Vet Med (Praha), 1982 Aug, 27(8), 449 - 58 {Differences in susceptibility of cows, in half-sisters by the same sire to mastitis}; S'tavikova M et al.; The set of 9,555 cows, Bohemian Spotted breed, was studied if the sires contributed significantly to higher resistance, or on the contrary to susceptibility, of daughters to mastitis . The study was performed in 67 groups of half-sisters . Statistically highly significant (P less than 0.01) and significant (P less than 0.05) differences were proved as regards the frequency of bacteriologically positive and negative half-sisters in 36 groups as compared with the frequency ratio of positive and negative animals in the population . The daughters of 20 sires were more influenced in the positive sense, i . e . they suffered from mastitis less frequently than the daughters of 16 sires with a higher occurrence of the disease. Gut, 1982 Aug, 23(8), 706 - 9 New disinfecting apparatus for gastrointestinal fibre-endoscopes; O'Connor HJ et al.; Bacterial contamination of gastrointestinal fibre-endoscopes is a potential source of clinically significant infection . Aqueous 2% alkaline glutaraldehyde adequately disinfects fibre-endoscopes but may cause serious sensitivity reactions among endoscopy staff . A new 'closed-system' disinfecting apparatus is described that disinfects with glutaraldehyde for 30 minutes before an endoscopy session, for two minutes between patient procedures, and for 10 minutes before storage . Bacteriological cultures of the endoscope after disinfection were virtually sterile . Extremely low glutaraldehyde vapour levels were detected by gas chromatography in endoscopy room air during disinfection procedures . This relatively simple apparatus offers rapid, effective, and safe disinfection of fibre-endoscopes. Clin Exp Immunol, 1982 Aug, 49(2), 317 - 24 Improved leucocyte migration inhibition response of leucocytes from lepromatous leprosy patients with hapten modified M . leprae; Fotedar A et al.; Two acetoacetylated derivatives of Mycobacterium leprae with variable hapten groups and a conjugate with tetanus toxoid were prepared . These were tested as antigens along with unmodified M . leprae in the leucocyte migration inhibition response of leucocytes from clinically, bacteriologically and histopathologically confirmed cases of lepromatous leprosy . LMI response was poor with M . leprae, but was significantly enhanced with acetoacetylated M . leprae. Jpn J Antibiot, 1982 Aug, 35(8), 2015 - 21 {Clinical studies on cefmenoxime in the intensive care unit}; Taenaka N; Two to 6 g of CMX was administered daily to 9 patients who were admitted to ICU, i.e . 5 cases with pneumonia and 4 with sepsis . In all cases, CMX was administered concomitantly with aminoglycoside which had been administered, and additional administration of other antibiotics was avoided . Bacteriologically, P . aeruginosa was isolated from 4 cases, K . pneumoniae from 4 cases, S . marcescens, P . mirabilis and P . cepacia respectively from 1 case . The CMX treatment was considered effective in 4 of 5 pneumonia cases and in 3 of 4 sepsis cases . In total, 7 of 9 cases responded effectively . The clinical effective rate was 77.8% . Elevation of GOT and GPT values was noticed in 1 case, however, the causality with CMX administration was unclear. Am J Surg, 1982 Aug, 144(2), 257 - 61 Short-term systemic prophylaxis with cefoxitin and doxycycline in colorectal surgery . A prospective, randomized study; Ivarsson L et al.; The efficacy of cefoxitin or doxycycline as antibiotic prophylaxis in colorectal surgery was compared in 102 elective operations . Both drugs were used perioperatively only . Cefoxitin was used in 55 cases and doxycycline in 47 . Ten patients in the cefoxitin group and 4 in doxycycline group had wound infections . Three intraabdominal abscesses were seen, one after cefoxitin and two after doxycycline prophylaxis . All three were due to anastomotic leakage . Bacteriologic studies revealed no negative ecologic effects of prophylaxis . The short-term prophylaxis used did protect against serious infectious complications . The extended spectrum of cefoxitin provided no added benefit in prophylaxis . Patients with inflammatory bowel disease treated preoperatively with salicylazosulfapyridine run a greater risk of postoperative infection in spite of the prophylaxis. Schweiz Med Wochenschr, 1982 Jul 17, 112(29), 1049 - 54 {Traveler's diarrhea}; Markwalder K et al.; Travelers' diarrhea is of concern to practitioners in temperate countries in two ways: people ask advice for effective prophylaxis before they leave for tropical regions, and returning travelers often complain of diarrhea after a journey to the tropics . Diarrhea at the beginning of a trip to southern regions is mainly due to bacterial pathogens; later, a parasitic origin for diarrhea becomes an increasing possibility . A rational and economic diagnostic approach to the diarrhea of returning travelers does not necessarily and always include bacteriological stool cultures . Situations warranting a wait-and-see symptomatic treatment are discussed . The authors believe that chemoprophylaxis for traveler's diarrhea should not be prescribed as a general measure. Ann Acad Med Singapore, 1982 Jul, 11(3), 458 - 63 Immunology in Singapore--past and future; Chan SH; In the past, immunology in Singapore was mainly confined to serology for the diagnosis of certain infectious diseases . Postgraduate education for immunology was not well developed and its undergraduate training was restricted to a few lectures within bacteriology . With the establishment of the W.H.O . IRTC in 1969, training and research in immunology were further developed and a group of scientists and technicians to conduct research work was subsequently built up . This enabled the Centre to provide some immunological services to the Government and University, and soon extended these to our neighbouring countries as well . Further research and the maintenance of international standards are essential for the future development of immunology in Singapore . And this is only possible with the moral and financial support of the Government, University and private granting bodies. Ann Osp Maria Vittoria Torino, 1982 Jul-Dec, 24(7-12), 251 - 9 {Endocervical and vaginal changes in women wearing IUD's}; Botta G et al.; The authors have studied the endocervical and vaginal changes in common vaginal smears from IUD supplied women . 521 smears from IUD supplied women have been comparized with 500 "normal" smears and 210 from women affected by lesions of the cervix uteri . The results point out that the IUD seems to be the cause of two different alterations: 1) bacteriological changes; 2) cytological changes . 1) There is a noticeable increase in mixed bacterial population and trichomonas; this picture corresponds to the one in women with cervical ectopia . 2) Cytologically there is an increase in parabasal-like cells as those from areas of squamous metaplasia . The Aa . assume that probable hormonal or mechanical changes may cause a squamous metaplasia of the cervix uteri in IUD supplied women . These stimuli themselves are the probable cause of the microbial morbid variations. J Cardiovasc Surg (Torino), 1982 Jul-Aug, 23(4), 338 - 43 Pneumococcal aortic valvar endocarditis with atrio-ventricular perforation; Louagie Y et al.; A case of pneumococcal endocarditis, complicated by a left ventricular-right atrial fistula and a rapidly progressing cardiac failure in a 56 year-old man, is reported here . In the acute period, an aortic valve prosthesis was installed and the atrio-ventricular fistula was closed with patches of pericardium . After serious post-operative complications, the patient left the clinic, cured of his bacterial endocarditis . He unfortunately died two months later of a massive myocardial infarction caused by a previously unrecognized atheromatous stenosis of the anterior descending branch and occlusion of the circumflex vessel . The authors discuss the bacteriological, anatomopathological and clinical aspects of this rare complication of bacterial endocarditis in light of the current available literature. Ann Intern Med, 1982 Jul, 97(1), 18 - 21 Antibiotic therapy of acute exacerbations of chronic bronchitis . A controlled study using tetracycline; Nicotra MB et al.; We conducted a double-blind, randomized, placebo-controlled trial in 40 patients to evaluate the need for antibiotics in acute exacerbations of chronic bronchitis . All patients were sufficiently ill to require hospitalization although none needed ventilatory support; the presence of pneumonia was excluded . Treatment consisted of bronchodilators, corticosteroids, and either tetracycline, 500 mg, or placebo by mouth every 6 hours for 1 week . Arterial blood gases, spirometric tests, bacteriologic evaluation of sputum, and patient and physician evaluation of the severity of illness were assessed at the beginning and end of the study . All patients improved both symptomatically and by objective measures of lung function . At the end of the study period there were no differences between those patients receiving tetracycline and those receiving placebo . We conclude that antibiotic therapy is not needed in moderately ill patients with exacerbations of chronic bronchitis. Laryngoscope, 1982 Jul, 92(7 Pt 1), 732 - 8 Evaluation of orbital cellulitis and results of treatment; Schramm VL Jr et al.; Optimal management of patients with orbital cellulitis depends on how accurately the disease is classified and on the appropriateness with which antibiotics and surgery are used to treat the disease . Therapy must be adjusted on the basis of the extent of the disease . In order to determine the balance of treatment modalities which is most beneficial for certain disease presentations, we reviewed a series of 303 patients with orbital cellulitis . The anatomical and bacteriological etiology of the disease was determined in each case on the basis of the examination, visual acuity, results of sinus radiography, results of culture, ultrasonography, and computerized tomography . To avoid the 5% complication rate that occurred in this series, an evaluation and treatment protocol is recommended. Crit Care Med, 1982 Jul, 10(7), 444 - 7 Colonization of the gastric contents in critically ill patients; Hillman KM et al.; In a study of 28 ventilated patients in the ICU, cimetidine was ineffective in maintaining gastric pH above 4 . Quantitative and qualitative bacteriological examination of daily gastric aspirates showed that when the pH was above 4, there was rapid colonization with high counts of organisms, predominantly coliforms . Progressive colonization by yeasts, independent of pH, was noted in nearly one-half of the patients . Gastric colonization has possible implications in terms of crossinfection of development of aspiration pneumonia . As these are seriously ill patients with compromised gastrointestinal (GI) barriers and decreased immunity, the large numbers of bacteria or their endotoxins may contribute to the high incidence of septicemia. Lepr India, 1982 Jul, 54(3), 448 - 53 Solid, fragmented and granular index as one of the parameters in drug trials; Sharma VD et al.; A bacteriological study of the skin smears of 108 bacteriologically positive cases of leprosy, 30 of them untreated, has been undertaken . In each case solid, fragmented and granular (SFG) index, bacteriological index (BI) and morphological index (MI) of skin smears from 4 sites were calculated . The results show that SFG index together with BI can be used as one of the parameters in drug trials . The importance of SFG index in research and as a routine laboratory procedure in leprosy control units undertaking multi drug therapy is discussed. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1982 Jul-Sep, 31(3), 205 - 10 {Incidence and prevalence of chronic pulmonary tuberculosis in the Cîmpulung-Argeş district 1972-1980}; Diaconescu M et al.; The study concerns 53 cases of chronic and hyperchronic pulmonary tuberculosis followed over a period of 9 years (1972-1980) . These cases are analysed from the viewpoint of the frequency of the disease in relation to age, sex and environment, as well as from the viewpoint of the localization, morphology, and bacteriology of the lesions . References are further made to causes which lead to chronicization of pulmonary tuberculosis starting from the cases in this group . The efficiency of the strictly supervised treatment is evaluated by the dynamics of chronic pulmonary tuberculosis over the 9 year period, as well as problems related to socio-professional rehabilitation of the patients. Sem Hop, 1982 Jul 1, 58(26-27), 1617 - 21 {Skin flora of the hands, elbow-hollow and fore-arm (author's transl)}; Reverdy ME et al.; During five years, the values of the skin flora of the hands, fore-arm and elbow-hollow were studied on volunteers, especially five of them . Samples were taken according to the washing method . Results show important quantitative variations of the flora between the differents volunteers and even for a same volunteer . In the five long term followed subjects, the differences were: 2.17 log 10 for aerobic flora and 1.97 log 10 for aeroanaerobic flora of the hands, 3.90 log 10 for aerobic flora and 3.88 log 10 for aero-anaerobic flora of the fore-arm, 2.95 log 10 for aerobic flora and 3.35 log 10 for aero-anaerobic flora of the elbow-hollow . These variations remained independent of the season . According to these variations, already notified by others authors it is suggested first to standardize sampling and bacteriological methods, second to develop multicentric programs in view to increase the number of subjects to be included in the study. S Afr Med J, 1982 Jun 5, 61(23), 871 - 2 {The relationship between bacterial sputum analysis and infection}; Opperman JC; Sputum specimens were examined microscopically for the presence of squamous epithelial cell (SECs) and leucoctyes . Where less than 10 SECs and more than 25 leucocytes per low-power field were present, pathogenic organisms were isolated from 84% of patients with pulmonary infections . Sputum specimens which did not comply with these requirements showed a weaker correlation and more non-pathogenic organisms of the buccal cavity were isolated . The bacteriological isolates in sputum specimens and the clinical conditions with which they were associated in this series, are described. Jpn J Antibiot, 1982 Jun, 35(6), 1395 - 8 {Studies on fortimicin in the field of ophthalmology}; Matsuya N et al.; Bacteriological and clinical studies of fortimicin in the field of ophthalmology were performed and the results obtained were as follows . 