Pathologist, 1984 Jul, 38(7), 415 - 23 A microcomputer-based clinical microbiology and epidemiology system in a community hospital; Greenberg AP; The author describes the structure of a comprehensive microcomputer-based microbiology and epidemiology system as implemented in a 150-bed community hospital . The article illustrates how the program provides more efficient, cost-effective, clinically relevant microbiology laboratory reports to clinicians . The author hopes the following discussion will lessen the reluctance of small laboratories to introduce microcomputers into the laboratory. Eur J Obstet Gynecol Reprod Biol, 1984 Jun, 17(4), 293 - 9 Fimbrial ciliated cells percentage and epithelial height during and after salpingitis; Donnez J et al.; Microbiopsies of 191 fimbriae were obtained from 146 patients undergoing laparotomy for acute salpingitis, or tubal surgery after salpingitis . The biopsies were classified in four groups according to the diagnosis at laparotomy: salpingitis, distal occlusion, peritubal adhesions or tuberculosis . The biopsies belonging to the group of distal occlusion were further classified in four sub-groups according to the extent of the lesions observed during the hysterosalpingography and laparoscopy . Since the crucial role of the ciliated epithelium in the ovum transport has been established, the percentage of ciliated cells and the epithelial height were determined in the groups and compared to those observed in fimbriae obtained from fertile women during an ovulatory cycle . Significant differences were noted in all groups when compared to fertile women . Acute salpingitis provoked a rapid and severe deciliation which recovered 3 months after triantibiotherapy . In the groups of distal occlusion, there was a significant correlation between the rate of deciliation and the extent of lesions . This suggests that deciliation of tubal epithelium is a sequela of salpingitis and that the extent of disease allows a prognosis of the percentage of ciliated cells. Cardiovasc Res, 1984 Jun, 18(6), 384 - 90 Microbiopsy metabolite and paired flow analysis: a new rapid procedure for homogenisation, extraction and analysis of high energy phosphates and other intermediates without any errors from tissue loss; Hearse DJ; A new procedure is described which allows for the rapid homogenisation, extraction and analysis of the metabolite content of microbiopsy samples (milligram quantities) while completely overcoming the major errors arising as the consequence of the substantial and variable tissue loss associated with conventional procedures . In addition to allowing more accurate and faster analysis of much smaller quantities of tissue the procedure also allows for the coincident paired measurement of flow (radioactive microspheres) in each biopsy . An example of the application of the method to the measurement of flow and high energy phosphate content in multiple microbiopsy samples from normal and ischaemic canine myocardium is provided. Br J Exp Pathol, 1984 Jun, 65(3), 389 - 96 A study of the susceptibility of three species of primate to vaginal colonization with Gardnerella vaginalis; Johnson AP et al.; In an attempt to develop an animal model of Gardnerella-associated vaginitis, several strains of Gardnerella vaginalis were inoculated into the lower genital tract of female pig-tailed macaques, tamarins and chimpanzees . G . vaginalis was not recovered from either tamarins or chimpanzees, but was recovered from each of 1O pig-tailed macaques inoculated with either of two freshly isolated Gardnerella strains, colonization persisting for 11-39 days . Examination of Gram-stained vaginal smears obtained from infected pig-tailed macaques failed to demonstrate clue cells, a feature which is pathognomonic of Gardnerella-associated vaginitis in humans . Other features characteristic of non-specific vaginitis, namely an increase in vaginal pH, and an increase in the ratio of succinate to lactate (S/L ratio) in vaginal fluid were not found . However, the physiology of the macaque vagina was found to be different from that of the human, the vaginal pH and S/L ratio of uninfected macaques both being higher than that seen in humans . The physiological differences between the macaque and human vagina may be due, in part, to a difference in their anaerobic vaginal flora . While these inter-species differences in vaginal physiology and microbiology limit the relevance of the pig-tailed macaque as a model of Gardnerella-associated vaginitis, the ease with which macaques are colonized with G . vaginalis may prove useful in studying bacterial adhesion and local immunity. Am J Infect Control, 1984 Jun, 12(3), 187 - 96 A national task analysis of infection control practitioners, 1982 . Part Two: Tasks, knowledge, and abilities for practice; Shannon R et al.; Respondents (N = 473) from a randomized stratified sample (N = 600) of U.S . hospital ICPs in a national survey sponsored by the Certification Board of Infection Control were asked to rate specific task, knowledge, and ability statements related to infection control for frequency and importance . The questions included 175 items, of which 99 were for specific tasks and 76 were for knowledge and abilities for practice . Areas covered included patient care practices, infectious diseases, epidemiology and statistics, microbiologic practices, sterilization and disinfection, education, employee health services, and management and communications . A "profile respondent" group (N = 317) was defined as persons most likely to be practicing the full scope of infection control practice and was used to identify key tasks, knowledge, and abilities for practice . Results showed that patient care practices (i.e., suctioning, dressing changes, and catheterization) were rarely performed . The development of infection control policies and procedures were key tasks . Knowledge of microbiology and infectious diseases in order to interpret laboratory reports and other patient data was rated as essential; however, few respondents actually performed laboratory procedures . Epidemiologic principles were frequently used for surveillance and problem investigation . Although presentation of epidemiologic data was rated as important, analytic statistics were rarely used . Assessment of educational needs and teaching were large components of ICPs' activities. J Med Syst, 1984 Jun, 8(3), 173 - 9 Bugs, drugs, and computers; Kilroy JE et al.; The paper describes the development, implementation, and review of a daily reporting system using data from two modules of a hospital information system: drug sensitivity reports from Microbiology, and patient drug profiles from Pharmacy . The system reviews each patient receiving antibiotics and compares that information with the patient's microbiology findings, looking for and flagging "no cultures," "negative cultures," and "mismatches," i.e., the patient is receiving an antibiotic to which the organism is resistant . Reports are produced daily and reviewed by the hospital's Infection Control nurse, who, in turn, notifies the attending physician when appropriate. Z Urol Nephrol, 1984 Jun, 77(6), 363 - 72 {Sterilization with formaldehyde vapors in a hypobaric procedure: microbiologic and toxicologic aspects}; Fleck H et al.; The use of formaldehyde gas is an alternative for the sterilization of thermolabile instruments . A report is given on the effectivity of a sterilization medium the production of which is not dependent on any imports, and on the suitability of sterile packaging materials produced in the GDR for this process . In further studies the formaldehyde residue on catheters and tubing used in urology following sterilization is measured . The question of whether formaldehyde residue on catheters is of toxicological significance is examined. Eur J Biochem, 1984 Jun 1, 141(2), 393 - 400 Isolation of active and inactive forms of isocitrate dehydrogenase from Escherichia coli ML 308; Borthwick AC et al.; In Escherichia coli ML308 isocitrate dehydrogenase is partially inactivated during growth on acetate {Bennett, P.M . and Holms, W.H . (1975) J . Gen . Microbiol . 87, 37-51} . The active form of isocitrate dehydrogenase was purified to homogeneity from cells grown on glycerol . The key step in the procedure was chromatography on procion-red-Sepharose, from which the enzyme was specifically eluted with NADP+ . Two forms of isocitrate dehydrogenase were purified to homogeneity from cells grown on acetate . One form did not bind to procion-red-Sepharose and was essentially inactive; this form could be resolved from the active form by non-denaturing gel electrophoresis . The other form was specifically eluted from procion-red-Sepharose and was partially active; analysis of this form by non-denaturing gel electrophoresis suggested that it was a mixture of the active and inactive forms . The three forms comigrated on denaturing gel electrophoresis and were identical by the criterion of one-dimensional peptide mapping . Analysis of the active and inactive forms by sedimentation equilibrium centrifugation and non-denaturing gel electrophoresis showed that they differed in charge but not in size . Amino acid analysis and two-dimensional peptide mapping showed that both forms were dimers of identical subunits . The active form of the enzyme contained no detectable alkali-labile phosphate, the inactive form contained 0.8 molecule/subunit and the partially active form contained an intermediate amount . The data suggest that the active and inactive forms of isocitrate dehydrogenase differ only in the presence of one phosphate group per subunit in the latter form; this is consistent with our results from phosphorylation of isocitrate dehydrogenase in vitro (Following paper in this journal) . The nature of the partially active form of isocitrate dehydrogenase and the significance of the results are discussed. J Clin Microbiol, 1984 Jun, 19(6), 794 - 7 Use of absorbed antisera for demonstration of antigenic variation among strains of Legionella pneumophila serogroup 1; Thomason BM et al.; Antigenic typing of strains of Legionella pneumophila serogroup 1 (Lp1) has been shown to be useful in epidemiological studies of outbreaks of legionellosis . Selective absorption of rabbit antibodies produced against five strains of Lp1 resulted in the recognition of 17 somatic types among the 176 strains tested . A comparison was made of our results and those obtained by McKinney et al . (Zentralbl . Bakteriol . Parasitenkd . Infektionskr . Hyg . Abt . 1 Orig . Reihe A 255:91-95, 1983) and Joly et al . (J . Clin . Microbiol . 18:1040-1046, 1983), who used monoclonal antibodies to subgroup Lp1 strains . The results indicate that antigens are present in Lp1 strains that were undetected by either system . The data presented in this study may be helpful in selecting for the production of additional monoclonal or absorbed antibodies for diagnostic purposes or epidemiological studies. J Physiol, 1984 May, 350, 109 - 19 Effects of chronic stimulation on the metabolic heterogeneity of the fibre population in rabbit tibialis anterior muscle; Buchegger A et al.; Chronic indirect stimulation (10 Hz) was performed on rabbit tibialis anterior muscle . Long-term stimulation (52-140 days) produced a transformation of the fast tibialis anterior into a slow red muscle as judged from the histochemistry of myofibrillar actomyosin ATPase, the pattern of myosin light chains and the thorough rearrangement of the enzyme activity pattern of energy metabolism . Activity levels of citrate synthetase (CS), malate dehydrogenase (MDH), succinate dehydrogenase (SDH), 3-hydroxy-acyl-CoA dehydrogenase (HAD), and lactate dehydrogenase (LDH) were determined quantitatively by either microbiochemical assays (CS, MDH, HAD and LDH) on microdissected, single fibres or by kinetic microphotometry on cross-sectioned fibres (SDH) . The activity profiles of these enzymes displayed pronounced scattering in the fibre population of the unstimulated muscle . Despite a several fold increase in the activities of CS, MDH, SDH and HAD and a pronounced decrease in LDH, chronic stimulation failed to abolish the metabolic heterogeneity of the fibre population . It is possible that chronic indirect stimulation cannot produce uniformity of fibres because of continuing diverse natural activity of the motor units. Am J Kidney Dis, 1984 May, 3(6), 466 - 8 National Kidney Foundation revised standards for reuse of hemodialyzers; Phaeohyphomycosis of the maxilloethmoid sinus caused by Drechslera spicifera: a new fungal pathogen; "Phaeohyphomycosis" refers to soft tissue and systemic infections caused by dematiacious septate fungi . Drechslera spicifera, a dematiacious fungus, rarely pathogenic in humans was found to cause maxilloethmoid sinus disease in two immunocompetent children . The clinical presentation was similar to noninvasive aspergillosis . Intracavitary surgical excision without adjuvant chemotherapy resulted in apparent cure . The microbiologic and clinicopathologic aspects of this mycotic sinus disease are reviewed and discussed in relation to the entire spectrum of human disease reported which has been attributed to this organism. Int J Dermatol, 1984 May, 23(4), 221 - 36 Mycetoma; Magana M; We have reviewed the outstanding facts about mycetoma, including the history, first reports in India, the different causal agents according to their geographic distribution, mycologic characteristics, pathology, microbiology, behavior, evolution, immunology, experimental inoculations, associated bacterial complications, and osseous lesions . Various drugs available for treatment are mentioned and recommended . Therapeutic results depend on the age of the disease, and, above all, the bony involvement . N . brasiliensis mycetoma is one of the most frequent species and causes the greatest number of mycetoma cases in America, especially in Mexico. Am J Hosp Pharm, 1984 Apr, 41(4), 690 - 3 Comparison of enzyme immunoassay, radioimmunoassay, and microbiologic assay for amikacin in plasma; Fukuchi H et al.; An enzyme-multiplied immunoassay technique (EMIT), radioimmunoassay (RIA), and microbiologic assay (MBA) were compared as methods of measuring amikacin in human plasma . Accuracy of the three methods was assessed in plasma with amikacin added in