J Bacteriol, 1989 Sep, 171(9), 4862 - 70 Identification of promoter mutants defective in growth-rate-dependent regulation of rRNA transcription in Escherichia coli; Dickson RR et al.; We measured the activities of 50 operon fusions from a collection of mutant and wild-type rrnB P1 (rrnB1p in the nomenclature of B . J . Bachmann and K . B . Low {Microbiol . Rev . 44:1-56, 1980}) promoters under different nutritional conditions in order to analyze the DNA sequence determinants of growth rate-dependent regulation of rRNA transcription in Escherichia coli . Mutants which deviated from the wild-type -10 or -35 hexamers or from the wild-type 16-base-pair spacer length between the hexamers were unregulated, regardless of whether the mutations brought the promoters closer to the E . coli promoter consensus sequence and increased activity or whether the changes took the promoters further away from the consensus and reduced activity . These data suggest that rRNA promoters have evolved to maintain their regulatory abilities rather than to maximize promoter strength . Some double substitutions outside the consensus hexamers were almost completely unregulated, while single substitutions at several positions outside the -10 and -35 consensus hexamers exerted smaller but significant effects on regulation . These studies suggest roles for specific promoter sequences and/or structures in interactions with regulatory molecules and suggest experimental tests for models of rRNA regulation. Infect Immun, 1989 Sep, 57(9), 2719 - 25 Genetic, immunological, and cytotoxic comparisons of Legionella proteolytic activities; Quinn FD et al.; Several strains of Legionella pneumophila and other species of Legionella with proteolytic activities were compared by assays, including Southern hybridizations and Western immunoblots, to determine their proteolytic, hemolytic, and cytotoxic activities . Only proteases from strains of L . pneumophila were both hemolytic and cytotoxic, and proteolytic activities extracted from other species of Legionella possessed only hemolytic activity . A 4.0-kilobase DNA sequence encoding the 38-kilodalton metalloprotease from L . pneumophila Philadelphia 1 that we showed previously was responsible for the observed hemolytic and cytotoxic phenotypes (F . D . Quinn and L . S . Tompkins, Mol . Microbiol., 3:797-805, 1989) was used in Southern hybridizations to probe chromosomal DNA from several strains of L . pneumophila and other Legionella species . The probe hybridized to the chromosomal DNA of all serogroups of L . pneumophila but not to any strains of L . dumoffii, L . micdadei, L . feeleii, or L . jordanis that we examined . Additionally, Western immunoblots done with rabbit antisera made to the cloned L . pneumophila protease demonstrated cross-reactions among 38-kilodalton proteins from strains of L . pneumophila, but no reactions were observed with proteins from other species of Legionella . Similarly, the cloned protease from L . pneumophila reacted with convalescent-phase sera from patients infected with L . pneumophila, but not with antisera isolated from patients infected with other Legionella species . Thus, despite some similarities among the proteolytic activities of members of the genus Legionella, including proteolytic and hemolytic phenotypes, metal requirements for zinc or iron, sensitivity to EDTA, and temperature and pH optima, we documented distinct genetic, immunological, and cytotoxicity differences among the proteolytic activities produced by Legionella species. Oral Microbiol Immunol, 1989 Sep, 4(3), 169 - 72 The capacity of subgingival microbiotas to produce volatile sulfur compounds in human serum; Persson S et al.; Hydrogen sulfide is formed by the subgingival microbiotas of periodontal pockets . The capacity of these microbiotas to form various volatile sulfur compounds in human serum was studied . Bacterial samples from nine deep periodontal pockets were incubated for 7 days in human serum and the amounts of volatile sulfur compounds and the degradation of serum proteins were determined . Hydrogen sulfide was the predominant volatile sulfur compound, but also methyl mercaptan was formed in significant amounts . Only traces of dimethyl sulfide and dimethyl disulfide were detected . There was an extensive degradation of the serum proteins . In most of the reaction mixtures hydrogen sulfide reached highly toxic levels. J Bacteriol, 1989 Sep, 171(9), 4852 - 61 Saturation mutagenesis of an Escherichia coli rRNA promoter and initial characterization of promoter variants; Gaal T et al.; Using oligonucleotide synthesis techniques, we generated Escherichia coli rrnB P1 (rrnB1p according to the nomenclature of B . J . Bachmann and K . B . Low {Microbiol . Rev . 44:1-56, 1980}) promoter fragments containing single base substitutions, insertions, deletions, and multiple mutations, covering the whole length of the promoter including the upstream activation sequence (UAS) . The activities of 112 mutant promoters were assayed as operon fusions to lacZ in lambda lysogens . The activities of most mutants with changes in the core promoter recognition region (i.e., substitutions, insertions, or deletions in the region of the promoter spanning the -10 and -35 E . coli consensus hexamers) correlated with changes toward or away from the consensus in the hexamer sequences or in the spacing between them . However, changes at some positions in the core promoter region not normally associated with transcriptional activity in other systems also had significant effects on rrnB P1 . Since rRNA promoter activity varies with cellular growth rate, changes in activity can be the result of changes in promoter strength or of alterations in the regulation of the promoter . The accompanying paper (R . R . Dickson, T . Gaal, H . A . deBoer, P . L . deHaseth, and R . L . Gourse, J . Bacteriol . 171:4862-4870, 1989) distinguishes between these two alternatives . Several mutations in the UAS resulted in two- to fivefold reductions in activity . However, two mutants with changes just upstream of the -35 hexamer in constructs containing the UAS had activities 20- to 100-fold lower than the wild-type level . This collection of mutant rRNA promoters should serve as an important resource in the characterization of the mechanisms responsible for upstream activation and growth rate-dependent regulation of rRNA transcription. Rev Sanid Hig Publica (Madr), 1989 Sep-Oct, 63(9-10), 65 - 77 {Effectiveness of the washing system in reusable glass containers: 3 "washing trials" at water bottling plants . Microbiologic results and methodologic and critical proposal}; Bellido Blasco J et al.; As a consequence of carrying out the Cleaning Analysis for recoverable containers with a capacity of over 2 litres used in water bottling plants, executed in accordance with instructions from the Ministry of Health and Consumer Affairs, an analysis is made on its suitability and a system for evaluation is proposed, based on statistically verifiable hypotheses, thus taking advantage of the information generated by the Cleaning Analysis . The conclusions recommend the modification of these tests which affect a product whose consumption grows daily. Wien Med Wochenschr, 1989 Aug 31, 139(15-16), 377 - 8 {Mycoses and AIDS}; Koch Y; The number of patients with AIDS is still growing rapidly . The identification of opportunistic diseases requires special skills in microbiology . The methods for identifying and distinguishing between opportunistic fungi and pneumocystis carinii are introduced. JAMA, 1989 Aug 25, 262(8), 1011 - 9 Undergraduate medical education; Jonas HS et al.; The number of applicants to US medical schools continued to decline, while the number of accepted applicants increased slightly . From 1987-1988 to 1988-1989 academic years, the number of first-year medical students (including repeaters) who were white non-Hispanic males decreased 2.5%, the number of black non-Hispanic males decreased 6.3%, and the number of Asians or Pacific Islander males increased 10.3% . During the same period, the number of first-year students who were white non-Hispanic females decreased 0.8%, the number of black non-Hispanic females decreased 4.8%, and the number of Asians or Pacific Islander females increased 13.7% . Women constituted one third of the entering class in the 1988-1989 academic year . During the past 5 years, the ratio of full-time medical school faculty to medical students increased from 0.88 to 1.08 . About 4.8% of budgeted full-time faculty positions were unfilled, down from 5% in the 1987-1988 academic year . However, in the 1988-1989 academic year, more than 5% of positions were unfilled in microbiology, anesthesiology, dermatology, family medicine, neurology, obstetrics-gynecology, ophthalmology, orthopedics, pediatrics, and surgery . Many schools are showing signs of adopting new curricular approaches . A majority of medical schools have implemented many recommendations of the GPEP Report, at least at some level . Problem-based learning is present in the curriculum of 82% of schools, mainly as an experience in one or a few courses . In about two-thirds of schools, computer-based instruction is a formal part of one or more courses or laboratories . Thus, the medical schools appear to be addressing the challenges presented by the changing environment of medical education. J Immunol Methods, 1989 Aug 15, 122(1), 79 - 90 Measurement of binding specificity between T cell lymphomas and murine leukemia viruses; O'Neill HC et al.; We have previously reported the presence of receptors on radiation leukemia virus (RadLV)-induced thymomas and malignant thymocytes from AKR mice which specifically bind retrovirus produced by these T cell clones . These receptors have been shown to have specificity for virus reminiscent of an immune-specific receptor . Previous studies on T cell lymphoma binding to retroviruses have involved measurement of the interaction of labelled virus with cells using fluorescence-activated cell sorter (FACS) analysis (McGrath et al., J . Virol . (1978) 25, 923; McGrath and Weissman, Cell (1979) 17, 65; Weissman and McGrath, Curr . Top . Microbiol . Immunol . (1982) 98, 103) . Here we report development of an assay for measuring lymphoma binding to virus, prepared as an immunoabsorbent adhered to a microtiter plate . Using this assay, we have shown that only T and not B cell lymphomas can bind to T cell-tropic viruses, and some cell lines have greatest specificity for homologous virus . The AKR-derived T cell lymphomas, SL3 and KKT-2, show greater specificity for leukemogenic AKR viruses, than for an AKR xenotropic virus or the recombinant AKR virus, MCF247 . The RadLV-induced T cell lines, C6VL/1 and BL/VL3, have been found to bind cross-reactively to several different murine leukemia viruses (MuLVs) . RadLV-induced T cell lymphomas do have greater specificity for their cognate retroviruses since free, homologous retrovirus can best block the interaction between cells and virus adhered to the wells of a microtiter plate . Cross-reactive interactions are more easily demonstrated by this assay, probably because low avidity interactions are stabilized as a result of the mode of virus presentation . Binding specificity for retroviral envelope determinants has been demonstrated using a rat anti-retroviral antiserum prepared as an F(ab)1 fragment . This antiserum can inhibit the interaction between the C6VL/1 thymoma and its RadLV virus . Specificity of this antibody for a gp70-like protein was confirmed by NaDodSO4-polyacrylamide gel electrophoresis (PAGE) and by loss of this activity after absorption of antibody on virus . Antibodies specific for RadLV/VL3 gp70 determinants can inhibit the interaction of C6VL/1 with RadLV/VL3 suggesting that cross-reactive binding to heterologous virus is also specific for a gp70 viral env determinant. Nippon Sanka Fujinka Gakkai Zasshi, 1989 Aug, 41(8), 960 - 70; discussion 1000-7 {Treatment of endometriosis associated infertility}; Inoue M; During the last 13 years, 2,080 infertile patients were subjected to diagnostic laparoscopy . The mean age was 32.3 and their mean infertility period was 6.0 years . Of these, 1,263(60.7%) patients were diagnosed to have endometriosis: 587(46.5%) were stage I (R-AFS), 348(27.6%) were stage II, 184(14.6%) were stage III and 144(11.4%) were stage IV . The age and the infertility period were almost the same among the stage of the disease . The overall pregnancy rate was 34.6%, after minimum 2 month follow up . The presence of endometriosis did not affect the prognosis of infertility: 34.2% pregnancy rate for patients with endometriosis, and 35.3% for those without endometriosis . There was an inverse relationship between the stage of the disease and the subsequent pregnancy rate: 37.8% for stage I, 34.8% for stage II, 32.1% for stage III and 20.8% for stage IV . But statistical significant difference was observed only between stage I and II, and stage IV . To elucidate the mechanism of endometriosis associated infertility, peritoneal fluid volume, intratubal sperm transport (peritoneal sperm recovery test), and phagocytosis of sperm in the tube and in the peritoneal fluid were examined in more than 1,000 cases . However, no positive relationship was found between the disease and these parameters . Fimbrial microbiopsy also revealed that endometriosis did not affect the ciliation index of the fimbria, nor changed the fine surface structure . Patients with minimal-mild disease were first managed expectantly for one year after laparoscopy: The pregnancy rate was 36.1% for stage I, and 29.7% for stage II . Ninety-eight patients who failed to conceive by expectant management were put on danazol therapy (600 mg/day, for 6 months) . However, the results were very disappointing . Of 44 patients with stage I disease, only 3(6.8%) achieved a pregnancy, and none of 54 stage II patients conceived so far . Moreover, second-look laparoscopy revealed that danazol had no effect on the eradication of minimal-mild endometriosis . The patients with stage I-II disease were then treated exclusively by electrocautery at the time of initial laparoscopy: The pregnancy rate was 30.8% (57/185) for stage I, and 23.8% (25/105) for stage II . At second-look laparoscopy, 45.5% (10/22) of stage I and 73.7% (14/19) of stage II were disease free or improved, although the pregnancy rate was not so good as expected.