1 . The concentration of fortimicin in serum, primary aqueous humor and secondary aqueous humor after intramuscular injection of 30 mg/kg to rabbit reached the peak value of 23.36 microgram/ml after 1/2 hour, 6.07 microgram/ml after 1 hour and 60.6 microgram/ml after 1 hour, respectively . 2 . The concentration of fortimicin in primary aqueous humor after subconjunctival injection of 10 mg (0.5 ml) in the rabbit eye reached the peak value of 8.06 microgram/ml after 1/2 hour . 3 . The concentration of fortimicin in plasma and primary aqueous humor after intramuscular injection of 200 mg in patients of cataract before operation reached the value of 8.85 microgram/ml and 0.74 microgram/ml after 1 hour . 4 . Fortimicin was administered to 5 cases of internal hordeolum and 2 cases of corneal ulcer . Clinical effects were excellent in 3 cases, good in 2 cases and fair in 2 cases . Side effect was observed diarrhea, but the causal relationship with fortimicin was unknown. Can J Microbiol, 1982 Jun, 28(6), 667 - 71 The occurrence of filamentous fungi in drinking water distribution systems; Nagy LA et al.; The densities of filamentous fungal colonies, together with physicochemical and bacteriological parameters, were assessed in a chlorinated and unchlorinated drinking water distribution system at eight separate times over a period of 1 year . Filamentous fungal colonies were enumerated by membrane filtration on Czapek-Dox agar . The mean number of filamentous fungal colony-forming units per 100 mL of drinking water was 18 in the unchlorinated and 34 in the chlorinated system . The majority of filamentous fungi isolated wee saprophytic Deuteromycotina . The four most frequently occurring genera were Penicillium, Sporocybe, Acremonium, and Paecilomyces . In the chlorinated system, only physicochemical parameters correlated with observed fungal frequencies, whereas in the unchlorinated system, none of the parameters exhibited significant correlations with fungal numbers. Am Rev Respir Dis, 1982 Jun, 125(6), 681 - 3 Rifampin-containing chemotherapy for pulmonary tuberculosis associated with coal workers' pneumoconiosis; Jones FL Jr; The outcomes of 20 anthracite miners with coal workers' pneumoconiosis and culture-proved pulmonary tuberculosis treated with rifampin-containing chemotherapeutic regimens were determined by a retrospective review . Their mean age was 65 yr, and the duration of underground dust exposure averaged 27 yr . Nine miners had simple pneumoconiosis, 11 had progressive massive fibrosis, and 13 had cavitary disease; 3 also had extrapulmonary disease . All patients were given rifampin (mean, 12 months in survivors) plus one or more other effective agents; the mean duration of treatment with 2 or more drugs was 17 months . Follow-up averaged 46 months in those surviving more than 1 yr . Sputum cultures became negative and remained so within 3 months in 17 patients and within 5 months in the remainder . Eighteen patients survived more than 1 yr after completing chemotherapy . No clinical, radiologic, or bacteriologic relapses were observed during follow-up, but 5 patients died of nontuberculous causes . These results are superior to those reported previously in patients with coal workers' pneumoconiosis treated for pulmonary tuberculosis with regimens not containing rifampin . They suggest that treatment of tuberculosis in coal workers, even in the presence of progressive massive fibrosis and cavitary disease, can yield results as favorable as in nonpneumoconiotic patients provided the initial treatment regimen includes rifampin plus one or more other effective agents. Biull Eksp Biol Med, 1982 Jun, 93(6), 122 - 3 {Development method providing fine-grain electron microscopic radioautographs}; Pal'tsyn AA et al.; A modification of the development of electron microscopy autoradiographs with p-phenylenediamine is suggested . The development in the mode described was found fairly convenient for bacteriological studies . The method provides small silver grains specific in shape, which leave open the greater part of a bacterium even in the presence of considerable accumulation of silver grains . The grains can be readily counted . The development results are reasonably reproducible. Parasitology, 1982 Jun, 84(Pt 3), 511 - 26 Growth of Trypanosoma cruzi in vitro: development and application of a continuous-flow culture system; Williams GT et al.; The design and operation of a modular, bacteriological continuous-flow culture system have been adapted for the growth of Trypanosoma cruzi epimastigotes in simple monophasic media . The system was designed to achieve a minimum of 200 days of continuous culture and provision was made for the continuous supply of medium and collection of parasites under sterile conditions . The system provides large quantities of epimastigotes with homogeneous morphology and uniform viability . The system also lends itself to the analysis of the factors which affect parasite growth . We examined the effects of changes in environmental parameters on epimastigote growth rate . Optimal growth was observed at 27 degrees C . The rate of stirring of the culture had a small but definable effect on the growth rate, which was greatest at 80 rp.m . Growth was only slightly affected by the level of dissolved oxygen between 10 and 50% saturation, but was inhibited at higher concentrations . Growth was slower at extreme values of pH but showed a broad optimum around pH 7.4. Am J Clin Nutr, 1982 Jun, 35(6), 1490 - 6 Enteral nutrition by nasogastric tube in adult patients treated with intensive chemotherapy for acute leukemia; de Vries EG et al.; In this study, nutritional status 3 wk after starting 20 induction course of chemotherapy with enteral nasogastric tube feeding was compared to the nutritional status after 35 courses with a normal oral hospital diet . Tube feeding consisted of 2000 to 3000 cal daily of a hospital made pasteurized formula or sterile Nutrison RTS . In the group fed by nasogastric tube the mean weight loss was significantly smaller (p less than 0.01) and there were fewer patients with a severe weight loss of more than 5% during the first 3 wk (p less than 0.01) than in the hospital diet group . Serum albumin reduction of more than 10% was present in 4/20 and 23/35 for each group respectively (p less than 0.01) . Bacterial contamination occurred in the pasteurized hospital-made formula which led to Pseudomonas septicemia in one patient . During a short-term catabolic state (3 wk) sterile feeding by nasogastric tube can prevent weight loss and hypoalbuminemia in most patients . Bacteriological control of the food and supply system is mandatory in granulocytopenic patients. Jpn J Antibiot, 1982 Jun, 35(6), 1523 - 52 {Comparative study on cefmetazole and cefazolin in the treatment of suppurative otitis media}; Baba S et al.; Cefmetazole (CMZ) was compared to cefazolin (CEZ) for efficacy and safety in the treatment of suppurative otitis media (including acute otitis media and chronic otitis media in acute aggravating stage) under well controlled clinical trials . The therapeutic effects were analyzed statistically in 172 patients (82 administered CMZ, 90 administered CEZ) . The adverse reactions were also analyzed statistically in 199 patients (CMZ 99, CEZ 100) in whom the judgement was possible . 1 . The efficacy rate of CMZ (72.3% for good to excellent response) was assessed by physicians in charge to be similar to that of CEZ (59.3%) . This was the same being assessed by the committee, too (CMZ 64.6%, CEZ 56.7%) . 2 . When patients were classified into 2 groups (acute otitis media, chronic otitis media in acute aggravating stage) with respect to diagnosis, statistically significant difference in clinical efficacy assessed by physicians in charge was observed in the cases with chronic otitis media (CMZ, CEZ) . In addition, the improvements of flares on the drum membrane and the mucous membrane of eardrum were significantly better in the CMZ group than in the CEZ group . 3 . Bacteriologically, 16 cases (19.8%) of S . aureus were resistant to CEZ, while only 1 case (1.2%) to CMZ . CMZ was judged to be effective in 5 of the 6 cases in which CEZ-resistant strains were detected . 4 . Side effects were found in 2 cases (2.0%) treated with CMZ: one complained of retching and abdominal pain and the other developed skin eruption . On the other hand, only 1 case (1.0%) developed skin eruption in the CEZ group . These results suggest that CMZ is a new antibiotic agent which is highly valuable in the treatment of suppurative otitis media. J Clin Neuroophthalmol, 1982 Jun, 2(2), 77 - 83 Is penicillin therapy always infallible in syphilis? Collart P, Poitevin M. Penicillin is undoubtedly the antibiotic most effective on Treponema pallidum, but is it possible to prescribe it according to a standard regimen? Experimentation proves that such a uniform therapeutic plan cannot be determined for the following reasons: 1) Treponema pallidum may divide every 30 to 33 hours, but this concept is only established during the period of exponential growth in the initial lesion . Moreover, if Treponema pallidum are very quickly disseminated throughout the organism, then they do not divide at the same rate . In addition, we take into account a whole series of factors which can interfere with their rate of multiplication . 2) A penicillinemia of 0.03 U/ml may kill all the Treponema pallidum when they divide, but Dr . Eagle's data, although this would be a fairly active serum level, showed that the effective maximal serum concentration should be far higher, about 0.820 U/ml . The experimental data prove it is not possible to point out an accurate correlation between blood and tissue levels; thus, the penicillin levels in the cerebrospinal fluid are about 1/100 lower than those obtained in the serum . Among other factors it is necessary to take into account not only the age of the patient but also the penicillin complex chosen . Although the total of injected penicillin can be the same, the kinetics of serum levels are essentially variable, both regarding the increase of levels and duration according to the drug used . 3) As noted it follows that penicillinotherapy prescribed early with high and prolonged doses may allow a bacteriologic sterilization of primary syphilis.(ABSTRACT TRUNCATED AT 250 WORDS) Br Med J (Clin Res Ed), 1982 May 29, 284(6329), 1594 - 6 Sterile microenvironment in prevention of wound infection; Scott JM et al.; A prospective controlled trial was carried out to assess the effect of using a wound isolator on reducing postoperative infection . A total of 291 patients undergoing hip pinning for fractures of the neck of femur entered the trial and were allocated at random to have their wound contained in a wound isolator (study group) or dressed with a standard gamma-irradiated adhesive dressing (control group) . The bacteriological flora of the patient was monitored before, during, and after operation and that of the ward before and after . No significant difference was found in the flora of the wards in which the patients were nursed . On several occasions the source of the infective organism was traced to the ward but never to the theatre . The isolator prevented direct contamination and airborne cross-infection of the wound and appreciably reduced the rate of infection. Lancet, 1982 May 29, 1(8283), 1199 - 202 Once-monthly rifampicin plus daily dapsone in initial treatment of lepromatous leprosy; Yawalkar SJ et al.; In an international multicentre controlled single-blind trial of 93 previously untreated lepromatous leprosy patients the therapeutic effects of adding rifampicin, 450 mg/day orally or 1,200 mg once monthly in a single oral dose, to dapsone (50 mg/day orally) for the first 6 months of treatment were compared . Clinical and histopathological improvements and bacteriological regression, indicated by the decreases in the bacterial and morphological indices of the skin and nose-blow smears, were satisfactory and practically identical after 6 months' treatment . The once-monthly rifampicin schedule was better tolerated than the daily one . In view of the good therapeutic efficacy and tolerability, the much lower cost of treatment (about one-tenth of that of the daily rifampicin regimen) and the possibility of administration under supervision, once-monthly rifampicin given in a single oral 1,200 mg dose should be recommended, along with a standard dapsone regimen, for large-scale, initial, and intensive combination treatment of patients with lepromatous and borderline-lepromatous leprosy, to help prevent an increase in dapsone resistance . A third antileprosy drug (e.g., clofazimine) may be added to this initial dual-treatment regimen. Sem Hop, 1982 May 27, 58(21), 1301 - 4 {Comparative study of the bacteriologic value of samples taken by transtracheal aspiration or fiberoptic bronchoscopy}; Peltier P et al.; To evaluate two methods of obtaining lower respiratory tract secretions, fiberoptic bronchoscopy (FB) and transtracheal aspiration (TA) were performed in ten patients . FB used an open-end brush-in catheter . TA was performed as described by Pecora . TA gave significantly better sensitivity and specificity (3/5 and O false positive results respectively) than FB (2/5 and 5 false positive results) . TA gives specimens which reflect the bacterial flora of the lung more reliably than those taken during FB. Clin Chim Acta, 1982 May 20, 121(2), 265 - 70 Determination of endotoxin using fluorescent probe; Yoshida K et al.; Bacterial endotoxin induces gel-formation of amebocyte lysate . This gelation test, the limulus test, was first described by Levin and Bang {1} . The limulus test has been widely used for the detection of endotoxin, not only in fundamental bacteriological research but also in clinical diseases {2} . Although the technique of the limulus test is simple, the endotoxin level can not be determined quantitatively . We developed a method to determine the endotoxin in physiological saline solution and glucose solutions using a fluorescent probe, fluorescamine. Schweiz Med Wochenschr, 1982 May 15, 112(20), 713 - 8 {Beta-lactamase producing gonococci in the Zurich region . Epidemiology and sensitivity to various antibiotics}; Eichmann F et al.; In a period of 15 months 601 patients (440 males, 161 females) with uncomplicated genital gonorrhea were examined bacteriologically and clinically . Diagnosis was by microscopy and culture . The sensitivity of the gonococci strains to antibiotics was tested by agar disc and the agar plate dilution culture media . 