concentrations of 2.5-50 micrograms/ml . Correlations between the assay methods were compared over a range of 0.5-50 micrograms/ml . Amikacin was also assayed in plasma to which had been added other drugs, including 16 antibiotics and 3 antineoplastic agents; also tested were samples that had been stored at 5 degrees C or -20 degrees C . Within the amikacin concentration range of 2.5-50 micrograms/ml, the coefficients of variation of all methods were within 10% . Correlation was good between EMIT and RIA as well as between EMIT and MBA . Of the other drugs tested, only tobramycin, dibekacin, and kanamycin affected amikacin EMIT determinations, while only kanamycin affected amikacin RIA determinations . No effect of cold and freezing was observed on amikacin determinations . EMIT assay is an acceptable method for routine analysis of amikacin plasma samples . The amikacin assay results for the three methods were highly correlated. Wien Med Wochenschr, 1984 Mar 31, 134(6), 137 - 40 {Multidisciplinary aspects of kidney transplantation in Austria . Internal preoperative examinations of continuously dialysed patients during the pre-transplantation phase}; Kopsa H; Successful renal transplantation requires a comprehensive preoperative program . Patient's investigation, EKG and laboratory data should be done at regular intervals . Microbiologic analyses comprise fungal, bacterial and viral diagnostic procedures . Roentgenograms should be achieved from thorax, skeleton and upper intestinal tract . Sonography is helpful in diagnosis of kidney, liver, spleen, pancreas, parathyreoidea and heart . Early manifestations of hyperparathyreoidism are detected by bone scanning . Possible foci have to be eliminated . Regular ophthalmologic and neurologic controls are required for proper therapy of patients on RDT. J Am Vet Med Assoc, 1984 Mar 15, 184(6), 706 - 15 Complications during treatment of traumatic disruption of the suspensory apparatus in Thoroughbred horses; Bowman KF et al.; A total of 19 Thoroughbred horses were treated for traumatic disruption of the suspensory apparatus, using either external support of the injured limb, removal of fractured proximal sesamoid bone fragments, metacarpophalangeal arthrodesis, compression screw fixation of the fractured proximal sesamoid bones, application of a cast-brace attached to a transfixation pin inserted through the third metacarpal bone, or combinations thereof . Major complications during the treatment of traumatic disruption of the suspensory apparatus were infection (9 of 19 horses, 47%), large cast sores (10 of 14 treated horses, 71%), laminitis (7 of 19 horses, 37%), and orthopedic implant failure or loosening (4 of 6 treated horses, 67%), which led to euthanasia in 16 of 18 cases with complete follow-up information . Increased pain and lameness signaled the development of such complications . In 7 of 9 cases with infection confirmed by microbiologic culture, the horse had received surgical treatment; in 6 of those 7 cases, the infection involved the surgical site . Postoperative wound infection developed in 4 of 7 cases when the surgery was performed within 18 days of injury . In 3 cases, septic metacarpophalangeal arthritis developed, but it was unrelated to surgical procedures . Implant failure or loosening and infection led to euthanasia in 5 of 6 horses treated by internal fixation to stabilize the metacarpophalangeal joint . Three of 6 attempts to perform metacarpophalangeal arthrodesis by application of a bone plate to the dorsal aspect of the joint resulted in implant failure after 45 to 101 days . Major complications did not develop in 2 horses that were treated successfully. Obstet Gynecol, 1984 Mar, 63(3 Suppl), 47S - 53S Osteomyelitis pubis after radical gynecologic operations; Hoyme UB et al.; The clinical and microbiologic features of five cases of osteomyelitis of the pubis after radical gynecologic and exenterative pelvic surgery are reported . Pain and tenderness over the pubic symphysis and difficulty with ambulation were common features . The interval between surgery and diagnosis ranged from eight to 17 weeks (average, 13.6 weeks) . Erythrocyte sedimentation rate and alkaline phosphatase level were often abnormal, and x-rays, bone scan, and gallium scan were useful diagnostic tests . Osteomyelitis of the pubis contributed to an increased hospital stay of 5.6 weeks (mean) for patients undergoing radical vulvectomy and ten to 24 weeks for patients undergoing total pelvic exenteration . Intravenous antibiotic therapy followed by long-term oral administration may provide effective therapy, but the presence of necrotic bone requires surgical excision of necrotic and infected tissue. J Clin Periodontol, 1984 Mar, 11(3), 193 - 207 Recolonization of a subgingival microbiota following scaling in deep pockets; Magnusson I et al.; The present investigation was carried out to study some aspects of the recolonization of a subgingival microbiota following subgingival instrumentation in sites with deep pockets . 16 patients were recruited for the study . From each patient 4 inflamed gingival sites with deep pockets were selected . These sites were examined for plaque, overt gingivitis, bleeding on probing and probing depth . Samples of the subgingival microbiota were obtained and examined in the darkfield microscope and in a Neubauer chamber . Following the Baseline examination the teeth of all 4 jaw quadrants were carefully scaled and planed . Subgingival instrumentation was carried out under local anesthesia and required between 2-4 appointments . The patients were subsequently divided into 2 groups (Groups A and B) consisting of 9 and 7 subjects, respectively . During the first 16 weeks of maintenance the patients of Group A were not supervised regarding their self-performed plaque control measures and they accumulated supragingival plaque . The patients of Group B, however, were during these 16 weeks recalled once every 2 weeks for professional tooth cleaning . In addition they rinsed twice daily with a 0.2% solution of chlorhexidine digluconate . Reexaminations including assessments of the same parameters as those studied at Baseline were performed after 2, 4, 8, 12 and 16 weeks . After the 16-week examination the patients of Group A received a new sequence of subgingival scaling and root planing . During the subsequent 16 weeks the patients of Group A were also recalled for professional tooth cleaning . They were reexamined 18, 20, 24, 28 and 32 weeks after the Baseline examination . Subgingival scaling followed by carefully supervised oral hygiene measures resulted in a marked improvement of periodontal conditions . This improvement was accompanied by a pronounced and sustained reduction in the motile segments of the subgingival microbiota . In the presence of supragingival plaque (Group A), however, a subgingival microbiota containing large numbers of spirochetes and motile rods was soon (4-8 weeks) reestablished . A small number of sites with deep pockets (greater than or equal to 8 mm) was not substantially reduced in depth following subgingival instrumentation . In these sites which were kept free from supragingival deposits a subgingival microbiota with a large proportion of motile bacteria soon recurred. Am J Pathol, 1984 Mar, 114(3), 496 - 514 Neuropathology of spiroplasma infection in the rat brain; Bastian FO et al.; This study was designed to demonstrate the neuropathology of persistent spiroplasma infection in the rat brain . GT-48 spiroplasmas were inoculated intracranially into a series of suckling Sprague-Dawley rats . Their brains were evaluated at specific time intervals by microbiologic assay and by morphologic studies including histology, electron microscopy, and immunocytochemistry . The spiroplasmas were observed in the tissues by electron microscopy at peak infection 14 days after intracranial inoculation . At that time they were seen in vacuoles and neuronal processes within the neuropil as filamentous or bleb-like forms . A single tight spiral was identified that closely resembled the spiroplasma-like inclusions previously reported in Creutzfeldt-Jakob disease . The spiroplasmas were shown to spread rapidly throughout the brain tissues presumably by intraneuronal transport . In specimens examined at 25 days after intracranial inoculation and beyond, organisms were localized to gray matter without inflammatory response . The spiroplasmas could not be identified by electron microscopy in the rat brain tissue at late stages of infection . This study has shown an unusual adaptation of spiroplasma infection to the mammalian host brain tissues. Infect Immun, 1984 Mar, 43(3), 959 - 65 Characterization of new hydrophobic pili of human enterotoxigenic Escherichia coli: a possible new colonization factor; Honda T et al.; Enterotoxigenic Escherichia coli strains were divided into five groups on the basis of their bacterial surface hydrophobicity (Honda et al., FEMS Microbiol . Lett . 17:273-276, 1983) . Strains in group III showed heat-stable high hydrophobicity, although they did not show mannose-resistant hemagglutination with either human or bovine erythrocytes . E . coli strain 260-1 in group III was characterized . Electron microscopic examination revealed the presence of pili on the surface of this strain, but not on that of strain 260-1a, which is a mutant of 260-1 showing low hydrophobicity . When strain 260-1 was grown at 18 degrees C, it did not produce pili or show high hydrophobicity . On homogenization of strain 260-1 grown at 37 degrees C the high hydrophobicity and the pili on its surface were lost . These results indicate that the pili of strain 260-1 are associated with the hydrophobicity . Strain 260-1 pili were purified to homogeneity by successive column chromatographies on Sepharose 4B and phenyl-Sepharose CL-4B . Their molecular weight was estimated to be about 18,000 . An antigenic difference between purified pili of strain 260-1 and colonization factor antigens I and II was demonstrated . The colonization ability of E . coli 260-1 was shown by animal experiments on suckling mice and infant rabbits . From these results it is concluded that the pili of strains in group III of human enterotoxigenic E . coli, which may play a role in colonization, are of a new type. Infect Control, 1984 Feb, 5(2), 85 - 7 Recommendations for the care of automated peritoneal dialysis machines: can the risk of peritonitis be reduced? Berkelman RL, Band JD, Petersen NJ. Automated peritoneal dialysis systems have helped make intermittent peritoneal dialysis an alternative to hemodialysis for long-term management of patients with end-stage renal disease . However, if not cleaned and maintained properly, these machines provide a reservoir for pathogens . The microbiologic barriers in these machines are not impenetrable, but sterile dialysate fluid can be produced if the machines are adequately cleaned and disinfected . Potential shortcomings of the microbiologic barriers are discussed, and guidelines to prevent contamination of the internal parts of a machine are suggested. Arch Pathol Lab Med, 1984 Feb, 108(2), 106 - 7 Penicillin-resistant pneumococci; Oxley DK; Because of reports documenting the occurrence of pneumococci resistant to penicillin, the Microbiology Resource Committee of the College of American Pathologists studied the accuracy of various Kirby-Bauer disks in identifying a pneumococcal organism known to be clinically resistant to penicillin . The only disk that showed acceptable performance was the 1-microgram oxacillin disk, using the inhibition diameter of 19 mm or less as the criterion for predicting clinical penicillin resistance . It is particularly important to understand that, at present, penicillin disks do not provide acceptable predictive accuracy. Eur J Clin Microbiol, 1984 Feb, 3(1), 4 - 9 Lectins in diagnostic microbiology; Doyle R et al.; Current literature suggests that lectins are becoming valuable reagents for the laboratory identification of infectious agents . The identification of bacteria, fungi, or protozoa may be confirmed if they bind to or agglutinate with certain lectins . Assay kits utilizing specific lectin agglutination reactions, coupled with conventional enzyme determinations, have been proposed for several bacteria . Factors such as specificity, stability, assay rapidity, and costs combine to make lectins attractive diagnostic reagents . It is likely that the use of lectins in diagnostic microbiology will continue to grow. Urol Clin North Am, 1984 Feb, 11(1), 15 - 25 Biology of sexually transmitted diseases; Krieger JN; The clinical concept of sexually transmitted diseases describes a common mode of transmission of pathogens spanning the full spectrum of medical microbiology . These organisms have few common biologic characteristics aside from their ability to colonize or invade particular anatomic sites . New information on the biology of sexually transmitted pathogens has led to improved diagnostic and therapeutic strategies . Understanding that patients with sexually transmitted pathogens may be asymptomatic or may be simultaneously infected with multiple organisms has important implications for epidemiologic control of these diseases. J Clin Microbiol, 1984 Feb, 19(2), 267 - 72 Enzyme immunoassay for rabies antibody in hybridoma culture fluids and its application to differentiation of street and laboratory strains of rabies virus; Smith JS et al.; A rapid and sensitive enzyme immunoassay is described for detecting rabies antibody in hybridoma culture fluids . Glass fiber filter disks were used to immobilize gamma-irradiated mouse neuroblastoma cells infected with street or laboratory strains of rabies virus . Bound rabies-specific antibody was detected by reaction with horseradish peroxidase-labeled goat anti-mouse immunoglobulin G . The assay was performed in a 96-well filtration device developed by Cleveland et al . (J . Clin . Microbiol . 