(ABSTRACT TRUNCATED AT 400 WORDS) Br J Ophthalmol, 1989 Aug, 73(8), 624 - 7 Tonicity of human tear fluid sampled from the cul-de-sac; Benjamin WJ et al.; A 'freezing point' depression technique was used to determine the osmolality of 384 samples of tear fluid originating from the middle of the lower tear prism and the lower cul-de-sac of one eye of each of 12 young adults . Tear fluid from the cul-de-sac (mean 341.0 mosm/kg) was found overall to be significantly hypertonic (p less than 0.0001) relatively to fluid from the tear prism (mean 315.5 mosm/kg) . However, the difference between the two sampling sites was highly variable between individuals, ranging from a maximum mean site difference of 64.5 . mosm/kg for one of the six cul-de-sacs found to be significantly hypertonic, to a mean site difference of 25.0 mosm/kg for one of the two cul-de-sacs found to be significantly hypotonic . These results suggest that a unique localised tear environment exists inside the lower cul-de-sac, which has several clinical consequences--for example, for pharmaceutical absorption, ocular microbiology, and hydrophilic contact lens performance. Hum Pathol, 1989 Aug, 20(8), 753 - 7 Concurrent neuroborreliosis and Alzheimer's disease: analysis of the evidence; Pappolla MA et al.; Several recent reports have claimed a possible association between Borrelia burgdorferi infection and Alzheimer's disease (AD) . Herein, we describe our search for additional evidence of neuroborreliosis in AD . Brain tissue from neuropathologically confirmed cases of AD was cultured for B burgdorferi using standard microbiologic methods . Material derived from culture was further examined using electron microscopy, direct immunofluorescence and acridine orange fluorescence . Previous studies have shown high titers of antiborrelia antibodies in CSF in all cases of confirmed neuroborreliosis; therefore, we tested CSF from neuropathologically confirmed cases of AD by indirect immunofluorescence and enzyme-linked immunoassay . In addition, imprint preparations from AD and control brain tissues were studied by direct immunofluorescence using a monoclonal antiborrelia antibody . Finally, a Western blot method was used to analyze protein extracts from cultures and AD brain tissue for the presence of borrelia antigen . Contrary to previous studies, our results do not support an association between infection with B burgdorferi and AD. Antonie Van Leeuwenhoek, 1989 Aug, 56(2), 109 - 26 Kluyver's work in retrospect: wisdom of foresight? Lecture delivered on October 27, 1988 before The Netherlands Society for Microbiology in commemoration of the birthday of Prof . dr . ir . A.J . Kluyver (1888-1956); Bulder CJ et al.; In this paper three former students of Kluyver look back upon his work and make an effort to assess its significance in the development of present-day microbiology. Rinsho Byori, 1989 Aug, 37(8), 918 - 22 {Isolation of Legionella spp . from cooling tower water and the effect of microbicides}; Kasai J et al.; Legionella spp., the causative organism of legionnaires' disease, were isolated from more than 80% of water samples in cooling towers before washing . Therefore, we evaluated the effect of microbicide treatment of cooling tower water on Legionella spp., other bacteria and protozoa . 2-Bromo-2-nitropane-1,3-dial, 2,4-dibromo-5,5-dimethylhydantoin or silver nitrate-treated silica gel was added to cooling tower water . The isolation rate of Legionella spp . in the cooling tower water was 50% after microbiocide treatment with 2-bromo-2-nitropane-1,3-dial being the most effective . The microbicide treatment had no effect on other bacteria or protozoa . These findings indicated the importance of regular washing and water exchange of cooling tower water with microbicide treatment. Am Rev Respir Dis, 1989 Aug, 140(2), 502 - 12 Short-term exposure to nitrogen dioxide enhances susceptibility to murine respiratory mycoplasmosis and decreases intrapulmonary killing of Mycoplasma pulmonis; Parker RF et al.; In C57BL/6N and C3H/HeN mice known to be free of all murine pathogens and matched for age, sex, microbiologic, and environmental factors, exposure to NO2 for 4 h prior to exposure to infectious aerosols of Mycoplasma pulmonis resulted in potentiation of murine respiratory mycoplasmosis (MRM) . In the C57BL/6N mice, NO2 increased the incidence of death, incidence of gross lung lesions, and incidence of microscopic lung lesions, but did not increase the incidence of infection in the lungs . Nitrogen dioxide affected the C3H/HeN mice (a strain known to be more susceptible than the C57BL/6N strain to MRM) similarly, with the exception that the incidence of death and microscopic lesions were not affected in this strain at the concentrations of M . pulmonis used . Exposure to the oxidant also increased the severity of microscopic lesions and the numbers of Mycoplasma organisms in the lungs of both mouse strains . Thus, NO2 appeared to affect host lung defense mechanisms responsible for limiting the extent of infection . The NO2 exposure level required to produce potentiation varied with the genetic background of the host, the number of Mycoplasma organisms administered, and the end point measured . In further experiments in C57BL/6N mice, exposure to 5 or 10 ppm of NO2 for 4 h prior to infection with aerosolized, radiolabeled M . pulmonis reduced clearance of these organisms from the lungs over a 72-h time period . Nitrogen dioxide exposure did not change the rate of physical removal of Mycoplasma organisms from the lung . Reduced clearance was due to impaired intrapulmonary killing of Mycoplasma organisms in NO2-exposed mice.(ABSTRACT TRUNCATED AT 250 WORDS) Dtsch Tierarztl Wochenschr, 1989 Jul-Aug, 96(7), 353 - 5 {The significance of mycotoxin assimilation for the productivity and health of animals}; Schuh M; In the last decade an increasing occurrence of feed intoxications of Austrian domestic animals could be observed . According to specific cases and one experimental study using fattening pigs, the clinical symptoms laboratory findings of blood and feed samples are described . Based on the case history, the clinical symptoms of the incriminated animals and by exclusion of other diseases an etiologic correlation with the feed and the course of disease, a feed intoxication could be diagnosed . By corresponding microbiologic as well as mycotoxicologic positive results of the examined feedstuffs the diagnosis "mycotoxicosis" could be confirmed. Respir Med, 1989 Jul, 83(4), 357 - 61 Recent surgical experience for pulmonary tuberculosis; Whyte RI et al.; Lung resection for pulmonary tuberculosis is unusual today . Over a 10-year-period 31 patients with pulmonary tuberculosis underwent thoracotomy at this Regional Centre . Five of these were for complications of known tuberculosis; two subsequently proved to be complications of pulmonary tuberculosis, and the remainder were for suspected malignancy . The clinical features, radiology, microbiology, and pathology are reviewed and the contemporary role of the surgeon in the management of pulmonary tuberculosis is examined. J Pharm Belg, 1989 Jul-Aug, 44(4), 292 - 301 {The new quinolones}; Lontie M; The new quinolones are reviewed . These drugs are fluorinated derivatives of nalidixic acid, like ciprofloxacin, norfloxacin, ofloxacin, pefloxacin, and others . The following aspects are discussed: microbiology, modes of action and of resistance, the pharmacologic properties, the adverse reactions, the interactions with other drugs, and the principal clinical applications. Postgrad Med J, 1989 Jul, 65(765), 444 - 8 Purulent pericarditis; Hall IP; Purulent pericarditis is an infrequent, but important complication of infective illnesses, in particular pneumonia, which if diagnosed early has a good prognosis . The incidence of the condition is probably increasing, particularly in the immuno-compromised group of patients . 'Classical' symptoms and signs are often absent, and a high index of awareness is required to diagnose the condition . This review deals with the epidemiology, microbiology, clinical features, treatment and prognosis of purulent pericarditis with two illustrative examples of typical cases. Kekkaku, 1989 Jul, 64(7), 459 - 63 {Identification of nontuberculous mycobacteria isolated from clinical materials and some comments on it}; Sato K et al.; Six mycobacterial strains which were isolated and identified with some suspicions in five hospitals in Japan were retested for their biological and biochemical characteristics for correct identification at the Department of Microbiology and Immunology, Shimane Medical University . One strain originally classified as Group IV Mycobacterium, and two unidentified strains were presently identified as Mycobacterium nonchromogenicum complex . Two strains originally identified as M . xenopi were identified by us as M . szulgai and M . avium complex, respectively . Finally, one strain originally identified as M . phlei was identified by us as M . fortuitum . In these cases, inexactly controlled examinations for growth rate, growth at 45 degrees C, Tween 80 hydrolysis, and pigment production or lack of tests for certain key characters of a given organism seemed to be main causes of initial incorrect identification. Ann Acad Med Singapore, 1989 Jul, 18(4), 465 - 76 Microbiology in Singapore; Tay L; The progress and development of microbiology services in Singapore during the last two decades are described . Rapid diagnosis, quality control, automation, nosocomial infections and national and international studies are some of the topics highlighted in this paper. Ophthalmology, 1989 Jul, 96(7), 1115 - 20 Advances in immunology and uveitis; Fujikawa LS; *Subspecialty synopses are intended to present major clinical developments and innovations in diagnosis, treatment, surgical technique, and recent clinical research . Each synopsis, written by a recognized knowledgeable subspecialist, is co-sponsored by a major subspecialty society or organization . This subspecialty synopsis is co-sponsored by the Ocular Microbiology and Immunology Group. Clin Microbiol Rev, 1989 Jul, 2(3), 241 - 9 Antigen detection for human immunodeficiency virus; Harry DJ et al.; The recent development of enzyme immunoassay procedures for the direct determination of human immunodeficiency virus (HIV) antigens has been of significant benefit in both clinical and research applications . The historical development of HIV antigen assays as well as their current and future applications for use in the clinical microbiology laboratory are reviewed . A detailed description of selected commercially available assays is presented, and a comparison is made of various parameters, including sensitivity, specificity, and cost . The use of the HIV antigen assay as an alternative to the reverse transcriptase assay in virus culture applications is also discussed . In addition, the diagnostic and prognostic utility of the HIV antigen assay is considered for various patient groups, including neonatal, high-risk asymptomatic, seronegative, and seropositive patient populations . The use of the HIV antigen assay as an adjunct to anti-HIV antibody testing, as well as its utility in assessing the therapeutic efficacy of antiviral drug therapy, is discussed . The biology of HIV antigen expression and modulation of anti-HIV antibody titers during infection are also discussed in terms of two possible models. DICP, 1989 Jul-Aug, 23(7-8 Suppl), S13 - 5 Monitoring antibiotic usage in the hospital; Huber S et al.; The authors outline the quality indicators being developed by the Joint Commission on Accreditation of Health Care Organizations to compare hospital performance . The Joint Commission has provided several incentives to encourage antibiotic monitoring based on criteria derived from standard practice, as defined in the literature, and on the clinical judgment of the medical staff . In addition, the drug review process should be continuous and should encompass all areas of drug use in the hospital, including effectiveness in terms of disease outcome as well as cost efficiency . The authors discuss procedures under development in their institution to promote cost efficiency and informed discussion regarding clinical use of antibiotics on the formulary . Microbiology reporting, drug use, requests for nonformulary drugs, and unusual patterns of infection and sensitivities are tracked to identify problem areas and a feedback loop is used to inform the medical staff. Cell Immunol, 1989 Jul, 121(2), 447 - 73 The birth of immunology . II . Metchnikoff and his critics; Tauber AI et al.; The presentation of the phagocytic theory of immunity, proposed by Metchnikoff in 1883, was immediately attacked by German pathologists and microbiologists . Led by Baumgarten and Ziegler, criticism was levied against the hypothesis in three general respects: 1) Can an analogy truly be established between leukocyte phagocytosis and feeding of monocellular organisms? 2) What is compelling about the phagocytic process as a universal defensive activity? 