10 cases of penicillinase producing gonococci strains were found among the 601 isolates . The presence of beta-lactamase activity in all strains was confirmed by the chromogenic cephalosporin test . PPNG strains proved to be highly resistant to penicillin . These strains (PPNG) have been imported from South East Asia and West Africa . Among the isolates, only 2 cases of the South East Asian strains displayed the common tetracycline resistance . All PPNG strains were sensitive to spectinomycin and cefuroxine. Arch Otolaryngol, 1982 May, 108(5), 315 - 8 Nasal obstruction . Adenoiditis vs adenoid hypertrophy; Kveton JF et al.; The terms "adenoiditis" and "adenoid hyperplasia" are often used interchangeably to describe posterior nasal obstruction in children, tending to obscure indications for adenoidectomy . To more clearly define the role of the adenoid bed in nasal obstruction and its relationship to aural disease, we examined tissue obtained at adenoidectomy from 22 children via the quantitative bacteriological technique . In three patients, adenoidectomy was performed for nasal obstruction alone, in nine patients for serous otitis media and nasal obstruction, and in ten patients for nasal obstruction with serous otitis media and recurrent bacterial otitis . Using the criteria that 10(5) bacteria per gram of tissue indicates infection, 90% of the patients in the last group had infected adenoids vs 8% of the patients in the first two groups . Quantitative immunoglobulin levels, WBC counts, or preoperative antibiotic therapy was not helpful in determining which patients had infected adenoids . Pressure-equalizing tubes were placed when appropriate . A follow-up of nine to 22 months is included. Rev Infect Dis, 1982 May-Jun, 4 Suppl, S122 - 8 Comparative properties of spiroplasmas and emerging taxonomic concepts: a proposal; Davis RE et al.; The major serogroups and distinct subgroups of spiroplasmas seem to represent distinct species . The scheme of classification into these groups was initially based on serologic properties and later supported by the results of studies of DNA-DNA homology and polyacrylamide gel electrophoretic analyses of cellular proteins . Because separate subgroups within the same major serogroup cross-react in growth inhibition tests and other serologic tests, a taxonomic scheme is proposed which implies that certain major criteria for species differentiation within the genus Mycoplasma cannot be appropriately applied to the genus Spiroplasma without modification . Nevertheless, the grouping scheme and proposed speciation satisfy requirements for a species concept that is utilitarian and operational and consistent with recommendations by the International Committee on Systematic Bacteriology, Subcommittee on the Taxonomy of Mollicutes. An Esp Pediatr, 1982 May, 16(5), 377 - 82 {Appendicular peritonitis: antibiotics and complications (author's transl)}; Eizaguirre I et al.; A retrospective study of the complications and bacteriologic findings in a group of 500 appendectomies in children under seven years is reported . A prospective trial on 64 appendiceal peritonitis revealed that there were no significant differences between two antibiotic policies (clindamycin plus gentamycin vs . cefoxitine alone) in regard to postoperative septic complications . Nevertheless, both policies significantly decreased the number of intraabdominal abscesses as compared with the treatments applied during the years of the retrospective study . No improvement was observed in the number of wound infections. Res Vet Sci, 1982 May, 32(3), 387 - 8 Failure to demonstrate the maintenance of leptospires by house mice (Mus musculus) in the south east of England; Hathaway SC et al.; A total of 272 house mice (Mus musculus) were trapped in farm buildings at four widely separated locations of south east England and examined for serological and bacteriological evidence of leptospiral infection . Only two low titres to autumnalis antigen (1:20 and 1:40) were recorded and all mice were bacteriologically negative . The absence of leptospiral infection in the house mouse in south east England is an interesting ecological finding, as this species is a maintenance host for ballum in many countries and also a common carrier of several other serovars . The source of ballum infections in domestic stock in England remains unknown. Ophthalmology, 1982 May, 89(5), 492 - 8 Orbital abscess . Presentation, diagnosis, therapy, and sequelae; Krohel GB et al.; Fifteen cases of orbital abscess were reviewed . Significant morbidity occurred despite treatment with intravenous antibiotics and surgical drainage . The complications included visual loss to less than 20/200 (four patients), residual proptosis (two patients), residual diplopia (two patients), osteomyelitis (one patient), and death (one patient) . Seven patients reported no pain . Fever was absent in eight patients . Four patients had normal white blood cell counts . Many of these patients had received inappropriate or inadequate doses of oral antibiotics before referral . Partially treated cases of orbital abscess may not manifest the expected clinical findings of orbital infection . Four patients presented in an insidious fashion with symptoms evolving over weeks to months . Their subacute presentations in the absence of fever, pain, or elevated white blood cell count mimicked the onset of orbital tumors . CT scan failed to detect an abscess in two cases . Conjunctival and nasal cultures were not helpful in determining the bacteriologic etiology of these infections . Surgical drainage and appropriate antibiotic therapy is the definitive treatment of orbital abscess. Can J Surg, 1982 May, 25(3), 304 - 7 The conduct of cholecystectomy: incision, drainage, bacteriology and postoperative complications; Lewis RT et al.; The benefits of some ancillary techniques of cholecystectomy are exaggerated by retrospective study of selected patients . Therefore, the authors performed a prospective, randomized study of 100 consecutive patients who underwent simple elective cholecystectomy for chronic cholecystitis and cholelithiasis . No patient was excluded because of incomplete hemostasis or fear of bile leakage . The frequency of pulmonary complications and wound infections was independent of the type of incision--vertical or subcostal . Peritoneal drainage was found to be unnecessary . Short-term drainage may increase the frequency of postoperative fever, but did not increase pulmonary complications or wound infections . In these patients, intra-abdominal sepsis is rare; wound infections were uncommon and the gallbladder bile was usually sterile and not the cause of postoperative infection. J Assoc Off Anal Chem, 1982 May, 65(3), 602 - 7 Detection of invasiveness of mammalian cells by Escherichia coli: collaborative study; Mehlman IJ et al.; In a collaborative study of 2 standard procedures (Procedure I, presented in J . Assoc . Off . Anal . Chem . 60, 546-562 (1977) and Procedure II in the Bacteriological Analytical Manual, 1978), 7 laboratories evaluated the invasive potential of Escherichia coli . Monolayers of HeLa cultures were infected with E . coli (infectivity ratio 100 bacteria/mammalian cell) suspended in 2 menstrua: heat-inactivated fetal bovine serum (Procedure I) and 0.2% bovine albumin Fraction V dissolved in Earle's buffered salts (Procedure II) . After uptake of the bacteria, intracellular growth, and differential staining, the percentages of HeLa cells containing a minimum of 5 bacteria were determined microscopically . All laboratories correctly identified invasiveness of E . coli by Procedure I; 5 of 6 laboratories recognized invasiveness by Procedure II . Although Procedure I was more reproducible than Procedure II, repeatability did not differ significantly . Procedure I was adopted official first action for presumptive recognition of invasiveness in E . coli. Clin Nephrol, 1982 May, 17(5), 262 - 5 Tuberculosis affecting a cadaveric renal allograft; Walker JF et al.; Tuberculosis is one of the more serious infections complicating renal transplantation . Although the incidence appears to be low, a dose of prednisone greater than 10 mg daily has been associated with a more severe form of disease . A case of tuberculosis with renal allograft involvement is described with documented bacteriological and radiological involvement in which treatment was successful with anti-tuberculosis chemotherapy . Deterioration in renal function did not occur . The prophylaxis of patients undergoing transplantation with a history of tuberculosis and the features, diagnosis and treatment of tuberculosis affecting a renal allograft are discussed. J Dent Res, 1982 May, 61(5), 665 - 72 Degradation of luting cements measured in vitro; Mesu FP; The described method of measuring degradation of luting cements in vitro, by which various media, including bacteriological, can be used, gives results indicating that degradation is a more complex process than could previously be measured . Degradation appears to be a process following a sequence of absorption, disintegration, and solution . Factors, such as cement, thickness of the cement layer, molarity, and pH of the medium, affect, mostly by interaction, the degradation speed . Though the clinical predictability of this test method is not yet determined, it gives the opportunity to measure the various stages of degradation and to appoint the different factors affecting this process . Clinical tests based on the same principle are in progress. JPEN J Parenter Enteral Nutr, 1982 May-Jun, 6(3), 232 - 5 Bacterial safety of reconstituted continuous drip tube feeding; Hostetler C et al.; Chemically defined diets require reconstitution and transfer to a delivery system . When reconstituted High Vivonex was noted in our Medical Center to be bacteriologically contaminated, we instituted a series of control procedures . We then reevaluated bacterial growth in reconstituted High Nitrogen Vivonex and diluted Isocal under ward conditions . The mixtures were prepared with sterile water versus tap water, using a hand washed blender versus a machine washed blender . We also investigated the bacteriological effect of blast freezing reconstituted High Nitrogen Vivonex . All preparations of the nonfrozen High Nitrogen Vivonex showed occasional low level contamination, although quantitative cultures did not show logarithmic growth over eight hours of observation . No growth occurred in the blast frozen High Nitrogen Vivonex or in the Isocal . We conclude that reconstituted High Nitrogen Vivonex and diluted Isocal may be prepared and hung safely for eight hours, and that blast freezing of High Nitrogen Vivonex is bacteriologically safe . As a result of our initial findings of bacteriologic contamination, we believe a program for bacterial monitoring of the tube feeding is desirable. J Med Microbiol, 1982 May, 15(2), 181 - 7 Identification of Legionella pneumophila antigens and antibodies by immunoferritin electron microscopy; Rodgers FG; Material from 18 lungs positive for Legionella pneumophila and 21 strains of legionella grown on bacteriological media or in the yolk sac of fertile hen's eggs were examined by direct negative stain and immunoferritin electronmicroscopy . The 18 lung samples and all preparations of cultivated organisms showed the presence of bacteria with the typical morphology of L . pneumophila . By immunoferritin electronmicroscopy, with specific antisera, it was possible to serogroup the organisms . The immunoferritin method in reverse made it possible to detect and titrate antibody in sera from patients . Direct and immunoferritin electronmicroscopy were as sensitive as immunofluorescent antibody tests for detecting the antigens and antibodies of Legionnaires' disease . Additional advantages of the ultrastructural technique are discussed. Monatsschr Kinderheilkd, 1982 May, 130(5), 287 - 91 {Infectious gastroenteritis in childhood (author's transl)}; Leidel J et al.; Stool specimens from 126 children with acute gastroenteritis and from 42 controls were screened bacteriologically and virologically including electron-microscopy . Rota viruses were found in 36.5% of the children with diarrhoea, enteropathogenic E . coli in 13.5% and candida in 7.1% . These pathogens were not found in the controls . Enteroviruses were found in almost the same frequency in both groups (13.5% in children with gastroenteritis, 