibiot, 1985 Jun, 38(6), 1533 - 51
{Clinical evaluation of sisomicin following intravenous drip infusion in respiratory tract infections}; Nagahama F et al.; The efficacy, safety and utility of sisomicin (SISO) followed intravenous infusion were evaluated in 35 cases with various respiratory infections . For many cases, SISO was given at a daily dosage of 100 mg, and a single dose was infused over about 1 hour . Clinical efficacy was evaluable in 28 cases including pneumonia (14 cases), bronchitis (8 cases), bronchiectasis (4 cases), pulmonary suppuration (1 case) and pulmonary abscess plus pyothorax (1 case) . Almost cases had diagnosis of serious infection associated with various diseases . Clinical efficacy was evaluated as "excellent" in 2 cases, "good" in 15 cases, "fair" in 5 cases and "poor" in 6 cases, and efficacy rate in total case was 60.7% . Efficacy rate stratified by disease was calculated as 57.1% in pneumonia, 87.5% in bronchitis, 50.0% in bronchiectasis . Responses against pulmonary suppuration or pulmonary abscess with pyothorax were little or not . Bacteriologically, organisms isolated from sputum cleared in 7 out of 15 evaluable cases, thus the responses rate was 46.7% . Adverse reaction probably due to treatment observed in 2 cases with hepatic dysfunction . Blood levels of SISO at the end of infusion were ranged from 2.1 to 6.4 micrograms/ml, and no tendency of accumulation in blood after repeated infusion was showed.

J Radiol, 1985 Jun-Jul, 66(6-7), 451 - 7
{Percutaneous bone puncture biopsy with trocar . Apropos of 60 cases}; de Cassin P et al.; Deep bone biopsies were performed in 58 patients over the last 2 years, in a radiology department in Tours, France, under television screen control . Data obtained included pathologic, cytologic and bacteriologic features in the 60 biopsies conducted, localization being the spine in 52 cases (12 dorsal, 36 lumbar, 4 sacroiliac) and the pelvis 8 times . Etiology was a tumoral process in 15 cases (14 metastases and 1 reticulosarcoma), 7 infectious processes including 2 cases of tuberculosis, 26 cases of decalcifying degenerative osteopathies, 1 Paget's disease, 1 ankylosing spondylitis and 1 bone infarct . Biopsy was unsuccessful in 9 cases, the success rate being an overall 85% . Complications were not observed . Conducted under local anesthesia, deep bone biopsy provides a rapid diagnosis and allows a shortened hospital stay . Surgery is generally avoided and appropriate treatment instituted more rapidly.

Rev Fr Transfus Immunohematol, 1985 Jun, 28(3), 215 - 26
{Comparison of two skin antiseptics in blood transfusion . Comparison with the results of the bacteriologic control of labile blood products}; Huttmann R et al.; The comparison of two skin antiseptics (70 degrees alcohol and 0,5% alcoholic chlorhexidine solution) was carried out by the method of in vivo impressions . The study used 45 healthy volonteers from whom a bacteriological sample was taken from both bends of the elbow, without use of an antiseptic, and after the application of one according to usual sample taking methods . The subjects were divided into two sets according to the antiseptic being tested . The results of the cultures after 24 and 48 hours are expressed in the number of germs per cm2, which thus permits us to calculate a reduction in percentage or log 10 form, and to appreciate the efficiency of the antiseptic studied . Routine bacteriological inspection of labile blood products was carried out on products picked at random every week during 18 months of exclusive use of 70 degrees alcohol by the sample taking services . The results show a comparable in vivo effectiveness of the two antiseptics on the superficial aerobic flora of the bend of the elbow, and the ease of use of 70 degrees alcohol has led to its choice . This choice is confronted with the results of the inspection of blood products: out of 1 293 inspections, only one slight contamination (cocci gram+) was found on a unit of whole blood . These data as a whole can be compared with the work of various authors.

Chemioterapia, 1985 Jun, 4(3), 218 - 21
Double-blind randomized comparative trial: ornidazole (Tiberal) versus tinidazole (Fasigin) for the treatment of non-specific vaginitis; Sanz Sanz F et al.; In a double-blind, randomized trial 60 patients with demonstrated bacteriological and clinical non-specific vaginitis were treated with tinidazole versus ornidazole . Thirty patients received tinidazole 2 g daily taken orally in two separate doses for two consecutive days . Twenty-three patients (76%) were cured, 3 patients (10%) relapsed and 4 patients were therapeutic failures . Thirty patients received ornidazole with the same regimen . Twenty-eight patients (93%) were cured, 1 patient (3.3%) relapsed and 1 patient had intolerance to the medication.

Int J Lepr Other Mycobact Dis, 1985 Jun, 53(2), 198 - 200
Effect of levamisole on bacterial index in BL and LL leprosy; Bera DK et al.; A 150 mg levamisole tablet once in every fortnight along with specific antileprosy drugs were administered to ten patients each in BL and LL groups of leprosy . A similar number of patients in each group receiving only specific antileprosy treatment served as controls . After 11/2 years of study a more significant improvement was noted in the bacteriological status in the levamisole-treated group . Thus, levamisole can be used as an effective adjunct for quicker recovery in lepromatous patients.

Gastroenterol Clin Biol, 1985 Jun-Jul, 9(6-7), 472 - 9
{Bacteriological, parasitological and virological study of the digestive flora in alpha-chain disease}; Harzic M et al.; Intestinal flora was explored in twelve patients affected with alpha-chain disease at different stages (stage A: 2 cases; stage B: 6 cases; stage C: 4 cases) . Bacterial overgrowth in the jejunum was observed in 11 cases, but intestinal flora was diverse and no one species was always present; although a 3-month oral antibiotic treatment induced complete remission in one patient (stage A) it was not possible to demonstrate any pathogenic bacterial species . Intestinal lambliasis was present in 40 p . 100 of cases . Virologic studies were negative . At stages A and B of the disease, antibiotic treatment was able to improve malabsorption and/or plasma protein digestive losses in 62 p . 100 of cases; this effect seemed related to the reduction of the bacterial flora and to giardiasis eradication.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Jun, (6), 40 - 4
{Results of the comparative use of virological and bacteriological control of routine disinfection in maternity homes}; Levi MI et al.; Bacterial viruses were often detected in washings from different environmental objects; not infrequently, the inoculation of washings from the same objects resulted in the growth of Escherichia coli . The expediency of making parallel tests of washings from these objects for the presence of wild strains of bacterial and viral cultures both during the control of disinfection measures and the determination of the effectiveness of disinfection agents is shown.

J Hosp Infect, 1985 Jun, 6(2), 209 - 17
Quantitative bacteriology of peripheral venous cannulae in neonates; Wilkins EG et al.; In a study of 50 peripheral venous cannulae removed from neonates in the special care baby unit, quantitative and qualitative techniques for cannula culture were compared and the results correlated with detailed clinical information . High-density colonization was demonstrated on the external and internal surfaces of nine, and on the external surface alone of four, cannula tips . Internal surface colonization was always associated with heavy external surface growth . In predicting high-density colonization by quantitative methods, qualitative culture in broth was 100% sensitive and 89% specific . There was a significant association between high-density colonization of the cannula tip and hub colonization, surrounding skin colonization, longer duration of cannula insertion, and slower average infusion rate . Similar organisms were isolated more frequently from the cannula tip and the hub than from the cannula tip and surrounding skin . These findings indicate that peripheral venous cannulae are a potential source of infection in neonates, that there is no advantage of techniques that identify internal surface colonization, and that most cannula tip infections have their origin in a colonized hub.

Int J Lepr Other Mycobact Dis, 1985 Jun, 53(2), 189 - 97
Relapse rate and incidence of dapsone resistance in lepromatous leprosy patients in Addis Ababa: risk factors and effect of short-term supplementary treatment; Warndorff van Diepen T et al.; A clinical trial was initiated at ALERT, Addis Ababa, Ethiopia, to study the effect of one-year supplementary treatment on the incidence of dapsone-resistant leprosy in lepromatous patients already on dapsone monotherapy . A total of 806 patients on dapsone therapy were assigned to one of four groups . The first group served as a control group, the second received a combination tablet of thiacetazone and INH (Thiazina) daily for 12 months, the third group received Thiazina daily for 12 months plus rifampin daily during months 1 and 7, and the fourth group received rifampin daily during months 1 and 7 but no Thiazina . Eighty-three percent of the patients were followed for five years after discontinuation of the supplementary treatment . The annual incidence of relapses and dapsone-resistant leprosy in the control group appeared to be 2.3% and 0.7%, respectively . The Thiazina treatment had no significant effect on either the overall relapse rate or the incidence of dapsone-resistant leprosy . The rifampin treatment, on the other hand, did significantly lower the relapse rate and only a single case of dapsone resistance was detected . A high incidence of relapse was found in young female patients . Nineteen of the 45 relapsed patients were bacteriologically negative at the start of the supplementary treatment and six had already been negative for over five years.

Br J Dermatol, 1985 May, 112(5), 603 - 6
Actinic superficial folliculitis; a new entity?
Nieboer C.
This paper describes two patients who developed an extensive superficial pustular folliculitis on the upper part of the breast, back, shoulders and lateral sides of the upper arms, starting within 24-36 h after exposure to sunlight . Bacteriological, immunohistopathological and photo-experimental investigations failed to reveal a cause for this sunlight-induced dermatosis, which seems not to have been hitherto described.

Appl Environ Microbiol, 1985 May, 49(5), 1304 - 6
Some goodness-of-fit methods for the Poisson plus added zeros distribution; el-Shaarawi AH; Methods for making inferences about the Poisson plus added zeros distribution and the truncated Poisson distribution are presented and illustrated with bacteriological data . Some of the methods are designed for testing the compatibility of the zero frequency with the Poisson distribution, whereas others are given for testing the goodness of fit for the truncated Poisson . In particular, a modified form of the Fisher index of dispersion is presented which is suitable for the truncated case . It is shown that the use of the usual expression of the index of dispersion for testing the adequacy of the truncated Poisson is not correct and leads to accepting inadequate fits more frequently than expected on the basis of test of significance . Furthermore, three test statistics are presented for testing the compatability of the zero frequency with the Poisson distribution . The results of the simulation show that two test statistics, one due to Cochran (W . G . Cochran, Biometrics 10:417-451, 1954) and the other to Rao and Chakravarti (C . R . Rao and I . M . Chakravarti, Biometrics 12:264-282, 1956), are preferable to those from the likelihood ratio test.

Ann R Coll Surg Engl, 1985 May, 67(3), 149 - 51
Changing knives a wasteful and unnecessary ritual; Hill R et al.; The use of two knives for making a surgical incision is a deeply ingrained practice of British surgery and a postal survey of the theatre superintendents in the South-West Thames Region revealed that out of 143 surgeons all but one use this technique . Therefore we undertook a bacteriological study of the knife blades used on a general surgical unit . This showed that under normal conditions pathogenic organisms do not contaminate the knife blade and are not carried into the wound by it . The use of only one knife to make an incision does not increase the incidence of wound infection . A survey of the world literature confirms these findings . The wasteful and unnecessary ritual of using two knives to make an incision through normal skin has no theoretical, scientific or clinical basis and can be discontinued.

Am J Surg, 1985 May, 149(5), 668 - 71
Effects of sphincteroplasty and endoscopic sphincterotomy on the bacteriologic characteristics of the common bile duct; Gregg JA et al.; Forty-five patients with sphincter of Oddi stenosis had specimens of common bile duct cultured during ERCP before either sphincteroplasty or endoscopic sphincterotomy . All had sterile bile before sphincter ablation . Bile was recultured 6 to 36 months later during endoscopy at which time 70 percent of the sphincterotomy and 76 percent of the sphincteroplasty patients had bile colonized principally by enteric organisms . Growth was heavy to moderate in most of the patients and contained few nasopharyngeal organisms . Despite bactobilia, no patient had symptomatic cholangitis, presumably due to excellent drainage of bile . The most likely source of the bactobilia is from direct extension of duodenal organisms into the common bile duct.

Infect Immun, 1985 May, 48(2), 507 - 19
Comparative bacteriology of juvenile periodontitis; Moore WE et al.; Statistical comparisons of the floras associated with juvenile periodontitis, severe periodontitis, and moderate periodontitis indicated that differences in the bacterial compositions of affected sites in these populations were not statistically significant . The subgingival flora of affected juvenile periodontitis sites was statistically significantly different from the adjacent supragingival flora and from the subgingival floras of people with healthy gingiva and of children with developing (experimental) gingivitis . However, the subgingival flora of affected juvenile periodontitis sites was not significantly different from the flora of sites with gingival index scores of 1 or 2 in adults with developing (experimental) gingivitis . Of 357 bacterial taxa among over 18,000 isolates, 54 non-treponemal species, 2 treponemal species, and mycoplasma were most associated with diseased periodontal sulci . These species comprised an increasing proportion of the flora during developing gingivitis and constituted over half of the cultivable flora of diseased sites.

Anaesthesist, 1985 May, 34(5), 247 - 51
{Hygienic relations and stability of drugs in peridural long-term infusion with implanted or external pumps}; Muller H et al.; Implantable devices (implanted pump/implanted catheter and port) are recommended for continuous epidural application of opiates or local anaesthetics in order to reduce hygienic problems during long term epidural medication . No signs of contamination could be found during bacteriologic culture of residual volumes of 30 patients treated with epidural drug delivery systems and of samples collected during an in vitro investigation (incubation of filled external pump systems at body temperature/storage of syringes with a premixed solution of opiate and local anaesthetic for repeated epidural bolus application) . As demonstrated in a case report prophylactic antibiotic coverage prior to implantation may be necessary in patients with a preexisting susceptibility to infection . The concentrations of morphine (radioimmuno-assay) and of bupivacaine (gas-solid chromatography) within the reservoir were stable during clinical therapy as well as during the in vitro experiments.

Jpn J Antibiot, 1985 May, 38(5), 1368 - 88
{Clinical evaluation of the TMS-19-Q.GC tablet in acute tonsillitis . A comparative double blind study with josamycin}; Baba S et al.; In order to compare the clinical efficacy and safety of TMS-19-Q.GC tablet (TMS) with josamycin tablet (JM) in acute tonsillitis, the double blind trial was carried out with the daily dosage of 200 mg X 3 in TMS and 400 mg X 3 in JM . Number of cases evaluated for clinical efficacy were 154 cases (73 treated with TMS and 81 treated with JM) . The effective rating of TMS and JM were 89.0% and 88.9% judged by doctors in charge, and 82.2% and 85.2% judged by committee respectively . Bacteriological effects were satisfactory to yield the eradication rates of 93.8% in TMS and 94.7% in JM . Number of cases evaluated for safety were 199 cases (101 treated with TMS and 98 treated with JM) . The incidence of side effect was 4.0% (4/101) in TMS and 5.1% (5/98) in JM and most of them were mild gastro-intestinal disorders . Number of cases evaluated for utility were 156 cases (74 treated with TMS and 82 treated with JM) . The usefulness rates were 85.1% in TMS and 86.6% in JM . There was no significant difference between TMS and JM, in clinical effect, bacteriological effect, safety and utility . From these results, daily 600 mg dosage of TMS was as useful as daily 1,200 mg dosage of JM in the treatment for acute tonsillitis.

Pathol Biol (Paris), 1985 May, 33(5), 444 - 9
{Activity of thiamphenicol in the early stage of syphilis}; Poitevin M et al.; Possible activity of thiamphenicol on Treponema pallidum during single-dose treatment of gonococcal infection with 10 tablets of 0.250 mg each was investigated using a new, more accurate method . We found that, under the conditions of our study, thiamphenicol fails to kill T . pallidum, exhibiting only incomplete activity . Thus, thiamphenicol taken during incubation of syphilis may delay or inhibit the emergence of primary manifestations but fails to achieve bacteriologic sterilization of T . pallidum acquired concomitantly with gonococcus . Clinical and serologic evidence of syphilis should therefore be looked for routinely three and six months after treatment.

Am Rev Respir Dis, 1985 May, 131(5), 727 - 31
Controlled clinical trial of two 6-month regimens of chemotherapy in the treatment of pulmonary tuberculosis . Tanzania/British Medical Research Council Study; Pathology of cloacal bursae of gnotobiotic turkeys orally inoculated with Escherichia coli; Cloacal bursae from three-week-old gnotobiotic turkeys were examined by light and electron microscopy and bacteriologic techniques at 1, 2, 5, 8, 12, and 16 days after oral inoculation of highly virulent (group 1) and weakly virulent (group 2) Escherichia coli . In both groups a significant decrease in follicular volume and increase in interstitial volume were associated with infection . Follicular cortical, follicular medullary and total follicular transectional areas increased with time in inoculated and control turkeys . In group 1, granulocytic inflammation developed in bursae on day 1 and diminished by day 8 after inoculation . Microabscesses were present on days 5 and 8 after inoculation in less than 1% of follicles . Bacteria were seen in few follicular medullae on days 5 and 8 after inoculation; bacteremia was detected on days 1, 2, and 5 after inoculation . In group 2, pyogranulomatous bursitis was first seen at five days after inoculation and became progressively more severe with time . Follicular alterations in group 2 included abscessation, lymphocyte necrosis, reticuloepithelial hyperplasia and perifollicular fibroplasia . Ultrastructurally, follicular pads had degenerate and necrotic epithelial cells, intercellular edema, and cystic spaces that contained acidic mucosubstances and laminar deposits of calcium salts . Bacteria were seen within necrotic centers of follicular abscesses, in phagosomes of macrophages and multinucleate giant cells and within extracellular spaces of follicular pads and follicular medullae from day 5 to day 16 after inoculation; no bacteremia was detected . We conclude that E . coli passes through the bursal follicle-associated epithelium and replicates within follicular medullae, that extensive follicular necrosis is associated with persistence of E . coli in follicular medullae, and that E . coli of low virulence may cause severe pyogranulomatous bursitis in young turkeys without causing the respiratory or systemic diseases which are commonly associated with organisms of high virulence.

Br J Rheumatol, 1985 May, 24(2), 191 - 3
Synovial rupture complicating Brucella arthritis; Laajam MA; A patient with Brucella arthritis presented as 'pseudothrombophlebitis syndrome', with rupture of knee synovial membrane into the calf . Bacteriological identification of the same organism from the patient's blood, knee effusion and calf-swelling aspirate suggested the diagnosis, and ultrasonography of the calf swelling gave supportive evidence . Synovial rupture into the calf in infective arthritis is a rare occurrence and this has not been reported previously in Brucella arthritis.

Clin Nucl Med, 1985 May, 10(5), 330 - 2
Gallium-67 citrate whole body scanning for the localization of infected vascular synthetic grafts; Thivolle P et al.; Ga-67 (3 mCi) was used in 11 patients to diagnose and locate an eventual infection of their synthetic vascular prostheses . In seven cases, an area of gallium uptake was found and the infection confirmed by surgery and bacteriology . In the remaining four cases, no uptake of gallium was found and the absence of infection was confirmed.

J Invest Dermatol, 1985 May, 84(5), 378 - 83
Fibronectin, as well as other extracellular matrix proteins, mediate human keratinocyte adherence; Clark RA et al.; During the reepithelialization of cutaneous wounds, the migratory epidermis transits over a provisional matrix of fibronectin and fibrin in the absence of laminin and type IV collagen as well as ultrastructurally identifiable basement membrane . Since significant quantities of fibronectin occur at these sites of reepithelialization, we surmised that fibronectin is a suitable substrate for keratinocyte adherence and therefore undertook the in vitro investigations reported here . Purified human plasma fibronectin precoated on bacteriologic microtiter wells was demonstrated to mediate human keratinocyte adherence when concentrations greater than 10 micrograms/ml fibronectin were used . Maximal keratinocyte adherence was obtained in wells precoated with 100 micrograms/ml fibronectin and when cells were incubated with substrate for 60 min or longer at 37 degrees C . Both primary and second-passaged human keratinocytes adhered as well or better to fibronectin than to types I and III collagen, laminin, or type IV collagen under both high- and low-Ca++ culture conditions . However maximal adherence to all substrates occurred when second-passaged keratinocytes were assayed in low-Ca++ medium . Under these latter culture conditions, keratinocyte phenotype resembles the phenotype of cells in the migrating epidermis . To determine specificity of these adherence reactions, antifibronectin antibodies were shown to block keratinocyte adherence to fibronectin but not to laminin substrates . Conversely, antilaminin antibodies blocked adherence to laminin but not fibronectin substrates . Thus, human keratinocytes demonstrate specific adherence to fibronectin in a time- and dose-dependent fashion and this adherence relies on de novo protein synthesis . We take these observations to support our hypothesis that the provisional fibronectin matrix observed beneath the migrating epithelium during tissue repair plays a functional role in the reepithelialization process.

Am J Otolaryngol, 1985 May-Jun, 6(3), 191 - 5
New perspectives in the direct microscopic examination of middle ear effusions; Van Cauwenberge P et al.; Detection and identification of bacteria in middle ear effusions from patients with otitis media with effusion requires sensitive bacteriologic techniques . Direct microscopic examination is very important in this respect . Three staining methods--Gram, Giemsa and the fluorescent acridine orange stain--were evaluated and compared by examining 112 middle ear effusions . Purulent effusions showed more bacteria than mucoid, and mucoid effusions showed more bacteria than serous in the direct microscopic examination of the smears . Acridine orange stain proved superior in detecting bacteria compared with Gram and Giemsa stains and distinguished dead from living bacteria . It is even more sensitive in this way than aerobic and anaerobic cultures . Giemsa stain was superior in the identification of inflammatory cells . Acridine orange and Giemsa stains are recommended in the bacteriocytologic examination of middle ear effusions; Gram stain may provide additional information.

S Afr Med J, 1985 Apr 13, 67(15), 588 - 90
Bacteriologically confirmed pulmonary tuberculosis in childhood . Clinical and radiological features; Donald PR et al.; Over a 4-year period 185 cases of pulmonary tuberculosis in children were confirmed by culture of Mycobacterium tuberculosis, usually from gastric aspirate . The majority of cases occurred in boys (62%) and the younger age groups were more commonly affected--26% of patients were less than 1 year old and 65% less than 3 years of age . At the time of presentation 40% of the 151 children tested had a negative tuberculin test . A chest radiograph was available in 136 cases . The commonest changes seen were lymphadenopathy (63%) and segmental lesions (56%) . The latter affected mainly the right lung and in particular the right middle lobe . Cavitating tuberculous disease was present in 19 children, including 5 aged less than 1 year.

Jpn J Antibiot, 1985 Apr, 38(4), 954 - 65
{Fundamental and clinical studies of cefpimizole in the field of obstetric and gynecologic infections}; Gorai I et al.; We made fundamental and clinical studies of a new cephalosporin derivative cefpimizole (AC-1370), and found the following . In 7 patients treated with AC-1370 for the fundamental study of the drug, the blood level of the drug in the uterine artery scarcely differed from that in the elbow vein, and it decreased steadily with time . It remained to be 6.5 approximately 7.0 micrograms/ml 5 hours after intravenous injection of 1 g of the drug . The tissue-serum concentration ratio of the drug was 122 approximately 58% in the portio vaginalis where the drug was transferred at the highest level, and 56 approximately 114% in the oviduct where it was transferred at the lowest level; the mean level was 61.5% . The responses to AC-1370 of 10 patients with genital infections were excellent in 1, good in 8 and poor in the other, with a response rate of 90% . Bacteriologically, pathogens were eradicated in 3, decreased in 2, and the response was unknown in the other 5 . No side effects or abnormal laboratory findings were noted except for leukopenia in 1 patient.

Jpn J Antibiot, 1985 Apr, 38(4), 940 - 53
{Fundamental and clinical studies on cefpimizole in the field of obstetrics and gynecology}; Obata I et al.; Cefpimizole (AC-1370) was studied for its transference into adnexa uteri and uterine tissues as well as for its effects and safety on gynecological infections . The results obtained are as follows: Peak levels of AC-1370 were obtained in the antecubital vein and uterine artery at 10 minutes, in the tissues of adnexa uteri and uteri about 30 minutes after one shot intravenous injection of AC-1370 1 g, and relatively high concentrations were maintained for several hours . In the treatment of 30 cases of gynecological infections, the clinical efficacy of AC-1370 was assessed as effective in all cases . As for the bacteriological effects of AC-1370, 77.6% of isolated organisms were eradicated and 90% of all cases were effective . Side effects and abnormal laboratory findings due to AC-1370 were not observed during and after administration.

Jpn J Antibiot, 1985 Apr, 38(4), 1001 - 10
{Fundamental and clinical studies of cefpimizole in obstetrics and gynecology}; Ishii Y et al.; The findings from recent fundamental and clinical studies of the efficacy of cefpimizole (AC-1370) in obstetrics and gynecology are reported in this paper . The AC-1370 concentrations in genital tissues sampled 30 to 56 minutes (a mean of 41.4 minutes) after intravenous injection of 1 g of the drug were 14 to 76 micrograms/g (a mean of 32.4 micrograms/g) . The mean transfer ratios of the drug into the genital tissues to the concentration in the uterine arterial blood were such that the transfer ratio into the portio vaginalis was the highest, followed by the uterine cervix and the myometrium, and that into the oviduct was the lowest with about 1/2 that into the portio vaginalis . The concentration in the antecubital venous blood and that in the uterine arterial blood remained similar for all patients . The transfer of AC-1370 into the pelvic dead space exudate reached a peak (49.5 micrograms/ml) 1 hour, and also a peak (49.8 micrograms/ml) 2 hours after the intravenous injection . It then decreased gradually, but remained high, being higher than that in the antecubital venous blood about 50 minutes after the intravenous injection . Ten patients with infections in gynecology were treated with 1.0 to 4.0 g daily of AC-1370, to a total dose of 6 to 52 g, over a period of 3 to 13 days . One of them showed excellent response, 8 showed moderate response, and another showed poor response to the treatment: in other words, a response rate of 90% was achieved . Bacteriologically, pathogens were eradicated from 3 and decreased in 3, and microbial substitution occurred in another patient . No side effects of the drug were observed except for eruption in 1 patient . None of the 10 patients showed any abnormalities in laboratory findings . From the present fundamental and clinical studies of AC-1370, we have drawn the conclusion that the drug is one of extremely useful antibiotics in the treatment of infections in obstetrics and gynecology.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 508 - 10
Comparative study of amoxicillin-clavulanic acid and cephalexin in the treatment of bacteriuria during pregnancy; Pedler SJ et al.; A comparative clinical trial of amoxicillin-clavulanic acid and cephalexin was carried out in 80 women with bacteriuria of pregnancy . Treatment was randomly allocated and consisted of either one tablet of amoxicillin plus clavulanic acid (250 and 125 mg, respectively) three times daily or cephalexin (250 mg) three times daily for 7 days . Overall bacteriological cure rates at 2 weeks were 77% in the amoxicillin-clavulanic acid group and 74% in the cephalexin group . At 6 weeks the respective rates were 76 and 60% . Twenty-five episodes of infection were with ampicillin-resistant strains; cure rates were 82% (2 weeks) and 80% (6 weeks) in the amoxicillin-clavulanic acid group and 85 and 64%, respectively, in the cephalexin group . Differences in cure rates were not statistically significant . No significant difference in the rate of side effects was found . In particular, no toxicity to the fetus was seen which could be ascribed to either drug . Amoxicillin-clavulanic acid would appear to be a safe and effective treatment for bacteriuria of pregnancy.