3) General philosophic objections were raised, centered upon the accusation of a teleologic formulation . Underlying the argument was the rejection of the notion that the response of phagocytic leukocytes was truly causal in the successful response to infection . We note that the humoral school of immunity was not established until 1888-1890, and the early debate between Metchnikoff and his detractors was not over an alternative theory of an active immune response . There was none . With the development of the humoralist position, in direct response to Metchnikoff's formulation, a true dialogue about immunity, in the modern context of active host response, was initiated . The debate at this point changed to issues of mechanism (cellular versus humoral effectors), and the relative importance of defining innate versus acquired immune processes . Our study traces the scientific and logical basis of the initial rejection of the phagocytosis theory . More broadly, the analysis of this debate elucidates the emergence of a new concept of immunity that rested upon the notion of an active host response . The humoralists erected their theory on Metchnikoff's original scaffold, and the ensuing debate of the nascent science relied on the successful establishment of his basic concept . With the studies of Bordet, Metchnikoff's protege, the essential resolution of the acrimonious debate was offered . Metchnikoff continued his research by attempting to apply the phagocytosis theory to mechanisms of senility, while immunology oriented itself toward the biochemical definition of immune recognition. Br J Clin Pract, 1989 Jul, 43(7), 238 - 41 An open study to assess the acceptability and effectiveness of miconazole 1,200 mg single ovule in the treatment of acute vaginal candidosis; Dinsmore WW et al.; The efficacy and acceptability of a single dose 'ovule' formulation of miconazole in the treatment of acute vaginal candidosis has been assessed in 42 patients attending a GU clinic . The signs and symptoms of vaginal candidosis were assessed by the investigator at an initial visit, and at seven and 28 days post-treatment . A high vaginal swab was taken at each visit, for routine microbiology . Patients also rated their symptoms daily for seven days post-treatment . The cure rate at Day 7 was approximately 88 per cent, with the recurrence rate at Day 28 estimated as 16 per cent of those cured . All patients found the single dosage formulation easy to use, and the majority thought the ovule effective as a treatment for their vaginal candidosis. Med Clin North Am, 1989 Jul, 73(4), 847 - 58 Pyogenic and amebic liver abscess; Rustgi AK et al.; Amebic liver abscess is more common than pyogenic liver abscess on a global scale . In the United States, pyogenic liver abscess is more frequently seen . The epidemiology, etiology, microbiology, clinical features, natural history, diagnostic studies, and treatment of pyogenic and amebic liver abscess are discussed. Eur J Biochem, 1989 Jul 1, 182(3), 667 - 71 Solubilisation of methane monooxygenase from Methylococcus capsulatus (Bath); Smith DD et al.; The membrane-bound (particulate) form of methane monooxygenase from Methylococcus capsulatus (Bath) has been solubilised using the non-ionic detergent dodecyl-beta-D-maltoside . A wide variety of detergents were tested and found to solubilise membrane proteins but did not yield methane monooxygenase in a form that could be subsequently activated . After solubilisation with dodecyl-beta-D-maltoside, enzyme activity was recovered using either egg or soya-bean lipids . Attempts to further purify the solubilized methane monooxygenaser protein into its component polypeptides were unsuccessful and resulted in complete loss of enzyme activity . The major polypeptides present in the solubilised enzyme had molecular masses of 49 kDa, 23 kDa and 22 kDa which were similar to those seen in crude extracts {Prior, S . D . & Dalton H . (1985) J . Gen . Microbiol . 131, 155-163} . Studies on substrate and inhibitor specificities indicated that the membrane-associated and solubilised forms of methane monooxygenase were quite similar to each other but differed substantially from the well-characterised soluble methane monooxygenase found in cells grown in a low copper regime and synthesised independently of the particulate methane monooxygenase. Biochem Biophys Res Commun, 1989 Jun 30, 161(3), 1244 - 51 Solubilization and activity of yeast cells in water-in-oil microemulsion; Pfammatter N et al.; Baker yeast cells are solubilized in organic solvents by the use of surfactants and small amounts of water . Data are reported for three different systems, Tween/Isopropylpalmitat, Asolectin/IPP, Asolectin/Hexadecane . The viability (life-capability) can remain as high as 80% for 10 Days, the asolectin systems being more efficient . The viability is significantly higher for yeast cells derived from cultures which had been previously solubilized in the microemulsion system . The implications of the finding for microbiology in organic solvents, and some general mechanistic aspects, are briefly discussed. Schweiz Rundsch Med Prax, 1989 Jun 20, 78(25), 718 - 21 {Disseminated nocardiosis due to Nocardia brasiliensis in an ambulatory patient}; Zufferey P et al.; We report the case of a 76-year-old man with generalized nocardiosis . The microbiologic pattern, the different clinical manifestations and the treatment of nocardiosis are discussed in general . In the particular case of our patient the disease manifested itself primarily as a subcutaneous abscess, a metastasis secondary to pulmonary nocardiosis . The disease was caused by a Nocardia brasiliensis, which is rarely seen in Europe and which does not usually cause a generalized form of nocardiosis. J Am Vet Med Assoc, 1989 Jun 15, 194(12), 1761 - 3 Guttural pouch tympany: 15 cases (1977-1986); McCue PM et al.; From 1977 to 1986, guttural pouch tympany was diagnosed in 15 horses--11 fillies and 4 colts . Review of the medical records provided results of physical, microbiologic, radiographic, and endoscopic examinations, treatment protocols, complications, and recovery rate . All affected horses had visible swelling in the parotid gland region, 9 had abnormal respiratory noise, 5 had pneumonia, and 1 had dysphagia . Six horses were treated by median septum fenestration alone, and in 8 horses, this procedure was combined with resection of the mucosal flap at the pharyngeal orifice of the eustachian tube . One horse was not treated . Follow-up information was obtained for 13 horses . Rate of recurrence was 33% (2/6) after fenestration alone and was 29% (2/7) when both procedures were combined . One horse that had been treated using combined procedures died of pneumonia, and a horse treated unsuccessfully by septum fenestration was euthanatized because of persistent dysphagia . Eight horses greater than 2 years old when follow-up information was obtained were reported to be healthy, and 4 of these had raced successfully. J Am Vet Med Assoc, 1989 Jun 15, 194(12), 1724 - 5 Blue-green algae (Anabaena spiroides) toxicosis in pigs; Chengappa MM et al.; Toxicosis caused by Anabaena spiroides was diagnosed in 7 of 26 finishing hogs in a farrow-to-finish operation in Kentucky . Several sick pigs in the herd had the following clinical signs: vomiting, dull appearance, lethargy, anorexia, muscle tremors, frothing at the mouth, coughing, sneezing, dyspnea, and bloody diarrhea . Of the 7 dead pigs, 2 were necropsied . Tissue speciments and stomach contents were obtained for microscopic, microbiologic, and toxicologic evaluations . In addition, vomitus from sick pigs and pond water samples were collected for laboratory analysis . Direct microscopic examination of pond water, vomitus, and stomach contents revealed nearly pure A spiroides, a toxic blue-green algae . The possible involvement of bacterial toxins in these pigs was not established; however, the laboratory and field data suggested that the clinical signs and death losses were attributable to the consumption of pond water mixed with the bloom of the alga, A spiroides. Wien Klin Wochenschr, 1989 Jun 9, 101(12), 423 - 4 {The Delphi panel "atherosclerosis report"--concept and experiences}; Kunze M et al.; While the overall mortality in Austria is decreasing and life expectancy is increasing the mortality rate from ischaemic heart disease has been stable for more than 15 years despite therapeutic progress . In many countries well-established prevention programs have helped to decrease the cardiovascular mortality by more than the overall mortality . In order to provide the basis of a nationwide program to reduce morbidity from cardiovascular diseases, their epidemiological importance must be documented convincingly, as well as the available strategies for their prevention and therapy . The most convincing form of documentation is a joint statement by leading medical experts . Hence, the "Delphi panel" method was chosen as the most appropriate approach . In Austria, the Institute of Social Medicine, University of Vienna and the Austrian Society of Hygiene, Microbiology and Preventive Medicine published the "Atherosklerosebericht" (atherosclerotic report), result of a written Delphi panel, in June 1988 . Concept and practical experiences are reported below. J Otolaryngol, 1989 Jun, 18(4), 176 - 80 Mycotic sinusitis: a management protocol; Parnes LS et al.; There has been a recent increase in reported cases of fungal sinusitis . This may be due to better awareness and improved histopathological methods as well as increasing numbers of immunologically compromised patients . We present a case of mycotic sinusitis in an immunocompetent individual to emphasize the clinical features of this disease . The pathology and microbiology are analyzed and a management protocol is discussed. Arch Intern Med, 1989 Jun, 149(6), 1274 - 8 Unsuspected pulmonary tuberculosis in a community teaching hospital; Counsell SR et al.; Tuberculosis remains a significant clinical and public health problem in the United States . To determine if a significant proportion of hospitalized patients diagnosed as having pulmonary tuberculosis were not suspected of the disease following initial patient assessment, we retrospectively reviewed the microbiology records of a 515-bed community teaching hospital and identified all patients with culture-proven Mycobacterium tuberculosis infection hospitalized between January 1983 and December 1987 . Pulmonary tuberculosis was not suspected in 13 (42%) of 31 patients with active disease . These patients were elderly (92% aged 65 years or older vs 8% aged less than 65 years), had a delay in respiratory isolation (6 vs 1 days) and diagnosis (8 vs 3 days), in addition to a longer hospitalization (16 vs 11 days) with increased mortality (46% vs 11%) . Inadequate diagnosis may contribute to the persistence of morbidity and mortality from tuberculosis in this country. Fertil Steril, 1989 Jun, 51(6), 919 - 30 Current management of a donor insemination program; Hummel WP et al.; Substantial evidence now exists to show that considerable maternal-fetal morbidity may result from microbiologic transmitted diseases that can be transmitted through artificial insemination by donor . In the present decade it has become increasingly clear that the use of fresh semen is potentially hazardous and its use has been discouraged by both the CDC and AFS . To minimize this risk, donor insemination programs should establish their own guidelines to thoroughly evaluate potential semen donors via history, physical examination, and laboratory evaluation before the use of donor semen after cryopreservation and quarantine . The management of a donor insemination program in the future requires uniform procedures for rigorous genetic and microbiologic screening before the selection and use of semen donors for artificial insemination. J Am Vet Med Assoc, 1989 Jun 1, 194(11), 1583 - 8 Subcutaneous abscesses and arthritis caused by a probable bacterial L-form in cats; Carro T et al.; Three cats in one household developed pyogenic subcutaneous abscesses and arthritis over a period of 9.5 months . Despite vigorous surgical and antibiotic treatment, the infections in each of these cats continued to spread locally and hematogenously to involve other joints and subcutaneous sites . Although the infections did not respond to modern broad-spectrum antibiotics, they were susceptible to tetracycline . In spite of a favorable response to tetracycline, all 3 cats were euthanatized . A causative agent could not be identified by microbiologic culture of tissues obtained prior to death and at necropsy, or with special tissue stains . The infection was transmitted experimentally by sc inoculation with cell-free material from one of the naturally infected cats to a specific-pathogen-free cat . A tissue extract from the experimentally infected cat was, in turn, infectious for another specific-pathogen-free cat . The experimentally induced lesion was a rapidly enlarging necrotizing and pyogenic cellulitis and panniculitis, with no demonstrable causative agent by special tissue stains or microbiologic culture . A probable bacterial L-form was visualized in affected tissues of the experimentally infected cats and propagated in special L-form broth . Like the natural disease, infection in experimentally inoculated cats was progressive in nature, but could be treated successfully with tetracycline. Clin Lab Med, 1989 Jun, 9(2), 319 - 40 Automated antibiotic susceptibility testing: comparative evaluation of four commercial systems and present state; Kiehlbauch J et al.; Automation of AST has come quite some way and is here to stay . In particular, fully automated, "hands off" instruments have great appeal to laboratories with a limited number of well-trained and experienced clinical microbiology personnel . None of the evaluated instruments is perfect, but then neither are the standard or reference techniques . Overnight incubation has been the yardstick since the early days of in vitro AST . Given the usually shorter therapeutic intervals of 4- to 12-hour dosage schedules, it is quite possible that shorter incubation times for in vitro tests will become more of a standard . Until that time, newer, including automatic, techniques need to be evaluated against the more traditional standard methods . Quality control is critical, and since no systematic approach aside from individual manufacturers' suggestions exists, it should be developed by the NCCLS or similar agencies . Quality control might include standards for the evaluation of such equipment and systems because the development of new technology in this area will continue . Overall, reproducibility and accuracy of the instruments and methods evaluated were quite promising and should encourage well-designed studies of clinical correlation and relevance . The AMS equipment has been in use for routine AST in the clinical laboratories of the Seattle Veterans Administration Medical Center and the University of Washington Hospital . Because of its simplicity and flexibility, the Kirby-Bauer method continues to be an alternate technique for certain important clinical isolates, for instance, blood cultures in both laboratories . Finally, it should be remembered that the most critical function of all such equipment is the reliable detection of resistance. Semin Respir Infect, 1989 Jun, 4(2), 85 - 92 