16.6% in the controls) . The etiologic role of adenoviruses, which could be seen in 5.6% of the diarrhoea group, remains unexplained. Pharm Weekbl Sci, 1982 Apr 23, 4(2), 49 - 56 A new approach to sterilization conditions . The IMO concept; van Asten J et al.; The sterilization requirements for medical/pharmaceutical applications are traditionally based on an extensive overkill . In the past few years, however, an evolution towards bioburden related sterilization processes has been started (F0 theory) . Especially manufacturers of large volume parenterals have - forced by the thermolability of the product - contributed to this development . In this paper both philosophies are combined, resulting in a concept in which the bacteriological and physical bases of the sterilization process are mathematically related by using the F0 theory and by introducing an Imaginary Micro-Organism (IMO) . The IMO concept provides the opportunity for anyone in the field of sterilization to raise the quality control level, which can be achieved by: - selecting optimum sterilization conditions without performing pre-sterilization counts: - step by step introducing the pre-sterilization count which results in even more favourable sterilization conditions. Wien Med Wochenschr, 1982 Apr 15, 132(7), 161 - 7 {Vienna and Budapest in Semmelweis' life work}; Antall J; Both Budapest and Vienna played a dominant role in the life of Semmelweis and this fact should mean connection and not separation in scientific research and interpretation . The Hungarian capital was his birth place, the scene of his education and partly also of his university studies, the city where he became professor, wrote his papers, propagated his doctrine and became a partaker of the spiritual workshop of the Pest medical school . Vienna was the city where--impressed by the second Vienna medical school--his medical view was formed, the place of the conception of the "Semmelweis doctrine" and also of his tragic death . Born in a German speaking family which was deeply rooted in historical Hungary, he was bilingual through all his life, avowed himself however as Hungarian . It should be avoided to make him either a hero of the barricades or an opportunist . By defining the etiology of puerperal fever and by elaborating the methods of its prevention he became a great figure of scientific research . As to the essence of the Semmelweis doctrine there is no place for debates of priority . The doctrine was confirmed in the era of bacteriology. Sem Hop, 1982 Apr 15, 58(15), 936 - 8 {Spontaneous peritonitis in a cirrhotic patient (author's transl)}; Mottier D et al.; A case of spontaneous peritonitis in a cirrhotic patient is reported . Because of marked peritoneal and hemodynamic signs, exploratory laparotomy was decided on . Such cases of spontaneous peritonitis, which mimick surgical affections, are very uncommon . Onset is usually insidious with increasing hepatic fluid as the only sign . Bacteriologic examination of the peritoneal fluid is often negative . Diagnosis should be considered if cytology shows more than 75 polynuclear leukocytes per mm . When bacteriology is negative, association of an aminoside with penicillin G and metronidazole seems to be the most satisfactory combination. Jpn J Antibiot, 1982 Apr, 35(4), 884 - 91 {Clinical evaluation of cefoxitin in treatment of infections in obstetric and gynecologic field (author's transl)}; Cho N et al.; Ten patients (8 with moderate or severe infections, 2 for prevention of postoperative infections) were treated with cefoxitin . The patients were given cefoxitin of 2 approximately 9 g, given once, or in 2 approximately 3 divided doses . Clinical efficacy was good in 7 cases, fair in 2 and poor in 1 . Transient nausea and vomiting occurred in 1 patient when a direct intrauterine injection (1 g of cefoxitin) was given, however, no side effects were observed in the other patients . The result of this study demonstrates that cefoxitin when given massively is effective in achieving bacteriologic and clinical cure in treatment of infections and for prevention of postoperative infections in the field of obstetrics and gynecology. Clin Otolaryngol, 1982 Apr, 7(2), 81 - 6 Bacteriological studies after obliterative mastoid operations; Ojala K et al.; This study evaluates the post-operative bacteriology and the clinical state of postoperatively infected ears which were operated on using obliterative techniques and relates these bacteriological findings with the disease present . Out of the 85 ears with post-operative infection, the discharge was mucous in nine ears, mucopurulent in 18 ears, and seropurulent in 34 ears . Twenty-four ears were moist . Epitympanal or antral cholesteatoma was noticed in seven ears and meso- or hypotympanal cholesteatoma in 12 ears . The post-operative Valsalva-test was positive in 61 ears and negative in 24 ears . The types of bacteria did not significantly depend on the quality of the post-operative discharge, existence of post-operative cholesteatoma, or clinical function of the Eustachian tube (estimated by the Valsalva test) . This study indicates that the bacteriology of the post-operatively moist or discharging ear does not significantly depend of the clinical state of the ear, nor can it be predicted on the basis of the clinical picture of the ear . A bacteriological examination of the ear seems to be the only way to control chemotherapy properly. J Am Vet Med Assoc, 1982 Apr 1, 180(7), 747 - 9 Inadequate skin preparation as a cause of intravenous catheter-related infection in the dog; Burrows CF; Eight-eight dogs admitted to the intensive care unit of the University of Pennsylvania School of Veterinary Medicine were studied to determine the frequency of intravenous catheter-related infection . Dogs were randomly assigned to 1 of 2 groups . In group 2, the skin was scrubbed with an iodine soap before final rinsing with alcohol and tincture of iodine . After withdrawal of each catheter, its tip was examined by bacteriologic culture, and the limb was examined for signs of phlebitis . Bacteria were isolated from 24 (48.9%) catheter tips in group 1 and from 6 (15.4%) in group 2 (P less than 0.005) . Phlebitis was evident in 6 dogs in group 1, and in 1 dog in group 2 . One death occurred in group 1, from causes possibly associated with catheter infection . These data suggest that catheter-related infection may be wide-spread in the dog and that it can be reduced by meticulous skin preparation. Ann Emerg Med, 1982 Apr, 11(4), 205 - 7 The bacteriologically battered baby: another case of Munchausen by proxy; Hodge D 3rd et al.; We present a case in which a mother who had had self-inflicted infections as a teenager also caused life-threatening infections in her year-old child . After testing for and treating various immunologic deficiencies without success, it was apparent that the infection was caused by contamination of intravenous sites . Strict isolation of the patient, with restricted and observed visitations by the mother, was the critical step in stopping the infections . Because the woman took her child to several emergency departments, this case is presented to alert emergency personnel to this entity and to explain some of the dynamics and the social issues that cause the problem. Laryngoscope, 1982 Apr, 92(4), 370 - 8 Ludwig's angina: an update; Patterson HC et al.; Despite a reduction in preantibiotic mortality rates that exceeded 50%, Ludwig's angina remains a potentially lethal entity primarily because of rapidly progressive airway obstruction . Since the reports of several large series in the 1940's, there have been put sporadic case reports because of widespread use of antibiotics in orodental infection, improved dental care, as well as adherence to strict diagnostic criteria . Since this entity is now uncommon, unnecessary delay in diagnosis and management may occur and may result in serious complications . This presentation will consist of an historical review, discussion of pathogenesis followed by clinical presentation, bacteriology and treatment, as well as a detailed analysis of our most recent 20 cases . There were no complications and no deaths . The infection resolved with medical therapy in 11 patients, while 9 patients required surgical procedures . Penicillin, clindamycin or chloramphenicol were started initially in all cases . Four of these 9 patients developed a localized abscess, while on antibiotics, which required drainage . Tracheotomy or intubation was necessary in 7 patients . Early and aggressive use of appropriate antibiotics and protection of the airway are the mainstays of a successful treatment regimen . Judicious surgical intervention is indicated in those patients who develop localized abscesses while on antibiotics or are unresponsive to medical management. Surg Gynecol Obstet, 1982 Apr, 154(4), 557 - 60 Incidence of wound infection for common general surgical procedures; Coles B et al.; Postoperative wound infection remains a ubiquitous problem with serious consequences, especially with regard to prolonged convalescence and in a source of physical and financial burden to the patient . Wound infection occurred in 13 of 1,346 of the patients during a single recent 12 month period with commonly performed surgical procedures at a large midwestern hospital . The bacteriologic findings of these infections was diverse. J Dairy Sci, 1982 Apr, 65(4), 659 - 64 Electrical conductivity of milk for detection of mastitis; Fernando RS et al.; The potential value of electrical conductivity of milk as a screening test for subclinical mastitis was evaluated . Conductivity of foremilk and of postmilking strippings from 368 quarters of 92 cows was measured . Infection status of quarters was determined by bacteriological analysis of strict foremilk samples . Infections were classified as by primary or secondary pathogens, depending on the importance of the isolated organism as a mastitis pathogen . Somatic cells were counted on foremilk samples . Milk conductivity increased with infection . Conductivity of postmilking strippings was higher than that of foremilk in samples from quarters infected by primary pathogens . By thresholds which correctly classified at least 90% of normal quarters, accuracy of identifying primary pathogen infections by absolute conductivity was 62.8 and 96.2% with foremilk and postmilking strippings . Differential conductivity and combination of absolute and differential methods also were evaluated with the latter being the most effective . Number of quarters with elevated conductivity of postmilking strippings tended to be higher when somatic cell count was greater than 500,000/ml in both normal and infected groups . Conductivity of milk seems to hold promise as an indicator of subclinical mastitis. Fertil Steril, 1982 Apr, 37(4), 557 - 64 The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay; Berger RE et al.; The relationship of the parameters of seminal fluid analysis (SFA) and seminal fluid leukocyte concentration to the in vitro sperm penetration assay (SPA) was studied in 217 men from infertile couples . Significant positive correlations were found between the SPA and sperm count, sperm motility, and morphologically normal sperm . The total number of leukocytes per milliliter, the number of polymorphonuclear leukocytes per milliliter (PMN), and the number of lymphocytes per milliliter were negatively correlated with the results of the SPA . The strongest correlation with an abnormal SPA (less than 11% of eggs penetrated) was the presence of greater than or equal to 1 PMN/100 sperm (8.17 increased relative risk of an abnormal SPA) . The most important predictor variables of the percent penetration of the sperm penetration assay were total numbers of leukocytes per milliliter, sperm count, and sperm motility . Microbiologic studies of semen were not correlated with SPA results or number of leukocytes in the semen. Gut, 1982 Apr, 23(4), 297 - 303 Technical hazards of using nutritive mixtures in bags for cyclical intravenous nutrition: comparison with standard intravenous nutrition in 48 gastroenterological patients; Messing B et al.; Three methods for dispensing nutritional solutions are compared in 48 patients with gastrointestinal diseases on intravenous nutrition during 3582 days . The protocol for intravenous nutrition applied by the nursing team and the solutions used were the same in the three groups . In group A standard bottles were used, while in group B, 31PVC-disposable bags were used--with fat emulsion included (group B1) or with fat excluded (group B2) . When fat was excluded from the bags it was infused separately from a bottle . The mixtures were made under laminar flow by the nursing team who applied a strict protocol which included bacteriological testing . The infection rate observed in the bags was 0.046% . The rate of septic complications was not significantly reduced in group B2 or B1 compared with group A; the type of container used was therefore unimportant and the key was the aseptic handling of the intravenous solutions . The rate of mechanical complications, mainly due to catheter obstruction, was higher (p less than 0.001) when fat was included in the bags--that is, in group B1--than in groups B2 and A . For 26 patients a cyclical regime of intermittent feeding was easier to manage when bags were used . In group B, this system replaced the continuous method n 75% of all therapeutic days without adverse effect; it improved compliance and allowed ambulatory treatment . The use of cyclical feeding with separate fat infusions has further reduced the hazards of intravenous nutrition and allowed the development of a programme that can be implemented at home. Lepr India, 1982 Apr, 54(2), 256 - 62 Clinico-pathological study of so-called immune zones in leprosy; Sahni U et al.; The clinical, bacteriological and histopathological features were studied in 20 cases of Leprosy (10 LL + 10 BL) from the so-called immune zones i.e . axilla, groin, and a narrow transverse band of skin over the lumbosacral region of the body . Apparently uninvolved skin over the chest was studied as control site . In the so-called immune sites, the clinical lesions of leprosy were noted in 40% of the cases (7 LL + 1 BL), AFB (both solid and granular forms) were detected in the smears of 45% cases (8 LL + 1 BL) and the histopathological evidence of the disease was observed in almost all the sites studied (100%) . The results obtained in the present study revealed that practically no area on the surface of skin is immune to leprosy. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1982 Apr-Jun, 31(2), 159 - 66 {Bacteriological examination of the sputum in support of a rational antibiotic therapy of bronchopulmonary infections}; Buiuc D et al.; An algorhythm of bacteriological investigation of the sputum is suggested for the etiological diagnosis of acute bronchopulmonary infections with pathogenically-conditioned bacteria . This investigation avoids misleading results, and provides, in a minimal time interval, both the first empiric criteria for the application of antibiotherapy--a definition of the microscopy category of the infecting pathogenically-conditioned bacteria--, and the second one, namely the antibiogram of the primary culture . This algorhythm is based on: decontamination of the sample by repeated washings; microscopical screening of the sample's quality, according to the ratio between inflammatory cells, squamous epithelial cells and the fibrin exudate; the qualitative bacterioscopic examination; the semi-quantitative culture of the sputum with the antibiogram on the primary culture; identification of infecting pathogenically-conditioned bacteria by confrontation of the microscopic significant amounts; inflammatory cells on the smear prepared directly from the sputum; the antibiogram on sub-cultures of the infecting, pathogenically-conditioned bacteria . Of high significance for the etiologic implication is the association of the inflammatory cells in quantities equal or greater than 13 organisms per microscopic field of pneumoncocoid bacteria, equal or greater than 20 organisms per microscopic field of the haemophilloid germs (with a significance threshold of 5%), and equal or greater than 18 organisms per microscopic field of neisseroid germs (at a significance threshold of 0.27%). Fortschr Med, 1982 Mar 25, 100(12), 510 - 5 {Current notes on the clinical aspects of tuberculosis}; Blaha H; First a review is given about the situation of tuberculosis in Western Germany in general . The knowledge about tuberculosis is diminishing together with falling numbers of incidence . Half of the general practicians do not see a case of tuberculosis by year . The incidence of bacillary tuberculosis has fallen from 44 per 100 000 in 1960 to 15 to 20 per cent 100 000 in 1980 . Diagnosis gets more difficult, differential diagnosis more important . We have to rely quite frequently--besides on bacteriology--on histological diagnosis with all its pitfalls . Military tuberculosis can easily be missed . Figures on bronchoscopy and perbronchial biopsies are given . The relative importance of "mycobacteriosis" other than tuberculosis is growing . The problem of bacterial resistance is unchanged over the last 10 years . Treatment results are good: a conversion rate of more than 98% after 2 years is given by the "Arbeits- und Forschungsgruppe Tuberkulose in Bayern" . Patients compliance is not always easily obtained . Tuberculosis is, in spite of its slowly declining slope, one of the most important medical problems in the world . The "Curatorium Tuberculosis in the World" takes care of the problem. Sem Hop, 1982 Mar 4, 58(9), 561 - 2 {Relapse of Addison's disease after apparent recovery : a case-report}; Heim J; In our observation, antituberculous therapy was given systematically, although neither interview nor bacteriology had provided unequivocal evidence of tuberculosis . Corticosteroid withdrawal by the patient was uneventful . After, withdrawal, the 17 OH steroids and the response to metyrapone were normal . The water load test was normal . After insulin, only cortisol levels did not increase . Salt-loss with hyponatremia then occurred spontaneously ; 17 OH steroids were low and did not increase after corticotrophin. Med Trop (Mars), 1982 Mar-Apr, 42(2), 173 - 6 {Bacteriological aspects of traumatisms caused by animals (author's transl)}; Peloux Y et al.; Bacterial complications of traumatisms caused by animals are very frequent if no proper therapy is applied . Germs detected in the wounds caused by cold-blood animals or by invertebrates are mostly represented by bacterias of telluric origin (responsible of gas gangrene, tetanus...) with the eventual worsening effect of venom . Germs detected in the wound caused by warm-blood animals have their origin in the dental commensal flora in which anaerobic germs prevail . Pasteurellosises are specially feared after animal bites but human bites too must not be neglected . Therapy first target must be the elimination of anaerobic conditions and antibiotherapy is required for every deep injury. Arch Androl, 1982 Mar, 8(2), 97 - 105 High-resolution protein patterns of human expressed prostatic secretion: a new tool for the diagnosis of prostatitis; Balerna M et al.; Expressed prostatic secretions (EPS) obtained from 62 infertile and urological patients have been analyzed for their protein content by sodium dodecylsulfate electrophoresis and isoelectrofocusing . Independent cytological and bacteriological screening on the same EPS samples was carried out to detect prostatic inflammation . EPS from both urological and infertile patients without inflammation had simple and characteristic protein patterns . Important qualitative and quantitative differences in the protein composition of EPS from patients with severe dysspermia or prostatic inflammation were found . The comparison of EPS protein patterns with those of seminal plasma obtained from the same patients led to the detection of a characteristic group of low-molecular-weight bands that were not of prostatic origin. Public Health Rep, 1982 Mar-Apr, 97(2), 127 - 33 The status of tuberculosis control in New York City; Vennema A; Problems in tuberculosis control still exist in New York City . They range from an increase in the incidence of the disease to the discovery of new cases in children under 5 years of age . Ninety-three percent (1,395) of the cases reported in 1980 were verified by cultures positive for tuberculosis . The rest of the cases in the 1980 tuberculosis disease count were verified by histology or a physician's recommendation for treatment with two or more antituberculosis drugs . Of the tuberculosis at extrapulmonary sites, pleural meningeal and miliary tuberculosis, as well as genitourinary tuberculosis, ranked high in incidence in 1980 . New tuberculosis cases occurred in all age groups, but the 37 cases in the age group 0-4 years is alarming and indicates a high rate of transmission of tuberculosis from parents to children . Performance indicators of the Centers for Disease Control show that in terms of drug continuity, completion of treatment, and bacteriological conversions to negative, a great deal needs to be done in New York City . The tuberculosis mortality rate for the city has been showing a steady decline over the years; it was 1.8 per 100,000 population in 1980. Rev Infect Dis, 1982 Mar-Apr, 4(2), 411 - 8 Combination of trimethoprim with sulfonamides other than sulfamethoxazole; Bernstein LS; Early in the development of trimethoprim (TMP), the response to the drug was less than enthusiastic . Preliminary clinical trials were performed with sulfonamides that were unsuitable partners . On the basis of bacteriologic and pharmacokinetic evidence, sulfamethoxazole (SMZ) was chosen for the fixed-ratio (5:1) combination with TMP . Possible criteria on which to base the choice of a sulfonamide partner for TMP have been delineated . The theoretical considerations may be questioned in view of limited clinical experience with some combinations and lack of controlled comparisons in well-designed clinical trials with others . Objective proof of the clinical superiority of newer TMP-sulfonamide combinations over TMP-SMZ is required. Pathol Biol (Paris), 1982 Mar, 30(3), 155 - 9 {Immediate hypersensitivity in brucellosis . New data (author's transl)}; Quaranta JF et al.; The presence of clinical manifestations of the "immediate hypersensitivity" process has been frequently described in veterinarians, bacteriological laboratory technicians and some patients with chronic brucellosis . We have looked for the presence of specific IgE in these conditions . Twenty-four patients, three months at least after the acute phase of their brucellosis, were given exploration of their humoral, cellular and specific immunity against brucellosis . For this purpose, beside usual classical tests: serodiagnosis, total and specific IgE assays, intradermoreaction and lymphoblastic transformation test with specific antigen (PI fraction) and an adaptation of human basophil degranulation test (HBDT) with PI fraction were performed on all 24 patients . Exploration of immediate hypersensitivity allows us to show neither an abnormal increase of hyper-IgE frequency nor an increase of anti-brucella specific IgE . HBDT is positive in 41 p . cent of the patients . It confirms that immediate hypersensitivity exists . HBDT gives justification for trying desensitization which has been proposed in the past . HBDT will possibly allow us to evaluate desensitization effectiveness. Zh Mikrobiol Epidemiol Immunobiol, 1982 Mar, (3), 48 - 52 {Use of the antibody neutralization reaction (after cultivation) for the diagnosis of intestinal coli infection}; Levi MI et al.; The combined bacteriological and serological method (viz., the antibody neutralization test after the short-time cultivation of the tested material on solid culture media) was used for the etiological diagnosis of intestinal E . coli infection and proved to be more effective in the study of sporadic and group infections than the bacteriological method. Trop Geogr Med, 1982 Mar, 34(1), 29 - 34 Bacteriological survey of leptospirosis in Zaria, Nigeria; Diallo AA et al.; A total of 252 rodents were trapped in the environs of Ahmadu Bello University, Zaria, over a two-year period, of which 221 were brown field rats (Arvicanthus niloticus) . Only these were found positive (4.5%) . Titers were detected against Leptospira interrogans, serovars australis, icterohaemorrhagiae, tarassovi and hardjo . All positive sera except one reacted against a single serovar . Eight isolates were obtained from field rats: five were serovar australis, one ballum and two unidentified . Five isolates were recovered from 74 bovine kidneys examined: one was serovar pyrogenes and four unidentified . One unidentified isolate failed to react with any of the 16 screening leptospira antisera and another was tentatively considered to be serovar ballum . Two isolates, one ballum and one unidentified, were recovered from the Kubani stream waters . No leptospira was isolated from piggery sewage effluents collected at Kano and Kaduna . It is suggested that serovar ballum be included in any screening battery for leptospirosis in man and animals in Nigeria. Laryngoscope, 1982 Mar, 92(3), 278 - 86 Panel discussion: pathogenesis of otitis media . Bacteriology and immunology; Lim DJ et al.; Three features of otitis media with effusion (OME) are important in understanding its pathogenesis: 1 . it is most common among children, when the eustachian tube is poorly developed; 2 . it is most common during the winter months, when the common cold is prevalent; and 3 . bacteria are found in a large number of middle ear effusions from OME patients . Although middle ear effusions are conventionally thought to be sterile, numerous recent investigations favor a bacterial pathogenesis of OME . Four possibilities can be considered: 1 . bacteria are modified by antibiotics or antibodies, causing a lingering inflammation; 2 . early antibiotic treatment may interfere with the development of local immunity; 3 . bacterial antigen trapped in the middle ear causes immune injury leading to OME; and 4 . bacterial endotoxin and inflammatory mediators cause middle ear effusions. Am J Physiol, 1982 Mar, 242(3), F293 - 6 Marshall Barber and the origins of micropipette methods; Terreros DA et al.; Current methods for the study of renal physiology depend heavily on the use of micropipettes fashioned from glass capillary tubes . The technique for making glass micropipettes and manipulating them in the field of a compound microscope appears to have been invented about 1904 by Marshall A . Barber, a bacteriologist at the University of Kansas . Barber's methods were passed on and successively modified by G . L . Kite and R . Chambers, and were finally adapted for renal studies by A . N . Richards . The apparatus for perfusing isolated segments of renal tubules in vitro is remarkably similar to the original device used by Barber over three-quarters of a century ago. Ann Ophthalmol, 1982 Mar, 14(3), 280 - 2 Chronic ulcerative conjunctivitis in a patient with alpha-1-antitrypsin deficiency; Tabbara KF et al.; A 62-year-old woman had chronic bilateral conjunctival ulceration of the palpebral and bulbar conjunctivae . Conjunctival scrapings for viral, chlamydial, and bacteriologic studies were unrevealing . A conjunctival biopsy specimen was taken and submitted for histopathologic and immunofluorescent studies . Hematoxylin-eosin-stained tissue sections showed lymphocytes, plasma cells, and eosinosphils . Laboratory findings showed serum alpha-1-antitrypsin deficiency . alpha-1-Antitrypsin has a molecular weight