Microbial

Chemioterapia, 1987 Jun, 6(3), 152 - 5
Efficacy of different surveillance systems in detecting hospital-acquired infections; Bartlett CL; Microbiology laboratory reports are the principal data source for nosocomial infection surveillance in most European countries . Such laboratory based surveillance inherently lacks sensitivity so that additional sources of data are necessary to increase the detection of infections . Long term compliance of voluntary reporting by clinical or ward nursing staff has rarely been achieved but continuous and selective clinical surveillance has been implemented successfully in the USA . Selective clinical surveillance, supplemented by laboratory data, may be a practical proposition in Europe, even with existing staffing levels and validation studies of the various methods are needed urgently.

J Histochem Cytochem, 1987 Jun, 35(6), 657 - 62
Rat uterine microbiochemistry: metabolic enzyme activities stimulated by 17-beta-estradiol are localized in epithelial cells; Holt JP Jr et al.; Lactate dehydrogenase (LDH; EC 1.1.1.27), citrate synthase (CS; EC 4.1.3.7), and beta-hydroxyacyl-CoA-dehydrogenase (beta-OH-acyl-CoA-DH; EC 1.1.1.35) activities were determined in each of the three major cell types of rat uterus, i.e., epithelial, stromal, and smooth muscle, using quantitative microanalytical techniques . Adult ovariectomized rats were treated with 17-beta-estradiol to determine the time course and dose response (0.025-50 micrograms/300-g rat) effect of estrogen on enzyme activity of each type of uterine cell . The use of "oil well" and enzyme-cycling microtechniques to determine the time course and the dose responses of enzyme activity changes required microassays involving 1595 microdissected single cell specimens . Estradiol treatment increased epithelial LDH, CS and beta-OH-acyl-CoA-DH activity but had no effect on these enzymes in the stroma or in smooth muscle cells . The estradiol-stimulated peak enzyme activities on Day 4 in the intervention group are compared with those in the ovariectomized rat controls as follows: LDH, 44.5 +/- 3.5 vs 22.3 +/- 3.9; CS, 3.5 +/- 0.2 vs 1.5 +/- 0.6; beta-OH-acyl-CoA-H, 3.5 +/- 0.32 vs 2.2 +/- 0.2 (mean +/- standard deviation; mol/kg/hr) . Stromal cell activities (LDH, 7.4 +/- 1.0; CS, 1.2 +/- 0.2; beta-OH-acyl-CoA-DH, 0.9 +/- 0.1) were significantly lower than epithelial cell levels and were similar to smooth muscle levels . Therefore, even in the ovariectomized animal epithelial cells have markedly higher metabolic activity compared with adjacent cells . The enzyme activities are expressed as moles of substrate reacting per kilogram of dry weight per hour . All three enzymes exhibited a 17-beta-estradiol-induced dose response between 0.025-0.15 micrograms/300-g rat . The three enzymes studied all had similar response patterns to estrogen . The effect of estradiol was restricted to epithelial cells, with enzyme activities increasing to maximal levels after approximately 96 hr of hormone treatment . This study therefore not only confirms the specific and differential metabolic responses of uterine cells to estradiol treatment, but clearly demonstrates that marked metabolic differences exist between epithelial cells and stromal or smooth muscle uterine cells.

J Clin Microbiol, 1987 Jun, 25(6), 1052 - 8
Protection between different serotypes of bovine rotavirus in gnotobiotic calves: specificity of serum antibody and coproantibody responses; Woode GN et al.; In a previous study, different U.S . isolates of bovine rotavirus were studied for their serotypes and cross-protective properties (G . N . Woode, N . E . Kelso, T . F . Simpson, S . K . Gaul, L . E . Evans, and L . Babiuk, J . Clin . Microbiol . 18:358-364, 1983) . Three viruses belonging to two different serotype groups were used as vaccines in gnotobiotic calves, which were subsequently challenged with B641 or B223, representing the two bovine serotypes . In the present work, the experiments were repeated with more calves and the specificity of their antibody responses was measured and compared with the results of the protection studies . Protection between different serotypes occurred under both homologous and heterologous conditions but was not directly serotype dependent . B223 virus showed both homologous and heterologous protection against B223 and B641 challenge viruses . This was a one-way reaction, as B641 did not induce protection against B223 . Neonatal calf diarrhea virus vaccine produced neither homologous (against B641) nor heterologous (against B223) protection . The plaque reduction neutralization titers of serum antibody and coproantibody did not predict a state of protection against the challenge virus . Calves vaccinated with neonatal calf diarrhea virus or B641 developed neutralizing antibodies to their respective heterologous challenge viruses but were not protected . After challenge, the boosted coproantibody plaque reduction neutralization response to the original vaccine virus was greater than that to the challenge virus.

Anal Biochem, 1987 May 15, 163(1), 117 - 22
A rapid assay method for ammonia using glutamine synthetase from glutamate-producing bacteria; Wakisaka S et al.; A rapid enzymatic assay method for ammonia was developed by using glutamine synthetase from glutamate-producing bacteria together with pyruvate kinase, lactate dehydrogenase, and NADH . The time required for determination of 25 nmol of ammonia was 5 min with 1 unit of glutamine synthetase, as opposed to 14-30 min with 1 unit of glutamate dehydrogenases from various sources . The present method was used to determine ammonia in serum, microbiol-culture broth, and waste water . The method can be modified for spectrophotometry in the visible region by substituting pyruvate oxidase, peroxidase, and appropriate chromogens for lactate dehydrogenase and NADH . With 4-aminoantipyrine (4AA) and phenol, and with 4AA and N-ethyl-N-2-hydroxyethyl-m-toluidine as chromogens, the sensitivity of ammonia determination was 0.65 and 1.7 times that with glutamate dehydrogenase, respectively . The present method was also applicable to the continuous detection of the activity of some ammonia-forming enzymes such as guanase, adenosine deaminase, and urease and to the determination of 0.5-30 microM ATP-ADP after some modification of the mixture.

J Adv Nurs, 1987 May, 12(3), 267 - 74
The life sciences in nursing: development of a theoretical model; Akinsanya JA; This paper explores the relationship between the life sciences of anatomy, physiology, microbiology and pharmacology and the teaching/learning problems of their application in nursing . A theoretical model is proposed derived from a conceptual consideration of nursing tasks and of nursing actions developed to account for a direct link between these sciences and nursing . It is argued that a 'bio-nursing' approach to the use of the life sciences in nursing is comparable to that of a 'bio-medical' approach in medical education and practice . The paper suggests that an appropriate examination of the contributions of the life sciences to nursing education will provide a more concentrated and illuminating exercise with regard to making possible the identification of a body of knowledge of direct relevance to nursing practice . The teaching/learning implications for nurse education and the development of a distinctive knowledge base derived from these sciences are discussed.

Rev Infect Dis, 1987 May-Jun, 9(3), 578 - 80
Mycobacterium szulgai: an unusual pathogen; Dylewski JS et al.; Mycobacterium szulgai is an unusual pathogen that accounts for less than 1% of all cases of non-tuberculosis mycobacterial infection . Infections with this organism usually involve the lung but may involve soft tissues . Although similar to tuberculosis in its clinical presentation, infection due to M . szulgai requires different management, and it is therefore important to distinguish disease caused by M . szulgai from that caused by M . tuberculosis . Isolation of M . szulgai implies the presence of clinical disease, and when the organism is identified, treatment based on sensitivity testing should be initiated . Although no standard recommendations for treatment exist, most infections due to M . szulgai have been treated with combined high doses of isoniazid, ethambutol, and rifampin for 18-24 months . M . szulgai has been isolated worldwide; the first case of infection reported from Canada is described, and the clinical presentation, microbiologic diagnosis, and therapeutic management of M . szulgai infections are reviewed.

Lab Invest, 1987 May, 56(5), 534 - 43
Dexamethasone-prepared Escherichia coli-induced disseminated intravascular coagulation . Animal model; Lopez-Garrido J et al.; We have developed a new model of disseminated intravascular coagulation in rats based on the induction of immunosuppression by prolonged high-dose dexamethasone treatment . Most models of disseminated intravascular coagulation are based on the generalized Shwartzman reaction, which is observed characteristically in experimental animals after two separate inoculations of bacterial endotoxins . These produce massive deposition of thrombi in the microcirculation and significant hemorrhagic and ischemic phenomena . We have demonstrated that the administration of glucocorticosteroids at the specific doses and intervals can adequately replace the first (preparatory) injection of endotoxin . For this reason, we have attempted to experimentally simulate a frequent clinical situation, such as sepsis secondary to peritonitis, by intraperitoneal inoculation of Escherichia coli and hog gastric mucin into rats pretreated with dexamethasone . This inoculation was equivalent to the second injection of endotoxin in the Shwartzman model (triggering inoculation) . A typical picture of disseminated intravascular coagulation induced by bacterial endotoxins developed, as demonstrated by the anatomopathologic, microbiologic, and hematologic studies performed . These results were then compared to those obtained in rats treated exclusively with dexamethasone or given, in addition, an effective antibiotic therapy.

Rev Infect Dis, 1987 May-Jun, 9(3), 625 - 35
A unique tribute to Theobald Smith, 1915; Chernin E; From 1895 to 1915 Theobald Smith served as Professor of Comparative Pathology in the Harvard Medical School in Boston and concurrently as Director of the Massachusetts State Antitoxin and Vaccine Laboratory . On the verge of his departure for a new post at the Rockefeller Institute in Princeton, New Jersey, Smith's colleagues sponsored an elaborate dinner in his honor . Marshall Fabyan, who was the moving spirit behind the affair, also designed an eight-inch by ten-inch souvenir card on which twenty-six sketches depicted Smith's signal researches . This previously unpublished card is reproduced in the present paper, and a digest of the work represented by each sketch is provided . Collectively these summaries are evidence of the remarkable range of Smith's accomplishments, and they serve as a remainder of why Smith is universally regarded as the premier American microbiologist of his day.

Rev Infect Dis, 1987 May-Jun, 9(3), 562 - 77
Environmental nonhuman sources of leprosy; Blake LA et al.; Leprosy has been considered to occur only after exposure to a human case . However, evidence has been accumulating that this conventional view is wrong and that an environmental nonhuman source is critical to some human infections with Mycobacterium leprae . Observations, some of which date back to the nineteenth century, support soil, vegetation, water, arthropods, and armadillos (Dasypus novemcinctus) as environmental sources of leprosy . Disparate clinical, epidemiologic, and microbiologic evidence has been critically reviewed in light of the fact that 50%-70% of sporadic cases of leprosy in well-studied populations occur in persons who have had no known contact with human leprosy . Historical data and current information alike substantiate the concept of nonhuman sources of the disease; recent observations with monoclonal antibody have shown that phenolic glycolipid-I antigen, which is unique to the M . leprae cell wall, is present in soil . In the absence of a technique for in vitro cultivation, indirect methods and the body of observations reviewed here persuasively favor but do not prove the existence of environmental nonhuman sources of M . leprae.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1987 May, 184(2), 95 - 107
{Thirty years of disinfection 1955-1985}; Bellinger H; The article deals with disinfectants and disinfection during 1955-1985 and analyses the disinfectant lists no . 1-6 made up by the German Society for Hygiene and Microbiology . It is shown that changes in test methods may influence the composition of disinfectants . During the time taken in consideration a change from phenols/phenol derivatives as main active material in disinfectants to aldehydes took place . Main active materials in hand disinfectants are the alcohols ethanol, iso-propanol and n-propanol . Since 1974 (list no . 4) the number of products based on PVP-iodine for hand disinfectants increases . Strikingly quaternary ammonium compounds in detergent disinfectants increase as well as sole active material or in combination with aldehydes . This depends on the fact, that their acceptance is well because they are less smelling . On the other hand in combination with aldehydes they make it possible to reduce the amount of bad smelling aldehydes.

Vopr Virusol, 1987 May-Jun, 32(3), 329 - 34
{Antiproliferative activity of different preparations of human interferons}; Voronina FV et al.; The conclusion that the AP activity of IFN in the ChLI-1 preparation was not lost but masked by an admixture of obscure factors was drawn on the basis of coefficients of AV/AP ratio titres of IFN-alpha preparations of various degrees of purification prepared at the Gamaleia Institute of Epidemiology and Microbiology and the shape of curves of the AP effect . It was found that the curve of AP activity of diluted interferon may be of parabolic shape which reflected AP effect of high and low concentrations in the absence of AP effect for some intermediate dilutions . This is due to competitive relationships of the growth-stimulating factors and IFN upon non-simultaneous elimination of its individual subtypes . The existence of a curve of such shape indicates the expediency of testing lower concentrations than those which are characterized by a sigmoid shape of curves of AP activity, especially for cells with low sensitivity to interferon.

Am J Med, 1987 Apr 27, 82(4A), 391 - 4
Economic impact of streamlining antibiotic administration; Quintiliani R et al.; Decisions concerning antibiotic administration in the treatment of serious hospital-associated infections present important cost considerations and opportunities for the prescribing physician . There tend to be three distinct stages of therapy for such infections and, especially in the latter two stages, cost containment is enabled by close monitoring of mode, level, and frequency of antibiotic dosing . The first stage of therapy typically lasts about three days, during which time uncertainty exists about what is the cause of the infection . Therapy is given empirically, often with the combination of an aminoglycoside and a beta-lactam antibiotic . The second stage begins about the fourth day, at which time definitive microbiologic and clinical data are available that should allow for streamlining of antibiotic therapy, usually from combination therapy to more cost-effective monotherapy . Unfortunately, even when new data indicate that single, inexpensive therapy is possible, physicians often continue with the initial, expensive empiric drugs . It is at this stage in the patient's hospital stay that routine assessment of antibiotic management would offer the first chance to reduce hospital antibiotic costs without compromising clinical outcome . The third stage of therapy typically begins around the seventh day, when the patient is usually clinically stable and afebrile . At this point, often the only reason for continued hospitalization is so that treatment with parenteral antibiotics may continue . In many of these patients, however, therapy can be switched from the parenteral to the oral drug mode, and thus they can be treated on an outpatient basis . Streamlining antibiotic therapy by changing modes and frequency of administration represents a major step toward effective, responsible cost containment.

J Am Vet Med Assoc, 1987 Apr 15, 190(8), 1027 - 34
Canine prostatic disease--comparison of ultrasonographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985); Feeney DA et al.; A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying (via a prepubic approach) the 2-dimensional, gray-scale ultrasonographic appearance most often associated with the various spontaneous prostatic diseases . Ultrasonography was of value in characterizing the parenchymal architecture as normal vs focally hyperechoic and diffusely hyperechoic (associated with chronic inflammation and neoplasia) or focally hypoechoic or anechoic (either accompanied by distant enhancement), which was associated with retention cyst or abscess . Further specificity based only on abnormal echotexture was not possible . Ultrasonography facilitated the differentiation of radiographically identifiable prostatomegaly attributable to abscess or neoplasia from apparent prostatomegaly attributable to paraprostatic cyst . An imaging protocol consisting of distention retrograde urethrocystography and prepubic ultrasonography was recommended, as a distended bladder aided ultrasonographic identification of the prostate gland . In addition, the combination of urethral morphologic features and urethroprostatic reflux appearance complemented the ultrasonographic appearance for differentiation of prostatic abscess from prostatic carcinoma . A classification scheme for spontaneous canine prostatic disease combining germane imaging morphologic features with microscopic and microbiologic findings was proposed.

P R Health Sci J, 1987 Apr, 6(1), 27 - 9
Dengue virus vaccine studies in Puerto Rico: a review; Kraiselburd E; This review summarizes part of the work performed at the Virology Laboratories (Department of Microbiology, University of Puerto Rico School of Medicine) with live attenuated dengue virus vaccines obtained from the Walter Reed Army Institute of Research . Vaccines were tested for their respective immunogenicity and attenuation in rhesus monkeys (Maccaca mulatta) and in mosquitoes (Toxorynchites amboinensis), respectively . This experimental model revealed that out of 6 vaccines tested, only two (DEN-2/S-1 and DEN-4 strain 341750) should be further evaluated for safety and immunogenicity . Further studies are required to develop an effective vaccine to prevent dengue fever and its hemorrhagic manifestations.

Orthop Rev, 1987 Apr, 16(4), 236 - 40
Treatment of septic arthritis . Diagnostic approach and rational use of antibiotics; Slama TG; The diagnosis of septic arthritis is best made by aspiration, either needle or arthroscopic, or by open drainage . Accurate clinical and microbiologic diagnoses are essential and dictate specific therapy . Although the exact length of intravenous antibiotic therapy is debatable, it is generally between two and six weeks, depending on the etiologic organism.

Am J Dis Child, 1987 Apr, 141(4), 454 - 7
The importance of the virology laboratory in the diagnosis and management of viral meningitis; Wildin S et al.; Recent advances in cell culture techniques have made possible the rapid and accurate detection of enteroviruses, the most commonly identified cause of aseptic meningitis . Between 1983 and 1985, 69 patients were diagnosed as having enteroviral meningitis by viral culture of cerebrospinal fluid, throat swab, and/or rectal swab or stool specimens . Half of the 49 patients in whom the diagnosis was based on positive cerebrospinal fluid culture benefited directly from viral culture results by early withdrawal of antibiotics, early discharge, or changing of the diagnosis and prognosis of the disease . Enteroviral cultures became positive in as early as 24 hours, and most of the cultures became positive within one week . The cost of viral culture is comparable with that of other microbiologic tests . The virology laboratory has proved useful in the diagnosis and management of patients with enteroviral meningitis.

S Afr Med J, 1987 Mar 21, 71(6), 371 - 5
The immunocompromised host; Jacobs P; The immunocompromised patient, with or without superimposed granulocytopenia, provides a wide range of life-threatening challenges for the primary medical and nursing care management group . In the context of haematological malignancy, particularly leukaemia and bone marrow transplantation, special expertise needs to be developed which includes competence in many aspects of general medical, nursing, and intensive care techniques . Clearly, the range of essential knowledge extends to other disciplines including respiratory, cardiac, and renal medicine, with important contributions from microbiology, virology, dietetics and parenteral nutrition . The increasing cure rate achieved in haematological malignancy and the ever-widening indications for bone marrow transplantation require a dedicated and experienced group, able to handle all challenges . Integral to managing the complete patient, both through the acute phase and into periods of recovery and long-term rehabilitation, is inclusion of the paramedical specialists--social workers, occupational therapists, physical medicine physicians and physiotherapists . Proper balance in the cost-effective use of expertise from each of these groups and the provision of a suitable physical facility with protected environment and intensive care facilities are the cornerstones on which individual patient survival and ultimately increase in cure rates depend.

S Afr Med J, 1987 Mar 7, 71(5), 293 - 7
Pneumocystis carinii pneumonia; Pincus PS et al.; Pneumocystis carinii pneumonia (PCP) has become one of the most important of the opportunistic pulmonary infections of the 1980s . In view of the rapidly expanding population of immunosuppressed patients, many more cases of PCP may be expected in the future . The history, microbiology, pathogenesis, pathology, clinical and laboratory features, diagnosis, treatment, course and prognosis of this disease are reviewed.

Cytometry, 1987 Mar, 8(2), 153 - 62
In vivo cell kinetic effects of cis-platinum on human ovarian cancer xenografts measured by dual parameter flow cytometry; Sevin BU et al.; Dual parameter flow cytometry, measuring DNA and nuclear protein of individual cell nuclei simultaneously, makes it possible to follow cell kinetic perturbations in six distinct compartments of the cell cycle following chemotherapy in vivo . Human ovarian cancer xenografts in nude mice from a primary and recurrent tumor of the same patient were studied . The response to intraperitoneal application of cis-platinum was assessed by tumor volume measurements, changes in labeling indices by autoradiography, and dual parameter flow cytometry . Sequential tissue samples were taken from each tumor using fine needle aspirations as a microbiopsy method . Pretherapy samples were compared to multiple specimens collected up to 18 days after therapy . Morphologic changes of each specimen were also assessed . Cis-platinum affects malignant cells in the G1B, S, G2A, and G2B compartments with various intensities and different time frames, depending on the drug sensitivity of each individual tumor.

J Clin Chem Clin Biochem, 1987 Mar, 25(3), 123 - 30
Gene analysis and the clinical chemist; Lang H et al.; Knowledge of gene analysis methods and concepts will be important to the clinical chemist in the near future . Currently most gene analyses must be performed by indirect techniques, using polynucleotide probes hybridizing close to or on the disease gene but not on the position of the mostly unknown gene mutation (restriction fragment length polymorphism analysis) . The sensitivity and specificity of such assays are affected by biological and methodologic factors, and are being continually improved . Preventive medicine is a promising area for gene analysis which will possibly fit well into the domain of clinical chemistry . The application of nucleotide hybridization analysis in tissue matching for organ transplantation, and in the detection and differential diagnosis of malignancies is in its early stages . A very promising, and rapidly emerging, technology is the direct detection and differentiation by gene probing of bacteria and viruses in medical microbiology . Guidelines for the ethical problems of gene analysis already exist within the field of medical ethics.

Infect Dis Clin North Am, 1987 Mar, 1(1), 235 - 51
Sexually transmitted enteric and rectal infections in homosexual men; Rompalo AM et al.; Intestinal infections represent a major health problem in homosexual men . The spectrum of potential pathogens includes classic sexually transmitted pathogens, enteric bacterial and protozoan pathogens, and a wide range of opportunistic infections seen in patients with human immunodeficiency virus (HIV) infections . Diagnosis and treatment of these infections must be comprehensive, including a full microbiologic evaluation, assessment of the immuno-competence of the patient, and repeat examination following completion of therapy.

Vopr Virusol, 1987 Mar-Apr, 32(2), 175 - 83
{Results of coded trials of the activity of the trivalent subunit influenza vaccine Grippovak in Moscow kindergartens in December 1983 through the 1st quarter of 1984}; Chumakov MP et al.; During the autumn-winter epidemic of influenza-like diseases in December, 1983--first quarter, 1984, in Moscow commissioned coded observations on the effectiveness of prophylactic vaccination against influenza of 3-7-year-old children with a preparation "Grippovak SE-AZh" were carried out in day-care centers . In the previous large-scale trials, 1981-1984, the "Grippovak" had been evaluated positively as a completely harmless, serologically and immunologically active preparation reducing 3-3.5-fold the number of laboratory-verified cases of viral type A and B influenza in the vaccinees . In 1986, however, the "Journal of Microbiology, Epidemiology, Immunology" (JMEI, 2: 49-54) published a paper whose authors, on behalf of the Commission which had checked the preparation in the day-care centers (Z.A . Bashliaeva, A.A . Sumarokov, et al.), came to a conclusion that "Grippovak" was ineffective in children . Other members of the above Commission disagreeing with this conclusion made a repeat analysis of the decoded materials of the observations in the day-care centers using computer methods and demonstrated that because of significant prevalence of non-influenza ARD cases and recurrent (up to 44%) ARD cases in children in the 4 months of observation, it was impossible to judge the effectiveness of the vaccine by comparison of the total incidence of influenza and ARD from the clinical data alone in the vaccinees and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Rev Infect Dis, 1987 Mar-Apr, 9(2), 392 - 7
In vitro antifungal susceptibility testing and measurement of levels of antifungal agents in body fluids; Drutz DJ; Interpretation of in vitro susceptibility data for antifungal drugs is hindered by the absence of standardized test criteria . Thus, it is extremely difficult to identify a clear relation between minimal inhibitory concentrations and clinical outcome . The situation appears more readily resolvable for yeast-like than for filamentous fungi since the former are more easily quantified by standardized microbiologic techniques . Accordingly the National Committee for Clinical Laboratory Standards has initiated the process of developing standards for yeast susceptibility testing . A related issue concerns the measurement of antifungal agents in body fluids . Whereas there may be little value in measuring concentrations of amphotericin B (because of its predictable pharmacokinetics), there is value to measuring levels of flucytosine (serum concentrations may relate to bone marrow suppression and/or the development of drug resistance) and ketoconazole (which may be absorbed unpredictably from the gut) . Laboratory standards for these measurements have not been established.

Rev Infect Dis, 1987 Mar-Apr, 9(2), 275 - 94
Mycobacteria other than Mycobacterium tuberculosis: review of microbiologic and clinical aspects; Woods GL et al.; The rate of isolation of mycobacteria other than Mycobacterium tuberculosis (MOTT) has increased over the past several years; in some areas the isolation rate for Mycobacterium avium-Mycobacterium intracellulare has surpassed that for M . tuberculosis . Simultaneously, the spectrum of clinical manifestations with the various species has widened . Outbreaks of disease due to Mycobacterium chelonae have occurred in renal dialysis patients . New species have been described: Mycobacterium malmoense is primarily a pulmonary pathogen, and Mycobacterium haemophilum has been recovered from cutaneous lesions in immunosuppressed patients . In addition, reports of disease due to species generally considered saprophytic have become more numerous . In this review, the epidemiologic, pathologic, and clinical features of the individual MOTT species are discussed . A brief summary of mycobacteria isolated at the Cleveland Clinic foundation between 1982 and 1985 is also presented.

J Clin Pathol, 1987 Feb, 40(2), 180 - 4
Value of perinatal necropsy examination; Porter HJ et al.; In a retrospective study of 150 stillbirths and 150 neonatal deaths carried out between 1981 and 1985 the necropsy findings were compared with the clinical diagnoses, which had been obtained from the postmortem request form, and the case notes completed before the necropsy was performed . In all cases the necropsy comprised macroscopic findings and histological examination of all organs, with microbiology, radiology, and cytogenetics where appropriate . Clinically important differences between clinical and pathological diagnoses in 54 of 150 cases (36%) were noted in the cases of stillbirth . Of the neonatal deaths, examination showed clinically important information that had not been recognised during life in 66 cases (44%) . Histological examination of tissues was essential for making or confirming the pathological diagnosis in 20% of all perinatal deaths.

J Clin Microbiol, 1987 Feb, 25(2), 445 - 8
Detection of metabolites by frequency-pulsed electron capture gas-liquid chromatography in serum and cerebrospinal fluid of a patient with Nocardia infection; Brooks JB et al.; Serum (SR) and cerebrospinal fluid (CSF) from a patient suspected of having tuberculous meningitis were submitted to our laboratory for analysis by frequency-pulsed electron capture gas-liquid chromatography (FPEC GLC) . The samples were tested for the presence of carboxylic acids, alcohols, hydroxy acids, and amines by methods described previously (C . C . Alley, J . B . Brooks, and D . S . Kellogg, Jr., J . Clin . Microbiol . 9:97-102, 1977; J . B . Brooks, C . C . Alley, and J . A . Liddle, Anal . Chem . 46:1930-1934, 1974; J . B . Brooks, D . S . Kellogg, Jr., M . E . Shepherd, and C . C . Alley, J . Clin . Microbiol . 11:45-51, 1980; J . B . Brooks, D . S . Kellogg, Jr., M . E . Shepherd, and C . C . Alley, J . Clin . Microbiol . 11:52-58, 1980) . The results were different from previous FPEC GLC profiles of SR and CSF from patients with known tuberculous meningitis . Both the SR and CSF contained several unidentified compounds that were not previously detected in tuberculous meningitis or any of our other studies of body fluids . Nocardia brasiliensis was later isolated from the patient . Detection of these metabolites by FPEC GLC could prove to be useful for rapid diagnosis of Nocardia disease, and their identification will provide a better understanding of metabolites produced by Nocardia sp . in vivo.

J Virol, 1987 Feb, 61(2), 344 - 53
Transcriptional activities of mammalian genomes at sites of recombination with foreign DNA; Schulz M et al.; The nucleotide sequences of several sites of recombination between adenovirus DNA and hamster, mouse, or human cell DNAs were determined . These sites of recombination had been cloned from adenovirus type 2 (Ad2)- or type 12 (Ad12)-transformed cells, from Ad12-induced tumor cells, or from a symmetric recombinant between Ad12 DNA and human cell DNA . One important precondition for the generation of recombinants between host and foreign DNAs might be the establishment of a chromatin configuration that permits access of foreign DNA and of the recombination machinery to cellular DNA . Such favorable chromatin structures might arise during cellular DNA replication or transcription or both . As a first approach toward investigating these more complex problems of foreign DNA insertion, we determined transcriptional activities of cellular DNA sequences at viral junction sites . The sites of linkage investigated in this study with respect to their transcriptional activities were those previously cloned and sequenced (W . Doerfler, R . Gahlmann, S . Stabel, R . Deuring, U . Lichtenberg, M . Schulz, D . Eick, and R . Leisten, Curr . Top . Microbiol . Immunol . 109:193-228, 1983) . In addition, a site from cell line HA12/7 which is described in this paper was also analyzed . The results presented demonstrate that the cellular DNA sequences involved in linkage to viral DNA at five completely different sites in DNA from three different species are transcribed into RNAs even in cells which have not been transformed or infected by adenovirus . Some of these RNAs were cytoplasmic and were not poly(A)+ . Human cell DNA sequences at the junction to Ad12 DNA in SYREC2 DNA were transcribed into poly(A)+ cytoplasmic RNA which could be translated in vitro . These results are consistent with the notion that at least some of the cellular DNA sequences at sites of insertion of adenovirus (foreign) DNA are transcriptionally active and thus provide an opportunity for recombination.

Gastroenterology, 1987 Feb, 92(2), 318 - 28
Histopathology differentiates acute self-limited colitis from ulcerative colitis; Nostrant TT et al.; Acute self-limited colitis (ASLC) must be distinguished from chronic ulcerative colitis (CUC) for the proper early management of patients with the acute onset of bloody diarrhea . This study was undertaken to determine if any clinical, endoscopic, microbiologic, or histologic parameters can be used to make this distinction reliably and quickly . Forty-eight patients with ASLC, 36 patients with chronic ulcerative colitis during their first attack {CUC(F)}, and 84 patients with recurrent flares of chronic ulcerative colitis {CUC(R)} were studied prospectively . The presence of fever (temperature greater than 100 degrees F), abdominal pain, or the time from onset of bloody diarrhea to presentation were not discriminatory . Overall clinical and endoscopic severity were identical among the three groups . Microbiologic studies identified an infectious agent in only 42% of patients with ASLC . Histopathologic features always distinguished patients with CUC from those with ASLC . No case of ASLC was misdiagnosed histologically as CUC or vice versa . Plasmacytosis in the lamina propria extending to the mucosal base and mucosal distortion were present in all cases of CUC(F) and CUC(R), but were absent in all cases of ASLC . The finding of focal cryptitis during the resolving phase of ASLC could be confused with similar lesions in biopsy specimens from patients with Crohn's disease and mandates clinical follow-up . Histopathology is thus the only reliable diagnostic tool for the rapid differentiation of ASLC from CUC . However, biopsy specimens are only diagnostic when obtained during the acute phase of illness; that is, usually within the first 4 days from the onset of symptoms.