Organization of microbiology laboratory services for the diagnosis of pulmonary infections in patients with human immunodeficiency virus infection; Hadley WK et al.; When faced with the ever-increasing demand for the rapid laboratory diagnosis of Pneumocystis carinii pneumonia (PCP), as well as a variety of fungal, parasitic, and bacterial opportunistic infections in Human Immunodeficiency Virus (HIV)-infected individuals, the Chest Service and the Clinical Microbiology Laboratory at San Francisco General Hospital developed a coordinated plan for the collection and rapid examination of specimens to allow presumptive diagnoses to be made as quickly as possible . Clinical studies have been performed to determine the efficacy of different specimens and diagnostic systems for the provision of clinically useful information . Our approach has been to provide medical care on an outpatient basis using less invasive diagnostic systems that do not require direct physician participation . Direct laboratory examination of a single specimen submitted to microbiology often yielded presumptive or final diagnoses that were directly communicated to the physician . The evolution of PCP diagnosis in AIDS patients is described . Our current procedure of examining mucolysed, concentrated induced sputum stained with a rapid Giemsatype stain, Diff-Quik (Baxter/Scientific Products, McGaw, IL), has a sensitivity for P carinii detection of 74% to 77% . We have found that the use of commercially available immunofluorescence staining diminishes screening time and increases the sensitivity of P carinii detection in mucolysed concentrated induced sputum . We also describe the appearance of bacterial, fungal, and parasitic agents seen on direct examination and the usefulness of antigen detection, serology, and various microbiologic culture systems for diagnosing infections caused by these organisms. Infect Immun, 1989 Jun, 57(6), 1697 - 701 Serotype 8- and serocluster-specific surface-expressed antigens of Ureaplasma urealyticum; Thirkell D et al.; The polypeptides of all 14 serotypes of Ureaplasma urealyticum were analyzed by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and silver staining . The electrophoretic patterns did not allow ready discrimination of individual serotypes or seroclusters . The analysis of the antigens of serotype 8 was reported previously (B . L . Precious, D . Thirkell, and W . C . Russell, J . Gen . Microbiol . 133:2659-2676, 1987) . In this study, three of the surface-expressed membrane antigens of 16, 17, and 96 kilodaltons were further investigated, and monoclonal antibodies were raised against these three polypeptides . The major 96-kilodalton polypeptide was serotype 8 specific, and the 16-kilodalton polypeptide was present only in the larger serocluster . We describe monoclonal antibody probes that unequivocally differentiate serotype 8 from the other serotypes and that separate the two seroclusters of the organism. Geburtshilfe Frauenheilkd, 1989 May, 49(5), 504 - 5 {Severe fetopathy--toxoplasma despite serologic screening . A case report}; Mayer HO et al.; Toxoplasmosis is a special prenatal infection because it is susceptible to medication . Serologic screening and early diagnosis of a new infection is a prerequisite for successful treatment, which protects the fetus from infection . A case of a twenty-two year old gravida-II shows, that infection is possible despite negative initial screening . A new infection was diagnosed because of seroconversion at a routine screening at the end of the second trimester . An ultrasound scan showed severe hydrocephalus, hepatomegaly, and ascites . Labor was induced in the 33rd gestational week . Conatal toxoplasmosis was confirmed by histologic and microbiologic studies of the placenta and membranes . We discuss the difficulties resulting from negative primary serology. J Pediatr Health Care, 1989 May-Jun, 3(3), 144 - 9 Chlamydia trachomatis infections: a health problem of infants; Sheahan SL et al.; As a result of chlamydia epidemic in the adult population, the incidence of Chlamydia trachomatis in infants is increasing . Certain population groups are at risk for development of an infection . This article discusses the epidemiology, microbiology, symptomatology, and management of this problem. Chest . 1989 May;95(5):1164. Endobronchial tuberculosis simulating foreign body aspiration; Caglayan S et al.; A case of sudden onset of severe respiratory distress is reported . Appropriate clinical and roentgenologic findings suggested foreign body aspiration . The foreign body was removed by fiberoptic rigid bronchoscope . Bronchoscopic, histopathologic, and microbiologic findings revealed that the foreign body was a granulomatous mass originating from endobronchial tuberculosis. Gastroenterology, 1989 May, 96(5 Pt 1), 1346 - 9 Cholangitis due to Blastomyces dermatitidis; Ryan ME et al.; A 70-yr-old woman presented with nonspecific complaints and had findings of a cholestatic liver enzyme pattern and a dilated left intrahepatic ductal system by radiographic imaging . Endoscopic retrograde cholangiopancreatography revealed multiple irregular flat stones and a fixed filling defect of the left hepatic duct . At the time of surgery a stonelike lesion of this ductal orifice was found along with a miliary pattern of infection of the left liver lobe . Histologic and microbiologic studies confirmed an infection by Blastomyces dermatitidis . Therapy with amphotericin B resulted in eradication of this infection . Despite their rarity, fungal infections of the biliary tree need to be considered in the differential diagnosis of biliary tract disease in the elderly and immunocompromised patient. Mod Pathol, 1989 May, 2(3), 217 - 21 The value of microbiologic culture of tissue samples in surgical pathology; Braunstein H; The diagnosis of infectious disease is best achieved, and appropriate therapy best effectuated, by isolation and identification of the causative agent . With appropriate exercise of foresight, the necessary procedures can be carried out readily on tissue samples obtained at surgery for morphologic study . Close cooperation among involved specialists permits microbiologic investigation of surgical specimens to be carried out routinely with results highly beneficial to patient care . Four cases illustrating the value of such studies in facilitating diagnosis and treatment are described. Infect Immun, 1989 May, 57(5), 1419 - 26 Comparative analyses of proteins extracted by hot saline or released spontaneously into outer membrane blebs from field strains of Brucella ovis and Brucella melitensis; Gamazo C et al.; Sheep infected with Brucella ovis produce antibody responses to the rough lipopolysaccharide and to proteins present in hot saline (HS) extracts of B . ovis (J . I . Riezu-Boj, I . Moriyon, J . M . Blasco, C . M . Marin, and R . Diaz, J . Clin . Microbiol . 23:938-942, 1986) . The distribution and antigenic relatedness of proteins in HS extracts and in outer membrane blebs were established by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting for 41 strains of B . ovis and 26 strains of Brucella melitensis of diverse geographic origin . Five major groups of proteins were identified in HS extracts of B . ovis that had been freed of rough lipopolysaccharide: proteins of 43 kilodaltons (kDa), group A (25.5 to 32.0 kDa), group B (21.5 to 22.5 kDa); group C (18.0 to 19.5 kDa), and group D (13.0 to 15.5 kDa) . Group A, B, C, and D proteins were also present in blebs . The profiles of proteins in HS extracts or blebs from strains of both Brucella species were very similar . Cross-reactions were demonstrated among HS extracts and blebs of all strains tested in immunoblots performed with an antiserum against the HS extract of a reference strain of B . ovis . Evidence was also provided of an antigenic relationship between group 3 proteins of the outer membrane and some of the proteins in groups A, B, and C . The conservation of these antigens and their immunogenicity in infected animals provide promise that they may serve as components of an effective subcellular vaccine for ovine brucellosis. Z Stomatol, 1989 May, 86(3), 131 - 8 {Chlorhexidine in the treatment of root canal infection and its sequels}; Klimm W et al.; The plaque inhibitor chlorhexidine digluconate was used for intra- and transcanal irrigation in the endodontic treatment triad for periapical lesions (circumscribed, diffuse, fistulating, cystic, suspected cystic lesions) . 50 patients were followed up by clinical and standardized radiologic studies . In another 18 patients microbiologic criteria were also used . 16 root canals showed pretreatment infection with mixed aerobic and anaerobic organisms . Mechanical preparation of the root canals with or without extension of the foramen and triple irrigation with 0.5% chlorhexidine digluconate produced clinical relief of symptoms (49 pts.), sterility (14 of 18 pts.) and reduction of the size of periapical lesions (12 pts.) . At a mean follow-up of 24 months 30 patients have so far shown complete restitution of periapical bone. Stomatol DDR, 1989 May, 39(5), 332 - 7 {Risk of periodontitis--etiology and assessment}; Gangler P; Highly pathogenic microbiota, mixed infections and opportunistic species are the major etiological factor in periodontal diseases, the progression is then modified by known or unknown host factors . Selection of periodontitis-risk individuals is in most cases difficult . Nevertheless epidemiologic data of 2263 subjects show clearly risk age groups (45-54 year and older) and risk teeth . Patients at risk age and risk teeth have to be followed up carefully . The individual risk for deep pocketing and/or attachment loss can be detected on the basis of bleeding after treatment, rapid attachment loss (greater than 1-2 mm/yr) and trends in colonization/recolonization of pathogenic subgingival flora. Adv Dent Res, 1989 May, 3(1), 3 - 6 Forty years of progress; Loe H; The celebration of the 40th anniversary of the National Institute of Dental Research (NIDR) provides an opportunity for reviewing the growth of dental research over the decades . The Institute owes its origin to public and professional concern over the dental health of Americans and the prospect that a Federal investment in dental research could pay off . The early years of the Institute were devoted to studies of fluoride and dental caries, with notable achievements in clinical trials of water fluoridation and caries microbiology . During the 1960s came the discovery that the periodontal diseases, like dental caries, were bacterial infections that could be prevented . Basic and clinical research expanded, and the research manpower pool grew with the addition of microbiologists, immunologists, salivary gland investigators, and other basic biomedical and behavioral scientists . The Institute created special broad-based Dental Research Institutes and Centers to foster interdisciplinary research, and continued to expand its research base . A national survey undertaken by NIDR in the late 1970s showed major declines in caries prevalence in schoolchildren . Recent NIDR surveys of adults and older Americans as well as a second children's survey have demonstrated overall improvements in oral health and a continued decline in childhood caries.(ABSTRACT TRUNCATED AT 250 WORDS) Virology, 1989 May, 170(1), 55 - 61 The VP7 gene of a new G serotype of human rotavirus (B37) is similar to G3 proteins in the antigenic c region; Hum CP et al.; The human rotavirus isolate B37 has a characteristic "super-short" RNA electropherotype and has been shown to represent a new VP7 serotype (M . J . Albert, L . E . Unicomb, and R . F . Bishop, 1987, J . Clin . Microbiol . 25, 183-185) . The VP7 gene was cloned, and its nucleotide and predicted amino acid sequences were compared to other published VP7 gene sequences . Consistent with the serological evidence, two major antigenic regions of the B37 VP7 (i.e., regions A and B) differ in sequence from those of other G serotypes . Unexpectedly, the C antigenic region shows close similarity to G3 rotaviruses, but we were unable to detect a serological relationship using serotype 3 monoclonal antibodies. Rev Med Chil, 1989 May, 117(5), 562 - 71 {The impact of molecular biology in medicine}; Chianale J et al.; Over 30 years ago the genetic material of most organisms was shown to be deoxyribonucleic acid . A considerable amount of information on the fine structure and function of cells has accumulated during this time and important methodological and conceptual advances have occurred . The molecular biology techniques, restricted for many years to basic biologic research, are now being introduced in several areas of clinical medicine . These new ideas are changing the way scientists and physicians think about normal cell function and disease . The DNA recombinant methods allow us to define the molecular mechanisms of several genetic diseases and consider new therapeutic approaches . The biotechnological industry is now producing hormones, peptides and several vaccines by manipulation of genes in bacteria and cell cultures . Our understanding of cell growth and cell differentiation is opening new ways in cancer research; the use of DNA probes in the diagnostic laboratory is exciting to the clinical microbiologist . Molecular biology will continue to advance in the next decades with increasing economic, social and ethical implications. J Bacteriol, 1989 May, 171(5), 2773 - 82 Genetic regulation of glycogen biosynthesis in Escherichia coli: in vitro effects of cyclic AMP and guanosine 5'-diphosphate 3'-diphosphate and analysis of in vivo transcripts; Romeo T et al.; Glycogen accumulation in Escherichia coli is inversely related to the growth rate and occurs most actively when cells enter the stationary phase . The levels of the three biosynthetic enzymes undergo corresponding changes under these conditions, suggesting that genetic control of enzyme biosynthesis may account for at least part of the regulation (J . Preiss, Annu . Rev . Microbiol . 