J Fr Ophtalmol, 1979 Aug-Sep, 2(8-9), 449 - 57 {Preoperative conjunctival bacterial flora and sensitivity to antibiotics (author's transl)}; Liotet S; 2 973 preoperative cultures of conjunctiva have placed in a prominent position 834 pathogenic germs . Cultures in an enriched medium and in an atmosphere including ten per cent of carbonic gas (10% of CO2) have widely increased the number of isolated Streptococus . A study of spectra of antibiotics used in ophtalmology has been made for all these germs . The instability of conjunctival flora with time implies a modification in tactics of bacteriological preoperative samples in order to obtain a better operative security. J Dairy Sci, 1979 Aug, 62(8), 1335 - 9 Mastitis history, California Mastitis Test, and somatic cell counts for identifying cows for treatment in a selective dry cow therapy program; Rindsig RB et al.; Mastitis history, California Mastitis Test scores, and filter-deoxyribonucleic acid cell counts from 232 cows were used to project the effectiveness of criteria which could be used to determine which cows to treat in a selective dry cow therapy program . Bacteriological analyses of quarter milk samples were used to identify infected cows . Effects of month, lactation parity, stage of lactation, and interaction of stage of lactation with lactation parity on somatic cell numbers in milk were determined . The various criteria singly or in combinations correctly identified from 50 to over 92% of the cows with one or more infected quarters at drying off . However, from 25 to 80% of the cows free of infection would have been treated as well . The most discriminating criteria were two monthly cell counts exceeding 500,000 cells per milliliter where 53% of the cows with infected quarters were identified correctly and only 25% of the uninfected cows would be treated, or the two monthly cell counts exceeding 500,000 cells per milliliter plus a California Mastitis Test score of +2 or +3 at drying off . Here 89% of the cows with infected quarters would be treated, and 56% of the uninfected cows would be treated. Anaesthesist, 1979 Aug, 28(8), 68 - 71 Subarachnoid block with an anaesthetic mixture containing dextran . Cytologic changes in the cerebrospinal fluid; Curelaru I et al.; The present study included 22 patients who received an anaesthetic subarachnoid injection of 1.0--1.2 ml Dixidextracaine-70 (a mixture of xylocaine 40.0 mg+cinchocaine 10.0 mg+Dextran-70 60.0 mg+distilled water ad 2.0 ml), associated with adrenaline in a final concentration of 1/10000 . Before and 24--168 hours after administration of the subarachnoid anaesthesia, 2.0 ml of cerebrospinal fluid was collected for quantitative and qualitative determination of the cellular elements and for physical and bacteriological examinations . No bacteriological contamination or qualitative and quantitative alterations of leucocytes in the cerebrospinal fluid were found after the administration of anaesthetic-dextran mixture . It is concluded that the association of Dextran-70 with xylocaine and percaine, as well as with adrenaline, for lengthening the duration of the subarachnoid anaesthesia has no acute irritative effect upon the central nervous system and its membranes in the course of seven days following its administration. Gastroenterol Jpn, 1979 Aug, 14(4), 299 - 305 A clinical study of tuberculous colitis; Hoshino M et al.; During the last 8 years, the diagnosis of tuberculous colitis has been made radiologically in 22 cases . Twelve were confirmed by histological or bacteriological evidences . The X-ray findings are classified into three types as follows: Type A, showing an extensive scarred area in the ileocecum and ascending colon . Type B, showing annular stricture in the ascending colon and dilatation of its oral side . Type C, showing pouchformation (pseudo-diverticulum) and deformity in the cecum . We emphasize that histological examination and culture of the biopsy specimens by endoscopy were useful for the diagnosis of tuberculous colitis . Furthermore, radiologic changes of the colon by administration of antituberculous drugs were observed. Am J Surg, 1979 Aug, 138(2), 326 - 9 Postlactational tumoral granulomatous mastitis: a localized immune phenomenon; Brown KL et al.; Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail . Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis . Systemic antibreast autoimmune mastitis and vasculitis are also ruled out . Its pathogenesis, differential diagnosis, surgical treatment, and prognosis are discussed. Scand J Respir Dis, 1979 Aug, 60(4), 168 - 71 Immunoprofile studies in patients with pulmonary tuberculosis . II . Correlation of levels of different classes of immunoglobulins and specific antibodies with the extent of tuberculosis; Skvor J et al.; Humoral immune response of patients with newly detected, bacteriologically confirmed pulmonary tuberculosis was determined prior to initiation of chemotherapy . Correlation with the extent of the disease was studied . A significant rise in the IgA and IgG levels in the serum was observed, the increase in the IgA levels correlated with the extent of the disease . In tuberculous patients elevated levels of anti-OT (ppd) antibodies were found by haemaggluination, but no marked correlation was observed with the extent of the disease . There was no interrelationship between the IgA or IgG increase and that of specific anti-OT (PPD) antibodies . The importance of the mentioned findings is discussed. Vet Rec, 1979 Jul 21, 105(3), 51 - 4 Canine bordetellosis: chemotherapy using a sulphadiazine-trimethoprim combination; McCandlish IA et al.; Respiratory disease was induced in young dogs by exposure to an aerosol of Bordetella bronchiseptica . The affected dogs were then treated with a sulphadiazine-trimethoprim combination by daily subcutaneous injection for five days . There was marked improvement in the clinical, bacteriological and pathological features of the respiratory disease during and immediately after the treatment period but treated dogs relapsed a few days after chemotherapy was stopped . The use of a sulphadiazine-trimethoprim combination over a longer period of time may be of value in the treatment of dogs with respiratory disease associated with B bronchiseptica. Am J Obstet Gynecol, 1979 Jul 15, 134(6), 655 - 61 Premature rupture of the membranes: a conservative approach; Kappy KA et al.; A conservative approach was followed in 188 patients with premature rupture of the membranes (PROM) over a 2 year period . There were no neonatal deaths from sepsis, and only one infant showed a positive central bacteriologic culture . Fifty-seven percent of all patients less than 37 weeks' gestation had a latent period of 24 hours and 19% went beyond 7 days before labor began . Patients less than 34 weeks' gestation who received antepartum steroids for lung maturation showed no increased infectious morbidity or mortality . A conservative approach to patients with PROM seems reasonable when either prematurity and/or a cervix unfavorable for induction further complicates the pregnancy. Int J Pediatr Otorhinolaryngol, 1979 Jul, 1(1), 33 - 40 High dosage tobramycin treatment of children with cystic fibrosis . Bacteriological effect and clinical ototoxicity; Thomsen J et al.; The bacteriological effect of chemotherapy against mucoid strains of Pseudominas aeruginosa in the lower respiratory tract of patients with cystic fibrosis is reported . A comparison of the effect of high doses of tobramycin (10 mg/kg/24 h) given alone or in combination with carbenicillin showed a significant difference in favour of the combination therapy . In 74.5% of the initially successful courses the patients were recolonized within one month . Fifty-three patients were examined by audiometric and vestibular tests . Only in one patient was it possible to register a transient, high tone hearing impairment at 8000 Hz bilaterally, that might be attributed to the tobramycin treatment . It is concluded that high dose tobramycin treatment in children and adolescents with normal kidney function implies only a minimal clinical risk of adverse ototoxic effects, even after repeated courses of treatment . No nephrotoxic side-effects were found in this material. Med Inform (Lond), 1979 Jul-Sep, 4(3), 165 - 72 Computerized management of a medical bacteriology laboratory using real-time processing; Brun Y et al.; The computer system of the Bacteriology Laboratory at the Hopital Cardiologique in Lyon is one of the elements in the computer management of patient data . It dovetails in with the various units for admission, patient location, ward surveillance, outpatient appointments . The main objectives are as follows: to improve quality of sample information, to reduce clerical work and accelerate information circulation, to widen the scope of epidemiological research . Computers can register samples, edit laboratory work sheets, entry lists, record results, generate reports, give a visual listing of all analyses performed before a patient leaves hospital, list pending analytical results, make available in the total system all laboratory-validated information, produce automatic billing of analyses and statistical editing . The Bacteriology Laboratory has three visual display units and two printers at its disposal . Computer laboratory management has been operational since May 1977 . First results are satisfactory and suggest extension of the system to other laboratories and handling of quality control. Zentralbl Bakteriol {Orig A}, 1979 Jul, 244(2-3), 302 - 8 {Nicotinamidase and the