Sci Total Environ, 1985 Apr, 42(3), 289 - 303
The use of historical data for estimating the number of samples required for monitoring drinking water; el-Shaarawi AH et al.; Statistical techniques are described for estimating the number of samples required to monitor the quality of drinking water when the dispersion of bacteria in the water can be modeled by the Poisson or the negative binomial distributions . The concept of the operating characteristic (OC) curve of the water distribution system is presented and is used to evaluate the risk of declaring that the bacteriological water quality regulation is met when only a small portion of the water is analyzed . Assuming that the regulation requires that the monthly mean bacterial counts for samples of standard volume are to be less than one per ml, the OC curves are compared for different sample sizes and for different values of the parameters of the negative binomial . The results indicate that the correct specification of the model is very important in evaluating the risk of sampling (i.e . making the wrong decision) . Total bacterial counts based on 1-ml samples, from the cities of Nancy and Metz in France, support the use of the negative binomial as a model for the dispersion of bacteria in drinking water . In the few cases where the negative binomial did not fit the data, the lack of fit can be attributed to the greater occurrence of the frequency of finding only one bacterium in the sample than that expected for the negative binomial . The OC curve indicated that the present monitoring strategy for the city of Nancy is adequate for monitoring the water quality if (i) the regulation requires that the monthly mean of total bacterial counts should not exceed one bacterium per ml, and (ii) the probability of accepting that the water quality is meeting the regulation, when the true mean number of bacteria per ml is two, should not be larger than 0.05 . On the other hand, the city of Metz data indicated that it is necessary to increase the intensity of sampling both in time and space in order to achieve the same level of adequacy as that of the city of Nancy.

Am J Vet Res, 1985 Apr, 46(4), 902 - 4
Characterization of Brucella abortus strain 19 isolated from human and bovine tissues and fluids; Meyer ME; One hundred isolates of Brucella abortus, which were recovered from bovine and human tissues or fluids, were identified as strain 19 by conventional bacteriologic methods . Each isolate was examined using a Warburg respirometer to determine oxidative rates on substrates of D- and L-alanine, L-glutamic acid, d(+)-galactose, D-ribose, and i-erythritol . These results were compared with those of repository (seed) cultures of strain 19 used for making antigens and vaccines . Except on the substrate of i-erythritol, each of the 100 isolates oxidized these substrates with rates different from the repository cultures and indistinguishable from those of field strains of B abortus . Thus, oxidatively, i-erythritol was the only substrate useful to help distinguish between strain 19 and virulent strains of B abortus biotype 1.

Indian J Lepr, 1985 Apr-Jun, 57(2), 376 - 82
Prevalence of drug resistance in Dharmapuri and A . Pallipatti areas of Tamil Nadu; Sreevatsa et al.; An evaluation of leprosy control project was undertaken in Dharmapuri and A . Pallipatti areas of Tamil Nadu to study the prevalence rate of drug resistance among the leprosy patients . At the end of 5 years of assessment 266 patients were still found to be bacteriologically positive among whom 25 patients were suspected to be clinically dapsone resistant . By mouse foot pad technique the drug resistant prevalence rate was found to be 1.1 per cent in these two areas.

Rev Fr Gynecol Obstet, 1985 Apr, 80(5), 287 - 91
{Salpingitis in children before puberty . Apropos of 2 cases}; Souteyrand P et al.; Salpingitis is exceptional in pre-pubertal girls . The authors compare a case of histologically and bacteriologically well documented salpingitis in a 3 year old girl to another case in a pre-pubertal 14 year old girl and review the literature on the subject . Six other cases have been reported . The clinical presentation is very variable and, in the absence of ultrasonography or laparoscopy, laparotomy is required for both the diagnosis and the treatment.

Appl Environ Microbiol, 1985 Apr, 49(4), 811 - 7
Fluorometric determination of the DNA concentration in municipal drinking water; McCoy WF et al.; DNA concentrations in municipal drinking water samples were measured by fluorometry, using Hoechst 33258 fluorochrome . The concentration, extraction, and detection methods used were adapted from existing techniques . The method is reproducible, fast, accurate, and simple . The amounts of DNA per cell for five different bacterial isolates obtained from drinking water samples were determined by measuring DNA concentration and total cell concentration (acridine orange epifluorescence direct cell counting) in stationary pure cultures . The relationship between DNA concentration and epifluorescence total direct cell concentration in 11 different drinking water samples was linear and positive; the amounts of DNA per cell in these samples did not differ significantly from the amounts in pure culture isolates . We found significant linear correlations between DNA concentration and colony-forming unit concentration, as well as between epifluorescence direct cell counts and colony-forming unit concentration . DNA concentration measurements of municipal drinking water samples appear to monitor changes in bacteriological quality at least as well as total heterotrophic plate counting and epifluorescence direct cell counting.

AJR Am J Roentgenol, 1985 Apr, 144(4), 787 - 92
Supplementary tissue-core histology from fine-needle transthoracic aspiration biopsy; Greene R et al.; Biopsies of 150 consecutive suspected lung cancers were performed with fine needles having circumferentially beveled tips that produced cytology and tiny tissue cores suitable for histology . Visible tissue cores were aspirated in 92% (n = 138) and histologic diagnoses were obtained in 72% (n = 108) . There were 118 (79%) proven malignant and 27 (18%) proven benign lesions . Sensitivity and specificity of cancer diagnoses were 97% and 100%, respectively . Biopsy histology was the only positive cancer specimen in two biopsies (1.7%) . Biopsy cytology was the only positive cancer specimen in 20 cases (17.2%) . Biopsy cytology and histology agreed with the proven cell type in 71.8% and 78.6% of cancers, respectively . As expected, when large-cell undifferentiated carcinoma was regarded as a nonspecific cell type consistent with either poorly differentiated adenocarcinoma or poorly differentiated epidermoid carcinoma, biopsy-cell-type accuracy increased greatly . Specific benign diagnoses were obtained in 44% of the 27 biopsies of proven benign lesions: cytology (four), core histology (five), and bacteriology (nine) . Simple and complicated pneumothorax occurred in 10% and 4% of biopsies, respectively . It was concluded that biopsy with fine, circumferentially beveled needles can produce useful histology to supplement biopsy cytology.

J Comp Pathol, 1985 Apr, 95(2), 137 - 49
Variable persistence of the contagious equine metritis organism in the genital tract of CBA/J, CBA/N, LAF1/J, BALB/c and congenitally thymus-deficient (nude) mice; Timoney PJ et al.; Five inbred strains of mice, CBA/J, CBA/N, LAF1, BALB/c and congenitally thymus-deficient nude mice of BALB/c background, varied considerably in their susceptibility to the contagious equine metritis organism (CEMO) . Whereas all the strains were virtually refractive to vaginal challenge, LAF1 and CBA/N mice were readily infected by intra-uterine inoculation . Based on infection rate and nature of the bacteriological response, CBA/N mice appeared the more susceptible of the 2 strains . Attempts to transmit CEMO to thymus-deficient nude mice were unsuccessful by both of these routes of challenge and by intraperitoneal inoculation, indicating that host resistance to the causal agent is independent of thymus-mediated immune phenomena . No clinical evidence of infection was observed in any of the experimentally infected mice . Although persistence of CEMO in the female reproductive tract varied widely, it could be isolated from some of the CBA/N mice for as long as 19 weeks after challenge by the intra-uterine route . The organism was cultured from the ovaries and/or oviducts of a high percentage of one group of CBA/N mice after 50 days, when it could no longer be recovered from the remainder of the genital tract . Limited attempts to achieve venereal transmission of CEMO between culture-positive female and companion male CBA/N mice were unsuccessful . The relative susceptibility of the CBA/N strain of mice to CEMO would suggest that host resistance to this infection is at least partly dependent on the presence of a fully functional B lymphocyte system . Further studies in this experimental model may elucidate some of the immunological mechanisms underlying development of resistance in the horse, more specifically as they relate to the occurrence of the carrier state in this disease.

Vet Q, 1985 Apr, 7(2), 112 - 9
A chronic indurative mastitis in sheep, associated with maedi/visna virus infection; van der Molen EJ et al.; A possible association of a chronic indurative mastitis with mvv (maedi visna virus) infection in sheep was investigated . Sheep of four flocks (group A), in which insufficient lamb growth apparently associated with insufficient milk production and probably related to udder induration, was a serious problem, were clinically examined in mid-lactation . The results were compared with four mvv-free flocks (group B) without such complaints . The incidence of udder induration in group A (n = 263) was about eight times higher than in group B (n = 206): 63.1 versus 8.0% . The clinical picture differed essentially between the groups . In group A the udder abnormalities were of a diffuse and indurative nature, involving both udder halves, while in group B the udder lesions were mainly nodular and often limited to one udder half . Bacteriological examination revealed a difference in infection rate of the udders (6.8% in group A versus 14.1% in group B) . A substantial difference was observed in a comparison of the bacteriological infection rate of the clinically abnormal udders (5.4% in group A, versus 47.0% in group B) . Serological examination with an indirect ELISA revealed 81% seropositive sheep in group A, versus 0% in group B . Twelve sheep of group A and five of group B, called for reason of mastitis, were selected for pathological examination . The gross and microscopic lesions showed a pronounced difference between both groups . In group A a diffuse interstitial mastitis with slight to moderate fibrosis and a pronounced lymphoid hyperplasia was observed . In group B the mastitis had a nodular character, with a chronic galactophoritis, extensive fibrosis, and in some cases chronic abscesses.(ABSTRACT TRUNCATED AT 250 WORDS)

J Gen Virol, 1985 Apr, 66 ( Pt 4), 777 - 86
The experimental infection of chickens with mixtures of infectious bronchitis virus and Escherichia coli; Smith HW et al.; By inoculating chickens intranasally with a collection of strains of infectious bronchitis virus (IBV) of the Massachusetts serotype and of Escherichia coli of different serotypes, a pool of viral and bacterial strains was selected which, on inoculation, consistently produced a highly lethal disease closely resembling the natural disease produced by these two organisms . The conditions for reproducing the experimental disease were not rigorous in that, within broad limits, the size of the viral and bacterial inocula were not important; neither were the times at which both organisms were administered in relation to each other . The breed or strain of chicken used was important and the resistance of chickens to fatal infection increased with age . When the E . coli strains of the pool were inoculated intranasally without the IBV component, the chickens remained well; bacteriological examination of chickens inoculated with one of the E . coli strains, O18, revealed little evidence of invasion of the tissues or even of persistence of the inoculated E . coli strain in the upper respiratory tract . A minority of the IBV strains examined were lethal for chickens when inoculated without E . coli but many of them only produced a substantial mortality when the E . coli were included in the inoculum; IBV strains in this latter category included the vaccine strains H52 and H120 . High concentrations of IBV strain M41 and E . coli O18 persisted in the upper respiratory tract for a number of days after they had been inoculated together . Much lower concentrations of IBV M41 were found in the internal organs, such as the spleen; E . coli O18 was only found in these sites in some of the inoculated chickens . Coliform organisms proliferated in the upper respiratory tract of chickens inoculated with IBV alone; they were rarely found in their internal organs.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1985 Apr, 259(2), 188 - 93
{Time requirements for positive blood cultures with reference to different methods of determining bacteria in blood cultures}; Kuchler R; The time required for the first detection of bacteria in 926 blood-cultures has been evaluated for different methods . The microscopical examination of samples after staining with acridine-orange has been found to be a rapid and simple method, which may reduce in 88% of the samples the time required for the processing and thus increase the value of blood-cultures for the treatment of patients with bacteremia significantly . The results demonstrate that a rapid detection of bacteria in blood-cultures by chemical or microscopical methods is an indispensable part of the processing of blood-cultures, although it has been used only in few bacteriological laboratories until now.

Z Orthop Ihre Grenzgeb, 1985 Mar-Apr, 123(2), 245 - 9
{Results of scintigraphy with labeled leukocytes for the diagnosis of infectious hip prosthesis loosening}; Schmitt O et al.; The present paper reports on the results of a specific scintigraphic examination method for diagnosing infections in cases of loosening of hip prostheses by means of labeled granulocytes . In 103 patients the result of the examination was compared with the result of the bacteriological and/or histological investigation following removal or replacement of the implant . Where there was an infectious loosening of the prosthesis the findings were in agreement with the results of the scintigraphic examination in 83.1% of the cases . It was possible to rule out infectious loosening of the prosthesis in 93% of the cases thus investigated.

Int J Clin Pharmacol Ther Toxicol, 1985 Mar, 23(3), 166 - 72
Physiopathological rationale and clinical aims of the use of a combination of cefuroxime and N-acetylcysteine in pneumology; Girbino G et al.; The trial population consisted of 50 patients suffering from acute exacerbations of chronic bronchial disease processes . Forty patients were treated with an extempore combination of cefuroxime and N-acetylcysteine at the doses of 2 g and 600 mg/day respectively in two i.m . administrations . The other 10 patients were treated with N-acetylcysteine alone at the same dose . Respiratory tract clinical and instrumental parameters were investigated, and bacteriological tests were performed on sputum samples before and after treatment . Tolerance of the treatment was assessed on the basis of measurement of blood-chemistry parameters.

Am J Surg, 1985 Mar, 149(3), 347 - 50
Does drainage of intraabdominal pus reverse multiple organ failure?
Norton LW.
Intraabdominal abscess induced multiple organ failure in 21 patients . Sepsis was most often due to perforation of the colon and was located with almost equal frequency in the upper and lower abdomen . Four patients died after single laparotomy for drainage . Seventeen were drained operatively more than once (average 3.4 operations) at mean intervals of 10 days . Sixteen of the 21 patients (76 percent) died with multiple organ failure despite drainage . Organ function improved temporarily in only one patient . Autopsy showed that pus had persisted or recurred in three patients . No significant predictors of survival were identified, although the advantage appears to lie with the younger patient in whom multiple organ failure develops relatively late after sepsis (mean 13 days) and who needs ventilatory assistance for less than 1 week . The location, size, and bacteriologic characteristics of abscesses do not appear to influence outcome . This study shows that early and repeated drainage of intraabdominal pus will not reverse multiple organ failure in the majority of patients.

J Clin Pathol, 1985 Mar, 38(3), 341 - 4
Assessment of rapid methods of pneumococcal antigen detection in routine sputum bacteriology; Whitby M et al.; Sputum specimens from 480 patients were examined for the presence of pneumococci by Gram film and culture and for pneumococcal antigen by counterimmunoelectrophoresis, coagglutination, and latex agglutination . Ninety six positive specimens were detected . Gram film and culture provided the most reliable techniques in well taken specimens collected early in the illness before antibiotic treatment had started . More than 70% of the specimens examined were submitted after starting antibiotics, however, and in these specimens, methods of antigen detection proved of greater value than either Gram film or culture . Counterimmunoelectrophoresis, coagglutination, and latex agglutination were similar in sensitivity and specificity, but coagglutination and latex agglutination were much easier to perform and to read.

Eur J Respir Dis, 1985 Mar, 66(3), 187 - 95
Efficacy of three mycobacterial antigens in the serodiagnosis of tuberculosis; Kiran U et al.; Three different antigens were tested for detection of mycobacterial antibodies . The 3 antigens were mycobacterial saline extract (MSE), mycobacterial sonicate (MSO) and PPD . For detection, both the soluble antigen fluorescent antibody (SAFA) and the enzyme-linked immunosorbent assay (ELISA) tests were used . We used 88 serum samples (50 from clinically, radiologically and/or bacteriologically proven cases of tuberculosis, 8 from proven cases of leprosy and 30 from healthy controls) . With MSE antigen, both the tests were found to be highly sensitive and specific . MSO antigen was found to give better results in ELISA than in SAFA . The sensitivity and specificity of ELISA as well as SAFA test was reduced when PPD was used as an antigen . However, both ELISA and SAFA tests revealed that the mean antibody level in the patients with active tuberculosis was significantly higher than that in the healthy controls, irrespective of the antigen used.

J Bone Joint Surg Am, 1985 Mar, 67(3), 465 - 76
Comparison of indium-labeled-leukocyte imaging with sequential technetium-gallium scanning in the diagnosis of low-grade musculoskeletal sepsis . A prospective study; Merkel KD et al.; We prospectively compared sequential technetium-gallium imaging with indium-labeled-leukocyte imaging in fifty patients with suspected low-grade musculoskeletal sepsis . Adequate images and follow-up examinations were obtained for forty-two patients . The presence or absence of low-grade sepsis was confirmed by histological and bacteriological examinations of tissue specimens taken at surgery in thirty of the forty-two patients . In these thirty patients, the sensitivity of sequential Tc-Ga imaging was 48 per cent, the specificity was 86 per cent, and the accuracy was 57 per cent, whereas the sensitivity of the indium-labeled-leukocyte technique was 83 per cent, the specificity was 86 per cent, and the accuracy was 83 per cent . When the additional twelve patients for whom surgery was deemed unnecessary were considered, the sensitivity of sequential Tc-Ga imaging was 50 per cent, the specificity was 78 per cent, and the accuracy was 62 per cent, as compared with a sensitivity of 83 per cent, a specificity of 94 per cent, and an accuracy of 88 per cent with the indium-labeled-leukocyte method . In patients with a prosthesis the indium-labeled-leukocyte image was 94 per cent accurate, compared with 75 per cent accuracy for sequential Tc-Ga imaging . Statistical analysis of these data demonstrated that the indium-labeled-leukocyte technique was superior to sequential Tc-Ga imaging in detecting areas of low-grade musculoskeletal sepsis.

Aust Vet J, 1985 Mar, 62(3), 91 - 3
Evaluation of an enzyme linked-immunosorbent assay for the diagnosis of Brucella ovis infection in rams; Lee K et al.; A simple enzyme linked immunosorbent assay (ELISA) was developed for the serological diagnosis of Brucella ovis infections in rams . Serums from brucellosis accredited-free flocks and flocks known to be infected with B . ovis were tested and the results correlated with warm complement fixation (CF) test and bacteriological examination of semen . Both the ELISA and the CF test detected 0.5% false positive reactions in rams from clinically negative flocks . However the ELISA detected significantly more positive reactors in infected flocks and the CF test failed to detect some rams excreting B . ovis . The ELISA proved to be a valuable test in eradicating brucellosis from infected flocks.

Ann R Coll Surg Engl, 1985 Mar, 67(2), 116 - 8
Silastic foam dressing: an appraisal; Groves AR et al.; Silastic foam polymerised in situ has been investigated as an alternative to other means of securely dressing split thickness skin grafts on involuted sites . The bacteriological risks and physical hazards have been explored . From a series of 25 patients silastic foam appeared to offer an easier safer and more effective means of graft fixation in difficult areas.

AJR Am J Roentgenol, 1985 Mar, 144(3), 529 - 33
A newly recognized profile in neonatal lung disease with maternal diabetes; Duara S et al.; A radiographic pattern associated with respiratory distress, distinct from hyaline membrane disease and transient tachypnea of the newborn, is described in eight infants of diabetic mothers . The radiographic findings demonstrate a regional distribution of reticulogranular densities accompanied by increased lung volumes . Clinical features were gestationally mature infants in moderate respiratory distress with tachypnea, hypercapnia, and hypoxemia requiring supplemental oxygen, with steady improvement and uneventful recovery within 2 weeks . There was no bacteriologic evidence of infection or radiographic evidence of delayed lung fluid absorption . The mothers had mild diabetes . These features characterize a newly recognized entity in diabetes-related idiopathic lung disease of the newborn . Possible causative factors are discussed.

Jpn J Antibiot, 1985 Mar, 38(3), 730 - 6
{Laboratory and clinical studies of cefminox in the pediatric field}; Nishimura T et al.; The authors have carried out the pharmacokinetic and clinical studies of cefminox (CMNX, MT-141) . The results were as follows: CMNX was given by intravenous drip infusion for 1 hour at a dose of 20 mg/kg b.w . to 2 children . The serum levels of CMNX were 103.02 micrograms/ml and 77.73 micrograms/ml at 1 hour after drip infusion, and the levels at 7 hours were 4.39 micrograms/ml and 4.19 micrograms/ml, respectively . The half life times were 1.20 hours and 1.32 hours, respectively . CSF concentrations of CMNX at 1 hour after drip infusion of a dose of 50 mg/kg in 3 patients with aseptic meningitis were 1.68 micrograms/ml (d.i . for 30 minutes), less than or equal to 0.25 micrograms/ml (d.i . for 1 hour) and 0.51 micrograms/ml (d.i . for 1 hour), respectively . CSF/serum ratios were 1.1% and 0.6% . Clinical efficacy was evaluated in 10 cases with purulent tonsillitis (3 cases), pneumonia (3 cases), pyelonephritis (1 case) and enteritis (3 cases) . Excellent and good responses were obtained in all cases . Bacteriological response in the form of eradication was noted 8 of 9 cases . No side effects were observed.

Jpn J Antibiot, 1985 Mar, 38(3), 643 - 70
{Clinical assessment of sulbactam/cefoperazone in comparison with ceftizoxime in patients with postoperative infections by well controlled method}; Yura J et al.; The clinical effectiveness in postoperative infections of sulbactam/cefoperazone (SBT/CPZ, (SBT 0.5 g+ CPZ 0.5 g) X 2/day) was compared to that of ceftizoxime (CZX, 1.0 g X 2/day) by a well controlled comparative study, to have the following results . The overall effectiveness rate of SBT/CPZ and CZX as judged by Judgement Committee was 84.0% (63/75) and 80.6% (50/62), respectively, and the effectiveness of SBT/CPZ and CZX as assessed by the attending surgeons was 84.0% (63/75) and 71.0% (44/62), respectively . No significant difference was noted in both assessments . In a total of 36 SBT/CPZ-treated patients with intraabdominal infections, the clinical efficacy was judged by attending surgeons to be excellent in 13 patients (36.1%), and to be excellent or good in 31 (86.1%) . In the 30 CZX treated patients, it was judged to be excellent in 6 patients (20.0%), and to be excellent or good in 19 (63.3%) . These results presented a significant difference (P less than 0.05, U-test) between the 2 drug groups . The final global improvement ratio judged by attending surgeons was 85.3% (64/75) for SBT/CPZ, and 79.0% (49/62) for CZX with no significant difference . In assessment of time-course improvement, the improvement ratio of SBT/CPZ on day 4 was significantly better than that of CZX (P less than 0.05, U-test) . The usefulness rate of SBT/CPZ and CZX was 84.0% (63/75) and 73.0% (46/63), respectively . There was no significant difference between the 2 drug groups . To assess the bacteriological efficacy, the eradication rate of SBT/CPZ was compared to that of CZX . There was no significant difference between 85.7% (36/42) for SBT/CPZ and 73.5% (25/34) for CZX . After SBT/CPZ administration, 2 patients (2.5%) complained of side effects . In the clinical laboratory tests, abnormality related to SBT/CPZ medication was observed in 6 patients (7.5%), and that related to CZX, in 5 patients (6.4%) . As to the types of side effects and frequency, no significant difference was observed between SBT/CPZ and CZX . It is concluded from the above assessments that SBT/CPZ is a useful drug in the treatment of post-operative infections.

J Dairy Sci, 1985 Feb, 68(2), 449 - 56
Comparison of electrical conductivity of milk with other indirect methods for detection of subclinical mastitis; Fernando RS et al.; Efficacy of detecting subclinical mastitis by electrical conductivity of milk was compared with that of other indirect methods including chloride, sodium, potassium, lactose, bovine serum albumin, and somatic cell count of milk . Quarter samples of foremilk, strippings, and bucket milk were obtained from 75 cows at the afternoon milking over 8 wk . Infection of quarters was ascertained by bacteriological analysis . Electrical conductivity, chloride, and sodium content of milk were more accurate for predicting infection status of quarters than were other variables . Most variables were more accurate in predicting infection when measures were in strippings rather than in foremilk or bucket milk . For measures in strippings, misclassifications by electrical conductivity were 11.2 and 15.5% for false positives and false negatives . The accuracy of the electrical conductivity of milk for detection of subclinical mastitis compared favorably with all indirect methods . Accuracy of detection and adaptability to both manual and automatic cow-side mastitis detection systems indicate that the method has considerable potential as a screening test for subclinical mastitis.

J Trauma, 1985 Feb, 25(2), 163 - 4
Retreatment of previously treated hand infections; Stromberg BV; Presenting patient profiles and bacteriologic culture and sensitivity data from 132 patients representing a 5-year experience with hand infections were examined . Patients were subdivided into those having no prior treatment and those having previously been treated with antibiotics . Presenting patient profiles showed the majority of patients to be young to middle-aged males . Temperature, pulse, and white blood cell counts, while usually mildly elevated, were usually not diagnostic . In comparison with patients not having been previously treated, patients having already received antibiotics with persistent or recurrent infections showed more of a tendency toward mixed infections . Anaerobic, mycobacterial, and fungal infections were also increased . Antibiotic susceptibility studies showed the cephalosporins and clindamycin maintain a reasonably good coverage (78% and 72%, respectively) . Penicillinase-resistant antibiotics also provided some coverage in two thirds of patients . Proper antibiotic therapy may depend on several factors including previous treatment . Other measures of surgical drainage when appropriate, elevation, compresses, and splinting remain important.

J Am Vet Med Assoc, 1985 Feb 1, 186(3), 252 - 6
Uterine involution in mares treated with progesterone and estradiol-17 beta; Sexton PE et al.; Bacteriology, histology, and scanning electron microscopy were used to evaluate uterine involution in 27 mares treated with daily injections of 150 mg of progesterone and 10 mg of estradiol-17 beta, commencing within 18 hours of parturition . These findings were compared with those for 24 untreated mares at postpartum day 10 or 11 . The treatment resulted in significantly (P less than 0.05) greater uterine gland proliferation . Gland density was significantly (P less than 0.05) greater in mares treated for 6 to 10 days than in those treated 2 to 5 days . The proportion of ciliated cells to secretory cells lining the endometrial surface was significantly (P less than 0.05) greater in mares during delayed foal estrus than in those at postpartum days 10 to 11 . The proportion of ciliated to secretory cells increased with increasing duration of treatment . It was concluded that treatment with progesterone and estradiol-17 beta allowed additional time for uterine involution in the early postpartum period.

Int J Clin Pharmacol Ther Toxicol, 1985 Feb, 23(2), 115 - 7
A combination of cefuroxime plus acetylcysteine in the intensive care of patients with respiratory insufficiency; Testasecca D et al.; Thirty patients admitted to our Intensive Care Unit for respiratory insufficiency attributable to a variety of disease conditions were treated with a combination of cefuroxime plus acetylcysteine . Clinical and laboratory variables were evaluated, and bacteriological tests were performed on tracheal aspirate . At the end of treatment, 12 patients were judged to be recovered, 14 improved and 4 unchanged . No side effects were observed.

Int J Clin Pharmacol Ther Toxicol, 1985 Feb, 23(2), 105 - 8
Clinical evaluation of cefotiam and cefamandole in respiratory tract infections; Beumer HM et al.; Eighty-two adult hospitalized patients suffering from respiratory tract infections were treated with cefotiam or cefamandole in an open comparative study . The patients were allocated randomly to one of the two treatments . The recommended dosage regimens (i.m . or i.v.) were used for both groups (cefotiam 1 g b.i.d., cefamandole 1 g t.i.d.) . The duration of treatment was 7 to 14 days according to the response of the disease condition . 80 patients were analyzed . The tolerability of both drugs was good and comparable . The clinical and bacteriological efficacy of both drugs was equivalent . The radiological examinations showed a better improvement of the patients treated with cefotiam.