Appl Environ Microbiol, 1987 Feb, 53(2), 266 - 9
Penicillium viridicatum, Penicillium verrucosum, and production of ochratoxin A; Pitt JI; The taxonomy of the important mycotoxigenic species Penicillium viridicatum and P . verrucosum was reviewed to clarify disagreements relating to the three P . viridicatum groups erected by Ciegler and coworkers (A . Ciegler, D . I . Fennell, G . A . Sansing, R . W . Detroy, and G . A . Bennett, Appl . Microbiol . 26:271-278, 1973) and the mycotoxins produced by them . Cultures derived from the types of these two species and authentic cultures from each group and from many other sources were examined culturally, microscopically, and for mycotoxin production . It was concluded that P . viridicatum group II has affinities with P . verrucosum and not with P . viridicatum, as indicated by J . I . Pitt in the 1979 monograph (The Genus Penicillium and Its Teleomorphic States Eupenicillium and Talaromyces) . As a result of this study it can now be unequivocally stated that the mycotoxins ochratoxin A and citrinin are not produced by P . viridicatum . Of species in subgenus Penicillium, only P . verrucosum is known to produce ochratoxin A.

Compr Ther, 1987 Feb, 13(2), 49 - 58
Pulmonary infections in AIDS; Donath J et al.; Based on our experience, we would like to offer a few pragmatic suggestions for the practicing clinician . These recommendations are summarized in Tables 1 and 2 . The first encounter with most patients gives the impression of either a dramatic acute infection, usually in the lungs, central nervous system, or gastrointestinal tract (in this order of frequency), or that of a chronic wasting disease . The former is frequently superimposed on the latter . The exploration of AIDS risk factors and a few easily detectable physical signs are the most important clues to the correct clinical diagnosis . Once AIDS is suspected, an aggressive and rapid approach for diagnosis is justified . Selected individually for each patient, the most commonly successful tests include bronchoscopy with BAL and/or transbronchial lung biopsy; bone marrow, lymph node, or liver biopsy with both microbiologic and pathologic processing of the material; blood (and often spinal fluid) cultures for fungal organisms; cranial computerized tomographic scan; and toxoplasma serology . Other tests, while potentially useful, are less important in immediate decision-making and treatment . In all cases of respiratory compromise or symptoms related to the chest, PCP has to be ruled out by invasive methods if the suspicion of AIDS is sufficiently strong . The diagnosis of one opportunistic infection should not be interpreted as a final answer . Rather, it should stimulate more vigilant efforts to uncover additional infections and other AIDS-related diseases if any abnormalities remain unexplained or persist despite treatment . Chest radiology should not be the main tool to diagnose or monitor lung infections.(ABSTRACT TRUNCATED AT 250 WORDS)

J Infect Dis, 1987 Feb, 155(2), 292 - 6
Rapid diagnosis of nocardiosis with an enzyme immunoassay; Angeles AM et al.; Diagnosis of nocardiosis is often delayed because of the frequently nonspecific nature of the illness and because of the long incubation period required to isolate the organism in the microbiology laboratory . Past experience with serological methods for diagnosing nocardiosis have met with little success, primarily because there was no suitable antigen . Using a previously identified Nocardia asteroides-specific protein, we developed an enzyme immunoassay for the rapid diagnosis of nocardiosis . We evaluated sera from 22 patients with nocardiosis, 83 hospitalized controls, and 21 patients with tuberculosis . Twenty (91%) of the sera from patients with nocardiosis had titers of antibody greater than or equal to 1:256, whereas all of the sera from controls and from patients with tuberculosis had titers less than 1:256 . This assay represents a highly sensitive and specific serodiagnostic tool for evaluating patients with possible nocardiosis.

Eur J Biochem, 1987 Jan 2, 162(1), 199 - 202
Isolation and characterization of a DNA-uptake-stimulating protein from the culture medium of Neurospora crassa slime strain; Toth G et al.; A protein fraction was purified to homogeneity from the culture medium of the wall-less (slime) strain of Neurospora crassa (FGSC 1118), which proved to be identical with DNA-uptake-stimulating factor (designated DUSF), which has been described earlier {Schablik, M . and Szabo, G . (1981) FEMS Microbiol . Lett . 10, 395-397} . The quantity of DUSF is measured by the amount of {3H}DNA uptake by Neurospora cells at standard conditions . Its relative molecular mass was 230,000 . It has an isoelectric point of pH 5.5 . This protein consists of two identical subunits, relative molecular mass 110,000.

Med Educ, 1987 Jan, 21(1), 53 - 8
Specialty choice of medical students in India; Ramalingaswami P; The objectives of this study are to investigate undergraduate medical students' attitudes towards different specialties and to investigate whether there are any differences between the attitudes of students of different sex and different socio-economic background . The sample consisted of 692 final-year students from 11 medical colleges in India . Scale values were worked out to find out the actual distance between students' attitudes . Sex differences were observed in the attitude towards surgery, obstetrics and gynaecology, orthopaedics, microbiology, social and preventive medicine and anatomy . There were no statistically significant differences between the attitudes of students from different socio-economic backgrounds.

J Clin Microbiol, 1987 Jan, 25(1), 172 - 3
Cryptosporidiosis in patients at a large teaching hospital; Marshall AR et al.; In 1984, all stool samples submitted to a microbiology laboratory (n = 2,197) from a predominantly hospital-based population were examined for Cryptosporidium oocysts after Ziehl-Neelsen staining, but only 0.5% were positive . We suggest that in low-incidence areas, individual laboratories examine stool samples for this organism only in immunosuppressed patients and those in whom symptoms persist.

Fertil Steril, 1987 Jan, 47(1), 76 - 81
Quantitative histochemistry of late luteal phase human endometrium; Holt JP Jr et al.; New techniques are needed to evaluate the luteal phase endometrium in the infertility patient . Toward this goal, we have applied quantitative microbiochemical techniques to the determination of enzyme activities in microdissected samples of each endometrial cell type (i.e., epithelial and stromal) from individual endometrial biopsies . Preliminary data on eight control patients are presented to establish a normal range of epithelial and stromal lactate dehydrogenase (LDH), beta-hydroxyacyl-CoA-dehydrogenase (beta-OH-acyl-CoA-DH), and citrate synthase (CS) enzyme activities . Significantly higher enzyme activities were found in the epithelial cell type, compared with the stromal cell type for all three enzymes . Mean enzyme activities for the eight patients, comparing epithelial to stromal values, respectively, were (1) LDH, 39.9 versus 15.4; (2) CS, 4.0 versus 1.2; and (3) beta-OH-CoA-DH, 3.9 versus 2.3 mol/kgD/hour . Enzyme activities are expressed as moles of substrate reacting per kilogram dry weight per hour (mol/kgD/hour).

Eksp Onkol, 1987, 9(5), 24 - 7
{Effect of benzo(a)pyrene on soil microbiocenosis}; Tonkopii NI et al.; The experimental studies have shown that benz(a)pyrene being in the soil affects the formation of soil microbiocenosis and biological activity of soils.

Vet Med Nauki, 1987, 24(5), 52 - 9
{Biopharmaceutical and clinico-pharmacological research on the intramammary preparation Cephamasten}; Donev B et al.; An animal drug formula, Cephamasten, for intramammary application in the treatment of mastitis-affected cows, ewes, and goats in the lactation period was worked out on the base of microbiologic, technologic, biopharmaceutic, and clinico-pharmacologic studies . Its active ingredient was the Pharmachim cephalexin-monohydrate . The consistence of Cephamasten has proved suitable for intracisternal introduction . It is tolerated well within the udder of cows, and it rapidly releases the antibiotic incorporated in it . The milk of the treated quarters has proved free from cephalexin after the 72nd hour of the last infusion . Cephamasten has shown high effectiveness in the treatment both of the preclinical and of the acute clinical mastitis . In the first case best results were obtained with the twofold treatment at a 24-hour interval, and in the second case--with the sixfold treatment at 12-hour intervals (intracisternal introduction of the preparation) . In the case of generalized mastitis, in dependence on the severity of the process Cephamasten is to be applied at 4-6-12 intervals along with frequent milking and the parenteral application of other agents.

Vet Med Nauki, 1987, 24(2), 40 - 5
{Effect of low vacuum on the health status of the udder in the machine milking of cows}; Bozhkova G et al.; Investigations were carried out with two groups of cows at first lactation to elucidate the effect of low rate vacuum on the health status of the mammary gland . The clinical, cytologic, and microbiologic studies were performed in dynamic . It was found that the milking of cows with the use of 39.9 kPa vacuum produced a negative effect on the normal udder . It led to secretory troubles, subclinical mastitis, and latent infection.

Ann Otolaryngol Chir Cervicofac, 1987, 104(1), 21 - 7
{Severe laryngeal dysplasia and synthetic retinoids}; Prades JM et al.; Nine patients with "severe" laryngeal dysplasia as shown by multiple microbiopsies during laryngoscopy were treated with a synthetic derivative of retinol (Etretinate 0.5 to 1 mg/kg/day) over one or two months . Follow up histology after 8 to 18 months surveillance showed histologic improvement with respect to dyskeratosis, atypical cells and to a lesser extent epithelial hyperplasia . The use of synthetic vitamin A derivatives for "severe" laryngeal dysplasia is discussed.

Gene, 1987, 56(1), 87 - 97
Complete nucleotide sequence of the penicillin G acylase gene and the flanking regions, and its expression in Escherichia coli; Oh SJ et al.; The pga gene coding for penicillin G acylase (PGA) in Escherichia coli ATCC11105 was cloned, and its complete nucleotide sequence including 5'- and 3'-flanking regions was determined . Two nonidentical subunits that constitute an active PGA enzyme complex are known to be formed by processing of a common precursor molecule {Bock et al., FEMS Microbiol . Lett . 20 (1983) 141-144} . This novel type of protein processing was confirmed by a nucleotide sequencing study together with amino acid sequencing of two PGA subunits . In addition, it was found that the initiation codon, AUG, is preceded by an authentic ribosome-binding site, a consensus promoter sequence and putative cAMP receptor protein (CRP)-binding sites, and that the termination codon, UAA, is followed by a putative transcriptional terminator . The promoter function was confirmed by galactokinase assay using galK fusion plasmids . A recombinant plasmid was constructed to overproduce the enzyme using phage lambda pL promoter . Unexpectedly, thermal induction led to accumulation of the 94-kDa polypeptide rather than active PGA in large amounts . Western immunoblot analysis showed that this large polypeptide is the real precursor of PGA . It is evident, therefore, that the synthesis of active PGA in E . coli is affected by growth temperature and that the precursor processing step(s) is temperature-sensitive.

Crit Rev Clin Lab Sci, 1987, 25(1), 71 - 103
Nucleic acid probes in clinical microbiology; Zwadyk P Jr et al.; The infectious disease applications of nucleic acid probe have been described . In addition, the basic procedures of nucleic acid probe technology have been discussed, as have the factors affecting implementation of probe technology in diagnostic laboratories . Despite the questions raised, nucleic acid probes will become part of the diagnostic laboratory in the near future . Commercial interests are developing and marketing new probes, reagents, and kits which will expedite the employment of this technology . High-volume reference laboratories will first use probes as part of a battery of tests which will include ELISA and monoclonal antibody methods . In all probability, probes will replace methods: that have proven to be ineffective, difficult, or costly such as culturing for some enteric pathogens and Legionella, that require long incubation periods, such as mycobacteria, or that have high costs and low yields, such as virology.

Z Erkr Atmungsorgane, 1987, 168(2), 157 - 67
{Legionellosis in a sample of pneumonia patients at a lung clinic}; Schmidt C et al.; The Legionellaceae as agents causing pneumonias are widespread distributed and lead to partially very serious diseases, particularly in predisposed persons with impaired resistance . Two of 12 cases observed are reported casuistically . Erythromycin as the drug of choice should be given already at suspicion . Since Legionellosis cannot be differentiated from pneumonias of other etiology on the basis of clinical findings alone, the authors refer to the importance of the relevant microbiologic methods.

J Cancer Res Clin Oncol, 1987, 113(5), 430 - 6
Decrease in glucokinase and glucose-6-phosphatase and increase in hexokinase in putative preneoplastic lesions of rat liver; Fischer G et al.; Preneoplastic liver lesions were produced in female Wistar rats by oral administration of 2-acetylaminofluorene for 165 days succeeded by a carcinogen-free standard diet up to 420 days . During the treatment numerous altered hepatic foci (AHF) and hyperplastic nodules (HN) were detected histochemically by a focal decrease or lack of adenosine-5-triphosphatase and glucose-6-phosphatase (G-6-Pase) activities . In addition, the immunohistochemically demonstrable amount of L-type pyruvate kinase was clearly reduced . The histochemically demonstrated decrease of G-6-Pase was substantiated by microbiochemical determination of the enzyme activity in microdissected material . Moreover, during the experimental period a continuous decrease in glucokinase and an increase in hexokinase was detected microbiochemically within AHF and HN . These alterations indicate a shift in the carbohydrate metabolism from gluconeogenesis to glucose utilization and pentose-phosphate-pathway for biosynthesis of nucleic acids . Beside other oncofetal markers, HK may be used as indicator of the early stages of liver carcinogenesis.

J Periodontol, 1987 Jan, 58(1), 34 - 9
Infantile agranulocytosis with survival into adolescence: periodontal manifestations and laboratory findings . A case report; Lamster IB et al.; A case of infantile agranulocytosis with survival into adolescence is presented . The polymorphonuclear leukocyte is considered an important source of lysosomal enzymes in gingival crevicular fluid, and evaluation of connective tissue-degrading enzymes in the fluid was performed . The activity of beta-glucuronidase, a ground substance-degrading enzyme that may serve as a marker for polymorphonuclear leukocytes, was markedly reduced in the fluid compared to samples from systemically healthy adults with periodontitis . The activities of the ground substance-degrading enzyme arylsulfatase, and collagenase, were in the low-normal range . The plaque microbiology, as characterized by dark-field microscopy and selective culturing, was consistent with advanced periodontitis . A review of the medical history revealed a series of bacterial infections since infancy . Improvement in the systemic health of the patient occurred at about the age of 15, and the intake of antibiotics to control infections was correspondingly reduced after this time . An exacerbation of the patient's periodontal disease, as evaluated by loss of alveolar bone on radiographs, occurred 1 to 2 years later . The progression of periodontal disease observed in this patient was apparently associated with the withdrawal of antibiotics administered for control of systemic (nonoral) infections.

Am J Forensic Med Pathol, 1986 Dec, 7(4), 278 - 82
Diagnosis of sudden death in infants due to acute dehydration; Huser CJ et al.; When infants die suddenly of acute dehydration, clinical signs and autopsy findings may be equivocal or absent, and microbiologic cultures often are not helpful . Vitreous humor electrolyte and urea nitrogen concentrations were measured in 53 infants dying of gastrointestinal infections, sudden infant death syndrome (SIDS), other infectious diseases, and miscellaneous causes to determine whether these parameters would assist in the recognition and confirmation of deaths resulting from dehydration . Significant differences were found when comparing the mean sodium and urea nitrogen levels of infants dying of gastrointestinal infections with those succumbing to SIDS or other causes . We recommend that these determinations be routinely performed whenever the gross autopsy findings are insufficient to explain the death.

Clin Obstet Gynecol, 1986 Dec, 29(4), 739 - 57
The microbiology of premature rupture of the membranes; Miller JM Jr et al.; The foregoing discussions bring to mind several salient facts: Although numerous barriers to infection exist, this aspect is understood incompletely . Conclusions on the pathogenicity or nonpathogenicity of certain organisms are often made from studies with very small numbers of patients, or in very specific patient populations . When such entities as low birth weight, premature labor, and PROM, which are all obviously related to some extent, are studied, very complicated analyses on large numbers of patients are required . Most of the organisms discussed are considered to be sexually transmitted . Because STDs are generally recognized to travel together in the same patient populations, the statistics necessary to separate one organism from another are complex indeed . The previous discussion notwithstanding, it is extremely difficult to form a solid conclusion about relation of these organisms to PROM with confidence . Many more patients need to be studied through many more pregnancies . In addition, differences among population subgroups make extrapolation extremely difficult . Currently the Louisiana State University is participating in a large, multicenter, collaborative study under the auspices of the National Institutes of Health . This study should provide an adequate data base concerning most of the isolates discussed and potential adverse outcomes of pregnancy . Then definitive statements may be made regarding both the screening of pregnant women and initiation of selective therapy . Specific management recommendations are discussed by Nagey and Saller in this symposium.

Scand J Dent Res, 1986 Dec, 94(6), 569 - 74
Clinical effects of glazing denture acrylic resin bases using an ultraviolet curing method; Budtz-Jorgensen E et al.; Control of denture plaque accumulation is essential to obtain and maintain a healthy oral mucosa in denture wearers . The present study was designed to study the effect on denture plaque accumulation and denture stomatitis of coating the fitting denture surface by a glaze . Twenty-one subjects wearing complete dentures participated in the study . Glazing of the denture surface was performed using a Perma Cure System . Plaque accumulation was studied clinically and using a semiquantitative microbiologic technique . Plaque accumulation on the glazed and the non-glazed halves of the fitting denture surface was compared after 1 wk . There was significantly less plaque on the glazed half of the denture (P less than 0.001), and the calculated number of CFU of bacteria/cm2 was significantly lower from the test area of the glazed half than from the test area of the non-glazed half of the denture (P less than 0.001) . When the patients were re-examined 1 month after the entire fitting denture surface had been glazed plaque scores, yeast scores and number of CFU of bacteria/cm2 were not significantly different from those observed before glazing . There was a reduction of the erythema of the palatal mucosa in 14/19 patients with denture-induced stomatitis . The study indicates that coating of the fitting denture surface by a glaze may be a means to improve denture cleanliness; however, the present glazing system should be further developed to produce a more uniform glazing.

Clin Lab Med, 1986 Dec, 6(4), 649 - 74
Quality control in microbiology: a review and bibliography; Braunstein H; Quality control in microbiology, with the proliferation and widespread usage of commercial identification systems, has largely passed into the hands of the manufacturer . In this review the author attempts to provide a spectrum of information concerning the validity, precision, and specificity of commercially available systems and individual methods for the identification of bacteria, of various types of yeasts, and of bacterial antigens, as well as a review of blood culture systems.

Arch Pathol Lab Med, 1986 Dec, 110(12), 1173 - 5
Rapid diagnosis of disseminated histoplasmosis in tissues; Klatt EC et al.; Disseminated histoplasmosis may resemble other disseminated infections, including mycobacterial, fungal, and parasitic diseases, and may be difficult to diagnose and treat in a timely fashion . Diagnosis may depend on microbiologic cultures that may take several weeks for definitive identification, with consequent prolonged hospitalization of the patient . An immunoperoxidase method is described for rapid diagnosis in tissues of Histoplasma capsulatum that can be applied to cytologic smears, frozen sections, and paraffin-embedded tissues processed by routine procedures . The stain can accurately distinguish histoplasma organisms from several other morphologically similar fungi or parasites, and can yield a definitive diagnosis in much less time than microbiologic culture.

Med Clin North Am, 1986 Nov, 70(6), 1279 - 94
Infective endocarditis: a challenging disease; Naggar CZ et al.; Enhanced clinical awareness of infective endocarditis, along with improved microbiologic methodology and more aggressive surgical intervention, has favorably influenced the outcome of the disease . The evolving nature of infective endocarditis over the past decade is described, as are the changing epidemiologic factors, microbiologic techniques, and echocardiographic contributions in the clinical management of patients with infective endocarditis.

J Bacteriol, 1986 Nov, 168(2), 486 - 93
Starvation proteins in Escherichia coli: kinetics of synthesis and role in starvation survival; Groat RG et al.; Starvation proteins synthesized by Escherichia coli at the onset of carbon starvation (R . G . Groat and A . Matin, J . Indust . Microbiol . 1:69-73, 1986) exhibited four temporal classes of synthesis in response to glucose or succinate starvation, indicating sequential expression of carbon starvation response (cst) genes . A cst mutant of E . coli showed greatly impaired carbon starvation survival . Thus, it appears that E . coli undergoes a significant molecular realignment in response to starvation, which increases its resistance to this stress . New polypeptides were also synthesized by E . coli in response to phosphate or nitrogen starvation . Some of these polypeptides were unique to a given starvation regimen, but at least 13 appeared to be synthesized regardless of the nutrient deprivation causing the starvation.

J Leukoc Biol, 1986 Nov, 40(5), 645 - 56
Naturally acquired leprosy in the nine-banded armadillo: a decade of experience 1975-1985; Walsh GP et al.; A decade has passed since our first report of naturally acquired leprosy in the nine-banded armadillo . Our studies and those of others during this period confirm the identification of the etiologic agent as Mycobacterium leprae . Confirmation is based on the results of histopathologic examination and microbiologic evaluations that included attempts to culture the organism, flourescent antibody studies, mycolic acid analysis, and DNA determinations demonstrating complete relatedness between the natural agent and M . leprae . Surveys involving large numbers of animals demonstrate a significant prevalence of the disease in armadillos captured in Louisiana and Texas . The discovery of naturally acquired leprosy in a chimpanzee in 1977 and a sooty mangabey monkey in 1979 reinforce the concept of leprosy as a zoonosis . Extensive contact with armadillos has been implicated by other observers in seven patients with leprosy in Texas . We believe the prevalence of leprosy in wild armadillos requires that they be considered a source of infection in patients from geographic areas where leprosy and armadillos co-exist.

Anal Biochem, 1986 Oct, 158(1), 64 - 7
Measurement of liver adenine nucleotides and S-adenosyl amino acids by one-step high-performance liquid chromatography; Gourdeau H et al.; A reverse-phase isocratic HPLC method is described for direct simultaneous assay of ATP, ADP, AMP, S-adenosylmethionine, S-adenosylhomocysteine, S-adenosylethionine, and other adenine derivatives in liver microbiopsies . The procedure was tested in conditions which alter the hepatic content of adenine nucleotides and sulfur-adenosyl amino acids in humans, rats, and guinea pigs.

Antimicrob Agents Chemother, 1986 Oct, 30(4), 542 - 4
Efficacy of alcohol-based hand rinses under frequent-use conditions; Larson EL et al.; Fifty volunteers randomly assigned to one of five hand washing agents (10 subjects per agent)--a nonantiseptic liquid soap (control), an antiseptic hand rinse containing 60% isopropyl alcohol (IPA) with emollients (Alc A), an antiseptic hand rinse containing 70% IPA and 0.5% chlorhexidine gluconate with emollients (Alc B), an antiseptic containing 4% chlorhexidine gluconate and 4% IPA (CHG), and 70% IPA--washed their hands 15 times per day for 5 days under supervision by using a standardized technique and measured amounts of test agent . Microbiologic samples of hand flora were obtained at base line and after hand washes 1 and 15 on test days 1 and 5 . After the initial hand wash there were significant reductions over base line in aerobic and anaerobic log CFU among those using Alc A, CHG, and IPA . By the end of the first day of hand washing (15 washes), there were 2-log or greater reductions in aerobic counts among subjects using all antiseptics, but no significant reductions in controls . By the end of day 5, all agents produced significant reductions in aerobic (P = 0.0002) and anaerobic (P = 0.002) counts over control soap . Subject assessment of effects of hand washing on the skin and overall satisfaction varied significantly by product (P = 0.04 and 0.05, respectively) . We conclude that alcohol-based hand rinses are highly efficacious, and such products are recommended as a health care personnel hand wash, particularly when sink and running water are inaccessible.

Am J Kidney Dis, 1986 Oct, 8(4), 265 - 6
Persistence of Candida despite seemingly adequate systemic and intraperitoneal amphotericin B treatment in a patient on CAPD; Bastani B et al.; A case of Candida peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD) is presented . Despite 2 weeks of intravenous and 4 weeks of intraperitoneal amphotericin B, good clinical response, and repeatedly negative fungal cultures from the peritoneal dialysate, her Tenckhoff catheter upon removal grew the same Candida species . This case emphasizes the point that Candida may persist on the catheter despite seemingly adequate antifungal treatment and good clinical and microbiologic response.

J Bacteriol, 1986 Oct, 168(1), 417 - 9
Cloning in Saccharomyces cerevisiae of a cycloheximide resistance gene from the Candida maltosa genome which modifies ribosomes; Takagi M et al.; We have previously shown that cycloheximide resistance can be induced in a strain of Candida maltosa by modifying ribosomes (M . Takagi, S . Kawai, Y . Takata, N . Tanaka, M . Sunairi, M . Miyazaki, and K . Yano, J . Gen . Appl . Microbiol . 31:267-275, 1985) . The present paper describes the cloning of the gene involved in this resistance (designated RIM-C for ribosome modification by cycloheximide) by using a host-vector system of Saccharomyces cerevisiae.

Crit Care Med, 1986 Oct, 14(10), 878 - 80
Elective orotracheal intubation and aspiration for microbiologic diagnosis in children; Kasian GF et al.; Endotracheal intubation is generally performed to facilitate the treatment of respiratory failure or to control the airway during general anesthesia . We electively intubated 14 children with undiagnosed pneumonia to obtain tracheobronchial secretions for microbiologic diagnosis . Three were intubated awake, three with sedation, and eight with sedation and neuromuscular blockade . Mycobacterium tuberculosis was isolated in four of six patients suspected of having tuberculosis . Other bacterial pathogens were isolated in three patients and viral pathogens in three patients . The procedure proved useful in 11 (79%) of the 14 patients, with no complications . We conclude that elective orotracheal intubation is a safe, simple, fast, and effective method of obtaining secretions for the culture of organisms responsible for lower airway and lung parenchymal infections in children.

Proc Natl Acad Sci U S A, 1986 Oct, 83(19), 7272 - 6
Color discrimination in halobacteria: spectroscopic characterization of a second sensory receptor covering the blue-green region of the spectrum; Wolff EK et al.; Halobacterium halobium is attracted by green and red light and repelled by blue-green and shorter wavelength light . a photochromic, rhodopsin-like protein in the cell membrane, sensory rhodopsin sR587, has been identified as the receptor for the long-wavelength and near-UV stimuli . Discrepancies between the action spectrum for the repellent effect of blue light and the absorption spectrum of sR587 and its photocycle intermediate S373 strongly suggest the existence of an additional photoreceptor for the blue region of the spectrum . Transient light-induced absorbance changes in intact cells and cell membranes show, in addition to sR587, the presence of a second photoactive pigment with maximal absorption near 480 nm . It undergoes a cyclic photoreaction with a half-time of 150 msec . One intermediate state with maximal absorption near 360 nm has been resolved . The spectral properties of the new pigment are consistent with a function as the postulated photoreceptor for the repellent effect of blue light . The phototactic reactions and both pigments are absent when retinal synthesis is blocked; both can be restored by the addition of retinal . These results confirm and extend similar observations by Takahashi et al . {Takahashi, T., Tomioka, H., Kamo, N . & Kobatake, Y . (1985) FEMS Microbiol . Lett . 28, 161-164} . The archaeobacterium H . halobium thus uses two different mechanisms for color discrimination; it uses two rhodopsin-like receptors with different spectral sensitivities and also the photochromicity of at least one of these receptors to distinguish between three regions covering the visible and near-UV spectrum.

Gastroenterology, 1986 Sep, 91(3), 651 - 9
Spectrum of rectal biopsy abnormalities in homosexual men with intestinal symptoms; Surawicz CM et al.; Homosexually active men have frequent intestinal and rectal symptoms resulting from sexually acquired gastrointestinal infections . We evaluated the histologic findings in rectal biopsy specimens obtained from 89 homosexual men with intestinal symptoms and 11 homosexual men without intestinal symptoms . All had undergone comprehensive microbiologic evaluation for rectal and enteric pathogens . Rectal biopsy specimens were evaluated without knowledge of clinical or microbiologic data by a standardized method for the presence or absence of abnormal histologic features . Forty-six percent of specimens from symptomatic men and 27% of those from asymptomatic men were abnormal . Acute inflammation was the most frequent histologic abnormality and was more frequent in men who had pathogens (51%) than men without pathogens (24%, p less than 0.02) . Acute but not chronic inflammation was seen also in specimens from homosexual men without intestinal symptoms . Intestinal spirochetosis was present in specimens from 23 (26%) of the symptomatic and 5 (45%) of the asymptomatic men . In 5 of the 89 symptomatic men, biopsy features of idiopathic inflammatory bowel disease (IIBD) were present; all 5 of these men were infected with either Treponema pallidum or Chlamydia trachomatis . Features of IIBD were present in 25% of those infected with C . trachomatis or T . pallidum . Chronic inflammation was more frequent in men infected with C . trachomatis, syphilis, or herpes simplex virus type II: 31% vs . 3%, p = 0.0002 . Acute inflammation was present in specimens from men with proctitis or proctocolitis and enteritis as well as in those from asymptomatic men, whereas chronic inflammation was present only in specimens from men with proctitis or proctocolitis . Both acute and chronic inflammation were more frequent when biopsy specimens of the abnormal mucosa were examined . When specimens from men with single infections were analyzed, histology was rarely diagnostic . We conclude that acute inflammation is frequent in rectal biopsy specimens from symptomatic and asymptomatic homosexual men; chronic inflammation is infrequent, but when present is significantly associated with syphilis, herpes simplex virus type II, and C . trachomatis infection.

Ann Intern Med, 1986 Sep, 105(3), 436 - 44
One hundred years of American internal medicine . A view from the inside; Beeson PB; The term internal medicine began to be used by German writers in the late 19th century to designate a branch of practice incorporating the growing understanding of morbid anatomy, microbiology, physiology, and biochemistry . American practitioners of internal medicine began to take a respected place in world medicine toward the close of the 19th century . Noteworthy changes followed World War II, owing to allocation of large sums of money for biomedical research by governments, philanthropic organizations, and the pharmaceutical industry . Clinical problems in this period shifted in preponderance from acute infections to the chronic diseases that accompany aging . Complex diagnostic procedures, together with a diversity of therapeutic choices, created need for full-time teachers and clinical investigators in medical schools, as well as for subspecialists in practice . The pendulum may have swung too far toward specialization, and in the future a substantial proportion of practitioners of internal medicine will still continue to serve as generalist physicians.

Fertil Steril, 1986 Aug, 46(2), 200 - 4
Prognostic factors of fimbrial microsurgery; Donnez J et al.; From January 1978 to December 1983, 600 infertile women underwent microsurgery for tubal infertility . Only 257 women with the same extent of distal lesions on both sides or with unilateral occlusion (after contralateral salpingectomy) were considered . Patients were classified in four subgroups on the basis of the extent of occlusion . After fimbrioplasty for occlusion of degree I and salpingostomy for occlusion of degree II, the term pregnancy rate was more than 50% . After salpingostomy for occlusion of degrees III and IV, the term pregnancy rate was, respectively, 25% and 22% . The ectopic pregnancy rate was the highest (12%) after salpingostomy for occlusion of degree IV . After microsurgical salpingolysis, the term pregnancy rate reached 64%, whereas the ectopic pregnancy rate was as low as 2% . Ampullary dilatation, as determined by hysterosalpingography and laparoscopy, influences the postoperative pregnancy rate . Fimbrial microbiopsies were taken, and the ciliated cell percentage was obtained . Results suggest that the ciliation index is a valuable method of prognosis of tubal surgery . In conclusion, the pregnancy rate after distal surgery is related to the tubal morphologic findings: ampullary dilatation, fimbrial ciliated cell percentage, and tubal wall thickness.