so-called pyrazinamidase in mycobacteria; the simultaneous occurrence of both activites (author's transl)}; Tarnok I et al.; Nicotin- and the so-called pyrazinamidase (in the following: "pyrazinamidase") have been found in strains of four mycobacteria species, M . fortuitum, M . gastri, M . bovis and M . microti . These findings are in contradiction to those summarized in Bergey's Manual of Determinative Bacteriology (1974) . The reason for the discrepancies is that the original method (Bonicke, 1961) for amidase determination has not taken the following aspects into consideration: a) The inducibility of the nicotin- and "pyrazinamidase" (example: M . fortuitum); b) The temperature sensitivity of these enzymes (M . gastri); c) The light sensitivity of nicotinamidase (in photochromogenic M . gastri strains); d) The optimal substrate concentration which must be at least 4 mM instead of 0,8 mm . The following consequences can be drawn for the taxonomy and biochemistry of the tested organisms: e) The species status of M . gastri should be annuled . The main difference between M . gastri and M . kansasii consists only of the non-agglutinability of M . gastri by anti-M . kansasii serum . "Pyrazinamidase" and also nitrate reductase (Tarnok et al., in press) are positive in strains of both species; f) M . bovis possesses nicotin- and "pyrazinamidase" as M . tuberculosis too . Thus, these two species are more closely related than suggested earlier; g) Till now, no Mycobacterium has been found showing nicotinamidase without "pyrazinamidase" activity (or vice versa) . It seems to be very probable that nicotinamidase, an enzyme of low substrate specificity, is able to hydrolyze several compounds with a nicotinamide-like structure such as pyrazinamide . Thus, we suggest the annulment of the term pyrazinamidase or the employment of quotation marks ("pyrazinamidase") to show the fictitious value of this designation. J Hered, 1979 Jul-Aug, 70(4), 255 - 8 Evidence for a new lethal gene causing cardiomyopathy in Japanese black calves; Watanabe S et al.; Sudden death with severe dyspnea in new-born or infant calves confined to a family of Japanese black cattle was studied . Neither environmental nor bacteriological factors seemed to be involved in the etiology of the disease . Histopathological examination revealed focal degeneration and necrosis of the muscle fibers in the myocardium, to which a diagnosis of idiopathic cardiomyopathy was proposed . The pedigree and mating type analyses suggested that a new autosomal recessive lethal gene was responsible for the syndrome . Rates of incidence of the affected calves in five sire families were tested for an expectation of 12.5 percent incidence by the chi-square method. Arch Surg, 1979 Jul, 114(7), 790 - 2 Bacteriology of the operating room with the use of helmet aspiration systems; Feagin JA Jr; The bacteriology of the operating room with the use of the helmet-aspirator system has been discussed . The surgical team predictably contaminates the operating room . Current cotton gowns worn loosely about the neck do not serve as effective barriers to bacterial penetration . Barrier draping of the surgical team is possible with impervious materials, but requires the use of a helmet-aspirator system to dissipate the heat and particulate debris . These are commercially available and their use has been shown to decrease colony-forming particles, decrease wound contamination, and decrease wound infection . Barrier draping of the surgical team through the helmet-aspirator system is effective and is to be recommended for infection-prone cases. Arch Surg, 1979 Jul, 114(7), 778 - 82 Environmental bacteriology in the unidirectional (horizontal) operating room; Nelson CL; The continuing attempts to reduce bacterial contamination through clean air systems have been of special interest to surgeons dealing in joint replacement surgery . Although the definitive relationship between airborne contamination and surgical infections is not universally agreed on, there is little question that clean air systems reduce bacterial contamination of the surgical wound at the time of operation . This report reviews the history of surgical infections, presents statistical data that show the reduction of bacterial contamination by a clear air system, and suggests a pragmatic attitude regarding airborne bacterial contamination of surgical wounds. Bol Med Hosp Infant Mex, 1979 Jul-Aug, 36(4), 725 - 33 {Treatment of typhoid fever with chloramphenicol or ampicillin combined with oxyphenbutazone}; Avendano LF et al.; Ninety-four patients with typhoid fever were treated, at random, with three therapeutic regimens: chloramphenicol alone, chloramphenicol plus oxyphenbutazone, and ampicillin plus oxyphenbutazone . The results are evaluated analyzing