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 di