Am J Infect Control, 1986 Aug, 14(4), 167 - 72
Infection control in the Netherlands; Meester HH et al.; A survey was made by the Dutch association of infection control practitioners (VHIG) concerning the organization of infection control in Dutch hospitals and the activities of its members . The results are reported and compared with recent American studies . A comparison is made between a group of infection control technicians (ICTs) who were not nurses and a group of nurses (ICNs), working in infection control . Although the ICT has significantly more daily contacts with the hospital microbiologist and is more often secretary to the infection control committee and the ICN visits the outpatient department significantly more often, the other activities in their practice are essentially the same . From this study we conclude that either an ICT or an ICN can adequately function as an infection control practitioner in the Netherlands.

Am J Clin Oncol, 1986 Aug, 9(4), 327 - 33
The pulse wash instrument . A new sampling method for uterine cervical cancer detection; Naslund I et al.; A new sampling method for uterine cervical cancer detection is described . In this method, sampling of cytologic material is done by using a pulse wash instrument . Liquid jets with a diameter of 0.2 mm at a speed of 20 m/s create a successful rinsing effect of cervical epithelial cells due to the high kinetic energy produced . Because cells are suspended in the flushing liquid it is possible to collect material for additional cytochemical, immunocytochemical, and microbiologic diagnostic techniques in addition to a conventional smear technique . Compared to a conventional Papanicolaou smear technique performed in 75 women at two cervical atypia clinics at the Karolinska Hospital, the pulse wash technique is suggested to result in a more representative cellular sample, thus offering a method to decrease false negative diagnoses in uterine cervical cancer detection.

J Am Acad Dermatol, 1986 Aug, 15(2 Pt 1), 186 - 91
Systemic administration of antibiotics in the management of venous ulcers . A randomized clinical trial; Alinovi A et al.; Forty-seven patients with chronic venous leg ulcers were included in a randomized clinical trial to evaluate the efficacy of systemically administered antibiotics in healing with condition . One group was treated by means of elastic support bandages only, whereas the other one received the same local treatment plus systemic antibiotics . No statistically relevant difference was noted between the two groups in healing rates of ulcers or in changes of the microbiologic flora . The results of our study do not support the routine administration of systemic antibiotics in the management of chronic venous leg ulcers.

Biopharm Drug Dispos, 1986 Jul-Aug, 7(4), 335 - 46
Ceforanide pharmacokinetics in haemodialysis: the effect of ultrafiltration; Lanao JM et al.; The kinetics of ceforanide in plasma and dialysate was studied in 8 patients with terminal renal impairment after undergoing haemodialysis sessions lasting between 4 and 5 h . All patients received a single i.v . dose of 15 mg kg-1 of the drug at the start of the session . The dialysers used in this study were Spiraflow capillar 1.3 m2, Travenol plates 1.4 m2, and PAN plates . Blood flow ranged between 200 and 300 ml min-1 and dialysate flow between 500-650 ml min-1 . Plasma ceforanide levels were measured at the input and output of the dialyser and the antibiotic levels in dialysate were determined coinciding with the withdrawal times of the blood samples . A microbiologic plate diffusion method was used to determine the antibiotic concentrations . The mean values of some pharmacokinetic parameters of ceforanide calculated with a non-linear regression program from the data obtained from arterial blood were the following: alpha (h-1) = 4.14 +/- 1.32; beta (h-1) = 0.26 +/- 0.07; t1/2 beta (h) = 2.82 +/- 0.82; Vdss (1) = 10.24 +/- 2.14 . From the relationships between the antibiotic concentrations at the input and output of the dialyser it was possible to calculate an extraction coefficient of 0.11 +/- 0.06 . The dialysis clearance of ceforanide was calculated from the determination of the extraction coefficient and from the measuring of antibiotic in dialysate, though different results were obtained with the two methods . Dialysis clearance calculated from the extraction coefficient showed a mean value of 18.68 +/- 12.16 ml min-1, significantly lower (p less than 0.01) than that established by analysis of the antibiotic in dialysate, which was 41.55 +/- 15.83 ml min-1 . These differences may be attributed to problems related to the determination of blood flow and to the ultrafiltration capacity of the dialysis membranes . A linear relationship was established between the percentage error in the observed and predicted extraction coefficients and the ultrafiltration rate . The results obtained suggest that the simultaneous measurement of the antibiotic in plasma and dialysate is the most suitable method for predicting the dialysis clearance of the drug . The amount of antibiotic extracted over a 4-hour dialysis session proved to be equal to 57.85 +/- 15.62 per cent of the dose administered.

Sex Transm Dis, 1986 Jul-Sep, 13(3), 151 - 5
Paromomycin therapy of endemic amebiasis in homosexual men; Sullam PM et al.; A prospective evaluation was made of the therapeutic efficacy of paromomycin, an orally administered, nonabsorbable aminoglycoside, in 114 homosexual men with mild-to-moderate (nondysenteric) intestinal amebiasis . All patients received 25-35 mg/kg daily in three divided doses for seven days . Of the 80 patients with gastrointestinal complaints at the onset of therapy, 55 (80%) of 69 were asymptomatic within four to six weeks after completion of treatment; 11 patients were lost to follow-up . Paromomycin produced long-term eradication of intestinal Entameba histolytica infection in 92% of all men evaluated . The rate of microbiologic cure among patients with symptoms at the onset of therapy was comparable to that among asymptomatic individuals . Paromomycin was well tolerated, with mild diarrhea during therapy the only frequent adverse effect (67% of patients) . Thus, paromomycin is an effective alternative to conventional multi-drug therapy for intestinal amebiasis, and it has the advantages of low toxicity, brief duration of therapy, and a high rate of patient compliance.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Jul, (7), 75 - 9
{Immune structure of the population in some regions of the USSR with respect to Legionella pneumophila}; Vasil'eva VI et al.; For the first time in the USSR the structure of the immunity of different population groups to L . pneumophila was studied . Antibodies to L . pneumophila were detected in the passive hemagglutination test with the use of erythrocyte diagnosticum prepared at the Gamaleya Research Institute of Epidemiology and Microbiology (Moscow) . The survey covered the total number of 2,902 persons in differ nt regions of the USSR, among them 2,430 adults and 472 children . Among the healthy adult population antibodies to L . pneumophila were detected, on the average, in 5.9% of persons . The highest number of persons with antibodies in diagnostic titers was detected among the population of the Baltic Republics (15.9%) and Kazakhstan (10.2%) . The survey revealed an essential difference in the number of children aged 3-7 years, found to have antibodies to L . pneumophila, in the Brest region of the Byelorussian SSR (31.4%) and in the Turkmen SSR (1.3%) . The high risk groups exposed to L . pneumophila infection were found to include narcological patients with the changed reactivity of the body and healthy adults professionally employed in earth-moving works.

Parazitologiia, 1986 Jul-Aug, 20(4), 249 - 55
{General patterns of the functioning of parasitic systems (the mechanisms of self-regulation)}; Beliakov VD; Parasitic system is determined as a parasite's population in interaction with its natural habitat (host's population) . Epidemiology, epizootiology and epiphitology as well as virology, microbiology, protozoology and helminthology study applied aspects of parasitic systems . The latter are characterized by four general principals determining selfregulation mechanisms of these systems: heterogeneity of interacting populations, their dynamic variability, phase functioning, dependence on conditions.

J Forensic Sci, 1986 Jul, 31(3), 953 - 61
Experimental study of postmortem change under field conditions: effects of freezing, thawing, and mechanical injury; Micozzi MS; Understanding the processes of postmortem change in biologic systems is important to the forensic sciences . Previous experimental studies of postmortem change in animals under field conditions made use of animal carcasses that had been incidentally exposed to the effects of freezing and thawing or mechanical damage, or both, and were limited to gross observations . The current study was designed to document intrinsic processes of postmortem change, and the effects of freezing-thawing and mechanical injury, under controlled conditions in the field, using histologic and microbiologic techniques, as well as gross observation . Insect and microbiologic succession sequences, and patterns of decomposition and disarticulation, were observable over time . Previously frozen-thawed animals showed predominantly decay (aerobic decomposition) in the field, while freshly killed animals showed predominantly putrefaction (anaerobic decomposition) . Previously frozen animals showed the same sequence, but accelerated rates, of disarticulation . Mechanically injured tissues showed accelerated rates of decomposition . These findings have implications for the interpretation of results of previous studies, as well as the interpretation of human and animal remains subjected to freezing and thawing.

Mikrobiyol Bul, 1986 Jul, 20(3), 129 - 38
{Examination of the role of C . trachomatis in genitourinary infections using enzyme immunoassay and Giemsa staining}; Koksal F et al.; In the past decade C . trachomatis (serotype D-K) has been established as an important etiologic agent in genitouriner tract infections in both women and men . Laboratory diagnostic tests for Chlamydia include direct microbiologic isolation and serologic and cytologic techniques . In studies lasting from Oct . 11th 1985 - to the Feb . 21st 1986, a total of 600 people were tested in parallel by EIA and giemsa staining . These people comprised three groups . The largest group, 380 patients, had genitourinary infections, the second, control group, of 127 people were healthy and the third, risk group (contacts of infected or suspected people) of 93 people were also healthy . C . trachomatis was found in 10.7% of the patients group, 7.2% of the risk group and 1.5% of the control group.

Infect Immun, 1986 Jul, 53(1), 16 - 25
Serological characterization and gene localization of an Escherichia coli-expressed 37-kilodalton Treponema pallidum antigen; Rodgers GC et al.; A recombinant plasmid containing a 5.6-kilobase-pair DNA fragment of the Treponema pallidum genome was characterized by endonuclease mapping, and the encoded proteins were expressed in Escherichia coli and analyzed by use of in vitro transcription and translation . One of the proteins, identified as having a molecular weight of 37,000 (37K protein), was selected for further study . Initially, the seroreactivity of the partially purified 37K antigen was demonstrated by immunoblotting . After its purification to near homogeneity, the cloned T . pallidum protein was assessed for diagnostic significance by radioimmunoassay . Although first identified as seroreactive by screening with secondary syphilitic sera (T . E . Fehniger, A . M . Walfield, T . M . Cunningham, J . D . Radolf, J . N . Miller, and M . A . Lovett, Abstr . Annu . Meet . Am . Soc . Microbiol . 1985, B156, p . 44), the antigen was shown to be serologically reactive with antibodies in serum from all stages of syphilis but was not recognized by serum from controls by both immunoblotting and radioimmune assay . Further, a monospecific polyclonal rabbit antiserum generated to the 37K antigen recognized a polypeptide of the same molecular weight from T . pallidum but did not efficiently recognize proteins from five nonpathogenic treponemes tested . Therefore, because of reactivity with and specificity for T . pallidum antibodies, the 37K antigen may be of serodiagnostic value in the detection of syphilis.

Public Health Rep, 1986 Jul-Aug, 101(4), 417 - 9
Histopathology in tropical medicine: a perspective; Pesce CM; Histopathology may serve a wide spectrum of diagnostic purposes in tropical medicine other than for infectious and parasitic diseases . In addition, it is essential in defining new pathological entities and collecting statistical data on morbidity and mortality . It should also constitute a basic support for advancement and research in tropical diseases . For practical purposes, both histopathology and cytopathology are often more effective than clinical chemistry and microbiology in providing the clinician with a final diagnosis . They do not rely on complicated and delicate equipment, and the few reagents they require can be stored indefinitely . Formalin fixation permits most histological methods to be used, including special stains and immunohistochemistry . Formalin-fixed material can be examined several days after excision . Implementing pathology laboratories in tropical countries may constitute a practical, cost-effective approach to the planning of diagnostic services at the regional or district level . A fraction of the medical graduates in developing countries should be devoted to the staffing of these laboratories.

Surg Technol, 1986 Jul-Aug, 18(4), 17 - 9
AIDS: the risk to you; Taylor WF; Acquired immunodeficiency deficiency syndrome (AIDS) is atopic that currently grips the attention of many people in this country . How many surgical technologists have taken the time to study this subject and learn how we should respond? This article briefly reviews the microbiology and the transmission of AIDS, as well as discussing briefly the groups at high risk for contracting AIDS . Some elementary precautions for surgical technologists will be listed, and then the relevance of this topic for surgical technologists will be discussed . It is important for surgical technologists to understand how AIDS is transmitted, not only to prevent the immediate spread of the disease, but so that surgical technologists can help inform the nonmedical public about the disease and thereby help minimize panic and hysteria.

NIPH Ann, 1986 Jun, 9(1), 23 - 31
External quality assessment for clinical microbiology in Norway 1985; Lassen J et al.; During 1985 four external quality assessment tests for clinical microbiology were performed, each consisting of four simulated clinical specimens . The results are reported, evaluated and some problem areas discussed.

Clin Lab Med, 1986 Jun, 6(2), 345 - 54
Proficiency of office microbiology testing; Belsey R et al.; Microbiology proficiency testing results from smaller physicians' office laboratories in the state of Pennsylvania are reviewed . Possible reasons for lower performance levels are discussed, and some approaches to improving microbiology proficiency in this setting are suggested.

HNO, 1986 Jun, 34(6), 262 - 6
{Rhinocerebral mucormycosis as a complication of cytostatic therapy}; Brusis T et al.; A twelve year old boy with acute lymphoblastic leukemia was treated with combination chemotherapy . Two weeks later a cellulitis of the left upper and lower eyelid appeared, followed by a rapidly increasing, deep necrotic inflammation of the periorbital area leading to proptosis . Mucormycosis was identified by histology and microbiology . The spreading inflammatory process was arrested by amphotericin B in a total dose of 1.2 g combined with a drainage of the necrotic tissue of the paranasal sinus, left orbit and bifrontal cerebral abscess . The patient is still in complete continuous remission four years later but a large defect of the nasal, maxillary and orbital area remains . This case demonstrates that the usual fatal outcome of mucormycosis in leukemia is curable with amphotericin B and aggressive surgery.

Hum Pathol, 1986 Jun, 17(6), 621 - 33
Diffuse intestinal ulceration after marrow transplantation: a clinicopathologic study of 13 patients; Spencer GD et al.; The cases of 13 allogeneic marrow transplant recipients who had undergone laparotomy for manifestations of severe enteritis were reviewed to determine the causes of the severe intestinal disease and to assess the relation between clinical, histologic, and microbiologic findings . Laparotomies were performed a median of 63 days (range, 11 to 273 days) after transplantation for suspected peritonitis, intestinal obstruction, or bleeding . Intestinal tissue was available from small bowel resections in nine patients, intraoperative biopsies in one, and from autopsies in three patients who died shortly after laparotomy . Widespread small bowel ulceration was present in all 13 cases . Four causes of ulceration were identified: chemoradiation toxicity (n = 2), acute graft-versus-host disease (GVHD) (n = 5), opportunistic infections superimposed on either GVHD or toxicity from chemotherapy (n = 4), and Epstein-Barr virus-associated lymphoproliferative disorder (n = 2) . Intestinal infections, unrecognized before laparotomy, were due to cytomegalovirus (CMV), herpes simplex virus (HSV), adenovirus, and Torulopsis glabrata . CMV- and HSV-infected cells, often lacking diagnostic inclusions, were identified in the intestine by in situ hybridization with biotinylated DNA probes . Eleven patients died in the perioperative period, and two died 452 and 558 days after surgery of complications of chronic GVHD . Poor outcomes were related to extensive intestinal involvement, which was commonly underestimated before surgery, failure to diagnose intestinal infections early, poor marrow function, impaired immunity, and refractoriness of severe GVHD.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Jun, (6), 78 - 80
{Time periods of antibody preservation in patients convalescing from hemorrhagic fever with renal syndrome in European foci of the infection}; Miasnikov IuA et al.; The radioimmunoassay of serum samples from 76 convalescents after hemorrhagic fever with the renal syndrome (HFRS), that took place in 1964 in Ufa, revealed the presence of specific antibodies in 75% of the convalescents . The absence of antibodies may be attributed both to their loss in some of the convalescents and to mistakes in the clinical diagnosis . The study of serum samples from 19 convalescents who had the infection in 1960 during the laboratory outbreak of HFRS at the Gamaleya Institute of Epidemiology and Microbiology (Moscow) showed the presence of antibodies in all convalescents . In both groups the infection was linked with common red-backed voles (the Western serological variant of the virus).

Proc Natl Acad Sci U S A, 1986 Jun, 83(11), 3688 - 92
A chemically explicit model for the molecular mechanism of the F1F0 H+-ATPase/ATP synthases; Scarborough GA; A general hypothesis for the molecular mechanism of membrane transport based on current knowledge of protein structure and the nature of ligand-induced protein conformational changes has recently been proposed {Scarborough, G . A . (1985) Microbiol . Rev . 49, 214-231} . According to this hypothesis, the essential reaction undergone by all proteinaceous transport catalysts is a ligand-induced hinge-bending-type conformational change that results in the transposition of binding-site residues from access on one side of the membrane to access on the other side . Subsequent release and/or alteration of the ligand or ligands that induce the conformational change facilitates the converse conformational change, which returns the binding-site residues to their original position . With this simple cyclic ligand-dependent gating process as a central feature, biochemically orthodox mechanisms for virtually all known transporters are readily conceived . In this article, a chemically explicit model for the molecular mechanism of the F1F0 H+-ATPase/ATP synthases of mitochondria, bacteria, and chloroplasts, formulated within the guidelines of this general transport paradigm, is presented . At least three points of potential interest arise from this exercise . First, with the aid of the model, it is possible to visualize how energy transduction catalyzed by these enzymes might proceed, with no major events left unspecified . Second, explicit possibilities as to the molecular nature of electric field effects on the transport process are raised . And finally, it is shown that enzyme conformational changes, energy-dependent binding-affinity changes, and several other related phenomena as well, need not be taken as evidence of "action at a distance" or indirect energy coupling mechanisms, as is sometimes assumed, because such events are also integral features of the mechanism presented, even though all of the key reactions proposed for both ATP-driven proton translocation and proton translocation-driven ATP synthesis occur at the enzyme active site.

South Med J, 1986 May, 79(5), 626 - 8
Brucella canis: an infectious cause of prolonged fever of undetermined origin; Rumley RL et al.; We have reported a case documenting the difficulties encountered in diagnosing and treating patients with brucellosis caused by Brucella canis, including the nonspecific clinical presentation, low level of intermittent bacteremias, the slow-growing, fastidious nature of the organism, and the lack of antigenic cross-reactivity with the antigens usually used in routine Brucella serology . Further, the predominant southeastern United States epidemiology of this organism and the importance of exposure to dogs are also demonstrated by this report . It is important that physicians caring for patients in this region of the country be aware of the epidemiologic, serologic, and microbiologic pitfalls encountered in diagnosing B canis infections.

J Med Educ, 1986 May, 61(5), 368 - 73
Effect of two preclinical curricula on NBME Part I examination performance; Farquhar LJ et al.; The Michigan State University College of Human Medicine conducts two preclinical medical education programs . In Track I (lecture-based), students attend classes 24 hours per week, and lecture time totals 908 hours over a 50-week period . In Track II (problem-based), students attend classes only 12 hours per week, and lecture time totals 112 hours over the same 50-week period . Institution of the Part I examination of the National Board of Medical Examiners (NBME) as a graduation requirement provided an opportunity to compare the performances of students in both tracks . When students from each track with similar Science Problems subtest scores on the Medical College Admission Test were compared, no significant differences were observed in the students' total scores or pass rate on the NBME examination . However, there were significant differences in scores on the microbiology subtest of the NBME examination, with the Track I students achieving higher scores . The 1984 report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine of the Association of American Medical Colleges stressed the need to examine critically and consider reducing the scheduled instructional and lecture hours in preclinical medical education programs . In the study reported here, the authors demonstrated that reduction of scheduled instructional time, when replaced by a guided problem-solving program, is not detrimental to students' performance on the NBME Part I examination.

J Lab Clin Med, 1986 May, 107(5), 447 - 52
Recognition of deficiency of vitamin B12 using measurement of serum concentration; Cooper BA et al.; Of 504 patients with low concentrations of vitamin B12 in serum by microbiologic assay (less than 120 pg/ml) in whom clinical information was available to evaluate vitamin B12 status, 109 (22%) were found to have clinically important deficiency of vitamin B12, and another 10 had pernicious anemia with deficient serum levels of both vitamin B12 and folate . Serum from patients deficient in vitamin B12 was assayed by several commercially available assay techniques . These used either purified or impure preparations of gastric intrinsic factor as binder, extracted cobalamins with either heat or alkali ("no boil") and separated bound from free vitamin B12 either with activated charcoal or by binding the intrinsic factor to glass beads ("solid state") . These kits were purchased commercially from Becton-Dickinson Co . (SimulTrac), BioRad Corp . (Quantaphase), Amersham Corp . (Vitamin B12/folate radioassay) and Corning Medical and Scientific (Immophase) . Serum vitamin B12 concentrations assayed in sera from patients deficient in vitamin B12 overlapped the normal range in 6% of all samples assayed by techniques using purified intrinsic factor assays (BioRad, Amersham, and the "blocked" SimulTrac assay), but no such overlap was found between deficient and nondeficient sera assayed with the solid-state pure intrinsic factor assay (Corning), the "unblocked" SimulTrac, or Euglena gracilis . It would appear that (1) radiodilution assays extracting serum by boiling and binding vitamin to binder fixed on a solid matrix may be the most reliable available at this time . These may be as reliable as microbiologic assay for separation of patients with deficiency from those without deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Pathol Biol (Paris), 1986 May, 34(5), 353 - 6
{Diffusion of an orally administered single dose of ofloxacin into human bronchial mucus}; Morel C et al.; As part of a systematic investigation of the penetration of antibiotics into human bronchial mucus, we assayed ofloxacin concentrations following ingestion of a single dose . 25 patients with acute superinfection of a chronic lower respiratory tract disease were studied . Each patient had single drug therapy with ofloxacin in a daily dosage of 200 mg taken in the morning on an empty stomach . Patients were divided into five groups according to the time interval between ingestion of ofloxacin and collection of samples (bronchial mucus and serum): 1 hour, 3 hours, 6 hours, 12 hours or 24 hours . Duplicate determinations of ofloxacin on individual samples were done using a microbiologic method . Mean serum concentrations were 1.85, 1.64, 1.32, 0.75 and 0.20 mg/l respectively, with a half-life of 6.7 hours; the corresponding concentrations in mucus were 1.83, 1.51, 1.20, 0.66 and 0.19 . These results demonstrate ofloxacin's outstanding penetration into bronchial mucus.

Hautarzt, 1986 May, 37(5), 266 - 9
{Benjamin Lipschütz (1878-1931) and his significance in dermatology (dermatovirology)}; Holubar K; The present study elaborates on the person of Benjamin Lipschutz, the jewish-austrian dermatologist and microbiologist (virologist) . His voluminous scientific oeuvre is appreciated, particularly with regard to his role as a pathfinder for the newly developing field of dermatovirology.

J Clin Periodontol, 1986 May, 13(5), 360 - 70
Epidemiology of gingivitis; Stamm JW; In recent years, tremendous strides have been made in understanding the etiology of gingivitis . This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology . Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors . The major restraint has been the great difficulty in reliably measuring gingival inflammation . This problem has resulted in great inter- and intra-study variation in diagnosing the prevalence and severity of gingivitis in human populations . Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners . Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained . A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed . With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life . Gingivitis during the adult period is much more difficult to characterize due to paucity of data . Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects . In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern . When adjusted for cohort effects, gingival disease appears to be on the decline.(ABSTRACT TRUNCATED AT 400 WORDS)

J Antimicrob Chemother, 1986 May, 17 Suppl C, 219 - 24
A randomized trial of Timentin and tobramycin versus piperacillin and tobramycin in febrile neutropenic patients; Mackie MJ et al.; The efficacy of ticarcillin and clavulanic acid (Timentin) was assessed in a regimen combined with tobramycin in febrile episodes in neutropenic patients . After randomization, 151 patients were assessable following treatment with either Timentin and tobramycin or piperacillin and tobramycin . The overall success rate was 70% in the Timentin and tobramycin group and 71% when piperacillin and tobramycin were given: when no infection could be demonstrated efficacy was 73% in the Timentin group, 65% when only clinical or radiological evidence of infection was present and 63% with conclusive microbiology . The figures in the groups treated with the piperacillin-containing regimen were 83%, 79%, and 50% respectively . There was no significant difference between the treatment groups . In septicaemic patients, the Timentin regimen was effective in 55% of cases, while the piperacillin group was successful in 40% . Timentin is a useful addition to the agents suitable for the treatment of febrile neutropenic patients.

Emerg Med Clin North Am, 1986 May, 4(2), 345 - 66
Microbiologic studies; Pancoast P et al.; Although useful to emergency physicians in determining and following up treatment, the microbiology department can be a source of frustration and erroneous results due to improper or inconsistent methodology, ordering, and interpretation . This article will review the principles of microbiologic specimen collection, handling, and processing as well as noting specific techniques for selected clinical settings.

Arch Dis Child, 1986 May, 61(5), 428 - 35
Evaluation of adenosine deaminase activity and antibody to Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid and the radioactive bromide partition test for the early diagnosis of tuberculosis meningitis; Coovadia YM et al.; A number of different biochemical and serological tests have been described recently for the early and accurate diagnosis of tuberculous meningitis . None of these tests has yet gained widespread acceptance in clinical medicine or in microbiology laboratories . To investigate this problem we evaluated adenosine deaminase activity (ADA), an enzyme linked immunosorbent assay (ELISA) that detects antibody to antigen 5 of Mycobacterium tuberculosis, and the radioactive bromide partition test (BPT) in the cerebrospinal fluid (CSF) . Cerebrospinal fluid specimens from children with tuberculous, pyogenic, and viral meningitis as well as from patients with pulmonary tuberculosis without meningitis and from controls with normal CSFs were included inn the study . In addition, we estimated ADAs in serum samples from selected children in these groups . The sensitivity and specificity of the three tests evaluated in the CSF were: ADA assay 73% and 71%; BPT 92% and 92%; and ELISA for antibody to antigen 5, 53% and 90%, 40% and 94%, and 27% and 100%, respectively, at tires of more than or equal to 1:20, 1:40, and 1:80 . The serum ADA was lower (11.0 +/- 6.15 IU/l) in children with tuberculous meningitis when compared with those with pulmonary tuberculosis alone (25.8 +/- 20.9 IU/l) . The BPT was found to be the most reliable test in the early differentiation of tuberculous from other causes of meningitis and remained abnormal for a period of up to five months after the beginning of treatment . Accordingly, we believe that the BPT should be used in conjunction with bacterial and fungal antigen detection systems for the initial differentiation of clinically suspicious tuberculous meningitis from Gram or culture negative cases, or both, of bacterial and fungal meningitis.

J Reprod Med, 1986 May, 31(5 Suppl), 384 - 9
Diagnostic techniques for evaluating herpes simplex virus infections . Laboratory considerations; Grossman JH 3rd; Recent advances in the management and treatment of genital herpes simplex virus (HSV) infections underscore the importance of timely and accurate diagnosis of the disease . Moreover, increased physician awareness of the importance of accurately diagnosing herpes has led to a better understanding of its natural history . Like all diagnostic medical devices, microbiologic tests used to diagnose HSV infections are subject to governmental regulations . Based on the current status of available testing and our knowledge of the nature of HSV, clearly there is still much to be learned about HSV infections . The answers to some key questions will provide advances in diagnostic expertise and, ultimately, in the effective treatment and prevention of HSV-associated illness.

Radiology, 1986 Apr, 159(1), 9 - 14
Nocardiosis of the lung: chest radiographic findings in 21 cases; Feigin DS; Pulmonary manifestations of nocardial infection were present in 21 patients, with microbiologic proof in all and pathologic proof in 12 . An analysis of the findings in these patients, combined with a review of previous reports of nocardiosis, suggests several important conclusions for radiologists . First, nocardiosis may occur in otherwise healthy persons but is most common in compromised patients, especially those being treated with anti-inflammatory agents, particularly corticosteroids, for chronic obstructive pulmonary disease and other systemic diseases . As pathologic manifestations are both suppurative and granulomatous, the chest radiographic manifestations are pleomorphic and not specific . Consolidations and large irregular nodules, often cavitary, are most common; nodules, masses, and interstitial patterns also occur . Pleural effusions are quite common, and lymph nodes may be enlarged . Difficulty and slowness of culture growth, along with the lack of a serologic test for nocardiosis, necessitate its inclusion in the differential diagnosis for both compromised and noncompromised patients in whom an apparent pulmonary infection cannot be rapidly diagnosed.

Mikrobiyol Bul, 1986 Apr, 20(2), 59 - 66
{Bacterial evaluation of wound infections}; Gedikoglu S; Collected wound samples were received by Hospital Microbiology Laboratory were examined for bacterial isolation, their antibiotic susceptibility and distribution in terms of clinical departments were determined . S . aureus was found to be the major causative agent with the ratio of % 38.92 . Wound infections were frequently encountered in the Pediatric department (% 43.83) and the isolated strains were found to be highly resistant to the most of the antibiotics.

Clin Exp Pharmacol Physiol, 1986 Apr, 13(4), 267 - 70
Effect of sodium intake and sodium delivery to the macula densa on renal renin content and juxtaglomerular apparatus morphology; Wong T et al.; Active and inactive renin were measured in individual juxtaglomerular apparatus (JGA) and in whole kidney homogenates . The morphology of the JGA was examined in microbiopsy glomerular specimens and in kidneys fixed by arterial perfusion . In rats on high and normal salt intake the total renin content of a single JGA was 14 (s.e.m . = 3) and 29 (s.e.m . = 4) ng AI/h, respectively . The amount of cystoplasm occupied by renin granules was 20% and 27% . Crystalline cores were seen in 1.5% and 7% of the granules, respectively . Increased delivery of NaCl to the macula densa did not alter total renin, but decreased inactive renin from 30% to 0, crystalline core-containing cells from 33% to 14% and decreased the percentage of granules with crystalline cores from 12% to 2.2% . Increased sodium in the diet and increased delivery of NaCl to the macula densa decreased the proportion of renin present in the inactive form and decreased the proportion of crystalline cores . These coincidental alterations suggest that crystalline cores contain inactive renin and suggest that the delivery of sodium to the macula densa activates renin.

Sex Transm Dis, 1986 Apr-Jun, 13(2), 81 - 7
In-vitro and in-vivo activity of parenterally administered beta-lactam antibiotics against Chlamydia trachomatis; Martin DH et al.; The extended-spectrum penicillins ticarcillin, mezlocillin, and piperacillin might be useful as single agents for the treatment of pelvic infections in women if it could be shown that these drugs are active against Chlamydia trachomatis . We found that the MIC90 (concentration at which 90% of strains are inhibited) values of ticarcillin, mezlocillin, and piperacillin were 16, 16, and 64 micrograms/ml, respectively . Several cephalosporins were found to have MICs for C . trachomatis of greater than 200 micrograms/ml . Ten women with postpartum endometritis who were colonized with C . trachomatis had repeated chlamydial cultures following treatment with beta-lactam antibiotics . All seven cases treated with ticarcillin plus clavulanic acid (a beta-lactamase inhibitor) or piperacillin alone had C . trachomatis-negative cultures after treatment . Three of four of these women had negative cultures at a second follow-up visit . In contrast, the three women treated with a cephalosporin were culture-positive at their first follow-up clinic visit . These data suggest that there is a correlation between the in-vitro measurement of beta-lactam antibiotic activity against C . trachomatis and the microbiologic outcome of treatment . We conclude that the extended-spectrum penicillins deserve further evaluation as single agents for the treatment of pelvic infections in women at high risk for C . trachomatis infections.