38:419-458, 1984) . We have begun to explore the molecular basis of this control by identifying factors which affect the expression of the glycogen genes and by determining the 5'-flanking regions required to mediate the regulatory effects . The in vitro coupled transcription-translation of two of the biosynthetic genes, glgC (ADPglucose pyrophosphorylase) and glgA (glycogen synthase), was enhanced up to 26- and 10-fold, respectively, by cyclic AMP (cAMP) and cAMP receptor protein (CRP) . Guanosine 5'-diphosphate 3'-diphosphate stimulated the expression of these genes 3.6- and 1.8-fold, respectively . The expression of glgB (glycogen branching enzyme) was affected weakly or negligibly by the above-mentioned compounds . Assays which measured the in vitro formation of the first dipeptide of glgC showed that a restriction fragment which contained 0.5 kilobases of DNA upstream from the initiation codon supported cAMP-CRP-activated expression . Sequence-specific binding of cAMP-CRP to a 243-base-pair restriction fragment from the region upstream from glgC was observed by virtue of the altered electrophoretic mobility of the bound DNA . S1 nuclease protection analysis identified 5' termini of four in vivo transcripts within 0.5 kilobases of the glgC coding region . The relative concentrations of transcripts were higher in the early stationary phase than in the exponential phase . Two mutants which overproduced the biosynthesis enzymes accumulated elevated levels of specific transcripts . The 5' termini of three of the transcripts were mapped to a high resolution . Their upstream sequences showed weak similarity to the E . coli consensus promoter . These results suggest complex transcriptional regulation of the glycogen biosynthesis genes involving multiple promoter sites and direct control of gene expression by at least two global regulatory systems. Am J Ophthalmol, 1989 Apr 15, 107(4), 331 - 6 The epidemiology of Acanthamoeba keratitis in the United States; Stehr-Green JK et al.; We surveyed members of the Ocular Microbiology and Immunology Group and reviewed laboratory requests at the Centers for Disease Control to determine better the epidemiology of Acanthamoeba keratitis in the United States . A total of 208 cases of Acanthamoeba keratitis were identified . The number of cases increased gradually between 1981 and 1984, with a dramatic increase beginning in 1985 . Males and females were equally affected . Of the 208 patients, 85 (41%) resided in California, Texas, Florida, or Pennsylvania . Of 189 patients, 160 (85%) wore contact lenses, predominantly daily-wear or extended-wear soft lenses . Of the 138 patients who wore contact lenses and for whom information was available, 88 (64%) used saline prepared by dissolving salt tablets in distilled water . Patients aged 50 years and older were more likely to have had a history of trauma than younger patients, and males were more likely to have a history of trauma than females. Genitourin Med, 1989 Apr, 65(2), 96 - 7 Taking cervical smears in departments of genitourinary medicine; Griffiths M et al.; The smear taking practices of departments of genitourinary medicine were investigated by telephone inquiry . Departments seem to be broadly and equally divided into those where the smear is taken before the cervix is wiped or endocervical specimens are taken for microbiology, and those where the smear is taken afterwards . In the unit at Guy's Hospital we compared cervical smears taken in both of these sequences and concluded that, to diagnose more cases of premalignant cervical disease, smears should be taken before any other cervical samples. J Am Podiatr Med Assoc, 1989 Apr, 79(4), 190 - 4 Gonococcal arthritis case report; Hirsch E et al.; In the case reported, the diagnosis of gonococcal arthritis unfolded over the course of 1 week and was not fully conclusive until presumptive therapy was initiated . Although the clinical, microbiologic, and immunologic characteristics of gonococcal arthritis can be differentiated from other types of bacterial arthritides, not all textbook symptoms are present at one time in one particular case . There also are subtle signs that are involved . In this case study, there was little definitive evidence that stood out to confirm the diagnosis . It was the interdependence of a complete history, serologic and radiographic studies, clinical presentation, and demographic considerations that led to an accurate diagnosis and timely treatment of gonococcal arthritis. Am J Perinatol, 1989 Apr, 6(2), 234 - 6 Infection and premature labor; Ledger WJ; The possibility that infection can cause premature labor is appealing . If true, antibiotics treat the cause, in contrast to tocolytic agents, which treat symptoms . There is strong evidence that infection is a factor in premature labor . Historical data from the preantibiotic era in patients with pyelonephritis and pneumonia support this . Vaginal bacterial colonization studies and amniotic fluid studies indicate that a portion of women with preterm labor have an identifiable microbiologic profile . Preliminary reports on antibiotic intervention in asymptomatic women and women in premature labor are encouraging . This may be the dawn of a new era in the diagnosis and treatment of preterm labor. Z Gesamte Hyg, 1989 Apr, 35(4), 184 - 6 {Virologic research at the Institute of Medical Microbiology at the Greifswald Ernst-Moritz-Arndt University}; Dohner L; A short review of the virological research at the former Institute of Hygiene and of one of its followers, the Institute of medical microbiology of the Ernst-Moritz-Arndt-University Greifswald is given. Z Gesamte Hyg, 1989 Apr, 35(4), 179 - 84 {100th anniversary of the Institute of Public Health at the Greifswald University}; Schneck P; The presented study reports on the history and development of the Institute of Hygiene at the University of Greifswald, which was founded in 1888 . The first decades of this Institute were shaped by the assistant of Robert Koch, Friedrich Loeffler (1852-1915), an important microbiologist and one of the founders of virology . After 1945 under new social and political conditions specially the Social Hygiene and Occupational Medicine have been expanded and taken up into the lectures . In 1959 the Chair of Microbiology became the status as an own institute . In further development separate chairs of General and Communal Hygiene, Social Hygiene, Occupational Medicine were founded and till 1964 as a particularity of Greifswald a chair of Rural Medicine too . In 1985 these chairs also received status of institutes. Antimicrob Agents Chemother, 1989 Apr, 33(4), 412 - 7 Decreased permeation of cephalosporins through the outer membrane of Escherichia coli grown in salicylates; Foulds J et al.; Escherichia coli K-12 cells grown in 1 to 5 mM sodium salicylate (SAL) or acetylsalicylate show increased phenotypic resistance to various antibiotics (J . L . Rosner, Proc . Natl . Acad . Sci . USA 82:8771-8774, 1985), including cephalosporins (this study) . To determine whether these effects are caused by a decreased uptake of the antibiotics, the permeation of several cephalosporins through the outer membrane was measured . For E . coli K-12 grown in LB broth containing 5 mM SAL or acetylsalicylate, permeation of the outer membrane by the five cephalosporins tested decreased three- to fivefold compared with that in cells not grown in salicylates . Permeation of the outer membrane by cephaloridine decreased within 15 min of the addition of SAL to cells grown in broth and reached a minimum in 1 to 2 h . When cells were transferred from broth with SAL to broth without SAL, their permeability to cephaloridine increased slowly for the first 45 min and more rapidly over the next 1.5 h; the permeability then attained normal levels by 3 h . The permeability changes that occurred after media shifts, either to or from SAL, were prevented by concentrations of chloramphenicol that inhibited protein synthesis . These effects of SAL on outer membrane permeability are fully consistent with their effects on antibiotic resistance and with the report (T . Sawai, S . Hirano, and A . Yamaguchi, FEMS Microbiol . Lett . 40:233-237, 1987) that the outer membranes of SAL-treated cells are deficient in certain porins . Permeation of cephaloridine through the outer membrane also decreased when a virulent strain of E . coli K1 was grown in the presence of as little as 1 to 2 mM SAL . This raises the concern that high levels of salicylates in patients night interfere with cephalosporin or other antibiotic therapies. Am J Clin Pathol, 1989 Apr, 91(4), 493 - 8 Human necrotizing splenitis caused by Borrelia burgdorferi; Rank EL et al.; A 25-year-old Hispanic male presented to the emergency room with complaints of severe left upper quadrant pain . Physicians determined that the patient had an acute inflammatory process with a possible diagnosis of splenic abscess . A splenectomy was performed . Histologic examination of the tissue sections revealed extensive necrosis and inflammation, but no etiologic agent was discernible . Microbiologic cultures of the tissue had negative results . A Dieterle silver stain revealed an overwhelming number of spirochetal bacteria most closely resembling Borrelia spp . The patient's serum was tested for serologic evidence of antibody to Borrelia burgdorferi with the following results; by indirect fluorescent antibody 1:32; by enzyme-linked immunosorbent assay for IgM, 1:320; and Western blotting had positive results for the presence of B . burgdorferi outer-surface protein antibodies . This is the first human case report of an acute necrotizing splenitis resulting from B . burgdorferi. Mikrobiyol Bul, 1989 Apr, 23(2), 110 - 5 {Determination of the csf lactate concentration by LDH enzymes for the diagnosis of bacterial and viral meningitis}; Kanra G et al.; Rapid and accurate diagnosis of bacterial infections is one of the aims of clinical microbiology . This especially true in bacterial meningitis, when delay in proper treatment can be harmful or even fatal . Because the currently used techniques such as Gram stain, culture and immunoelectrophoresis have serious limitations . We previously evaluated cerebrospinal fluid (CSF) lactate levels by analytic way . In this study, we evaluated the diagnostic utility of CSF lactate concentrations which are determined by the enzyme LDH. Med Lab Sci, 1989 Apr, 46(2), 141 - 5 MANAGER: a multi-user computer scheme for management of laboratory staff working hours; O'Hara SP et al.; To administer a flexible-working-time system in a busy medical microbiology department, without increased administrative workload, a set of programs was produced for computer monitoring of staff time-keeping records . The programs--initially written to facilitate management and minimise clerical work, and extended to encompass all staff absences--are collectively called MANAGER . They allow efficient management of working hours and staff absences, using a multi-user laboratory computer . The programs were all written in MUMPS and evolved in-house, but could be developed for any multi-user laboratory computer system. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Stomatol, 1989 Apr-Jun, 36(2), 109 - 15 {A comparative study of antibiogram methods employed in endodontic stomatological procedures}; Puchita M et al.; The study demonstrates the importance of the antibiogram in the determination of the sensitivity of microbiocenosis of the infected dental canals . The methods and the techniques for the sampling of the pathological products are presented . The classical technique for antibiograms, consisting in horizontal diffusimetry is compared with the modern method of double-layer diffusimetry which employs a "redox" indicator (C.T.T.-triphenyl-tetrazolium-2, 3, 5-chloride) which accelerates the lecture of the results by altering the colour of the culture medium . The study was carried out in 200 patients and showed that the antibiotics with the widest spectrum on the microbiocenosis of the infected dental canals were, by order of efficiency, the following: erythromycin, chloramphenicol, ampicillin, and tetracycline . Antibiograms should be done in the shortest possible time, and the time for the lecture of the results was reduced from 36-48 hours in the case of the classical antibiograms to 16-18 hours in the case of the rapid technique . The shortening of the working time allows for a more rapid individualization of the treatment, and the preparation of antibiotic-incorporating pastes that will reduce the number of procedures to 1-2 procedures in the simple form of the pulp gangrene and to 3-4 procedures in the cases of complicated pulpal gangrene. J Biol Chem, 1989 Mar 5, 264(7), 4015 - 20 Characterization of the calmodulin-binding and of the catalytic domains of Bordetella pertussis adenylate cyclase; Ladant D et al.; The structural organization of the low molecular mass form (43 kDa) of Bordetella pertussis adenylate cyclase was dissected taking advantage of the known sequence of the bacterial cya gene (Glaser, P., Ladant, D., Sezer, O., Pichot, F., Ullmann, A., and Danchin, A . (1988) Mol . Microbiol . 