Chest, 1985 Feb, 87(2 Suppl), 117S - 124S
Standard therapy for tuberculosis 1985; Snider DE Jr et al.; PIP: Numerous clinical trials of chemotherapy for tuberculosis conducted throughout the world over the past 4 decades have established 2 basic principles of treatment: effective treatment requires the initial concomitant administration of at least 2 drugs to which the patient's organisms are susceptible; and cure of tuberculosis requires that treatment continue beyond the time of sputum conversion and amelioration of symptoms . The treatment of tuberculosis was revolutionized in the late 1960s with the introduction of rifampin . Shorter regimens of 6-9 months in duration became possible . Scores of trials of short-course chemotherapy have been conducted, and more are planned . The goals of the new treatment regimens are to achieve effective sterilization of the tuberculous lesion in the shortest time possible . A table lists drugs now in use in the US and Canada and gives the usual doses, common side effects, and important interactions among drugs . Chemotherapeutic regimens acceptable for use in the US and Canada are well-defined combinations of drugs which must be regularly administered in the recommended dosages and rhythm for a specific time period . Regimens should be highly effective, i.e., a relapse rate of less than 5%, and have a low risk of toxic effects . Regimens also should be acceptable to patients and applicable on a community-wide basis . The regimens recommended meet these criteria and are backed by well-conducted clinical trails . A 9-month regimen consisting of isoniazid and rifampin throughout, usually supplemented in the initial phase by ethambutol, streptomycin, or pyrazinamide, is a well-tolerated regimen which will cure virtually all patients with susceptible organisms . The initial daily phase may last 2-8 weeks; the continuation phase may be administered daily or twice weekly . These regimens have an overall bacteriologic relapse rate of between zero and 4% . When 4 drugs -- isoniazid, rifampin, pyrazinamide, and either ethambutol or streptomycin -- are given under close during supervision during the initial 2 months of daily or "induction" therapy, followed by an additional 4 months of isoniazid and rifampin, the results have been excellent . Where primary resistance to isoniazid or streptomycin is suspected, the patient should be placed on 1 of the following 3 regimens: isoniazid, rifampin, and ethambutol; isoniazid, rifampin, pyrazinamide, and streptomycin; or isoniazid, rifampin, pyrazinamide, and ethambutol . Short-course chemotherapy for extrapulmonary tuberculosis and chemotherapy of tuberculosis in children are reviewed along with several conditions which affect therapy -- tuberculosis during pregnancy, renal and hepatic disease, cancer and other conditions associated with immunosuppression, and drug interaction .

Ann Rech Vet, 1985, 16(4), 351 - 6
Vaccination of ewes by a single conjunctival administration of Brucella melitensis Rev . 1 vaccine; Fensterbank R et al.; In a lot of 99 ewes, the efficacy of a single vaccination by the conjunctival route (VC) with either 1.4 X 10(8) or 1.4 X 10(9) CFU Brucella melitensis Rev . 1 was compared with that of normal subcutaneous (SC) vaccination with 1.6 X 10(9) CFU . The ewes were challenged seven months after vaccination, when 85 days pregnant, with 5 X 10(7) CFU Brucella melitensis strain H38 administered by conjunctival route . Complement fixation, Rose Bengal and allergic tests were performed at intervals between vaccination and slaughter, and clinical and bacteriological examinations between challenge and slaughter, six weeks after lambing . After VC vaccination, few animals showed Brucella antibodies whatever the dose, and all were seronegative as early as four months after vaccination whereas a few SC vaccinated individuals were still seropositive at ten months . There were more allergic reactions among SC than VC animals, but sensitization was shown to be long-lasting in all vaccinated groups, whatever the administration route of the vaccine . VC vaccination with 10(9) CFU appeared to afford slightly greater protection than that with 10(8) CFU, and slightly lower protection than that induced by SC vaccination, but differences were not statistically significant . It is suggested that conjunctival vaccination with 10(9) CFU Rev . 1 would induce a good level of protection against Brucella melitensis infection and allow test and slaughter procedures as early as four months after vaccination.

Vox Sang, 1985, 49(6), 373 - 80
Isolation of mononuclear leukocytes in a plastic bag system using Ficoll-Hypaque; Carciero R et al.; Mononuclear cells, present in bone marrow and peripheral blood, have been isolated from red cells and granulocytes using a ficoll-hypaque density centrifugation process . Cells isolated by this process which uses centrifuge tubes may become contaminated . In 19 studies in our laboratory we used Ficoll-Hypaque treatment to isolate mononuclear cells from cellular residues obtained during plateletpheresis using a modified 600-ml polyvinyl-chloride (PL-146) plastic bag with the Haemonetics blood processor V-50 or the Fenwal CS-3000 blood processor . The 600-ml PVC plastic bag was modified by sealing its vertical edges using radio frequency to form a narrow bag with a volume of approximately 200 ml . A 125-volume of diluted apheresis cellular residue was collected, and the mononuclear cells were isolated as follows: the diluted cellular residue was layered onto 75 ml of Ficoll-Hypaque with a specific gravity of 1.077 and was centrifuged at 260 g for 30 min at 22 degrees C . The supernatant plasma was removed . The mononuclear cell layer was transferred to a sterile 600-ml transfer bag, and the cells were washed with saline . Of the 4.24 +/- 0.9 X 10(9) mononuclear cells applied to the gradient, approximately 3.73 +/- 0.8 X 10(9) cells were recovered . The recovered cells consisted of 77.3 +/- 8% lymphocytes, 19.0 +/- 7% monocytes, and 3.6 +/- 3% granulocytes . There was no significant difference in tissue culture growth in the CFU-GEMM assay of mononuclear cells whether the plastic tube or the plastic bag system was used . Aerobic bacteriologic cultures were negative . The PL-146 plastic bag system used in this study proved to be a significant aid in isolating mononuclear cells from plateletpheresis residue.

Biomed Pharmacother, 1985, 39(6), 314 - 25
{Bacteriological study of hygienic conditions in the Department of Blood Diseases and Tumors of the Paul Brousse Hospital at Villejuif . I . The atmospheric flora}; Jacques L et al.; Admission to hospital considerably increases the risk of cross infection . The sources of contamination are of exogenous origin (airborne flora) or endogenous (intestinal flora) . Because of the great susceptibility of immunosuppressed patients to microbial agents, it is essential to treat them in a special environment in which there is rigorous attention to hygiene and asepsis . In order to ensure these optimal conditions have been attained, we have made a bacteriological survey for several months in the Service des Maladies Sanguines et Tumorales of the Paul Brousse Hospital, Villejuif . The first part of the survey has given an assessment of the efficiency of the positive pressure air filtration system in one of the units on the Service . Although it should not be neglected, the airborne microbial flora appears to have only a slight effect on the development of infections in our patients . By contrast, the endogenous flora is the main source of infection . Apart from infection via intravenous drips, it is essentially transmitted by direct contact with the nurses' hands or via a variety of instruments . On account of its importance the direct transmission will be described in the second part of this report.

Ann Biol Clin (Paris), 1985, 43(2), 163 - 5
{Current role of ELISA methods in bacteriology and virology}; Ramuz M; The use of fixed-phase immuno-enzymatic methods (ELISA) is becoming more widespread . In theory, these methods appear to be attractive because of their adaptability to various clinical situations . However, in practice problems remain to be solved . The detection of serum antibodies would seem to be easier, with the exception of tests for IgM, which are interfered with by rheumatoid factor . The detection of viral or bacterial antigens in pathological material would seem to be more difficult to achieve, but holds great promise for the future . Improvements have already been made, but progress remains to be made in the technique and in the clinical interpretation of the results.

Int J Clin Pharmacol Res, 1985, 5(5), 345 - 50
Acute and exacerbated chronic respiratory tract infections: treatment with a combination of cefuroxime and acetylcysteine; Dal Negro RW et al.; Sixty-five patients, 25 with acute bronchopulmonary respiratory tract diseases and 40 with acute exacerbations of chronic respiratory tract infections, were treated by means of intramuscular injection of an extempore combination of 1 g of cefuroxime and 300 mg of acetylcysteine . Patients were divided into two groups according to the acute or chronic nature of their respiratory tract diseases . Positive clinical results were obtained in 62 of the 65 patients . Of a total of 52 pathogens isolated in pretreatment bacteriological tests on sputum cultures, only three were still detectable after treatment . Tolerance of the treatment was good in all patients, no side-effects of any kind being observed.

Scand J Infect Dis, 1985, 17(3), 271 - 6
Bacterial endocarditis in patients with native or prosthetic heart valves: bacteriological and clinical findings; Bliddal H et al.; The clinical course of 12 episodes of native valve endocarditis (NVE) and 15 episodes of prosthetic valve endocarditis (PVE) was studied . The mortality in NVE was 3/12 episodes and in PVE 5/15 . No significant differences in prognosis were observed in relation to the bacterial taxonomy, which was stated in all cases . Though surgical valve replacement was performed on the relative indications heart failure, resistance to treatment, or major embolism, the regimen was primarily conservative, and the results comparable to the reports in the literature of a more surgically active attitude.

Ophthalmic Physiol Opt, 1985, 5(3), 287 - 90
Planning a bacteriology project: a tutorial; Tuxford AF; This tutorial paper reviews the action that should be taken at the planning stage of a bacteriological research project to ensure that the final results will have maximal value . Particular consideration is given to the problems of environmental sampling, patient involvement and testing for disinfection and chemotherapy.

Eur Urol, 1985, 11(3), 170 - 6
Six-month chemotherapy for urogenital tuberculosis; Skutil V et al.; Rifampicin (RMP, 600 mg), isoniazid (INH, 300 mg) and pyrazinamide (PZA, 1,000 mg) administered daily in the hospital for a duration of 2 months was followed at home by daily administration of 600 mg RMP and 300 mg INH for a duration of 4 months . 113 patients with previously untreated and bacteriologically proven urogenital tuberculosis were admitted to the study . Therapy was completed and evaluated in 106 (94%) patients . No failure of chemotherapy was observed during the treatment; one bacteriologically proven relapse occurred after completion of treatment within the 45- to 63-month follow-up . This 6-month chemotherapy seems as efficient as the standard treatment which lasted for 18-24 months.

Rev Epidemiol Sante Publique, 1985, 33(2), 134 - 41
{Bacterial contamination of the air in different operating rooms}; Audurier A et al.; Bacteria air samples were taken in the operating rooms, with no people present, to specify the level of air contamination and suggest bacteriological standards for different operating rooms . In the first step of this study, for 5 months the air contamination mean value of operating rooms, ventilated at 15 changes/hour was 18.5 Cfu/m3 +/- 1.9 . In the second part of the study, during two years, 1 381 air samples were taken in 8 different operating rooms . The mean values of air contamination range from 1.4 Cfu/m3 in a Charnley isolator system to 121 Cfu/m3 in an operating room ventilated at 7.5 changes per hour . As a general rule, the airborne contamination is more significant in the oldest operating rooms than in the new one with filtrated air . The variations observed between 1981 and 1982 are explained by technical modifications of the system or progress in control of operating room conditions . Measurements of the bacterial contamination of the air give useful informations, but it is however better to ensure that the specifications for volume air supply and positive air pressure in the operating theatres are being fulfilled . The airborne bacterial concentration in a modern ventilated operating room should not exceed 30 Cfu/m3.

Int J Clin Pharmacol Res, 1985, 5(3), 175 - 9
Clinical study on the efficacy of clofoctol in the treatment of infectious respiratory diseases; Danesi R et al.; The effectiveness and the safety of a new chemotherapeutic phenol derivative, clofoctol, was evaluated in adult hospitalized patients affected by infectious diseases of the bronchopulmonary tract . The clinical diagnosis included acute exacerbation of chronic bronchitis, acute bronchitis, bronchiectasis, pneumonia, bronchopneumonia and lung cavitary neoplasm . Expectoration, cough, dyspnoea, respiratory murmur and body temperature were considered as clinical factors to which an arbitrary score was given . Functional respiratory parameters including FVC, FEV1 and FEV1/FVC X 100 were also evaluated . All the patients were treated rectally with clofoctol 1500 mg daily for five days . Bacterial evidence of infection was obtained by sputum culture, which was repeated at the end of treatment . At that time, bacteriological results were 72.4% disappearance of baseline pathogens, 20.7% persistence of baseline pathogens and 6.9% presence of different organisms . Functional respiratory parameters were found to be significantly improved by treatment . Clinical results, arbitrarily evaluated on the basis of the overall assessment of laboratory and functional data, were excellent in 33.3%, good in 44.4%, fair in 5.6% and poor in 16.7% of patients . Tolerance was generally good; side-effects included maculopapular rash in 2 patients and rectal disturbances in 10 patients . In conclusion, for the treatment of bronchopulmonary diseases clofoctol offers an interesting alternative to antibiotic therapy.

Ann Clin Res, 1985, 17(1), 32 - 6
Gastritis, duodenogastric reflux and bacteriology of the gastric remnant in patients operated for peptic ulcer by Billroth I operation; Paakkonen M et al.; Of 101 patients undergoing Billroth I gastrectomy (BI) 14 years previously, we were able to investigate 39 . General abdominal symptoms, haematological status, basal (BAO) and maximal (MAO) hydrochloric acid secretion were studied before (I) and 1 year (II) and 14 years (III) after the operation . Stump mucosa morphology was investigated before the operation and 14 years afterward . Duodenogastric reflux with radioisotope and fasting bile reflux methods and stump bacteriology were studied at the last follow-up and compared with those of controls who had had peptic ulcer 15 years ago . Only 10% of the operated patients could be classified as Visick Grade III, the others being Grades I-II . At the time of the follow-up, mean body weight had not changed . Serum iron was better at 14 than one years after the operation . BAO and MAO decreased significantly after the operation, but these decreases did not continue during the postoperative period . Duodenogastric reflux was significantly greater in the gastrectomized patients than in the controls . Neither the progression of gastritis nor the degree of postoperative gastritis correlated with the reflux . Of the operated patients, 6% had normal stump mucosa and 80% had atrophy . From the stump we cultured colonic bacteria in 44% of the patients, pharyngeal flora in 71% and Candida in 56% . The stomach bacteriology of the controls was: 10% colonic, 35% pharyngeal flora and 30% Candida . The general status of BI-patients remains good . Although gastritis progresses to atrophy and duodenogastric reflux increases, the reflux and atrophy do not seem to be related . In spite of increasing atrophy hydrochloric acid secretion continues.

Ann Fr Anesth Reanim, 1985, 4(3), 264 - 70
{Central venous catheterization in pediatric hematology}; Douard MC et al.; Central venous catheters (CVC) have proven to be a reliable route of the administration of chemotherapy, saline, blood cells and nutritional support in patients with malignant haematological disease . However, infection remained one of the most important causes of morbidity associated with this procedure . The aims of this study were a) to evaluate the efficacy of laminar air flow to prevent CVC infections, b) to study morbidity associated with polyethylene (PE) and silicone (S) catheters, and c) to evaluate the part played by increasing staff practice . 177 CVC were inserted in 170 children during a period of 20 months . Ages ranged from 5 months to 15 years (mean: 7 years) . All the S CVC were tunnelled whereas, because of their rigidity, none of the PE CVC were . At the time of their removal, bacteriological samples from the CVC skin exit site, blood drawn through the catheter and the tips of these CVC were cultured . During the first period (one year), three groups of CVC were studied: in group 1, 37 S CVC in patients placed in a non-sterile ward; in group 2, 40 S CVC in children nursed under laminar air flow; in group 3, 60 PE CVC in patients of a non-sterile ward . During the second period (8 months), 40 new S CVC were inserted in children nursed in non-sterile wards, but after nursing staff training (group 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Acta Chir Scand, 1985, 151(2), 187 - 9
Thrombosis in the superior mesenteric artery simulating acute pancreatitis . A case report; Lasson A et al.; A case of thrombosis in the superior mesenteric artery simulating acute pancreatitis, but causing intestinal gangrene, is described . The possibility of other simulating diseases must always be considered when non-operative peritoneal lavage is used as a treatment of acute pancreatitis . Bacteriological examination of the peritoneal fluid might be beneficial . Laparotomy is indicated when there is a marked discrepancy between the general condition of the patient and the objective clinical signs of pancreatitis.

Med Trop (Mars), 1985 Jan-Mar, 45(1), 35 - 41
{Role of eye manifestations in chlamydioses}; Vedy J et al.; Following an up-to-date bacteriological resume, are recalled the most important clinical manifestations presently attributed to C . trachomatis: general manifestations (pulmonary, articular, venereal, congenital, viscereal and others still under discussion); ocular manifestations (trachoma, inclusion conjunctivitis of newborn infants or adults, other ocular affections still under discussion) . The main theories are exposed, which try to explain some epidemiological links between all these manifestations.

Jpn J Antibiot, 1985 Jan, 38(1), 4 - 7
{Efficacy of ceftriaxone against gynecoobstetric infections}; Chimura T et al.; Ceftriaxone (Ro 13-9904, CTRX), a newly developed parenteral cephalosporin antibiotic was clinically evaluated in gynecoobstetric infections and the following results were obtained . CTRX was administered by intravenous drip infusion twice a day in a daily dose of 2 to 4 g to 10 cases with gynecoobstetric infections, consisting of 8 with intrauterine infections, 1 with adnexitis and 1 with infection of external genitalia . The global clinical efficacy was excellent in 2 and good in 6 out of 8 cases with intrauterine infections, and in 2 others, the efficacy rate being 100% . Bacteriologically, the eradication of bacteria was observed in 5, unchange in 2 and alternation of bacteria in 2 among 9 cases where the causative strains were detected . Neither adverse reaction nor laboratory test abnormality was observed . The above-mentioned results suggest that CTRX is a highly safe antibiotic expected to be excellent in the clinical efficacy and bacteriological effects.

J Chir (Paris), 1985 Jan, 122(1), 53 - 8
{Nonwoven textiles in the operating room}; Champault G et al.; Non-woven textiles are still not widely used in France, despite the great variety of their presentations . These products are clearly superior to traditional textiles in terms of a bacteriological barrier, which results in a lower rate of post-operative sepsis . It costs the same or less than classical textiles and it reduces the tasks of personnel and administration . Its presently limited used is essentially due to the reticence of surgeons, based on a poor understanding of the products and a psychological barrier which is difficult to overcome.

Pathol Biol (Paris), 1985 Jan, 33(1), 55 - 6
{Pseudomonas pickettii septicemia}; Chomarat M et al.; A case of bacteremia caused by Pseudomonas pickettii in an insulin dependent diabetic patient is reported, the portal of entry was unknown . After a failure of cefotaxime therapy whereas the strain was found susceptible by disk assay to this antibiotic, the patient became afebrile with doxycycline treatment . The bacteriological findings as well as the clinical problems are reported in the present paper.

J Thorac Cardiovasc Surg, 1985 Jan, 89(1), 136 - 41
The exposed cardiac pacemaker . Treatment by subfascial pocket relocation; Garcia-Rinaldi R et al.; Ten patients were treated for skin erosion and exposure of chronically implanted pacemakers . The pulse generators had been implanted either subcutaneously or in the subpectoral, submammary location . All patients were treated either by primary or secondary relocation of the pulse generator to deeper subfascial planes . Pacemakers relocated primarily to subfacial planes healed without resurfacing . Those pacemakers relocated to other superficial planes resurfaced but healed in a second subfascial translocation . Bacteriologic studies on these patients revealed that the organisms cultured or antibiotics utilized did not influence the fate of the relocated pulse generator . The subfascial location was the only determinant of the ultimate healing of the exposed pacemaker . We conclude that subfascial relocation of well-functioning pacemaker generators should be considered as an alternative to complete replacement of the unit.

Pediatr Med Chir, 1985 Jan-Feb, 7(1), 63 - 7
{Infection by Mycoplasma pneumoniae . Epidemiologic investigation and statistical clinical study of 122 children admitted to the Institute of Pediatrics of the University of Florence during the period 1 January 1977 to 31 December 1983}; Calandi C et al.; We carried out an epidemiologic research about M . Pneumoniae infection from 1977 to 1983: determination of CF antibodies has been performed by the Bacteriology and Virology Laboratory (Prof . Lamanna, USL 10/D, Florence) . Serum samples were collected by the laboratory itself and by hospitals and university departments of Florence and neighbouring communes . Our research confirms cyclic behaviour of M . Pneumoniae infection: we could follow up a 3 years long epidemic after a previous 2 years long endemic disease . We found a major sera-positive rate for M . Pneumoniae in children than in adults . In the same period we carried out a clinical-statistical study on 122 children (80 males and 42 females) admitted to the Pediatric Institute "A . Meyer" in Florence because of an infection due to M . Pneumoniae . The most affected age range sems to be included between 5 and 10 years . Pneumonia is the commonest clinical feature of M . Pneumoniae infection (85.2%): furthermore, we must point out some cases in 0-2 years-old subjects . In our patients, clinical features, X-ray findings and laboratory tests strictly agree with those reported by other authors . We treated all our patients with erythromycin: in three weeks we obtained thee normalization of clinical patterns and X-ray findings in all cases.

Soc Sci Med, 1985, 21(10), 1163 - 6
The medical and economic consequences of automation in bacteriology: a case study in a French university hospital; Sailly JC et al.; In a bacteriology laboratory where automated and non-automated procedures co-existed during the study period (1 year), patients were randomly assigned to each type of procedure and we observed the physicians behaviour as well as patients well-being in a surgical service using the results from the laboratory . Contrary to our expectations, the reduction in the time delay necessary to obtain information did not alter either the prescribing behaviour of physicians nor the welfare of patients . Besides, the gain in time was significantly lower than expected . We also discuss in detail the meaning and relevance of the results.

Z Hautkr, 1985 Jan, 60(1-2), 93 - 9
{Comparison of tuberculosis cutis luposa and cutaneous leishmaniasis}; Kaufmann I et al.; We present a comparative study concerning two cases of tuberculosis cutis luposa and cutaneous leishmaniasis, respectively . These two Turkish female patients had suffered from changes of the facial skin since 20 years (tuberculosis cutis luposa) and for 5 months (cutaneous leishmaniasis) . The tuberculosis cutis luposa had been misdiagnosed as cutaneous leishmaniasis and surgically treated . Both cases showed an apple jelly-like color at the edges of the lesions with soft tissue . With tuberculosis cutis luposa, the lesions had a larger extension and a more hyperkeratotic picture . We discuss the different histopathologic changes of both cases . As bacteriologic culture revealed mycobacterium tuberculosis, on one hand, and histopathology leishmania species intrahistiocytically, on the other, we could finally make the corresponding diagnoses.

Drugs Exp Clin Res, 1985, 11(11), 815 - 8
Treatment of ear, nose and throat infections with clofoctol; Ghilardi PL et al.; Fifty-two adult patients affected by infectious otorhinolaryngological diseases were treated rectally with clofoctol, a new chemotherapeutic phenol derivative . The clinical diagnoses included tonsillitis, paranasal sinus infections, nose and nasopharyngeal infections, external ear canal and middle ear infections . Evaluation of the results was based on clinical and bacteriological data; the effectiveness of the drug was also confirmed by statistical reference to a control group consisting of 52 adult patients affected by otorhinolaryngological infections treated only with topical agents or not treated at all . In the patients treated with clofoctol, good therapeutic results were obtained in over 90% of cases . Only four patients showed mild adverse reactions . On the whole, results demonstrated that clofoctol is very valuable for the management of most of the infectious diseases common in ENT practice.

Tierarztl Prax, 1985, 13(4), 513 - 7
{Diagnosis and treatment of Mycoplasma bovis mastitis (MbM) in dairy cows}; Vandeplassche M; The diagnosis of Mycoplasma bovis mastitis (MbM) usually comes too late . Consequently the capital early symptoms are described for a probable diagnosis in order to enable prophylactic measures and to prevent ineffective expensive treatments and loss of time . Following a definite diagnosis of MbM by culture, a repeated application of the CMT milk test combined with bacteriological culture detects infected cows and they should be culled . All cows of exceptional breeding value can be treated by repeated intramammary infusions of specific antimycoplasma antibiotics with a fair chance of healing, by preference during the dryudder period.

Scand J Urol Nephrol Suppl, 1985, 92, 71 - 3
Therapeutic regimen of septic vascular complications in kidney grafting; Buchholz B et al.; In spite of highly sophisticated tissue matching reducing immunogenicity of a graft a high degree of immunosuppression is mandatory to achieve good graft survival . Septic complications such as a rupture of an anastomosis threaten the recipients life . Thorough donor selection, strict asepsis, as well as repeated bacteriologic examination gives the chance to decrease morbidity and mortality of kidney grafting . In the retrospective analysis of 135 kidney transplantations septic vascular complications occurred in 3.7% . The surgical procedure of choice after graft removal is the ligation of the external iliac artery . Only in one out of four cases ischemia of the lower extremity had to be treated by an extra-anatomic femoro-femoral bypass.

Med Cutan Ibero Lat Am, 1985, 13(4), 357 - 61
{Folliculitis caused by Pityrosporum}; Cuadra Oyanguren J et al.; During the summer months three young patients were examined by us for an asymptomatic cutaneous eruption of erythematous papules located on neck, shoulders and back . They were heat-resistant to several antiseptics and systemic antibiotic treatment . The mechanical expression of these lesions did not reveal the appearance of pus, but a hard keratinous matter . The histopathological findings of the lesions show a non specific folliculitis, but the PAS stain shows numerous spores of yeast forms within the keratinous material of the follicle . The culture of this material in bacteriological and mycological ordinary media is negative, but the culture in the Dixon media reveals the growth of typical colonies of Pityrosporum orbiculare . The patients responded successfully to a 3 weeks course of ketoconazole (200 mgr/d).

Crit Rev Toxicol, 1985, 16(1), 31 - 103
The effect of diet on the mammalian gut flora and its metabolic activities; Rowland IR et al.; The review will encompass the following points: A brief introduction to the role of the gut flora in the toxicology of ingested food components, contaminants, and additives, including known pathways of activation and detoxication of foreign compounds and the implication of the flora in enterohepatic circulation of xenobiotics . The advantages and disadvantages of the various methods of studying the gut flora (classical bacteriological techniques, metabolic and enzymological methods) will be critically discussed with special reference to their relevance to dietary, toxicological, and biochemical studies . Sources of nutrients available to the gut flora will be described including host products (mucus, sloughed mucosal cells, hormones, proteins) and exogenous nutrients derived from diet . An account of the problems involved in studies of dietary modification with special reference to the use of stock laboratory animal diets, purified diets, and human dietary studies . The influence of dietary modification on the flora will be assessed on the basis of changes in numbers and types of bacteria and their metabolic activity, drawing on data from human and animal studies . The effects of manipulation of the quantity and quality of protein, fat, and indigestible residues (fiber) of the diet will be described together with their possible implications for toxicity of ingested compounds.

Ann Biol Clin (Paris), 1985, 43(2), 173 - 5
{The bacteriology laboratory of tomorrow}; Flandrois JP et al.; The development of needs and the conditions for performing examinations in clinical bacteriology leads us to consider that bacteriological analysis should eventually: be closer to clinical requirements . This results in an accelerated bacteriology (whose response-times approach those of other biological specialties) and in a consideration of the diagnostic and therapeutic importance of the response; be less costly . This leads to an increase in productivity, and involves an introduction of computers, automatic systems for antibiograms and identification, and appropriate and inexpensive bioreagents; consider the requirements of the technicians in order to avoid diminishing the interest of the work . This development demands a recognition of needs, whether expressed or not, and a rejection of olds habits that are not adapted to the requirements of a bacteriology which is closer to the patient, quicker, and finally, less costly.

Pharmatherapeutica, 1985, 4(2), 126 - 31
Fusidic acid plus betamethasone in infected or potentially infected eczema; Hjorth N et al.; Eighty-one patients with atopic dermatitis and contact dermatitis received a 1-week treatment with 0.1% betamethasone alone on one side and 0.1% betamethasone plus 2% fusidic acid on the other side . Clinically, the combination was marginally superior and in patient preference a significant difference in favour of the combination was recorded . Bacteriologically, the combination eliminated 67% of bacteria originally present in the skin lesions compared with 51% with steroid alone.

Ann Clin Res, 1985, 17(2), 76 - 80
The treatment of Gardnerella vaginalis vaginosis: a randomized comparison of pivampicillin with metronidazole; Csango PA et al.; The efficacy of pivampicillin and metronidazole were compared in the treatment of Gardnerella vaginalis associated bacterial vaginosis . In a multicenter trial 86 women were given pivampicillin (P) 700 mg twice daily for 6 days and 86 women received metronidazole (M) 400 mg three times daily for 7 days . At control, 2 weeks from the start of treatment, patients in group P showed the best clinical results, 77.9% in group P vs . 64.0% in group M (p = 0.066) . P showed a higher clinical efficacy than M, both in women using intra-uterine device and in patients using other forms of contraception . Negative post-treatment cultures were seen in 43% of women in group P and 64% in group M (p less than 0.002) . Bacteriological cure was unrelated to disappearance of discharge, odour and itching, although it correlated significantly with a negative amine test (p less than 0.00005) . Pivampicillin in the dosages used in the present investigation is a useful alternative to metronidazole therapy.