Eur J Pediatr, 1986 Apr, 144(6), 532 - 8
The cephalosporin antibiotics in pediatric therapy; Eichenwald HF et al.; The cephalosporins have been available for clinical use for nearly 20 years and a large number is presently marketed, including drugs with a wide range of different pharmacokinetic and microbiologic properties . While some of these agents have certain specific uses in which they excel, the cephalosporins have not replaced older antibiotics but do provide the physician with a broader range of choices for the treatment of many infections, allowing greater individualization of therapy.

Arq Gastroenterol, 1986 Apr-Jun, 23(2), 88 - 94
{Experimental dilatation of the cecum and colon in rats . III . A model induced by prolonged administration of lactose in the diet of animals in the chronic phase of infection by the Y strain of T . cruzi}; Collares EF et al.; Female Wistar albino rats (30 days of age), weighing about 60 g, were inoculated intraperitoneally with 1000 parasites/g of the Y strain of T . cruzi . The strain of T . cruzi has been maintained by in vivo passage of the parasites from mice to mice in the Department of Parasitology, Microbiology and Immunology, Medical School of Ribeirao Preto . Rats of the same sex and age were used as controls . One-hundred days after inoculation the animals were allocated into 4 groups: group I (control), divided into subgroup L (fed lactose for 4 weeks) and subgroup S (fed saccharose for 4 weeks); group II (inoculated), divided into subgroup L (fed lactose for 4 weeks) and subgroup S (fed saccharose for 4 weeks); group III (control), divided into subgroup L-S (fed lactose for 4 weeks and saccharose for the following 4 weeks) and subgroup S (fed saccharose for 8 weeks); and group IV (inoculated), divided into subgroup L-S (fed lactose for 4 weeks and saccharose for the following 4 weeks) and subgroup S (fed saccharose for 8 weeks) . The disaccharide (lactose or saccharose) was added to a standard laboratory diet, 25 g/100 g of the final weight of the diet . At the end of the experimental periods the animals were sacrificed in ether anesthesia . The volume of the large intestine was measured, and the weight of cecum and colon were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

Tijdschr Diergeneeskd, 1986 Mar 1, 111(5), 247 - 53
{People are always saying...}; Kampelmacher EH; In his address, delivered on the occasion of his farewell as extraordinary professor of food microbiology and hygiene at the University of Agriculture in Wageningen, the author discussed a number of features of current problems in the field of disease caused by foods . It was pointed out that the risks constituted by chemicals and additives in foods are usually strongly exaggerated by consumers, whereas there is far too little understanding of and information concerning infectious diseases which are transmissible to man by foods . As regards this last-mentioned fact, attention is drawn to the increase, and that which can be anticipated, of cases of food infection and poisoning in Europe . It was stressed that the consumer is an important factor in regard to these forms of disease in view of the fact that a large proportion of these infections may be prevented by a number of relatively simple measures such as cooling or heating of food and adequate hygiene in the kitchen.

Am J Epidemiol, 1986 Mar, 123(3), 455 - 63
Validity of the fatty acid composition of subcutaneous fat tissue microbiopsies as an estimate of the long-term average fatty acid composition of the diet of separate individuals; van Staveren WA et al.; The relationship between the fatty acid composition of subcutaneous adipose tissue and diet was estimated in 59 Dutch women aged 32-35 years . Food consumption was estimated by taking the means of nineteen 24-hour recalls administered over a period of two and a half years, August 1981-December 1983 . Highly significant correlations were found between linoleic acid content of fat tissue and diet (r = 0.70) and also between the linoleic acid-to-saturated fatty acid (linoleic/S) ratio of fat tissue and diet (r = 0.62) . This confirms the hypothesis that on an individual level the fatty acid composition of the adipose tissue is a valid index for the habitual dietary fatty acid composition of free-living adults . When using one 24-hour recall instead of the average of 19 recalls, the correlation coefficient between the linoleic/S ratio of the diet and that of the adipose tissue was substantially decreased . This demonstrates the weakening effect of the large day-to-day variation in within-person intake on the correlation between a short-term assessment of the nutrient intake of an individual and a biochemical indicator of long-term nutritional status.

Int J Clin Pharmacol Ther Toxicol, 1986 Mar, 24(3), 123 - 9
Pharmacokinetics of parenteral ticarcillin formulated with clavulanic acid: Timentin; Staniforth DH et al.; The pharmacokinetics of a formulation of clavulanate potentiated ticarcillin (Timentin) have been investigated following a bolus intravenous injection of 1.2 g, infusions of 3.2 g over periods ranging from 30 minutes to three hours, and a bolus dose of 1.2 g followed by an infusion of 3.2 g . The effect of probenecid has also been investigated . The serum levels of clavulanic acid are discussed in relation to the microbiology and therapeutic implications.

Diagn Microbiol Infect Dis, 1986 Mar, 4(3 Suppl), 151S - 156S
Clinically expedient reporting of rapid diagnostic test information; Doern GV; With the development of rapid diagnostic tests in the clinical microbiology laboratory has come an awareness of the importance of rapid results reporting . Clearly, the potential clinical impact of rapid diagnostic tests is dependent on expeditious reporting . Traditional manual reporting systems are encumbered by the necessity of transcription of test information onto hard copy reports and then the subsequent distribution of such reports into the hands of the user . Laboratory computers when linked directly to CRTs located in nursing stations, ambulatory clinics, or physician's offices, both inside and outside of the hospital, permit essentially instantaneous transfer of test results from the laboratory to the clinician . Computer-assisted results reporting, while representing a significant advance over manual reporting systems is not, however, without problems . Concerns include validation of test information, authorization of users with access to test information, mechanical integrity, and cost . These issues notwithstanding, computerized results reporting will undoubtedly play a central role in optimizing the clinical impact of rapid diagnostic tests.

Am J Surg, 1986 Mar, 151(3), 400 - 6
Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions; Zamora JL; The chemical, microbiologic, and toxic characteristics of povidone-iodine solution, a commonly used antiseptic agent, are addressed in a collective review of relevant works published from 1956 to the present . Interactions of this agent with the thyroid gland and the kidneys and its toxicity at the cellular and systemic level are discussed.

Fertil Steril, 1986 Mar, 45(3), 397 - 402
Demonstration of antispermatozoal antibodies in varicocele-related infertility with an enzyme-linked immunosorbent assay (ELISA); Golomb J et al.; To assess the existence of a possible immunologic factor in varicocele-associated infertility, we searched for antispermatozoal antibodies in serum, seminal plasma, and bound to spermatozoa in 32 infertile men with varicocele and 22 infertile patients without palpable varicocele, with the use of an enzyme-linked immunosorbent assay . In addition, we performed morphologic and microbiologic analyses of the semen and urethral smears for isolation of Chlamydia trachomatis . Twenty-nine men from the varicocele group (90.6%) demonstrated antispermatozoal antibodies, compared with only 9 men (40.9%) in the control group . The antibodies in both groups, when present, were mainly serum and seminal plasma immunoglobulins IgA and IgM . A significant quantitative difference between the varicocele and control groups was also observed for serum IgA, seminal plasma IgA and IgM, and sperm-bound IgG, IgA, and IgM . Oligozoospermia and asthenozoospermia were significantly more prevalent in the varicocele men . An asymptomatic genital tract infection with C . trachomatis, Ureaplasma urealyticum, and Escherichia coli was traced in 40.6% of the varicocele men and in 45.5% of the control group . No interaction could be demonstrated between the infection and antispermatozoal antibody formation . These data suggest that an immunologic factor may play a role in varicocele-associated infertility; however, its impact on reproduction has yet to be assessed.

Diagn Microbiol Infect Dis, 1986 Mar, 4(3 Suppl), 135S - 142S
Effect of diagnosis-related groups on diagnostic methodology in the hospital laboratory; Ferraro MJ; Traditionally physicians have ordered clinical laboratory tests for a variety of reasons . The establishment of a federally mandated prospective payment system for Medicare patients based on diagnosis-related groups has, among other things, necessitated a review of these reasons as well as the level of use of clinical laboratory services for a given diagnosis . Diagnosis-related group payment to hospitals is independent from the number of laboratory studies performed as long as the diagnosis-related group diagnosis is substantiated at the time the patient is discharged from the hospital . The cost-effective utilization of present tests as well as the adoption of new diagnostic methodologies depends on the assessment of whether a test possesses the appropriate parameters to be of sufficient diagnostic value . These factors include sensitivity, specificity, prevalence, speed, and the costs associated with false-negative or false-positive results . The assessment of the diagnostic value of present or future laboratory methods will require careful analysis relative to their financial impact both within the laboratory and for the hospital as a whole . The laboratory's knowledge of the diagnosis-related group accounting for the highest percentage of their hospital's costs, the highest volume of their cases, and the highest use of their services can aid in assessment of the appropriateness and level of laboratory services . An analysis of the percentage of microbiology costs associated with these diagnosis-related group categories for a large, tertiary care hospital is discussed.

Acta Radiol Oncol, 1986 Mar-Apr, 25(2), 131 - 6
Evaluation of the pulse wash sampling technique for screening of uterine cervical carcinoma; Naslund I et al.; The efficacy of a new sampling technique performed for early detection of cervical carcinoma is compared with Pap smears with the swab-and-wooden spatula technique in 312 women . In this new method, sampling of cytologic material is achieved by using a pulse wash instrument described in a previous article . Cells are rinsed and detached by liquid jets of 0.2 mm in diameter which are produced by a spray nozzle connected with a pressure hose to a high pressure pump . The liquid molecules pass through the spray nozzle at a speed of 20 m/s thus creating a successful rinsing effect on cervical epithelium due to high kinetic energy . Rinsed cells are mixed with the small amount of the flushing liquid . The suspension of cells and liquid accumulated in the speculum is then transported to a small container by a suction pump . The results of this work suggest that the pulse wash technique gives a more representative cell sample than the Pap smear sampling technique, thus offering a simple method to decrease false negative diagnoses in the detection of carcinoma of the uterine cervix . Samples by the new technique give an abundance of cells for slide preparation for cytodiagnostic techniques as well as for additional cytochemical, immunocytochemical and microbiologic diagnostic techniques.

Foot Ankle, 1986 Feb, 6(4), 199 - 207
Limb salvage in a diabetic with necrotizing fasciitis: case report and literature review; Carlow SB et al.; Necrotizing fasciitis must be considered in a diabetic with cutaneous ulceration . A case report of limb salvage in a 48-year-old diabetic female with progressive necrotizing fasciitis is presented . Methods of early diagnosis including clinical signs, radiographs, and soft tissue biopsy of the involved extremity are reviewed . The microbiology of the disease is also discussed . A modification of the Orr technique using infrequent dressing changes in the management of necrotizing fasciitis is presented . In our case this resulted in preservation of life and a functional limb.

South Med J, 1986 Feb, 79(2), 151 - 8
Infectious endocarditis at three hospitals in the same city: two study periods a decade apart; King JW et al.; We reviewed the records of patients with infectious endocarditis from three hospitals in the same city from 1970 to 1972 and from 1980 to 1982 . A total of 43 episodes of infectious endocarditis occurred in 42 patients . The clientele of these hospitals differ in that one is a teaching hospital which treats principally indigent tertiary care patients, one treats principally private patients, and one provides care for military veterans . In our study we noted that changes in the frequency and etiology of endocarditis observed at our teaching hospital were not seen in either of the other hospitals . We also noted that the predilection for men and mitral valve involvement observed in some retrospective reviews of endocarditis from large metropolitan centers could not be extended to our city's hospitals . Although some interhospital variations in epidemiologic and microbiologic parameters in infectious endocarditis may be explained by different patient populations, others, such as local variations in the frequency of valvular involvement, cannot be reliably predicted from published series . We conclude that a larger data base founded on statewide reporting of infectious endocarditis would lead to a better understanding of the microbiology, anatomy, and demography of infectious endocarditis.

Laryngoscope, 1986 Feb, 96(2), 204 - 5
A technique for measuring the rate of cerumen production; Cipriani C et al.; A technique is described for quantitatively measuring the rate of cerumen production . Two different washing solutions were tried . A mixture of alcohol/ether (3:1 v/v) appeared to be the best extracting solution yielding 2.05 +/- 0.22 versus 0.73 +/- 0.14 mg/week per ear obtained with Triton X-100 solution . In addition, reproducibility was definitely better . Triton X-100 may be useful whenever microbiologic evaluations are requested . Total lipids accounted for 73.3% of cerumen extracted with the former solution, triglycerides being 19.5%, and cholesterol 7.2% . Our extracting technique appears to be a good estimate of the cerumen global output and may supply important information about cerumen in several biologic conditions.

Geburtshilfe Frauenheilkd, 1986 Feb, 46(2), 102 - 4
{Local metronidazole and PVP-iodine prevention before abdominal and vaginal hysterectomy}; Lelle RJ et al.; One day before abdominal or vaginal hysterectomy 37 patients received a vaginal suppository of (I) metronidazol (200 mg) (II) PVP-iodine or (III) a placebo . Microbiologic analysis was performed before application and three or four days post surgery . No differences between the three groups were observed regarding bacterial status and postoperative morbidity . Occurrence of postoperative infections did not decrease as a result of the local treatment and dosage as described.

Am J Infect Control, 1986 Feb, 14(1), 41 - 6
Understanding the blood culture report; Flournoy DJ et al.; There are no hard-and-fast rules for judging whether an organism is a pathogen or contaminant . Experience is critical . In the end, the physician is responsible for determining whether an organism is a contaminant or a pathogen on the basis of laboratory and clinical data, which often include patient history, physical examination, body temperature, peripheral leukocyte count and differential, clinical course, and culture results . When blood culture results are given to a nurse, she or he should communicate this information to the attending physician as soon as possible, with greatest emphasis placed on positive cultures with probable pathogens . The assumption that a blood culture isolate is a pathogen, in the absence of other supporting facts, can lead to inappropriate therapy . On the other hand, assuming a pathogen to be a contaminant can ultimately lead to patient mortality if treatment is delayed . Questions as to how blood cultures are handled should be directed to microbiology personnel, whereas interpretation problems should be discussed with infectious disease specialists . Good communication among the nurses, laboratory personnel, and physicians involved with blood culture studies is invaluable to effective patient care.

Mol Cell Biol, 1986 Feb, 6(2), 462 - 9
Regulation by copper of the expression of plastocyanin and cytochrome c552 in Chlamydomonas reinhardi; Merchant S et al.; Plastocyanin and cytochrome c552 are interchangeable electron carriers in the photosynthetic electron transfer chains of some cyanobacteria and green algae (P . M . Wood, Eur . J . Biochem . 87:9-19, 1978; G . Sandmann et al., Arch . Microbiol . 134:23-27, 1983) . Chlamydomonas reinhardi cells respond to the availability of copper in the medium and accordingly accumulate either plastocyanin (if copper is available) or cytochrome c552 (if copper is not available) . The response occurs in both heterotrophically and phototrophically grown cells . We have studied the molecular level at which this response occurs . No immunoreactive polypeptide is detectable under conditions where the mature protein is not spectroscopically detectable . Both plastocyanin and cytochrome c552 appear to be translated (in vitro) from polyadenylated mRNA as precursors of higher molecular weight . RNA was isolated from cells grown either under conditions favorable for the accumulation of plastocyanin (medium with Cu2+) or for the accumulation of cytochrome c552 (without Cu2+ added to the medium) . Translatable mRNA for preapoplastocyanin was detected in both RNA preparations, although mature plastocyanin was detected in C . reinhardi cells only when copper was added to the culture . Translatable mRNA for preapocytochrome, on the other hand, was detected only in cells grown under conditions where cytochrome c552 accumulates (i.e., in the absence of copper) . We conclude that copper-mediated regulation of plastocyanin and cytochrome c552 accumulation is effected at different levels, the former at the level of stable protein and the latter at the level of stable mRNA.

J Clin Microbiol, 1986 Feb, 23(2), 311 - 7
Novel chemical method for the preparation of nucleic acids for nonisotopic hybridization; Viscidi RP et al.; A novel chemical method was used to prepare biotin-labeled nucleic acids for nonisotopic hybridization . The method involves the transamination of unpaired cytosine residues in polynucleotides with sodium bisulfite and ethylenediamine . Primary amino groups on the cytosine derivatives are then reacted with biotinyl-e-aminocaproic acid N-hydroxysuccinimide ester . Biotinylated probes hybridized with 1 to 2 pg of nitrocellulose filter-bound DNA and were visualized with a colorimetric detection technique . This method is simpler and less expensive than other methods for the preparation of nonisotopic probes . In addition, it is more versatile since the chemically modified bases can potentially react with other "indicator" molecules or proteins such as an enzyme . The specificity for unpaired cytosine residues is another advantage which could allow for the selective labeling of a specific region of a double-stranded nucleic acid . This improved labeling method should lead to the wider application of hybridization techniques in diagnostic microbiology and basic research in infectious diseases.

JAMA, 1986 Jan 17, 255(3), 374 - 82
Regulation of physicians' office laboratories . The Idaho experience; Crawley R et al.; Timely availability of reliable test results enhances the office practitioner's ability to provide high-quality care that is personally satisfying to patients . Modern technology allows physicians to have such timely information available through test analyses performed in an office laboratory . Studies of physicians' office laboratories in Idaho found the performance, initially, to be unacceptably variable for many hematology, urinalysis, clinical chemistry, and microbiology tests . State regulation, requiring each office laboratory to comply with quality assurance guidelines and to participate in a proficiency testing program, resulted in a marked improvement in the proficiency level of office laboratory testing in Idaho . With the increasing dispersion of clinical laboratory technology, it is essential that standards of practice for the office laboratory be developed that ensure, within reasonable limits, the reliability of test information used in patient care . If widespread acceptance of such standards cannot be developed with a voluntary approach, states should consider regulation of office laboratories within their jurisdiction . Compliance with standards of practice, voluntarily or as a result of regulation, should promote quality performance in the office laboratory and allow the physician to use confidently the timely test information in dealing with diagnostic and management problems in patient care.

J Biol Chem, 1986 Jan 15, 261(2), 832 - 8
Chemical cross-linking of thioredoxin to hybrid membrane fraction in Escherichia coli; Lunn CA et al.; Thioredoxin was cross-linked to a membrane fraction in vivo using the heterobifunctional photoreactive cross-linking reagent p-azidophenacyl bromide, chosen to couple thioredoxin via its highly reactive thiol . Under mild reaction conditions, a significant amount of thioredoxin (30%) was rapidly cross-linked to the crude membrane fraction . The cross-linking reaction was selective, with thioredoxin purified 15-fold in the cross-linked membrane fraction . Membrane fractionation studies showed that thioredoxin associated with the inner membrane and with a hybrid membrane fraction . This hybrid membrane fraction banded at a density between the inner and outer membranes . This result is consistent with the localization of thioredoxin in association with the bacterial membrane adhesion sites first described by Bayer (Bayer, M . (1968) J . Gen . Microbiol . 53, 395-404) . Association of thioredoxin with the membrane adhesion sites defines a structure corresponding to the osmotically sensitive cytoplasmic compartment (Lunn, C . A., and Pigiet, V . (1982) J . Biol . Chem . 257, 11424-11430).

Ter Arkh, 1986, 58(10), 29 - 32
{Effect of interferon on clinico-laboratory indicators in patients with acute viral hepatitis B}; Pokrovskii VI et al.; A study was made of the therapeutic efficacy of human leukocytic alpha-interferon obtained at the N . F . Gamaleya Institute of Epidemiology and Microbiology in the treatment of grave viral hepatitis B . The drug was explored in a group comprising 44 patients . Of these, 24 patients made up the main group whereas 20 served as control . The drug was administered according to the following scheme: during the first 3 to 5 days the patients were given it intramuscularly (and intravenously) in a dose of 3 X 10(6)-6 X 10(6) Units followed by the dose reduction and drug administration every other day . As compared with control, the predominating number of the patients treated with the drug manifested a more rapid diminution of the signs of intoxication and normalization of liver function . The plasma interferon content increased . Interferon stimulated the activity of natural killers . The use of the drug is advisable for early treatment of the grave patterns of viral hepatitis B.

Dev Biol Stand, 1986, 64, 181 - 93
The application of flow microfluorimetry to biomedical research and diagnosis: a review; Mackenzie NM et al.; The application of flow cytometric or microfluorimetric techniques to the biomedical sciences is a major growth area . Flow microfluorimetry is the science of analyzing and separating populations of cells (and their sub-cellular components) using fluorescent markers (usually fluorescent antibodies or fluorescent DNA-binding dyes) . Each cell is analysed individually allowing assays to be performed on small samples (less than 10,000 cells) . Interesting cells can be sorted out to a high degree of purity (up to 99%) . Flow microfluorimetric analysis enjoys multidisciplinary use, ranging from cell biology, microbiology and immunology to cell cycle analysis and "flow karyotyping" of cells . Examples taken from both clinical and research settings are discussed.

Adv Exp Med Biol, 1986, 202, 63 - 72
M.I.D.A.S.--an on-line microbiology information system; Kiehn TE; The system I have described is the result of several years of study and design . A special thanks is in order to our many friends who shared thoughts, both good and bad, about their own systems . Computerization of clinical microbiology laboratories requires planning that varies considerably from other diagnostic laboratories . As we develop and update our systems it will be very important for us to continue this dialogue . The microbiology Computer Users Group, started by George E . Buck at Texas, is a good example of this effort.

Ter Arkh, 1986, 58(6), 96 - 8
{Long-term prognostic effect of treatment in chronic non-ulcerative colitis and dyskinesia of the large intestine}; Esedov EM; The efficiency of stepwise therapeutic courses was assessed on the basis of clinical data, and histomorphologic and histochemical findings in large-intestinal mucosa of patients with chronic non-ulcerative colitis and colodyskinesia, followed up for 6 to 15 years . The duration of remissions in chronic colitis and colodyskinesia depends on the diet and regular meal-taking, adequate long-term combined treatment taking into account histomorphologic and morphometric parameters of large-intestinal inflammation, the extent of disturbance in intestinal microbiocenosis, and the clinical pattern of functional intestinal disorders . Recurrent acute attacks of colodyskinesia (its hyperkinetic variant, in particular) may result in inflammation of colonic mucosa.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Jan, (1), 35 - 40
{Microecology of the gastrointestinal tract of chronic enteritis patients}; Kanareikina SK et al.; The results obtained in the simultaneous study of the microbiology of different sections of the gastrointestinal tract (the oral cavity, the stomach, the large and small intestines) in chronic enteritis patients, as well as in the study of biopsy mucosa samples from the small intestine of such patients, are presented . This method has been shown to give a complete picture indicating both the severity of dysbiotic disturbances in the patient and the degree of their spread in the alimentary canal, which should be taken into account in clinical practice for the determination of the severity of the disease, the rational course of treatment and the time of the discharge of the patient from the hospital.

Boll Ist Sieroter Milan, 1986, 65(6), 512 - 5
The identification of Gardnerella vaginalis; Reali D et al.; In an attempt to develop a rapid identification system for Gardnerella vaginalis that could be used in a clinical microbiologic laboratory, we examined 102 samples of vaginal discharge from women with symptoms of vaginitis . Gardnerella vaginalis was obtained from 77 of 102 cases . We found a combination of six tests of particular value for distinguishing G . vaginalis from other catalase-negative coryneforms isolated from vagina.

Antonie Van Leeuwenhoek, 1986, 52(6), 555 - 66
Influence of light and natural microbiota of the Butrón river on E . coli survival; Barcina I et al.; The survival of an E . coli strain in water samples from the Butron river has been studied . The input of E . coli cells in the aquatic system breaks down the established balance among the components of the natural microbiota: E . coli becomes the object of the active protozoal predation whereas the autochtonous heterotrophic community become alternative preys . As a result of this new situation, the natural microbiota increases but returns to the initial values once the E . coli cells have been removed from the system . The effect of the temperature of incubation on the survival is exerted through the effect of this parameter on the predatory activity of the protozoa . Light has a lethal and direct action on the E . coli cells, the effect of this parameter is even superior to that of predation.

Gene, 1986, 45(1), 37 - 44
Genetic characterization of the gene hupB encoding the HU-1 protein of Escherichia coli; Kano Y et al.; The gene hupB encoding the HU-1(HU beta) protein of Escherichia coli was mapped between proC at min 9 and minA at min 10 on the K-12 genome by plasmid integration and chromosome transfer studies . Genetic studies using plasmid rescue techniques demonstrated that the lon gene is located very close to the 5' end of hupB and that the two genes are both transcribed clockwise on the E . coli map {Bachmann, Microbiol . Rev . 47 (1983) 180-230}.

Dent Clin North Am, 1986 Jan, 30(1), 3 - 23
Biomaterials, biocompatibility, and peri-implant considerations; Lemons J et al.; There are series of tests recommended for evaluation of dental implants . These materials and instrumentation coupled with the publications reviewed here that deal with animal experimentation and implant experience in humans provide an outline of data that have made tissue response to dental implants more clearly delineated . However, there are several specific aspects of cellular response that remain to be illuminated and correlated with clinical and radiographic signs . The further study of the interface zone with corresponding characterization of materials will produce the final chapter in the development of this most interesting area of dentistry . As stated, no epithelial attachment to any dental implant post has been comprehensively described that utilizes light and electron microscopy or histochemistry . Rather, a concept of a biologic seal has emerged that delineates the external milieu of the mouth with its microbiota and plaque from the internal milieu of bone and connective tissue, where true osseointegration can and does take place.

Avian Dis, 1986 Jan-Mar, 30(1), 3 - 11
Biotechnology: a selective survey; Goldsby RA; Biotechnology is a selective amalgam of the ideas and techniques of many fields, particularly biochemistry, microbiology, genetics, and developmental biology . The identifying signature of biotechnology is the calculated manipulation, modification, and even creation of new genetic entities . This review examines such aspects of biotechnology as: (a) the analysis and cloning of DNA; (b) the production of transgenic organisms and some speculations on the use of this technology in animal husbandry; and (c) the construction and uses of monoclonal-antibody-secreting hybridomas.

G Batteriol Virol Immunol, 1986 Jan-Jun, 79(1-6), 168 - 80
{Diet and immunity}; Cavallo G; Diet modulates the immune system and cell reactivity in particular since it may induce an early aging . A survey of published data on diet-immune system relationship is presented . Studies performed at the Institute of Microbiology, University of Turin, are discussed more in detail.

J Basic Microbiol, 1986, 26(5), 259 - 69
{Effect of 2-ethyl-2-ene-1-al and analogous compounds on the growth and ultrastructure of fungi}; Casperson G et al.; Analogs of the natural substance (E)-hex-2-en-1-al which occurs naturally in green plants and is known to have microbiocidal properties were synthesized and studied with respect to their antifungal properties . Saturated and unsaturated aldehydes, alcohols, carbon acids and enolacetate were tested against various fungi by applying these compounds either over the gaseous phase or in suspension . The following ranking was observed on the basis of fungicidal activity: enolacetate of 2-ethylhex-2-enoic acid greater than 2-ethylhex-2-en-1-al greater than 2-ethylhex-2-en-1-al greater than 2-ethylhex-2-en-1-ol . Saturated analogs showed the same order of activity as the unsaturated ones, however, they were less efficient . The effects on the ultrastructural changes were analyzed in Mucor mucedo exposed to concentrations of the analogs that inhibited growth . Main effects were observed on mitochondrial and nuclear membranes . The kind of destruction caused by enolacetate of 2-ethylhex-2-en-1-al differed from the other substances tested . Aspects of the mode of action are discussed.

Tierarztl Prax, 1986, 14(3), 353 - 63
{Infectious diarrheal diseases in swine: morphologic and microbiologic findings}; Pospischil A et al.; Infectious diarrhea in piglets can be caused by TGE, EVD and rota virus . The present report shows another viral agent (para-rota virus) to be present . In addition the report describes light and electronmicroscopic findings of the enteric mucosa caused by the agents mentioned . The degree and distribution of villous atrophy, one of the main histological findings, of infections with TGE, EVD, rota and para-rota virus is compared . A correlation of the results obtained with fluorescent antibody staining and ultrastructural diagnosis of agents was done . An application of the latter seems advisable in case of negative FA staining results.

Diagn Cytopathol, 1986 Jan-Mar, 2(1), 40 - 5
Diagnosis of cystic lesions of the pancreas: a biochemical and cytologic analysis of material obtained utilizing radiographic or intraoperative technique; Pinto MM et al.; The widespread use of imaging modalities may detect clinically unsuspected "pancreatic cysts" in which the differential diagnoses include pseudocysts, cystic neoplasms, necrotic carcinomas, abscesses, and, uncommonly, islet cell tumors . Accurate preoperative diagnosis requires clinical, radiologic, microbiologic, cytologic, and biochemical studies . Material obtained by fine-needle aspiration from cysts can be triaged for cytology, amylase, and carcinoembryonic antigen (CEA) studies . The four cases described suggest that an elevated fluid CEA is specific for carcinoma, and an elevated amylase and negative CEA suggests pseudocysts, while both amylase and CEA are negative in abscesses . Thus, "cystic lesions of pancreas" can be accurately diagnosed in cases in which radiologic and cytologic studies are inconclusive . The routine inclusion of these tests with cytologic study should be encouraged to obviate unnecessary surgery for diagnostic purposes.

J Clin Microbiol, 1986 Jan, 23(1), 17 - 21
Techniques for examining Pneumocystis carinii in fresh specimens; Ruffolo JJ et al.; Pneumocystis carinii was examined in fresh preparations of infected rat lung homogenates and tissue culture supernatants by a variety of light microscope techniques, vital dyes, and histologic stains . Phase-contrast microscopy, Nomarski interference-contrast microscopy, and bright-field microscopy with oblique illumination provided excellent views of P . carinii . Erythrosin B, and to a lesser extent trypan blue, were helpful in assessing organism viability . The use of Triton X-100-Giemsa stain permitted differentiation of the developmental stages in the P . carinii life cycle . The techniques developed here are easily adaptable to the microbiology laboratory and thus should have important clinical and research applications.

J Health Care Technol, 1985 Winter, 1(3), 213 - 30
Automated microbiology systems . An ECRI technology assessment; Forecasting staffing needs for productivity management in hospital laboratories; Daily and weekly prediction models are developed to help forecast hospital laboratory work load for the entire laboratory and individual sections of the laboratory . The models are tested using historical data obtained from hospital census and laboratory log books of a 90-bed southwestern hospital . The results indicate that the predictor variables account for 50%, 81%, 56%, and 82% of the daily work load variation for chemistry, hematology, and microbiology sections, and for the entire laboratory, respectively . Equivalent results for the weekly model are 53%, 72%, 12%, and 78% for the same respective sections . On the basis of the predicted work load, staffing assessment is made and a productivity monitoring system constructed . The purpose of such a system is to assist laboratory management in efforts to utilize laboratory manpower in a more efficient and cost-effective manner.