2, 19-30) and its low content of Trp and Met residues . Cleavage of the 43-kDa protein and of its complementary tryptic fragments (T25 and T18 peptides) with N-chlorosuccinimide and cyanogen bromide followed by sodium dodecyl sulfate-polyacrylamide gel analysis of digestion products allowed the following conclusions: (i) the catalytically active 43-kDa form of B . pertussis adenylate cyclase is within the first 400 residues of the protein encoded by the cya gene . T25 occupies the N-terminal domain of the protein (residues 1-235/237) . Isolated T25 fragment exhibits a low but measurable enzymatic activity which indicates that it harbors the catalytic site; (ii) T18 which is the main calmodulin-binding domain, occupies the C-terminal segment of protein (residues 236/238-399) and is devoid of catalytic properties; (iii) the two complementary peptides T25 and T18 reassociated only in the presence of calmodulin, leading to significant recovery of the original activity . These results demonstrate that both fragments of the 43-kDa form of adenylate cyclase are essential for a high level of enzymatic activity. Health Bull (Edinb), 1989 Mar, 47(2), 78 - 84 Laboratory investigations in a rural general practice--cost and effect implications; Orlandi M et al.; An audit of a rural practice's use of laboratory investigations, over a period of three months, 3,4 in that as well as calculating costs an attempt has been made to assess the effectiveness of the investigations' results in relation to subsequent decisions concerning patient management . Two principals and a trainee were involved in the project, in a practice with a list of 3,200 patients . Approximately 12% of patients contacts were investigated which is comparable with previous studies 3, 4, 5 . Cervical cytology and pregnosticon testing were excluded from the study . A total of 594 investigations were requested from 421 patients . Microbiology accounted for 39.8% of the total requests, Haematology 31.3%6, Biochemistry 22.4% and Radiology 6.5% . These results are similar to other published studies, though, requests for Radiological were somewhat lower 3, 4, 5, 7 . An estimate of the annual cost of investigations is given (see Tables I-IV) . Implications of the results for the practice in cost terms is discussed. Int J Artif Organs, 1989 Mar, 12(3), 165 - 9 Acute abdominal events and their impact on morbidity and mortality in a CAPD program; Chandran PK et al.; A retrospective analysis was done to explore the impact of acute abdominal events other than peritonitis, on morbidity and mortality in a CAPD program over a span of 6 years . Subtlety of clinical manifestations and low yield from investigational attempts (except microbiologic) made decision-making as to whether or not to continue CAPD, hard . An increased prevalence of septicemic shock with its inevitable high risk of morbidity and mortality was striking . Timely termination of CAPD and change over to hemodialysis may help to prevent dissemination of infection in these patients . Among the vascular causes of death in CAPD patients, bowel infarction seemed to be the most common. J Clin Microbiol, 1989 Mar, 27(3), 431 - 5 Diagnosis of Giardia lamblia infections by detection of parasite-specific antigens; Janoff EN et al.; Antigen detection methods may facilitate diagnosis of Giardia lamblia in stool specimens . As determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis and immunoblotting, G . lamblia cysts and trophozoites share several antigens, especially in the 65-kilodalton and 30- to 34-kilodalton regions . By using blind methods, we compared results obtained by counterimmunoelectrophoresis using cyst-immune rabbit serum and by enzyme-linked immunosorbent assay (ELISA) using trophozoite-immune rabbit serum with results obtained by microscopic examination of a preserved, concentrated, and permanently stained stool specimen . Results were similar when these three methods were used to examine 118 stool specimens from clinical microbiology laboratories (53 specimens with G . lamblia) and specimens from 239 day-care-center toddlers (39 specimens with G . lamblia) . Compared with microscopy, we found, for counterimmunoelectrophoresis and ELISA, respectively: sensitivity, 88 versus 94%; specificity, 97 versus 95%; positive predictive value, 86 versus 76%; negative predictive value, 98 versus 97%; and concordance, 89% . The false-positive rate by ELISA was 24% (10 of 42) in day-care-center toddlers but only 3% (1 of 32) in healthy adults (P less than 0.04) as corroborated by microscopy . This discrepancy suggests that the ELISA may be more sensitive than microscopy, which is considered the reference standard, and that results may be dependent, in part, on the epidemiology of the infection in the study subjects. Rev Infect Dis, 1989 Mar-Apr, 11(2), 208 - 12 Polymicrobial fungemia: microbiology, clinical features, and significance; Guerra-Romero L et al.; In a retrospective study covering a period of 13 1/2 years, polymicrobial fungemia was documented in 22 (3.4%) of 645 patients with fungemia . These infections were hospital acquired and occurred in patients with significant underlying diseases . In terms of the clinical setting and features, predisposing factors, fungal species responsible, management, and mortality rate (59%), polymicrobial fungemia appears similar to the more common "monomicrobial" fungemia . With increasing numbers of patients at risk and improved laboratory detection of fungemia, clinicians will probably encounter increasing numbers of these polymicrobial bloodstream infections. Ther Umsch, 1989 Mar, 46(3), 178 - 84 {Echography of the soft tissues of the neck}; Anderegg A; Clinical examination remains of utmost importance when dealing with patients presenting with symptoms in the cervical region . High frequency real time ultrasound can confirm a clinical diagnoses and give precise information about measurements and content of the lesion . Ultrasound guided needle punctures for cytology or microbiology are most informative . Duplex or better color Doppler instruments provide information about the vascular supply of a lesion . Thyroid, parathyroid, salivary glands, lymph nodes and blood vessels of the cervical region are studied . Malformations and tumors of the neck, of the tongue and of the subclavian fossae are portrayed. Keio J Med, 1989 Mar, 38(1), 1 - 12 A review of Nobel prizes in medicine or physiology, 1901-87; Kantha SS; This review examines the awards of Nobel Prizes for Medicine or Physiology discipline between 1901 and 1987, in order to evaluate the advances made in biomedical sciences in the twentieth century . A total of 78 awards had been made amounting to 144 laureates . Countrywise, scientists from the USA lead the tally of Nobelists with 62 laureates, followed by those from Britain and Germany . In the first quarter (1901-25), majority of the awards were given to pioneering studies in microbiology and physiology . Following three decades (1926-55) show the emergence of biochemists as preferred winners with many of the nutrition-related discoveries receiving the recognition . During and immediately after the Second World War (between 1939 and 1957), pharmacology related studies were also awarded Nobel merit . Molecular biology, genetics and immunology had become the prime areas for recipients during the last three decades beginning with 1958 . Apart from these four distinct speciality areas, classic discoveries in the fields of neurosciences and behavior, clinical medicine, experimental biology endocrinology had also been recognized at regular intervals. Rev Infect Dis, 1989 Mar-Apr, 11(2), 184 - 96 Spirochete-like organisms in the human gastrointestinal tract; Ruane PJ et al.; Spirochete-like organisms were first detected in human feces in 1884 . In the century since that observation an appreciable amount of epidemiologic and morphologic information has been published; nevertheless, it is not known how many species of cultivable human intestinal spirochetes exist, nor is the role of these organisms in health and disease known . Recent advances in microbiologic techniques, coupled with the recognition that the rate of carriage of such spirochetes in certain populations is approximately 30%-40%, should provide the impetus for careful scientific study of these organisms and of their importance-if any-to human health. Oralprophylaxe, 1989 Mar, 11(1), 3 - 8 {Plaque--gingivitis--periodontitis . (2) Microbiology and pathogenesis of periodontitis}; Plagmann HC; In a survey, current conceptions regarding the origin of gingivitis and periodontitis, as well as their clinical picture, are described . After the build-up of the bacterial plaque in several phases to form a periodontal pathogenic plaque, following a short, acute stage, a chronic gingivitis soon establishes itself in the neighbouring soft gingival tissue, from which, not inevitably, however, a periodontitis can develop after some years, the osseous parts now also being involved in the periodontal destruction, in which the polymorphonuclear neutrophilic granulocytes appear to have a major share . Depending on the age of the patient, progress of the disease, and the composition of the subgingival plaque, endeavours are made to classify the periodontal diseases into four subgroups . In recent years, however, doubt has increased as to whether gingivitis and even the periodontitides can be considered as comprising a single disease . However, this does not affect therapeutic concepts developed on the basis of opinions to date and which, as a rule, are successful, so that, for the time being, there is no reason for a change in this sphere. J Virol, 1989 Mar, 63(3), 1431 - 4 RNA-RNA hybridization identifies a human rotavirus that is genetically related to feline rotavirus; Nakagomi T et al.; A human rotavirus AU228 strain which resembled the AU-1 strain (O . Nakagomi, T . Nakagomi, Y . Hoshino, J . Flores, and A . Z . Kapikian, J . Clin . Microbiol . 25:1159-1164, 1987) in its novel characteristics (that it belonged to subgroup I yet possessed a long RNA pattern) was compared with various human and animal strains by RNA-RNA hybridization in solution . This strain showed a high degree of homology with the AU-1 strain but not with either the Wa (subgroup II, long pattern) or the KUN (subgroup I, short pattern) strain, indicating the presence of an additional group of human rotaviruses that do not belong to either of the two human rotavirus families previously identified by RNA-RNA hybridization . It is of particular interest that the AU228 strain showed an unexpectedly high degree of homology with a feline rotavirus isolated recently in Japan . These results indicate transmission of a feline rotavirus to humans and suggest a role of animal rotaviruses in the evolution of human rotaviruses. Eur J Clin Microbiol Infect Dis, 1989 Mar, 8(3), 191 - 202 Current knowledge on Chlamydia pneumoniae, strain TWAR, an important cause of pneumonia and other acute respiratory diseases; Grayston JT et al.; This article reviews current knowledge of Chlamydia pneumoniae strain TWAR, a newly recognized Chlamydia organism that causes acute respiratory infection, especially atypical pneumonia . Information is included on the microbiology, classification and laboratory diagnosis of the organism . Details of a series of studies of both endemic and epidemic respiratory infections are reviewed to present information on both the clinical and epidemiological characteristics of infection with strain TWAR . Laboratory studies of antibiotic sensitivity and recommendations for treatment are presented. JPEN J Parenter Enteral Nutr, 1989 Mar-Apr, 13(2), 176 - 84 Blood levels of water-soluble vitamins in pediatric patients on total parenteral nutrition using a multiple vitamin preparation; Marinier E et al.; Although guidelines for the parenteral use of vitamin preparations in pediatric patients have been published, there are very limited data on the efficiency of these preparations and on the exact needs of infants and children on total parenteral nutrition (TPN) . We report here an open, prospective, study of the blood levels of water-soluble vitamins in infants and children on TPN before and during supplementation with a new water-soluble multivitamin formula containing per vial unit: B1, 3 mg; B2, 3.6 mg; B6, 4 mg; niacin, 40 mg; pantothenate, 15 mg; ascorbate, 100 mg; biotin, 60 micrograms; folic acid, 400 micrograms; B12, 5 micrograms . Thirteen children, 9 months to 15 yr old, on home TPN for 1.5 months to 7 yr, and 17 hospitalized infants and children, 1 week to 15 yr old, receiving TPN were studied for 2 weeks to 4 months . Daily doses were given according to age: 1/2 vial if less than 18 months; 1 vial if greater than 18 months and less than 10 years; 1.5 vials if greater than 10 years . Assays for B1, B2, biotin, niacin, plasma and red blood cell (RBC) folates were performed by microbiologic methods, B12 was measured by radioimmunoassay . During the study, B1 levels were consistently above the upper limit of the normal range, B2 and B12 remained in the normal range although there was a slight decrease in B12 values . Almost half of the patients had initially low levels of biotin, niacin, and folates . Biotin, after a significant sharp rise during the first month of supplementation returned to normal range . Niacin levels were initially low in infants and rose toward normal values during treatment.(ABSTRACT TRUNCATED AT 250 WORDS) Rev Med Chil, 1989 Mar, 117(3), 339 - 41 {The "Revista Médica de Chile." 100 years ago}; Costa-Casaretto C; An article on the treatment of tuberculosis encouraging the possibilities of successful outcome; comments upon private and public hygiene, upon the development of microbiology in Germany, are included . The creation of the Pasteur Institute in Paris for the treatment of rabies is reported. J Am Vet Med Assoc, 1989 Feb 15, 194(4), 561 - 2 Abortion, stillbirth, neonatal death, and nutritional myodegeneration in a rabbit breeding colony; Yamini B et al.; Vitamin E deficiency was found to be the cause of reproductive failure and nutritional myodegeneration in a rabbit breeding colony . The diagnosis was based on the low vitamin E concentration of doe liver (5.73 micrograms/g) associated with myodegeneration of tongue, skeletal muscle, and heart and the absence of other abnormal microbiologic and parasitologic findings . Supplementation of the diet with wheat germ oil returned the does' fertility to normal, and abortion, stillbirth, and neonatal death ceased. Wien Klin Wochenschr, 1989 Feb 3, 101(3), 105 - 6 {Requests for chemical analysis: growth without end?