15:402-407, 1982) for the typing of herpes simplex viruses . When partially disrupted cells were used, both internal and external viral antigens were available for reaction . The procedure is rapid (less than 4 h for completion) and requires only small amounts of fluid, and the gamma-irradiated antigen is noninfectious . When the procedure was used to screen 145 fluids from rabies-immune spleen-myeloma cell fusions, 132 were positive for rabies antibody . Other commonly used assays for the detection of rabies-specific antibody were less sensitive . Simultaneous analyses of many hybridoma fluids against a battery of street and laboratory strains of rabies virus are possible and allow rapid selection of useful monoclones. Avian Dis, 1984 Jan-Mar, 28(1), 25 - 43 Epizootiology, pathology, and microbiology of an outbreak of urolithiasis in chickens; Mallinson ET et al.; An outbreak of urolithiasis that doubled the annual mortality rate of chickens in a large flock of table-egg-layers is described . Despite the presence of a large unilateral urolith and/or severe renal atrophy, the layers often maintained active egg production and apparent homeostasis until a small urolith blocked the ureteral flow from the contralateral kidney . This terminal episode appeared to produce acute obstructive renal failure, rapidly developing visceral gout (visceral urate deposition), uremia, and death . The atrophy observed appeared to be acquired and progressive . Histologic features in the kidneys were acute to chronic glomerulonephritis, interstitial nephritis, and pyelonephritis . Epizootiologic and microbiologic studies indicated that a combination of infectious and noninfectious mechanisms may have been involved . Causative roles for calcium-phosphate imbalance, infectious bronchitis (IB), Newcastle disease (ND), and adenovirus or reovirus infections could be neither excluded nor confirmed . Contributory factors may have been spray ND-IB and other vaccinations of 15-week-old ND-IB-susceptible pullets, water deprivation, shipping stress, Mycoplasma synoviae infection, immune complex disease, and mycotoxins. Folia Microbiol (Praha), 1984, 29(1), 51 - 89 Compounds isolated at the Department of Biogenesis of Natural Substances, Institute of Microbiology, Czechoslovak Academy of Sciences, in 1954-1983; Podojil M et al.; Substances studied at this department in 1954-1983 are reviewed; a total of 226 compounds are characterized in a tabular form . They include natural compounds as well as those prepared by biotransformation, by semisynthetic and synthetic methods. Ann N Y Acad Sci, 1984, 428, 243 - 50 The computer in microbiology: future applications in test performance and reporting; Ryan KJ; The use of minicomputers dedicated to laboratory use offers the greatest hope for continued progress in computerization of clinical microbiology . Such systems can be interfaced with microcomputers performing discrete tasks within the laboratory and with larger computers to form a total hospital or interhospital information system . As such systems are designed they should include features that allow ready access to the microbiologic data without reentry of primary results or delays of days to weeks . Many of these features have been accomplished in existing laboratory systems. Infect Control, 1984 Jan, 5(1), 38 - 40 Training of personnel for infection control; Crow S; The overall objectives for implementing an infection control program are to make hospital personnel aware of nosocomial infections and to educate these persons in their role in decreasing the risk of these infections . The infection control practitioner (ICP) implements these objectives by performing surveillance to determine problem areas and by developing policies and procedures that prevent and control nosocomial infections . Appropriate qualities for an ICP include initiative, leadership, communication skills, commitment, and charisma . Expertise in patient care practices, aseptic principles, sterilization practices, education, research, epidemiology, microbiology, infectious diseases, and psychology are acquired skills . Local, state, and national organizations, as well as universities, are responsible for ICP training, In the US the Centers for Disease Control have established a training program for the beginning ICP and the Association of Practitioners in Infection Control (APIC) has developed a study guide for developing infection control skills . The ultimate responsibility for education is an individual obligation, however . Certification of the ICP would insure a minimum level of knowledge, thereby standardizing and upgrading the practice of infection control. Histochemistry, 1984, 81(5), 477 - 83 Microbiochemical investigation on diurnal rhythmic changes of the activities of the lactate dehydrogenase in the periportal and perivenous zones of the acinus of the rat liver; Hildebrand R et al.; Activities of the lactate dehydrogenase within the periportal zone and within the perivenous zone in the first layer of hepatocytes adjacent to terminal hepatic venules and the remainder of the perivenous parenchyma of the liver acinus were measured using a Lowry technique during a full 24-h cycle (08.00-08.00) in untreated adult male Wistar rats kept under 12 h of light and 12 h of darkness, scotophase 18.25-06.25 . In all three regions studied a broad first maximum was recorded between 10.00 and 22.00 with the peak value at 16.00 and a high and narrow peak at 24.00 . Zonal and intrazonal heterogeneity of the lactate dehydrogenase were retained during the full day and night cycle . The regions displayed individual dynamic changes in enzyme activity. Vet Med Nauki, 1984, 21(7-8), 79 - 86 {Quality of meat from lambs fattened on feed mixtures with added bacterial protein}; Ionova I et al.; Physico-chemical, microbiologic, and histologic investigations were carried out with meat and parenchymal organs of lambs offered feed mixtures with a supplement of bacterial protein on methanol basis in fattening the animals up to 35 kilograms . The addition of 5 per cent bacterial protein which replaced in terms of protein equivalent 60 per cent of the sunflower oil meal and totally the amount of urea in the mixtures had no negative effect on the physical and chemical composition of the meat and its biologic value . Histologically, no degenerative changes in the skeletal muscles and parenchymal organs were found . There was hypofunction of the thyroid gland in the test lambs . No pathogenic and occasionally pathogenic organisms were found in the sampled meat and organs. Int J Clin Monit Comput, 1984, 1(2), 81 - 91 Physician decision-making--evaluation of data used in a computerized ICU; Bradshaw KE et al.; New instrumentation, techniques and computers have made such large amounts of information rapidly available to ICU clinicians that there is now a danger of information overload . To help with this problem at LDS Hospital, a computerized system was implemented in the Shock-Trauma ICU . This ICU is almost totally computerized with each patient's physiologic, laboratory, drug, demographic, fluid input/output and nutritional data integrated into the patient's computer record . In the ICU, physician decision-making takes place in two situations: during rounds and on-site . For this study, data usage in decision-making was evaluated in both of these environments . The items of data used in decision-making were tabulated into six categories: bedside monitor, laboratory, drugs, input/output and IV, blood gas laboratory, observations and other . Comparisons were made between the portion of the computerized database occupied by a category and its use in decision-making . Combined laboratory data (clinical, microbiology and blood gas) made up 38 to 41% of total patient data reviewed and occupied 16.3% of the database . Observations made up 21-22% of the data reviewed and occupied 6.8% of the database . Drugs, input/output and IV data usage ranged from 13% to 23%, but occupied 36% of the database . Bedside monitor data usage was 12.5% to 22% and occupied 32.5% of the database . The 'other' category, used 2.5% to 5% of the time, made up 8.4% of the database . These results indicate that patient data collection and storage must be evaluated and optimized . This evaluation, along with implementation of the computerized ICU Rounds Report developed for optimal data presentation, will help physicians to evaluate patient status and should facilitate effective decisions. Nahrung, 1984, 28(6-7), 593 - 8 {Victor van der Reis--a pioneer in the gastrointestinal microbiology of man}; Knoke M; From 1919 up to 1928 Viktor van der Reis (1889-1058) elaborated the fundamental knowledge in the field of gastrointestinal microecology of man . During this time he worked at the Medical Clinic of the University of Greifswald . His curriculum and his role in the fields of the pathophysiology of the small intestine and of microbiology are presented from the aspect of recent medical-historical and bibliographical researches. Gerontology, 1984, 30(5), 308 - 15 Aging and tuberculosis; Nagami P et al.; In the United States, an increasing proportion of all forms of reactivation tuberculosis occurs in patients over the age of 60 years . Atypical presentations and presence of chronic illness obscure the diagnosis of tuberculosis in the elderly . Prompt diagnosis requires a high index of suspicion and aggressive procedures for diagnostic microbiology . Short-course (9 months) chemotherapy with isoniazid and rifampin is the treatment of choice for elderly patients with uncomplicated pulmonary tuberculosis . Isoniazid chemoprophylaxis is recommended for selected elderly patients. Pathol Annu, 1984, 19 Pt 1, 37 - 79 Hemorrhagic endovasculitis of the placenta: an indepth morphologic appraisal with initial clinical and epidemiologic observations; Sander CH et al.; A vasodestructive process has been identified within the placenta, which focuses on the entire placental vascular tree . Its presence is correlated with significant fetal mortality; liveborn infants are growth retarded and frequently in distress . Characteristic morphologic features have been identified in chorionic vessels of all sizes and these explicit pathologic changes are repetitive from case to case . Associated events suggest that hemorrhagic endovasculitis of the placenta is a clinicopathologic entity having maximal impact on pregnancies of affected patients . A number of accompanying pathologic and clinical features would suggest an infectious association or cause . There are several known categories of disease which manifest similarity to this placental alteration . These include microangiopathic hemolytic anemia, several postinfectious states, several known types of vasculitis, and AIDS . Long-term studies to gain further insight into this pathologic event are currently underway at the Michigan Placental Tissue Registry . These studies include: an epidemiologic field investigation with followup on growth and development of liveborn infants; data collection and analysis with respect to recurrence, geographic distribution, and the clinical course of affected pregnancies . An indepth pathologic analysis is ongoing including ultrastructural and immunopathologic studies on affected and control placentas . Appropriate microbiologic and serologic studies are planned with reference to the infectious aspects of this entity we have described . It is hoped that increasing awareness of this pathologic process within the placenta, particularly by pathologists, will contribute to our understanding of events which are deleterious to intrauterine growth and survival. Microbiol Immunol, 1984, 28(7), 821 - 30 Requirement of anionic groups for the mitogenicity of a fungal mitogen, vesiculogen; Ohno N et al.; Active site(s) of a B-cell mitogen, vesiculogen, was investigated by means of chemical and enzymic modifications . Vesiculogen is a non-dialyzable fraction of a hot water extract from a fungus, Peziza vesiculosa (Yadomae et al, Microbiol . Immunol . 23, 997 (1979}, and was composed of protein (approximately 60%), carbohydrate (approximately 30%), and a small amount of amino sugar, uronic acid, phosphate, and lipid . The mitogenicity was not affected by periodate oxidation, N-acylation, defatting treatment, destruction of the three dimensional structure, protease digestion, nuclease digestion, N-bromosuccinimide treatment, and beta-mercaptoethanol treatment . However, the mitogenicity was decreased by a modification of carboxyl groups, such as 1-ethyl-3(3-dimethylamino propyl)-carbodiimide or dicyclohexylcarbodiimide treatment . Vesiculogen contains a large amount of acidic amino acids . These results suggest that the mitogenicity of vesiculogen is due to the presence of anionic groups, such as aspartic acid and glutamic acid, and that the mitogenic substance is a novel, heat stable polyanionic B-cell activator obtained from Ascomycotina. Derm Beruf Umwelt, 1984, 32(6), 195 - 205 {Diseases caused by atypical mycobacterial}; Kruger M et al.; Infections having atypical mycobacteria are occurring more frequently for 2 main reasons . First there are the disturbances of the immunity system, whether due to the acquired immune deficiency syndrome (AIDS) or the result of therapeutic measures taken against malignant processes, other diseases or after organ transplantation . Second, travel and free-time activities increase the risk of an infection . In many cases such infections become localized on the skin, but can also develop changes in the lungs, depending on the patient's occupation . For this reason we provide a review of the new literature on the microbiology of mycobacteria as well as on the symptoms of diseases of the skin and other organs which are caused by atypical mycobacteria, such as swimming pool granuloma or Buruli ulcer. Contemp Top Immunobiol, 1984, 14, 1 - 28 Transductional mechanisms of chemoattractant receptors on leukocytes; Snyderman R et al.; Phagocytic leukocytes contain receptors for chemoattractants on their cell surface . Binding of chemotactic factors to these receptors initiates a number of coordinated cellular responses in a strict dose-dependent manner . Motility-related functions such as shape change, cytoskeletal rearrangement, and chemotaxis are stimulated by relatively low doses of chemoattractants, while microbiocidal or cytotoxic functions (i.e., secretion of lysosomal enzymes or stimulation of the respiratory burst), require approximately 10- to 50-fold higher concentrations of these agents . The receptor for oligopeptide chemotactic factors on leukocytes has provided an important model for the study of stimulus-response coupling in phagocytic cells . This receptor on human polymorphonuclear leukocytes exists in two affinity states that are partially interconvertible . Guanine nucleotides regulate the convertibility between a portion of the high- and low-affinity states, thereby suggesting that a nucleotide regulatory protein allosterically modifies receptor affinity and participates in its transduction mechanisms . A fraction of the high-affinity receptors in PMN membranes is not subject to guanine nucleotide regulation and appears to be formed by prior exposure of the receptors to specific agonists . This high-affinity form of the oligopeptide chemoattractant receptor is rapidly internalized at 37 degrees C, and its formation may be dependent on aggregation or covalent modification of the receptor . The chemotaxis and microbiocidal functions of PMNs can be divergently manipulated by pharmacological agents indicating that the transduction mechanisms for these two types of processes are independently regulated . Aliphatic alcohols at doses that induce mild fluidization of PMN membranes increase the average affinity of the chemoattractant receptor and enhance chemotactic functions but markedly depress lysosomal enzyme secretion and the respiratory burst . In contrast, polyene antibiotics that bind to membrane cholesterol lower the receptor's affinity and depress chemotactic functions but enhance secretion of specific granule enzymes . In addition, transmethylation reactions mediated by S-adenosyl-methionine appear to regulate receptor affinity . When such reactions are blocked pharmacologically, the oligopeptide receptor on macrophages reverts to a lower average affinity form and is ineffective in transducing chemotactic as well as microbicidal functions.