of approximately 60,000 and inhibits a number of proteolytic enzymes including cellular trypsin, elastase, collagenase, and proteases . The deficiency of alpha-1-antitrypsin may have caused such enzymes to perpetuate the tissue damage, thus eventuating in chronic ulcerative conjunctivitis . The association of deficient alpha-1-antitrypsin with chronic ulcerative conjunctivitis could thus have been coincidental or a contributing factor to the conjunctival disease. Vet Rec, 1982 Feb 27, 110(9), 194 - 6 Unsuccessful attempts to collect ova by surgical fixation of uterine catheters in superovulated cows; Baker AA et al.; Attempts were made to collect ova from superovulated cows by surgically fixing indwelling silastic balloon catheters in the uterine lumen . No ova were collected from the four catheterised cows and it was shown that ovarian activity was depressed . In this group, only 16 ovulations occurred compared with six control cows in which a total of 121 ovulations were recorded and 84 ova were collected . Also the ovaries of the catheterised cows had six large cysts, whereas no cysts were recorded in the control cows . The catheters flushed perfectly and bacteriological cultures of the flushing and uteri showed that no infections had occurred . The cows tolerated the catheters extremely well . There was no depression in appetite nor was any abnormal behaviour recorded . However, the severe depression of ovulation and the formation of ovarian cystic follicles prevents the technique from having any practical application as a means of collecting ova. Sem Hop, 1982 Feb 25, 58(8), 473 - 4 {Clinical and pathological study of a peculiar form of tuberculous meningitis: diagnostic and therapeutic problems (author's transl)}; Boudouresques J et al.; The authors report a case of tuberculous meningitis in which multiple bacteriological samples were negative during the eleven months of the clinical course . There were no other visceral localizations . The fatal outcome was due to vascular lesions (multiple cerebral infarcts), and to CSF flow disorders . The findings of cranial computerized axial tomography and of the pathological examination are reported. J Med Microbiol, 1982 Feb, 15(1), 141 - 7 Quantitative methods for studies on vaginal flora; Wilks M et al.; Three recently described methods for quantitative sampling of the bacterial flora of the vagina were evaluated and none proved satisfactory . In a third of the samples, paired swabs showed large differences between the two weights of vaginal secretion collected by this method, and the recovery rate of bacteria deliberately added to test swabs was unsatisfactorily low . A calibrated loop gave a wide variation in the amount of secretion collected, due to variations in density and viscosity of the secretion . When secretion was collected with a calibrated pipette, it was often difficult to expel the collected volume from the pipette for testing . The simple weight-based method was devised in which a loop was used to collect an undefined volume of secretion for weighting in a tube of transport medium before homogenisation and quantitative bacteriological testing . Initial assessment indicates this to be a satisfactory method for quantitative studies of the vaginal bacterial flora. An Esp Pediatr, 1982 Feb, 16(2), 176 - 80 {Intervertebral disk infection in children (author's transl)}; Lopez Ros S et al.; Discitis, or infection of an intervertebral disk, is a diagnostic challenge in the preschool age, unless there is good reason for suspicion . Two children, two and four years old, are discussed here . They had abdominal pain for several days, difficulty in movement and anomalous sitting postures . In both, L4-L5 was affected, and laboratory, including bacteriology, studies were negative, except for leucocytosis and slight-to-moderately elevated sedimentation rates . The diagnoses were confirmed by lumbar spine X-rays, though not until the third week after onset of symptoms . Discussed are the values of bone gammagraphy in early diagnosis, favourable clinical evolution in spite of an abnormal radiological picture, and treatment. J Clin Pathol, 1982 Feb, 35(2), 219 - 22 Osteomyelitis and septic arthritis caused by Kingella kingae; Davis JM et al.; The clinical and bacteriological findings in two cases of osteomyelitis and one case of septic arthritis caused by Kingella kingae are presented . This appears to be the first report providing clear evidence for a pathogenic role for this species in bone and joint infections. Pathol Biol (Paris), 1982 Feb, 30(2), 92 - 6 {Skin flora of the hands, elbow-hollow and fore-arm (author's transl)}; Reverdy ME et al.; During five years, the values of the skin flora of the hands, fore-arm and elbow-hollow were studied on volunteers, especially five of them . Samples were taken according to the washing method . Results show important quantitative variations of the flora between the different volunteers and even for a same volunteer . In the five long term followed subjects, the differences were 2,17 log 10 for aerobic flora and 1,97 log 10 for aero-anaerobic flora of the hands, 3,90 log 10 for aerobic flora and 3,88 log 10 for aero-anaerobic flora of the fore-arm 2,95 log 10 for aerobic flora and 3,35 log 10 for aero-anaerobic flora of the elbow-hollow . These variations remained independent of the season . According to these variations, already notified by others authors it is suggested first to standardize sampling and bacteriological methods, second to develop multicentric programs in view to increase that number of subjects to be included in the study. Z Orthop Ihre Grenzgeb, 1982 Feb, 120(1), 5 - 9 {The patellar focus, a rare form of localization of bone tuberculosis}; Richter R et al.; Patellar foci of any origin are very rare . Form 1955 to the end of 1979, 9 patients underwent patellar surgery in our hospital . 7 of these patients had tuberculosis, whereas in one case the patient had chronic nonspecific osteomyelitis, and in one case we were unable to clarify the underlying cause of the focus, neither from the histological nor from the bacteriological aspect . All tuberculous foci, one of which had penetrated into the knee joint, were situated in the corpus of the patellar . In a 10-year old girl, the entire patellar was infected with tuberculous foci . In the anterior-posterior x-ray film, the processes mainly presented a circular appearance . Their diameter different between 6 and 25 mm . In one of the foci, two sequesters were conspicuous, and one in another patient . 6 of the patients had an active organ tuberculosis at the same time, or reported on a specific disease during anamnesis . The period from the onset of complaints until diagnosis had been established, was on the average 14.4 months with the 7 patients under investigation (average age 29 years, 4 female/3 male) . In view of the fact that all the patients reported here were late cases, the results of the combined drug and surgical removal of foci (filling of the surgical cavities with spongiosa) must be classified as good . One knee joint had to be stiffened by operation . There were no reactivations within an average followup period of 3 years. Sci Total Environ, 1982 Feb, 22(3), 235 - 41 Heavy metal content of oysters from the Lynher Estuary, U.K; Bland S et al.; The concentrations of As, Cd, Hg, Pb and Zn have been determined in oysters and sediments from the Lynher Estuary, U.K . The sediments contained high levels of Cu, Fe, Pb and Zn probably associated with run off from a metalliferous catchment area and high Hg associated with a local sewage input . In contrast, the analyses of the oyster tissue showed that only Cu and Zn were concentrated in the flesh . The majority of samples contained coliform bacteria in excess of 1000 organisms per ml of tissue . It is concluded that the quality of the oysters from this fishery was limited by the bacteriological cleanliness rather than toxic metal content. Am J Clin Pathol, 1982 Feb, 77(2), 184 - 90 Cost effectiveness of quality control in bacteriology; Bartlett RC et al.; The cost effectiveness of quality control in bacteriology stipulated by regulators is not established . The authors evaluated 111 surveillance procedures applied to 54 different operations; 100 had been performed in the authors' lab between 1965 and 1980, 91 of which had been performed 50 times . Forty-six conformed to CLIA requirements (CLIA-P) . Thirty-seven others were CLIA-P, which had been modified (CLIA-PM) by reducing frequency and extent because few or no deficiencies had been observed . Eight others were devised by the authors (HH-P) . The number detecting deficiencies, the per cent, and the mean per cent of deficiencies detected were: CLIA-P, 31, 67%, 3.5%; CLIA-PM, 8, 22%, 2.1%; HH-P, 8, 100%, 8.8% . Compliance with CLIA would cost HH $20,700/year (3.4% of total bacteriology laboratory cost) . HH-P would cost an additional $9000/year . Discontinuation of CLIA-P not detecting deficiencies would reduce HH costs by $2900/year . Application of other low yield CLIA-P only to new lots of selected dehydrated media and fresh batches of selected reagents would reduce cost further by $2000/year. Doc Ophthalmol, 1982 Jan 29, 52(3-4), 339 - 45 The phlycten, a come-back? Koppert HC, van Rij G. In February 1980 acute keratoconjunctivitis was seen in a girls' class in a school in Rotterdam . Bacteriological and virological examination was performed on 20 girls . The agent causing this epidemic could not be demonstrated . Three patients had phlyctens at the limbus . In the year following this observation (March 1980 till March 1981) 42 cases of phlyctenular keratoconjunctivitis were examined prospectively . The condition was most commonly seen in 13- to 18-year old girls . The phlycten can be considered as an elementary form of inflammation in the conjunctiva and cornea, based on an immune reaction of the delayed type (Gell and Coombs' type IV) . The hypersensitivity to tuberculin, which was formerly an important feature of this inflammation ('scrofulous ophthalmia'), is of little importance in the Netherlands at the present day . However, in every case of phlyctenular keratoconjunctivitis tuberculosis should still be excluded by the medical history, and if necessary by a Mantoux reaction. Sem Hop, 1982 Jan 21, 58(3), 139 - 42 {An empirical combination of antibiotics used in aplasias during chemotherapy for acute malignant hemopathies (author's transl)}; Fiere D et al.; Continuous infusion of amikacin, cotrimoxazole and carbenicillin was the second empirically established combination of antibiotics used when fever occurred during the induction phase of chemotherapy in sixty-five patients (58 acute myeloid leukemias, 5 acute lymphoid leukemias, 2 non Hodgkin lymphomas) . Clinical evidence of infection was available in 25 cases and the infection was bacteriologically documented in 19 cases . Therapy was successful in 57 patients (89%) . When infection was clinically or bacteriologically documented tha success rates were 92 and 82% respectively . The average length of treatment was ten days . In 25 patients receiving 2 g of amikacin in continuous infusion, the mean serum concentration was 15,9 micrograms/ml; in 17 patients receiving 3 g, the mean serum concentration was 19,4 micrograms/ml. Eur Surg Res, 1982, 14(6), 401 - 8 Glucan-induced enhancement of host resistance in experimental intraabdominal sepsis; Lahnborg G et al.; Glucan, a 1-3-polyglucosidic component of the cell wall of Saccharomyces cerevisiae, was evaluated for its ability to alter survival in rats with induced intraabdominal sepsis . In four groups, each of 15 rats, the bacteriological flora was changed into that of humans by giving the animals a meat chew . Intraabdominal sepsis was induced by resecting 1 cm of the intestine and reimplanting it in the abdominal cavity after reestablishing the intestinal continuity by one-layer end-to-end anastomosis . The rats were injected with either glucan or isovolumetric saline or benzylpenicillin or glucan plus benzylpenicillin . The results indicate no significant difference in mortality rate between the groups treated with either glucan or benzylpenicillin on the one hand and, on the other, the group given saline alone . However, the group treated with glucan plus benzylpenicillin differed significantly from the control group given just saline . The bacterial flora did not seem to be influenced by glucan administration . It is concluded that glucan has a clear effect on the survival rate of rats with induced peritonitis, probably by enhancing the activities of the reticuloendothelial system--an important part of the total host resistance. Neurochirurgie, 1982, 28(6), 379 - 82 {Bacteriologic monitoring of external ventricular drainage in children}; Santini JJ et al.; The authors report 27 cases of external ventricular drainage employed in children . The usage of this technique caused neither infection nor surinfection in any of the cases . It is difficult to interpret the analysis of the cerebrospinal fluid thus obtained . Decisive criteria for recovery or non infection can be derived by studying the isozymatic profile of the L.D.H . (lactic dehydrogenase). Cancer Immunol Immunother, 1982, 13(2), 75 - 84 Autologous anticancer antigen preparation for specific immunotherapy in advanced cancer patients . A phase I clinical trial; Slanetz CA Jr et al.; A phase I clinical trial was performed to detect adverse reactions in far advanced cancer patients treated with a unique specific cancer immunotherapy . The vaccines consisted of autologous tumor cell membranes and manganese phosphate gel . From 133 patients admitted into the trial, 95 vaccine batches were made . No batch was toxic in animals . One batch was bacteriologically contaminated . Sufficient patients survived or complied to receive 32 complete and 23 partial courses for a total of 707 SC and ID