Vet Med Nauki, 1985, 22(5), 53 - 9
{Role of atypical mycobacteria in the occurrence of nonspecific tuberculin reactions in cattle}; Dimov I et al.; Bacteriologic investigations were carried out with a total of 295 cattle of the Holstein-Zebu breed that responded positively to tuberculin . Mycobacterium bovis was isolated from 66 animals, and 12 species of atypical mycobacteria were isolated from 94 animals . Parallel studies were comparatively made of the intradermal reaction test and the bacterial findings . Three groups of calves were infected with various atypical mycobacteria, and their response was followed up with the use of the avian and the bovine type of tuberculin on the 100 th day of infection . It was found that the unspecific tuberculin response of cattle in Cuba were not uncommon, and the best proportion of such reactions were shown to be due to the involvement of atypical mycobacteria . The investigated cattle with a positive response to bovine tuberculin at a single intradermal test were harbouring M . bovis in 66 cases (22.3 per cent), atypical mycobacteria in 94 cases (32.1 per cent), and Actinomyces bovis in 7 cases (2.3 per cent) . In 128 of the cases (43.3 per cent) both the morphologic and the bacteriologic findings were negative . The cases with a stronger response at the single intradermal tuberculin test in which the skin fold enlarged over 6.5 mm corresponded to a larger extent to the actual specific infection in the animals than to an infection caused by atypical mycobacteria, however, this could not be absolutely stated for all animals . Following a muscular as well as an oral infection of calves with atypical mycobacteria the allergic response was enhanced from the 40 th up to the 100 th day, the positive reaction to avian tuberculin becoming stronger than to bovine tuberculin.(ABSTRACT TRUNCATED AT 250 WORDS)

Padiatr Padol, 1985, 20(3), 315 - 23
{Inflammatory diseases of the nose and nasal sinuses in children}; Albegger K et al.; Inflammatory diseases in childhood are quite different from those occurring in adults . The reasons are the special physiological, anatomical and immunological factors at the different stages of development . The different diagnostic possibilities (nasal swabs for virological and bacteriological examinations, X-ray, sonography, CT, endoscopy of the nose and paranasal sinuses) are discussed and the principles of the conservative and surgical therapy were demonstrated.

Vet Med Nauki, 1985, 22(3), 23 - 5
{Separation of colicins from E . coli strains isolated from lambs}; Mokhamed T et al.; Bacteriologic and serologic studies were carried out on the etiology of coli infections in newborn and young lambs . Ascertained was the participation of some serogroups of Escherichia coli in cases of lamb septicaemia, such as 019, 020, 025, 078, and 0101 . Colicin was found to be produced by a total of 64 strains as well as colicin V by 14 strains, all belonging to serogroup 025.

Infect Control, 1985 Jan, 6(1), 14 - 23
Handwashing and skin . Physiologic and bacteriologic aspects; Larson E; Handwashing practices are often based on tradition and belief . To develop sound rationale for handwashing practices, the physiologic and bacteriologic effects of handwashing must be examined . The purposes of this article are to review the three major microenvironments of the skin with their bacterial flora, to discuss physiologic and bacteriologic characteristics of the skin with particular reference to handwashing, and to describe current handwashing recommendations and practices.

Int J Gynecol Pathol, 1985, 4(1), 1 - 10
Chorioamnionitis: a comparative histologic, bacteriologic, and clinical study; Zhang JM et al.; Using morphologic and bacteriologic techniques, we examined placentas from 224 deliveries considered potentially complicated by infection . The severity of the chorioamnionitis was graded histologically according to the intensity of the inflammatory infiltrate . Chorioamnionitis or funisitis occurred in 111 placentas . Neonatal morbidity in this group was 48 (43%) as compared with 14 (12%) in those without chorioamnionitis . Pathogens were cultured from 49 of the 111 placentas with chorioamnionitis . Neonatal morbidity or mortality occurred in 28 (58%) of the group with positive cultures but occurred also in 20 (32%) of the 63 with chorioamnionitis from which no pathogens were cultured . Perinatal mortality was especially high (64%) among premature infants (less than 30 weeks) with infection . A comparison of culture techniques (surface swab versus swab of subchorionic fibrin after searing amnionic surface) showed similar rates of recovery but less contamination using the deep culture technique . Neonatal morbidity and mortality with severe chorioamnionitis (grades II and III; 62% and 82%) were significantly greater than with little or no chorioamnionitis (grades I and 0; 43% and 36%) . Higher grades of histologically demonstrable chorioamnionitis are associated significantly with the highest rates of neonatal morbidity or mortality . In many instances, pathogens are not recovered by conventional aerobic and anaerobic bacteriologic study . A search for other infectious agents (viruses, mycoplasmas, chlamydiae) deserves attention.

J Dairy Sci, 1985 Jan, 68(1), 114 - 22
Milk antitrypsin as a marker of bovine mastitis--correlation with bacteriology; Mattila T et al.; Milk antitrypsin reflects leakage of protein of blood plasma into milk . Mastitis detection can be based on measurement of the trypsin-inhibitor capacity in milk; the "Eflab Mastitis Test" procedure is based on this principle . The procedure was developed to screen for subclinical mastitis; high capacity and sensitivity permits whole herds to be analyzed on a quarter basis to identify inflamed quarters during a single sampling . Milk antitrypsin was measured on 2174 quarter milk samples by a colorimetric procedure . The Multiskan MC reader was hooked to desk computer to interpolate antitrypsin from the standard curve and to analyze results . The analysis of inflammation was based on antitrypsin as well as computerized interquarter evaluation . These measures were compared with bacteriologic study of milk to set criteria for automatic identification of mastitis in individual quarters . The comparison against the lowest teat antitrypsin gave better indication of infection than antitrypsin as such . By strict criteria that identified inflammations caused by major pathogens, 18.8% of uninfected quarters were identified as false positive . The explanation is that a single bacteriological culture is not reliable for detecting mastitis, because there are temporary causes of tissue irritation other than bacteria that may be identified during standard bacteriologic examination.

South Med J, 1985 Jan, 78(1), 45 - 7
Cephalexin in the treatment of acute and chronic maxillary sinusitis; Schaefer SD et al.; We evaluated the efficacy of cephalexin therapy in 104 patients with infectious maxillary sinusitis . Confirmation of diagnosis was made by x-ray film, antral puncture, and culture . Sixty-nine patients met all criteria for evaluation . The majority of patients received cephalexin, 1 gm/day in four divided doses for ten days, including the 48-hour period after the patient had become asymptomatic . Patients returned for observation one week and two weeks after initiating therapy . Satisfactory clinical results were obtained in 57 (83%) . Results showed that cephalexin was effective in treating sinusitis and that adverse reactions were rare . Bacteriology results showed that many of the pathogens usually involved in infectious maxillary sinusitis were resistant to the recommended or frequently prescribed antibiotics . These same pathogens, however, did not show resistance to cephalexin.

Life Support Syst, 1985, 3 Suppl 1, 414 - 8
A new bioprosthesis: impermeable for bacteria, permeable for fluids, incorporable by connective tissue; Schauwecker HH et al.; Polyurethane non woven membranes with microporous inner layer and macroporous outer layer where tested bacteriologically and histologically . It was proved that the macroporous layer is suitable for the ingrowth and maturing of connective tissue, while the microporous structure prevents the invasion of bacteria, nevertheless being permeable for nutrient substances . So the material could be yield favourable presupposition to achieve bioincorporation in contaminated borderlines.

Scand J Infect Dis, 1985, 17(4), 407 - 10
Levels of C-reactive protein in patients with hematologic malignancies; Kostiala AA et al.; The levels of C-reactive protein (CRP) were assayed in 282 serial sera of 70 patients with hematologic malignancies who were under antineoplastic medication, and surveyed with frequent blood cultures . The mean peak value of CRP in febrile patients with bacteriologically verified sepsis was 162 mg/l and differed significantly (p less than 0.001) from that (23 mg/l) of afebrile patients with negative blood cultures, but not from that (115 mg/l) of febrile patients without confirmed bacteremia . All the values in afebrile patients with negative blood cultures were less than 100 mg/l; 71% of their peak values were less than 40 mg/l . Thus the malignancy itself or its treatment did not considerably mount CRP response.

Ann Rech Vet, 1985, 16(3), 271 - 7
{Relation between the cell concentration of individual cow's milk, milk production and the cow's susceptibility to mammary infection}; Serieys F; The relations between the cell concentration in the milk from individual cows, their susceptibility to mastitis and milk production capacity were studied for 30 months on the 62 black-and-white French Frisian X Holstein cows of an experimental herd . During this period, the cows were regularly submitted to bacteriological tests for intramammary infections, individual cell counts and controls of the milk production . The cell concentrations in the milk before infection were not different for two groups of cows that showed more or less susceptibility to mastitis . The corrected milk production fell linearly with the logarithmic mean of the lactation cell concentration, leading to a decrease of the yield that was as great as between 100 000 and 200 000 as between 200 000 and 400 000 cells/ml . The reduction in yield was particularly large in cows that presented brief clinical infections followed by persistent inflammatory sequelae . The biological significance of these results and their implications for the control of mastitis were discussed.

Ann Rech Vet, 1985, 16(3), 255 - 61
{Cell concentration of individual cow's milk: effect of the status of mammary infection, parity, lactation stage and milk production}; Serieys F; The relative effect of the intramammary infections and of different factors related to the cow (parity, stage of lactation, milk yield) on the individual cell counts, were studied for 30 months on the 62 black-and-white Holstein cows of an experimental herd . During this period, the cows were regularly submitted to bacteriological tests for intramammary infections, individual cell counts and controls of the milk yield . The infection status of the cows at the time of counting was the main factor affecting the cell concentrations in the milk: the values ranged from around 5 X 10(4) cells/ml in the absence of infection in the four quarters, to values that were on average twice as high in the case of infection by a minor pathogen and ten times as high in the case of infection by a major pathogen . The mean cell concentrations in the milk of uninfected cows were significantly lower during the first lactation; they varied during the lactation according to a curve which had the form of an inverted lactation curve . The mean cell count during a lactation was independent of the mean milk yield per day of lactation . In cows infected by a major pathogen, the effect of the number and stage of lactation was different . Only the variation apparently associated with the stage of lactation had a sufficient amplitude to bring the mean cell concentrations of uninfected cows close to the values recorded in cows infected by a minor pathogen . The average results from cows infected by a major pathogen were, however, much higher at all stages of lactation.(ABSTRACT TRUNCATED AT 250 WORDS)

Indian J Lepr, 1985 Jan-Mar, 57(1), 90 - 6
Prothionamide and dapsone therapy in leprosy--a clinical study; Kundu SK et al.; Combined therapy with prothionamide and dapsone was instituted in fifteen active untreated lepromatous leprosy cases for a period of 18 months . Clinical improvement was good with attainment of zero morphological index in about 66% cases . Bacteriological improvement was rather unsatisfactory as one case only reached zero level . Side effects were observed in few cases necessitating withdrawal of combined therapy and patients' prothionamide compliance was rather unimpressive.

Indian J Lepr, 1985 Jan-Mar, 57(1), 159 - 63
Multi-drug therapy for multi-bacillary cases in Wardha district, Maharashtra, India; Rao MS et al.; 2786 infectious patients of Wardha district are now receiving multi-drug therapy . 67% of those who have received 2 years' treatment have become bacteriologically negative . Side-effects due to drugs have been comparatively few . In the majority of patients who had such side-effects, they have been mild.

Drugs Exp Clin Res, 1985, 11(6), 361 - 8
Combined cefuroxime plus acetylcysteine in the treatment of bacterial infections of the respiratory tract; Bonavita E; Fifty adult patients (29 males, 21 females) suffering from respiratory tract infections with substantial production of mucus were treated with cefuroxime 1 g and acetylcysteine 300 mg administered simultaneously by i.m . injection twice daily for 10 days . Bacteriological tests were performed before and after treatment . Clinical variables (fever, cough, quantity and type of sputum, difficulty in expectorating) were evaluated, and assigned scores ranging from 0 to 3 according to an arbitrary semiquantitative scoring system . The therapeutic results obtained were positive . No side-effects were observed.

Auris Nasus Larynx, 1985, 12 Suppl 1, S73 - 6
Bacteriological and cytological findings according to the macroscopic characteristics of the middle ear effusions; Van Cauwenberge P et al.; With standardized bacteriological methods, where direct microscopic examination took a very important place, 112 effusions from children (aged 1 to 6 years) with OME (minimum 2 months duration) were examined . It was demonstrated that acridine orange stain was superior to Gram stain in detecting bacteria, while Giemsa stain gave more information about the inflammatory cells involved . Purulent OME revealed most frequently bacteria (in total 92%), as well by direct microscopic examination (83%) as by culture (83%) . Bacteria were found in the direct microscopic examination of 45% of the serous and 72% of the mucoid secretions . Cultures were positive in 45% of the serous and in 32% of the mucoid effusions . In the mucoid group, the sticky glue effusions had the lowest detection rate, especially when culturing (only 21% positive cultures) . Polymorphonucleocytes were present in all purulent but also in all serous effusions, and in 76% of the mucoid effusions (57% of glue effusions) . Lymphocytes often accompanied polymorphonucleocytes, especially in serous (45%) and seromucoid (47%) effusions . Mono-nuclear cells and macrophages were only rarely found.

Polim Med, 1985, 15(3-4), 135 - 47
{Studies of the possibility of repeated use of capillary dialyzers . I . Renovation method and the evaluation of biological reactivity}; Szepietowski T et al.; A method devised by the authors of renovation of capillary dialyzers, after rinsing the blood and the liquid systems of the dialyzers is discussed . After rising the blood and the liquid systems of the dialyzers by water at 2 atm.--water being conditioned by the apparatus for reverse osmosis--in the liquid system overpressure of 2 atm was produced by water, the by 0.5% solution of sodium hypochlorite . After 2-3 minutes sodium hypochlorite was rinsed out and both systems were filled in by 1-2% formaldehyde solution . Immediately before using the dialyzer in the same patient the fluid system was rinsed with conditioned water, and the blood system with 21 of sterile distilled water and with 41 of 0.9% NaCl solution . In order to facilitate the renovation process a semi-automatic apparatus was designed, which makes it possible to renovate two dialyzers at once . This method makes it possible to use 80% capillary dialyzers four times with lateral input of the blood system, and four times 100% ones with central input . Experiments on animals and clinical observations and bacteriological studies shoved that the renovation process was atoxic, apyrogenic and sterile . No damage of capillaries and no reactions in subsequent use in patients under dialysis were observed.

Zentralbl Neurochir, 1985, 46(4), 354 - 9
{Intracranial late abscesses following injuries caused by grenade splinters}; Waldbaur H et al.; On the basis of 6 cases of late cerebral abscesses after lesions caused by shell-splinters treated by us, clinic, diagnostics and therapy of this complication are discussed in detail . In 3 patients there were no direct relations between the splinters and the abscesses so that further factors (age, vascular wall changes, and the like) must play a role in the formation of the abscesses; such vascular wall fibroses were found histologically in 3 of the examined abscess capsules . In 3 cases the bacteriological identification of the pathogens was possible . The treatment was carried out by employing puncture or extirpation or the combination of the two methods.

Clin Lab Haematol, 1985, 7(4), 307 - 16
C-reactive protein levels in neutropenic patients with pyrexia; Gozzard DI et al.; This study describes the experience of a clinical haematology unit in dealing with pyrexial episodes in 62 patients . Serum C-reactive protein levels were serially estimated and proved to be useful in following the course of the illness . No significant difference could be demonstrated in the C-reactive protein levels of those patients with bacteriologically proven illnesses, those in whom a clinically evident infection was present, and those with a 'pyrexia of unknown origin' . However, those patients in whom disease activity was thought to be responsible for the pyrexia had significantly lower C-reactive protein levels compared with those patients who had a septicaemic illness.

J Gynecol Obstet Biol Reprod (Paris), 1985, 14(4), 477 - 85
{Acute gonococcal salpingitis}; Body G et al.; The authors describe their experience in handling cases of acute salpingitis in a retrospective study that lasted six years . The protocol of investigation in particular consisted in routine laparoscopy and a complete bacteriological investigation . 266 patients had laparoscopy on suspicion of salpingitis and the diagnosis was confirmed in 199 cases (64.8%) . Out of the 134 patients who were fully explored bacteriologically and kept in the study the principal group consisted of cases of gonococcal salpingitis (41.8%), whereas 29.8% of the cases had infection with opportunistic pathogens and 28.3% were of doubtful aetiology or where no bacteria were discovered . The figures for recovery of gonococcal bacteria were constant throughout the six years of the study . Gonococcal salpingitis occurred more often in younger women (the mean age was 24.4 years) . The signs that were statistically most frequent were: discharge, metrorrhagia and a raised sedimentation rate . The differences that concerned the epidemiology of the cases as well as the clinical and bacteriological data as given in our series and in the literature are presented and discussed.

Z Erkr Atmungsorgane, 1985, 164(1), 25 - 38
{Bronchial secretion and bronchial mucosa in children with mucoviscidosis: results of comparative bronchoscopic, biochemical, bacteriologic, light and electron microscopic studies}; Wunderlich P et al.; Twenty two patients with cystic fibrosis, 7 to 17 years of age, underwent each two bronchoscopic investigations, the second six months later than the first, in general anaesthesia with muscle relaxation using a ventilation bronchoscope and taking small biopsies of the mucous membrane . The degree of reddening, swelling of the mucous membranes and hypersecretion was in some agreement with the intensity of the cellular infiltration and the production of pus (microscopic investigation) . Secondary ultrastructural changes were detected in nearly all children: e.g . cellular oedema, protrusion of cells and fusion of cilia, microtubular abnormalities of the cilia, lesions of the apical cell membranes and increased number of goblet cells . These changes of ultrastructure were not correlated to the mentioned signs of inflammation.

Dev Biol Stand, 1985, 61, 325 - 30
Improved serodiagnosis of whooping cough caused by Bordetella pertussis by determination of IgG anti-LPF antibody levels; Nagel J et al.; The enzyme-linked immunosorbent assay (ELISA) has been used for the determination of the isotype and the specificity of Bordetella pertussis serum antibodies induced by natural infection and by vaccination . In a previous study (J . Med . Microbiol., 16, 417-426 (1984)) it was shown that the presence of pertussis serum IgA antibodies could be used as an indicator of infection: IgA antibodies were not induced by vaccination nor transported from the mother to the serum of the child . In the present study ELISA was used for the determination of IgA, IgM and IgG antibodies . From the results obtained with sera from suspected pertussis cases, it was concluded that antibodies against FHA are hardly induced by infection, in contrast to anti-LPF (determined in a fetuin sandwich ELISA) and anti-LPS antibodies . In view of the lower standard deviation of the mean anti-LPF antibody titer these antibodies were studied more extensively . From a number of bacteriologically proved pertussis cases, it was shown that high levels of IgG anti-LPF antibodies were found before IgA antibodies could be detected . On the other hand, we had the impression that IgG antibodies declined more rapidly than IgA antibodies . One has, however, to take into account that IgG antibodies are transferred from mother to child . From assay of sera from infants prior to, during and two months after vaccination (ages of vaccination: 3, 4, 5 and 12 months) it was concluded that IgG anti-LPF antibodies were induced to a much lower level by DTP-polio vaccination (10 O.U . per dose) than by natural infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Scand J Plast Reconstr Surg, 1985, 19(1), 91 - 5
Qualitative and quantitative bacteriological studies in infected surgical wounds treated with Debrisan or saline; Ransjo U et al.; In a study of methods for the evaluation of clearing of wound infection, local treatment with Debrisan (10 wounds) or saline (11 wounds) was examined clinically and bacteriologically . No correlation was found between clinical course and numbers of bacteria found in wound biopsies or swabs . Biopsy results varied greatly between sites in the same wound . In wounds with established infection, biopsies or wet swabs yielded little more information than conventional dry swabs . Debrisan seemed to offer no advantage over saline as regards clearing of infection in this small patient group.

Vet Rec, 1984 Dec 15, 115(24), 623 - 6
Possible role of leptospires of the Pomona serogroup in sporadic bovine abortion in the south west of England; Hathaway SC et al.; An investigation of a small outbreak of abortion in mixed-age cows in a dairy herd in Somerset produced circumstantial evidence that a leptospire belonging to the Pomona serogroup was the causative agent . Although the initial epidemic involved more than 30 per cent of the herd, agglutination titres did not persist in the majority of animals and bacteriological monitoring produced no evidence that this leptospire could establish endemic infection in dairy cattle . An isolate recovered from the kidney of a cow which aborted was found to be similar to mozdok, a serovar maintained by free-living species in continental Europe, and it is probable that free-living species also maintain the Pomona serogroup organisms that have been isolated in England . Clinical disease caused by infection of domestic stock with Pomona serogroup organisms other than pomona has not been recognised in other countries but this may be because of the presence of endemic infection with pomona, a serovar that causes a very similar clinical and serological response.

Int J Lepr Other Mycobact Dis, 1984 Dec, 52(4), 482 - 7
Problems of urban leprosy control with special reference to case holding; Koticha KK et al.; The prevalence of leprosy and the proportion of bacteriologically positive cases in different parts of endemic and highly dense Bombay, India, are presented . The attendance of 8574 cases is retrospectively analyzed with respect to age, sex, occupation, type of leprosy, and presence or absence of deformity . Defaulters (6090) were traced, and the reasons for nonattendance were ascertained in 22% of the cases . In those cases who could be contacted and in those who had high bacterial and morphological indexes, multidrug therapy was being given at either a clinic or, if not possible, at their homes by experienced field workers under supervision . Recommendations are made for improving urban leprosy control work in general and for case holding in particular.

J S Afr Vet Assoc, 1984 Dec, 55(4), 173 - 9
Epididymitis of rams in the central and southern districts of the Orange Free State; De Wet JA et al.; Scrotal palpation, microscopical examination of semen smears and the application of bacteriological techniques, revealed the incidence of Actinobacillus seminis and Brucella ovis infection of rams in the central and southern districts of the Orange Free State to be 2,9% and 4,3%, respectively . More Dorper than Merino rams were affected . Although clinically detectable epididymitis was found in 5,9% of rams examined, infection with A . seminis and B . ovis, as measured by the presence of neutrophils in semen and positive semen cultures, could only be demonstrated in a small minority of affected cases . These organisms were found more regularly in clinically negative rams excreting neutrophils in their semen . Possible reasons for the high incidence of sheep brucellosis in rams in the particular area as well as the higher incidence of infection in Dorper rams are discussed.

Trop Geogr Med, 1984 Dec, 36(4), 375 - 81
Water quality and water quantity and wasting in south India; Hebert JR; Bacteriological quality, quantity and availability of water are generally considered the important water supply characteristics in terms of human health . The present study shows that for children 18 months old and younger water quality is a relatively more important determinant of wasting than other attributes of water supply . For children 19 to 36 months of age, quality of the water is slightly less important than quantity of water stored in the house.

J Epidemiol Community Health, 1984 Dec, 38(4), 331 - 4
A new approach to tuberculosis notification; Shanks NJ et al.; A tuberculosis notification system was initiated which used several sources--the doctor, the diagnostic services of bacteriology, histopathology and radiology, and the pharmacy . The results of six months' notifications have shown that the pharmacy was by far the most complete source (74% of all new cases); doctors notified only 21% of all new cases . The combination of both doctors and the pharmacy was the most complete pair, notifying 85% of all new cases . It is suggested that consideration should be given to the use of pharmacies as a source of notification both in other settings and for other diseases.

Monatsschr Kinderheilkd, 1984 Dec, 132(12), 880 - 5
{Current evaluation of diphtheria}; Bachmann KD; Between 1973-1983 there were 103 scattered cases of diphtheria in the FRG . The mortality rate was 22% . The question remains open, whether there are juts sporadic cases or the beginning of a new epidemic . During the past 200 years diphtheria occurred in waves with a peak every 30 years . Diagnostically we should be on the alert, and start special treatment already with the clinical diagnosis . For a start hyperimmunoglobulin should neutralize still circulating equine toxins which are no longer caught once they are within cells e.g . heart muscle . Only after this, antibiotics should be considered as an addition to kill toxin-producing bacteria . Antibiotics alone do not prevent the sometimes lethal action of toxins . For the bacteriologic proof of the diagnosis not only the coryne bacteria have to show but the toxin production as well . The transformation of non-toxin-producing into toxin-producing coryne-bacteria following an infection with bacteriophages has been observed recently in children during an epidemic.

Kidney Int, 1984 Dec, 26(6), 816 - 22
Pyelonephritis: the role of cell-mediated immunity defined in a congenitally athymic rat; Miller T; Thymus-derived lymphocytes (T-cells) have been shown to be present in the inflammatory infiltrate in renal infection but their role in host defense mechanisms has not been defined . Indirect evidence suggested that T-cells contributed to host protection but selective depletion of T-cells did not influence the course of pyelonephritis . In the present report, the characteristics of the athymic New Zealand nude rat (rnunz), which lacks T-lymphocytes, are detailed . This mutant was then used to assess the effect of an absence of T-cells on the bacteriological and histopathological features of pyelonephritis . No significant differences in the bacteriological course of the disease were found . Apart from fewer lymphocytes in the kidney lesions of nude rats and a slight, lag in the resolution of these lesions, no differences were observed in the histopathological course either . These observations, which have analyzed the quantitative relationship between cell-mediated immunity (CMI) and host resistance to renal infection, have shown that a gross reduction in CMI does not affect host resistance once bacteria have gained access to the kidney.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 Dec, 179(6), 596 - 604
Pilot studies with an apparatus for automatic bacteriological testing of water; Kvittingen J; The data presented have demonstrated the applicability of monitored, automatic bacteriological testing of water from different sources . Information from experiment show a continuous variation in the number of polluting bacteria in water samples obtained from the same water source, thus indicating the necessity of using multiple samples in order to establish a "most probable contamination" . When trying to determine the pollution of a certain water source, assay must be performed at different seasons of the year and under various climatic and weather conditions like heavy rain fall, drought and sub-zero temperatures . Working with sea water obtained from the same spot at sea, the degree of pollution in some samples appears to be influenced by changing wind and currents, high and low tide . The advantages of automatic sampling, inoculation and incubation on the spot are obvious . It is visualized that an industrial adapted modification of the prototype machine may serve wide variations of individual requirements pertinent to water assay.

J Periodontol, 1984 Dec, 55(12), 684 - 8
The role of bleeding upon probing in the diagnosis of periodontal disease . A literature review; Greenstein G; Assessment of bleeding upon probing is an integral part of a periodontal examination . Recent investigations have indicated that bleeding reflects histological, clinical and bacteriological alterations associated with periodontal disease . Furthermore, clinical and histologic data suggest that bleeding is an earlier sign of gingivitis than visual signs of inflammation (redness and swelling) . The current literature referring to the role of bleeding upon probing in the diagnosis of periodontal disease is reviewed, and its limitations as a clinical parameter are discussed.

Aust N Z J Surg, 1984 Dec, 54(6), 535 - 41
Prophylactic antibiotics in appendicectomy: a prospective double blind randomized study; O'Rourke MG et al.; Our double blind prospective randomized trial comparing intravenous cefoxitin with rectal metronidazole in appendicectomy reveals both groups to be similar regarding basic data, with no significant difference in the results between the two drugs . Nearly all the wound infections occurred after the patient went home . Most were minor infections and the overall infection rate was 6% . The intravenous route was the more certain but the more expensive . Bacteriology suggests that the same flora were present in the appendiceal wall of normal and acute non-perforated appendices . This would suggest bacteriologically that the same risks exist with non-inflamed appendicectomy as occurs with inflamed non-perforated appendices . These findings support the use of short course prophylaxis in appendicectomy.