the body temperature graph and by serial blood had bone marrow cultures taken at intervals until they became negative . Bacteriologic diagnosis was confirmed by blood culture (39.3%) and/or bone marrow culture (77%) . The mean duration of fever was 3.3 days for the group treated with chloramphenicol-oxyphenbutazone, 4.3 for those with chloramphenicol alone and 5 days for the group ampicillin-oxyphenbutazone; at the same time, blood cultures became negative at 4.4, 5.5 and 4.4 days respectively . Negativization of bone marrow cultures was not influenced by the addition of oxyphenbutazone . It is concluded that the influence of oxyphenbutazone in shortening the febrile period or in the negativization of blood cultures is not significant . It is considered that oxyphenbutazone is not an important therapeutic tool in this group of diseases. Vopr Virusol, 1979 Jul-Aug, (4), 385 - 9 {Virological and serological study of rotavirus gastroenteritis}; Drozdov SG et al.; Cases of acute gastroenteritis with negative bacteriological analyses were examined . Preparations of feces collected from patients in the acute stage of the disease were found by immune electron microscopy to contain typical rotavirus particles forming specific aggregates in the presence of convalescent sera . Examinations of paired acute and convalescent sera of the patients revealed the presence in convalescent sera of specific antibodies neutralizing simian rotavirus SA 11 antigenically related to human rotavirus . The specificity of the antibody was confirmed by their titrations by immune electron microscopy and HI test . Thus, rotavirus etiology of cases of gastroenteritis in various parts of the country was confirmed, and the possibility of specific laboratory diagnosis of such cases using simian rotavirus SA 11 was demonstrated. J Wildl Dis, 1979 Jul, 15(3), 367 - 72 Brucella abortus in coyotes . I . A serologic and bacteriologic survey in eastern Texas; Davis DS et al.; Prevalence of Brucella abortus serum antibodies in coyotes from east central Texas was determined by the buffered Brucella antigen (card test), rivanol, standard agglutination tube, and cold complement fixation tube tests . Eighteen percent (9 of 51) of the coyotes were positive serologically . B . abortus biotype 1 was isolated from various tissues from 7 of 43 coyotes by bacteriologic culture . Congenital transmission was found. Hautarzt, 1979 Jul, 30(7), 392 - 5 {Effect of a corticosteroid additive on the result of local therapy of bacterial superinfection in tinea pedis intertriginosa}; Grunder K et al.; Sixty cases of tinea pedum intertriginosa were topically treated in a double-blind trial . In 34 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline, gentamycin and fluprednyliden-21-acetate . In 26 cases a cream was used, which contained 5-chloro-8-hydroxyquinoline and gentamycin alone . Treatment was continued over three weeks . In weekly intervalls mycological, bacteriological and clinical controls were performed, which showed that the steroid-component had no disadvantageous effect on the course of infection . In contrast the steroid containing preparation proved to be slightly superior. Chirurg, 1979 Jul, 50(7), 441 - 4 {Bacteriological findings in patients with cholelithiasis and duodenal diverticuli}; Eggert A et al.; In a prospective study of 70 patients with duodenal diverticula and calculous biliary tract disease, bacteriocholia with typical intestinal bacteria was found in 69%, whereas in cholelithiasis without duodenal diverticula this complication was present in 30% of the cases . With growing distance between duodenal diverticula and the papilla of Vater the rate of bacteriocholia decreases . Rising age of patients results in augmentation of bacteriocholia . Bacteriocholia on the basis of duodenal diverticula seems to present an additional pathogenetic factor for inflammatory biliary tract disease in 69% and for pancreatitis in 20% of the cases . Consequently the pathologic value of diverticulas close to the papilla of Vater is more prominent than reported so far. Can J Microbiol, 1979 Jul, 25(7), 850 - 4 An agar--gel immunodiffusion test for detection of Brucella antibodies in human serum; McMahon KJ et al.; A comparison was made of results obtained with a Brucella agar--gel immunodiffusion (AGID) test and the standard tube-agglutination test on 612 human sera . Agreement between the tests was 97% when the titer was 1:160 or higher . Of 448 sera that showed no agglutination titer, 447 were negative with the AGID test . Results of the AGID test were also compared to those obtained with the 2-mercaptoethanol (2-ME) agglutination test on 148 sera that demonstrated a standard tube-agglutination titer of 1:20 or higher . All sera with a 2-ME-agglutination titer of 1:40 or higher