Tijdschr Diergeneeskd, 1985 Dec 1, 110(23), 1002 - 7
{Developments in research on mycotoxins}; van Egmond HP et al.; Since the early 1960's attention has been paid to mycotoxins by various disciplines of the National Institute of Public Health and Environmental Hygiene (RIVM) (Analytical Chemistry, Microbiology, Toxicology) . A major part of the work is carried out at the request of the Chief Medical Office . The activities undertaken on behalf of the Chief Veterinary Officer concern investigations on the causes of fungal growth and toxin production as well as on the presence of aflatoxin B1 and the analytical possibilities of determining aflatoxin B1 in feeds and aflatoxin M1 in milk . Because of its structural relationship with aflatoxin B1, aflatoxin M1 is suspected of having carcinogenic properties . In order to be able to do chronic toxicity studies in rats, efforts are being made to synthesize approximately 25 g . of aflatoxin M1 in co-operation with the State University of Utrecht, which was found to be a time-consuming and extremely difficult job . From the point of view of the Chief Veterinary Officer, it is expected that the analytical and toxicological features of aflatoxin M1 will continue to be of interest in the near future.

Clin Lab Med, 1985 Dec, 5(4), 761 - 91
Cost containment in microbiology; Bartlett RC; Prospective reimbursement will impose an additional challenge on clinical microbiologists . In order to avoid an inevitable decrease in quality and increasing delay in providing results of examination of specimens, efforts must be undertaken to restrict the submission of specimens and the extent of work that is performed to that which is cost effective for patient care . This will require education and the introduction by the laboratory of controls on ordering and specimen submission . Laboratory personnel must also establish criteria to limit the extent of specimen processing to the production of information that can be expected to be clinically useful . This will involve a close interaction with infectious disease services and clinical departments . Introduction of new screening tests, rapid antigen detection procedures, computers, and automation may provide some increase in productivity but cannot be expected to solve the entire problem . Currently, most attention to controlling hospital cost is being given to the length of patient stay, and little progress has been made in establishing more effective communication between laboratory staffs, house staffs, medical staffs, and hospital administration in monitoring and controlling misuse of laboratory resources.

J Periodontol, 1985 Dec, 56(12), 740 - 7
Microscopic monitoring of pathogens associated with periodontal diseases . A review; Greenstein G et al.; Microscopic monitoring of the subgingival microbiota to detect pathogens associated with periodontal diseases has been an active area of investigation . Researchers have demonstrated that plaque samples obtained at diseased sites contain more motile bacteria and less coccoid forms than healthy sites . Therapy at diseased locations has resulted in a shift in the microbiota to one that resembles healthy sites . However, the ability to predict disease activity based on morphotype counts still remains unverified . The current literature addressing chairside microscopic assessments as a diagnostic parameter is reviewed and discussed.

J Dent Educ, 1985 Dec, 49(12), 814 - 9
Microbiology teaching in American dental schools; Henry CA et al.; A comprehensive questionnaire on current practices relevant to teaching microbiology to dental students was sent to all dental schools in the United States . The survey collected information on resources available, modes of teaching, and evaluation processes . Seventy percent (42/60) of the schools responded . Great variation was found in the teaching of microbiology largely due to the variety of educational resources, perspective of subject matter by the faculty, and the backgrounds of entering students . Data are presented that document the integration of microbiology with other courses, placement of microbiology in the curriculum, class attendance policies, availability of advanced selective and/or elective courses, and National Board reviews . These and other data indicate some prevailing trends in the teaching of microbiology to dental students.

Arch Dis Child, 1985 Dec, 60(12), 1128 - 33
Early congenital syphilis still occurs; Ewing CI et al.; Seven cases of early congenital syphilis have been recorded in the past 10 years in the Mersey Regional Health Authority . Antenatal serology was initially negative in five mothers, who were either incubating or acquired the infection later, and treatment had probably failed in two women given erythromycin for syphilis during pregnancy . Serology should be repeated later in pregnancy in those at high risk . Social factors that define this group include women who book for antenatal care late in pregnancy, have a past history of sexually transmitted disease, and have multiple consorts . Clinical signs in the infant such as failure to thrive, hepatosplenomegaly, symmetrical rash, rhinitis, and osteochondritis should alert the clinician to the possibility of congenital syphilis . Adequate management of mother and baby requires close liaison between the genitourinary physician, microbiologist, obstetrician, and paediatrician . Penicillin remains the treatment of choice.

J Hosp Infect, 1985 Dec, 6 Suppl C, 15 - 22
Incidence and risk of transmission of HTLV III infections to staff at a London hospital, 1982-85; Shanson DC et al.; In 1982 only two cases of acquired immune deficiency syndrome (AIDS) and one case of persistent generalized lymphadenopathy (PGL) were diagnosed at St Stephen's hospital in central London . By 31 July 1985, the numbers of cases with these conditions had increased to 41 and 185 respectively and a total of approximately 400 patients had been recognized as having HTLV III infection . A large increase in the numbers of cases of AIDS was noted between July 1984 and July 1985 . Over 80 patients with HTLV III infection were admitted to hospital and had surgery or other invasive procedures carried out . Approximately 3000 blood samples from HTLV III antibody positive patients were processed by the pathology department--mainly by the microbiology and haematology laboratories . Hospital and laboratory staff observed hepatitis B precautions . In spite of regular contact with patients with HTLV III infection and their samples, serological studies on 150 hospital staff showed no evidence of spread of HTLV III from patients to staff.

Appl Environ Microbiol, 1985 Nov, 50(5), 1149 - 54
Effects of metals on Legionella pneumophila growth in drinking water plumbing systems; States SJ et al.; An investigation of the chemical environment and growth of Legionella pneumophila in plumbing systems was conducted to gain a better understanding of its ecology in this habitat . Water samples were collected from hospital and institutional hot-water tanks known to have supported L . pneumophila and were analyzed for 23 chemical parameters . The chemical environment of these tanks was found to vary extensively, with the concentrations of certain metals reaching relatively high levels due to corrosion . The effect of various chemical conditions on L . pneumophila growth was then examined by observing its multiplication in the chemically analyzed hot-water tank samples after sterilization and reinoculation with L . pneumophila . L . pneumophila and associated microbiota used in these experiments were obtained from a hot-water tank . These stains were maintained in tap water and had never been passaged on agar . The results of the growth studies indicate that although elevated concentrations of a number of metals are toxic, lower levels of certain metals such as iron, zinc, and potassium enhance growth of naturally occurring L . pneumophila . Parallel observations on accompanying non-Legionellaceae bacteria failed to show the same relationship . These findings suggest that metal plumbing components and associated corrosion products are important factors in the survival and growth of L . pneumophila in plumbing systems and may also be important in related habitats such as cooling towers and air-conditioning systems.

Am J Reprod Immunol Microbiol, 1985 Nov, 9(3), 77 - 83
Pregnancy-associated nonspecific immunosuppression: kinetics of the generation and identification of the active factors; Davies M et al.; The effect of gestational age and maternal parity on the development of nonspecific immunosuppressive activity in the sera of pregnant women, which inhibited the in vitro transformation of unrelated lymphocytes by phytohemagglutinin, was examined . Quantitative demonstration of this activity was dependent, in part, on the source of the lymphocytes and on the serum concentration in culture . The immunosuppressive activity became evident as the pregnancy progressed, and in late-pregnancy sera it was mediated by two factors, immunosuppressive factors (ISF) I and II with apparent Mr of 2 X 10(6) and 150,000 daltons . By analysis and comparison of different types of sera fractionated by gel filtration on Sephacryl S-300, it was evident that ISF-I and ISF-II were also present in male and nulliparous nonpregnant female sera, but in inactive forms . Hence the immunosuppressive factors did not appear to be "produced" in pregnancy, but the observed activity was a reflection of the "activation" of preexisting molecules in the serum . An accompanying report (Am J Reprod Immunol Microbiol . 1985; 9:84-90) describes the regulation of the activation event.

Can J Surg, 1985 Nov, 28(6), 478 - 81
The comprehensive burn unit; Snelling CF; A burn unit is only as good as its staff . Trained, experienced nurses, therapists and surgeons accustomed to dealing with large open wounds are a major requisite for the care of burned patients, who have a multisystem disease . Equipment needs include monitors, hydrotherapy tank, ready access to the operating room and comprehensive rehabilitation facilities . Skilled anesthesia, consultative support in nephrology, respirology, pediatrics and infectious diseases, a blood bank, access to human allograft and good microbiology support are necessary . Ventilatory support for associated smoke inhalation injury may be provided on the unit or in a separate ventilatory intensive care unit with isolation capability . In 1982, 29.9 Canadians per 100 000 were hospitalized for burn care (approximately 20% to 25% in burn units) . Burn care requires a high staff-to-patient ratio and a hospital budget to support this is mandatory.

Diagn Microbiol Infect Dis, 1985 Nov, 3(6 Suppl), 65S - 71S
Potential impact of rapid microbiology tests in the prospective payment era; Ferraro MJ; The potential impact of rapid microbiology tests in the prospective payment era is complex and difficult to assess . Although several of the newer methods have been shown to speed detection, isolation, and susceptibility testing of clinical isolates, many of these improvements come only at an additional cost to the microbiology laboratory . Decisions as to whether it is cost-effective to implement these tests may necessitate an analysis at three separate but interdependent levels: level 1--laboratory costs, level 2--hospital costs, and level 3--morbidity and mortality . Within each of these levels, cost offsets associated with a variety of factors may be identifiable . These factors should be carefully evaluated before implementing new methodologies in the microbiology laboratory.

Vet Clin North Am Small Anim Pract, 1985 Nov, 15(6), 1159 - 76
Two-dimensional, gray-scale ultrasonography . Applications in canine prostatic disease; Feeney DA et al.; The technique of and general appearance of suprapubic gray-scale prostatic ultrasonography in the dog are described . Using case examples, the various spontaneous diseases of the canine prostate are described and compared to the defined normal appearance of the prostate . An integrated approach to imaging the canine prostate gland is advocated and includes radiographic techniques, specifically distension retrograde urethrocystography . A clinically relevant classification scheme for use with microbiologic, cytologic, and imaging techniques is proposed.

Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S703 - 8
Overall clinical experience with aztreonam in the treatment of obstetric-gynecologic infections; Henry SA; Gynecologic infections (primarily endometritis and pelvic inflammatory disease) in 73 women were evaluated for clinical and microbiologic response to treatment with aztreonam plus clindamycin or a control regimen . The dosage of aztreonam used most frequently was 1 g three times daily . For 72 of the 73 women, a microbiologic cure and a satisfactory clinical response were achieved . Twenty-three of the 73 patients were treated with aztreonam in an open study; all experienced a microbiologic cure and a favorable clinical response . Fifty of the 73 patients treated with aztreonam plus clindamycin were entered into a comparative study that included 38 patients who received gentamicin (3-5 mg/kg per day) plus clindamycin (600 mg three times a day) . In 49 (98%) of the aztreonam-treated patients and in 36 (95%) of the gentamicin-treated patients, the causative organism was eradicated, and in 98% and 89% of the patients, respectively, a favorable clinical response was achieved.

Diagn Microbiol Infect Dis, 1985 Nov, 3(6 Suppl), 9S - 14S
Manual approaches to rapid microbiology results; Murray PR; Rapid generation of microbiology results does not require sophisticated automated instruments . Many common laboratory procedures, such as microscopic examination of clinical specimens, use of manual screening tests, macroscopic examination of isolated colonies, and performance of rapid biochemical tests, can provide the physician with clinically useful information . These tests are neither expensive nor time-consuming and should be used routinely to generate rapid test results.

Diagn Microbiol Infect Dis, 1985 Nov, 3(6 Suppl), 73S - 78S
Means to facilitate physician acceptance and use of rapid test results; Matsen JM; Rapid testing methods can have a positive impact on patient care and help ease the mounting economical pressures facing clinical microbiology laboratories . Rapid test reporting, the validation of rapid test procedures and results, and physician acceptance and use of these tests are among the 10 categorical measures outlined to help laboratories optimize productivity, efficiency, and economic and patient-care impact.

Acta Cytol, 1985 Nov-Dec, 29(6), 979 - 82
Fine needle aspiration biopsy cytology in the diagnosis of inflammatory lesions; Pontifex AH et al.; In 42 fine needle aspirations (FNA), the cytologic findings were interpreted as either suppurative or granulomatous inflammation . The majority of these FNAs were performed in patients with a known history of malignancy in whom recurrent or residual malignancy was suspected clinically . In 13 cases, a specific microbiologic diagnosis was made on the basis of the aspirate, either by cytology or by culture . In the remaining 29 cases, no specific diagnosis was possible . Open biopsies were later performed in 9 of the 29 cases, revealing the presence of actinomycosis of the parotid in one case and of carcinoma of the breast in a second . Five additional patients in whom only inflammation was diagnosed on the aspirate subsequently proved to have tumor at the FNA site . FNA therefore is not absolutely reliable for the exclusion of malignancy and requires correlation with other data and appropriate follow-up . Aspiration did, however, rapidly provide solutions to otherwise confusing clinical problems in the majority of instances.

Ann Acad Med Singapore, 1985 Oct, 14(4), 686 - 8
The microbiology of non-gonococcal urethritis (NGU) in Singapore; Lim KB et al.; Ninety-six men with non-gonococcal urethritis (NGU) were studied to determine the microbiology of NGU in Singapore . Chlamydia trachomatis emerged as the most common aetiologic agent, being isolated in 29 (30.2%) of 96 patients . The recovery rate of other potential pathogens and their significance locally are discussed.

Am J Clin Pathol, 1985 Oct, 84(4), 425 - 32
The bone marrow in AIDS . A histologic, hematologic, and microbiologic study; Castella A et al.; During one year, 55 bone marrow biopsies from 49 patients with CDC-defined acquired immune deficiency syndrome (AIDS) were studied . Eighty-three percent were normocellular or hypercellular; 17% were hypocellular . Marrow plasma cells were increased in 83% of patients, most showing polyclonal hypergammaglobulinemia . Forty percent of patients showed peripheral neutropenia, 29% thrombocytopenia, and 79% lymphopenia with markedly reduced T4+ lymphocytes . Eighty-five percent of patients were anemic, with iron studies showing a pattern consistent with the anemia of chronic disease . Mycobacterium avium-intracellulare (MAI) grew from ten (20%) biopsies, four with granuloma and six without granuloma (five of these six also showed marrow hypocellularity) . Small poorly formed granuloma (70-150 micron) were seen in eight (16%) patients (four AFB-culture positive, 4 negative) . Three of four granuloma-positive, culture-negative cases eventually grew MAI from autopsy material . Five (10%) patients had lymphoplasmacytic aggregates; later, one developed lymphoma, another, markedly atypical lymphoid hyperplasia . Two additional patients showed marrow B-cell lymphomas . Of these findings, only marrow MAI meets the CDC definition of AIDS . However, in this series, small ill-defined granulomas, lymphoplasmacytic aggregates, and B-cell lymphomas also were found . The authors conclude that these latter findings, when seen in high-risk patients, particularly those with lymphopenia, anemia, and/or hypergammaglobulinemia, also strongly suggest the diagnosis of AIDS.

Can J Ophthalmol, 1985 Oct, 20(6), 225 - 8
Lasiodiplodia theobromae panophthalmitis; Slomovic AR et al.; Lasiodiplodia theobromae is a rare ocular pathogen . We report a case of panophthalmitis caused by this fungus . The patient was a healthy 62-year-old janitor with no history of ocular trauma in whom keratitis developed . Cultures of corneal scrapings identified the fungus . Despite treatment with appropriate antimycotics the keratitis progressed to infectious scleritis and then spontaneous perforation of the globe, which necessitated enucleation . The ultrasonographic, microbiologic and histologic findings are discussed and the results of in-vitro sensitivity testing presented.

Am J Surg Pathol, 1985 Oct, 9(10), 752 - 8
Q-fever . The liver and bone marrow pathology; Srigley JR et al.; Eighteen liver and seven bone marrow biopsies from 44 patients with clinically and serologically proven Q-fever seen during a recent outbreak were studied . Highly distinctive fibrin-ring granulomas were found in seven liver and four bone marrow specimens . Lipid or nonspecific granulomas often containing neutrophils and variable numbers of giant cells were noted in 13 livers and seven bone marrows . A wide variety of nongranulomatous histological changes, frequently including steatosis and nonspecific "reactive" hepatitis, were seen in the liver biopsies . Identifiable rickettsiae were not present in tissue sections studied by microbiologic stains or electron microscopy . The histological response pattern to Coxiella infection is varied, and Q-fever should always enter the differential diagnosis of a granulomatous disease encountered in liver and bone marrow specimens.

Radiology, 1985 Oct, 157(1), 157 - 66
Vertebral osteomyelitis: assessment using MR; Modic MT et al.; Thirty-seven patients who were clinically suspected of having vertebral osteomyelitis were prospectively evaluated with magnetic resonance (MR), radiography, and radionuclide studies . These findings were correlated with the final clinical, microbiologic, or histologic diagnoses . Based on the results of these latter studies, 23 patients were believed to have osteomyelitis . MR examinations consisted of at least a sagittal image (TE = 30 msec, TR = 0.5 sec) and an image obtained at TE = 120 msec, TR = 2-3 sec . All patients underwent radiographic and MR examinations, 36 underwent technetium 99m-HDP bone scanning, and 20 patients underwent gallium 67 scanning . Nineteen patients underwent both bone and gallium scanning . The imaging studies were reviewed independently by investigators blinded to the final diagnoses . MR had a sensitivity of 96%, specificity of 92%, and accuracy of 94% . Combined gallium and bone scan studies (19 cases) had a sensitivity of 90%, specificity of 100%, and accuracy of 94% . Bone scans alone had a sensitivity of 90%, specificity of 78%, and accuracy of 86% . Plain radiographs had a sensitivity of 82%, specificity of 57%, and accuracy of 73% . The MR appearance of vertebral osteomyelitis in this study was characteristic, and MR was as accurate and sensitive as radionuclide scanning in the detection of osteomyelitis.

Infect Control, 1985 Oct, 6(10), 418 - 9
Public health implications regarding the epidemiology and microbiology of public whirlpools; Castle SP; High temperature bathing in hot tubs, spas and whirlpools poses four potential public health concerns: injury/death, disease transmission, possible teratogenic effects, and congestive heart failure or dysrhythmias for individuals with cardiac problems . Health departments need criteria before initiating environmental and epidemiologic investigations . These criteria must include severity of the disease and number of individuals possibly exposed . In addition, public health officials are obligated to define the magnitude of the problem, inform affected individuals and institute appropriate control measures . Optional information should be collected during an environmental and epidemiologic investigation to clarify the mechanisms of disease transmission and design control measures . The public health response to improving hot water bathing safety and sanitation should be directed at primary prevention . Educational efforts would be directed toward whirlpool operators, users and the medical community . Included should be a review of regulations addressing the construction and operation of public spas and whirlpools.

Mikrobiyol Bul, 1985 Oct, 19(4), 229 - 34
{The incidence of intestinal helminths in Samsun district}; Gedikoglu S; 17954 stool specimens that were brought to the Microbiology department of Ondokuzmayis University were investigated in regard to the intestinal helminth eggs and the incidence was found to be 16% and 62% of them being Ascaris lumbricoides . The incidence of the intestinal helminth which was %21.08 in 1978 was found to be decreased to %10.45 in 1984.

Pathology, 1985 Oct, 17(4), 629 - 32
Rapid diagnosis of viral infections with fluorescent antisera; Hallsworth PG et al.; Viral immunofluorescence tests were performed with commercial antisera on 1046 specimens of respiratory, conjunctival corneal and dermal origin to compare the diagnostic effectiveness of direct examination by immunofluorescence with culture . The fluorescence assays were found to be highly sensitive for respiratory syncytial and measles virus in nasopharyngeal aspirates from children, but less satisfactory for other respiratory viruses . The test detected 38% of the adenovirus positives from conjunctival specimens and 67% of the combined herpes simplex virus positives from the latter 3 groups . Despite the reduced sensitivity of fluorescence for some viruses, a case is presented for more widespread use of fluorescence in routine microbiology laboratories because of its simplicity, speed and cost-effectiveness compared with culture which is labour-intensive and time consuming.

Biochemistry, 1985 Sep 10, 24(19), 5052 - 61
Secondary structure of a 345-base RNA fragment covering the S8/S15 protein binding domain of Escherichia coli 16S ribosomal RNA; Kean JM et al.; A technique for isolating defined fragments of a large RNA has been developed and applied to a ribosomal RNA . A section of the Escherichia coli rrnB cistron corresponding to the S8/S15 protein binding domain of 16S ribosomal RNA was cloned into a single-stranded DNA phage; after hybridization of the phage DNA with 16S RNA and digestion with T1 ribonuclease, the protected RNA was separated from the DNA under denaturing conditions to yield a 345-base RNA fragment with unique ends (bases 525-869 in the 16S sequence) . The secondary structure of this fragment was determined by mapping the cleavage sites of enzymes specific for single-stranded or double-helical RNA . The fragment structure is almost identical with that proposed for the corresponding region of intact 16S RNA on the basis of phylogenetic comparisons {Woese, C . R., Gutell, R., Gupta, R., & Noller, H . (1983) Microbiol . Rev . 47, 621-669} . We conclude that this section of RNA constitutes an independently folding domain that may be studied in isolation from the rest of the 16S RNA . The structure mapping experiments have indicated several interesting features in the RNA structure . (i) The largest bulge loop in the molecule (20 bases) contains specific tertiary structure . (ii) A region of long-range secondary structure, pairing bases about 200 residues apart in the sequence, can hydrogen bond in two different mutually exclusive schemes . Both appear to exist simultaneously in the RNA fragment under our conditions . (iii) The long-range secondary structure and one adjacent helix melt between 37 and 60 degrees C in the absence of Mg2+, while the rest of the structure is quite stable.

J Appl Bacteriol, 1985 Sep, 59(3), 277 - 81
Mycobacterium senegalense from bovines in Eastern Nigeria; Mohan K; Detailed characteristics of three mycobacterial strains sharing important properties of Mycobacterium senegalense are described . Their physiological properties were compared with those of a typical M . senegalense strain described by Chamoiseau (1979), six strains of M . senegalense and one typical strain of M . fortuitum from the culture collection of Institute of Microbiology, Rutgers . The three Nigerian strains exhibited minor variations in their physiological properties when compared with other strains of M . senegalense . Unlike the strain of Chamoiseau the Nigerian strains did not utilize benzoate or citrate . The strains were also different from the other six strains of M . senegalense by utilizing trehalose and in failing to produce acid in mannitol . Unlike earlier isolates of M . senegalense the Nigerian strains were not from cases of bovine farcy but from cases with pathological manifestations of pulmonary tuberculosis . They appeared to be intermediate strains between M . senegalense and M . fortuitum . These results raise doubts on the justification for giving specific rank to M . senegalense.

Diagn Microbiol Infect Dis, 1985 Sep, 3(5), 397 - 401
Evaluation of a new screening system for enteric pathogens; Hinrichs J et al.; The two-hour Rapid SST strip (DMS Laboratories, Inc.) was compared with our standard screening system (triple sugar iron agar, lysine iron agar, and urea) for enteric pathogens . We tested 50 stock cultures of enteric pathogens and 213 stool cultures received in the Barnes Hospital Clinical Microbiology Laboratory over a two-month period . All enteric pathogens from the stock cultures and clinical specimens were identified correctly with the Rapid SST system . More false-positive reactions were observed with the Rapid SST system (34%) than with the conventional system (23%) . However, the costs associated with using both systems were equivalent and the test results were available one day faster with the Rapid SST system . Thus, the Rapid SST is a rapid, accurate, and cost-effective method for screening stool specimens for enteric pathogens.

Clin Lab Med, 1985 Sep, 5(3), 561 - 74
Use of monoclonal antibodies in the diagnosis and epidemiologic studies of legionellosis; Joly JR et al.; The routine use of monoclonal antibodies against L . pneumophila and other Legionellaceae has not yet reached the clinical microbiology laboratory . Most of these antibodies are still under evaluation and are not available commercially . However, it is obvious that some of them will be available in the next few years . Because of the numerous subtypes and serogroups of L . pneumophila already identified, extreme caution must be used before they are adopted routinely by a given laboratory . Testing against a large number of strains will have to be performed, and even then unidentified subtypes may not be recognized . Monoclonal antibodies against species-specific antigens of Legionella may prove to be the most useful for routine work, but once again a large number of strains will have to be tested before they are adopted . Under certain circumstances and especially in epidemiologic studies, well-chosen anti-L . pneumophila serogroup 1 monoclonal antibodies that define different subtypes may prove to be invaluable . This is currently the area in which the use of monoclonal antibodies against L . pneumophila is best defined.

Infect Control, 1985 Sep, 6(9), 381 - 3
Francisella tularensis; Evans ME; Francisella tularensis is an infection acquired from animals . Although the pathogen is not a cause of nosocomial infections, it is a major hazard to workers in the clinical microbiology laboratory and could easily become a problem for the infection control officer in this setting . The organism can be cultured from many sites but is difficult to recover unless the appropriate media are used . A number of clinical syndromes are caused by this pathogen . Most are characterized by an ulceration and regional lymphadenopathy . Typhoidal tularemia, however, can present as an obscure fever often complicated by pneumonia . The therapy of choice for tularemia is streptomycin although gentamicin and tobramycin are reasonable alternatives.

Clin Lab Med, 1985 Sep, 5(3), 503 - 12
Biotin-labeled DNA probes for detection of Epstein-Barr virus by in-situ cytohybridization; Sixbey JW et al.; Conventional laboratory diagnosis of EBV-related disease is now performed by one of three methods: serology, lymphocyte transformation assay, or Epstein-Barr nuclear antigen (EBNA) staining of cell preparations . Of these techniques, serology is the most widely used . However, this approach assumes an intact host immune system, which is absent or impaired in some of the more baffling EBV-related syndromes . Detection of infectious virus by the lymphocyte transformation assay is labor-intensive, requires access to human umbilical cord blood lymphocytes, and requires a two-month period of incubation . Although detection of EBNA in tissue imprints is rapid, the anticomplement immunofluorescence assay, when applied to clinical materials, is subject to misinterpretation and requires multiple controls . Because of these difficulties, hybridization analysis of clinical materials for presence of EBV with biotinylated DNA probes promises to have wide-ranging applicability in the clinical microbiology laboratory . These techniques can readily be used in other viral systems and have proved useful for detection of human CMV and HSV DNA and RNA . Extension of the techniques to detection of specific nonviral nucleic acid sequences is the next frontier, limited essentially only by definition of significant target sequences.

J Thorac Cardiovasc Surg, 1985 Aug, 90(2), 225 - 34
Imidazole-buffered cardioplegic solution . Improved myocardial preservation during global ischemia; Vander Woude JC et al.; Progressive acidosis is a constant finding in global myocardial ischemia and is associated with reduced myocardial contractility after ischemia . The hypothesis tested in these experiments was that imidazole (pKa = 6.7 at 37 degrees C), a commonly used buffer in physiology and microbiology, would provide superior buffering capacity when used in lieu of bicarbonate (pKa = 6.1 at 37 degrees C) in a cardioplegic solution . Twenty-eight isolated, working rabbit hearts were perfused, and preischemic and postischemic determinants of performance were measured . The 30 minute interval of normothermic global ischemia was altered by the injection at 0 and 15 minutes of 2 ml/gm wet weight of a buffered cardioplegic solution . Control hearts received a bicarbonate-buffered cardioplegic solution and experimental hearts received a solution buffered with imidazole . In the imidazole-buffered group, there was a superior recovery of coronary flow, developed left ventricular pressure, peak rate of rise of left ventricular pressure, peak rate of relaxation, and stroke work indices (p less than 0.05) . Recovery of mechanical parameters was coincident with an improved acid-base status of the coronary sinus effluent at the end of ischemia . Coronary sinus effluents in the imidazole group had significantly higher pH values and lower partial pressures of carbon dioxide than coronary sinus effluents in the bicarbonate-buffered group (p less than 0.001) . The data suggest that improved buffering of the extracellular and possibly intracellular space during global ischemia with a nonbicarbonate buffer is beneficial and provides improved postischemic myocardial recovery.

J Trauma, 1985 Aug, 25(8), 798 - 800
Microbiologic progression of post-traumatic peritonitis; Nystrom PO et al.; The natural course of post-traumatic peritonitis was studied in 17 pigs . Following a standardized missile wound to the abdomen the pigs were operated on and observed in continuous anesthesia for periods up to 3 days . Bacterial density was measured in peritoneal exudate, parietal peritoneum, laparotomy wound, and projectile entrance and exit wounds at this operation and also at relaparotomy, which terminated the experiments . The bacterial density showed significant perioperative fall, averaging X 1,905 in peritoneal exudate and X 40 in parietal peritoneum . From a low postoperative level (mean c . 10(2)/ml or /gm), bacterial density increased significantly in the observation period . In peritoneal exudate the increase was X 4,073 and in peritoneum X 2,630 . In laparotomy and projectile entrance and exit wounds the corresponding figures were X 234, X 126, and X 15 . The bacterial population's perioperative reduction and subsequent proliferation were interpreted as reflecting the host defense, which accordingly was limited in capacity and duration.

Arch Pathol Lab Med, 1985 Aug, 109(8), 739 - 43
Fusobacteria . An important cause of chorioamnionitis; Altshuler G et al.; Prematurity is the main cause of human perinatal disease and chorioamnionitis is the main cause of prematurity . The diverse etiologic role of infection is incompletely known . Fusobacteria (FB) are herein reported to be delineated by the Warthin-Starry (WS) stain; an animal model was developed to reinforce evidence that FB cause chorioamnionitis . Isolates of these bacteria from three human placentas were inoculated into rabbits to develop antisera . Within an annual study of 297 human placentas, 138 were processed with WS stains . By WS stain, microbiologic culture, and immunofluorescent labelling of three placentas, FB were proved to cause chorioamnionitis . Sixty-two (35%) of 176 premature newborns had chorioamnionitis . Of these 62, 11 (18%) had morphologically evident FB; FB-like organisms were associated with chorioamnionitis and prematurity . Our findings support and expand clinical investigation of the amniotic infection syndrome.

J Bacteriol, 1985 Aug, 163(2), 785 - 6
Cloning and location of the dgsA gene of Escherichia coli; Morris PW et al.; The dgsA locus of Escherichia coli was isolated on plasmids obtained from the library of L . Clarke and J . Carbon (Cell 9:91-99, 1976) . Restriction fragment analysis and further subcloning demonstrated that the gene is located at kilobase 425 on the Bouche physical map of the terminus region (J . P . Bouche, J . Mol . Biol., 154:1-20, 1982) . This corresponds to 35.2 min on the Bachmann genetic map (B . J . Bachmann, Microbiol . Rev . 47:180-230, 1983).