(ABSTRACT TRUNCATED AT 400 WORDS) Aust Health Rev, 1984, 7(4), 269 - 77 Assuring rational antibiotic use: the impact of a joint microbiology-pharmacy surveillance program; Plumridge RJ et al.; A comprehensive antibiotic surveillance program conducted in cooperation with the Microbiology and Pharmacy departments in a teaching hospital is described . The program consists of a number of interrelated processes including the personal advice of specialists including a Clinical Microbiologist, Infection Control Nurse and Ward Pharmacists, re-educative strategies and non restrictive administrative policies . The program does not involve the use of formularies or published guidelines, and retains complete clinical freedom of choice for antibiotics . Studies, including antibiotic prevalence and prescribing surveys, indicate that the program has been an effective means of improving antibiotic use, reducing costs and promoting infection control . This has been achieved by educative means through the provision of relevant information on antibiotic principles, and opportunities for prescribers to improve their problem solving skills, resulting in long term attitudinal change. J Nutr, 1983 Dec, 113(12), 2587 - 94 Radiometric-microbiologic assay of niacin using Kloeckera brevis: analysis of human blood and food; Guilarte TR et al.; Kloeckera brevis, a yeast, was used as the test organism for the development of a radiometric-microbiologic (RMA) assay for niacin . The assay was determined to be sensitive to the 2 ng niacin per vial level and specific for the biologically active forms of this vitamin . The method was shown to be simple, accurate, and precise in the analysis of niacin in human blood and food . The application of the radiometric technique eliminates some of the problems encountered with conventional turbidimetric-microbiologic assay. J Clin Microbiol, 1983 Dec, 18(6), 1417 - 8 Rapid latex particle agglutination test for Escherichia coli strains of porcine origin producing heat-labile enterotoxin; Finkelstein RA et al.; A latex particle agglutination test previously shown to be suitable for the rapid identification of Escherichia coli strains of human origin producing heat-labile enterotoxin (R . A . Finkelstein and Z . Yang, J . Clin . Microbiol . 18:23-28) is equally applicable to strains of porcine origin. Ann Intern Med, 1983 Dec, 99(6), 777 - 82 Antigen detection in the diagnosis of invasive aspergillosis . Utility in controlled, blinded trials; Weiner MH et al.; Two blinded, controlled trials were done to evaluate the usefulness of fungal antigen detection for the diagnosis of invasive aspergillosis . Detection of Aspergillus fumigatus carbohydrate by radioimmunoassay was compared with antibody detection by an enzyme-linked immunosorbent assay and with diagnostic microbiologic and histopathologic procedures . In the first trial, antigenemia was detected in 4 of 6 leukemic patients with invasive pulmonary aspergillosis, but not in 8 acute leukemic controls or in 24 normal controls . Fungal antigenemia persisted for 8 to 75 days in 4 patients and seroconversion occurred at the onset of pulmonary infiltrates in 3 . Antibody to A . fumigatus was detected in 2 of the 6 patients with aspergillosis, but also in 2 leukemic controls and 6 normal controls . Aspergillus species were identified in four of seven bronchoscopies done in 5 patients with invasive pulmonary aspergillosis . Prospective nasal cultures grew Aspergillus species in 4 of the 6 patients with invasive aspergillosis, but in only 1 patient was this information available before a histologic diagnosis was made . In a second trial, antigenemia was detected in 2 patients with invasive aspergillosis, and in 1 with possible invasive aspergillosis, but not in 9 controls . This study indicates that the radioimmunoassay for A . fumigatus antigen is a highly specific and moderately sensitive serodiagnostic test for invasive pulmonary aspergillosis . Prospective nasal cultures grew Aspergillus species in 4 of the 6 patients with invasive aspergillosis, but in only 1 patient was this information available before a histologic diagnosis was made . In a second trial, antigenemia was detected in 2 patients with invasive aspergillosis, and in 1 with possible invasive aspergillosis, but not in 9 controls . This study indicates that the radioimmunoassay for A . fumigatus antigen is a highly specific and moderately sensitive serodiagnostic test for invasive pulmonary aspergillosis. Am J Anat, 1983 Dec, 168(4), 543 - 94 Quo vadis basic and clinical chronobiology: promise for health maintenance; Halberg F; Chronobiology is the eminently interdisciplinary science of interactions in time among metabolic, hormonal, and neuronal networks . It involves anatomy, biochemistry, microbiology, physiology, and pharmacology, at the molecular, intracellular, intercellular, and still higher levels of organization . The compounds coordinating a time structure--proteins, steroids, and amino-acid derivatives--provide for the scheduling of interactions among membrane, cytoplasmic, and nuclear events in a network involving rhythmic enzyme reactions and other intracellular mechanisms . The integrated temporal features of the processes of induction, repression, transcription, and translation of gene expression remain to be mapped in relation to the available framework, consisting of the sequences of phospholipid and RNA labeling, DNA formation, and mitosis, to delineate a circadian cell cycle upon which further hormonal and neural coordination acts (Halberg et al., 1959a,b, 1979a) . There is a need for communication over temporal as well as spatial distances among different specialized structures devoted, in individuals, to metabolism, growth, reproduction, and the ability to adjust, and, in species, to the capacity to adapt . For a better understanding at all levels of behavior in its broader sense of organization in time, chronobiology requires familiarity with temporal aspects of metabolism, hormones, and neurons . In other words, broadly trained, full-time "general practitioners" of a chronobiology in its own right are needed. Appl Environ Microbiol, 1983 Nov, 46(5), 1113 - 7 Effect of ambient temperature storage on potable water coliform population estimations; Standridge JH et al.; The effect of the length of time between sampling potable water and performing coliform analyses has been a long-standing controversial issue in environmental microbiology . The issue is of practical importance since reducing the sample-to-analysis time may substantially increase costs for water analysis programs . Randomly selected samples (from those routinely collected throughout the State of Wisconsin) were analyzed for total coliforms after being held at room temperature (20 +/- 2 degrees C) for 24 and 48 h . Differences in results for the two holding times were compared with differences predicted by probability calculations . The study showed that storage of the potable water for up to 48 h had little effect on the public health significance of most samples containing more than two coliforms per 100 ml. Am J Clin Pathol, 1983 Nov, 80(5), 714 - 8 An atypical subcutaneous infection associated with acquired immune deficiency syndrome; Stoler MH et al.; Cases of acquired immune deficiency syndrome (AIDS) continue to be reported at an alarming rate . As the numbers of cases increase, so too does the list of unusual manifestations associated with this syndrome . We report here a patient with AIDS who, during his clinical course, had a previously undescribed, histologically atypical, subcutaneous infection develop . Light microscopic, electron microscopic, and microbiologic data are presented . The cause and pathogenesis of this lesion are discussed. Clin Immunol Immunopathol, 1983 Nov, 29(2), 157 - 66 Radioimmunoassay for immunoglobulin G autoantibody on the surface of mouse erythrocytes; Jones CE et al.; A radioimmunoassay (RIA) for the determination of autoantibody on the surface of erythrocytes from New Zealand Black (NZB) mice is described . This method was adapted to hemagglutination plates in order to facilitate the separation of bound and unbound 125I-labeled rabbit anti-mouse immunoglobulin G with an automated cell harvester . Intra- and interday precision, over the useful quantitative range of the standard curve, was 3.9 and 12.9%, respectively . The RIA was five to ten times more sensitive than the direct antiglobulin test which, unlike the RIA, provided little quantitative information on a group of 20 experimental NZB mice . This is publication number 562 from the Department of Basic and Clinical Immunology and Microbiology, Medical University of South Carolina. J Clin Periodontol, 1983 Nov, 10(6), 590 - 601 Effect of long-term tetracycline therapy on human periodontal disease; Lindhe J et al.; The present investigation was performed to study the effect of long-term, low dosage tetracycline therapy on advanced periodontal disease in humans . 14 volunteers participated in the trial . Each of the participants had at least 4 pairs of diseased sites around contralateral premolars and incisors with deep pockets and advanced bone loss . The trial extended over a 50-week period and was designed as a double-blind split-mouth study . A Baseline examination included assessments of oral hygiene, gingival conditions, probing depth, attachment level and analysis of the composition of the subgingival microbiota in samples obtained from 8 selected diseased sites . All participants received oral hygiene instruction . In each patient 2 quadrants of the mouth, chosen at random, were treated by scaling and root planing . The 2 remaining quadrants were left unscaled . Following the Baseline examination the patients were randomly distributed into 2 groups of 7 members each . In one of the groups the patients received tetracycline on a daily basis during a 50-week period . The participants of the control group received placebo . Reexaminations were performed 2, 10, 20, 30 and 50 weeks after the Baseline examination . The findings demonstrated that in patients with advanced periodontal disease long-term tetracycline therapy in the absence of scaling resulted in the establishment of a subgingival microbiota almost devoid of motile bacteria and in markedly reduced signs of gingivitis, probing depth and attachment loss . In fact, the alterations observed as a result of tetracycline administration to patients with excellent self-performed plaque control were similar to those obtained by conventional scaling and root planing in the control group. J Clin Microbiol, 1983 Nov, 18(5), 1141 - 5 Toluidine red unheated serum test, a nontreponemal test for syphilis; Pettit DE et al.; We have shown that a modification of the color-coded antigen developed by Kasatiya and Lambert (Appl . Microbiol . 28:317-318, 1974) can be used as a substitute for other nontreponemal antigens used in screening tests for syphilis . The antigen is based on the Venereal Disease Research Laboratory antigen, with EDTA, choline chloride, and toluidine red toner added . Performance of the toluidine red unheated serum test (TRUST) is identical to that of the rapid plasma reagin 18-mm circle card test (U.S . Department of Health, Education, and Welfare, Public Health Service Publication no . 