were positive with the AGID test . Of 123 sera that showed no 2-ME-agglutination titer, 21 were positive with the AGID test . Two of these 21 sera were obtained from patients with bacteriologically proven brucellosis, and eight were from abattoir employees with suspected but not bacteriologically proven brucellosis. Arch Orthop Trauma Surg, 1979 Jun 29, 94(1), 59 - 62 A bacteriological evaluation of a programme for preoperative total body-washing with chlorhexidine gluconate performed by patients undergoing orthopaedic surgery; Bergman BR et al.; Twenty-eight orthopaedic patients were taught to wash their entire bodies with chlorhexidine gluconate on two consecutive days preoperatively, starting in their homes . The operation field was also washed a third time . A bacteriological evaluation was performed using contact plates . A significant reduction of the skin flora, including Staph . aureus, was registered . No adverse side effects of total body-washing were observed. Med Clin (Barc), 1979 Jun 25, 73(2), 73 - 6 {Pulmonary nocardiosis . A case report (author's transl)}; Garcia Rodriguez JA et al.; Within the genus Nocardia three species are at present considered to have human pathologic interest: N . asteroides, N . brasiliensis, and N . caviae . These species are usually the etiologic agents of at least two clinical pictures: nocardiosis and actinomycetoma . A case of pulmonar nocardiosis in a 62-year-old male is reported . The patient had asthmatic episodes and on several occasions received treatment with corticoids . The clinical picture basically consisted of an impairment of the general condition with respiratory symptomatology and fever of 38 to 39 degrees C . An opaque pleuropulmonary image was observed on the chest X-ray film, and the diagnosis of tuberculosis was initially established . The correct diagnosis was confirmed through the bacteriological examination of the transtracheal aspirate with the isolation of N . asteroides . Treatment with streptomycin, sulfamethoxazole and trimethoprim achieved the clinical and roentgenologic cure of the patient . After 2 months of treatment the clinical manifestations had disappeared and after 5 months the chest X-ray was normal . Some epidemiologic data are reviewed. Br Med J, 1979 Jun 2, 1(6176), 1467 - 8 Disposable syringes for insulin injection; Greenough A et al.; Results of a questionnaire on use of glass syringes among diabetic patients showed considerable variation in methods of keeping the syringes and in the duration of their useful life . Thirty patients took part in an investigation in which each patient used the same disposable syringe in place of the glass syringe for up to two months . No clinical or bacteriological evidence of infection was found . Used in this way, disposable syringes were less expensive than glass syringes . They are lighter than glass syringes, less susceptible to damage, and more easily carried on journeys. Lancet, 1979 Jun 2, 1(8127), 1178 - 81 An outbreak of gastroenteritis in young children caused by adenoviruses; Richmond SJ et al.; During October and November, 1978, gastroenteritis developed in 17 of 24 young children aged between eight months and two years from an R.A.F . station in the U.K . The illness, in which diarrhoea was always the predominant symptom, had an incubation period of eight to ten days and lasted about a week . It seemed to be transmitted from child to child, and in all but one instance parents and older siblings remained well . Stool specimens from 14 of the affected children were examined bacteriologically and virologically, and a highly significant association was found between the presence of adenovirus particles in stools, identified by electron microscopy, and the acute stage of the illness . This evidence suggests that an adenovirus was the cause of this outbreak of gastroenteritis. Quad Sclavo Diagn, 1979 Jun, 15 Suppl 1, 377 - 85 {Bacteriological sensitivity "in vitro" and therapeutic response (author's transl)}; Lamanna A et al.; After some general considerations on the validity of antibiograms as a therapeutic guide, three methods are described and analyzed . Bacterial chemosensitivity to antimicrobic drugs were tested by the following methods: diffusion, dilution and automized methods . Only when transferred into routine laboratory methods that would reveal the results of chemosensitivity in quantitative values will a valid guide to antimicrobic chemotherapy be possible . Expressing chemosensitive bacteria directly in values of minimum inhibiting concentrations would evaluate the pharmokinetic action of single chemotherapeutical agents in relation to infective organ or apparatus pathologies which limits the practical significance of posology . Unfortunately, the collaboration between the clinical bacteriologist