Am J Ophthalmol, 1985 Jul 15, 100(1), 199 - 201
Stromal keratitis complicating anterior membrane dystrophy; Shoch DE et al.; Recurrent erosion of the cornea has been well documented in patients with nontraumatic anterior membrane dystrophies of various types . We examined five patients who, in addition to an erosion, developed stromal keratitis . Three of these patients were subjected to a complete microbiologic workup, but the lesions were all sterile . The lesions healed with conservative treatment of patching and, in some cases, a soft contact lens . Stromal keratitis should be recognized as a complication of the non-traumatic recurrent erosion syndrome, which in turn is frequently associated with anterior membrane dystrophy . The finding of such anterior membrane changes in either eye will lead to the correct diagnosis and treatment of the affected eye.

N Engl J Med, 1985 Jul 11, 313(2), 74 - 9
An erythema infectiosum-like illness caused by human parvovirus infection; Plummer FA et al.; In the spring of 1980, an epidemic of an illness that resembled erythema infectiosum occurred in Manitoba, Canada . We initiated prospective epidemiologic, clinical, and microbiologic studies of this illness among elementary-school children and their families . Initial microbiologic studies failed to identify the cause of the exanthem . After a similar illness associated with serologic evidence of human parvovirus infection occurred in London, stored specimens of 12 patients with exanthem were investigated for parvovirus infection . Eleven patients had parvovirus-specific IgM antibody, as did two family contacts and a teacher with nonexanthematous illnesses, and two asymptomatic family members . None of 28 children with measles or rubella had serologic evidence of recent parvovirus infection . Human parvovirus was detected by DNA hybridization and immune electron microscopy in the serum of one patient who later had a rash and in one unaffected family contact . Parvovirus DNA was also detected in the pharyngeal specimen of the teacher who was ill but did not have a rash . We conclude that human parvovirus infection can be asymptomatic or cause a variety of clinical manifestations, including nonexanthematous illness and an illness resembling erythema infectiosum.

Appl Environ Microbiol, 1985 Jul, 50(1), 10 - 5
Metabolism of the benzidine-based azo dye Direct Black 38 by human intestinal microbiota; Manning BW et al.; Benzidine-based azo dyes are proven mutagens and have been linked to bladder cancer . Previous studies have indicated that their initial reduction is the result of the azo reductase activity of the intestinal microbiota . Metabolism of the benzidine-based dye Direct Black 38 was examined by using a semicontinuous culture system that simulates the lumen of the human large intestine . The system was inoculated with freshly voided feces, and an active flora was maintained as evidenced by volatile fatty acid and gas production . Within 7 days after exposure to the dye, the following metabolites were isolated and identified by gas chromatography-mass spectrometry:benzidine, 4-aminobiphenyl, monoacetylbenzidine, and acetylaminobiphenyl . Benzidine reached its peak level after 24 h, accounting for 39.1% of the added dye . Its level began to decline, and by day 7 the predominant metabolite was acetylaminobiphenyl, which accounted for 51.1% of the parent compound . Formation of the deaminated and N-acetylated analogs of benzidine, which have enhanced mutagenicity and lipophilicity, previously has not been attributed to the intestinal microbiota.

Am J Otol, 1985 Jul, 6(4), 316 - 22
Otitis media and the Australian aboriginal; Willis R; Australia's aboriginal population, which numbers 150,000 persons, suffers much more from otitis media than does the nonaboriginal population, which numbers 15,000,000 . Moreover, the clinical presentation, course, and pathology of otitis media in aboriginals have features that differ from what are considered usual . Problems of isolation, communication, and socioeconomic circumstances require that specially designed treatment projects be set up . Debate continues as to why aboriginal otitis media behaves so differently, and theories cover the full range: genetic factors, environment, protein-calorie malnutrition and immunity mechanisms, allergies, different microbiology, and so on . Current research may point up a link to ocular trachoma . The process of spontaneous healing of drum perforations is being studied in an attempt to identify those factors that may delay or prevent such healing.

Arch Phys Med Rehabil, 1985 Jul, 66(7), 463 - 5
Diabetic Charcot spine as cauda equina syndrome: an unusual presentation; Race MC et al.; Some 6% to 21% of Charcot joints occur in the spine . The underlying disease is usually tabes dorsalis, but diabetes mellitus is another etiology . Degeneration of spinal elements is accelerated and lumbar spinal stenosis with weakness may occur, as has been reported in tabetic arthropathy . The case presented is unusual in two respects: first, the Charcot spine was secondary to diabetic complications, which resulted in a compressive cauda equina syndrome; second, the patient presented with progressive paraparesis and bowel and bladder dysfunction but physical examination by several examiners revealed no clinically evident sensory abnormality . The patient had vague and inconsistent sensory complaints for several years preceding definitive workup, but the overall picture of his disease process only could be made following multiple laboratory, electrodiagnostic, microbiologic, and radiologic testing . The patient presented with subacute paraparesis, providing a wide differential diagnosis ranging from Guillain-Barre syndrome to spinal neoplasm . The physical, radiologic, laboratory, electrophysiologic, histologic/pathologic findings, treatment, and recovery status are included in this report.

Crit Care Med, 1985 Jul, 13(7), 548 - 55
Microbiologic risk of invasive hemodynamic monitoring in patients undergoing open-heart operations; Damen J et al.; The microbiologic risk of invasive hemodynamic monitoring was studied prospectively in 574 patients undergoing open-heart surgery under cover of cephalothin prophylaxis . Of a total of 2277 catheters inserted in these patients, 1.5% yielded positive cultures . The rate of positive cultures was not significantly different between percutaneous and surgically placed catheters (1.7% vs . 0.8%, respectively) . Specifically, the incidence of positive catheter tips for intravenous, central venous, arterial, and pulmonary artery catheters was 1.1%, 3.9%, 1.5%, and 2.1%, respectively; while the corresponding rates for surgically inserted right atrial and left atrial catheters were 0.8% and 0, respectively . Pulmonary artery catheters had a significantly (p less than .01) higher incidence of positive catheter tips after 72 h in situ . However, there was no relationship between the in situ time and the incidence of positive tips for arterial and intravenous catheters . Although the rate of positive catheter tip cultures was low, it affected 4.9% of the patients . Nevertheless, no patient developed catheter-related septicemia or endocarditis, and the data generally supported the microbiologic safety of invasive hemodynamic monitoring in patients undergoing open-heart surgery.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Jul, (7), 95 - 9
{Relations between the methods of isolating Brucella lipopolysaccharides and their effect on hemopoiesis in mice}; Malikov VE et al.; The comparative study of the effect produced by different lipopolysaccharide (LPS) preparations obtained from B . melitensis virulent strain 565 and B . abortus vaccine strain 19-BA on hematopoiesis in mice was made . The LPS preparations were obtained (1) by Boivin's technique, (2) by Westphal's technique and (3) by mild alkaline hydrolysis of Bovin's active complex, this technique having been developed at the Brucellosis Laboratory of the Gamaleya Research Institute of Epidemiology and Microbiology . All tests (the spleen endocolonization test, the hydroxyurea kill test, the determination of the content of splenic colony-forming units in the peripheral blood) showed that LPS from B . melitensis virulent strain 565 had a more pronounced disturbing effect on hematopoiesis than LPS from B . abortus vaccine strain 19-BA . Among the LPS preparations obtained by different methods, the one obtained with the use of the technique developed at the Gamaleya Research Institute of Epidemiology and Microbiology proved to have the mildest effect on hematopoiesis, probably due to the partial saponification of the lipid component of LPS . Lipid A in a dose of 0.1-10 micrograms produced no activating effect on the hematopoiesis characteristics under study . None of the LPS preparations proved to be capable of stimulating the formation of transitory endogenous colonies in the spleen of mice.

Acta Cytol, 1985 Jul-Aug, 29(4), 628 - 31
Unsuspected strongyloides coexisting with adenocarcinoma of the lung; Gocek LA et al.; The findings in an unsuspected case of Strongyloides stercoralis infestation coexisting with adenocarcinoma of the lung are presented . The diagnosis of adenocarcinoma was confirmed histologically by lung biopsies; the parasitic infection was initially diagnosed by sputum cytology and then by bronchial washings . A stool specimen submitted to the microbiology laboratory confirmed the diagnosis of S . stercoralis infection . This case again suggests the possibility that neoplastic disease may play a role similar to that of immunosuppression in creating an immune deficiency, thus increasing the susceptibility to infectious diseases.

J Clin Periodontol, 1985 Jul, 12(6), 420 - 31
Effect of self-administered daily irrigation with 0.02% SnF2 on periodontal disease activity; Boyd RL et al.; To determine the effect on periodontal health of a daily self-administered irrigation with 0.02% stannous fluoride (SnF2) solution, 28 subjects who had moderate to advanced periodontitis were randomly divided into 3 groups: a control group (n = 9) which used no irrigation, a group (n = 8) which used a self-administered water irrigation device (Water Pik) daily with water (H2O group) and a group (n = 11) which used the Water Pik in a similar manner but with SnF2 solution (SnF2 group) . All subjects were instructed in routine tooth brushing and flossing but received no other periodontal treatment . 4 study sites were selected from each patient which had pocket depths greater than 4 mm and bleeding upon probing . Plaque index, gingival index, bleeding tendency, pocket depth, loss of attachment, and microbiologic samples of subgingival plaque for morphologic determinations were collected from all study sites at baseline, 2, 6, and 10 weeks . A cross-over was then initiated for 2 additional monthly checks in which the H2O group changed to SnF2 and the SnF2 group was divided into 2 subgroups which either continued to use SnF2 or changed to H2O . The control group completed the study at the beginning of the crossover . The clinical data showed significantly more improvement in periodontal health during the first 10 weeks for the SnF2 group (p less than 0.01) . After cross-over, the clinical data indicated the group that changed from H2O to SnF2 significantly improved their periodontal health, while the group that changed from SnF2 to H2O became worse . The microbiologic data showed trends which agreed with the clinical data during the first 10 weeks but were less significant . After cross-over, the %s of motile rods and spirochetes were too small (0-7%) to establish statistically significant changes considering the accuracy of the technique used.

J Oral Maxillofac Surg, 1985 Jul, 43(7), 510 - 6
Pericoronitis: a reappraisal of its clinical and microbiologic aspects; Nitzan DW et al.; Pericoronitis is an infectious disease of the operculum overlying an erupting or semi-impacted tooth . It manifests itself mainly in late adolescence and young adulthood and nearly always occurs around the lower third molar . The distinctive location, age, clinical picture, and link with predisposing factors warranted a reappraisal of pericoronitis and its etiology . Spirochetes and fusobacteria proved prevalent at all stages of the disease . The presence of these microbacteria may provide a clue as to the late appearance, particular location, and singular clinical picture of pericoronitis . The fact that spirochetes and fusobacteria are also found in acute necrotizing ulcerative gingivitis, and have been associated with alveolar osteitis, indicates a possible relationship between these disorders and pericoronitis.

Am J Med, 1985 Jun 7, 78(6A), 79 - 84
Imipenem/cilastatin in the treatment of obstetric and gynecologic infections; Berkeley AS et al.; Fifty-five patients with soft tissue pelvic infections were treated with imipenem/cilastatin 500 mg intravenously every six hours for a minimum of four days . Six patients were unevaluable, one because of protocol non-compliance and five because no pathogen was isolated . At enrollment, mean temperature was 39.5 degrees C and the mean white blood cell count was 14,700 . Of 49 evaluable patients, 43 (87.8 percent) had complete clinical cures . In three of the six patients with clinical failures, subsequent alternative antibiotic treatment also failed and they required operative intervention for pelvic abscess . In two of the patients with failures, antibiotic-associated pseudomembranous colitis developed after three days of imipenem/cilastatin therapy, requiring discontinuation of the medication . At the time of discontinuation, both patients had clinical failures . All microbiologic isolates were susceptible to imipenem/cilastatin, although at least one pathogenic organism persisted in two patients with clinical failures despite apparent in vitro susceptibility of the organism to imipenem/cilastatin . Imipenem/cilastatin is a promising agent for the empiric treatment of serious obstetric and gynecologic infections although surgery often remains a necessary treatment for pelvic abscess regardless of initial antibiotic choice.

Hum Pathol, 1985 Jun, 16(6), 549 - 59
Anatomic analysis of removed prosthetic heart valves: causes of failure of 33 mechanical valves and 58 bioprostheses, 1980 to 1983; Schoen FJ et al.; The details of heart valve prosthesis-associated problems are not widely known . This study investigated the etiologies of the failures of 91 valves, 33 mechanical prostheses and 58 bioprostheses, obtained at reoperation (83) or autopsy (eight) at the Brigham and Women's Hospital during the 42-month period from mid- 1980 through 1983, one to 264 months (mean, 72 months) after valve replacement . Analysis was by gross, histologic, radiographic, and microbiologic examination, as well as review of clinical records . Overall causes of failure included paravalvular leak (15 per cent), thrombosis (7 per cent), tissue overgrowth (8 per cent), degeneration or mechanical failure (43 per cent), and endocarditis (19 per cent) . Endocarditis and paravalvular leak were equally frequent with mechanical prostheses and bioprostheses . In addition, thrombosis (18 per cent), tissue overgrowth (21 per cent), and structural failure (12 per cent) were all important failure modes for mechanical prostheses . Sterile degeneration was the overwhelming cause of failure for bioprostheses, accounting for the failure of 35 of 58 (60 per cent) of those recovered . Sterile degeneration took several forms: calcification, with or without cuspal tears (27 cases, 47 per cent of bioprostheses; mean, 77 months, range, 44 to 108 months) and cuspal defects without calcification (eight cases, 14 per cent; mean, 59 months, range, eight to 122 months) . In general, calcification increased with time after implantation, but the propensity for the mineralization of bioprostheses varied widely among patients . Four torn valves that had been in place for more than six years had radiographically undetectable calcific deposits . The results of this study indicate that paravalvular leak and endocarditis are frequent causes of failure for all valve types . No clear failure mode predominates with mechanical valve prostheses, although some designs have specific inherent limitations . In contrast, degeneration, especially that related to mineralization, is the most important cause of the late failure of contemporary bioprostheses.

Clin Haematol, 1985 Jun, 14(2), 547 - 70
Genetic engineering and coagulation factors; Fass DN et al.; It is unfortunate that we cannot report, in the area of coagulation, advances that have been seen in related fields such as thrombolytic therapy . The reported progress (Gold et al, 1984; Van de Werf et al, 1984) with human recombinant tissue plasminogen activator (Pennica et al, 1983) augers well for the application of recombinant technology to the problems faced by patients with coagulation defects . While plasminogen activator is being assessed in an acute therapeutic setting, its use signals a beginning of the application of the technology to abnormalities of the haemostatic mechanism . Chronic administration of coagulation factors for prophylaxis and replacement therapy would appear to be just one more step down the pathway illuminated by the biochemists, microbiologists and cell biologists who have preceded the clinicians in this promising area . There is no record of the use of genetically engineered materials in the treatment of coagulation defects, primarily because the body of knowledge and refined techniques have only recently been acquired . For this reason we have had to project developments in other areas onto the problems that exist for the haemostatically compromised patient . In describing the potential usefulness of these technologies, it is difficult to ascertain where the logical projection, from a fully investigated model system, diverges from flights of imaginative fancy . Cloning projects considered overly ambitious and grandiose at the beginning of this decade are already accomplished feats . The feasibility of gene therapy in the mammalian system has been demonstrated, and trade publications now discuss governmental approval for investigative use of this procedure in 1985 . Panels of physicians, scientists and even politicians now seriously contemplate and promulgate views and regulations pertaining to the efficacy and ethics of the use of genetic engineering in the treatment of human disease . The haemophilias will certainly be among the first genetic diseases to be approached with the techniques of recombinant DNA technology . Diagnostic testing, using cloned DNA, is already underway and therapeutic trials are predicted for the near future . Every observer of this rapidly growing field has to define for himself when the future is . For the potential carrier of haemophilia B, the future is now . For the physician managing the patient with a haemophilic inhibitor, the future can't come soon enough . And, for those who are concerned with man's tampering with the gene pools of living things, from viruses to humans, the future comes too quickly to be dealt with in a rational and understanding way.

J Virol, 1985 May, 54(2), 271 - 7
Locations of bacteriophage T4 origins of replication; Yee JK et al.; Partially replicated bacteriophage T4 DNA containing cytosine was isolated from cells 6.5 and 7 min after infection and cleaved with restriction endonuclease BglII or BamHI . Positions of replication eyes relative to the cleavage sites were observed by electron microscopy . Four groups of eyes were found . They are consistent with replication from origins located at map positions 34, 60, 73, and 86 kilobases . In individual molecules that contained two or three eyes, the distribution of the eyes agreed with the initiation of replication at more than one of these four assigned origins and possibly at two additional origins located near 15 and 110 kilobases, which were reported by P . M . Macdonald, R . M . Seaby, W . Brown, and G . Mosig (p . 111-116, in D . Schlessinger, ed., Microbiology--1983, 1983) and M . E . Halpern, T . Mattson, and A . W . Kozinski (Proc . Natl . Acad . Sci . U.S.A . 76:6137-6141, 1979).

Pathol Biol (Paris), 1985 May, 33(5), 365 - 7
{Cefmenoxime diffusion into cerebrospinal fluid during human purulent meningitis}; Stahl JP et al.; We treated 10 patients with bacterial meningitis by 150 mg/kg/day cefmenoxime divided into six intravenous infusions . CSF samples were taken one hour after an IV on the second and fifth days . CSF cefmenoxime determined by microbiologic assay was 8.3 mg/l on days 2 and 5 . Every patient recovered without sequelae . In our opinion, these results may support use of cefmenoxime in bacterial meningitis.

J Periodontol, 1985 May, 56(5), 265 - 72
Periodontal disease treatment by local drug delivery; Goodson JM et al.; The subgingival microbiologic composition of diseased periodontal sites was evaluated by darkfield microscopy before and after scaling or local delivery of tetracycline . A standardized sampling and counting method using a crevicular washing technique was developed to determine both numbers and proportions of morphotypes using darkfield microscopy . Tetracycline-loaded hollow fibers established an initial intrasulcular concentration of 200,000 micrograms/ml, which decreased exponentially to 15 micrograms/ml in 24 hours . Repetitive intrasulcular placement of these fibers at periodontitis sites produced an incremental reduction in bacterial counts over a 10-day period . Monolithic fibers made of ethylene vinyl acetate loaded with 25% tetracycline hydrochloride provided sustained release for 10 days under in vitro test conditions . Ten patients were treated in a study comparing the effects of these fibers with scaling . Fibers were placed subgingivally to fill pockets to their probable depth and covered with a periodontal dressing which was maintained for 10 days . The average intrasulcular tetracycline concentration measured at the end of the 10-day period was 643 micrograms/ml . At these sites, total counts, spirochetes, motile rods and nonmotile rods were significantly reduced immediately following treatment . Total counts were depressed to levels near the detection limit of darkfield microscopy . In comparison, scaling produced much smaller alterations of darkfield counts which were not statistically significant.

J Clin Periodontol, 1985 May, 12(5), 374 - 88
Scaling and granulation tissue removal in periodontal therapy; Lindhe J et al.; The present clinical trial was performed to study whether subgingival scaling is a method of therapy which is equally effective as "access" flaps in reducing gingivitis and probing depths and in improving probing attachment levels . The study was also designed to assess whether granulation tissue removal is a determining factor for proper healing in the treatment of periodontal disease . 15 patients with advanced periodontal disease were included in the study . Each patient had at least 4 sites in each quadrant of the jaws with probing depths exceeding 6 mm . A baseline examination was performed to assess the following parameters: the oral hygiene status, the gingival conditions, the probing pocket depths and the probing attachment levels . In addition, in each quadrant, 3 approximal sites were selected for analysis of the subgingival microbiota . All of these sites showed signs of gingivitis . One site had a probing depth of less than 4 mm, another a probing depth between 4 and 6 mm and the third site had a probing depth exceeding 6 mm . The subgingival bacterial samples were studied by dark-field microscopy and the % of spirochetes and motile rods was assessed . By random selection the 4 jaw quadrants in each patient were treated for periodontal disease by the use of (1) the modified Widman flap procedure, (2) the modified Kirkland flap procedure or by (3) nonsurgical scaling and root planing . In all, 20 quadrants were treated with each of the 3 procedures . After the termination of active periodontal treatment, all patients were recalled for professional tooth cleaning once every 2 weeks during a 12-week period . Subsequently, they were recalled for prophylaxis every 3 months . The patients were examined 6 and 12 months after treatment using the same parameters as used at baseline . The data from the examinations demonstrated that subgingival scaling is an effective measure in the treatment of periodontal disease . Both in terms of average gingivitis resolution and average probing depth reduction, non-surgical therapy appeared to be equally effective as a surgical approach to treatment . It was also observed, however, that following non-surgical treatment, a larger number of sites with pockets exceeding 6 mm remained than following surgical therapy . Most of these deep pockets in non-surgically treated quadrants bled on probing to the base of the pocket . In addition, the subgingival microbiota of such sites were found to harbor more than 20% spirochetes and motile rods.(ABSTRACT TRUNCATED AT 400 WORDS)

J Virol, 1985 May, 54(2), 623 - 4
A candidate for a new serotype of human rotavirus; Matsuno S et al.; We investigated genetic and serological characteristics of a human rotavirus isolate from Indonesia which had a "super short" RNA electrophoretic pattern (A . Hasegawa, S . Inouye, S . Matsuno, K . Yamaoka, R . Eko, and W . Suharyono, Microbiol . Immunol . 28:719-722, 1984) . This virus, strain 69M, was found by RNA-RNA hybridization to have a low degree of homology with the representative strains of all four human serotypes . Furthermore, it could not be classified by neutralization analysis into any of these serotypes . Therefore, this virus might belong to a new serotype.

Wien Klin Wochenschr, 1985 Apr 12, 97(8), 346 - 9
{History of the Institute for General and Experimental Pathology of the University in Vienna}; Wyklicky H; Salomon Stricker became the first head of the Department of General and Experimental Pathology, which was inaugurated by Rokitansky . Stricker, who was originally a histologist, recognized, in the colouring matters with which he treated surviving tissue, also the function of reagents . Knoll urgently requested a ward to be attached to the department . Paltauf extended the field of work by dissection for experimental pathology, microbiology of pathogenic germs, pathological morphology and chemistry . Rothberger's research concerning the anatomical basis of electrocardiography originated here . The department was closed down before 1938 . Its revitalization came in 1956 by Adolf Lindner.

Am J Med, 1985 Apr, 78(4), 703 - 7
Wangiella dermatitidis endocarditis in an intravenous drug user; Vartian CV et al.; Wangiella dermatitidis is an infrequently encountered dematiacious fungus that usually causes localized infections of the skin and subcutaneous tissues . This report presents the first well-documented case of natural valve infection caused by this organism as it occurred in intravenous drug abuser . His course has been complicated by relapsing infection of two aortic prostheses and dissemination to the vertebral spine . Treatment with a combination of amphotericin B, rifampin, and ketoconazole has arrested the progression of his infection . The microbiologic features and existing clinical information regarding this fungus are reviewed and in vitro susceptibility data for the present isolate are presented.

J Laryngol Otol, 1985 Apr, 99(4), 327 - 33
Otomycosis--a continuing problem; Mugliston T et al.; The microbiology of 12,174 symptomatic ears presenting over an eight-year period to one hospital was examined in detail . 1,061 cases of fungal infection were found . The incidence and pattern of these fungi and the accompanying bacteria, in cases of mixed infection, do not appear to have been affected by the widespread use of powerful topically-applied antibiotic/steroid preparations over more than two decades . Otomycosis remains an uncommon, often overlooked but important cause of morbidity in a temperate climate.

Can Med Assoc J, 1985 Apr 1, 132(7), 750 - 2
Statement on human milk banking . Nutrition Committee, Canadian Paediatric Society; Development of a computerized infectious disease monitor (CIDM); At the LDS Hospital in Salt Lake City, an interface was developed between the microbiology laboratory computer system and the HELP integrated central hospital computer system . The HELP system includes medical information from most clinical care support areas . The microbiology data are translated from the laboratory computer file structure to a hierarchical data structure on the HELP system . A knowledge base was created with the help of infectious disease experts, and became part of a Computerized Infectious Disease Monitoring system (CIDM) . The knowledge base is automatically activated when specific microbiology data are entered into a patient's computer file (data driven), thus decisions are made automatically with no additional effort required of medical personnel . The CIDM was designed to inform infectious disease personnel when a patient has one of the following conditions: a hospital-acquired infection, an infection at a normally sterile body site, an infection due to a bacteria with an unusual antibiotic sensitivity pattern, an infection for which the patient is not receiving an antibiotic to which the offending bacteria is sensitive, an infection that could be treated with a less expensive antibiotic, an infection which is required by law to be reported to state and national health authorities, and those patients receiving prophylactic antibiotics longer than is medically indicated . All of the microbiology data are now extensively reviewed by nurses and physicians from terminals at nursing stations or intensive care units . The CIDM is currently being used for hospital-acquired infection surveillance at LDS Hospital.

Am J Orthod, 1985 Apr, 87(4), 294 - 302
The effect of topical fluoride treatment on enamel fluoride uptake and the tensile bond strength of an orthodontic bonding resin; Bryant S et al.; Enamel demineralization occurring adjacent to directly bonded orthodontic attachments is of great concern to orthodontists . The topical application of fluorides to enamel surfaces before acid etching and the bonding of the attachments is not recommended by many investigators . The objective of this study was to determine the enamel fluoride acquired from various topical fluoride agents and to determine the effect of the acquired fluoride on the tensile bond strength of an orthodontic bonding system . Fifty extracted maxillary central incisors were mounted in cups and the facial surfaces of the crowns were polished on 600-grit silicon carbide paper . Enamel microbiopsies were performed just off the midpoint of each tooth . Ten teeth served as controls and received no topical fluoride treatment, while a similar number were treated with either APF, SnF2, Duraphat, or Fluor Protector . The teeth were suspended in synthetic saliva 4 minutes after fluoride application . The topical fluoride agents were removed after 24 hours and the teeth were again suspended in synthetic saliva at 37 degrees C for 7 days . Enamel biopsies were again performed just off the midpoint of each tooth on the side not previously biopsied . The enamel surfaces were etched for 1 minute and the tensile bond strength of Concise orthodontic bonding system to the etched enamel surfaces was determined . The enamel surfaces acquired significantly different amounts of fluoride from the topical fluoride agents, but the bond strengths to these surfaces were not significantly different . The results of this in vitro study suggest that the application of topical fluoride agents to enamel surfaces 7 days before the bonding of orthodontic attachments will not have an adverse effect on bond strength.

Am J Clin Pathol, 1985 Apr, 83(4), 520 - 1
Babesiosis: problems in diagnosis using autoanalyzers; Bruckner DA et al.; A 76-year-old white man previous diagnosed as having Waldenstrom's macroglobulinemia continued with persistent fevers and sweats for two and a half years . Recently, repeated automated differentials during 11 days of hospitalization failed to note any intracellular inclusions in the RBCs . Blood sent to the Microbiology Laboratory was noted to contain Babesia species . A review of the hematology slides revealed that Babesia species was present on all the slides the analyzer had screened . This failure to note infected RBCs may pose serious diagnostic problems.

Appl Environ Microbiol, 1985 Mar, 49(3), 678 - 81
Macrocyclic trichothecene toxins produced by Stachybotrys atra strains isolated in Middle Europe; Bata A et al.; A total of 17 strains of Stachybotrys atra isolated in Hungary and Czechoslovakia were cultured on Sabouraud agar, and the toxins produced by them were chemically analyzed by gas-liquid chromatography, high-pressure liquid chromatography, and mass spectroscopy . Furthermore, brine shrimp (Artemia salina) bioassay was used for the determination of toxicity of the compounds examined . Macrocyclic trichothecenes (satratoxins H and G, roridin E, and verrucarin J as well as two other unidentified macrocyclic trichothecenes) were found in all of the cultures tested . The identities of satratoxins H and G, roridin E, and verrucarin J were qualitatively determined by high-pressure liquid chromatography and gas-liquid chromatography . The ratio of satratoxins H and G and roridin E was found to be similar in each of the strains tested, but the amount of verrucarin J found was different in each of them . One of the unidentified macrocyclic trichothecenes was equivalent to the compound isolated by Harrach et al . (Harrach et al., Appl . Environ . Microbiol . 41:1428-1433, 1981) . The other one proved to be a newly isolated macrocyclic trichothecene toxin . Stachybotryotoxicosis, one of the oldest mycotoxicoses known, and a serious problem in Middle Europe (Gy . Danko, Magy . Allatorv . Lapja 31:226-232, 1976), is believed to be caused by macrocyclic trichothecene toxins produced by Stachybotrys atra (R . M . Eppley, in Rodricks et al., ed., Mycotoxins in Human and Animal Health, p . 285-293, 1977) . Forty years ago, the death of animals in the Soviet Union was associated with this fungus (C . U . Ruhliada, in Proceedings of the All-Union Sci . and Tech . Conf., p . 47-51, 1980).(ABSTRACT TRUNCATED AT 250 WORDS)

Clin Lab Med, 1985 Mar, 5(1), 19 - 58
Packaged commercial bacterial identification systems; Fenn JP et al.; The authors attempt to provide a useful and current guide for clinical microbiologists who are seeking a review of the available packaged commercial systems for bacterial identification . Each system is outlined according to test principle, laboratory procedures, turn-around time, and limitations . Selected peer evaluations and references for many of the systems are also cited.

Trop Geogr Med, 1985 Mar, 37(1), 77 - 80
Ear, nose and throat diseases in Saudi Arabia . Microbiology and clinical observations; Hossain A et al.; Clinical specimens from 243 patients attending the ENT clinics at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia were investigated for the pathogens attributing to otitis media and tonsillitis . In children as well as in adults with otitis media, the main bacterial causative organisms were Staph, aureus and Ps . aeruginosa; Asp . flavus was detected in 1% and 4% of adult and children cases of otitis media . In tonsillitis H . influenzae, Strept . pneumoniae, Staph . aureus, Strept . gr . A were isolated in only 18% of the children and Strept . pneumoniae, Strept . gr A in 16% of adults . A possible involvement of viruses in tonsillitis is indicated.

Am J Vet Res, 1985 Mar, 46(3), 547 - 53
Experimental bovine respiratory syncytial virus infection in conventional calves: light microscopic lesions, microbiology, and studies on lavaged lung cells; Castleman WL et al.; Conventionally raised male Holstein calves, 1 month of age, were infected by intranasal and intratracheal inoculation with bovine respiratory syncytial virus . Viral antigen was identified by fluorescence microscopy most commonly in the cytoplasm of tracheal and bronchial epithelial cells 3 to 5 days after inoculation . Cytoplasmic viral antigen was identified also in nasal, nasopharyngeal, bronchiolar, and alveolar epithelial cells and in alveolar macrophages . Bronchitis and tracheitis, characterized in part by epithelial necrosis, formation of syncytial epithelial cells and epithelial hyperplasia, were the most common lesions observed histologically . Rhinitis, bronchiolitis, and interstitial pneumonia were observed less frequently . Alterations were not detected in the numbers of cells recovered by bronchoalveolar lavage after inoculation . An increase in the phagocytic rate of latex beads occurred in macrophages 5 days after inoculation . Viral-induced lesions were resolved by 30 days after inoculation . The results indicated that bovine respiratory syncytial virus inoculation of calves results in reversible alterations in airway epithelial structure and in the phagocytic function of alveolar macrophages.