411) . In a series of preliminary evaluations, the TRUST antigen was found to be stable over a period of 6 months at 4 degrees C . In a comparison of TRUST with the rapid plasma reagin card test, the qualitative agreement was 100%, whereas agreement between these two tests and the Venereal Disease Research Laboratory slide test was 99.7% . The quantitative agreement +/- 1 twofold dilution between TRUST and the rapid plasma reagin card test was 100%; between TRUST and the Venereal Disease Research Laboratory slide test it was 75.0%; and between the rapid plasma reagin card and Venereal Disease Research Laboratory slide tests it was 60.0%. J Nutr, 1983 Nov, 113(11), 2192 - 6 The folacin contents of foods as measured by a radiometric microbiologic method; Chen MF et al.; A radiometric microbiologic assay for folate was applied to measure food folacin levels . Sixteen different foods were analyzed . The total folacin content of the 16 foods obtained by the radiometric microbiologic method was found to compare well with that obtained by the turbidimetric microbiologic method . The folacin content ranged from 9 ng/ml of frozen reconstituted grape juice to 1820 micrograms/100 g of the cereal Total . The study showed that the radiometric microbiologic assay can be used to measure folacin content in foods. J Clin Pathol, 1983 Nov, 36(11), 1241 - 5 An evaluation of gentamicin EMIT--its performance on the Kem-O-Mat and its role in the small laboratory; Masterton RG et al.; An investigation was made into the use of gentamicin EMIT on the Coulter Kem-O-Mat in a small microbiology laboratory . EMIT was found to correlate well with plate assay and to be a more rapid, more precise and technically less time-consuming method . EMIT was more expensive in clinical use . This single disadvantage was considered to be outweighed by a saving in capital equipment expenditure and by the benefits to the laboratory and clinician. Medicine (Baltimore), 1983 Nov, 62(6), 372 - 83 Granulomatous bone marrow disease . A review of the literature and clinicopathologic analysis of 58 cases; Bodem CR et al.; We have reviewed 58 cases of bone marrow granuloma at a single institution over a 20-year time span, and have summarized the available English literature . We conclude that bone marrow granulomas are an infrequent pathologic finding which, when found, require definition as to an underlying etiology . Undoubtedly, the illnesses associated with marrow granuloma are similar to those causing granulomatous hepatitis . The following additional statements may justifiably be made based on this review . There are no morphologic features which allow reliable differentiation between the causes of bone marrow granuloma . By combining careful histologic, microbiologic, and serologic techniques, an etiology can be documented in most (87%) patients with marrow granulomas . A medication history is an important element of this evaluation . Rocky Mountain spotted fever, cytomegalovirus infection, ibuprofen, acute lymphocytic leukemia, and various collagen vascular diseases should be added to the list of causes of marrow granuloma . The prognostic significance of marrow granuloma in patients without an ascertainable underlying illness remains unclear. J Infect Dis . 1983 Nov;148(5):942. Avidin-biotin radioimmunoassay for human rotavirus; Yolken RH; RIAs have a number of advantages which make them ideally suited for use in diagnostic microbiology . These advantages include sensitivity, objectivity, and versatility . However, the widespread application of RIAs has been limited by the instability of the reagents required for the performance of available solid-phase RIAs . The relatively short half-life of gamma-emitting isotopes is particularly a problem in cases where multiple antigens must be assayed, since distinct radioactively labeled reagents are required for each antigen to be measured . The problems associated with the use of standard RIAs could be avoided if the specific immunoglobulin directed at the antigen were labeled with a stable, nonradioactive isotope and if a generally reactive radioactive ligand were bound in a subsequent reaction . We have thus developed RIA systems that use immunoglobulin linked with biotin by reaction with biotin N-hydroxysuccinamide ester {1} . The biotin bound to the solid phase is subsequently measured by reaction with unlabeled avidin and 3H-labeled biotin (New England Nuclear Corp, Boston) . The reaction is quantitated by the measurement of tritiated biotin in a standard scintillation counter . This reaction format takes advantage of the stability of biotin-immunoglobulin conjugates, the high affinity of biotin to avidin, and the fact that a single molecule of avidin can react with four molecules of biotin {2} . We devised an avidin-biotin RIA that uses goat and guinea pig antisera directed at human rotavirus and used it to detect rotavirus in 44 stool specimens obtained from children with acute gastroenteritis during the winter months {3}.(ABSTRACT TRUNCATED AT 250 WORDS) Tumori, 1983 Oct 31, 69(5), 423 - 35 Electron microscopy applied to fine-needle aspiration . A report of six cases from various sites; Cinti S et al.; The authors report the results obtained from the application of electron microscopy techniques to the cytology of fine-needle-aspirated samples of neoplastic lesions from various body sites . These results show that the tissue structure, which is usually lost during the squashing necessary for light microscopy cytology, is preserved when the samples are processed for ultrastructural analysis . Electron microscopy also allows a highly detailed study of the cell's inner structures . Thus, when this technique is applied, fine needle-aspirated samples can be regarded as actual microbiopsies . However, because of the high cost of ultrastructural techniques, we suggest that actual analysis be performed only in selected cases, whereas fixation and inclusion for electron microscopy could be done routinely. Arch Pathol Lab Med, 1983 Oct, 107(10), 505 - 9 Recombinant DNA technology and laboratory medicine; Rabson AB et al.; Recombinant DNA technology has already had a major impact on our understanding of microbiology, cell biology, and genetic diseases and it will certainly have extensive applications in laboratory medicine . The techniques of restriction endonuclease analysis of DNA, nucleic acid hybridization after electrophoretic separation of nucleic acid fragments, and molecular cloning of bacterial, viral, and human genes are already being used in epidemiologic studies and the prenatal diagnosis of certain genetic diseases, such as sickle cell anemia and the thalassemias . New insights into genes that may be involved in human cancer are being developed and may lead to improved methods for diagnosis and classification of tumors. J Hand Surg {Am}, 1983 Sep, 8(5 Pt 1), 568 - 73 Mycobacterium marinum infection of the hand involving deep structures; Chow SP et al.; Five patients with Mycobacterium marinum infection of the hand involving deep structures were seen recently . Four of them were fishermen . Hydrocortisone injection or simple incision and drainage led to worsening of the infection . The clinical presentation, operative finding, and histopathologic and microbiologic features were quite similar in all five patients . Extensive debridement and therapy with ethambutol and rifampin led to satisfactory results in four patients while biopsy and therapy in the fifth patient seemed to offer another form of acceptable treatment. Am Rev Respir Dis, 1983 Sep, 128(3), 534 - 8 Paragonimiasis in Indochinese refugees . Roentgenographic findings with clinical correlations; Johnson RJ et al.; Twenty-five Indochinese refugees with paragonimiasis were reviewed . Thirteen patients were diagnosed by ova identification in sputum specimens, but 12 patients were diagnosed by an elevated complement fixation titer in conjunction with clinical and epidemiologic criteria . Roentgenographic lesions included diffuse (44%) and segmental (24%) infiltrates, nodules (20%), and cavities (20%) . The classic ring shadow was present in only 8% . Of note was the frequency of pleural effusions (48%), which were massive in 6 patients and the sole manifestation in 5 . Although tuberculosis should always be excluded, work-up of pulmonary effusions and infiltrates in immigrants from Southeast Asia should include a serologic and microbiologic search for paragonimiasis. JPEN J Parenter Enteral Nutr, 1983 Sep-Oct, 7(5), 462 - 4 Stability of the B vitamins in mixed parenteral nutrition solution; Chen MF et al.; The effects of various light conditions such as fluorescent light, and indirect and direct sunlight on the stability of the water-soluble B vitamins in parenteral mixtures were studied . The levels of the B vitamins were determined by microbiologic assays and spectrophotometrically . Most of the B vitamins were found to be stable . However, indirect and direct sunlight destroyed 47 and 100%, respectively, of riboflavin-5-phosphate in eight hours . Direct sunlight destroyed 86% of pyridoxine HCl . There was no loss of folic acid in parenteral nutrition mixtures after storage for 7 wk . The microbiologic assays were found to be reliable to measure the levels of the B vitamins in parenteral nutrition solution. Rev Infect Dis, 1983 Sep-Oct, 5 Suppl 4, S793 - 6 Bacterial virulence and the inflammatory system; Ward PA et al.; The sequence of events by which bacteria activate immune responses is extremely complex . The culmination of these events often leads to immunopathologic consequences, which are evident in both local and systemic bacterial infections . Where mediators are generated, immune/inflammatory cells are activated, and tissue is destroyed . In the case of acute inflammatory reactions, the following scenario can occur: bacteria activate the complement cascade, polymorphonuclear leukocytes are recruited, and lysosomal enzymes and toxic oxygen products that destroy both the inciting bacteria and the surrounding tissue are generated . The complex interplay among the various mediator systems, inflammatory cells, and toxic products is recognized as a complicated array of pathways necessary for clearance of a given bacterial infection . Understanding these pathways, which ultimately lead to an appropriate immune response to the bacteria, is an extremely challenging problem to microbiologists and immunologists alike. Am J Vet Res, 1983 Sep, 44(9), 1656 - 9 Experimental respiratory syncytial virus pneumonia in young calves: microbiologic and immunofluorescent findings; McNulty MS et al.; Young calves were inoculated with respiratory syncytial virus (RSV) intranasally or by a combined intranasal and intratracheal route and were killed between postinoculation (initial) days (PID) 1 and 14 . Viral antigens were detected by immunofluorescence in nasopharyngeal cells from calves killed between PID 2 and 10 . Evidence of infection of the trachea and lungs with RSV was obtained by immunofluorescence and virus isolation in calves inoculated by the combined route, but not in calves inoculated intranasally . Within the lungs, RSV antigens were observed in epithelial cells of bronchioli and alveoli . The only virus detected in inoculated calves was RSV . With the exception of 1 calf, bacteria or mycoplasmas were not isolated from the lower respiratory tracts of inoculated calves . Antibody to RSV was not detected in calves killed up to PID 5, but 4 of 5 colostrum-deprived calves killed between PID 10 and 13 had antibodies to RSV . Preexisting, maternally derived antibody to RSV did not protect the calves from infection . Seemingly, the clinical signs of pneumonia and pathologic lesions observed in inoculated calves were caused by RSV infection. Infect Immun, 1983 Sep, 41(3), 1138 - 43 Effect of heptakis (2,6-O-dimethyl) beta-cyclodextrin on the production of pertussis toxin by Bordetella pertussis; Imaizumi A et al.; The effect of heptakis (2,6-O-dimethyl) beta-cyclodextrin (Me beta CD) on the production of pertussis toxin was evaluated . The addition of Me beta CD to the medium stimulated cell growth and pertussis toxin production . Me beta CD enhanced pertussis toxin production 100 times more in synthetic media, such as Stainer-Scholte medium (D . W . Stainer and M . J . Scholte, J . Gen . Microbiol . 63:211-220), than in Me beta CD-free medium in 2-day shake cultures . Maximum production of pertussis toxin was estimated as 50 mg of protein per liter of culture broth both by in vitro and in vivo assays . Purified toxin was demonstrated to be biochemically and biologically identical to the toxin produced in Me beta CD-free static cultures. Infect Immun, 1983 Sep, 41(3), 1031 - 7 Isolation, propagation, and characterization of a second equine rotavirus serotype; Hoshino Y et al.; A rotavirus designated strain H-2 was isolated in primary African green monkey kidney cells from a foal with diarrhea . This cell culture-adapted strain was found to be similar, if not identical, to simian rotavirus (strains MMU18006 and SA-11) and canine rotavirus (strain CU-1) and, in addition, demonstrated a one-way antigenic relationship with five human rotavirus strains (P, B, no . 14, no . 15, and YO) of the third human rotavirus serotype by the plaque reduction neutralization test . This is the fifth example of an animal rotavirus which shares serotypic specificity with a human rotavirus . The H-2 strain is distinct from the H-1 strain (Y . Hoshino et al., J . Clin . Microbiol., in press) of equine rotavirus not only in serotypic specificity by neutralization but also in subgroup specificity, hemagglutinating activity, and RNA electrophoretic migration pattern, thus establishing the existence of a second equine rotavirus serotype . This H-2 isolate is also distinct by neutralization from three other human rotavirus serotypes, 1 (Wa), 2 (DS-1), and 4 (St . Thomas no . 