J Infect Dis, 1984 Dec, 150(6), 935 - 40
Neonatal meningitis caused by Escherichia coli in The Netherlands; Mulder CJ et al.; Bacteriological and clinical data on 132 children with neonatal meningitis caused by Escherichia coli were analyzed as a part of a larger study of bacterial meningitis undertaken between 1976 and 1982 in The Netherlands . Eighty-eight percent of the E . coli strains that were isolated carried the K1 capsular antigen . Most (80%) of these E . coli K1 strains were serotyped as O7, O18, O83, or were autoagglutinable . The male/female ratio of the infants was 1.64 . In the majority of cases the onset of meningitis was at the end of the first week of life . The birth weight of 42% of the infants was less than or equal to 2,500 g, and congenital defects were present in 11% of the infants . Thirty-seven percent of the neonates had no recognized risk factors . The case fatality rate was 26% . Meningitis recurred in 8% of the survivors.

Ann Intern Med, 1984 Dec, 101(6), 738 - 42
Sporadic cases of hemorrhagic colitis associated with Escherichia coli O157:H7 . Clinical, epidemiologic, and bacteriologic features; Pai CH et al.; During a 6-month period in 1983, Escherichia coli O157:H7 was isolated from 19 (15%) of 125 patients with grossly bloody diarrhea and 1 sibling with non-bloody diarrhea in the Calgary area . There was no clustering of the cases geographically or in time . All but 1 had clinical manifestations typical of hemorrhagic colitis associated with E . coli O157:H7 . The illness appeared to be associated with consumption of hamburgers by 15 patients . The diarrheal illness was usually self-limited, but 3 children developed the hemolytic-uremic syndrome shortly after onset of illness . The organism was excreted in the stools very briefly in adults, although bacterial shedding continued for a longer period in children . All isolates produced verotoxin, and cytotoxic activities were present in stool filtrates . The results suggest that the incidence of sporadic cases of hemorrhagic colitis due to E . coli O157:H7 may be higher than has been suspected, and that patients with grossly bloody diarrhea should be studied promptly for E . coli O157:H7 infection . Specific techniques for identifying this serotype must be applied to the stool cultures . Detection of free cytotoxin in stool filtrates may be an effective diagnostic procedure.

Presse Med, 1984 Dec 1, 13(43), 2635 - 9
{Value of thoracoscopy}; Boutin C et al.; Formerly used in active tuberculosis to divide pleuro-pulmonary adhesions and to complete therapeutic pneumothorax, thoracoscopy has now become the object of renewed interest . By introducing, after pneumoserosa and usually through the axilla, a fine trocar into the chest, the whole thoracic cavity, including parietal pleura, diaphragm, lung and lung fissures, mediastinum and pericardium, can be explored . This technique, performed under local rather than general anaesthesia or under neuroleptanalgesia, is innocuous, fairly cheap and effective . In addition, the patient is immobilized for only 4 or 5 days on average and surgery, which is much heavier, can be avoided in many cases . Thoracoscopy nowadays is mostly used: (1) to determine the cause of a chronic pleurisy unexplained after 3-4 weeks (positive results: 95-97% for cancer, 92% for tuberculosis); (2) to dry up pleural effusions by talc and drainage (satisfactory results in 90% of the cases); (3) to establish the pathophysiological diagnosis of spontaneous pneumothorax (bullae, blebs, adhesions, fistulae), to treat it with talc and with coagulation of small "bullae", or to decide in favour of surgery; (4) to perform lung biopsies which clinch the diagnosis in 95-97% of cases of diffuse interstitial pneumonia . The same technique is also used methodically and efficiently for optic and electronic microscopy, bacteriological or mycological examination, immunofluorescence, hormone receptor detection and study of organic particles or minerals . Thoracoscopy lies half-way between pure medical practice and surgery and deserves to be widely used again by pneumologists, provided they learn to master its technique by regular, assiduous and sufficient practice . Pneumologists do not become thoracoscopists at a moment's notice; it is a skill which must be included in their training.

An Esp Pediatr, 1984 Nov 30, 21(8), 753 - 6
{Comparative course of pneumonia with suppuration}; Cortes Lozano A et al.; Certain clinical, biochemical, bacteriologic and radiographic parameters are compared, as well as the evolution and treatment of two groups of purulent pneumonias followed during the two trienniums 1968-1970 and 1980-1982 . In the more recent triennium stands on the decrease in the incidence of this type of pneumoniae as well as a shorter hospital admittance and a lesser need for surgical therapy.

Equine Vet J, 1984 Nov, 16(6), 499 - 508
Collection and evaluation of tracheobronchial washes in the horse; Whitwell KE et al.; A flexible endoscope was used to obtain 223 tracheal washes from 191 horses in three clinical categories . Total cell counts, cytological and bacteriological examinations are reported and the features of the main cell types encountered described . The presence and degree of inflammatory airway disease was determined by a semiquantitative assessment of the neutrophil response and was an important consideration in the interpretation of the bacteriological results . Potential pathogens were isolated from approximately 30 per cent of samples . Cytological changes suggestive of lungworm infestation, virus infection and chronic airway disease are described . Haemosiderophages, indicative of pulmonary haemorrhage, were found in all horses in full training . The techniques used were rapid and simple and were found to improve the accuracy of diagnosis of pulmonary disease . Sequential samples were useful for monitoring the progress of clinical cases.

J Clin Microbiol . 1984 Nov;20(5):995.
Prosthetic valve endocarditis caused by group Ve-1 bacteria (Chromobacterium typhiflavum); O'Leary T et al.; A case of fatal prosthetic valve endocarditis was caused by group Ve-1 bacteria . Bacteriological characteristics and antibiotic susceptibilities are presented, as well as a brief discussion of the isolates of the Ve-1 organism in Ontario.

Isr J Med Sci, 1984 Nov, 20(11), 1064 - 7
Tuberculous peritonitis; Yampolski I et al.; Two patients with tuberculous peritonitis are described to exemplify some of the diagnostic problems that may be encountered in this rare disease . Both presented with fever, abdominal pain and a deterioration in their general condition . In both cases Ziehl-Neelsen staining and animal inoculation were negative . In the first patient, who underwent repeated hospitalization and investigation, the diagnosis was established following a therapeutic trial with antituberculous drugs administered after unsuccessful treatment of a cecocutaneous fistula that developed after drainage of a periappendicular abscess and appendectomy . In the second patient, the diagnosis was confirmed at laparatomy . Since bacteriological studies often fail to render a positive diagnosis, it is suggested that the clinical picture together with a histological finding compatible with tuberculous peritonitis should be sufficient for diagnosis and the institution of treatment.

Pathol Biol (Paris), 1984 Nov, 32(9), 923 - 9
{The microcomputer in bacteriology . Value in the automated performance of antibiograms in hospitals}; Legras B et al.; In microbiology, most computerization is carried out by means of important centralized computers . On the contrary, our work is based upon the use of inexpensive microcomputers . We have developed general programs for the acquisition of data, their correction, and retrieval of lists arranged according to desired parameters (hospital department, germ, or sample) and various statistics, especially with respect to germ sensitivity . This system has been used on a routine basis since April 1982 in the Bacteriology Laboratory of Nancy University Hospital . It could easily be adapted to other laboratories and could provide a wide range of essential epidemiological data on the resistance of bacterial strains to antibiotics and their evolution with time.

J Clin Pathol, 1984 Nov, 37(11), 1272 - 5
Mucosal flora of the small intestine and the effect of preoperative antibiotics; Elmes ME et al.; Samples of mucosa from the small intestines of 100 patients undergoing intestinal surgery were examined bacteriologically . Sixty four patients had received chemotherapy, 12 for more than 24 h before operation . Most of the jejunal samples were sterile unless there was a carcinoma, previous surgery, or potential intestinal stasis . Ileal mucosa was more likely to contain intestinal organisms . Most of the strains isolated were sensitive in vitro to the antibiotics given in vivo, but short term treatment may not have allowed sufficient time for the treatment to have become effective . The findings suggest that antibiotics are not needed for most operations on the duodenum or jejunum but may be required for operations on the ileum.

Arch Surg, 1984 Nov, 119(11), 1269 - 73
Peritonitis due to intraperitoneal perforation of infected urachal cysts; Agatstein EH et al.; Acute bacterial peritonitis due to intraperitoneal perforation of an infected urachal cyst represents a potentially lethal complication of the rare anomalies of the fetal urachus . We report four cases of this disease, including what we believe is the first to have been correctly diagnosed prior to operation . All four patients underwent emergency laparotomy and curative excision of the urachal remnant . Review of our four cases plus seven previously reported cases disclosed the perforated urachal cyst to be predominantly a disease of young males who initially have acute peritonitis but often without specific indication of a urachal anomaly . Bacteriologic examination has identified a wide variety of infecting organisms . Umbilical sinography or abdominal ultrasonography may allow accurate preoperative diagnosis . Broad-spectrum antibiotic coverage and laparotomy are indicated and excision of the entire urachal remnant is consistently curative.

Am J Surg, 1984 Nov, 148(5), 609 - 12
Cholecystectomy for acute cholecystitis: timing of operation, bacteriologic aspects, and postoperative course; Sianesi M et al.; There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis . For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied . During the first period, there were two types of surgical intervention: during hospitalization after resolution of the acute episode, and during a second hospitalization 2 to 3 months later . During the second period, early cholecystectomy within 72 hours of the onset of symptoms became the option . Emergency operations did not reflect a surgical choice but rather conditions of necessity . The results of this study demonstrate that early cholecystectomy is preferred for a variety of reasons, the most important of these being a low incidence of positive results of bile culture in this phase, a negligible percentage of postoperative complications and mortality, and a short hospitalization period with resulting cost containment.

JPEN J Parenter Enteral Nutr, 1984 Nov-Dec, 8(6), 673 - 8
Bacterial contamination of tube-feeding formulas; Anderson KR et al.; Bacterial cultures were made on tube-feeding formulas provided to 35 unselected adult patients on termination of the infusion . Bacteria were counted and identified using routine procedures . Formulas were classified as nonmanipulated, manipulated, or locally prepared . Medical records were reviewed to determine if diarrhea was present during the period that included 2 days on either side of the sampling day . A significant association was observed between the extent of bacterial contamination and the presence of diarrhea (p = 0.027) . Locally prepared and manipulated formulas contained a significantly greater number of organisms when compared to nonmanipulated formulas (x2 = 17.81, p less than 0.001) . Counts for two baseline and four termination cultures on locally prepared formulas exceeded the acceptable limit for coliform organisms in pasteurized milk according to public health standards . Eight additional cultures on commercial feeding formulas which were presumably sterile initially, exceeded these standards at the end of the administration period . Thus 12 of 35 formulas (34%) would not meet public health standards applicable to pasteurized milk . Use of sterile nonmanipulated formulas in a closed administration set is recommended, along with routine, periodic bacteriologic surveillance of enteral feeding programs.

J Am Acad Dermatol, 1984 Nov, 11(5 Pt 1), 781 - 7
Ecthyma gangrenosum: report of clinical, histopathologic, and bacteriologic aspects of eight cases; Greene SL et al.; The records of eight patients with ecthyma gangrenosum who were treated at the Mayo Clinic between 1970 and 1982 were reviewed . All patients had hematologic disease and had received immunosuppressive drugs . Patients with neutropenia that did not resolve by the end of a course of appropriate antibiotic treatment usually died . Solitary lesions of ecthyma gangrenosum were associated with a better prognosis than were multiple lesions . The typical skin findings of ecthyma gangrenosum usually occurred early and were often incorrectly diagnosed, resulting in time lost during which antibiotic therapy could have been instituted . For patients with ecthyma gangrenosum, a systematic procedure is important to establish the diagnosis early, so that appropriate systemic antibiotic therapy can be initiated.

Surv Ophthalmol, 1984 Nov-Dec, 29(3), 169 - 78
Orbital abscess; Hornblass A et al.; Although orbital or subperiosteal abscess may originate from a number of sources, paranasal ethmoidal sinus disease is the most common source of infection, particularly in children . Prompt diagnosis and treatment are necessary to prevent severe visual loss and even death . The authors review the five-group classification of orbital abscess and summarize data regarding source, bacteriology, treatment and visual results from 13 series reporting 148 patients . Four new cases are presented in detail . Diagnostic procedures, including laboratory testing, sinus radiography, ultrasound and CT scanning, are discussed and recommendations are given for medical and surgical management.

HNO, 1984 Nov, 32(11), 441 - 9
{Infection causing pathogens in the area of the upper respiratory tract . Bacteriologic diagnosis and chemotherapy from the viewpoint of the bacteriologist}; Burkhardt F; After a short survey of the indigenous bacterial flora, and of the important bacteria causing infections of the upper respiratory tract, the conditions which are mandatory for proper evaluation of the bacteriological results and which must be observed by the physician in obtaining and forwarding specimens are discussed . Swabs must be sent in preservation media; otherwise the detection rate of viable organisms will fall considerably . Transport should therefore be as rapid as possible . Viral infections often pave the way of infections of the upper respiratory tract . In hospitalised patients however the suppression of the normal flora and selection of resistant strains by antibiotics often play the major role . Chemotherapy should be preceded by bacteriological investigation or, at least, by taking a suitable specimen for the detection of the causal bacteria and determination of their susceptibility to antibiotics . "Blind" therapy will result in 20-30% failures of the treatment . The following questions should be answered before antibiotics are started: Is there really a need for immediate chemotherapy? How likely are the causal bacteria to be sensitive? What defence mechanisms can be expected from the patient? What side effects of the antibiotic must be taken into consideration? The most important infections of the upper respiratory tract, the selection of effective antibiotics and the susceptibility of the more frequent pathogens of this area are also discussed . Finally some aspects of perioperative prophylaxis of infections after surgery of the upper respiratory tract are described.

Br J Surg, 1984 Nov, 71(11), 845 - 9
Are bile bacteria relevant to septic complications following biliary surgery?
Willis RG, Lawson WC, Hoare EM, Kingston RD, Sykes PA.
Bile bacteriology, wound sepsis and the effect of prophylactic antibiotics have been studied in a controlled prospective double blind randomized trial on 375 patients undergoing elective cholecystectomy at a district general hospital . We have examined the overall prevalence of bacteria in bile and have identified several factors associated with an increased incidence . The identity of organisms isolated from a total of 21 patients with infected wound swabs was compared with isolates from the bile at operation, and in only two instances was there a correlation . Cephazolin, given either pre-operatively, or into the wound, reduced wound infection rates compared with a control group (from 11.8 to 2.4 per cent, P less than 0.005) . We conclude that the majority of wound infections in this series were caused by organisms from the patients' skin or exogenous sources, rather than by bacteria from the biliary system.

Jpn J Antibiot, 1984 Nov, 37(11), 2251 - 5
{Clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Ikushima Y et al.; Sulbactam cefoperazone (SBT/CPZ), a combination drug of SBT and CPZ, was administered to 5 cases with obstetrical and gynecological infections in a daily dose of 2-6 g for 3-5 days . Clinical efficacy was good in 4 cases and poor in 1 case with adnexitis . Bacteriologically, organisms were detected in 2 out of 5 cases, beta-lactamase producing P . aeruginosa was detected in 1 case, but, their bacteriological responses were not clarified . Neither side effect nor abnormal laboratory findings due to this drug were observed . From the results we concluded that SBT/CPZ was an effective and safe antibiotic in the field of obstetrics and gynecology.

Jpn J Antibiot, 1984 Nov, 37(11), 2223 - 33
{Fundamental and clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Hirabayashi K et al.; Fundamental and clinical studies on sulbactam/cefoperazone (SBT/CPZ), a combination drug of sulbactam and cefoperazone, were carried out in the field of obstetrics and gynecology . The following results were obtained: Transfer into female genital organ tissues Following 1 hour intravenous drip infusion of SBT/CPZ, favourable transfers of both of SBT and CPZ to female genital organ tissues and pelvic dead space exudate were observed . Clinical evaluation A total of 12 cases comprising 6 with intrauterine infection, 1 with pyometra, 1 with abscess of portio vaginalis, 2 with parametritis, 1 with pelvioperitonitis and 1 with purulent lymphocyst was treated with SBT/CPZ . Clinical efficacy was excellent in 6 cases, good in 5 cases and poor in 1 case, with overall efficacy rate of 92% . The bacteriological efficacy was judged as eradicated in 3, and as decreased in 2 out of 5 evaluable cases . In all of the 5 cases, isolated organisms were beta-lactamase producing organisms . No notable side effects or abnormal laboratory findings were observed except 1 case with elevations of GOT and GPT.

Jpn J Antibiot, 1984 Nov, 37(11), 2208 - 12
{Clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Horii T et al.; Sulbactam (SBT), a new beta-lactamase inhibitor, in combination with cefoperazone (CPZ) was studied for the clinical efficacy in the field of obstetrics and gynecology . SBT/CPZ was given to 5 cases with the following infections; 2 of pyometra, 2 of endometritis and 1 of abscess of adnexa . Clinical efficacy was good in 3 cases and poor in 2 cases . Bacteriologically, only 1 strain of P . vulgaris was beta-lactamase producer but was persisted after treatment . Neither side effects nor abnormal laboratory findings was observed.

Jpn J Antibiot, 1984 Nov, 37(11), 2203 - 7
{Clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Takayama T et al.; Sulbactam/cefoperazone (SBT/CPZ), a new developed antibiotic, was clinically studied . The following results were obtained . Total of 5 cases comprising 1 with endometritis, 3 with Bartholin's abscess, 1 with pyometra (due to corpus cancer) were treated with SBT/CPZ at a dose of 1 g twice daily for 4-5 days by intravenous injection or intravenous drip infusion . The clinical response was good in all cases . A case with pyometra did not respond to the therapy in bacteriologically . Side effects and abnormal laboratory findings due to the drug were not noted.

Minerva Med, 1984 Oct 27, 75(41), 2449 - 54
{Tuberculous lymphadenitis . Apropos of a non-typical histological picture}; Artusi T et al.; The case is presented of a young Somali with acute lymphadenitis . Whereas histological examination indicated abscessing granulomatous lymphadenitis, bacteriological studies revealed the presence of M . tuberculosis in the pus taken from the lymph node . Hence the aetiological diagnosis contradicted the morphological picture.

Indian J Lepr, 1984 Oct-Dec, 56(4), 877 - 83
Value of pilocarpine test in early diagnosis of leprosy; Chattopadhyay SP et al.; Modified Pilocarpine Test was carried out in 48 patients under investigation for Leprosy . 37 cases showed deficient sweating of varying degree . Many of these patients did not reveal confirmatory histopathological changes and were bacteriologically negative . In the absence of other causes of neuropathy this finding of deficient sweating by modified pilocarpine test, was significant . Same test was carried out in 8 confirmed cases of Tuberculoid leprosy . All cases showed positive results.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 Oct, 179(5), 381 - 96
{Dynamics of endogenous bacterial nitrite formation in the stomach . 1 . Follow-up studies in humans under natural conditions}; Mueller RL et al.; The fasting gastric secretion was analysed both bacteriologically and chemically in 15 young, voluntary test subjects with histories of a healthy stomach and physiological gastric secretion tests (Basal Acid Output, Peak Acid Output) made at regular intervals of two and 4 weeks over a period of three and six months . Two thirds of the persons studied showed during the entire period of examination the same pH values with tolerable variations and, as a result, the same order of magnitude for the total germ count, the colony count of the nitrite-forming bacteria and for the NO2- concentration . From this the conclusion can be drawn that, depending on the acidity of the individual stomach, there is an autonomous bacterial flora, which repeated examinations have shown to remain unaltered in quality and quantity . It was only in one third of the test persons that major variations of the pH values could be recorded occasionally . This, however, invariably led to corresponding changes in the bacteriological and chemical parameters . For requirements imposed by preventive medicine and hygiene, in future greater attention must be paid to the bacterial flora of the intact stomach, while making due allowance for the endogenous nitrite formation.

Eur Heart J, 1984 Oct, 5 Suppl C, 87 - 91
Surgery in infective endocarditis; Witchitz S et al.; Three hundred and seventy eight patients with infectious endocarditis (IE) were studied, including 299 cases of native IE {154 subacute (SIE), 145 acute (AIE)} and 79 cases of prosthetic endocarditis (PIE) . One hundred and fifty patients were operated on (40%): 117 for haemodynamic complications, 10 for bacteriological indications and 23 for mixed indications (112 patients in the acute phase) . Complications were more frequent in AIE than in SIE, in PIE than in native IE . Surgery is more urgent in aortic insufficiency and in Oslerian mitral stenosis (7 cases) than in mitral insufficiency . Eight tricuspid valvulectomies were performed . In 5 cases out of 11 rupture syndrome was cured without surgery . The patient's clinical condition contra-indicated surgery in 63 cases . The surgical mortality was 51/150 (34%) . It was significantly lower in SIE (21%) than in AIE (39%), in native IE than in PIE (53%), after antibiotic therapy than in the acute phase . Mortality was not higher when surgery was performed before the 8th day of antibiotherapy but perivalvular leaks were more common (31% vs 4%, P less than 0.01) . Mortality was higher when the culture of valve was positive than when it was negative (45% vs 26%, P less than 0.06) . However, surgery should be immediately considered in cases of haemodynamic complications.

HNO, 1984 Oct, 32(10), 424 - 5
{Diagnosis of middle ear tuberculosis}; Kley W; Middle ear tuberculosis is underdiagnosed . Clinical suspicion requires extensive diagnostic and therapeutic procedures . Due to a high degree of error in bacteriological and histological examination they must often be repeated . Indications for tentative diagnosis are given.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 407 - 9
Treatment of gonorrhea with thiamphenicol; Alessi E et al.; For many years thiamphenicol has been the drug of choice for the treatment of uncomplicated gonorrhea at the Center for Venereal Disease of the University of Milan . During the last four years, 1,110 of 1,112 cases of uncomplicated gonorrhea treated with 500 mg of oral thiamphenicol three times a day for six days have been cured . Recently, the effectiveness of single-dose treatment of uncomplicated gonorrhea with this drug was evaluated . A dose of 2.5 g of thiamphenicol was given orally to 159 patients . The diagnosis of gonococcal infection was based on culture results in all cases . In 77 cases red and white blood cell counts and hemoglobin and serum iron determinations were made before and one week after therapy . Clinical and bacteriologic cure was achieved in 144 (90.6%) of the 159 patients . The only adverse reactions to the drug were transient diarrhea in ten patients, epigastric pain in two, and vomiting in one . No statistically significant variations were detected in blood tests.

J Otolaryngol, 1984 Oct, 13(5), 321 - 4
Ludwig's-like angina (pseudo-angina Ludovici); Hall SF; Ludwig's angina and its variants (referred to as pseudo or Ludwig's-like angina) are a group of classical space infections in the head and neck . Recent papers have emphasized the bacteriology and complications . This paper, using three case studies, further examines relevant investigations and treatment.

Indian J Lepr, 1984 Oct-Dec, 56(4), 912 - 8
Role of Dapsone in chemotherapy of leprosy--a comparison of responses to therapy in two cohorts in 1960s and 1970s; Reddy BN et al.; Two cohorts of bacterio-positive cases registered and started on treatment during 1960-62 and 1968-70 were studied for differences in their response to DDS monotherapy . Proportion of male and female cases, mean Bacteriological Index (B.I.) and the distribution of cases according to the initial BI did not differ between the two cohorts . 49.7% of the patients in the II cohort were taking regular treatment against 27.4% in the I cohort . At the end of 7 years of treatment, proportion of the cases that were bacteriologically negative were 68.6% and 83.0% in I and II cohorts respectively . Relapse rates in I and II cohorts were 14.3% and 7.9% respectively, over a period of 7 years . The findings showed that Dapsone continued to be an effective antileprosy drug and must be included in all multidrug regimens in the therapy of leprosy.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 444 - 8
Thiamphenicol in the prophylaxis and treatment of mixed infections of the female genital tract; Moroni M et al.; Surgical procedures involving bacteriologically contaminated sites (e.g., vaginal or abdominal hysterectomy) are frequently followed by local or systemic infections . The efficacy of thiamphenicol against such infections was investigated in two studies: an open clinical study of the treatment of severe, mixed aerobic-anaerobic infections of the female genital tract and a randomized, prospective, controlled trial of short-term perioperative prophylaxis . Thirty-five patients were enrolled in the first study and 750 patients in the second (490 undergoing abdominal hysterectomy and 260 undergoing vaginal hysterectomy) . Thiamphenicol appeared to be effective in both trials . When used for prophylaxis, it significantly reduced three postoperative parameters: infectious morbidity, use of antibiotics, and period of hospitalization . When used for treatment, it cured 30 (86%) of 35 postoperative gynecologic infections, including 13 infections that had not responded to previous, empirical antibiotic therapy.

Eur J Clin Microbiol, 1984 Oct, 3(5), 478 - 87
A multiclinic randomized study of the comparative efficacy, safety and tolerance of imipenem/cilastatin and moxalactam; Calandra GB et al.; The efficacy, safety and tolerance of imipenem/cilastatin and moxalactam were compared in a randomized trial in the United States involving 19 centers and 441 patients . Significantly more organisms were susceptible to imipenem than moxalactam . Although the bacteriological outcomes were similar, the clinical outcome was significantly better in the imipenem/cilastatin treatment group . The incidence of colonization and superinfection was similar in both groups . Moxalactam was less irritating at the site of injection than imipenem/cilastatin . The safety profiles were similar except for bleeding episodes in the moxalactam group.

Ann Thorac Surg, 1984 Oct, 38(4), 415 - 23
Mediastinal infection after cardiac surgery; Sarr MG et al.; Mediastinitis is an uncommon complication after cardiac surgery; however, its associated morbidity and mortality demand early recognition and emergency therapy . This review is intended to emphasize certain features of the incidence, pathogenesis, and bacteriology of this complication in patients undergoing cardiopulmonary bypass through a median sternotomy . The diagnosis and treatment of mediastinitis after cardiac surgical procedures, as well as methods of prevention, are also reviewed.

Surgery, 1984 Oct, 96(4), 723 - 30
Surgical considerations of continuous ambulatory peritoneal dialysis; Robison RJ et al.; The surgical considerations pertaining to 173 continuous ambulatory peritoneal dialysis catheters were reviewed in 140 patients from 1979 through 1983 . All catheters were inserted in the operating suite by an open technique . Local anesthesia was used in the majority of patients (59%) . Catheter peritonitis was the most frequent complication, 228 episodes/2407 patient months . Twenty-three percent of the patients accounted for 51% of catheter-related peritonitis . Sixteen catheters were removed because of an inability to clear the infection . Intra-abdominal catastrophes were noted in four patients and differentiation from continuous ambulatory peritoneal dialysis peritonitis was based on serial examinations, bacteriologic cultures, and/or a progressive increase in free abdominal air . Surgically-related catheter complications were designated either early (less than 1 month) or late (greater than 1 month) in relation to catheter placement . Frequent early complications were mechanical flow problems and dialysate leaks . Five of 11 mechanical flow difficulties required catheter replacement while none of the dialysate leaks required surgical intervention, and all healed spontaneously . Common late complications included 35 tunnel infections, 23 of which were associated with peritonitis . Nine of these catheters (25%) were removed . Cuff extrusion was also associated with a high incidence (83%) of catheter attrition . Thirty-six patients underwent renal transplantation and in no instance did the catheter increase patient or renal allograft morbidity rates.