J Laryngol Otol, 1985 Mar, 99(3), 289 - 91
Ear involvement in human brucellosis; Elidan J et al.; A case report of mixed-type hearing loss following brucella infection is presented . Damage to the ear in brucellosis is well documented in the Polish literature whereas, surprisingly, it is not mentioned in the otolaryngologic and microbiologic English literature . Otolaryngologists should be aware of possible ear damage in brucellosis, in order to be helpful in the diagnostic process, with the aim of starting antibiotic treatment as soon as possible, in order to prevent irreversible ear damage.

JPEN J Parenter Enteral Nutr, 1985 Mar-Apr, 9(2), 179 - 88
Blood vitamin levels of long-term adult home total parenteral nutrition patients: the efficacy of the AMA-FDA parenteral multivitamin formulation; Shils ME et al.; Although the AMA-FDA parenteral adult multivitamin formula is now widely used, there are no published data on the efficacy of this formulation in maintaining adequate vitamin nutriture in patients on long-term parenteral nutrition . Blood levels of its constituent nutrients were determined in 16 clinically stable home total parenteral nutrition patients with severe gastrointestinal dysfunction, the majority of whom had been on home total parenteral nutrition for 1 to 9 yr and most of whom were ingesting some food orally . The daily formula (MVI-12) was added to the basic total parenteral nutrition formula in 2-day batches; the vitamins were thus infused approximately 3 hr after preparation on day 1 and after 27 hr on day 2 . The duration of infusions was from 8 to 16 hr . Blood was drawn approximately 36 hr after completion of the last vitamin infusion . Plasma, trichloroacetic acid-treated plasma, and whole blood were frozen until analyzed for the vitamins by microbiologic or chemical methods . All vitamin levels, except for vitamin D metabolites, were measured four times in each patient between the 4th and 36th wk while receiving daily MVI-12 . Single determinations of 25-OH and 1:25 (OH)2 vitamin D were made in eight of the 16 patients between the 61st and 84th wk while on MVI-12 . Repeat values during this extended period were also made on five of the patients for vitamins A and E . These values were compared with serum vitamin levels obtained on an earlier formulation (MVI concentrate, Berocca C, and folate each given twice weekly and B12 given once weekly) . The AMA-FDA formula given daily maintained blood levels above the lower normal limits for most of its constituent vitamins and vitamin D metabolites for the great majority of stable home total parenteral nutrition adults with unexplained occasional exceptions . However, almost half of the vitamin A levels and some of the pantothenate and biotin values were above the normal range; these tended to be associated with the presence of renal disease . Ascorbic acid and thiamin levels tended to be clustered in the lower normal range . Because of evidence for loss of ascorbic acid standing in total parenteral nutrition solutions for 24 hr prior to infusion, it is recommended that the vitamin formulation be added to the total parenteral nutrition solution just prior to infusion.

Am Ind Hyg Assoc J, 1985 Mar, 46(3), 154 - 61
A synopsis of agricultural respiratory hazards; Popendorf W et al.; This report summarizes the current state of both knowledge and programs concerning a wide range of respiratory hazards facing agricultural producers including cotton dust, grain dust, agricultural chemicals, organic and inorganic dusts, and microbiologic and immunologic agents . Comparisons and criticisms are made among the hazards on the basis of their epidemiology, their occurrence within the agricultural setting, and current approaches, interest, and support for evaluating and controlling the hazard . This report was prepared as both an overview of the technical issues and as a focal point of organizational concern for what appears to be a very broad and largely underrecognized spectrum of occupational health hazards affecting large segments of the agricultural industry . The difficulties confronting research and human health in these areas are at once technical, sociological, and organizational in nature, and remain a challenge to the industry, to government, and to the health profession.

Nurs Clin North Am, 1985 Mar, 20(1), 171 - 9
Microbiologic aspects of infection in the compromised host; Ristuccia P; The severe morbidity and mortality associated with infection in the compromised host is a serious problem . Many infections are caused by organisms considered to have a low degree of pathogenicity under normal circumstances . It is essential to have rapid procedures available to isolate and identify these etiologic agents of infections so that rational therapy is begun.

J S Afr Vet Assoc, 1985 Mar, 56(1), 25 - 9
Arthropod-borne virus zoonosis surveillance in the Cape Province: 1 . Prospective serological investigations for virus activity in the Beaufort West and Middelburg Districts during 1981; van der Riet FD et al.; In addition to the routine sero-epidemiological surveillance for arthropod-borne viral zoonoses in the Cape Province carried out by the Department of Medical Microbiology and State Health Department of Virology laboratory, we conducted a prospective serological investigation for virus activity during 1981 in two districts of the Province, namely the Beaufort West and Middelburg districts, which experienced heavy rainfall during the first two months of that year . The approach used was to obtain paired serum samples from identified domestic stock representative of several species from 2-5 months apart and to test them for haemagglutination inhibition antibodies to Rift Valley fever, Wesselsbron and Middelburg virus antigen preparations in order to ascertain, as an indication of viral activity, whether changes in antibody levels occurred between the collection dates . The results indicated that there was probable activity of Rift Valley fever virus and activity of Wesselsbron virus (or related flaviviruses) and Middelburg virus (or related alphaviruses) in the Karoo between the middle of February and the end of July 1981 . Despite this activity and heavy rainfall registered at meteorological stations in both the Beaufort West and Middelburg districts as well as general reports of heavy rainfall and considerable mosquito activity over widespread areas of the Karoo, Eastern and S.W . Cape Province, there were no epizootics or epidemics of overt arthropod-borne zoonotic viral disease in the province during 1981.

Eur J Biochem, 1985 Feb 15, 147(1), 207 - 15
Fructose-1,6-bisphosphatase from Synechococcus leopoliensis . Substrate-dependent dimer-tetramer interconversion; Gerbling KP et al.; Extracts of Synechococcus leopoliensis (Anacystis nidulans) contain two forms of D-fructose-1,6-bisphosphatase (EC 3.1.3.11) previously designated as forms A and B {Gerbling, K.-P., Steup, M., and Latzko, E . (1984) Arch . Microbiol . 137, 109-114} . Form B, which probably represents the major part of the total extractable fructose-1,6-bisphosphatase activity, has been purified to apparent homogeneity . Gel filtration, non-denaturing polyacrylamide gel electrophoresis, and cross-linking with bis(sulfosuccinimidyl)suberate revealed that the fructose-1,6-bisphosphatase B exists in either a dimeric or in a tetrameric subform, depending upon the absence or presence of fructose-1,6-bisphosphate and Mg2+ . The dimer--tetramer interconversion was readily reversible . The results provide evidence for a two-step activation of fructose-1,6-bisphosphatase B involving the reduction of the dimeric subform and the subsequent substrate-dependent conversion of the reduced dimer to a reduced tetramer, which is the only catalytically active state . In contrast to form B, no substrate-dependent interconversion was detected with form A from S . leopoliensis.

J Biol Chem, 1985 Feb 10, 260(3), 1730 - 3
An interferon-induced mouse protein involved in the mechanism of resistance to influenza viruses . Its purification to homogeneity and characterization by polyclonal antibodies; Horisberger MA et al.; Interferon-alpha + beta (IFN-alpha + beta) plays a central role in the specific resistance to influenza virus infection of those mice carrying the gene Mx (for review, see Haller, O . (1981) Curr . Topics Microbiol . Immun . 92, 25) . Particularly, mouse IFN-alpha + beta induces a unique protein in cultivated Mx-bearing cells which is associated with a highly efficient and specific antiviral resistance to influenza viruses (Horisberger, M . A., Staeheli, P., and Haller, O . (1983) Proc . Natl . Acad . Sci . U . S . A . 80, 1910) . In this report, a procedure is described for the induction of this protein in several organs of Mx-bearing mice and a method for its purification from liver tissue . The protein Mx is nucleophilic and has a Mr approaching 78,000 . It is not concentrated in nucleoli and it is not tightly bound to chromatin or nuclear matrices . Polyclonal antibodies to the protein Mx were raised in BALB/c mice . They recognized the protein Mx immobilized on nitrocellulose in a dot immunoassay and they immunoprecipitated the IFN-induced protein Mx from cultivated Mx-bearing cells labeled with a radioactive tracer.

Aust J Exp Biol Med Sci, 1985 Feb, 63 ( Pt 1), 99 - 107
Microbiology of chronic otitis media with effusion among Australian Aboriginal children: role of Chlamydia trachomatis; Dawson VM et al.; Serum, eye secretions, post-nasal swabs, external ear swabs and middle ear effusions (MEE) were collected from 131 Australian Aboriginal children with chronic otitis media with effusion (COME) . The children were all resident in a trachoma endemic region . Chlamydia trachomatis was recovered from the MEE of 2 children . Probable bacterial pathogens were isolated from 34 (12.7%) ears . The remainder were sterile (52.4%) or contained normal skin flora (34.9%) . Serum and secretions were examined by the microimmunofluorescent technique for the presence, titre and serotype of anti-chlamydial antibody . Antibody, predominantly of the C serotype, was found in a high percentage of sera (80%) and secretions (approximately 50%) . This serotype is associated with ocular trachoma . It is concluded that C . trachomatis is associated with COME among some Aboriginal children in this trachoma endemic area.

J Pediatr, 1985 Feb, 106(2), 243 - 6
Mycotic cervical lymphadenitis following oral mucositis in children with leukemia; Shenep JL et al.; Four children developed mycotic cervical lymphadenitis while receiving cytotoxic chemotherapy for acute leukemia . Neutropenia, oral mucositis, and broad-spectrum antibiotic administration preceded the appearance of lymphadenitis in each case . Enlarged tender cervical lymph nodes of mycotic origin were not clinically distinguishable from lymphadenitis of bacterial or viral origin . Although cervical lymphadenitis was the initial clinical manifestation of deep fungal infection, computerized tomography of the chest and abdomen subsequently demonstrated asymptomatic pulmonic, splenic, or hepatic lesions characteristic of fungal abscesses in all four children . These findings demonstrate the importance of microbiologic identification of the etiologic agents of cervical lymphadenitis following mucositis and neutropenia in children with leukemia.

J Clin Pathol, 1985 Feb, 38(2), 215 - 21
Microcomputer system for multistep specimen processing and reporting in a microbiology laboratory; Ashley R et al.; A microcomputer system for use in the sequential processing of specimens has been developed in a hospital microbiology department which receives 90 000 specimens a year . Data handling is performed directly through the computers without the use of cards or worksheets . The system facilitates the multistep processing of specimens and the servicing of results inquiries and provides an alphabetical daysheet of completed and incomplete work, report form printout, and automatic transfer of reported data to an existing on line database . The system includes on line break point antibiotic sensitivity testing and multipoint agar organism identification . The hardware was purchased as required at small cost per unit, and the software was written by the authors . More than 80% of specimens received are processed using the computers, the remainder being under development . The system has been running for three years without major breakdown.

J Clin Pathol, 1985 Feb, 38(2), 208 - 14
A study of workload units in five microbiology laboratories; Cartwright RY et al.; A study of a modified Canadian unit system of measuring laboratory workload was undertaken in five joint Public Health Laboratory Service and hospital microbiology laboratories . Ten percent of the specimens received over six months were sampled, the number of units expended on each was recorded, and the results were analysed on a central computer . The process of gathering information in the absence of laboratory computers was time consuming and, despite careful planning, differences were found in the recording practices of the laboratories . The analysis of results did not lead to major changes in data gathering techniques because the same information about laboratory workload could be obtained by collecting numbers of clearly defined specimens . Analysis of workload units could be useful for particular purposes, such as comparing differences between laboratories using different techniques for the same investigation or assessing the possible benefits of automation . It must be appreciated, however, that workload units are measures of quantity not of laboratory performance.

Am J Infect Control, 1985 Feb, 13(1), 7 - 15
Surveillance for the detection of nosocomial infections and the potential for nosocomial outbreaks . II . Development of a laboratory-based system; Parkhurst SM et al.; We describe the development of a surveillance system that uses thresholds for detecting nosocomial infections and the potential for nosocomial outbreaks based on data from microbiology laboratory records at our hospital from 1980 to 1982 . These records were monitored weekly to determine the number of positive isolates by the identity of the organism and by the site of the culture . A mean of 225 specimens was processed weekly, with 60 of these yielding bacteria or fungi . The average number of organisms isolated per positive culture was 1.46 . Two methods of establishing thresholds were compared, one based on percentiles of ranked isolates, the other based on the mean plus intervals of standard error . The system using thresholds established by the standard error method was consistently more useful to highlight weeks for which there was high risk of a problem occurring in less time than were the surveillance techniques traditionally employed.

Am J Hosp Pharm, 1985 Feb, 42(2), 313 - 5
Computer-assisted concurrent antibiotic review in a community hospital; Scarafile PD et al.; A computer-assisted program that monitors the appropriateness of antibiotic prescribing by matching microbiology reports and patient drug profiles is described . An antibiotic review committee in conjunction with the quality assurance department developed the computer-assisted antibiotic review program . An antibiotic order sheet was incorporated into the physicians' order form . Automatic stop dates were assigned according to the reason the antibiotic was ordered, e.g., surgical prophylaxis or documented infection . Numerous reports are generated from the data gathered from the physicians' order form . A drug/microbiology report is used to match patients' antibiotic drug profiles with their microbiology culture and sensitivity results . This report identifies all patients who have been receiving antibiotics for 72 hours or longer with sensitivities on file and mismatched sensitivity results . All mismatches that are considered important are investigated . Any actions taken are reported to the antibiotic review committee for peer review . The computer-assisted program has helped this hospital screen large populations of inpatients receiving antibiotics . The concurrent review of the drug/microbiology report has made it possible to detect within 24 hours, patients who are receiving antibiotics inappropriately . A computer can be used to perform daily concurrent antibiotic use review as a by-product of order entry by both the pharmacy and laboratory.

J Virol, 1985 Feb, 53(2), 495 - 500
Physical locus of the DNA polymerase gene and genetic maps of bacteriophage T5 mutants; Fujimura RK et al.; Segments of DNA that contained the DNA polymerase gene of bacteriophage T5 were isolated . The physical locus of the gene was identified by transforming Escherichia coli with purified DNA fragments generated by restriction enzyme digestions, and the transformed cells were used to rescue amber mutants of T5 with mutations in the gene for DNA polymerase . The method is applicable to any other gene that has mutations with low reversion frequencies . We studied the following mutations of the T5 DNA polymerase gene, reading from left to right by the standard convention (D . J . McCorquodale, Crit . Rev . Microbiol . 4:101-159, 1975): D7, D8, aml, ts5E-ts53, am6, and D9 . These loci were found to reside within three pieces of DNA with a total length of 3,600 base pairs . Because the structural gene for T5 DNA polymerase is estimated to be 2,600 base pairs long, the whole structural gene may reside in these segments . These are located 58.3 to 61.3% of the distance from the left end of the DNA . The left-end piece of the DNA (1,100 base pairs) containing the polymerase gene has loci D7 and D8, and the right-end piece (1,600 base pairs) has locus D9, according to the results of the transformation assay . These results are consistent with the genetic map.

J Gynecol Obstet Biol Reprod (Paris), 1985, 14(6), 675 - 80
{Hydrosalpinx and sterility . Value of studying tubal microbiopsies using scanning electron microscopy}; Lescoat D et al.; Microbiopsies were taken from the tubes of 13 women who were sterile with hydrosalpinges . They were studied using scanning electron microscopy . It was possible to point out several degrees in the evolution of these lesions of the tubal epithelium . These lesions occurred in the fimbrial portion, the ampulla and the isthmus of the tubes . The value of this investigation in diagnosis and prognosis in cases of sterility due to hydrosalpinx is discussed.

Educ Med Salud, 1985, 19(2), 173 - 86
{A contemporary model of environmental health sciences: its application in the recruitment of faculty and in academic development}; Guidotti TL et al.; The authors describe the development and application of an intellectual model fitted to the environmental health sciences . The model became the basis for the design of a new study plan in addition to providing the strategy for recruitment of the faculty for the new School of Public Health of the San Diego State University in San Diego, California . They give an account of the circumstances leading up to the establishment of this institution, the gradual consolidation of the different health science programs into a single school with graduate studies leading to masters degrees in six main fields: environmental health, occupational health, epidemiology, maternal and child health, health services administration, and health development . The authors see the beginning of a redefinition of the function of the basic sciences represented in environmental health in the light of new knowledge and technology, and believe that all fields of knowledge (microbiology, parasitology and health development) will contribute as a unified whole to increase the capacity of public health to place both biological and environmental health problems in a context that society can control.

Nahrung, 1985, 29(5), 523 - 32
Studies on fish protein concentrate and fish meal from river Nile bolti fish (Tilapia nilotica); Zein GN et al.; Fish protein concentrate (FPC) from river Nile bolti fish (Tilapia nilotica) was prepared and compared with commercial FPC and fresh bolti fish flesh . Fish meal (FM) from bolti fish offals was prepared and compared with commercial FM and also fresh bolti fish flesh . FPC from bolti fish showed a higher crude protein content but less fat, ash, calcium and sand than the commercial sample, while FM from bolti fish showed a higher content of ash and phosphorus than commercial FM but was nearly similar in crude protein, fat, calcium and sodium chloride . FPC from bolti fish had a higher content of lysine, arginine, aspartic acid, glycine and glutamic acid and a lower content of the other free amino acids . The bolti fish FM had a lower content of total amino acids and the contents of the free amino acids cysteine, glycine, aspartic acid, serine, alanine, valine, and methionine increased slightly . The yield was 12% for FPC and 19.5% for FM . Coliform bacteria were not present in both FPC and FM from bolti fish . Low moisture contents of FPC and FM were essential for preventing microbiol growth and to attain a good keeping quality . The FPC and FM from bolti fish reached moisture equilibrium and stopped increasing in weight within 144 to 192 h.

Mikrobiyol Bul, 1985 Jan, 19(1), 9 - 14
{Dermatophytes isolated in the Sivas area of Turkey}; Oztunali O et al.; In the Mycology Laboratory of the Department of Microbiology, Faculty of Medicine, Cumhuriyet University, the following dermatophytes were isolated from clinical specimens sent in for mycological examination: 26% T . rubrum, 21% T . menta, 10% T . shonleinii, 9% M . 12% E . floccosum, canis, 5% T . violaceum, 5% M . gypseum, 12% Candida sp.

Ophthalmology, 1985 Jan, 92(1), 34 - 8
Bimanual endoscopic orbital biopsy . An emerging technique; Norris JL et al.; Diagnostic biopsy specimens from six posterior orbital lesions have been obtained under direct endoscopic view with either a fine needle aspiration or an intracannular microbiopsy forcep . This method is comparable to earlier fine needle aspiration techniques, but has the decided advantage of providing a specimen from visually indentified abnormal tissue . In those cases where inadequate specimens are obtained by fine needle aspiration, a microforcep is used to obtain a substantial specimen . The microinvasive endoscopic biopsy technique of the Orbital Unit at Pacific Medical Center is described with an analysis of six cases . The emerging technology of fiberoptic illumination, minified color video cameras, sophisticated imaging, efficient microsurgical instruments and laser delivery methods make the potential for deep orbital endoscopic microinvasive surgery exciting.

J R Coll Physicians Lond, 1985 Jan, 19(1), 7 - 9
Future consultant staffing in communicable and tropical diseases . A report of the Royal College of Physicians; The "atypical" mycobacteria: recognition and disease association; Although techniques based on immunologic or chromatographic analyses have been described for identifying mycobacteria in clinical laboratories, most microbiologists continue to rely on a series of specialized physiological and biochemical tests for this purpose . The recognition of additional significant species over the past decade has required the addition of more tests to the battery used for mycobacterial identification . This paper will review briefly the taxonomic status of species likely to be encountered in clinical specimens and the most useful tests for characterizing them . Strategies will be presented for using these tests in the most efficient way to provide optimal resolution of taxa without use of an unreasonably large battery of tests . A brief survey of techniques that may become more practical in the future will also be included.

Eksp Onkol, 1985, 7(3), 31 - 4
{Use of nucleic acid preparative electrophoresis in molecular oncological research}; Fedorov SN et al.; Application of preparative electrophoresis in agarose gel for isolation of chromosomal and extrachromosomal genetic elements is described . The above-mentioned method is used for fractionation of chromosomal DNA according to the molecular weight; for isolation of the plasmid containing the insertion of the viral oncogene myc and for separation of the viral oncogene myc insertion from the vector (a linear form of plasmid pBR 322) . The method can be successfully applied in molecular biology, microbiology and medicine.

J Reprod Immunol, 1985 Jan, 7(1), 41 - 57
Auto- and iso-antigens of human spermatozoa detected by immunoblotting with human sera after SDS-PAGE; Naaby-Hansen S et al.; A sodium dodecylsulphate-polyacrylamide gel electrophoretic system for analysis of the proteins of human spermatozoa was established . Subsequent immunoblotting of the gels with human sera gave a reproducible immunolabelling of distinctive polypeptide bands . To identify auto- and isoantigens, 28 well-characterized sera from the WHO Reference Bank for Reproductive Immunology (1977, Acta Pathol . Microbiol . Scand . Sect . C, Suppl . 252) containing agglutinating and complement fixating antibodies (9 female (F) and 19 male (M) and 30 normal sera (14 F and 16 M) were analysed with reference to binding of IgG . Three spermatozoal antigens with Mr values in reduced state of 120,000 (6), 41,000 (6) and 32,000 (15) were found to be specifically correlated to the agglutinating activity of the reactive sea . (The number of these are given in parentheses) . Furthermore, IgG from 2 and 3 of the normal sera and 14 and 17 of the agglutinating sera reacted with 78 and 64 kDA polypeptide, respectively . Identical binding patterns of IgG to spermatozoal polypeptides were obtained with IgG from male and female sera . The IgG-binding could not be correlated to the modes of spermatozoal agglutination . In a similar analysis of the IgM binding antigens of 21 agglutinating and 12 normal sera no differences in binding between the sera were found, except for a specific reaction to a 78 kDa antigen for 5 of the agglutinating sera.

Can J Surg, 1985 Jan, 28(1), 23 - 4
Mycotic abdominal aortic aneurysm: a case report; Bednar DA et al.; A case of mycotic aneurysm of the abdominal aorta, arising as a complication of subacute bacterial endocarditis in a 75-year-old white woman, is presented . The dramatically expansile nature of this aneurysm is well documented . The history, clinical presentation, etiology, microbiology and surgical management of this rapidly progressive and often fatal condition are discussed through a review of the literature.

Am J Epidemiol, 1985 Jan, 121(1), 140 - 51
Use of epidemiology in medical specialties: an examination by citation analysis; Dannenberg AL; Epidemiologic methods have been applied unevenly among medical specialties . Identifying current uses and areas of potential research helps clarify and define the field . Using citation analysis of published data, the patterns of references to and by the American Journal of Epidemiology were examined for 1974-1982; 17,574 citations to and 15,872 citations by that Journal were classified according to the subject category of the referencing or referenced journal . Internal medicine and public health/epidemiology journals accounted for the largest proportion of all citations, followed by journals of immunology, cancer, microbiology, pediatrics, cardiovascular system, virology, tropical medicine, statistics, and obstetrics/gynecology . Few citations to or by the Journal were found in the allergy, anesthesiology, dermatology, geriatrics, hematology, nephrology, orthopedics, otorhinolaryngology, radiology, rheumatology, and urology journals . Examination of citations between clinical and epidemiologic literature suggests that adequate interchange between clinicians and epidemiologists is occurring . Citation analysis results for the American Journal of Epidemiology were significantly correlated (p less than 0.05) with those from a MEDLINE search on epidemiologic methods used in research in 22 clinical specialties . Despite inherent limitations, citation analysis appears to be a useful tool for examining interactions and trends in epidemiology and for identifying fields which may be ripe for new epidemiologic studies.

Epidemiol Rev, 1985, 7, 127 - 46
Epidemiology of genital herpes simplex virus infection; Guinan ME et al.; PIP: This paper offers a comprehensive review of the literature on the epidemiology of genital herpes simplex virus infection . Topics covered include its microbiology, immunology, incidence, prevalence, pathogenesis and clinical course, diagnosis, treatment, transmission, prevention, and effect on pregnancy outcome . The prevalence of genital herpes is estimated at 20 million persons in the US, about 25% of whom are symptomatic . Determination of the actual incidence and prevalence of genital herpes requires the availability of methods able to distinguish precisely between type 1 and type 2 antibody . Indirect evidence suggests an increasing incidence of the disease over the past 15 years . Asymptomatic infected persons may shed virus in the absence of lesions and thus transmit genital herpes to their sexual partners . Of particular concern is vertical transmission of virus from the maternal genital tract to newborns . In the majority of documented cases of neonatal herpes, the mothers were asymptomatic at the time of delivery . Because of the severe morbidity and mortality associated with neonatal herpes infection, studies are urgently needed to identify risk factors for vertical transmission and to design and test appropriate preventive intervention strategies . At present, treatment of genital herpes is limited to palliative therapy . No known antiviral agent either prevents or eliminates viral latency, although vaccines are under development for primary prevention . The role of contraceptive practice in the prevention of genital herpes infection is unclear . Although theoretically plausible, the efficacy of barrier methods in decreasing the risk of acquiring or transmitting infection has not yet been demonstrated . Virus may be present in areas not covered by condoms . Use of a spermicidal cream or jelly with a diaphragm may reduce the risk of virus infection and transmissions, but, again, this method cannot protect from virus transmission to or from the external genitalia .

Am J Physiol, 1985 Jan, 248(1 Pt 2), F152 - 9
ATP and cAMP system in the in vitro response of microdissected cortical tubules to PTH; Kiebzak GM et al.; Responsiveness of proximal convoluted tubule (PCT) and distal convoluted tubule (DCT) microdissected from mouse kidney to PTH, in terms of cAMP accumulation and stimulation of adenylate cyclase, was examined . In both PCT and DCT, the cell-free adenylate cyclase was stimulated at least 10-fold by the same dose (10 U/ml) of PTH, and activity of cAMP phosphodiesterase was about 80% higher in DCT than in PCT . In intact tubules, while the incubation with PTH increased cAMP content in DCT more than 10-fold, it failed to increase the cAMP levels in PCT . To explain discrepancies between cell-free and intact cell incubations, ATP content in microdissected tubules was determined with use of a microbioluminescence assay . ATP content in PCT (4.0 +/- 1.3 fmol/mm, n = 30) was dramatically lower than ATP content of DCT (376.8 +/- 54.3 fmol/mm, n = 25) . Incubation with 1 microM rotenone reduced markedly (delta -98%) the ATP content in DCT . In DCT, with ATP depleted by 1 microM rotenone, PTH failed to increase the cAMP, although 1 microM rotenone did not inhibit the adenylate cyclase activity . When 0.1 mM of 1-methyl-3-isobutylxanthine (MIX) was added to the incubation medium, PTH caused a marked elevation in tubular cAMP in PCT and to even a greater degree in DCT . Present results show that various segments of microdissected tubules differ greatly in their ability to maintain adequate ATP levels for cAMP generation in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Dev Biol, 1985 Jan, 107(1), 198 - 205
Acquisition process of differentiation competence in Dictyostelium discoideum; Okamoto K; It was previously shown {K . Okamoto, J . Gen . Microbiol . 127, 301 (1981)} that Dictyostelium discoideum cells dissociated from early aggregates, but not aggregation competent cells obtained in a suspension culture, undergo prespore differentiation, when transferred into a medium containing glucose, albumin, and cAMP . Therefore, the former, but not the latter, is considered to have been acquired "differentiation competence." In the present work, the requirements for cells to acquire the differentiation competence are investigated with D . discoideum NC4 strain . On solid substratum, the incubation above a threshold density is absolutely required for this process, while cell aggregation itself is not essential . In suspension cultures, the competence is acquired only under hypertonic conditions . Inhibition of protein synthesis or depletion of cAMP does not affect the acquisition process of the competence . The requirement of hypertonic treatment was also investigated with several other D . discoideum strains.

Histochemistry, 1985, 83(5), 431 - 6
Microquantitative determination of the distribution patterns of alcohol dehydrogenase activity in the liver of rat, guinea-pig and horse; Maly IP et al.; Microquantitative measurements of ADH-activity were carried out on the livers of male and female rats, guinea-pigs and horses (two geldings and a mare) . Lyophilized cryostat sections of liver parenchyma were microdissected the whole way along the sinusoidal length from the terminal afferent vessels to the terminal efferent venule . ADH activity in samples of about 50-150 ng was measured in a microbiochemical assay using the oil-well technique without enzymatic cycling, by direct luminometric determination of NADH . On the basis of the single measurements, mean values of total hepatic ADH activity could be calculated and the specific distribution patterns graphically demonstrated . Total activity of ADH in the liver of the female rat is 1.6 times higher than in the male; the male distribution pattern exhibits a relative maximum in the intermediary zone of the acinus while the activity in the liver of female rats increases towards a perivenous maximum . Mean values for total ADH activity in the livers of male and female guinea-pigs are almost equal and there is, moreover, no clear intra-acinar gradient . Mare and castrated male horses show high hepatic ADH activity which is evenly distributed in the liver acinus.

Microbiol Immunol, 1985, 29(9), 791 - 801
Cloning and expression of the pnd gene of R16: determination of transcriptional direction and evolutionary analysis; Sakikawa T et al.; The gene promoting nucleic-acid degradation (pnd) of IncB plasmid R16 was cloned into the vector plasmid pACYC177 . The pnd gene was found to be located on a 0.55-kilobase (kb) AluI-PstI fragment by constructing subclones carrying various portions of the initially cloned fragment . The direction of transcription of the pnd gene was determined by inserting the gene in both orientations into the lacZ' gene of the plasmid pUR222 . In the recombinant plasmid pCM2, transcription of the pnd gene was controlled by the lac promoter region . Addition of cAMP at 42 C resulted in rapid degradation of stable RNA in cells harboring pCM2 . In contrast, no RNA degradation was observed in cells harboring pCM14, which has the same insert as pCM2 but in the opposite orientation . The equivalent gene, pnd of IncI alpha plasmid R483, has previously been cloned, and a detailed restriction map of the region has been constructed (Akimoto, S., and Ohnishi, Y . 1982 . Microbiol . Immunol . 26: 779-793) . We constructed a detailed restriction map of the pnd region of R16 and compared it with that of R483 . Restriction analyses revealed a similar structure in these two pnd regions . The results suggest that the pnd genes of R16 and R483 have a common evolutional origin.