4), as well as bovine (NCDV), and porcine (OSU) rotaviruses. Am J Obstet Gynecol, 1983 Aug 15, 146(8), 938 - 41 Leukocyte counts and microbiologic cultivation in the diagnosis of puerperal mastitis; Thomsen AC et al.; In order to study the value of leukocyte counts and quantitative microbiologic cultivation of milk in the diagnosis of puerperal mastitis, 491 milk samples from nursing women were examined . In milk samples from mammary glands without inflammatory symptoms, leukocyte counts were less than 10(6)/ml of milk, and the milk was sterile or harbored less than 10(3) bacteria/ml . Samples from mammary glands with inflammatory symptoms could be divided into three groups . In one group, leukocyte counts were less than 10(6)/ml of milk, and cultivation results were similar to those of mammary glands without symptoms . The symptoms persisted for an average of 2.1 days . These cases were considered as milk stasis . In another group, the leukocyte counts were greater than 10(6)/ml of milk, but the milk was sterile or contaminated by skin flora bacteria . Average duration of symptoms was 5.3 days . These cases were considered as noninfectious inflammation of the breast . In the third group, leukocyte counts were greater than 10(6)/ml of milk and bacteria occurred in numbers of greater than 10(3)/ml, which suggests the presence of infectious mastitis . In these cases only antibiotic treatment should be recommended. Emerg Med Clin North Am, 1983 Aug, 1(2), 345 - 70 Pneumonia and lung abscess; Carden DL et al.; The epidemiologic, microbiologic, radiographic, and clinical presentations of pneumonias caused by the most common pathogens are discussed in detail, and current recommendations for hospitalization are reviewed . Also considered are the clinical characteristics, diagnosis, and treatment of primary and secondary lung abscess. Am J Med, 1983 Jul 28, 75(1B), 109 - 18 Antigen detection in cerebrospinal fluid--pros and cons; Kaplan SL; Over the past decade, rapid diagnostic techniques for detection of bacterial polysaccharide antigens have been developed and successfully applied in the clinical setting . Currently, countercurrent immunoelectrophoresis, latex particle agglutination, and coagglutination are the techniques most used in microbiology laboratories . Enzyme immunoassays may become more practical in the future . Quantitation of antigen concentration in cerebrospinal fluid provides prognostic information at the time of admission . This review summarizes the advantages, disadvantages, and clinical applications of these techniques. N Engl J Med, 1983 Jul 14, 309(2), 67 - 71 Single-dose therapy of chancroid with trimethoprim-sulfametrole; Plummer FA et al.; We conducted a randomized double-blind trial comparing a single dose of trimethoprim-sulfametrole (640 to 3200 mg) with five-day regimens of either trimethoprim-sulfametrole (160 to 800 mg twice daily) or trimethoprim alone (200 mg twice daily) for the treatment of men with chancroid . Of 95 patients, 78 had cultures positive for Hemophilus ducreyi . Twenty-seven, 23, and 28 patients, respectively, were assigned to the single-dose trimethoprim-sulfametrole, the five-day trimethoprim-sulfametrole, and the five-day trimethoprim treatments . The rate of ulcer and bubo resolution, the mean (+/- S.D.) healing times (10.3 +/- 5.7, 11.0 +/- 7.4, and 11.9 +/- 8.2 days, respectively), the microbiologic response, the number of treatment failures, and the number of recurrent ulcers were similar in all three treatment groups . We conclude that single-dose trimethoprim-sulfametrole is a highly effective, inexpensive therapy for chancroid in men and may prove to be an important strategy for the control of H . ducreyi infection. Rev Infect Dis, 1983 Jul-Aug, 5(4), 713 - 9 Role of Chlamydia trachomatis in perinatal infection; Alexander ER et al.; The transmission of Chlamydia trachomatis from the infected cervix of a mother to the eye of an infant, with resultant inclusion conjunctivitis, was documented in humans and in primates 75 years ago by cytologic methods . With modern microbiologic methodology it is possible to quantitate this transmission . It is now known that 2%-24% (usually 7%-12%) of cervices are infected before delivery and that 18%-50% (usually 20%-25%) of infants born to culture-positive mothers develop conjunctivitis . In addition, nasopharyngeal infection occurs in 15%-20% of infants, and 3%-18% develop pneumonia due to C . trachomatis . Bronchiolitis and otitis media are less common infections . The consequence of rectal and vaginal colonization remains unknown, as does the significance of the increase in antibody titers against C . trachomatis throughout early childhood . Early studies suggesting that C . trachomatis was a prominent cause of postpartum endometritis and a cause of premature delivery have not been confirmed in larger prospective studies when mycoplasma species were simultaneously studied . A subset of mothers with active infection, as evidenced by IgM antibody against C . trachomatis, may have earlier delivery, but it is clear that evaluation of the contribution of C . trachomatis to maternal and fetal risk will require larger studies with evaluation of possible concurrent mycoplasmal infection. J Am Dent Assoc, 1983 Jul, 107(1), 37 - 41 A rationale for the management of periodontal diseases: effects of tetracycline on subgingival bacteria; Rams TE et al.; Microbiologic criteria obtained with phase-contrast microscopy were used in a short-term, double-blind study to measure the effects of systemic tetracycline HCl on subgingival bacterial populations in advanced periodontal pockets refractory to local therapy (repeated scaling, root planing, and the subgingival administration of chemotherapeutic agents {H2O2, NaHCO3, NaCl, MgSO4}) . Twenty-one subjects, selected for study, had at least one of the following conditions present after local therapy: spirochetes, motile rods, or crevicular leukocytes greater than or equal to 125 per phase-contrast microscopic field . Tetracycline HCl (1 gm/day for 14 days) was randomly distributed to 11 subjects and a placebo to ten subjects, so that neither the subjects nor investigators were aware of the prescription contents . Evaluations after two weeks disclosed that tetracycline HCl significantly reduced elevated levels of spirochetes, motile rods, and crevicular leukocytes to low or undetectable levels, whereas levels in the placebo subjects remained generally unchanged . The results clearly demonstrate the value of tetracycline HCl as an adjunct to periodontal therapy in reducing remaining suspected periodontopathic bacterial populations in advanced lesions after local therapy of scaling, root planing, and topically applied chemotherapy. Drug Intell Clin Pharm, 1983 Jul-Aug, 17(7-8), 544 - 6 Falsely elevated aminoglycoside serum levels in jaundiced patients; Wagner JC et al.; Two cases in which hyperbilirubinemia produced falsely elevated aminoglycoside concentrations, using the Emit assay, are described . Patients' sera were analyzed by both the Emit and a microbiologic assay . The first patient had a 26-percent greater tobramycin concentration with the Emit assay, as compared with the microbiologic assay, when the total bilirubin was 20.1 mg% . For the same patient, there was essentially no difference between the two assays when the total bilirubin was 4 mg% . The Emit concentrations in the other patient were 34-percent elevated with a total bilirubin of 9.7 mg% . Pharmacokinetic analysis also was performed on serum levels reported by each method . Calculated kinetic parameters and dosage regimens varied greatly . Patients with total bilirubin concentrations greater than 4 mg% may need to have aminoglycoside serum levels assayed by a method other than the Emit assay. Nature . 1983 Jun 2-8;303(5916):369. Scientific fraud . The system defends itself; David P; KIE: Nicholas Wade, co-author of the book Betrayers of the Truth, defended his views on fraud in academic science before a panel at the 1983 meeting of the American Association for the Advancement of Science . Participants reacted negatively to his argument that recently-revealed episodes of cheating and plagiarism involving respectable scientists are not isolated incidents, but indicators of widespread problems in the field . Microbiologist Norman Zinder and other participants challenged Wade's statements and rejected his criticisms of peer review and other traditional checking mechanisms in science . Quad Sclavo Diagn, 1983 Jun, 19(2), 159 - 75 {Comparative evaluation of 3 miniaturized systems (API 20E, Enterotube II, Sensititre AP60) commonly used in clinical microbiology laboratories}; Chiaradia V et al.; API 20E, Enterotube II, Sensititre AP60 have been evaluated . Some biochemical tests (lysine, ornithine, VP, H2S, adonitol , arabinose, citrate) have revealed significative differences among three systems . The total correlations about bacterial identifications have been very similar . The repetibility of identifications of strains isolated from clinical specimens has been 98.7% for Enterotube and API 20E, 95.5% for Sensititre . The biochemical tests have revealed repetibility greater than or equal to 94%, citrate repetibility instead has been 91%. Pathologist, 1983 Jun, 37(6), 404 - 9 Decisions related to automation in microbiology; Sodeman TM et al.; The selection of instruments for the microbiology laboratory poses unique problems . The author of this article recommends useful steps in this process. Zh Mikrobiol Epidemiol Immunobiol, 1983 May, (5), 70 - 5 {Inoculation properties of live combined vaccine against measles and mumps}; Vasil'eva GA et al.; The data obtained in the study of the immunization properties of experimental and production lots of combined parotitis-measles vaccine prepared at the Pasteur Research Institute for Epidemiology and Microbiology (Leningrad) in 1971-1979 are summarized . The preparation was shown to possess low reactogenicity and, at the same time, high immunogenic activity . The reactogenicity of the preparation depended mainly on the presence of the measles component in the divaccine and its immunogenicity, on the measles virus/parotitis virus ratio in one vaccination dose . The concentration of measles virus between 300 and 10000 infective units and parotitis virus between 5000 and 100000 infective units in one vaccination dose, as well as the age of the vaccinees, did not affect the immunization properties of the divaccine . The use of the combined vaccine in the foci of parotitis infection did not increase the reactogenicity of the preparation, but enhanced its immunogenic properties. Am J Med Technol, 1983 May, 49(5), 323 - 5 Automation in microbiology: a physician's viewpoint; Dupont PF; Physicians in clinical practice are often less than fully aware of the problems and potential resources of the microbiology laboratory . While automation can be of significant benefit simply within the laboratory itself, communication with those directly responsible for patient care is vital if the full potential of automation to improve the quality of health care is to be realized . This paper presents the clinician's viewpoint and suggests affirmative actions the microbiologist can take to improve the clinician/laboratory working relationship. Am J Med Technol, 1983 May, 49(5), 299 - 301 Roots of automation in microbiology: an introduction; LeBeau LJ; It seems like a long way from the early work of Pasteur and Koch to the automated microbiology laboratory of today . But every advance rests on a knowledge base gleaned from past work; and to understand where we are today, it is necessary to know how we got there . This paper explores the historical roots of current microbiology technology. Cancer, 1983 May 1, 51(9), 1653 - 5 Enzymatic analysis of gastric microbiopsy specimens . An aid in the differential diagnosis between peptic ulcers and gastric carcinoma? Kuhn SH, Bezuidenhout DJ. Microgastric biopsies were obtained from 20 patients with clinical, radiologic, and endoscopic features of gastric neoplasms . Biopsy specimens were taken from both macroscopically normal gastric mucosa (confirmed histology), and from the lesion . In 16 patients, various stages of adenocarcinoma were confirmed . Repeated biopsy examinations, ruled out malignancy in the four remaining patients, in which a final diagnosis of healing ulcers was established . Homogenates were prepared from the biopsy specimens, and subsequently assayed individually for acid- and alkaline phosphatase and acid proteases . Significant variances (P less than 0.05), were demonstrated for acid protease activities when tumor homogenate levels were compared; firstly with normal mucosa and secondly with ulcer homogenate levels . Biopsy hydrolase determinations may be valuable in providing important additional information not obtained from histologic examinations. Pathol Biol (Paris), 1983 May, 31(5), 419 - 24 {Results of a comparative therapeutic trial of single-dose treatment of non-complicated acute male gonorrhea}; Ancelle R et al.; A single dose treatment trial with: spectinomycine 2 g, ampicilline + probenecide 3.5 g + 1 g, thiamphenicol 2.5 g, minocycline 300 mg was undertaken . Three teams were involved, epidemiologists clinicians, microbiologists, 636 patients were included, 483 resumed for control . A negative culture on the third day was considered a success . Failure rates were: spectinomycine 4%, ampicilline-probenecide 3%, thiamphenicol 4%, minocycline 3% . No significant difference was noted between the four rates . The delay of clinical cure was 1.98 days for spectinomycin, 1.87 days for ampicilline - probenecide, 2.16 days for thiamphenicol and 2.12 for minocycline without significant difference . When side effects were analysed, 10% of the patients reported asthenia without difference between the four treatments . Thiamphenicol is responsible for diarrhea 28%, P less than 0,01 minocycline more significantly responsible for guidiness 13%, P less than 0,001, and 18% treated by spectinomycine complained of pain at the time of injection . The antibiotics MIC's are studied . After the analysis of the results, the cost, and the resistances, one treatment was selected. Am J Med Technol, 1983 Apr, 49(4), 247 - 52 A continuing education program for rural communities: evaluating cognitive and behavioral change; Bruce AW et al.; A total of 133 laboratory workers from 60 institutions participated in a unique continuing education project in North Dakota . Cognitive and behavioral changes of the participants were measured in an attempt to evaluate the effectiveness of the Laboratory Education for North Dakota (LEND) program, which included self-instructional programs (SIPs), telelectures, and workshops . The effects of variables such as institutional size, educational level of participants, topic presented, and type of participation were studied . Institutional size had no significant effect on cognitive change (P greater than .05) but had some effect on behavioral change . Educational level was found to significantly affect pretest scores (P less than .05), but was not a major factor in post-test scores . Certain topics presented (i.e., quality assurance and microbiology) resulted in significantly more behavioral changes than other categories . Behavioral changes and degree of cognitive change did not always correspond . Significant correlation was shown between attendance at wet workshops and the number of behavioral changes. J Bacteriol, 1983 Apr, 154(1), 253 - 60 Mutations in a new gene, secB, cause defective protein localization in Escherichia coli; Kumamoto CA et al.; We isolated a new class of Escherichia coli mutants with pleiotropic defects in protein secretion . Using a previously described selection procedure (Oliver et al., Ann . Microbiol . {Paris} 133A:105-110, 1982), we obtained a large collection of strains containing mutations that affect protein localization . In many cases, the lesions causing the secretion defects were mapped in or near the previously identified gene, secA (Oliver and Beckwith, Cell 