Eur Heart J, 1984 Oct, 5 Suppl C, 71 - 5
Rheumatic symptoms and signs in subacute infective endocarditis; Azevedo J et al.; Two hundred patients (90 men and 110 women), mean age 36.2 years, admitted to a Department of Medicine, between 1961 and 1979 with subacute infective endocarditis (SIE) were studied . Rheumatic heart valve disease was the predisposing lesion in 94% and the mitral valve was involved in about 80% of the cases . Diagnosis of SIE was confirmed by blood cultures in 66 patients and at autopsy on another 57 patients . The rheumatic symptoms and signs (RSS) considered were: arthralgia, rachialgia, arthritis, myalgia and Osler's nodes . RSS showed up in 50 (25%) of the subjects and arthralgias were the most frequent (12.5%) . There were no significant differences between the 50 RSS patients and the other patients, regarding bacteriological and other laboratory data, including immunoglobulins . RSS patients were significantly younger (P less than 0.001) . Out of the 200 patients, 71 (35.5%) died . Eight (16%) of these were in RSS subgroup of 50 patients . Presence of RSS did not worsen prognosis in our patients . Septic bone metastasis was not identified.

Jpn J Antibiot, 1984 Oct, 37(10), 1939 - 55
{Fundamental and clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology}; Cho N et al.; A combination of sulbactam, a beta-lactamase inhibitor, plus cefoperazone (SBT/CPZ = 1/1) was studied in the field of obstetrics and gynecology, and the results were following: Absorption and transfer into genital organ tissues were good . With the 1g intravenous injection the maximum serum concentrations in the uterine artery were 88.6 micrograms/ml for CPZ and 50.0 micrograms/ml for SBT, and the maximum tissue concentrations were 12.2-17.4 micrograms/g for CPZ and 9.8-21.4 micrograms/g for SBT . When the 2 g was administered, the maximum tissue concentrations were 11.9-26.7 micrograms/g for CPZ and 6.0-8.0 micrograms/g for SBT . These elimination showed the similar trend as their serum levels, and their tissue levels were higher than MIC80 for the main organisms . Their penetration into the intrapelvic dead space exudate was also good and showed that the peak levels were 30.1 micrograms/ml for CPZ and 17.4 micrograms/ml for SBT at 2 hours after the 2 g intravenous injection . The peak levels of 34.4 micrograms/ml for CPZ and 8.8 micrograms/ml for SBT at 6 hours after 2 g intravenous drip infusion were obtained . Their elimination was slow, and the concentration higher than MIC80 for main organisms was maintained for a long period of time . For gyneco-obstetrical infections such as adnexitis, intrauterine, intrapelvic and external genital organ infections, a daily dose of 2-4 g of SBT/CPZ produced a 100% clinical efficacy in 10 patients and a 88.9% bacteriological effect . The eradication ratio was more than 80% against beta-lactamase producing organisms . Side effects were few . The above results indicated that SBT/CPZ was useful in the field of obstetrics and gynecology.

Jpn J Antibiot, 1984 Oct, 37(10), 1919 - 24
{Clinical and bacteriological efficiency of sulbactam/cefoperazone in gynecological infectious diseases}; Saito Y et al.; The combined antibiotics, sulbactam/cefoperazone (SBT/CPZ), was administrated intravenously to 10 patients with various kinds of gynecological infectious diseases and the efficiency of the drug was investigated clinically or bacteriologically . The results obtained were as follows . The clinical and bacteriological efficiency rate of SBT/CPZ on gynecological infectious diseases was determined as about 100 per cent and 75 per cent . Three species out of 11 isolated bacteria produced beta-lactamase . Two cases out of 3 beta-lactamase positive bacteria were disappeared in the materials obtained from the patients after the treatment of the drug . No remarkable side effect except for 1 buccal exanthema and 1 genital candidiasis was detected during the administration course of the drug.

Gut, 1984 Oct, 25(10), 1071 - 7
Comparison between the bacterial and oligosaccharide content of ileostomy effluent in subjects taking diets rich in refined or unrefined carbohydrate; Berghouse L et al.; Dietary surveys have shown that patients with Crohn's disease tend to eat more sucrose than control subjects and this investigation was undertaken to determine whether a diet rich in refined carbohydrate affects the bacterial flora of the terminal ileum . Ileostomy effluent in five patients with Crohn's disease and five with ulcerative colitis after two weeks on a diet rich in sucrose and refined cereal has been compared with the same period on a diet low in sucrose and rich in unrefined cereal . Observations were made hourly for nine hours after equicaloric breakfasts representing the two diets . The amount of ileostomy effluent was greater on the unrefined carbohydrate diet both in terms of wet weight (238 +/- 89 g vs 162 +/- 79 g, p less than 0.02) and dry weight (23 X 6 +/- 6.8 g vs 14.9 +/- 6.6 g, p less than 0.01); surprisingly, the amount of glucose and oligosaccharide was also greater (169 +/- 41 mg vs 82 +/- 26 mg, p less than 0.001) in all 10 volunteers . The bacteriological flora per gram was also higher on the unrefined carbohydrate diet after the test meal (p less than 0.02 between three and six hours) as a result of a general increase in all organisms . The relative proportions of the organisms did not vary between the two diets . No differences were detected between patients with ulcerative colitis and those with Crohn's disease.

Schweiz Med Wochenschr, 1984 Sep 22, 114(38), 1304 - 7
{Diagnostic value of cerebrospinal fluid analysis}; Steck AJ; The increasing importance of cerebrospinal fluid (CSF) analysis as a diagnostic tool in neurology is the consequence of major advances in neuroimmunology . Thus, immunological mechanisms are involved not only in acute infections of the CNS but also play a role in many subacute and chronic inflammatory diseases of the nervous system as well as in neoplastic disorders . CSF analysis is important to the clinician in providing clues for the detection of immune processes that are restricted to the brain . A wide variety of techniques, including cytological, bacteriological, virological and immunological methods, are now available as routine clinical laboratory tests . A few clinically relevant applications in study of the CSF are discussed.

Somat Cell Mol Genet, 1984 Sep, 10(5), 445 - 54
Isolation and partial characterization of lectin-resistant F9 cells; Draber P et al.; Cytotoxic plant lectins have been used for the single-step selection of mouse embryonal carcinoma cell mutants with altered expression of surface glycoconjugates . Following mutagenesis, several F9 and OTF9-63 cell lines resistant to the lectins from Triticum vulgaris or Ricinus communis were obtained . At least five distinct lectin-resistant (LecR) phenotypes have been identified on the basis of their relative sensitivities to four different plant lectins and their altered lectin-binding properties . None of the mutant types exhibits a significant change in the ability to bind a monoclonal antibody against the stage-specific embryonic antigen, SSEA-1 . All of the mutants form aggregates when cultured in bacteriological petri dishes and appear to differentiate into endoderm-like cells following exposure to retinoic acid . However, two of the LecR cell lines exhibit an altered morphology when grown on a plastic substratum.

Yale J Biol Med, 1984 Sep-Oct, 57(5), 737 - 41
Diagnostic virology laboratory within a microbiology setting; Rubin SJ; The virology section at St . Francis Hospital and Medical Center, Connecticut, is not a separate laboratory division but is a part of the microbiology division and is supervised by the same personnel who supervise bacteriology, mycology, mycobacteriology, and serology . Current volume is over 1,000 cultures yearly with 12 to 24 percent positive . Isolates are confirmed and typed by the Connecticut State Health Department Laboratory . Specimen distribution, percentage positive specimens, and distribution of viral isolates are similar to those reported from microbiology laboratories with separate virology laboratories directed by a full-time doctoral-level virologist . Our seven years' experience demonstrates that a microbiology laboratory without a full-time doctoral-level virologist can provide clinically useful virologic information.

Southeast Asian J Trop Med Public Health, 1984 Sep, 15(3), 317 - 22
A simple and rapid diagnostic test for typhoid fever; Tantivanich S et al.; Barber protein sensitized latex particles were used in the latex agglutination test for the diagnosis of typhoid fever and the result compared with that of Widal 'O' and 'H' agglutination test . The latex agglutination test was positive in all 20 bacteriologically proved typhoid patients, in 81 of 85 (95.3%) typhoid suspected patients, and only in 2 of 85 (2.3%) blood donors . In contrast, the positive rates were 60% for both 'O' and 'H' Widal agglutinations in bacteriologically proved typhoid patients, 34.2% and 71.7% respectively in typhoid suspected patients, and none of blood donors were positive . The sensitivity and specificity of the latex agglutination test were 100% and 97.6% respectively with positive and negative predictive values of 90.9% and 100% respectively . The latex agglutination test may be particularly useful for the presumptive diagnosis of typhoid fever in remote health centres.

J Assoc Off Anal Chem, 1984 Sep-Oct, 67(5), 942 - 5
Comparison of helium leak test and vacuum leak test using canned foods: collaborative study; Rhea US et al.; Two can leak tests were compared by 7 collaborators . In the helium leak test, pressurized helium is applied to the outside of the container, and a headspace gas sample from the can is then analyzed for the presence of helium . The vacuum test is described in the Bacteriological Analytical Manual . Ninety No . 303 cans of creamed-style corn, green beans, carrots, fruit cocktail, and whole-kernel corn were shipped in 3 groups . Two groups of 30 cans had 10 dented flat cans, 5 flat controls (nondented), 10 dented swollen cans, and 5 swollen control cans (nondented) . The third group had 10 dented swollen cans and 5 swollen control cans . Of 600 cans analyzed, 37 (6.2%) were deleted from the analysis because results were not available for both tests . One laboratory was constrained by scheduling to analyze 15 of 45 swollen cans . The helium leak test found 12 (13%) positives of 92 nondented swollen cans . One pressurization test yielded 7 of those 12 positives . Of the 400 dented cans sent as possible leakers, the helium test found 267 positives, and the vacuum test found 181 . Five of the 7 analysts had significantly (alpha = 0.05) higher percent positive helium results . One analyst found more leakers by the vacuum leak test . Both tests found fewer positives in the swollen dented cans than in the flat dented cans . After exposure to pressurized helium, all cans with greater than 8 psi headspace pressure were positive helium leakers . The method was adopted official first action.

Anaesthesist, 1984 Sep, 33(9), 433 - 9
{Long-term experiences with continuous peridural opiate analgesia with an implanted pump}; Muller H et al.; Continuous epidural opiate analgesia with an implantable, percutaneously refillable pump was induced in 6 patients with chronic pain of malignant origin . The efficacy of this method was compared with that of on-demand bolus-injections of epidural opiate . Side-effects and development of tolerance were not observed during a more than one year period of treatment . Increased daily doses for some days were only necessary in case of additional pain sources, e.g . induced by an intermediate operation . There were no hygienic problems (bacteriologic investigations) or problems due to technique of implantation (localisation of the implant, stability of the fixation, patency of the catheter) . Examination of post mortem explanted pumps (determination of the flow rate, inspection for precipitation within the pump, testing of permeability of filters) and catheters (electron microscopy, testing of the material for surface conditions, tensile strength and elongation) as well as histological findings for local compatibility did not reveal adverse reactions after long-term treatment . Indications for this new method of pain treatment were established.

South Med J, 1984 Sep, 77(9), 1133 - 5
Bacterial colonization of amniotic fluid in patients with intact membranes during labor; Apuzzio JJ et al.; Amniotic fluid from gravidas with intact membranes was obtained for bacteriologic culture at the time of cesarean section . The incidence of positive cultures from patients not in labor was 8% . When the length of labor was eight hours or less (mean 6.1 hours) and the membranes were intact, the incidence of positive cultures was 37%; in patients whose length of labor was 12 hours or less (mean 9.7 hours) with intact membranes, 55% of cultures were positive . The incidence of endomyometritis in patients with bacterial growth from the amniotic fluid cultures in each group was 33%, 33%, and 45%, respectively.

J Epidemiol Community Health, 1984 Sep, 38(3), 253 - 8
Pulmonary tuberculosis among contacts of patients with tuberculosis in an urban Indian population; Kumar RA et al.; The study was conducted among 1810 contacts of 50 index "cases"/"suspects" of pulmonary tuberculosis including 312 household and 1498 neighbourhood contacts in the Jhansi city of Uttar Pradesh . The overall prevalence of radiologically active and bacteriologically confirmed tuberculosis was 2.9% and 1.1% . The prevalence rates of radiologically active and bacteriologically confirmed disease, although comparatively high in both the contact groups, were significantly higher in household (5.4% and 2.6%) than in neighbourhood contacts (2.3% and 0.8%) . Significant differences in distribution of secondary cases among clusters were observed . Although higher prevalence rates were found in contacts of sputum positive source than in contacts of sputum negative source in both the contact groups, the statistical difference was observed to be insignificant . Case yield among contact symptomatics was 80.0% (30.8% cases and 49.2% suspects).

Clin Radiol, 1984 Sep, 35(5), 343 - 5
Ultrasonic appearances associated with prostatic inflammation: a preliminary study; Griffiths GJ et al.; Per-rectal ultrasonography was performed on 40 patients in whom a diagnosis of prostatitis had been made on the basis of symptoms and signs of prostatic inflammation confirmed by bacteriology, microscopy or pH changes of expressed prostatic secretion . Certain ultrasonic features were present in all patients to a variable degree . A change in volume and weight of the prostate could be an indicator of treatment response.

Antimicrob Agents Chemother, 1984 Sep, 26(3), 318 - 21
Ceftazidime as initial therapy for suspected bacterial infections in hospitalized pediatric patients; Reed MD et al.; Ceftazidime, a new beta-lactam antibiotic, was used to treat 60 children with suspected bacterial infections occurring outside the central nervous system . The patients ranged in age from 0.1 to 21 years and received 30 mg of ceftazidime per kg up to a total single dose of 1 g administered every 8 h . Fifty-three pathogens were isolated from 43 children before the initiation of therapy . All children responded clinically, although one child failed bacteriologically and five children were considered colonized at the end of ceftazidime therapy . Adverse reactions associated with ceftazidime administration were primarily alterations in laboratory parameters and were clinically insignificant . Ceftazidime administered on an 8-h dosing regimen is effective monotherapy for the treatment of childhood infections.

Am J Surg, 1984 Sep, 148(3), 301 - 2
Bacteriologic evaluation of electric clippers for surgical hair removal; Masterson TM et al.; Clipper blade assemblies for electric clippers used repeatedly without sterilization demonstrated high levels of bacterial contaminations that are potential sources of infection . A technique of sterilization of the clipper blade has been reported that eliminates the exogenous bacterial contamination.

Obstet Gynecol, 1984 Sep, 64(3 Suppl), 30S - 33S
Recurrent idiopathic fetal hydrops: results of prenatal therapy; Seeds JW et al.; A case of nonimmune hydrops recurring within a sibship is reported . Progressive severe fetal ascites and hydramnios at 31 weeks' gestation led to fetal paracentesis for both therapeutic and diagnostic purposes . A successfully placed indwelling peritoneal-amniotic diversion shunt functioned well but became dislodged, and rapid recurrence of ascites and hydramnios required two subsequent drainage procedures . Neonatal death occurred from pulmonary failure after delivery at 34 weeks' gestation, as had happened in the similarly affected sibling . Amniotic and fetal peritoneal pressures, biochemical analysis, and bacteriologic studies of fluid samples are reviewed . Although this experience adds to the knowledge of fluid dynamics in fetal ascites and hydramnios, it does not clearly support or refute such therapy in the care of fetal hydrops from nonimmunologic causes . Management issues are discussed.

J Theor Biol, 1984 Aug 21, 109(4), 475 - 8
Hypothetical entropy-driven mechanism for self-regulation of the size and division of primitive cells, suggesting the origin and nature of mesosomes; Douglas J; It is proposed that, when a critical cell radius was reached, spontaneous invaginations caused by adhesion of adjacent nodes in membranes rippled by Brownian bombardment, became progressive due to re-orientation of self-seeking molecules . Some circumstantial bacteriological evidence is adduced; the significance of mesosomes is discussed.

Cancer, 1984 Aug 15, 54(4), 734 - 8
A controlled trial of prophylactic granulocyte transfusions during induction chemotherapy for acute nonlymphoblastic leukemia; Gomez-Villagran JL et al.; Thirty-five noninfected patients undergoing induction chemotherapy for acute nonlymphoblastic leukemia (ANLL) were randomized to either receive (19 patients) or not receive (16 control patients) prophylactic granulocyte transfusions (PGT) when their granulocyte count fell below 0.5 X 10(9)/1 . Both groups received identical anti-infectious and supportive care except for granulocyte transfusions . The authors found a nonstatistically significant decrease of the infection rate in the prophylactic group . However, the bacteriologically documented infections and septicemia incidence was significantly higher in the control than in the prophylactic group (P less than 0.05) . In the control group they observed in 8 of 16 cases life-threatening infections in contrast with only 1 case in the prophylactic group (P less than 0.01) . A significant reduction of deaths due to infectious causes in the prophylactic versus control group were also found (P less than 0.05) . The authors did not find an increase of pneumonia or pulmonary infiltrates in the patients belonging to prophylactic in comparison to control group.

Unfallchirurgie, 1984 Aug, 10(4), 168 - 72
{Perioperative antibiotic therapy--clinical experiences with a combination of mezlocillin/sisomicin in accident surgery}; Lais E; The clinical and bacteriological efficiency of the combination Mezlocillin and Sisomicin was studied in 25 patients from the Department of trauma . In 9 cases the combination of antibiotics was used for treatment of manifest infections . 16 patients received a prophylaxis before and after operation . Among them were patients with open fractures, with a large soft tissue damage, polytraumatized patients with multiple injuries or patients with pathological fractures . Dosage of Mezlocillin was 4 g every 8 h, and dosage of Sisomicin was 75 mg every 8 h . Mean duration of therapy was 6 days . In 24 cases the combination of antibiotics was successful . In one case occurred a postoperative haematoma without bacterial findings . In all infections (9 cases) isolated germs were achieved with the combination Mezlocillin and Sisomicin.

Vet Med (Praha), 1984 Aug, 29(8), 479 - 87
{The effect of apramycin on bacterial contamination and the survival of boar semen during a short preservation period}; Kozumplik J et al.; 264 ejaculate samples taken from seven boars were tested for the bacteriostatic action of apramycin and for its effect on some sperm quality parameters during 96-hour storage . Apralan soluble powder, produced by Elanco Products Limited, was used in the trials at the concentrations of 2.5 to 500 mg per 1000 ml of diluent . The preparation was evaluated according to sperm motility during storage, according to the concentration pattern of hydrogen ions, morphological changes in spermatozoa, thermoresistance test, bacteriological tests and other examinations . The concentrations of 200 to 250 mg of apramycin in combination with 500 000 i . u . of G-penicillin potassium salt had a statistically significantly more favourable effect on the survival of boar sperm, as compared with the combination of streptomycin with penicillin.

Surg Clin North Am, 1984 Aug, 64(4), 639 - 52
Closure of contaminated wounds . Biologic and technical considerations; Tobin GR; The current knowledge in the field of wound bacteriology and host resistance to wound infection is summarized . This knowledge provides specific measures to increase the success rate of primary wound healing in contaminated wounds that must be closed.

Am Surg, 1984 Aug, 50(8), 418 - 23
Single dose cefuroxime/metronidazole versus metronidazole alone in elective colorectal surgery; Mittermayer H et al.; Sixty assessable patients undergoing elective colonic and rectal surgery were randomly allocated to receive prophylaxis with a combination of 1.5 g cefuroxime plus 500 mg metronidazole or 500 mg metronidazole alone as single doses by the intravenous route, given at the beginning of anesthesia . The two groups were matched for age, sex, malignancy, and type of operation . Primary wound infections were observed in one patient (3.7%) in the combination group and six (18.2%) in the group given metronidazole alone . This trend was not statistically significant . Bacteriologic examination of the anastomoses, abdominal walls, and wounds showed significantly more sterile cultures in the combination group, although more aerobic cefuroxime-resistant isolates were seen in this group . There is no evidence that the emergence of resistant strains had any influence on the outcome of patients in the study . It was concluded that an appropriate antibiotic prophylactic regimen for colorectal surgery should be directed against aerobic and anaerobic organisms . Cefuroxime plus metronidazole is an effective regimen for the prevention of postoperative infection.

Boll Ist Sieroter Milan, 1984 Jul 31, 63(3), 237 - 43
{The diagnosis of leptospirosis in the hospital microbiology laboratory}; Cacciapuoti B; Confirmatory diagnosis of clinical leptospirosis may be achieved by each hospital laboratory performing all-purpose bacteriological methods . Direct microscopic examination of blood may frequently demonstrate circulating leptospiras in the first few days of pyrexia . Leptospiras may be tentatively cultured from blood in the same initial period of illness, in fluid semisynthetic commercial media according to the original Ellinghausen medium . Sero-conversion for leptospira antibodies is constantly observed on two serum samples taken in the first few days of illness and ten days thereafter respectively, in each case of current leptospirosis.

J Comput Tomogr, 1984 Jul, 8(3), 225 - 9
Fibrobullous disease of the upper lobes: an extraskeletal manifestation of ankylosing spondylitis; Rumancik WM et al.; Fibrobullous disease of the upper lobes of the lungs is a rare extraskeletal manifestation of ankylosing spondylitis, occurring in 1.3% of patients with ankylosing spondylitis . We present a patient with this disease, and discuss this pulmonary manifestation . Because the radiographic appearance of the chest in this disease resembles that in tuberculosis, many patients are misdiagnosed and treated for tuberculosis despite negative bacteriology . Computed tomography is useful in delineating the extent of pleural thickening, bullous changes, volume loss, parenchymal fibrosis, and bronchiectasis, as well as identifying or excluding an intracavitary pulmonary mycetoma.

Am J Clin Pathol, 1984 Jul, 82(1), 78 - 84
Workload, space, and personnel of microbiology laboratories in teaching hospitals; Elin RJ et al.; The resources needed to operate a microbiology laboratory are known only as rough approximations . In order to gather more information about these resources, a 13-page questionnaire was completed by 50 pathology departments, of which 38 departments provided adequate information about their microbiology sections to permit data analysis . This study reports the results for resource and work load factors and significant regression analyses among these factors for the whole microbiology section and the subsections of aerobic bacteriology, anaerobic bacteriology, mycobacteriology , mycology, parasitology, virology, and antibiotic sensitivity . These data provide a basis for evaluating the current needs of microbiology laboratories and for making projections for the future.

Indian J Lepr, 1984 Jul-Sep, 56(3), 600 - 14
Incidence rates of leprosy among household contacts of "primary cases"; Jesudasan K et al.; The data consisted of information from 1,564 "Primary cases" of leprosy of all classification and 9,162 of their household contacts . Household contacts of Indeterminate (Ind), Borderline (BL) and Lepromatous (LL), "Primary case" (PC) had an incidence rate (IR) of 5 per 1000 person years of risk (PYR) . Household contacts of Tuberculoid (TT) and borderline tuberculoid (BT) patients had an IR of 3.2 and 3.8 per 1000 PYR respectively . Compared with an incidence rate of leprosy of 1.6 per 1000 PYR among individuals not exposed to leprosy in the same area, household contacts of Non-lepromatous patients had a relative risk of twice as high and contacts of lepromatous and borderline lepromatous patients a relative risk of 3 times as high . The incidence rate was higher among household contacts of bacteriologically positive patients, among contacts closely related and in households with multiple cases . The peak age specific incidence rate among household contacts was between the ages 5-9 years of age . The significance of these findings are discussed.

Urologe A, 1984 Jul, 23(4), 189 - 93
{Principles of drug therapy in urogenital tuberculosis}; Jungbluth H; Every case of tuberculosis must be treated with drugs, especially before and after operative interventions . The therapeutic regimen consists of four different drugs, always including Isoniazid and Rifampicin . The length of treatment should be 7-12 months depending on the type of medication used . Most important for a successful treatment is the isolation of the mycobacterium before starting therapy according to the sensitivity testing . The effectiveness of therapy has to be controlled monthly by bacteriologic examinations . During the whole period regular examinations of the patient are necessary for the early detection of side effects.

Dis Colon Rectum, 1984 Jul, 27(7), 451 - 3
A controlled trial of a plastic wound ring drape to prevent contamination and infection in colorectal surgery; Nystrom PO et al.; A controlled, randomized study of the efficacy of a plastic wound ring drape (Opdrape, Triplus) to prevent contamination and infection in elective colorectal operations is reported . Seventy patients were operated upon with the wound ring drape and 70 patients without . All patients received preoperative systemic antibiotic prophylaxis . Abdominal wound infection was observed in seven of 70 (10 per cent) patients with the wound ring drape and six of 70 (9 per cent) without (N.S.) . An operative swab for bacteriologic evaluation was obtained from 85 per cent of the wounds . There was no evidence that the drape protected the wound from contamination with intestinal bacterial flora . It was concluded that the wound ring drape prevents neither contamination nor infection.

J Leukoc Biol, 1984 Jul, 36(1), 39 - 50
Superoxide generation by neonatal and adult rabbit alveolar macrophages; Sherman MP et al.; We compared the abilities of alveolar macrophages (AM) from neonatal and adult rabbits to generate and release superoxide (O2-) after exposure to soluble and particulate stimuli . Basal rates of O2- release, 0.1-0.2 nmol/10(6)AM/10 min, were modestly increased by exposing AM to phorbol myristate acetate, (dihydro)cytochalasin B, or cytochalasin C . Opsonized zymosan was a more effective stimulus, and maximal rates of O2- release were observed when AM were stimulated by a combination of opsonized zymosan and one of the aforementioned cytochalasins . Cytochalasins D and E were each potent activators of O2- production by AM in the absence of additional stimuli . Adult AM released 24.8 +/- 6.0, 20.4 +/- 4.4, and 33.5 +/- 6.4 nmol O2-/10(6)AM/10 min after stimulation by cytochalasin D, cytochalasin E, and dihydrocytochalasin B plus opsonized zymosan, respectively . Following exposure to the same stimuli, AM from 1, 3- and 7-day-old rabbits released O2- at rates that ranged from 45 to 75% of corresponding adult values . The discrepancy between O2- production by neonatal and adult AM was accentuated when comparisons were restricted to AM recovered from bacteriologically sterile respiratory tracts . Our data show the O2- generating capacity of neonatal AM to be substantially less than that of the adult AM . Immaturity of this response could predispose neonates to pulmonary infection.

Z Hautkr, 1984 Jul 1, 59(13), 894 - 901
{Treatment of gonorrhea with spectinomycin and penicillin}; Backhaus A et al.; In an open clinical trial, spectinomycin and penicillin G were compared with regard to clinical efficacy, side effects, as well as bacteriological sensitivity in patients suffering from acute gonorrhea . The study was concerned with 176 female patients of a harbor medical practice who were frequently changing partners . 87 out of these patients were treated with spectinomycin, 89 of them with penicillin G . Smear specimens of all patients were tested microscopically; in addition, we performed bacteriological tests (as agar diffusion test, tube dilution test, beta-lactamase test) . Both spectinomycin and penicillin showed a good clinical efficacy, except for one case of resistance against penicillin . Afterwards, this patient was successfully treated with spectinomycin . Apart from intermittent pain in the injection area, no side effects have been reported in either group of patients.

Gut, 1984 Jul, 25(7), 723 - 7
Mutagenicity in gastric juice; Morris DL et al.; Mutagenicity has been measured in the gastric juice of 228 patients using the Ames bacteriological test system; while mutagenicity in control and duodenal ulcer patients did not differ from saline controls, mutagenicity was significantly increased compared with controls in patients suffering gastric ulcer (p less than 0.002), carcinoma (p less than 0.002), and in patients after gastric resection (p less than 0.01) . A transient rise in mutagenicity was seen following H2 antagonist ingestion (p less than 0.002) . Increased levels of mutagenicity were found to correlate closely with gastric juice pH and bacterial count . Histidine concentrations in gastric juice did not explain the mutagenicity results.

Pediatrie, 1984 Jul-Aug, 39(5), 379 - 83
{Role of fibrinogen among the inflammatory proteins in neonatal infections}; Relier JP et al.; The increase of the fibrinogen level appears to be an important feature in the neonatal infection as well for diagnosis as for prognosis . Levels above 3,50 g per liter during the first days after birth is in favor of bacterial materno-foetal infection and will return to normal in the next 3 days after antibiotics therapy . Conversely high fibrinogen levels persist as long as the infection remains active and must be an indication to modify antibiotics prescription even when bacteriological results are not known.