}; Thomas L; The number of analyses dealt within laboratory medicine increased from 1970 until the middle of the 80s by about 15% per annum in the German Federal Republic . The number of analyses in clinical chemistry, haematology, blood banking and haemostaseology have now reached a plateau . Because these analyses account for 85% of laboratory testing in big hospitals, the problems of rapid growth do not exist any longer . The single most important concern today is the spiralling cast of the remaining 15% of analyses, in the fields of serology, tumour diagnosis and monitoring, endocrinology, drug monitoring and microbiology . These investigations, which are rapidly increasing at the rate of about 15% annually, are mainly analyzed by means of the immunoassay technique . Immunoassays are very cost-intensive and, thus, current trends in laboratory medicine are characterized by an overproportional increase in costs with no foreseeable diminution in escalation. Chest, 1989 Feb, 95(2), 299 - 303 Safety and efficacy of using high-dose topical and nebulized anesthesia to obtain endobronchial cultures; Berger R et al.; We evaluated the safety and efficacy of high-dose topical and nebulized airway anesthesia in normal volunteers and in patients undergoing diagnostic fiberoptic bronchoscopy . Lidocaine solution (4 percent) was used for gargling, for spraying the palate and oropharynx with an atomizer, and for nebulization with an air-powered nebulizer (mean total dose, 1,682 mg) and 2 percent lidocaine (Xylocaine) jelly for anesthetizing nasal passages . In six normal subjects and in eight patients, lidocaine blood levels were measured at baseline, after gargling, after spraying, after nebulization, and then at 5, 10, 15, 30, and 60 min; 19 normal subjects and ten patients underwent the same anesthesia protocol but had no blood drawn . Fiberoptic bronchoscopy was performed in 21 normal volunteers and in 18 patients and cultures obtained using the protected specimen brush . Additional endobronchial lidocaine (mean 256 mg) was given to the 18 patients after collecting the microbiology specimens . Peak lidocaine blood levels remained below 6 micrograms/ml in all cases . Cough and discomfort during bronchoscopic examination was absent or minimal in 17 of 21 normal subjects (80 percent) and in 14 of 18 patients (77 percent) and was severe in only one instance (5 percent) . There were no related complications . Using only topical and nebulized anesthesia is safe and effective for performing fiberoptic bronchoscopy, especially when bacterial cultures are to be obtained and endobronchial instillation of lidocaine must be avoided. J Pediatr, 1989 Feb, 114(2), 194 - 203 Hemorrhagic shock and encephalopathy: clinical, pathologic, and biochemical features; Levin M et al.; To further define the clinical, pathologic, and biochemical features of hemorrhagic shock and encephalopathy syndrome, we studied 25 affected children (aged 3 months to 14 years) admitted to a single center between 1982 and 1985 . A prodromal illness comprising vomiting, diarrhea, listlessness, and fever was present in 84% of the cases . Acute onset of shock, convulsions and coma, bleeding (or laboratory evidence of disseminated intravascular coagulation), elevated plasma activity of hepatic enzymes, acidosis, and impaired renal function was present in every case . Twenty patients died, and all the survivors are neurologically damaged . At postmortem examination, intravascular microthrombi coexisting with hemorrhages and petechiae were found in most organs . Centrilobular liver necrosis and cerebral edema were prominent features . No microbiologic cause for the disorder was identified, but decreased plasma levels of the protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin, together with increased levels of circulating proteolytic enzymes, were frequently present . An overrepresentation of the uncommon variant phenotypes of alpha 1-antitrypsin was found in first-degree relatives of affected patients (four had the MZ phenotype, and one each the MS or MC phenotype, of 19 relatives studied) . Abnormal accumulation of alpha 1-antitrypsin was detected immunohistochemically in the livers of six of the patients . Defective protease inhibitor production or release may be involved in the pathogenesis of the disorder. J Parodontol, 1989 Feb, 8(1), 31 - 51 {Current classification of periodontal diseases}; Suzuki JB et al.; Since the last 15 years, tremendous progress have been made on epidemiology, microbiology, natural history, immunology, and periodontal tissue response to different treatment modalities . Thus, we are able to suggest today a relatively new classification of the different periodontal diseases far from the one based on the concept of "the periodontal disease" . This article aims to help clinicians in understanding the classification of such diseases allowing better treatment and eventually better results. Urol Clin North Am, 1989 Feb, 16(1), 139 - 47 Infections in genitourinary prostheses; Carson CC; During the past two decades, the use of implantable prostheses has experienced exponential growth . In urology, penile prostheses have been especially popular . Although many mechanical problems have been reported, the most disastrous complication is infection, which usually mandates prosthesis removal and often leads to severe disability or loss of function of the organ in which the prosthesis was implanted . The author reviews the pathogenesis, microbiology, diagnosis, and treatment of genitourinary prosthesis infections. Am J Med, 1989 Feb, 86(2), 173 - 7 Mycobacterium chelonae: a cause of nodular skin lesions with a proclivity for renal transplant recipients; Cooper JF et al.; PURPOSE: Infections due to Mycobacterium chelonae are uncommon . Several renal transplant recipients at our medical center have developed M . chelonae infections during the past several years, so we decided to review our recent experience with M . chelonae infections . PATIENTS AND METHODS: The clinical microbiology laboratory records of four Vanderbilt University Affiliated Hospitals were reviewed . Ten patients with M . chelonae tissue or blood infections were identified between 1982 and July 1988 . RESULTS: All infections involved the skin and subcutaneous tissue . Three infections developed at the sites of medical injections . The remaining seven infections occurred in renal transplant recipients and produced a clinically distinctive syndrome . All were indolent tender nodular lesions on the extremities, usually the lower legs . Systemic symptoms were absent, and white blood cell counts were within normal limits . Diagnosis required tissue biopsy and cultures that were incubated for a month . Therapy consisted of surgical excision combined with long-term antibiotics . Even so, some patients had a chronic, relapsing course . CONCLUSION: Although other diagnoses must be considered, the presumptive diagnosis of M . chelonae infection is suggested by the appearance of nodular erythematous lesions on the legs of a renal transplant recipient. Enferm Infecc Microbiol Clin, 1989 Feb, 7(2), 77 - 82 {Lymphocytic meningitis . Virologic study . Analysis of the study carried out from 1984 to 1986 (632 cases)}; Tellez A et al.; The experience with the virological diagnosis of lymphocytic meningitis in the Centro Nacional de Microbiologia during 3 years (1984-1986) included 632 cases . The most common causative organism was the parotiditis virus (46.9%), particularly in children (64.6%), followed by the non-polio enteroviruses (25.3%) . The varicella-zoster virus was the most common organism found in adults (33.3%) . We describe some clinical and epidemiological aspects, emphasizing the absence of clinical features suggesting herpesvirus infection in about 50% of cases . Finally, we indicate the study techniques or methods more adequate in each instance (specific IgM detection, isolation techniques or detection of intrathecal antibody production), and we define a study protocol for cases of acute lymphocytic meningitis which permits a high diagnostic yield (44.1-54.9%). FEMS Microbiol Lett, 1989 Feb, 48(3), 317 - 22 Demonstration of clonal variation amongst O-antigen serotype variants of Escherichia coli O2 and O18 using DNA probes to the rfb region of the E . coli strain B41 (O101:K99/F41); Beger DW et al.; The confirmation at the DNA level of the existence of clonal variants within Escherichia coli O2 and O18 serotypes has been shown by Southern hybridization analysis of restriction endonuclease digested genomic DNA and subsequent probing with contiguous subclones of the E . coli O101 rfb region . The O101 rfb subclones are believed to represent a conserved region of DNA (Heuzenroeder et al . Molec . Microbiol, in press) and identify serotype variants by means of restriction fragment length polymorphisms (RFLP) within homologous DNA of O2 and O18 E . coli . A number of different restriction enzymes have been used singly and in combination to digest the genomic DNA, thereby allowing construction of restriction maps of the region displaying homology to the O101 rfb region subclones . This analysis further substantiates previously defined evolutionary relationships between O2 and O18 E . coli . These simple probes appear to be able to provide the same clonal information as a battery of isoenzyme, outer membrane protein (OMP) and lipopolysaccharide (LPS) analyses. Exp Hematol, 1989 Feb, 17(2), 116 - 9 A new bioassay for human granulocyte colony-stimulating factor (hG-CSF) using murine myeloblastic NFS-60 cells as targets and estimation of its levels in sera from normal healthy persons and patients with infectious and hematological disorders; Shirafuji N et al.; {3H}thymidine uptake by NFS-60 cells in microcultures was found to increase in a linear fashion with the increasing doses of purified recombinant human granulocyte colony-stimulating factor (rhG-CSF) . Such increases were found neither with rhG-CSF samples pretreated with rabbit anti-rhG-CSF serum nor with other human colony-stimulating factors such as granulocyte-macrophage colony-stimulating factor (hGM-CSF) or macrophage colony-stimulating factor (hM-CSF) . Based on these findings, sera from normal persons and patients with severe infections or various hematological disorders were tested after dialysis using this system in order to determine whether G-CSF levels in sera can be estimated or not . In ten normal persons, five patients with acute myelogenous leukemia (AML M1, M2, and M3), five with myelodysplastic syndrome, and four with chronic myelogenous leukemia, no increases in {3H}thymidine uptake were found within the dose range of 0.4 microliters to 50 microliters . In contrast, linear dose responses parallel to a G-CSF standard curve were observed in one patient with a severe bacterial infection, four with aplastic anemia, two with acute myelomonocytic leukemia (AMMoL) (M4), and two with idiopathic neutropenia tested . From the standard curve, the probable levels of G-CSF were calculated as follows: approximately 200 pg/ml with infection, 130-220 pg/ml with aplastic anemia, 150 and 200 pg/ml with AMMoL, and 1120 and 1200 pg/ml with idiopathic neutropenia . The activities of sera were reduced by the anti-rhG-CSF serum pretreatment in the same way as documented in the case of rhG-CSF . Furthermore, the level in a patient with a severe infection became undetectable soon after elimination of the infection and blood neutrophil counts had returned to normal . These findings indicate that the microbioassay system will be useful for measuring circulating G-CSF levels which would fluctuate in accord with requirements for stimulating neutrophil production or with abnormal production of hG-CSF. J Neurosci Res, 1989 Jan, 22(1), 36 - 49 Novel astrocytic protein in multiple sclerosis plaques; Malhotra SK et al.; Monoclonal antibody J1-31 (MAb J1-31, isotype IgG 2b) was raised against crude homogenate of brain tissue from a multiple sclerosis (MS) patient (autopsy sample; Malhotra et al.: Microbios Letters 26:151-157, 1984) . In human brain, MAb J1-31 recognizes an intracellular protein antigen (J1-31 antigen), which bands at approximately 30,000 daltons under reducing conditions for sodium dodecyl sulfate gel electrophoresis (Singh et al.: Bioscience Reports 6:73-79, 1986) . By immunofluorescence microscopy, MAb J1-31 stains those cells that are also stained by antiserum to glial fibrillary acidic protein (GFAP), namely astrocytes, retinal Muller cells, and tanycytes in the ependyma (Predy et al.: Bioscience Reports 7:491-502, 1987) . In addition, MAb J1-31 stains ciliated ependymal cells that do not express GFAP . Using a model system for gliosis (laceration-type injury of rat spinal cord), we were able to show that astrocytes responding to central nervous system injury exhibit greatly enhanced staining for J1-31 antigen (Predy et al.: Journal of Neuroscience Research 19:397-404, 1988; Predy and Malhotra: Brain Research Bulletin in press, 1989) . In this article, we demonstrate that immunofluorescence staining owing to MAb J1-31 is greatly enhanced in MS plaques, as compared to adjacent "apparently normal" white matter . (This is consistent with previous results as MS plaques characteristically show an astroglial response {reactive gliosis} leading to the formation of a glial scar {McKhann: Annual Review of Neuroscience 5:219-239, 1982}.) In addition, we present further evidence that J1-31 antigen is distinct from GFAP, although these two proteins may be associated spatially with one another. Chemotherapy, 1989, 35(2), 123 - 9 Pitfalls in testing drug uptake by leukocytes using radiolabeled drugs and an explanation of conflicting results with clindamycin; Maderazo EG et al.; Although studies of drug uptake by leukocytes use similar methods, the results reported are sometimes vastly different . To determine the possible reasons for this, we studied neutrophil uptake of {3H}-clindamycin using the most frequently used density gradient centrifugation method and the volume probes 3H2O and {3H}-polyethylene glycol . We found that the {3H}-clindamycin available to investigators had undergone radiolytic decomposition; thus, its microbiologic activity was only 20% of its original potency . By thin-layer chromatography and autoradiography, four extra label-bearing regions were observed with {3H}-clindamycin . Results of neutrophil uptake studies have shown a drop of cellular:extracellular concentration ratios from 40:1 in 1981 to 10:1 in 1982 and 1987. Pathologica, 1989 Jan-Feb, 81(1071), 47 - 56 Cryptosporidiosis of human large intestine in H.I.V . Report of a case examined under light and electron microscope study; Grigolato PG et al.; The Light and Electron Microscope aspects of a colonic Cryptosporidiosis in a H.I.V . patient are reported . The authors stresses the importance of Endoscopic biopsies and Electron Microscopic studies in confirming the microbiologic stool examination for oocysts of the parasite . In particular, by an histological point of view, there are no specific findings indicative for Cryptosporidium infection, apart the identification of the parasite forms with PAS, Giemsa and Grocott stains . Electron Microscopy reveals in this case only the presence of Macrogametocyte. Toxicol Pathol, 1989, 17(4 Pt 1), 617 - 28; discussion 629 Significance