25:765-772, 1981) . However, the selection also yielded mutants with mutations in a new locus, which was designated secB . These secB mutants were defective in the localization of maltose-binding protein and, in at least one case, OmpF protein . Double mutants with lesions in both secA and secB had strong defects in the secretion of maltose-binding protein and OmpF protein . The secB locus mapped near cysE at min 80.5 on the E . coli genetic map . The properties of secB mutants suggest that the secB product could be a component of the E . coli secretory apparatus. J Gen Microbiol, 1983 Apr, 129 (Pt 4), 973 - 80 Flow cytometry of bacteria: a promising tool in experimental and clinical microbiology; Boye E et al.; The DNA and protein content of individual Escherichia coli cells were measured at a rate of 10(4) cells per second with a sensitive microscope-based flow cytometer . DNA and protein were quantified by measuring the fluorescence from cells stained with a combination of the DNA-binding drugs Mithramycin and ethidium bromide and by scattered light, respectively . Separate experiments demonstrated that the light scatter signal was proportional to protein content . Dual parameter histograms (fluorescence/scattered light) of bacterial cultures gave detailed pictures of changes dependent upon the growth conditions and of the cell cycle kinetics . Effects of antibiotics could be readily detected and characterized after a few hours . The results demonstrate that flow cytometry is a promising method for application in experimental and clinical microbiology. Ann Trop Med Parasitol, 1983 Apr, 77(2), 113 - 7 The reliability of the microscopic diagnosis of malaria in the field and in the laboratory; Collier JA et al.; Four hundred and seventy thick and thin blood films were prepared from 129 villagers in the Solomon Islands . After staining with Giemsa, Leishman's, and Field's stains, they were randomized and examined in the field, using a miniature McArthur microscope . The specimens were then examined in the local central laboratory and by a microbiologist at a hospital in England . Films over which there was disagreement were examined by an expert at the Liverpool School of Tropical Medicine . The rate of false negative diagnoses (for thick films) was 3% for the field worker, 9% for the malaria laboratory, and 27% for the English hospital . Field diagnosis was no less reliable than laboratory diagnosis (P less than 0.001) . Field's stain was the most reliable stain for both thick films (P less than 0.001) and thin films (P less than 0.05), for which a new staining technique is described. Ophthalmology, 1983 Mar, 90(3), 195 - 203 Bacterial periorbital and orbital cellulitis in childhood; Weiss A et al.; The clinical features, microbiologic data, complications, and treatment in 137 children with periorbital cellulitis and 21 children with orbital cellulitis is presented . Periorbital cellulitis was more frequent (87%) than orbital cellulitis (13%) . Periorbital cellulitis is a heterogeneous disease that may complicate trauma of the eyelids, external ocular infection, and upper respiratory infection . Children with periorbital cellulitis related to trauma or external infection tended to be less than 5 years old with negative blood cultures (99%) and positive cultures of percutaneous aspirates (42%); while children with periorbital cellulitis related to upper respiratory infection also tended to be less than 5 years of age, but blood cultures were frequently positive (42%) and cultures of percutaneous aspirates were usually negative (92%) . Three children in the latter group developed meningitis . Intravenous antibiotic alone was effective treatment in most patients (90%) . Orbital cellulitis was more frequent in children older than 5 years and frequently associated with sinusitis (90%) . Blood and skin cultures were usually negative . Intravenous antibiotics alone were effective management in many patients (62%), but a significant proportion required paranasal sinus or orbital surgery (38%). Proc Soc Exp Biol Med, 1983 Mar, 172(3), 301 - 7 Dimethyl sulfoxide (DMSO) does not affect epidermal wound healing; Goldblum OM et al.; We studied the effect of 95% DMSO on dermal/epidermal healing and microbiol flora in partial-thickness wounds . Wounds of 0.3 mm were made in the skin of Yorkshire pigs with a keratome and treated daily with either 95% DMSO, water, or they were left untreated . Wounds were excised on Days 2-7 and the dermis was separated from the epidermis . The dermis was assayed for collagen biosynthesis (by measuring the production of {14C}hydroxyproline (HP) and amount of radioactive peptides released after collagenase digestion) and absolute HP (by spectrophotometric analysis) . The epidermis was evaluated macroscopically for resurfacing . Aerobic bacteria from unwounded and wounded skin were identified and quantitated . There were no significant differences between treatment groups in HP incorporation or absolute collagen content from Days 2-6 after wounding . HP incorporation in the total protein fractions and in the collagenase digestible fractions were analogous . Collagen biosynthesis was similar in both unwounded, untreated, and unwounded DMSO-treated skin . Epidermal healing did not differ between treatment groups . There were no differences in the number or types of bacteria in wounds between treatment groups . These results indicate that topical DMSO is neither beneficial nor harmful in the healing of superficial wounds. J Virol, 1983 Mar, 45(3), 1159 - 63 Molecular cloning of infectious viral DNA from ecotropic neurotropic wild mouse retrovirus; Jolicoeur P et al.; Among a mixture of amphotropic and ecotropic murine leukemia viruses (MuLVs) isolated from paralyzed wild mice, only N-tropic ecotropic MuLV, cloned by cell culture techniques, has been shown to induce paralysis after reinjection into susceptible mice (M . B . Gardner, Curr . Top . Microbiol . Immunol . 79:215-239, 1978) . The viral DNA genome of one of these neurotropic MuLVs (Cas-Br-E) has been cloned in Charon 21A at the SalI site . One clone, designated NE-8, was studied in more detail . A restriction endonuclease map of this cloned DNA was derived . Cloned viral DNA microinjected into NIH 3T3 cells produced infectious MuLV which was characterized as XC+, ecotropic, and N-tropic . The virus that was recovered after the microinjection of NE-8 DNA was also injected into susceptible SIM.S and NIH Swiss mice and was found to induce lower limb paralysis in these animals . These results make it highly unlikely that other agents (which might have escaped detection and separation from ecotropic MuLV by the techniques previously used) play a role in the etiology of this disease and clearly indicate that the ecotropic MuLV genome harbors sequences responsible for this paralysis . The availability of this clone DNA would now allow us to map these sequences on the genome. Appl Environ Microbiol, 1983 Feb, 45(2), 360 - 5 Enhanced recovery of injured Escherichia coli by compounds that degrade hydrogen peroxide or block its formation; McDonald LC et al.; Escherichia coli LSUFS was injured either by freezing at -10 degrees C or by heating at 57 degrees C for 12 min . Surviving cells were recovered on nonselective tryptone-glucose extract agar and selective violet red bile agar supplemented with compounds that degrade hydrogen peroxide or block its formation . Various concentrations of the following compounds were tested: sodium pyruvate, 3,3'-thiodipropionic acid, catalase, ascorbic acid, potassium permanganate, sodium thioglycolate, dimethylsulfoxide, ethoxyquin, n-propyl gallate, alpha-tocopherol sodium metabisulfite, and ferrous sulfate . Sodium pyruvate and 3,3'-thiodipropionic acid, when added to either medium, significantly (P greater than 0.01) increased recovery of injured cells . More than 90% of the heat-injured cells and 40 to 90% of the freeze-injured cells failed to grow on unsupplemented tryptone-glucose extract agar . Supplementation of violet red bile agar increased recovery, but the counts remained considerably lower than the tryptone-glucose extract agar counts . The repair detection procedure of Speck et al . (M . Speck, B . Ray, R . Read, Jr., Appl . Microbiol . 29:549-550, 1975) was greatly improved by the addition of pyruvate or 3,3'-thiodipropionic acid . However, when this improved repair detection procedure was applied to foods, pyruvate-supplemented media showed some false-positives . We therefore recommend that 3,3'-thiodipropionic acid be used to supplement media in the repair detection procedure. Br Med J (Clin Res Ed), 1983 Jan 8, 286(6359), 118 - 22 Audits of antibiotic prescribing in a Bristol hospital; Swindell PJ et al.; Audits of antibiotic prescribing were done for periods of up to eight weeks in two successive years on medical, surgical, orthopaedic, gynaecology, obstetric, and urology wards and in an accident and emergency department . Clinical details were matched with antibiotic prescribing, and the appropriateness of the latter was judged independently by two medical microbiologists . Only when they agreed was an individual prescription included in the analysis . Overall, 28% of prescriptions in 1979 and 35% in 1980 were judged as unnecessary, with 17% and 16%, respectively, being for inappropriate choices of antibiotic . An educational programme about antibiotic prescribing carried out between the audits had no beneficial effect overall . Though the results compared favourably with those of audits published, prescribing could still be much improved . To judge by the failure of education, however, this might be difficult to achieve . Most prescriptions were written by junior staff, who in the absence of guidance from their seniors and because of their frequent moves would require a widespread and continual education programme . Published concern about the quality of antibiotic prescribing appears to be justified. Clin Radiol, 1983 Jan, 34(1), 95 - 7 Overwhelming post-splenectomy infection in Hodgkin's disease: pathogenesis and prevention; Shimm DS et al.; After staging splenectomy, the risk of overwhelming sepsis in patients with Hodgkin's disease reaches 21% in certain subgroups . Youth, recent splenectomy and vigorous chemoradiotherapy predispose patients to this complication . Because of its explosive course and its known microbiology, post-splenectomy sepsis is better suited to prevention than to treatment . Since immunisation prior to treatment produces good antibody responses, all patients with Hodgkin's disease should probably be vaccinated against encapsulated bacteria at least 10 days prior to the onset of therapy. Zentralbl Gynakol, 1983, 105(24), 1585 - 96 {Diagnostic verification of Group III and III D cytological tests with special reference to follow-up}; Schlegel H et al.; The diagnostic verification of Pap III and Pap III D-smears from mass screening is described with special regard to the importance of colposcopical and cytological long-term controls . 233 (59.8%) out of 390 patients were verified within one year (1.1.-31.12 . 1977) . A high percentage (27.5%) of the first control smears was negative or the cytological picture had become normal (19.5%) after vaginal treatment by antibiotics and application of estrogens . 50 women were cured by conization or primary hysterectomy as the cytological diagnosis yielded suspicion of severe dysplasia or carcinoma in situ . Depending on cytological differential diagnosis, individual situations and the developmental tendency of the atypical epithelium 157 patients (40.2%) were observed for several years . The great diagnostical-therapeutical importance of colposcopy for the early recognition of cervical intraepithelial neoplasia (CIN) is demonstrated . A direct microbiopsy controlled by colposcopy is a valuable completing method if there are differences between colposcopical and cytological findings during a long-term control of the cases . A slight or moderate dysplasia can be observed for about 2 or 3 years, as most regressions are seen in this period . In problematic cases (young nullipare, patients treated because of infertility or sterility, pregnant women, old women) with severe dysplasia/carcinoma in situ it is possible and justifiable to control the patient temporarily in short distances . All cases which are suspicious of an early stromal invasion call for a definite diagnosis and therapy without any delay . Primary hysterectomy is preferred in patients aged 35 years or more. Histochemistry, 1983, 78(4), 539 - 44 Microbiochemical approach to liver cell heterogeneity around terminal hepatic venules; Hildebrand R; Using lyophilized cryostat sections of liver the activities of alanine aminotransferase, lactate dehydrogenase, and pyruvate kinase were measured using a Lowry technique in the first layer of hepatocytes adjacent to terminal hepatic venules and in the residual parenchymal of the perivenous zone of the acinus in normally fed adult male Wistar rats . Alanine aminotransferase was homogeneously distributed in the two areas measured (ratio hepatocytes adjacent to terminal hepatic venules/residual parenchyma of the perivenous zone: 1.05) . Enzyme activities of the lactate dehydrogenase were significantly lower in the hepatocytes adjacent to terminal hepatic venules (ratio: 0.65) and those of the pyruvate kinase significantly higher (ratio: 1.12) than in the residual parenchyma of the perivenous zone indicating liver cell heterogeneity in this zone of the liver acinus. Epidemiol Rev, 1983, 5, 96 - 123 Epidemiology of sexually transmitted Chlamydia trachomatis infections; Thompson SE et al.; PIP: This paper provides a comprehensive review of the literature on the epidemiology of sexually transmitted chlamydial infections . Its major sections focus on the following substantive areas: microbiology, serologic classification, infections of men (urethritis, epididymitis, prostatitis), infections of women (endocervicitis, urethritis, salpingitis, endometritis, infertility, ectopic pregnancy), effect of genital chlamydial infections on pregnancy, other diseases (Reiter's syndrome, cervical atypia, gastrointestinal infection, lymphogranuloma venereum), and prevention and control programs . It is conceded that wide gaps remain in our understanding of the epidemiology