injections . Minor swelling and occasional minimal pain occurred at injection sites . There were two possible vaccine-related systemic reactions but no evidence of tumor transplantation, tumor acceleration, sepsis or autoimmune disease . Subjective and objective improvement occurred in a number of patients . The vaccines are safe . Their efficacy must be determined . The value of ID vaccine skin testing and the unexpectedly little bacteriological contamination require further study. Arkh Patol, 1982, 44(11), 24 - 30 {Characteristics of the infectious process in animals susceptible and resistant to glanders}; Ferster LN et al.; Combined bacteriological, pathomorphological, luminescent-serological, and electron microscopic studies were used to elucidate some aspects of pathogenesis of glanders in animals with different susceptibility to this infection . The animals highly susceptible to glanders (golden hamsters) were shown to develop the infection of the sepsis type with granulomas of the exudative nature . In the animals highly susceptible to glanders the bacteria were proved experimentally to parasitize in a rod-shaped form within macrophages of the spleen, liver, and lungs as well as extracellularly . In white mice resistant to glanders the infection developed as chronic septicemia with granulomas of the exudative-proliferative nature . Glanders bacteria in this animal species undergo L-transformation. Immunol Commun, 1982, 11(5), 377 - 86 Alloantigen-mediated adherence of rat hepatocytes to antibody-coated polystyrene dishes; Hunt JM et al.; Rat alloantigens expressed on normal hepatocytes have been utilized in a cell "panning" procedure to mediate the haplotype-specific adherence of collagenase-isolated hepatocytes to antibody-coated polystyrene dishes . A polyvalent F344 anti-WF alloantiserum was prepared by immunizing F344 rats with WF tissue . The alloantibody IgG purified from the alloantiserum, when reacted with either WF or (WF X F344)F1 hybrid rat hepatocytes, caused the adherence of these hepatocytes to bacteriological-grade polystyrene dishes coated non-specifically with a xeno-antibody, rabbit anti-rat IgG . Similarly-treated hepatocytes of the F344 strain, which lack WF alloantigenic determinants, failed to be adsorbed above background level to the coated dishes. IARC Sci Publ, 1982, (41), 345 - 55 N-nitroso compounds in gastric juice and their relationship to gastroduodenal disease; Walters CL et al.; Of the N-nitroso compounds derived from precursors in gastric juice, only a very small proportion are in the form of volatile N-nitrosamines . However, about 40% of the remainder can be converted by methylation into a form(s) suitable for gas chromatography . In this way, at least 20 individual peaks were detected with the Thermal Energy Analyzer as detector . N-Nitroso compounds have been determined as a group in the fasting gastric juice of normal individuals and patients with conditions including duodenal ulcer, gastric ulcer, atrophic gastritis, pernicious anaemia, gastric carcinoma, dyspepsia with normal endoscopy or subjected to operative procedures, such as vagotomy or partial gastrectomy . Both the levels of N-nitroso compounds and pH values increased significantly with age in normal subjects and in those with pathological conditions . Sex and cigarette smoking had no significant influence . In particular, a positive correlation was found between pH and the level of N-nitroso compounds, with a p value of less than or equal to 10(-6) . Their concentration rose from a geometric mean of 0.11 mumol.1(-1) at pH 1.0-1.5, to a value of 1.3 mumol.1(-1) within the pH range 6.5-9.0 . Whilst quantitative bacteriology was not carried out, a highly significant relationship was also observed between the concentration of N-nitroso compounds and the availability of nitrate-reducing bacteria . Thus, conditions conducive to gastric cancer are associated with higher levels of compounds responding to group analysis as N-nitrosamines and/or N-nitrosamides. Zentralbl Chir, 1982, 107(13), 768 - 72 {Anti-infectious regime and bacteriological status}; Siggelkow G; The functioning of our anti-infectious regimen now working over a period of 7 years with 4 checks per year has been controlled . The wound infection rate came up to a percentage of 1.55 . Blunders concerning chemical disinfection especially could be detected in spite of check-ups made every 3 months. Rev Fr Mal Respir, 1982, 10(4), 249 - 58 {Bacteriology of bronchial secretions . Proposals for a practical attitude in bacterial respiratory tract infections}; Touaty E et al.; The inadequacy of the standard bacteriological method in the study of expectorations is unanimously accepted . Oropharyngeal contamination of specimens largely explains why this examination is a poor index of the causative organisms in bacterial respiratory infections . In a mixed clinical situation with few or non-specific signs of bacterial infection and of variable severity, the physician should answer two questions: 1) Is it a bacterial infection? 2) What is the causative organism? and their corollary: 1) Should one prescribe an antibiotic? 2) Which one? Only culture of blood or pleural fluid allow an accurate reply to these questions in about 50% of cases and they are the indispensable investigations of reference . Initial efforts undertaken to improve the standard examination of expectorations never overcome the stumbling block of oro-pharyngeal contaminations . The bacterial count of expectorated bacteria, a non traumatic method, represents some real progress . In 50% of cases it enables a predominant pathogen to be identified before any antibiotics are given . Bronchoscopy diminishes contamination, allows direct sampling and the inspection and biopsying of bronchial mucosal lesions and aids drainage in very suppurative disorders . Trans-tracheal puncture avoids oropharyngeal contamination in the majority of cases and appears to provide reliable results much more often . A pragmatic approach is recommended according to the clinical picture . Bronchial and limited alveolar infections which are well tolerated, heal without exception on blind antibiotic therapy . In suppurating infections (bronchiectasis, cavitating pneumonias), the yield and the reliability of the examinations are increased . Serious bacterial infections, by their extent or by their site, justify a more aggressive diagnostic and therapeutic attitude . It should be stressed, however, that death caused by inadequate antibiotic therapy remains the exception when one or two successive courses of antibiotics have been prescribed for the pathogens presumed responsible according to the clinical picture or found after one or more bacterial examinations. Comp Immunol Microbiol Infect Dis, 1982, 5(1-3), 359 - 68 {Activities of the diagnosis centre of the Institut Pasteur de Lyon 1976-1980}; Lery L; A report is presented of five years of work in the Rabies Diagnosis Centre at Lyon . This Centre, supported by the Ministry of Health at the Institut Pasteur of Lyon, investigates the diagnosis in animals of having contaminated humans . During these five years 4012 samples from animals were analysed, 179 of which being diagnosed as rabid (i.e . 4.53%) . Four samples from humans were also analysed, one of which being positive . Data collected concerning rabid animals are compared to national or regional data . Studies of various methods used (immunofluorescence test, inoculation in mice, histology--Dr . J.-A . Grimaud and Dr . M . Chevallier) for diagnosis allowed evaluation of each of them . Some of these analyses were completed by bacteriological studies (Dr . E.-N . Guillermet) . Besides this diagnosis the Centre takes part in epidemiological study of the disease, maintains a virus collection and allows diagnosis of other zoonosis or anthropozoonosis useful for veterinarians and for better protection of human health. Arch Otorhinolaryngol, 1982, 234(3), 219 - 23 Chronic myringitis and chronic suppurative otitis media; Hoshino T et al.; Thirty-four chronic myringitis cases were examined by otoscopy, pure tone audiometry, tympanometry, skull X-rays, and bacteriologic study of otorrhea . Five atypical cases are presented in detail . Three of these five cases had a perforation of the tympanic membrane preceding the appearance of typical chronic myringitis . The remaining two cases showed a transient small tympanic membrane perforation during the long course of chronic myringitis . These cases suggest that chronic myringitis could occur in some chronic suppurative otitis media and that myringitis could cause tympanic membrane perforation. Vet Med Nauki, 1982, 19(2), 76 - 83 {Bacterial contamination, clinical and pathohistological findings in the sex organs of cows following parturition}; Radoslavov V et al.; Studied were a total of 119 cows of the Bulgatian Brown breed in different physiologic status at various numbers of days following parturition . Thirty-seven of the animals showed puerperal endometritis, while the remaining showed a normal course during puerperium . Uterine secretion and biopsic material for bacteriologic and histologic investigation were taken from all cows . Sixteen species of organisms were isolated from the animals with endometritis, and 12 species - from those with normal puerperium . Highest bacterial counts in both groups were found on the eighth to twelfth day, however, with the endometritis-affected cows they remained at a comparatively high level up to the 40th day after giving birth . With the cows of normal puerperium the bacterial count was found to drop abruptly after the twelfth day . No correlation was found between the bacterial and the histologic finding . Histologically, recovery processes set in by the 25th-30th day and clinically, the involution of the uterus set in by the 30th-35th day after calving. Infection, 1982, 10 Suppl 2, S74 - 8 {Diseases of the lungs caused by legionella species (author's transl)}; Fleurette J et al.; Ever since the 1976 Philadelphia epidemic and the isolation of the causative organism by MacDade in 1977, numerous clinical, epidemiological and bacteriological papers have stressed the significance of the "new" causative organisms responsible for serious cases of pneumonia . On the basis of knowledge available at present, the Legionellaceae family accounts for these bacteria . There are five different species in the genus Legionella: L . pneumophila, L . micdadei, L . bozemannii, L . dumoffii and L . gormanii . L . pneumophila occurs most frequently and has six serogroups (Serogroups 1-6), the first of which is the most important . Legionelloses, the diseases caused by these organisms, occur epidemically, endemically or sporadically . In clinical terms, these are acute cases of pneumonia which occur especially frequently in older persons and immunocompromised hosts . The course is severe in such patients . There is increased lethality . Erythromycin, rifampicin and cefoxitin are the most effective antibiotics . After the culture has been made in the suitable milieu and the material obtained by pulmonary aspiration has been inoculated into guinea pigs, the bacteriological diagnosis is made by direct immunofluorescence . The serological diagnosis is based on evidence of serological changes demonstrated by the indirect immunofluorescence test. Curr Med Res Opin, 1982, 8(2), 97 - 103 The use of netilmicin in a district general hospital; Mummery RV; Twenty patients with a variety of serious or difficult infections and 5 additional orthopaedic patients with clinical evidence of post-operative wound infection were treated with netilmicin . The results indicate that twice daily dosage with 150 mg intramuscularly, either alone or in combination with other antibiotic therapy, was highly effective . Overall, 25 (96%) infections responded clinically and 19 (73%) were improved bacteriologically . There was no evidence of ototoxicity: a number of patients had impaired renal function which developed during therapy, but all returned to normal or pre-treatment levels by the time that treatment was completed, despite the fact that 15 patients were receiving diuretics . It is suggested in view of its effectiveness, more predictable serum levels after standard dosage and apparent lack of toxicity, that netilmicin should be considered as the first choice aminoglycoside antibiotic instead of gentamicin. Laryngol Rhinol Otol (Stuttg), 1982 Jan, 61(1), 17 - 9 {A clinical and experimental study on precious metal ventilation tubes (author's transl)}; Heumann H et al.; Incompatibility reactions which lead to a profuse aural discharge and often necessitate the removal of the ventilation tube occur in approximately 10% of patients if ventilation tubes made of synthetic materials are used . We have used golden and other precious metal alloy grommets in patients after extensive bacteriological and animal experiments . The most important advantage is the oligodynamic action which gives the surface of the ventilation tube repellent properties against bacteria . The drainage function is excellent due to the smooth surface structure and no incompatibility reactions were seen. Zentralbl Gynakol, 1982, 104(5), 268 - 87 {Genital tuberculosis of women (author's transl)}; Renziehausen K et al.; Genital tuberculosis of women, one of the extrapulmonary forms of tuberculosis, has remained to be in existence, though morbidity and mortality of the disease are on a declining trend . Affected are women of all age groups . A general account is given of gynaecological and obstetric aspects relating to the clinical pattern of genital tuberculosis, with reference being made to the author's own findings recorded from 155 patients in ten years, on the basis of bacteriologically or histologically secured diagnosis . These results have reaffirmed the need for complex diagnosis, therapy, and aftercare for female patients