S Afr Med J, 1984 Jun 16, 65(24), 951 - 3
Concomitant and secondary bacterial infection of the pus in hepatic amoebiasis; Gathiram V et al.; In a series of 48 consecutive patients with clinically diagnosed uncomplicated amoebic liver abscess (ALA), the pus obtained by closed drainage of the abscess was bacteriologically sterile . Secondary bacterial infection of the ALA as a direct result of the aspiration procedure occurred in only 1 patient, the causative organism being Escherichia coli . Entamoeba histolytica was identified in a total of 39 cases (81%) by means of direct microscopy of the pus as well as culture methods.

J Pediatr Gastroenterol Nutr, 1984 Jun, 3(3), 364 - 7
Breath hydrogen test in infants and children with blind loop syndrome; Nose O et al.; Breath hydrogen production after oral lactose loading was examined in infants and children with stagnant loop syndrome, blind loop syndrome, or both . All six infants under 3 years of age had bacteriological evidence of small intestinal colonization . The characteristics of the breath hydrogen test in this syndrome are: (a) extremely high basal excretion of breath hydrogen (after overnight fasting); (b) an earlier and greater breath hydrogen value (0.293 +/- 0.201 ml/min/m2: mean +/- SD) after oral lactose administration than formed in lactose malabsorption alone (0.050 +/- 0.041 ml/min/m2); and (c) the observation of a sustained hydrogen rise over several hours . This investigation demonstrated that the breath hydrogen test is a promising and noninvasive tool for diagnosing blind (or stagnant) loop syndrome.

South Med J, 1984 Jun, 77(6), 777 - 9
Legionnaires' disease with rhabdomyolysis and acute reversible myoglobinuric renal failure; Johnson DA et al.; We have described a patient with rhabdomyolysis, myoglobinuria, and acute reversible renal failure . Serologic studies were diagnostic for legionnaires' disease and were negative for other viruses associated with rhabdomyolysis . Bacteriologic cultures were also negative, and other nontraumatic causes of rhabdomyolysis were ruled out . No other causes of acute reversible renal failure were found . With a clinical picture of pneumonia, rhabdomyolysis, myoglobinuria, and acute renal failure, legionnaires' disease should be considered in the differential diagnosis and appropriate antibiotic therapy instituted.

J Pediatr, 1984 Jun, 104(6), 869 - 72
C-reactive protein as a detector of organic complications during recovery from childhood purulent meningitis; Peltola H et al.; Twenty-eight bacteriologically proved episodes of purulent meningitis in 27 infants and children were monitored prospectively with sequential determinations of serum C-reactive protein . Except in one rapidly fatal case, all the patients showed decreasing CRP values for about 1 week . In five patients the CRP values than returned to a high level (P less than 0.001) . Each of these patients developed an organic complication (subdural effusions in three, transient widening of the ventricles in one, purulent arthritis with osteomyelitis in one) . Except for one infant with sensorineural hearing loss, which probably had developed early in the course of meningitis, no permanent sequelae were found in the patients with uncomplicated courses . One infant later had a relapse of Escherichia coli meningitis, reflected in a sharp increase of CRP . We conclude that sequential CRP measurements may be performed routinely to detect potential complications at an early stage of bacterial meningitis.

Trop Geogr Med, 1984 Jun, 36(2), 127 - 32
A prospective study of the role of bacterial infection and G6PD deficiency in severe neonatal jaundice in Nigeria; Dawodu AH et al.; 109 Nigerian neonates with serum bilirubin of 12 mg% and above, who presented at the Children's Emergency Room of the University College Hospital, Ibadan between November 1980 and February 1981 were investigated for bacterial sepsis and other causes of hyperbilirubinaemia . A detailed history of exposure to drugs likely to be icterogenic was also taken . Of the 109 infants, 67 (62%) were G6PD deficient and 41 (67%) of the latter had no obvious cause for the precipitation of jaundice . However 106 (97%) of the jaundiced infants had been exposed to agents capable of causing haemolysis in G6PD deficiency; 24 (22%) had bacteriologically proven septicaemia and in only five (4.6%) was sepsis the sole cause of hyperbilirubinaemia . There was no significant differences in the frequency of bacteriologically proven sepsis between the infants with normal or deficient G6PD status . Septicaemia however significantly increased the severity of jaundice among G6PD deficient infants . This study suggests that infection is common in severely jaundiced Nigerian infants and there is a need to reassess the role of exogenous agents in the pathogenesis of neonatal hyperbilirubinaemia in our community.

Vet Med (Praha), 1984 Jun, 29(6), 321 - 8
{Experience with the use of Chronicin foam and Masticort PS in the nonselective treatment of milk cows during the dry period}; Vasil' M et al.; The effect of the non-selective treatment of dairy cows with antibiotics (Chronicin foam--Galena, and Masticort PS--Poland) and the effect of teat disinfection (Jodonal A--Lachema) at the last milking in lactation was studied as exerted on the reduction in the occurrence of infection processes in mammary gland after calving . The trials were performed with 180 cows in three groups of 60 animals . At the last milking the mammary secretion of each cow was sampled for bacteriological examination . Two cow groups were treated at the same time . The occurrence of infection processes in the mammary gland in the period after calving can be characterized as follows: a) in the period after calving the control group had an increased proportion of cows with an infection process in their udders (from 58.3% at the end of lactation to 68.3% in the period of 14 days following calving); b) in the group treated with Chronicin foam the infection was reduced by 3/5, i . e . from 71.7% of cows infected at the start of drying off to 28.3% with infection process after calving; c) in the group treated with Masticort PS the infection after calving was reduced by 3/4 as compared with the infection at the onset of drying off, i . e . from 80% to 20% . In the control group 20% of the cows recovered spontaneously . The preparation Chronicin foam showed 79.1% therapeutic effectiveness . Therapy with Masticort PS was successful in 81.3% of the animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Aust N Z J Med, 1984 Jun, 14(3), 223 - 6
Culture negative infective endocarditis; Abraham AK et al.; Twenty cases of culture negative infective endocarditis admitted to the Cardiology Department of Green Lane Hospital from 1959 to 1980 out of a total of 265 cases (7.5%), were analysed retrospectively . Cases were included only when adequate proof of endocarditis was available at surgery or postmortem . Indiscriminate use of antibiotics before taking blood cultures was the most common association with failure to obtain positive cultures, seen in 16 of the 20 patients described . Failure to obtain positive cultures in four cases was attributed to inadequate bacteriologic techniques before 1967 . Where no antibiotics were given prior to collecting blood cultures and bacteriologic techniques were adequate, proven culture negative endocarditis was virtually unknown . When antibiotics have been given, repeated blood cultures are recommended following withdrawal of antibiotic for at least four days.

J Radiol, 1984 Jun-Jul, 65(6-7), 477 - 80
{The Fitz-Hugh-Curtis syndrome . Apropos of an unusual hepatic ultrasonic aspect}; Saint D et al.; A 22 year old woman was diagnosed as having a Fitz-Hugh and Curtis syndrome (FHCS) or venereal perihepatitis during laparoscopy for investigation of pain in right hypochondrium and fever . Abdominal ultrasonography images presented an unusual appearance suggestive of a perihepatic effusion and of thickening of Glisson's capsule, lesions that were confirmed on laparoscopy . This ultrasound image could not be formally distinguished from a normal variant, but ultrasonography is still a valid method of diagnosis of FHCS . An acute cholecystitis in a young woman should suggest the diagnosis; absence of a right renal, hepatic or gallbladder anomaly should lead to investigation by ultrasound of the possible presence of an abdominal effusion of fluid and pelvic inflammation . Perihepatitis is confirmed on laparoscopy, which also allows sampling for bacteriologic and serologic tests to identify the causal germ: gonococcus and particularly Chlamydia trachomatis . Treatment consists of administration of specific antibiotics (ampicillin or doxycycline).

Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 604 - 6
{Comparison of 2 antiseptic soaps used for preoperative showers}; Enjalbert L et al.; This study was carried out in cardiovascular surgery wards and a single operating room . Two different antiseptic scrubs, A and B, were used for two showers given 48 and 24 hours respectively prior to surgery . A scrub (chlorhexidine digluconate 40 mg/ml) was used in 61 patients and B scrub (benzalkonium chloride 5 mg/ml) in 52, for a total of 113 participants . Clinical and bacteriological evaluations show statistically significant superiority of A scrub.

Int J Lepr Other Mycobact Dis, 1984 Jun, 52(2), 208 - 30
Metabolism in Mycobacterium leprae: its relation to other research on M . leprae and to aspects of metabolism in other mycobacteria and intracellular parasites; Wheeler PR; Recently, some knowledge of metabolic pathways, rather than individual enzyme activities of M . leprae, is becoming available . Ultimately this may be useful in devising culture media for M . leprae . Knowledge restricted to individual reactions may be misleading . For instance, the detection of GlcNacase and beta-glucuronidase and the subcellular localization of hyaluronic acid led to attempts to cultivate M . leprae on hyaluronic-acid based medium . Subsequent investigations suggested that there was no pathway for the breakdown of hyaluronic acid in M . leprae . The biochemical pathways for breaking down glucose and glycerol seem to be complete, and thus similar to many bacteria, but there is an unusually high level of one enzyme, 6-phosphogluconate dehydrogenase (6PGDH) . Although 6-phosphogluconate is oxidized by M . leprae, and this is an unusual activity, reflecting very high levels of 6PGDH, glycerol may be a preferable energy source (on the basis of rates of oxidation by suspensions) for M . leprae in attempts to cultivate the bacterium . The utilization of 6-phosphogluconate might be important for other aspects of M . leprae metabolism not yet investigated (e.g., pentose metabolism) or it may be an adaption, not needed in vitro, to its existence in host macrophages . Alternatively, its oxidation may be a way of rapidly generating NADPH at critical times for the bacterium . Other unusual activities which have been reported are the presence of an enzyme characteristic of chemoautotrophism , completely surprising in view of the biology of M . leprae . This report needs to be confirmed--some aspects, in fact, have failed to be confirmed . o-Diphenoloxidase activity is unique, among mycobacteria, to M . leprae, but there is still doubt over whether or not it is an enzymatic activity and its function is unknown . A transpeptidase which may be involved in cell wall synthesis, recently demonstrated in M . leprae, is a typical mycobacterial enzyme . It is now known that iron could be supplied to M . leprae in potential media in the form of ferriexochelin from M . neoaurum . Two "deletions" in the metabolic processes of M . leprae have been observed . Catalase appears to be absent in M . leprae; its addition to media stimulates the growth of some organisms since peroxides form in the bacteriological media . Purine synthesis de novo occurred at a very low rate compared with purine scavenging . Whether this is an adaption to growth in vivo is not known.(ABSTRACT TRUNCATED AT 400 WORDS)

Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 547 - 51
{Bacteriologic, clinical and kinetic evaluation of cefmenoxime (SCE 1365) in the treatment of 68 cases of septicemia . A multicenter trial}; Bryskier A et al.; Cefmenoxime (SCE 1365), a new broad-spectrum, third generation cephalosporin was used in the treatment of 68 patients with bacteremia . Cefmenoxime was given as monotherapy to 63 patients in a mean daily dosage of 3 g (range: 1 to 6 g) . 63 successes were recorded . Results were inconclusive in the remaining five cases . General and biological tolerance of cefmenoxime was excellent.

Boll Ist Sieroter Milan, 1984 May 31, 63(2), 165 - 6
Simultaneous infection with Legionella pneumophila and Legionella micdadei in an immunologically intact host . A case report; Fumarola D et al.; The Authors reported a case of dual infection with Legionella Pneumophila and Legionella micdadei in an immunologically intact host . The bacteriological and serological data are compatible with a simultaneous recent infection.

Biull Eksp Biol Med, 1984 May, 97(5), 542 - 4
{Disorder of the phagocytosis process in alveolar macrophages in thermal injury}; Vazina IR et al.; Bacteriological assay, cytochemical studies of succinate and malate dehydrogenases, acid phosphatase, glycogen and lipids, as well as electron microscopy were used in experiments on 75 rabbits to examine over time phagocytosis of alveolar macrophages and some mechanisms of its disturbance after burn trauma . It was established that the phagocytic function of alveolar macrophages gets disturbed shortly after trauma, remaining depressed up to the time of convalescence . It was demonstrated that the mechanism by which phagocytic function gets disturbed differs with time following trauma . Primary depression of phagocytosis occurs immediately after burn . At the height of burn disease the cells develop an energy deficient state, whereas the time of convalescence is marked by the emergence of poorly differentiated forms of macrophages having the reduced phagocyte capacity.

Clin Orthop, 1984 May, (185), 126 - 30
Charnley low-friction arthroplasty for the treatment of hips with late complications of femoral neck fractures; Turner A et al.; Two hundred five Charnley low-friction arthroplasties (LFA) were performed in 205 patients for late complications of femoral neck fractures . LFA was an excellent procedure for relieving pain and restoring function with a good range of movement . The deep infection rate was 3.9% . A detailed analysis of the patients with infection showed a high incidence of previous superficial wound infection or positive bacteriologic culture swabs obtained from the wound at the time of LFA.

J Chir (Paris), 1984 May, 121(5), 347 - 53
{Aorto-enteric and paraprosthetic fistulas . Apropos of 5 cases}; Glock Y et al.; Five cases of aorto-enteric fistula (AEF) are reported . The first case was a primary AEF from rupture of the infrarenal section of the abdominal aorta treated successfully by an obliteration and graft . The second patient had a primary AEF from rupture of an abdominal aorta aneurysm, complicated after an obliteration and graft of the primary AEF, requiring excision of the graft and an extra-anatomical shunt (EAS): healing following parenteral hypernutrition . The third case, a patient with a primary AEF from rupture of an aortic adventitial cyst in the left colon, died from septic complications . The fourth case died with heart rhythm disorders on the 4th day after resection and EAS for an aortic fistula . The fifth patient had a secondary AEF with cataclysmic digestive hemorrhage: excision of the graft with digestive closure and aortofemoral bypass did not prevent a fatal outcome on the 20 th day . Digestive hemorrhage and septic signs may be combined or occur as isolated complications . The most valid complementary investigation is fibroscopy, bacteriological culture of arterial blood distal to the prosthesis having an orientation value . Ultrasound, computed tomography or Gallium scintigraphy imaging may detect a retroperitoneal abscess . Effective treatment of all aneurysms can prevent primary AEF and avoidance of infection and interpositioning of viable tissue between duodenum and anastomotic line reduce the risk of secondary AEF . Maximum chances of success require aggressive surgery: aortic ligature; excision of all septic material and duodenal closure or segmental digestive resection with discharge of proximal pocket . Lower limb ischemia is treated by insertion of an EAS.

J Bone Joint Surg Br, 1984 May, 66(3), 326 - 30
Bone and joint tuberculosis . A survey of notifications in England and Wales; Davies PD et al.; Of the 4172 patients in a survey of all cases of tuberculosis notified in a six-month period in England and Wales in 1978-79, 198 had a bone or joint lesion; 79 were white and 108 were of Indian subcontinent (Indian, Pakistani or Bangladeshi) ethnic origin . The estimated annual notification rates for orthopaedic tuberculosis were 29 per 100 000 for the Indian subcontinent group and 0.34 per 100 000 in the white group, a ratio of 85 to 1 . Rates increased with age in both groups . The spine was the most common site, and was affected in 30% of the white patients and 43% of the Indian subcontinent patients; the distribution of other sites was similar in both groups . Positive culture from a bone or joint lesion was obtained in 99 (50%) of the 198 patients (58% of white patients and 47% of the Indian subcontinent patients) . Bacteriological or histological confirmation of tuberculosis either from a bone or joint lesion or from another site was obtained in 68% of the patients . Mycobacterium tuberculosis was isolated from the orthopaedic lesions in 79 of the 82 patients with identification test results and M . bovis in the 3 remaining patients . Of the 61 patients with M . tuberculosis and with no history of previous chemotherapy, 5 had resistant strains compared with 1 of the 18 patients who had previously received chemotherapy . All 6 patients with resistant strains were of Indian subcontinent ethnic origin.

Monatsschr Kinderheilkd, 1984 May, 132(5), 270 - 3
{Collection and bacteriologic quick testing of the milk of mothers with premature infants}; Matthaei S et al.; Collecting milk from mothers of preterm infants and feeding it unprocessed to their own babies has been tested . Mothers were instructed by protocoll and by intensive personal informations . Unprocessed human milk samples were bacteriologically screened by Uricult-dip-slides . 69% of 2,261 milk samples examined showed a total colony count of less than or equal to 10(4)/ml and no growth of gramnegative bacteria . These samples could be given unprocessed to the preterm infants . No side effects have been noticed . Bacteriological criteria for feeding unprocessed human milk are discussed in the paper.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 May, 179(2), 130 - 8
{Evaluation of the use of bioindicators of spore-containing soil for the evaluation of steam sterilization in general practice conditions}; Bergmann HJ; In this publication quantitative researches on the use of so-called spore-containing earth for monitoring steam-sterilization are described . The three factors necessary for medical steam-sterilization - the correct combination of saturated steam, temperature and time - cannot kill all the spores in their original earth . The surviving of single spores in native earth after steam-sterilization is of use to the calculation of the resistance of spore-containing earth by saturated steam at 121 degrees C (250 degrees F) . Besides the resistance depends on the conditions under which the earth was tested for surviving germs . The relative frequency of sterile samples after steam-penetration (Po) was utilized for the calculations of characteristic lines according to the transformation in y = lg ( - ln Po) The quantity of the germs killed (G) was exactly computed by the integration of steam-temperature and the time of penetration according to the equation G = fk X dt The quantities of k were calculated and they are discovered in Table 1 . A charge of spore-containing earth only then will be suitable for monitoring steam-sterilization if its characteristic line fulfils the requirements of DIN 58946, part 4, October 1978 . The evaluations demonstrate that it is necessary to adapt the samples of spore-containing earth to specific conditions of incubation . The tests carried out show that native earth as bioindicator is well suited for monitoring steam-sterilization by a bacteriological laboratory (Fig . 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 May, 179(2), 112 - 24
{A simple wash technic for the recovery of test pathogens in the evaluation of surface disinfection procedures}; Koller W; Methods currently recommended for quantitative bacteriological sampling of surfaces usually suffer from either unreliable results (plain swabbing techniques and contact cultures) or high expenses in terms of material, equipment and/or labour (rinse techniques using sampling fluids) . Therefore, a modified swab-rinse technique (SRT) was devised as a reasonably precise and simple alternative: A small amount of sampling fluid (1.5 ml), which can contain neutralisers, is transferred onto the flat surface under investigation; with this fluid and a pre-moistened small cotton-swab an area of 3 cm diameter is thoroughly washed for 15 s . Then 0.1 ml- and 0.5 ml-amounts of the washliquid are collected with automatic microliter pipettes and transferred and spread onto Casein-Soy-Agar for enumeration . In parallel experiments with contact cultures (rodac plates), the new SRT up to 3000 cfu per sample exhibited a linear answer to increasing inocula of E . coli on tiles (Fig . 1, rings) . Rodac-plates proved to possess a rather limited span of reliable counts: above 100 colonies, increasing numbers of bacteria were prevented from forming distinguishable colonies (Fig . 1, dots and +es); thus, colony counts higher than 100 on rodac plates cannot be expected to be true estimates . In addition, in the higher count range the results of a common, simplified counting technique differed markedly from results of true counts (Fig . 2) . Both methods were equally sensitive in detecting low counts of bacteria (Fig . 1, Fig . 3) . Shake-rinse techniques using high volumes of sampling fluid provide lower sensitivity than contact cultures or the new SRT: The use of 100 ml of sampling fluid (15) and plating of 0.1 ml- or 1.0 ml-aliquots of sampling fluid keeps the threshold for detection of bacteria as high as 1000 and 100 per sample, respectively (Fig.3); nevertheless, sensitivity of shake-rinse techniques can be increased by filtration of the whole sample . Thus, the new swab-rinse technique combines several advantages: wide span of true estimates since washliquid can be diluted for enumeration of high counts; high sensitivity ( = ability to detect small numbers of testbacteria in sample) since about one half of the sample is plated; good recovery of testbacteria from both smooth and coarse surfaces; simplicity; the new swab-rinse technique requires basic laboratory equipment and ordinary media and no shaking- or filtration devices; option for immediate and strong neutralisation of disinfectant residues; the sampling fluid can contain any neutraliser; option for automated colony counts since any kind of petri-dishes can be used for culture.

South Med J, 1984 May, 77(5), 579 - 83
Secondary bacterial peritonitis in cirrhotic patients with ascites; Caralis PV et al.; Bacterial peritonitis in patients with cirrhosis has a wide variety of clinical presentations . We report a group of 21 cirrhotic patients with secondary peritonitis from intra-abdominal sources . Seven had infected ascites . All of them had unrecognized secondary peritonitis which was diagnosed and treated as spontaneous (primary) bacterial peritonitis (SBP) . Ascitic fluid analysis yielded a mean white blood cell count of 23,750 +/- 10,935/cu mm with 91.5% polymorphonuclear leukocytes, significantly higher than patients surveyed with SBP, 1,757 +/- 2,154/cu mm (P less than .001) . Ascitic fluid protein levels were also higher than those typically seen in SBP: 4.4 +/- 1.5 gm/dl vs 0.8 +/- 0.4 gm/dl (P less than .001) . The ascites: serum protein ratio was consistent with an exudate in those patients with secondary peritonitis (0.7 +/- 0.2) in contrast to typically infected transudate in patients with SBP (0.15 +/- 0.05) (P less than .001) . Bacteriologic determination was similar: single organisms with Escherichia coli the most common . Often the clinical features and ascitic fluid analysis will not differentiate spontaneous from secondary peritonitis . It is, therefore, clinically prudent to consider secondary bacterial peritonitis in cirrhotic patients, especially with ascitic fluid WBC counts in excess of 5,000/cu mm and protein levels of greater than or equal to 2.5 gm/dl . Noninvasive diagnostic procedures should be included to search for sources of intra-abdominal infection.

Lancet, 1984 Apr 21, 1(8382), 868 - 71
Imipenem/cilastatin versus gentamicin/clindamycin for treatment of serious bacterial infections . Report from a Scandinavian Study Group.
{Endoscopic exploration of the small intestine}
Mainguet P, Debongnie JC, Crinquette JF, Bekri L.

The development of Japanese enteroscopes, mot of which are still prototypes, has made it possible to explore the entire small bowel . These instruments are either introduced into the jejunum like an ordinary endoscope, or pushed along a guidewire, or weighted with mercury, like a Miller-Abbott probe . A simplified study of the adult malabsorption syndrome can be performed by proximal jejunoscopy, usually carried out in Europe with a paediatric colonoscope . Perendoscopic forceps biopsy of the jejunum can replace probe sampling and is well suited to measurements of disaccharidase activity . In cases with "blind loop syndrome", bacteriological examination of the intestinal juice, endoscopically collected in sterile conditions, usefully supplements the visual and bioptic information . Since several investigations can be performed during one single enteroscopic examination, this method will be increasingly used in the study of small bowel diseases.

Can J Ophthalmol, 1984 Apr, 19(3), 134 - 41
Ocular effects of water from acidic lakes: an experimental study; Basu PK et al.; The purpose of this experimental study was to determine the effects on the conjunctiva and cornea of eyes exposed to water from acidic lakes in comparison with water from lakes having a nearly neutral pH . One eye each of 190 rabbits was exposed to an experimental sample of water having a pH of 5.18, 5.04, 4.70 or 4.50 . The other eye of each rabbit was simultaneously exposed to a control sample of water having a pH of 6.40 or 6.21 . The water was continuously instilled for 15 minutes every day for 7 days . Observations were made daily . The two eyes of each rabbit were compared for conjunctival congestion, corneal staining with fluorescent dye, the granulocyte count and osmolarity of the tears, bacteriologic findings in conjunctival swabs, corneal cell damage, corneal thickness and ultrastructural features of the corneal epithelium . Although some of the rabbits showed a difference of reaction in the two eyes, the majority showed similar reactions to water from the acidic and nearly neutral lakes.

Laryngoscope, 1984 Apr, 94(4), 455 - 63
Retropharyngeal abscess--a ten-year experience; Barratt GE et al.; The authors present an extensive review of current literature as well as their ten-year experience in management of patients with retropharyngeal abscesses . Emphasis is placed upon age, sex, type and duration of symptoms, bacteriology, methods of diagnosis, therapy, and complications . The authors' series reveals that retropharyngeal abscesses are found in adults, there is a wide spectrum of bacteriological organisms represented, and with appropriate antibiotic and surgical management the majority of patients survive without major residual sequelae.

Indian J Lepr, 1984 Apr-Jun, 56(2), 280 - 91
An approach to leprosy work in south Bombay--a preliminary communication; Daniel JR et al.; The city of Bombay with its teeming eight million citizens is characterised by varied types of living pattern in its different parts and the approach to leprosy control work should be flexible to suit these facets of living conditions . Earlier reports (Ganapati and Girija 1979) have indicated the possibility of the successful application of techniques based on mass surveys in North Bombay where people belonging to low socio-economic strata live in somewhat organised slums or shanty towns . However, extreme South Bombay is marked by the paucity of such vast slums and one is struck by the more permanent multistoreyed housing structures . Living in commercial establishments as well as footpath dwelling are common . This presentation consists of an attempt to gauge the leprosy problems in this part of the city taking advantage of 425 patients registered at a leprosy clinic run in conjunction with the dermatology out patient department of a big general hospital over a period of 40 months . 212 cases (50%) hailing from South Bombay proper were the subject matter for analysis . 66% (140) belonged to progressive types of leprosy classifiable as BT through LL and of the Ridley-Jopling classification and 30.7% were bacteriologically positive . 42.9% of the patients had some degree of deformity . Males formed 80% of the sample and 76% were above 15 years of age . Analysis of duration of residence revealed that 68% were living in Bombay for over six years and 53.5% were residing in the city for 11 years or more . This finding is contrary to the expectation of leprosy patients in Bombay belonging to a "floating population" . Attempts at field work revealed the following findings: Slum pockets being few (only four), patients were expected to live in residential buildings; but it was found that 25% of population were staying in work places . 17% were footpath dwellers and 18.9% shared their accommodation with people other than family members . 10.4% were domestic servants staying in the residences of their employees . The labour class constituted 50.5% the unemployed housewives group formed 21.7% and beggers 0.9% . 4.2% only were slum dwellers . Locating and examining contacts of patients was difficult as 42.9% could not be traced owing to faulty addresses or patients having changed residences or shifted to native places . Of the 111 patients (52.3%) contacted, 26.4% were living with families and 26.1% were staying alone or with others.(ABSTRACT TRUNCATED AT 400 WORDS)

Indian J Lepr, 1984 Apr-Jun, 56(2), 264 - 8
Thalidomide in lepra reaction (ENL) in lepromatous leprosy patients; Chandorkar AG et al.; Six male bacteriologically highly positive patients of lepromatous leprosy with ENL reaction not adequately controlled by conventional antireaction drugs were put on thalidomide 400 mg per day in four divided doses . Reaction was controlled between 13th to 18th day of therapy . There was no change in the bacteriological status . Liver functions, renal functions and hemogram were normal before therapy and remained unaltered at the end of treatment . Apart from fatigue, drowsiness and occassional constipation, thalidomide had no adverse effect . Control of ENL reaction by thalidomide in these patients is probably due to its immunosuppressive effect, more likely by its stablising action on lysosomes.