Infect Control, 1984 Dec, 5(12), 573 - 6
Nosocomial mycobacterial pseudoinfection in a Georgia hospital; Goodman RA et al.; Nosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed . Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981 . Because the patients' clinical illnesses were not uniformly consistent with mycobacterial disease, we hypothesized that pseudoinfections had occurred and searched for a common source of contamination . The investigation suggested that specimen contamination was associated with one microbiology laboratory technician: 6 of 22 (27%) specimens processed by that person were positive compared with 1 of 103 (1%) specimens processed by the other five technicians . However, a specific mechanism of contamination was not identified . Nosocomial pseudoepidemics associated with false infections should be suspected and investigated when clinical features and laboratory findings do not agree.

Am J Infect Control, 1984 Dec, 12(6), 318 - 24
Surveillance for the detection of nosocomial infections and the potential for nosocomial outbreaks . I . Microbiology culture surveillance is an effective method of detecting nosocomial infection; Laxson LB et al.; A study was undertaken to determine the sensitivity and specificity of a laboratory-based surveillance system using numbers of positive cultures in our institution . A randomized retrospective review of 575 medical-surgical patient charts revealed 70 nosocomial infections in 41 patients . Review of microbiology records indicated positive cultures for 71%, cultures obtained but inadequate for 6%, no culture necessary for 7%, and no culture obtained for 16% . Patients over 60 years old were significantly more likely to have a nosocomial infection cultured than were younger patients (p less than 0.025) . There was no significant difference in rate of nosocomial infections classified by clinical service, site of infection, or length of stay in the hospital . By randomly selecting 100 positive cultures and reviewing the charts of the affected patients, we found that 48% represented nosocomial infections . Thus laboratory-based surveillance was 84% sensitive and 48% specific for detecting nosocomial infections.

J Med Microbiol, 1984 Dec, 18(3), 399 - 403
A simplified method for detecting the heat-labile enterotoxin of Escherichia coli; Chapman PA et al.; A tissue-culture method is described that is suitable for screening large numbers of Escherichia coli isolates for heat-labile enterotoxin production . The method uses readily available laboratory media for culture of the E . coli and does not require cell-free extracts . Antibiotics are used to increase toxin production to levels that allow cultures from several different colonies to be pooled for testing, thus minimising the number of tissue-culture monolayers required . Y1 mouse adrenal cells are used in microplate cultures . The method is simple, sensitive and economical and is suitable for use in a routine diagnostic microbiology laboratory.

Biken J, 1984 Dec, 27(4), 169 - 76
Incidences of HBeAg and anti-HBe in, and clinical course of hepatitis B virus carriers; Tsuchie H et al.; A total of 336 hepatitis B virus (HBV) carriers were followed for more than 3 years with serial measurements of serological markers of HBV to determine the correlation between their clinical course and the HBeAg-anti-HBe system . In all, 139 had hepatitis B e antigen (HBeAg) at the beginning of the study . During the study, 30 of 139 HBeAg-positive carriers became HBeAg negative and subsequently gave a positive reaction for antibody to HBeAg (anti-HBe) . The rate of seroconversion was 3.6% per year . Two types of profile of seroconversion were observed, rapid and gradual . No significant differences were observed in the incidences of HBeAg and anti-HBe in HBV carriers with or without liver cirrhosis (LC) and hepatocellular carcinoma (HCC) . These findings do not support the report by Chung et al . (1983, J . Med . Virol . 11: 99-104) that a prolonged replicative phase of chronic HBV infection is essential for the occurrence of HCC . Two HBV carriers were diagnosed as having HCC at the time of seroconversion from HBeAg to anti-HBe . This finding supports the reports by Coursaget et al . (1978, J . Clin . Microbiol . 7: 394-395) and Musca et al . (1983, Hepatogastroenterology 30: 3-5) that actively replicating HBV sometimes becomes defective during the course of malignant transformation.

J Biol Chem, 1984 Nov 25, 259(22), 14088 - 93
Isolation and characterization of thioredoxin f from the filamentous cyanobacterium, Anabaena sp . 7119; Whittaker MM et al.; Two thioredoxin fractions had previously been reported to occur in Anabaena 7119 by Buchanan and co-workers (Yee, B . C., dela Torre, A., Crawford, N . A., Lara, C., Carlson, D . E., and Buchanan, B . B . (1981) Arch . Microbiol . 130, 14-18) . These proteins were detected by their ability to activate spinach fructose-1,6-bisphosphatase (Fru-P2-ase) . The partially purified proteins resembled similar thioredoxins found in spinach chloroplasts and were designated thioredoxin f (Tf) for the fraction most effective in activating spinach Fru-P2-ase and thioredoxin m (Tm) for the fraction most effective in activating spinach NADPH-malate dehydrogenase . Using the assay system of Yee and co-workers, we were able to separate and purify to homogeneity two thioredoxin fractions from Anabaena extracts . Tm corresponded to the thioredoxin fraction we had isolated and studied previously (Gleason, F . K., and Holmgren, A . (1981) J . Biol . Chem . 256, 8301-8309) . The other fraction, Tf, was characterized further . Unlike the thioredoxins found in higher plants, the cyanobacterial thioredoxins do not appear to be related . Anabaena thioredoxin f has a Mr = 25,500 as compared to the more usual Mr = 12,000 for Tm . From a comparison of the amino acid composition, Tf is not obviously a dimer or otherwise related to Tm . Tf has one active center cystine disulfide . Anabaena Tf activates spinach Fru-P2-ase very efficiently but has very little activity with spinach malate dehydrogenase . Anabaena Tf, unlike Tm, does not reduce the homologous ribonucleotide reductase . Anabaena Tf also does not activate a partially purified preparation of Anabaena Fru-P2-ase . We conclude that the cyanobacterial Tf is a unique protein with no structural or functional properties in common with other thioredoxins.

Int Nurs Rev, 1984 Nov-Dec, 31(6), 182 - 3
WHO's first research unit: immunology; Goodman H; The Advisory Committee on Medical Research has just celebrated its 25th anniversary . The first research unit concerned itself with immunology and it provides an excellent example of the foresight of ACMR . Immunological tests are now an integral part of all branches of medicine . All nurses need to have an awareness of the rapid growth of immunology, from its roots in microbiology to its present status as a scientific discipline.

J Clin Pathol, 1984 Nov, 37(11), 1298 - 300
Endocarditis caused by Rothia dentocariosa; Broeren SA et al.; A case of infective endocarditis caused by Rothia dentocariosa is described in a 53 year old man with a history of rheumatic fever . R dentocariosa is a component of the oral microbiota and has only rarely and recently been recognised as a human pathogen . In this patient the oral flora was the probable source of infection, with a broken molar tooth providing the probable avenue for infection.

Am J Clin Pathol, 1984 Nov, 82(5), 597 - 601
Fungal sinusitis in healthy and immunocompromised individuals; Morgan MA et al.; Clinical and microbiologic aspects of fungal sinusitis occurring in six patients are presented . Three of the six patients were immunosuppressed . Fatal disseminated fungal disease developed in two of those immunosuppressed . The three patients with normal immune function had fungal infections confined to the nasal sinuses . Aspergillus fumigatus and Aspergillus flavus were recovered from the immunosuppressed patients and Sporothrix schenckii, Alternaria species, and Pseudallescheria boydii were recovered from the immunocompetent patients . Surgical debridement was performed on all patients; however, anti-fungal therapy only was prescribed in patients who were at risk of progressive fungal disease . The microbiology laboratory aids in the diagnosis of fungal sinusitis by examining surgical biopsy material for fungal organisms and by culturing the material for recovery of the fungal pathogen.

Clin Orthop, 1984 Nov, (190), 14 - 22
Microbiology for orthopaedic surgeons: selected aspects; Monson TP et al.; The treatment and prevention of orthopedic sepsis is based on the principles of any surgical sepsis and the factors that influence the chronicity of infection and microbiology . In the past, the field of orthopedic sepsis has been neglected and has retained the methodologies of previous years without a sharp focus on the principles and pathophysiology of infectious disease . Over the last ten years there has been an increasing interest in orthopedic sepsis along with significant changes in our concepts of antibiotics, principles of treatment, and microbiology . In this article the authors hope to identify the practical uses of clinical microbiology in diagnosing and managing orthopedic infections . The surgeon can use microbiologic techniques in many ways: (a) to determine sterility of wounds, (b) to detect the presence of infection, (c) to estimate the timing of primary closure of acute and chronic wounds and the application of skin grafts, and (d) as guides for the surgeon and infectious disease physician in the choice of appropriate antibiotics.

J Clin Microbiol, 1984 Nov, 20(5), 891 - 3
Importance of culture in laboratory diagnosis of Bordetella pertussis infections; Gilligan PH et al.; Nasopharyngeal secretions from 223 patients were examined for the presence of Bordetella pertussis and B . parapertussis by culturing on Regan-Lowe agar (J . Regan and F . Lowe, J . Clin . Microbiol . 6:303-309, 1977) and by direct fluorescent-antibody testing . B . pertussis was found in 38 patients; B . parapertussis was recovered from 2 . Culturing was more sensitive (38 of 38 patients) than direct fluorescent-antibody testing (26 of 38 patients) for the detection of B . pertussis . Overgrowth by other organisms (7 of 223 patients) was uncommon . The patients with B . pertussis infections were generally less than 1 year old, had received no or one immunization, and had coughing spells but infrequently had whooping cough . Accurate diagnosis of B . pertussis infections should include culturing.

J Periodontol, 1984 Oct, 55(10), 581 - 4
Pulmonary actinomycosis of periodontal origin; Suzuki JB et al.; A case of pulmonary actinomycosis of periodontal origin is presented . Microbiologic testing including culture and typing of multiple systemic and oral lesions revealed the presence of Actinomyces naeslundii and A viscosus in all sites . In addition, biopsies demonstrating branching filamentous forms and "sulfur granules" were found in exudates from the lungs, submandibular region and left quadrants of the oral cavity . Seeding of tooth-associated materials containing Actinomyces sp into the pulmonary field may have resulted in this case of pulmonary actinomycosis . Therapy of the pulmonary and periodontal infections was completed and the patient is maintaining satisfactory health 18 months later.

J Fam Pract, 1984 Oct, 19(4), 491 - 4
Clothing factors and vaginitis; Heidrich FE et al.; Associations of clothing factors and vulvovaginal symptoms, signs, and microbiology were sought in 203 women seeking care at a university family medicine clinic . Clothing factors studied were use of panty hose, underwear for sleep, cotton lining panels, and pants vs skirts . Women wearing and not wearing panty hose had similar rates of vaginitis symptoms and signs, but yeast vaginitis was about three times more common among wearers . Relationships of other clothing factors to vaginitis were not found . Nonspecific vaginitis was not found to be related to clothing.

Surgery, 1984 Oct, 96(4), 642 - 7
Surgonomics: the cost of cholecystectomy; Munoz E et al.; Health care costs presently comprise more than one tenth of the nation's gross national product: One third of these expenditures are made by Medicare-Medicaid . National reimbursement changes for Medicare under a Diagnostic-Related Group system began October 1, 1983 . Hospital charges (excluding physician charges) for all patients who underwent cholecystectomy without common bile duct exploration (Diagnostic-Related group 197 and 198) from Jan . 1, 1983 to March 31, 1983 were examined to quantify mean charges, variances, and components of hospital charges . Twenty-one patients (mean age 46.1 years) underwent elective cholecystectomy and 24 patients (mean age 64.9 years) underwent emergency cholecystectomy . The mean charge for elective cholecystectomy was $4763 +/- $1656; the mean length of stay (LOS) was 8.0 +/- 3.2 days . Low and high trim points were $3211 to $10,639 and 5 to 19 days LOS . Quartile cost analysis of the cost per patient showed that Q1 = 18.5%, Q2 = 21.2%, Q3 = 24.0%, and Q4 = 36.3% . Analysis of services showed that laboratory work (urinalysis, hematology, coagulation, microbiology, and biochemistry) averaged $451 +/- $298 (9.5% of total), room and board $2635 +/- $1044 (55.3% of total), operating and recovery room $924 +/- $167 (19.4% of total), and central supply-pharmacy $350 +/- $158 (7.4% of total) . The mean charge for patients undergoing emergency cholecystectomy was $11,436 +/- $4185; mean LOS was 17.8 +/- 6.5 days . Low and high trim points were $6353 to $19,734; LOS was 9 to 30 days . Services as percent of total were laboratory 15.8%, room and board 53.7%, operating and recovery room 9.14%, central supply-pharmacy 7.3%, and radiology 8.2% . Several important findings are noted: (1) For a given disease there is marked variance of hospital charges . (2) Mean charges of emergency patients were 240% that of elective patients . (3) Consumption of services varies significantly within each group and between groups . This study demonstrates the importance of in depth financial analysis of therapies . This is a first step to identify the components of variance where reduction will not affect quality of care.

Pathology, 1984 Oct, 16(4), 431 - 3
Malaria in Christchurch; Ikram RB et al.; Thirty seven cases of malaria were diagnosed in the Christchurch Hospital Microbiology Laboratory from January 1978 to December 1983 . Cases occurred in most age groups with various occupations . Prophylactic drugs may not give protection because of lack of patient compliance and/or parasite resistance . A case of malaria which recrudesced following treatment recommended in New Zealand is also included.

Obstet Gynecol, 1984 Oct, 64(4), 535 - 8
Topical treatment of flat vaginal condyloma with human leukocyte interferon; Vesterinen E et al.; Human leukocyte interferon cream was evaluated in a double blind placebo-controlled trial in 13 patients with widespread vaginal flat condylomatous dysplasia . Patients applied 12 million units of interferon vaginal cream daily into vagina during four two-week treatment courses separated by one-week intervals . Five of eight patients treated with interferon showed clear remissions in colposcopy . Cytologic examinations, however, revealed cells typical of condyloma in all cases . Two responding patients relapsed one and two months after the treatment . Among five patients using placebo, the lesions remained unchanged in three patients and progressed in two . Interferon treatment did not alter the microbiologic or cytologic picture of Papanicolaou smears, but lymphocytic infiltrations in the stroma next to condylomas were seen in histologic samples . No overt side effects were observed during interferon treatment.

J Bacteriol, 1984 Oct, 160(1), 137 - 42
Induction of superoxide dismutases in Escherichia coli by manganese and iron; Pugh SY et al.; Growth of Escherichia coli B in simple media enriched with Mn(II) resulted in the elevation of the manganese-containing superoxide dismutase, whereas growth in such medium enriched with iron caused increased content of the iron-containing superoxide dismutase . Enrichment of the medium with Co(II), Cu(II), Mo(VI), Zn(II), or Ni(II) had no effect . The inductions of superoxide dismutase by Mn(II) or by Fe(II) were dioxygen dependent, but these metals did not affect the CN- -resistant respiration of E . coli B and did not influence the increase in the CN- -resistant respiration caused by paraquat . Mn(II) and paraquat acted synergistically in elevating the superoxide dismutase content, and Mn(II) reduced the growth inhibition imposed by paraquat, E . coli grown in the complex 3% Trypticase soy broth (BBL Microbiology Systems)-0.5% yeast extract-0.2% glucose medium contained more superoxide dismutase than did cells grown in the simple media and were less responsive to enrichment of the medium with Mn(II) or Fe(II) . Nevertheless, in the presence of paraquat, inductions of superoxide dismutase by these metals could be seen even in the Trypticase-yeast extract-glucose medium . On the basis of these observations we propose that the apo-superoxide dismutases may act as autogenous repressors and that Mn(II) and Fe(II) increase the cell content of the corresponding enzymes by speeding the conversion of the apo- to the holoenzymes.

Ophthalmic Surg, 1984 Oct, 15(10), 837 - 40
Painless endophthalmitis after cataract surgery; Deutsch TA et al.; Pain is one of the classically described symptoms of postoperative bacterial endophthalmitis, and has been thought to be a useful and early warning symptom . Three cases, however, of culture-proved endophthalmitis presented without pain . Detection of abnormal physical findings suggested the diagnosis in each case, and led to the appropriate microbiologic evaluation and therapy . Early and frequent postoperative ocular inspection is the responsibility of the ophthalmologist . Exclusive reliance on symptoms experienced by the patient in the postoperative period is insufficient if complications such as endophthalmitis are to be diagnosed and treated optimally.

Vet Rec, 1984 Sep 22, 115(12), 292 - 5
Exsanguination of animals at slaughter and the residual blood content of meat; Warriss PD; About 40 to 60 per cent of the total blood volume is lost at exsanguination . The loss can be influenced slightly by differences in traditional slaughter techniques and is considerably reduced after cardiac arrest in sheep and cattle . Blood not lost at sticking is probably largely retained in the viscera rather than the carcase . The residual blood content of lean meat is 2 to 9 ml/kg muscle . There is no evidence that this amount is affected by different slaughter methods or that large amounts of residual blood influence the microbiology of meat.

Biochem J, 1984 Sep 15, 222(3), 797 - 804
The phosphorylation of Escherichia coli isocitrate dehydrogenase in intact cells; Borthwick AC et al.; The isocitrate dehydrogenase of Escherichia coli ML308 can be reversibly activated by addition of pyruvate to cells growing on acetate {Bennett & Holms (1975) J . Gen . Microbiol . 87, 37-51} . By using cells pulse-labelled with {32P}Pi we showed that the activation and inactivation of the enzyme in these conditions correlate with its dephosphorylation and rephosphorylation respectively . Incubation of cell extracts prepared during an activation/inactivation cycle with purified isocitrate dehydrogenase phosphatase confirmed that the pyruvate-induced activation of the dehydrogenase goes essentially to completion . The results show that the reversible changes in the activity of the dehydrogenase in cells grown on acetate are solely due to phosphorylation/dephosphorylation . Inactive 32P-labelled isocitrate dehydrogenase was isolated from cells incubated with {32P}Pi in the presence of acetate . Both this material and purified enzyme phosphorylated in vitro were digested with chymotrypsin, and the phosphopeptides were isolated and analysed . Only one phosphopeptide was observed in each case; the results show that the residue phosphorylated in vivo is identical with that phosphorylated by purified isocitrate dehydrogenase kinase in vitro.

Pathologist, 1984 Oct, 38(10), 658 - 60
Purchasing instrumentation for the microbiology laboratory; Matsen JM; Though the decision of whether or not to purchase instrumentation for clinical microbiology depends on the circumstances in the individual laboratory, the author believes that a knowledge of the proper perspective and some general rules will make decision making easier . In this article he presents a list of guidelines.

Vaccine, 1984 Sep, 2(3), 171 - 2
When will prevention of HTLV-III infection be possible?
Tedder R, Weiss R.
Over the last five years, the pattern and prevalence of the Acquired Immune Deficiency Syndrome (AIDS) has taxed microbiologists . The disease has increasingly looked like the result of a transmissible agent which though of low infectivity, has a predilection for certain well-defined social groups . Homosexual men are among the most commonly affected but drug addicts and haemophiliacs are also at risk . The existence of the disease in central Africa suggests also that there may be a natural focus perhaps as the result of interaction between the human population and enzootic animal virus . Nevertheless, the origin of the disease remains obscure.

J Pharmacol Exp Ther, 1984 Sep, 230(3), 550 - 7
Production and antagonism of cutaneous vascular permeability in the guinea pig in response to histamine, leukotrienes and A23187; Rinkema LE et al.; The method of Katayama et al . (Microbiol . Immunol . 22:89-101, 1978) for assessing cutaneous vascular permeability was modified and used to evaluate responses of the dermal vasculature to histamine, leukotriene (LT)C4, LTD4 and the ionophore A23187 . These agonists were given intradermally, whereas antagonists and other types of inhibitors were administered i.v . Histamine was shown to cause vascular leakage via an H1 receptor . No evidence for H2 receptor activation or involvement of cyclooxygenase products was found . The results also suggested that a portion of the response to histamine was due to the liberation of LTD4 . LTC4 produced a mixed response comprised of vasoconstriction and increased vascular permeability, the latter possibly due to its conversion to LTD4 . FPL 55712 antagonized LTD4-induced permeability in a dose-dependent manner, whereas indomethacin had no effect . Neither pyrilamine nor FPL 55712 reduced the response to A23187 . A dose of indomethacin that did not affect the response to A23187 when given alone markedly reduced the ability of ionophore to cause vascular leakage when combined with either pyrilamine or FPL 55712 . Thus, histamine and LTD4, in combination with one or more of the cyclooxygenase products, may be involved in A23187-induced cutaneous vascular permeability . Finally, two calcium channel blocking agents, nifedipine and diltiazem, did not block the vascular leakage caused by A23187.

J Clin Microbiol, 1984 Sep, 20(3), 434 - 7
Interlaboratory comparison of the toluidine red unheated serum test antigen preparation; Parham CE et al.; The toluidine red unheated serum test (TRUST) antigen, a macroscopic flocculation test antigen developed by Pettit et al . (J . Clin . Microbiol . 18:1141-1145, 1983) by modifying the color-coded antigen of Kasatiya and Lambert (Appl . Microbiol . 28:317-318, 1974), was compared with the Venereal Disease Research Laboratory (VDRL) slide and rapid plasma reagin (RPR) 18-mm circle card tests for sensitivity, specificity, and reproducibility . Two lots of TRUST antigen were prepared by two laboratories in the Centers for Disease Control . Both laboratories performed the TRUST and VDRL slide test on serum samples from 1,102 patients attending the DeKalb County, Georgia, Sexually Transmitted Disease Clinic . In addition, one laboratory performed the RPR card test . Reactive sera were quantitated in the three nontreponemal tests and confirmed with the fluorescent treponemal antibody absorption test . The sensitivity in untreated syphilis for all nontreponemal tests involved was 98.4% . The specificity for these tests was 98.6% . The qualitative reproducibility among the four lots of TRUST antigen, VDRL slide, and RPR card tests was 98.2% . Only 20 sera showed discrepant results . Intralaboratory reproducibility of the two TRUST antigens was 100% for one laboratory and 99.6% for the other . Interlaboratory reproducibility for the four lots of TRUST and the VDRL slide test was 99% . Quantitative agreement +/- 1 dilution between the TRUST and RPR card test was 92.3%, and quantitative agreement +/- 1 dilution for the TRUST and RPR card test versus the VDRL slide test averaged 50% . The TRUST appeared to be comparable to the RPR card test in all parameters compared.

J Diarrhoeal Dis Res, 1984 Sep, 2(3), 142 - 6
Clinical features and laboratory diagnosis of rotavirus-associated gastroenteritis in infants and children; Kumar A et al.; PIP: This study was undertaken to compare countercurrent immunoelectrophoresis (CIE) and enzyme-linked immunosorbent assay (ELISA) using Rotazyme kit to detect rotavirus antigen in the stools of children with gastroenteritis and to compare and contrast the signs and symptoms of rotavirus antigen-positive with antigen-negative children . Over 2 years, 171 infant and children admitted to the pediatric in-patient unit at St . Luke's Hospital, Cleveland, Ohio, with gastroenteritis were evaluated . Stools from 108 (63%) had rotavirus antigen . In most patients, antigen was detected by both CIE and ELISA . 100 (94%) of the 108 patients were under age 2; 72 (66%) rotavirus-positive patients were seen during the colder months . Frequency and duration of diarrhea, presence and duration of vomiting, presence and duration of fever, and lack of examination findings distinguished the rotavirus antigen-positive from the rotavirus antigen-negative patients . CIE and ELISA are reliable, simple laboratory methods for identifying this etiologial agent in stool . Rotavirus antigen was detected by both CIE and Rotazyme technique in most patients . In a few patients only 1 test was positive for the antigen . In 16 (14.8%) positive specimens antigen only could be detected by CIE, while in 11 (10.2%) positive specimens the antigen was demonstrable only by the Rotazyme method . This discrepancy is hard to explain since both methods are sensitive and compare well with immune electron microscopy . CIE is an inexpensive, simple test which can be done easily in any microbiology or clinical laboratory, with the results ready in 3 hours . Rotazyme is very sensitive but it is also more complicated than CIE .

Biochemistry, 1984 Aug 14, 23(17), 3927 - 33
Electron microscopy of secondary structure in partially denatured Escherichia coli 16S rRNA and 30S subunits; Klein BK et al.; Loops observed in partially denatured 16S rRNA lie within three domains, each about 500 nucleotides long . The loops observed in the 5' and central domains agree well with features of the model proposed by Woese et al . {Woese, C . R., Gutell, R., Gupta, R., & Noller, H . F . (1983) Microbiol . Rev . 47, 621-669} . The structure in the 3' domain is more complex and variable but is still consistent with the model . Published psoralen cross-linking studies have reported one of the observed loops but have also identified loops other than those observed here or predicted by any secondary structure model . These loops are stabilized by increasing concentrations of Mg2+ ions and by bound ribosomal proteins . For example, protein S4 in LiCl core particles stabilizes a loop of 370 nucleotides which forms part of its putative binding site on rRNA . The loop structures are characteristic enough to permit an overall comparison of the most stable of the predicted and observed loops in 16S and 23S rRNAs . Both rRNAs show a stable 5'-terminal loop and a set of subterminal nested loops near the 3' end.

Oral Surg Oral Med Oral Pathol, 1984 Aug, 58(2), 121 - 9
Further observations on dental parameters of trigeminal and atypical facial neuralgias; Roberts AM et al.; One hundred thirty-one patients with primary trigeminal neuralgia and 77 patients with atypical facial neuralgia or pain were treated by oral surgical procedures, with complete or almost complete pain remission in 88% of the cases and without persistent residual anesthesias, dysesthesias, or dysalgesias . The following conditions were related to patients' pain perceptions: cavities in alveolar bone at tooth extraction sites, bone fistulas, periodontal infections, and maxillary sinus infections draining into alveolar bone . The bone cavities and fistulas mentioned above were usually not visualized by standard x-ray diagnostic procedures, and their detection required a new diagnostic approach which is described . Microbiologic findings indicated involvement of a mixed, variable flora in the above conditions . Histopathologic observations of scrapings from involved bone showed a variable incidence of bone necrosis, predominantly chronic inflammatory cell populations and fibrous tissue.

Infect Control, 1984 Aug, 5(8), 378 - 84
Postoperative infections following cardiac surgery: association with an environmental reservoir in a cardiothoracic intensive care unit; Dandalides PC et al.; During 1981, 39 nosocomial infections occurred in 27 of 223 patients undergoing cardiac surgery in the North Carolina Memorial Hospital . The peak attack rate (23.7%) occurred in August and September compared to 10.1% in January through July . A case-control study demonstrated that the only risk factor common to poor and stable health groups compared to controls was duration of stay in the cardiothoracic intensive care unit (CTICU) . Microbiologic studies of the environment, personnel and patients showed that colonization or infection of patients occurred 1 to 6 days after admission to the CTICU and that nosocomial pathogens were found: 1) in and around the unit's soiled utility sink, 2) in pooled handwashing cultures of unit personnel, and 3) on contaminated clean hands and air near the soiled utility sink, plus nearby bedside air only while the water in the sink was running . Environmental and personnel hand contamination by soiled utility sink aerosols likely contributed to these infections . Infection control measures, including discontinued use of the soiled utility sink, resulted in a significantly lower infection rate (5.6%).

J Pediatr Orthop, 1984 Aug, 4(4), 500 - 2
Kingella kingae osteomyelitis of the clavicle; Rotbart HA et al.; Kingella kingae is the most recent addition to the list of etiologic agents causing osteomyelitis and septic arthritis in previously well children . A case is presented of a child with K . kingae osteomyelitis of the clavicle--an uncommon site of infection due to any organism . In the hope of facilitating the detection and treatment of this increasingly recognized pathogen, a brief discussion of its microbiologic characteristics and a summary of the patients reported to date with bone and joint infections due to this organism are included . To our knowledge, this is the first discussion of K . kingae in the orthopedic literature.

J Virol, 1984 Aug, 51(2), 340 - 5
Many rhinovirus serotypes share the same cellular receptor; Abraham G et al.; Twenty-four human rhinovirus serotypes were grown and purified by centrifugation in metrizamide density gradients . These preparations had a lower buoyant density (1.24 g/cm3) and higher specific infectivities (1:24 to 1:240) than did rhinoviruses described previously (E . J . Stott and R . J . Killington, Annu . Rev . Microbiol . 26:503-524, 1972) . Binding conditions in which the unique cellular receptors for virus attachment were saturated were determined for each serotype . Competition binding assays between pairs of serotypes allowed 20 of the 24 serotypes to be assigned to the same cellular receptor . The remaining four serotypes appeared to attach to a different cellular receptor . Since most serotypes were chosen for study at random, it seems likely that many of the yet unstudied rhinoviruses will share this common cellular receptor.

Pathology, 1984 Jul, 16(3), 235 - 9
External quality assurance in microbiology . The programme of the Royal College of Pathologists of Australasia; Ackerman VP et al.; Since 1967 the Royal College of Pathologists of Australasia has been providing an external quality assurance programme in microbiology . The number of participants has risen from 70 to 222, and the samples distributed for investigation have increased in quantity, now totalling 35-40 per annum, and in variety, so that most aspects of clinical microbiology are now touched on . In recent years clerical accuracy and the adequacy of reports have been examined . However, more emphasis is needed on the stability of the specimens (freeze-drying will be introduced soon), the assessment of a laboratory's general performance, the standardization of methods and the educational aspects of external quality control.

Blood, 1984 Jul, 64(1), 91 - 8
Coenzyme function of cobalamin analogues from calf kidney; Thorndike J et al.; Calf kidney has been used as a tissue source for the isolation of cobalamin analogues, which are defined here as cobalt-containing compounds of distinctive chromatographic behavior that are extractable from tissues by methods conventionally used to extract cobalamin and which, in radioisotope dilution assays, are more active with R-protein as binder than intrinsic factor and are relatively less active in microbiologic assays . Preparatory methods employed reverse affinity chromatography or a series of chemical extractions for the isolation of corrin followed by Dowex-50 chromatography . An analogue-containing fraction (peak 2) was eluted by acetate buffers between pH 4 and 5 . This material was shown to contain cobalt, to migrate differently than the four cobalamins in Dowex-50 and paper chromatography, and to display a pattern of properties that is compatible with the above definition of cobalamin analogues . These analogues stimulated crude preparations of N5-methyltetrahydrofolate-homocysteine methyltransferase (EC 2.1.1.13) from Escherichia coli and rat liver at far lower concentrations (1-40 nmol/L) than the major cobalamins . No evidence of enzymatic conversion of cobalamin to analogue could be demonstrated.

Pathology, 1984 Jul, 16(3), 345 - 9
Clinching the diagnosis--sputum and other specimens in respiratory tract infection; Pritchard RC; Routine sputum culture in microbiology laboratories is frequently a source of dissatisfaction to microbiologists and clinicians alike . Care should be taken to ensure that the investigations requested are appropriate and that an adequate specimen is collected . Co-operation between the microbiologist and the clinician is required if the laboratory's facilities are to be properly exploited for the etiological diagnosis of respiratory tract infection . In clinical conditions such as lung abscess and atypical pneumonia sputum is not an appropriate specimen for the laboratory to work on and early consideration should be given to obtaining lower respiratory tract secretions free of oropharyngeal contamination.

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