with genital tuberculosis . It is a challenge which, together with the demand for thorough prophylaxis, cannot be met unless meaningful interdisciplinary cooperation is ensured. Zh Mikrobiol Epidemiol Immunobiol, 1982 Jan, (1), 58 - 63 {Spread of whooping cough among adults today}; Okinshevich EA et al.; Epidemiological surveys with the use of the clinical and bacteriological methods of examination were carried out in 107 foci of pertussis in families (283 adults), 25 foci in children's institutions (103 employees) and 1 focus in a surgical department for infants (29 adults) . The infection was shown to be widely spread among adults at present: 23.7% in the surveyed families, 10% in children's institutions and 6.9% in the surgical department for infants . In the familiies, 26.2% of the adults were the first to fall ill with pertussis . no essential differences in the terms of the release of the infective agent, as well as in the course of the disease, in adults and in vaccinated children were found . Antiepidemic measures in respect to adult pertussis patients is proposed. J Clin Pathol, 1982 Jan, 35(1), 94 - 100 System for laboratory proficiency testing in bacteriology: organisation and impact on microbiology laboratories in health care facilities funded by the Ontario Government; Whitby JL et al.; The Ministry of Health requires that all medical laboratories in the Province of Ontario participate in a laboratory proficiency testing program (LPTP) . In bacteriology compliance has been excellent . Eighty-six laboratories, for various reasons over the period under review, have surrendered their licence or, because of poor performance on LPTP test surveys, have had their licence withdrawn by the Ministry . The highest percentage of withdrawals occurred in small hospitals in isolated areas . In April 1979 there were 249 participating laboratories . Participants' results are first analysed by computer, and, subsequently, approximately 20% of participants' reports are reviewed by the Committee . Various Committee actions ensue: correspondence with the laboratory director regarding errors; an offer of a visit; and possibly a report via a senior LPTP committee to the Ministry that a laboratory is non-proficient and, in LPTP's terms of reference, non-remediable . Subsequent Ministry action might be the withdrawal of a laboratory's licence . However, this last recourse only occurs when educational efforts have proved ineffectual . Overall, performance in LPTP bacteriology surveys has improved over the period 1975-8, with 68% of 263 laboratories achieving a score of 70% or higher and 26% of 263 laboratories scoring less than 60%. Early Hum Dev, 1982 Jan, 6(1), 15 - 23 Evaluation of infectious episodes in neonates using a new procedure for the nitroblue tetrazolium test; Dalens B et al.; A new procedure for the NBT slide test for peripheral blood neutrophils has been tested . 255 neonates were studied of which 63 served as control cases . Among the 114 term infants, 37 were patently infected, 30 suspicious and 47 non-infected . The latter did not significantly differ from control cases, whereas suspicious and infected infants were credited with significantly higher NBT scores . 78 infants were preterm, 31 of which were patently infected, 22 suspicious and 25 non-infected . NBT scores of infected and suspicious infants were significantly higher than those of non-infected infants, but, as previously reported, scores of preterm infants were systematically and significantly lower than those of full-term infants of the same bacteriological class . Threshold values are suggested; they could represent an accurate diagnostic aid in the early differentiation of healthy infants from high-risk infants regarding bacterial infections. Soc Sci Med, 1982, 16(9), 997 - 1004 Hansen's Disease in the United States; Hudson T et al.; This article offers a general overview of Hansen's Disease (leprosy) and examines in some detail the spatial characteristics and demographic profiles of known sufferers . Over the years the pejorative labels attached to the disease and the societal and psychological attitudes which produce and accompany them have stigmatized leprosy sufferers . Unfortunately this stigma has often pre-empted rational understanding and treatment . Contrary to popular belief, leprosy, caused by the bacteriological agent Mycobacterium leprae, is relatively non-contagious and can be rendered completely non-contagious by chemotherapy . Incidence rates in the United States are extremely low (0.08 per 100,000 in 1979), but have shown a slight if erratic increase since 1942 . Most of this can be attributed to increases in the number of foreign born cases; a result of immigration from areas of higher incidence (e.g . Southeast Asia, Latin America) . Six states, California, Texas, Hawaii, New York, Florida, and Louisiana accounted for over 80% of the 1432 cases reported in the United States between 1967 and 1976. Scott Med J, 1982, 27 Spec No., S24 - 7 Respiratory tract infections caused by beta-lactamase producing organisms treated with augmentin; Mehtar S; Twenty-three patients were treated with Augmentin for severe respiratory tract infections caused by beta-lactamase producing organisms . The success rate, clinically and bacteriologically, was 19 out of 23 . One non beta-lactamase producing H . influenzae, and three mixed organisms including Staph aureus accounted for the four failures . The elimination of the organisms, sensitive to Augmentin were quick and clinical improvement was seen in 72 hours . The only side effects noted were nausea in three patients, which abated on taking the tablets with meals . Augmentin is a useful drug in the treatment of respiratory tract infection particularly in acute exacerbation of chronic bronchitis. Clin Ther, 1982, 4(6), 510 - 4 A comparison of cinoxacin and co-trimoxazole in the treatment of cystitis; Schneider RE; This paper describes a study of patients with cystitis treated with 1 gm/day of cinoxacin or four tablets/day of co-trimoxazole (trimethoprim, 80 mg, and sulfamethoxazole, 400 mg), both drugs given twice a day for 14 days . Of the 64 patients with cystitis, complete bacteriological data were available for 27 patients in the cinoxacin group and 23 patients in the co-trimoxazole group . In most instances, the infecting organism was Escherichia coli . Twenty-six (96%) patients who received cinoxacin and 22 (96%) patients who received co-trimoxazole had a satisfactory clinical response . Two patients on cinoxacin became reinfected with a new pathogen, and one had a recurrence of infection with the same pathogen; on patient on co-trimoxazole became reinfected with a new pathogen . Adverse reactions were reported by six (19%) of the 32 patients in the cinoxacin group, none of whom discontinued therapy, and by 18 (56%) of the 32 patients in the co-trimoxazole group, five of whom withdrew from the study . These differences between the groups were significant (P less than 0.05) . It is concluded that cinoxacin is an effective, well-tolerated agent for use in cystitis caused by the common pathogens. Acta Paediatr Scand Suppl, 1982, 299, 51 - 7 Donor breast milk; Baum JD; A simple system for the collection and storage of human milk, as a voluntary community activity, is described . The case is made for preferring drip breast milk as the main source of human milk for the milk bank . The central place of precise pasteurization is emphasised as the essential feature for maintaining bacteriological quality control and simplicity of organisation . The suitability of donor breast milk for the nutrition of the low birthweight infant is discussed and evidence presented to indicate that low birthweight infants fed exclusively on donated human milk are of similar size to control term infants when assessed at 18 months corrected postnatal age . Emphasis is placed on the importance of controlled trials in relation to all innovations in feeding of low birthweight infants. J Reprod Fertil Suppl, 1982, 32, 181 - 5 Results of concurrent bacteriological and cytological examinations of the endometrium of mares in routine stud farm practice 1978-1981; Wingfield Digby NJ et al.; The results of 4024 concurrent endometrial swab and smear tests taken from maiden, barren and post-parturient mares during early oestrus, before coitus demonstrated the practical value of these tests in routine stud farm practice . The use of cytological examinations provided a more direct diagnostic test for acute endometritis and this increased the accuracy of interpretation of the bacteriological findings. Arzneimittelforschung, 1982, 32(10a), 1368 - 75 {Alteration of cartilage by microbial agents and granulocytes}; Drommer W et al.; Severe polyarthritis was induced in 42 SPF piglets by subcutaneous and intraarticular infection in one joint of the bacterium Erysipelothrix rhusiopathiae (Serotype B, strain T 28), which in its chronic stage morphologically resembles human c.P . The light and electron microscopic examination of the articular cartilage and synovial membrane reveals a parallel evolution of hyaline cartilage degeneration, and activation and proliferation of synovial lining cells . The initial cartilage alteration with demasking of collagen fibrils and focal degeneration of chondrocytes in the erysipelas model is caused by direct action of the microbial agent, fibrin and few granulocytes Erysipelothrix bacteria and neutrophilic granulocytes are able to invade the superficial and intermediate cartilage layers . This model is not considered a suppurative infectious arthritis . In chronic villous erysipelas polyarthritis, which develops without the presence of neutrophils in the cartilage, the invasively growing synovial pannus dominates, which deeply destroys the pre-damaged cartilage, resulting in macroscopic focal or wide-spread cartilage erosion . We consider the poorly vascularized cartilage and the particular fibrosis suitable sites for the extremely long (up to three years) persistence of this microbial agent . The persistence of the agent is considered necessary for the persisting immunological reactions and the perpetuation of erysipelas polyarthritis . With longer duration (1-3 years) of experimental erysipelas polyarthritis the number of bacteriologically positive arthritic joint decreases . Microscopically, the causative bacteria may only sporadically identified. Vet Med Nauki, 1982, 19(5), 40 - 4 {Counterimmunoelectrophoresis in the diagnosis of infectious epididymitis in rams}; Ivanov P et al.; Both the 'counter' immunoelectrophoresis method and the complement-fixation test were employed to study a total of 767 samples of blood sera taken from rams . Five-hundred and seventeen of these were taken from ram flocks in which the infection was recorded by the clinical and the bacteriological method and the remaining 517 samples were taken from rams of intact flocks . A comparative evaluation was made of the two methods for the diagnosis of the disease when the animals were alive . Results made it clear that the 'counter' immunoelectrophoresis method was advantageous and could be used as a perspective adjunct in diagnosing the disease. Acta Paediatr Acad Sci Hung, 1982, 23(3), 357 - 60 Isolation of aerobic bacteria from the placenta; Kovalovszki L et al.; Cultures for aerobic bacteria were prepared from 353 placentas . Specimens were taken from the chorion after removing the amnion . The specimens were immersed into Stuart transport medium . Microscopic examination of the placenta and cultures from the throat and ear of newborns were also done . The rate of positive bacterial cultures was 16% . Chorioamnionitis was found in 15% . The proportion of chorioamnionitis caused by aerobic bacteria was 44% . The rate of positive bacterial cultures from the placenta in the group of newborns with clinical signs of intrauterine infection was 63% . Bacteria can be present on the chorionic plate without any histological evidence of chorioamnionitis . Bacteriological examination of the placenta is therefore mandatory when amniotic fluid infection is suspected. Acta Leprol, 1982 Jan-Jun, (86-87), 35 - 45 {Current data on the bacteriology of leprosy}; Grosset J et al.; Microscopic examination and mouse foot-pad inoculation are the main tools in Mycobacterium leprae bacteriology . Microscopic examination enables to calculate bacteriological (IB) and morphological (IM) indexes . The former scores the density of acid-fast organisms in the lesions and the latter scores their viability since only solidly stained acid-fast organisms are likely to be alive . Mouse foot-pad inoculation provides the opportunity for studying the growth curve of M . leprae . Alterations of this growth curve under drug therapy enable to assess the antileprosy activity of drugs and to determine the drug sensitivity of organisms . Acquired and primary drug resistances to DDS are to date the most important events in the chemotherapy of leprosy . Researches are in progress on mice with congenitally reduced immunological capacity (nu/nu mice) and on antileprosy vaccination . Although no decisive advances have been obtained in these fields, researches in progress are promising. Z Erkr Atmungsorgane, 1982, 158(1-2), 95 - 100 {The epidemiological effectiveness control of antituberculous measures in the experimental territories}; Chomenko AG; Report on the effectiveness of antituberculous measures in 8 experimental territories of USSR . These territories were organized in 1972 . Measures for the control of tuberculosis are comprehensively performed and checked . Repeated mass x-ray examinations of the whole population (covering more than 90%) have produced a marked reduction of tuberculosis incidence already within 2 to 3 years . The intensified bacteriological diagnostic with cultures increased the portion of positive cases up to 55-60% . Other important indices for the assessm