of sequential cellular changes inside and outside foci of altered hepatocytes during hepatocarcinogenesis; Bannasch P et al.; A variety of phenotypic cellular changes emerge in the liver of different species prior to the appearance of hepatocellular adenomas and carcinomas induced by carcinogenic agents (chemicals, radiation, hepadna viruses) or develop "spontaneously." Foci of altered hepatocytes have been studied most extensively in rats treated with chemical carcinogens; they are considered preneoplastic lesions and have been used in several laboratories as endpoints in carcinogenicity testing . The principles and problems of the morphological classification of foci of altered hepatocytes are presented . In addition to the 4 types of foci generally accepted (clear, acidophilic, basophilic and mixed cell foci), further subtypes (intermediate cell foci) or other types of foci, namely tigroid cell foci and amphophilic cell foci, have more recently been separated as distinct pathomorphological entities . Whereas the amphophilic foci might result from a modulation of clear and acidophilic cell foci, the tigroid cell foci apparently represent a stage in a separate cell lineage leading to hepatocellular adenomas . It remains open whether the tigroid cell foci may also progress to carcinomas . Extrafocal phenotypic changes of hepatocytes might also be involved in hepatocarcinogenesis . The cellular phenotypes within foci also depend strongly, among many other factors, on the dose and duration of the carcinogenic treatment . Cytomorphological, cytochemical, microbiochemical and stereological studies suggest that the predominant sequence of cellular changes during hepatocarcinogenesis leads from the clear and acidophilic cell foci storing glycogen in excess through mixed cell foci and nodules to basophilic cell populations prevailing in hepatocellular carcinomas . A multitude of metabolic aberrations is associated with the sequential cellular changes . Aberrations in carbohydrate metabolism are particularly prominent and might be causally related to the neoplastic transformation of the hepatocytes. Pharmacotherapy, 1989, 9(6), 363 - 71 Clinical features and treatment of Lyme disease; Tortorice KL et al.; Lyme disease is caused by the spirochete Borrelia burgdorferi, which is carried by infected ticks . This disorder has a variable clinical course with multisystem manifestations, including dermatologic, neurologic, cardiac, and rheumatologic abnormalities . Although Lyme disease has been commonly associated with stages, the utility of staging may be limited due to the inconsistency of clinical manifestations among patients . Furthermore, stages may overlap as a result of the acute and chronic phases of the disease . The laboratory characteristics of Lyme disease are highly variable . The use of microbiologic cultures in establishing the diagnosis requires several weeks and has a low yield of positivity . Serologic assays using indirect immunofluorescence and enzyme-linked immunosorbence are preferred . Because of the highly variable features of Lyme disease, clinical and laboratory features must be correlated and interpreted in the context of the disease . Treatment should be initiated as early as possible after the onset of illness . Prompt therapeutic intervention may result in early resolution of the dermatologic hallmark, erythema chronicum migrans, as well as prevention and attenuation of subsequent complications. Med Cutan Ibero Lat Am, 1989, 17(4), 255 - 9 {Epidemiological study of tinea pedis in a population studied in Santa Casa de Sao Paulo}; Zaitz C et al.; The authors make an epidemiologic study of tinea pedis aiming at establishing its minimal frequency in the population studied, as well as recognizing the most frequent fungi and the clinical aspects they determine . We've tried to study the role of the dermatophytes in the normal microbiota of the feet . Finally we analyzed the influence of sex and seasonality factors on the incidence of tinea pedis. Clin Prev Dent, 1989 Jan-Feb, 11(1), 3 - 7 Effects of smoking on oral ecology . A review of the literature; Macgregor ID; The smoking habit is associated with a variety of deleterious changes in the mouth . In this review, the toxicology of tobacco smoke and its effects on the saliva, oral commensal bacteria and fungi, and oral polymorphonuclear leukocytes, are described . Smoking increases salivary flow rate, but does not alter the composition of plaque or its rate of deposition . Smoking appears to enhance anaerobiosis in the oral cavity, and depress the activity of oral leukocytes . Additionally, tobacco smoke components may have a selective toxic effect on particular species of microbiota . Gingival fluid exudate is reduced in smokers, with the consequence that the carriage of leukocytes and immunoglobulins is likely to be diminished. Fortschr Ophthalmol, 1989, 86(5), 509 - 14 {New immune proteins and their perspectives for ophthalmology}; Scheiffarth OF; Research and progress in immunology and microbiology made the characterization and production of immunological active proteins possible . Lymphokines and monoclonal antibodies can be synthesized by new methods of gene technology and cell fusion techniques . These proteins meanwhile are of essential importance in biomedical research and are becoming an important tool in clinical medicine too . The possibility to modify the proteins or to label them with cytotoxic substances provides exciting aspects of medical progress for the future . Applications in ophthalmology hopefully will lead to new and successful ways for the diagnosis and therapy of ocular diseases. Ann Chir, 1989, 43(6), 451 - 7 {Pancreatic cystadenoma}; Le Borgne J; Pancreatic cystadenomas are infrequent cystic neoplasms which include 2 different lesions: microcystic cystadenomas and mucinous cystadenomas . Over a 37 year period, we observed 25 pancreatic cystadenomas: 15 microcystic cystadenomas and 10 mucinous cystadenomas . The microcystic cystadenomas corresponded either to a localized tumor (13 cases) or multiple diffuse cystic lesions of similar histology occurring within the context of Von Hippel-Lindau disease (2 cases) . Localized or multiple microcystic cystadenomas are benign tumors with no risk of degeneration . Mucinous cystadenomas are potentially malignant large unilocular or multilocular cystic tumors . Preoperative differentiation between the 2 types of cystadenomas is based essentially on ultrasound and computed tomography to a lesser extent on angiography . Localized microcystic cystadenomas are low-density, hypervascularized solid or mixed tumors . Mucinous cystadenomas are anechogenic, often show septation, and are water-dense and avascular . They should be differentiated from a microcystic cystadenoma with unilocular cyst features (2 cases in our series) and especially from pancreatic pseudocyst, particularly in case of a history of trauma and associated chronic pancreatitis (2 cases) . Multiple microcystic cystadenomas should be differentiated from congenital polycystic disease of the pancreas . Determination of the benign or malignant nature of a mucinous cystadenoma is difficult despite the contribution of ultrasonically-guided percutaneous puncture and microbiopsy . Such samples are either insufficient or too limited, incurring the risk of over looking an area of localized degeneration . However, intraoperative biopsy of pancreatic cyst wall can correct an erroneous diagnosis of pseudocyst (1 case) and avoid inappropriate internal drainage . Total excision of mucinous cystadenomas represents the only suitable solution in view of the malignant potential of this tumor.(ABSTRACT TRUNCATED AT 250 WORDS) Scand J Thorac Cardiovasc Surg, 1989, 23(1), 51 - 6 Early clinical experience with a simple method for autotransfusion in cardiac surgery; Szecsi J et al.; A simple method for intraoperative autotransfusion (ATF) in open-heart surgery was tested in a prospective clinical trial . The patients were randomly assigned to a control group (33) or to the ATF group (35) . The intraoperative ATF was combined with preoperative collection of blood and postoperative ATF . The postoperative chest-tube drainage was reduced by 24.3%, the donor-blood requirement by 43.3% and the consumption of fresh-frozen plasma by 43.9% in the ATF group as compared with the controls (all differences statistically significant) . To investigate possible haematologic side effects of ATF, measurements of haemoglobin, haematocrit, fibrinogen concentration, thrombin, prothrombin and partial thromboplastin time, antithrombin-III and fibrinolytic activity were made in all patients preoperatively and on postoperative days 1 and 2 . No statistical differences were then found between the controls and the ATF group . Microbiologic tests of blood sampled from the cardiotomy reservoir gave satisfactory results. Stereotact Funct Neurosurg, 1989, 52(2-4), 250 - 61 Intraoperative CT-guided serial microbiopsy of brain lesions and concomitant use of CT air and angiographic studies; Uematsu S et al.; The value of step-by-step confirmation of the location of the brain biopsy probe is demonstrated, using serial CT scanning to confirm the exact source of the sample tissue . Concomitant use of CT angiography and a CT air study makes possible the biopsy of small areas and of areas near major cerebral vessels, as well as of lesions near critical areas like the optic chiasma, basal ganglia, midbrain, and other complex lesions . The pathologist on-line examination of the CT-confirmed serial samples enables the surgeon to obtain the most informative tissue for the ultimate histopathological diagnosis . Our experience with the technique is illustrated by examples of its application in some complex cases. Acta Radiol, 1989 Jan-Feb, 30(1), 45 - 7 Mucinous cystadenocarcinoma of the pancreas . Ultrasonographic findings in 5 cases; Bastid C et al.; The ultrasonographic findings in 5 patients (4 males, 1 female, mean age 70 years) presenting with mucinous cystadenocarcinoma of the pancreas are described . The lesion was located in the head and body of the pancreas in 2 cases, in the head alone in 2 others, and in the tail in one . The size ranged from 40 to 85 mm (mean 64 mm) . Internal septa were seen in 5 patients, endocystic proliferation in 2, parietal calcifications in 1 and mixed cystic-solid areas in 3 . The estimation of CEA in the fluid collected by sonographic guided puncture may be useful in diagnosis . Guided microbiopsy and fine needle cytology performed in 3 cases confirmed the diagnosis . Moreover, ultrasonography clearly showed the modifications of the vessels (splenic and portal veins, inferior vena cava) secondary to the tumor . It is concluded that ultrasonography with guided puncture is a simple, inexpensive and effective method for the diagnosis of mucinous cystadenocarcinoma of the pancreas. Folia Microbiol (Praha), 1989, 34(6), 525 - 35 Compounds isolated at the Department of Biogenesis of Natural Substances, Institute of Microbiology, Czechoslovak Academy of Sciences, in 1984-1988; Podojil M et al.; A total of 41 compounds studied at the Department of Biogenesis of Natural Substances between 1984 and 1988 are characterized and tabulated . They include natural, semisynthetic and synthetic compounds. Horm Res, 1989, 32(5-6), 218 - 23 A new microbioassay for the measurement of lactogenic hormones in human serum; Maddox PR et al.; The standard Nb2 assay for biologically active prolactin has been modified to allow a rapid convenient microbioassay without loss of specificity or accuracy . Lactogenic hormones specifically stimulate the replication of Nb2 node rat lymphoma cells in suspension culture and form the basis of a currently available bioassay to measure prolactin and growth hormone in human serum . A new microbioassay was developed using microtest plates enabling a large number of samples to be assayed simultaneously whilst maintaining the overall sensitivity of the bioassay for lactogenic hormones . Growth of the Nb2 node lymphoma cells, measured by a light scattering technique using optical density on a spectrophotometer, was shown to be closely correlated with the cell number determined on a Coulter counter . Addition of excess anti-human prolactin and anti-human growth hormone completely inhibited the growth stimulatory effects of both human prolactin and human growth hormone . This new microbioassay (BA) and conventional radioimmunoassay (RIA) were used to measure lactogenic hormones in 48 normal subjects . There was a close correlation between the results of both assays for each hormone studied in the control sera . The mean basal BA/RIA ratio was 1.5 (range 0.8-2.0) for prolactin, 0.7 (range 0-4.5) for growth hormone and 1.3 (range 0.5-1.9) for total lactogenic activity. Periodontal Case Rep, 1989, 11(1), 12 - 9 Clinical and microbiologic changes following the irrigation of periodontal pockets with metronidazole or stannous fluoride; Lazzaro AJ et al.; The purpose of this investigation was to determine the efficacy of subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions on the clinical and microbiologic parameters of adult periodontitis as compared with scaling and root planing . Twelve patients with moderate to advanced periodontitis were selected, and one pocket of a minimum 5-mm probe depth in each quadrant received one of the following treatments: (a) one session of scaling and root planing at the beginning of the experiment, (b) stannous fluoride irrigation, (c) metronidazole irrigation, and (d) saline irrigation . Results showed that scaling and root planing provided significantly better improvement in most of the clinical parameters than did the two tested irrigants . Saline also provided a statistically significant improvement, but only during the first 4 weeks . The four methods of treatment provided a sustained decrease in spirochetes, with a concomitant increase in coccoid cells . It was concluded that although subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions improved periodontal health, they never achieved the same efficacy as scaling and root planing and, therefore, should not be substituted for fastidious mechanical subgingival plaque and calculus removal. Ann Biol Clin (Paris), 1989, 47(10), 607 - 19 Ferrocene modified po