of these organisms . If the estimate that 20% of salpingitis cases are due to C trachomatis is accepted, then at least 20,000 women/year in the US may be infertile because of chlamydial infection . At present, there is a need to define the prevalence and incidence of chlamydial infection in different populations so that high risk groups can be identified and targeted for prevention programs . Studies must also continue to test the link between maternal chlamydial infection and abortion, prematurity, perinatal mortality, and puerperal maternal infections . Ultimately, the most efficient approach to managing chlamydial infection may be provided by a vaccine . Clin Chest Med, 1983 Jan, 4(1), 55 - 62 Hypersensitivity pneumonitis; Stankus RP et al.; Hypersensitivity pneumonitis represents a disease spectrum and not a single pulmonary disorder . Both acute and chronic forms of disease occur and presumably reflect different yet interrelated immune mechanisms of pathogenesis . The diagnosis of hypersensitivity pneumonitis, although often straightforward, may depend on the use of immunologic and microbiologic analyses with the aid of inhalation challenge testing . Finally, the immune pathway to disease expression is as yet undefined and may represent subtle changes in "suppressor" cell populations and their regulatory effects on immune effector cells. Clin Pharmacol Ther, 1983 Jan, 33(1), 73 - 6 Mezlocillin kinetics in hepatic insufficiency; Bunke CM et al.; To establish elimination kinetics of mezlocillin in patients with hepatic insufficiency, we gave eight normal subjects and four patients with hepatic insufficiency and normal renal function a single 3-gm dose of mezlocillin by intravenous infusion . Subjects with hepatic insufficiency all had serum bilirubins levels of above 3 mg/dl, prothrombin times more than 2 sec longer than control, and creatinine clearances above 60 ml/min . Mezlocillin concentrations were determined by microbiologic assay . Kinetic analysis was by model-independent methods . Elimination half-life was 0.96 hr for subjects with normal liver function and 2.62 hr for patients with hepatic insufficiency . Mean total body clearance for normal subjects was 247 ml/min, while in patients with hepatic insufficiency it was 125.4 ml/min . We conclude that hepatic insufficiency prolongs mezlocillin elimination and suggest that therapeutic guidelines be set up. Int J Dermatol, 1982 Dec, 21(10), 602 - 3 Improved methods for office fungal culture; Gip L; A new screening culture method which can be used as an office fungal culture involves a microculture, where a selective medium (DTM) is used for coating a thin transparent plastic slide . Sampling is performed with a transparent adhesive tape which is pressed on to the surface of the agar and allows daily microscopic examination of the culture . Identification of the fungus is based on its micromorphologic features and possible color change of the substrate . Growth of dermatophytes and candida usually can be detected and registered within 48 hours . The screening method is simple to handle and read and may be monitored by inexperienced personnel with virtually no microbiologic knowledge. Lab Invest, 1982 Dec, 47(6), 568 - 78 Legionnaires' pneumonia after intratracheal inoculation of guinea pigs and rats; Winn WC Jr et al.; We have developed a model of legionnaires' pneumonia in guinea pigs and rats . A reproducible population of Legionella pneumophila was obtained in late exponential growth phase and inoculated into the trachea of young animals . Either immunologic or microbiologic evidence of infection was demonstrated in 27 or 28 guinea pigs and 19 of 20 rats that had been inoculated with 10(5) to 10(7) colony-forming units . An acute pneumonia that resembled human legionnaires' disease was produced in both species, and Legionella antigen was closely related to inflammation in the distal air spaces . A fatal illness was produced in guinea pigs, and pneumonia was more extensive than in rats . Extrapulmonary inflammatory lesions, particularly splenic necrosis, were more frequent in guinea pigs than in rats . Each rodent species has potential advantages for testing specific questions and both should be useful for future investigations. Am Rev Respir Dis, 1982 Dec, 126(6), 1050 - 7 Legionnaires' pneumonia after aerosol exposure in guinea pigs and rats; Davis GS et al.; We developed an animal model of Legionnaires' pneumonia to permit study of aerosol infection, pathogenesis, and pulmonary host defense mechanisms in this disease . Guinea pigs and rats were exposed in a nose-only inhalation facility for 30 min to an aerosol of Burlington serogroup 1 Legionella pneumophila . Lungs contained 10(3) to 10(4) L . pneumophila immediately after exposure . Both guinea pigs and rats developed pneumonia, with 100% infectivity by microbiologic, histologic, and serologic criteria . Guinea pigs demonstrated illness, fever, and 56% mortality; rats showed little illness and 11% mortality . In both species, diffuse patchy pneumonitis coalesced and consolidated as the disease progressed . Aerosol challenge with 3H-L . pneumophila showed exponential growth of the bacteria in the lungs of both species . Guinea pigs and rats can be infected by aerosol exposure to L . pneumophila to produce a disease that closely simulates human Legionnaires' pneumonia . Rapid initial intrapulmonary growth suggests that resident lung defense mechanisms are quite ineffective against L . pneumophila, and that recruited or immunospecific defenses may be more critical in the outcome of infection . The difference in severity of illness between guinea pigs and rats may be exploited for different experimental designs. Appl Environ Microbiol, 1982 Dec, 44(6), 1296 - 307 Estimates of bacterial growth from changes in uptake rates and biomass; Kirchman D et al.; Rates of nucleic acid synthesis have been used to examine microbiol growth in natural waters . These rates are calculated from the incorporation of {3H}adenine and {3H}thymidine for RNA and DNA syntheses, respectively . Several additional biochemical parameters must be measured or taken from the literature to estimate growth rates from the incorporation of the tritiated compounds . We propose a simple method of estimating a conversion factor which obviates measuring these biochemical parameters . The change in bacterial abundance and incorporation rates of {3H}thymidine was measured in samples from three environments . The incorporation of exogenous {3H}thymidine was closely coupled with growth and cell division as estimated from the increase in bacterial biomass . Analysis of the changes in incorporation rates and initial bacterial abundance yielded a conversion factor for calculating bacterial production rates from incorporation rates . Furthermore, the growth rate of only those bacteria incorporating the compound can be estimated . The data analysis and experimental design can be used to estimate the proportion of nondividing cells and to examine changes in cell volumes. Am Rev Respir Dis, 1982 Dec, 126(6), 981 - 5 The value of bronchoscopy in establishing the etiology of pneumonia in renal transplant recipients; Hedemark LL et al.; Fifty-two episodes of fever and new pulmonary infiltrates were evaluated prospectively in 51 renal allograft recipients . Thirty-nine flexible fiberoptic bronchoscopies were performed in the diagnostic evaluation of these infiltrates . Specific etiologic diagnoses were obtained in 30 (77%) of the patients . This information was clinically useful, as defined by preset criteria, in 21 (54%) of the patients and definitive but not clinically useful in an additional 9 (23%) . In the remaining 9, it was neither definitive nor clinically useful . Microbiology brush specimens were useful in establishing etiologic diagnoses in 12 (44%) of the 27 patients in whom it was performed . Transbronchial lung biopsies yielded specific etiologic diagnoses in 9 (53%) of the 17 biopsies obtained . Complications related to the bronchoscopic procedure occurred in 2 patients (5% of total bronchoscopies) . No prolonged morbidity was noted . We conclude that fiberoptic bronchoscopy is a safe, useful procedure, and should be considered early in the diagnostic evaluation of pulmonary infections in renal transplant recipients. Am J Hosp Pharm, 1982 Nov, 39(11), 1920 - 3 Accuracy and efficiency of three methods of preparing piggyback admixtures; Fraterrigo CC et al.; The efficiency and accuracy of three methods of preparing i.v . admixtures in small-volume plastic bags were compared . One hundred individual 1-g doses of cephalothin sodium in 50-ml minibags were prepared by each of three methods; the PharmAide Fluid Dispensing System (PAFDS), the Valleylab IV Formulator, and the Viavac vacuum unit, using 20-g, 20-g, and 1-g vials of cephalothin sodium, respectively . For each method, preparation time and cost were recorded . To determine accuracy, a random 10% sample of minibags prepared by each method was assayed for cephalothin concentration by microbiologic assay . The IV Formulator required the least time to prepare 100 doses, followed by the PAFDS and the vacuum unit . Cost data for the three methods were nearly identical, with a difference of only $0.07 per dose between the least and most expensive . The minibags prepared using the vacuum pump and unit-of-use vials were more accurate than those prepared with 20-g vials and the other two methods . However, the initial concentration of the cephalothin sodium vials before transferring to the minibags was not tested . Each method studied was found to have advantages and disadvantages . No one system could be judged best for all situations. Am J Epidemiol, 1982 Nov, 116(5), 834 - 9 An outbreak of Norwalk gastroenteritis associated with swimming in a pool and secondary person-to-person transmission; Kappus KD et al.; In June 1977 an outbreak of acute gastroenteritis affected 103 students and teachers at an elementary school in Ohio . The illness typically lasted 24 hours or less and was characterized by vomiting (86%) and cramping (70%), but more than half of the persons involved also reported having nausea, diarrhea, and headache . Similar illness frequently followed in household members (29%) of families with primary cases . Investigation revealed that 70% of the children and teachers who swam in a pool at an all day outing June 1 (4 classrooms) and 55% of those who swam during a similar outing June 2 (2 classrooms) had the onset of acute illness from 12--48 hours later . None of the children who attended the outings but did not swim had a similar illness . The evidence suggested that the primary outbreak was caused by contaminated water in the pool and that person-to-person spread of illness followed . Results of a microbiologic study of pool water were negative for bacterial and viral pathogens . Throat washings, stool specimens, and paired blood samples studied for evidence of pathogens were negative initially, but subsequent serologic studies suggested that infection by Norwalk virus was the cause of the outbreak . The pool chlorinator which was inadvertently unconnected at the time of the school visits was reconnected and an underground leak in the water supply pipes was corrected . No more cases were reported after the pool was drained, cleaned, and reopened. Pediatrics, 1982 Oct, 70(4), 511 - 5 Pediatricians and general practitioners: a comparison of the management of children with febrile illness; Leduc DG et al.; To assess the relative competence of pediatricians and general practitioners in managing febrile illnesses in childhood, a prospective study was undertaken of 259 children less than 10 years of age seen consecutively at the emergency room of a children's hospital and a general hospital . Both groups of patients were similar in demographic characteristics, age, sex, presenting complaints, and height and duration of fever . Of the 148 patients entered in the study at children's hospital and the 111 at general hospital, 90% and 94%, respectively, were interviewed by telephone within two weeks of their emergency room visit to determine outcomes based on duration of the acute illness episode and further physician contacts or admissions to hospital . Although no significant differences in the measured outcomes of febrile illnesses seen by pediatricians or general practitioners were found, a trend in favor of those cared for by pediatricians was discernible with respect to two key measures: unresolved symptoms at one week (8.3% vs 12.5%) and subsequent hospitalization (0.8% vs 3.0%) . The overall frequency of laboratory use and antibiotic prescriptions was the same in both groups; however, significant differences were noted in the type of laboratory test used: general practitioners ordered three times more roentgenograms than pediatricians and one fifth the number of microbiologic tests . Larger prospective studies are needed to test how these findings may be generalized in view of their importance for quality assurance in the primary care of children. Med Hypotheses, 1982 Oct, 9(4), 369 - 73 Systemic lupus erythematosus - a state of hyperinterferonemia? Weinberger A, Aderka D, Pinkhas J. On the basis of immunologic and microbiologic data as well as recent observations it is postulated that interferon is responsible for many of the clinical signs and symptoms in systemic lupus erythematosus such as alopecia, joint manifestations, fever and leukopenia . Recognition of the important role of interferon in active systemic lupus erythematosus leads to some practical conclusions: a) a new therapeutic approach to active lupus must consider a treatment which will lead to reduced interferon activity; b) one of the laboratory parameters of activity of the disease may be interferon measurements. Philos Trans R Soc Lond B Biol Sci, 1982 Sep 13, 298(1093), 473 - 97 Microbiology of thiobacilli and other sulphur-oxidizing autotrophs, mixotrophs and heterotrophs; Kuenen JG et al.; Recent studies on the ecophysiology of the obligate chemolithotroph Thiobacillus neapolitanus have given better insight into its specialization for an autotrophic mode of life . This appears not only from its high constitutive levels of autotrophic enzymes, but also from its possession of carboxysomes, which seem to be specialized organelle