Acta Pathol Microbiol Immunol Scand {B}, 1984 Apr, 92(2), 119 - 26
A microcomputer-assisted bacteriology reporting and information system; Moller JK; A microcomputer system for recording and reporting all specimens processed by a routine laboratory of clinical bacteriology is described . The system is based upon two multi-user microcomputers and all functions are carried out within the laboratory by the medical, technical and clerical staff . Data are recorded using visual display units ( VDU *s) and the laboratory has issued about 2700 final reports per week since January 1981 . Data on all specimens are kept for immediate recall on a VDU for a period of about 6 weeks and hereafter stored on floppy disks . The computer system also produces laboratory statistics for internal use, epidemiological information for the surveillance of nosocomial infections, and makes accounting information for the accountants office.

Med Trop (Mars), 1984 Apr-Jun, 44(2), 127 - 32
{57 cases of infectious endocarditis: diagnosis, clinical course, prognostic factors}; Touze JE et al.; Through a retrospective study on 57 patients, the authors have studied the diagnosis signs, the clinical course, and the factors which affect the prognosis of bacterial endocarditis . Echocardiography has allowed them to establish a diagnosis with 72 p.c . of cases and the bacteriological investigations with 42 p.c . Out of these endocarditides, 39 were found on natural valves, 6 were associated with congenital cardiopathies, 9 followed the replacement of a valvula, and 3 were associated with endomyocardial fibrosis . Cardiac insufficiency (56 p.c.), and renal insufficiency (24 p.c.) were prevailing . The discussion turns on the diagnosis factors and the factors involved in the prognosis . Considering that the death rates were 64 p.c . with the patients who had undergone medical treatment and 14 p.c . with those who had undergone operations, the relevance of the surgical treatment has been emphasized.

Am J Public Health, 1984 Apr, 74(4), 344 - 8
Evaluation of tuberculosis control programs: some national trends; Powell KE et al.; Increasing numbers of tuberculosis control programs compile information about the number, location, bacteriologic status, and chemotherapy status of tuberculosis patients within their jurisdiction . Reports from these programs show that during the 1970s the prevalence of patients requiring supervision decreased three times faster than the incidence of tuberculosis; this decline occurred because low relapse rates among patients who had received adequate therapy allowed the recommended duration of follow-up after completion of therapy to diminish from lifetime to none . The prevalence of patients hospitalized for tuberculosis decreased four times faster than the incidence of tuberculosis because the duration of hospitalization decreased from many months to a few weeks and because a small proportion of patients were hospitalized . Future declines in these two program aspects are expected to be much smaller and should parallel the decline in morbidity more closely . Other measures of program performance have shown a less favorable trend and suggest an impeded flow of information to the health department from other persons or agencies involved in the care of tuberculosis.

J Appl Bacteriol, 1984 Apr, 56(2), 317 - 20
A comparison of contact plate and calcium alginate swab techniques for quantitative assessment of bacteriological contamination of environmental surfaces; Scott E et al.; A contact plate method for enumeration of bacteriological contamination at 9 environmental sites in 64 homes was compared with swab sampling techniques . Contamination levels of 100 or more organisms/21-25 cm2 were demonstrated more frequently using swab methods, but for some sites where low numbers of organisms were present, higher recovery rates were obtained using contact plates . When contamination levels from contact plate and swab techniques were compared according to rank order a good correlation was obtained . Results of this investigation indicate that the contact plate method is satisfactory for differentiation of hygiene levels at environmental sites whilst facilitating handling of large numbers of samples in a field survey.

J Immunol Methods, 1984 Mar 30, 68(1-2), 119 - 29
Culture and recovery of macrophages and cell lines from tissue culture-treated and -untreated plastic dishes; Fleit SA et al.; Macrophages can be separated from other cell types by their ability to readily attach and spread on glass or on plastic surfaces which are treated for optimal growth of cultured cells (tissue culture-treated plastic) . To detach macrophages from these surfaces, techniques must be used which require prior preparation of special flasks or vessels, utilize expensive equipment, are time-consuming and almost uniformly require that the macrophages be exposed to various chemicals . We now report that macrophages can be enriched and recovered efficiently after attachment to disposable polystyrene bacteriologic petri dishes simply by gentle scraping with a rubber policeman . In this paper we compare this method to others currently in use in which resident peritoneal cells, peritoneal exudate cells or cells from bone marrow-derived cultures are detached from treated dishes using cold shock, chelating agents and lidocaine . In all studies, advantages were noted when cells were incubated in untreated dishes and detached by gentle scraping . In addition, untreated dishes supported the growth of adherent cell lines IC-21 and L929B and yielded large numbers of cells, with high viability, which were easily harvested.

Boll Soc Ital Biol Sper, 1984 Mar 30, 60(3), 513 - 7
{Some components of preputial bacterial flora in the ram}; Sbernardori U et al.; During the reproductive period the AA have carried on bacteriological researches in the preputial cavity in eight sardinian rams, without pathological processes, living in eight flocks in the country around Sassari, in order to detect the bacteriological flora . This flora could interfere both with fertility and with conservation of seminal material for artificial insemination . Three withdrawals have been carried on before, during and after the reproduction season . E.coli, P . mirabilis, Staph . epidermidis have been found in the varius examined subjects . The AA stress that the same bacterium which had been isolated in the first withdrawal . Moreover in some subjects the bacteriological flora had increased . The AA stress how these data can be useful in order to control the flock fertility and in order to improve the technology of conservation of seminal material.

Minerva Med, 1984 Mar 17, 75(11), 565 - 8
{Diagnosis of tuberculosis today}; Pescetti G et al.; Authors analyse the main aspects about the diagnosis of tuberculosis and they emphasize that the bacteriological and immunological tests are very important, beside the clinical, radiologic and hematic picture . As regards bacteriological research, Authors dwell upon the significance of repeated sputum specimens and they reevaluate the use of fluorochrome staining . The immunological "in vivo" tests are represented by tuberculin skin test, that must be correctly made and valued to avoid wrong unresponsiveness, at the other hand also caused by host factors . About immunological "in vitro" tests, Authors report the good prospects opened by the serological diagnosis with an immunoenzymatic method specific for S antigen of M . tuberculosis.

Aust Vet J, 1984 Mar, 61(3), 75 - 6
A necropsy technique for cattle to eliminate contamination of lymph nodes by mycobacteria; Norton JH et al.; A field necropsy technique for cattle is described which avoids contamination by environmental mycobacteria of tissues intended for bacteriological examination . Settling the dust by hosing on and around the carcase, using sterile instruments for the collection of each tissue, excising lymph nodes without incising the capsule and submitting the nodes to the laboratory intact in saturated tetraborate solution resulted in uncontaminated samples even under adverse field conditions . The procedure is recommended for future investigations into the role of mycobacteria other than Mycobacterium bovis in the sensitisation of cattle to the intradermal test for tuberculosis.

Vet Clin North Am Large Anim Pract, 1984 Mar, 6(1), 203 - 13
Factors limiting the usefulness of histopathologic examination of skin biopsies in the diagnosis of large animal dermatoses; McGavin MD et al.; Skin biopsy for histologic, immunofluorescent, parasitologic, and bacteriologic examination is a common procedure, but for maximum effectiveness the clinician must realize the importance of precautions to select the correct stage of lesion of different diseases; avoiding creating artifacts during removal and fixation; and give full details of history, clinical diagnosis, and differential diagnoses on the laboratory request sheet . Pathology reports describing the subtleties of histologic changes are difficult to write, particularly if the lesions are not specific . Overly long histologic reports without a definitive diagnosis may frustrate a clinician who is unfamiliar with the significance of histologic lesions . For these reasons, clinician and pathologist must develop a rapport and empathy for the other's difficulties and adequately communicate to allow each to make a maximum contribution toward the final diagnosis . Histopathologic examination of skin lesions may not produce a specific diagnosis but is frequently useful in the elimination of other suspected diagnoses.

Tubercle, 1984 Mar, 65(1), 5 - 15
Study of a fully supervised programme of chemotherapy for pulmonary tuberculosis given once weekly in the continuation phase in the rural areas of Hong Kong; Bacteriology of diabetic foot ulcers; Diabetic foot ulcerations exhibit a wide range of the bacterial spectrum . A long-standing question is whether any particular bacterium or class of bacteria is responsible for the more involved ulcers . A review of such cases at Sheridan Park Hospital reveals that there may be factors other than bacterial type that may account for the virulence of diabetic ulcers . Multifactorial causes host a vital role in this common, but potentially serious, podiatric problem.

J Clin Microbiol, 1984 Mar, 19(3), 326 - 32
Capillary gas chromatographic analysis of carbohydrates of Legionella pneumophila and other members of the family Legionellaceae; Fox A et al.; Legionella pneumophila, the causative agent of Legionnaires disease, and related organisms have previously been characterized primarily by conventional bacteriological methods, DNA-DNA hybridization, antigenic analysis, and fatty acid analysis . By capillary gas chromatographic analysis for carbohydrates, we have shown that muramic acid and glucosamine, characteristic markers of bacterial cell walls, were present in samples of L . pneumophila and a group of legionella-like organisms . Some bacterial samples contained two unusual isomeric aminodideoxyhexoses (X1 and X2) . L . pneumophila was characterized by the absence of fucose and the presence of the peak X1 . Tatlockia micdadei (Legionella micdadei) was distinguishable by the presence of large amounts of rhamnose and fucose and by the absence of X1 and X2 . Fluoribacter strains were much more variable in their carbohydrate composition . These data suggest that, in addition to other reported techniques, carbohydrate profiling by capillary gas chromatography can be a valuable diagnostic method in reference microbiology laboratories for differentiating members of the family Legionellaceae.

Infection, 1984 Mar-Apr, 12(2), 58 - 63
Bacteriological and biochemical criteria for the diagnosis of bacterial infections in chronic obstructive pulmonary disease (COPD); Bartmann K et al.; In a prospective study the quantitated culture of washed sputum, the number of leukocytes and the concentration of albumin and fibrinogen in sputum were compared as diagnostic parameters for bacterial infections in patients with chronic obstructive pulmonary disease . No single criterium and no combination of criteria showed satisfactory specificity and sensitivity . Two reasons were established for the relatively loose correlation between the parameters: 1) they follow a different time course and 2) the biochemical and cellular signs of inflammation have a certain non-specificity with regard to bacterial infections . They also depend on the underlying disease . The selection of optimal criteria will become feasible only after the dynamics of bacterial and other inflammations of the respiratory tract have been studied in detail.

Genetika, 1984 Mar, 20(3), 469 - 77
{Genetic nature of atrophic rhinitis in swine . I . The results of a test cross and bacteriological study in atrophic rhinitis in swine}; Gavrichenkov AI; It is well established that the swine atrophic rhinitis (AR) is controlled by the only gene with two alleles, R and r, the former being a dominant . Our study was designed to determine the role of these factors in appearance of AR of swine among the offspring . Normal and diseased pairs of animals were mated . The heterozygotic (Rr) phenotypically normal but potentially ill hogs and sows were revealed at the farm where AR was spread . The phenotypically normal hogs and sows (RR, Rr) were mated with diseased (rr) or potentially diseased ones, and phenotypically normal heterozygotic (Rr) hogs and sows (control) . The diseased sucking-pigs revealed in the litter were removed . It has been established that the sucking-pigs were normal when mating normal homozygotic animals . These sucking-pigs were used to replace the live-stock of sows . When mating normal homozygotic animals with recessive ones, the sucking-pigs were also normal, the normal alleles being dominant . In matings of heterozygotic animals 27.3% of the litter were wry-snouted . However, even healthy heterozygotic animals should not be used for replacing the live-stock, because they have both the normal and recessive alleles . When recessive animals were mated, all sucking-pigs proved to have the symptoms of AR . Such sucking-pigs, together with their parents were necessarily removed.

Urology, 1984 Mar, 23(3), 252 - 5
Antibody-coated bacteria in ejaculate in bacterial prostatitis; Riedasch G et al.; In patients with bacteriologically proved prostatitis (Stamey test) ejaculate was examined for antibody-coated bacteria (ACB) . Forty-four of the 68 patients (65%) with bacteriologically proved prostatitis had ACB in the ejaculate, but only 7 of 89 patients (8%) with prostatodynia . Concomitantly, coeruloplasmin and complement (C3) concentrations in the ejaculate were examined by radial immunodiffusion (RID) . The ACB test had much higher specificity (92%) than RID, and the sensitivity of ACB was 65 per cent.

Am Rev Respir Dis, 1984 Mar, 129(3), 494 - 6
The management of thirty immunocompromised patients with tuberculosis; Dautzenberg B et al.; Between 1978 and 1981, 30 of 870 bacteriologically confirmed cases of tuberculosis occurred in immunocompromised hosts . One year after the diagnosis, 11 patients were dead, only 2 of them of tuberculosis . In the other 19 patients, the course of tuberculosis under standard chemotherapy was the same as in nonimmunocompromised hosts . Among the 24 patients still alive more than 2 months after the diagnosis of tuberculosis, the treatment of the underlying disease was changed in 14 patients to avoid worsening of the course of tuberculosis; 5 patients died and 4 kidney transplant carriers rejected their transplants . The treatment of the underlying disease was not changed in 10 patients: all of these remained alive 1 yr later, and 2 were kidney transplant carriers who did not reject their transplants . We conclude that the clinical response of the immunocompromised tuberculous host was good and that treatment of the underlying disease should not be modified.

Acta Orthop Scand, 1984 Feb, 55(1), 63 - 5
Ileopectineal bursitis following total hip replacement; Kolmert L et al.; Two cases of ileopectineal bursitis following total hip replacement are presented . Inflammation, infection and trauma are discussed as pathogenic factors . The results of fine needle biopsy, radiologic examination including CT and ultrasonography, as well as bacteriological cultures are described . The therapy was surgical in both cases.

J Rheumatol, 1984 Feb, 11(1), 87 - 9
Septic polyarthritis in a hemophiliac; Cobb WB; A first report in the English literature of septic polyarthritis in a hemophiliac is reported . The patient was a 40-year-old man with classic hemophilia and an inhibitor who developed S . aureus bacteremia and multiple septic joints . The previous 4 cases with single septic joints are discussed with regard to therapy and relation to underlying joint disease and presence of antibodies to Factor VIII . Awareness that infection can occur in hemophiliacs should prompt aspiration and bacteriologic study of suspicious hemarthrotic joints.

J Infect Dis, 1984 Feb, 149(2), 251 - 6
Plasmids as epidemiological markers in nosocomial Legionnaires' disease; Nolte FS et al.; Plasmid analysis was used in the investigation of an outbreak of nosocomial Legionnaires' disease in four patients . Serogroup 1 strains were isolated from two patients, the air-conditioning cooling tower, and two hot-water tanks . All serogroup 1 strains contained two plasmids with approximate molecular masses of 21 and 48 megadaltons (Mdal) . The serogroup 1 strain found in the cooling-tower isolate also contained an additional 1.9 Mdal-plasmid . Restriction-endonuclease analysis of the 21-Mdal plasmid that was present in patient and hot water-tank isolates revealed identical EcoRI and HaeIII fragment patterns . Digestion of the similarly sized plasmid in the cooling-tower isolate resulted in a unique fragment pattern . The data provide direct bacteriologic evidence implicating the hot-water tanks rather than the cooling tower as the source of the infecting strain.

Am J Surg, 1984 Feb, 147(2), 230 - 3
Microbiologic efficacy of a surgically constructed nipple valve; Chardavoyne R et al.; The efficacy of a surgically constructed nipple valve in preventing reflux of colonic bacteria into the small bowel was evaluated . The nipple valve significantly decreased the number of S . marcescens, a marker bacterium, in the small bowel when compared with plain ileocolic anastomosis . In this study, the nipple valve prevented the reflux of bacteria similar to an intact ileocecal valve which suggests that the nipple valve is an effective bacteriologic barrier and may be used as a substitute for the ileocecal valve in patients with short bowel syndrome.

J Dairy Sci, 1984 Feb, 67(2), 459 - 71
Traits for sire selection related to udder health and management; Miller RH; Traits related to udder health were discussed: bacteriological measures, clinical frequency, and milk properties (somatic cell count, enzymes, etc.) . Bacteriological testing of quarters maximizes information on infection but is impractical on a population scale . Clinical recording is an objective measure but fails to indicate subclinical cases and is not available in most countries . Cell counts are economical to obtain but are highly variable, difficult to interpret, and not sensitive indicators of subclinical infections . Several milk enzymes are possible indicators of tissue damage . Heritabilities are about .2 for cell counts and .1 for other measures, reflecting genetic variation in teat defenses, phagocytosis, or immune response . There appears to be genetic antagonism between cell count and milk yield (positive gentic correlation of .1 to .2) in contrast to the negative phenotypic relationship between milk yield and cell count . A program to select sires whose progeny have lowest cell counts should be formulated carefully; more needs to be known about interpretation of cell count as a defense mechanism . Heightened cell counts decrease the probability of infection upon subsequent challenge with pathogens . Is there heritable variation in cell count of cows before exposure? A combined criterion of cell count, lactose, and enzyme concentration should be studied.

J Antimicrob Chemother, 1984 Feb, 13(2), 161 - 70
Clinical, bacteriological and pharmacokinetic results from an open trial of sultamicillin in patients with acute exacerbations of chronic bronchitis; Davies BI et al.; Thirty hospitalised patients with acute purulent exacerbations of chronic bronchitis were treated orally with either 750 or 1000 mg of sultamicillin (a mutual prodrug of ampicillin and sulbactam) twice daily for ten days . Twenty-eight of these patients were evaluated for clinical response at end-of-treatment (day 11) and at one week post-treatment (day 17) . The overall clinical cure rates at these times were 73% (22/30) and 60% (18/30) respectively . Five beta-lactamase-producing organisms were identified in the pre-treatment sputum specimens, but all were eliminated by day 17 . The means of the peak serum concentrations of ampicillin achieved after the first 750 and 1000 mg doses were 9.1 and 14.4 mg/l respectively, the corresponding values for sulbactam being 6.4 and 7.9 mg/l . Both the ampicillin and the sulbactam peaks occurred approximately one hour after dosage . Mean peak sputum concentrations of ampicillin of 0.7 and 1.2 mg/l were achieved following the 750 and 1000 mg doses . Concentrations of sulbactam in sputum were above the limit of detection (0.5 mg/l) in only four patients . Although both clinical and bacteriological responses at follow-up (day 17) appeared to be somewhat more favourable at the higher dose, the small number of patients in each group did not permit a statistically valid comparison to be made . One patient in each dosage group discontinued the medication because of severe diarrhoea.

Z Erkr Atmungsorgane, 1984, 162(2), 155 - 62
{Case reports on the problem of atypical roentgen pictures in lung tuberculosis}; Kerenyi A et al.; With four cases the authors are demonstrating radiographic findings showing that pulmonary tuberculosis has changed its pattern in the recent period . The reasons are analyzed by reviewing literature . Also in " nontypical " roentgenograms tuberculosis must be remembered . Even in future the x-ray picture will remain an important part of finding and identifying this disease, but bacteriological examinations by smear and culture are the essential parts of diagnosis . In cases of x-ray pictures apparently noncharacteristic intensive examinations by bronchological methods or percutaneous needle biopsy may become necessary.

Scand J Plast Reconstr Surg, 1984, 18(1), 153 - 4
Clinical results of treatment of patients in the air-fluidized bed (Clinitron) during a one-year period; Kalaja E; Beside the nursing difficulties in using the Clinitron bed we have experienced further technical difficulties during the introduction period which are described . However, the beds have been most effective from a bacteriological point of view and have reduced the infection rate.

Jpn J Antibiot, 1984 Jan, 37(1), 97 - 103
{Clinical use of cefoxitin in respiratory tract infections}; Niki Y et al.; Cefoxitin (CFX) was used in 9 patients who had respiratory tract infections and following results were obtained: CFX was used in 2 patients with acute pneumonia, 2 with lung abscess, 3 with a mixed infection of lung cancer, 1 with a mixed infection of pulmonary tuberculosis and 1 with empyema . The overall efficacy rate was 77.8%; results were excellent in 2, good in 5 and poor in 2 . Bacteriologically, all strains except P . aeruginosa were eradicated after treatment . No side effects were observed . A slight transient elevation of transaminase was observed in 1 patient after doses of 4 approximately 8 g daily . From the above, CFX seems to be a useful and safe drug as an initial choice in the treatment of respiratory tract infections.

Curr Med Res Opin, 1984, 8(10), 708 - 13
A comparative study of spiramycin and erythromycin in acute tonsillo-pharyngitis; Zulkifli et al.; In a clinical and bacteriological study of 42 patients with acute tonsillo-pharyngitis or chronic tonsillo-pharyngitis with acute exacerbation, patients were allocated at random to receive either a 3-day course of spiramycin or a 5-day course of erythromycin, both antibiotics being given in a dosage of 500 mg 3-times daily . The median time to disappearance of patient complaints such as fever, difficulty in swallowing, sore throat, cough and mucus was 3 days in each group and there was a significant reduction from pre-treatment to normal levels in total white cell count and erythrocyte sedimentation rate after treatment . Although more patients were considered to have shown a good clinical response to spiramycin, the difference was not statistically significant . From a bacteriological point of view, however, treatment with the regimen used was considered a failure in all cases in that neither antibiotic completely eradicated the pathogens identified at the start of treatment even though, with 3 exceptions, all of the micro-organisms were shown to be sensitive to the antibiotics before and after treatment . Few side-effects were reported in either group.

Ann Fr Anesth Reanim, 1984, 3(1), 47 - 8
{Facial cellulitis of dental origin}; Granthil C et al.; A case of facial cellulitis of dental origin associating a retropterygoidal necrosis, a retro-orbital abscess and a cervicofacial cellulitis is reported . No related risk factors were found in this 28 year old man . Bacteriological analyses showed a mixed bacterial flora and the presence of candida . Direct examination favoured an anaerobic germ infection . However the culture and identification of theses germs were impossible . The clinical circumstances together with the results of facial computed tomography tended to make the diagnosis of an anaerobic cellulitis highly probable . The diagnostic and therapeutic managements are reviewed.

Cancer, 1984 Jan 1, 53(1), 137 - 41
Post-sepsis prophylaxis in cancer patients; Hughes WT et al.; One hundred children with cancer and bacterial sepsis were observed for one month after completion of antibiotic treatment for subsequent episodes of infection . After satisfactory clinical and bacteriological responses were achieved and antibiotic therapy terminated, 38 of the patients were maintained on trimethoprim--sulfamethoxazole (TMP-SMZ) and 62 did not receive the drug combination . Of the 26 neutropenic patients not receiving TMP-SMZ 23 (88%) had episodes of infection, whereas 4 (36%) of the 11 given the drug had recurrent or re-infection episodes (P = less than 0.001) . A difference of similar significance was observed in the non-neutropenic patients . Infections in children in relapse of their malignancy were twice as frequent in those not receiving the drug as in those who received it (P = less than 0.02, greater than 0.01) . Of the 19 patients who died during the month of observation, none had received TMP--SMZ . This study shows that the administration of TMP--SMZ after bacterial sepsis reduces the number of infectious episodes in neutropenic and non-neutropenic patients, with the exception of the non-neutropenic patient in remission.

Eur J Pediatr, 1984 Jan, 141(3), 165 - 7
Generalized lymphadenitis following B.C.G . vaccination in an immunocompetent 12-year-old boy; Katzir Z et al.; An immunocompetent, healthy 12-year-old boy was presented with generalized large lymphadenopathy in the left side of the body, 1 month after a BCG vaccination with a regular dose . A Mantoux test before vaccination was negative . Histological and bacteriological findings from the largest lymph node biopsy revealed BCG'itis . The patient recovered spontaneously after 7 months . He was confirmed as being immunocompetent by normal serum immunoglobulin levels, normal B and T cell function tests, and a conversion of Mantoux test . BCG infections including lymphadenitis are rare and have been described hitherto mainly in infants, in immune deficient patients, or related to overdose . Such a complication must be taken into consideration when dealing with lymphadenopathy in healthy school-age children, who now undergo BCG vaccinations in many countries.

J Med, 1984, 15(3), 185 - 92
Fever of unknown origin: a survey on 133 patients; Barbado FJ et al.; The hospital records of one hundred and thirty-three patients with fever of unknown origin (FUO) were studied . An etiologic diagnosis had been made in 105 patients: 41 patients had an infection, 24 had a neoplasm, 17 had a connective tissue disease, and 23 had various diseases grouped under "miscellaneous." FUO was self-limiting in 25 of the remaining patients . Invasive procedures (arteriography, biopsy, laparoscopy, paparotomy) were necessary to establish a diagnosis in 67 patients, non-invasive tests (sero-immunologic, bacteriologic, conventional radiologic tests, clinical course and treatment response) were sufficient in 27 patients . In 11 patients, the cause of FUO was determined in necropsy . Thirty patients died of FUO: 6 patients with a neoplasm, 4 with a connective tissue disease, and 7 with diseases termed miscellaneous.

Scand J Gastroenterol Suppl, 1984, 90, 37 - 52
Prophylactic regimens in colorectal surgery . Comparison between metronidazole used alone or in combination with either ampicillin or doxycycline; Roland M et al.; Sixteen hospitals are participating in this study, that started in October 1982 and will be concluded when 456 patients have been admitted . The study includes patients eligible for elective colorectal surgery . Inclusion criteria, surgical techniques, definition of recognizable infection, sampling of specimens for bacteriological investigations, bacteriologic techniques, and evaluation criteria were standardized . Patients were divided into 2 main groups . Patients in Group 1 received either a single intravenous dose of 1500 mg metronidazole or this dose was combined with a single, intravenous dose of 6 g ampicillin . Patients in group 2 received either a single intravenous dose of 1500 mg metronidazole or this dose combined with a single intravenous dose of 400 mg doxycycline . Dosage regimens were allocated randomly . The current results concern 136 patients . Postoperative infections were seen in 6.7% of the patients receiving metronidazole alone, and 2.9% of the patients receiving metronidazole + ampicillin (Group 1) . In Group 2, postoperative infection occurred in 17.1% of the patients receiving metronidazole alone, and in 2.7% of those receiving metronidazole + doxycycline.

Comp Immunol Microbiol Infect Dis, 1984, 7(2), 131 - 40
Transmissibility of the contagious equine metritis organism for the cat; Timoney PJ et al.; A group of SPF cats were moderately susceptible to the causal organism of contagious equine metritis (CEM) following intra-uterine or intrapreputial challenge with an Irish streptomycin resistant strain isolated from a clinically infected mare . Subclinical infections were established in only 50% of the cats, none of which became long-term carriers of the organism . Cytological examination of vaginal smears was of no diagnostic value in confirming infection in inapparently infected cats . Bacteriological responses after primary or secondary challenge with the CEM organism were essentially similar, with one exception, a female cat in which there was possible evidence of local immunity persisting after the primary infection . Efforts to reactivate shedding subsequent to the immediate post-challenge period were unsuccessful . Throughout the experimental period, the cats remained sero-negative to the complement-fixation test, and they failed to develop any significant increase in the levels of antibody activity as measured by the kinetics-based ELISA or KELA system . On day 89 after primary challenge, the cats were euthanized and various sites in the genitourinary tract and the internal iliac lymphatic glands subjected to bacteriological and pathological examination for evidence of CEM infection with negative results . The findings of this study, although establishing the transmissibility of the CEM organism for the cat, demonstrate the limited value of this species as an experimental model system for the disease in the horse.

Indian J Lepr, 1984 Jan-Mar, 56(1), 78 - 85
Evaluation of multidrug therapy with rifampicin, clofazimine and D.D.S . in multibacillary leprosy cases; Kundu SK et al.; Rifampicin, Clofazimine and D.D.S . have been tried in fifteen active untreated lepromatous cases for a period of two years . Compared to dapsone monotherapy remarkable clinical and bacteriological improvement was observed with this combined therapy with attainment of negative BI in ten cases . Use of this combination therapy is thus advocated to achieve noninfectivity in a shorter period and to prevent emergence of dapsone resistance thereby causing the path of leprosy control before it becomes unmanageable due to dapsone resistance.

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