and the chemoterapist is still a long way off because of technical and laboratory difficulties delineating the pharmokinetic aspects in the use of the many chemoterapeutical agents in man. Clin Orthop, 1979 Jun, (141), 237 - 46 Penetration of gown material by organisms from the surgical team; Hamilton HW et al.; The routes by which viable organisms shed by the surgical team reach the wound are not yet fully understood . Bacteriologic studies show that shedding is greater in surgeons than their assistants or scrub nurses, and is increased by activity and temperature, but is primarily related to the individual's shedding characteristics . Comparison of the ability of 3 types of cotton gowns to contain the surgical team's bacterial effluent shows that the body exhaust system gowns developed by Charnley are superior to more conventional gowns . It is clear that viable organisms can penetrate very closely woven Ventile (pore size 10 microns) as well as balloon cloth (pore size 50 microns) . Ventile used without a body exhaust system does not appear to increase gown efficiency . Penetration of gown material by organisms from the surgical team is responsible for 20% of wound contamination . The gown glove cuff junction is an important leakage point for organisms shed by the surgical team . A newly designed "mitt" cuff more effectively seals this area than the conventional stockinette cuff. Clin Orthop, 1979 Jun, (141), 143 - 57 Treatment of subacute sepsis of the hip by antibiotics and joint replacement . Criteria for diagnosis with evaluation of twenty-six cases; Hughes PW et al.; Total hip replacement fixed with acrylic cement can be successful despite past or present hip infection . Recovery of the infecting organism must be vigorously pursued, either by repeated aspirations or open biopsies . Staging the reconstruction is determined by the pathogenicity of the infecting organism, gram stain, frozen section, and above all the surgeon's observations of the condition of the wound . If in doubt, treatment of infection must take precedence over the reconstruction . Adequate antibiotic coverage should begin as soon as the diagnosis is certain and the organism identified . Antibiotics should be continued postoperatively for one month intravenously, followed by 4--8 months oral therapy, though the length of oral antibiotics could be debated . A number of authors have based their diagnosis of hip infection on clinical, roentgenographic, laboratory and bacteriologic studies . However, they have not given specific guidelines for the determination of deep hip infection . The application of the criteria outlined in this paper can distinguish superficial from deep hip infection as illustrated in 40 cases with no evidence of recurrence of infection . For the present only relative guidelines may be drawn for the treatment of subacute or recently arrested sepsis of the hip . Considering some 80,000 total hip replacements done in the U.S . in the past year, a significant number of patients will require treatment of this type and appropriate programs should be established for the welfare of the patients. Clin Orthop, 1979 Jun, (141), 138 - 42 Total hip replacement following infection in the opposite hip; del Sel HJ et al.; Total hip replacements without ensuing infection were performed in 31 patients in the presence of infection in the contralateral hip . Infection in the opposite hip was proved bacteriologically in the follow-up in 19 cases averaged 5 years (2 years 3 months to 10 years) . In another 12 hips in the same circumstances, without positive bacteriological evidence of active infection on the opposite side, healing occurred without infection. Gut, 1979 Jun, 20(6), 493 - 8 High flow oxygen therapy for pneumatosis coli; Holt S et al.; Symptomatic and radiological resolution of pneumatosis coli was achieved by intermittent high flow oxygen therapy in five patients . In each case the extent of the disease was defined by colonoscopy and contrast radiography before treatment . Despite the confirmation of pneumocyst resolution, recurrence of colonic gas cysts was noted in two patients at six months and one year after treatment . Bacteriological studies indicated that resolution of the disease, induced by oxygen therapy, was not associated with eradication of anerobic bacteria from stool and colonic mucosa . The clinical features and response to treatment of this group of patients are discussed, with particular reference to previously reported methods of oxygen administration. Gut, 1979 Jun, 20(6), 467 - 75 Morphology of experimental antibiotic-associated enterocolitis in the hamster: a model for human pseudomembranous colitis and antibiotic-associated diarrhoea; Price AB et al.; The morphology of antibiotic-associated enterocolitis in the hamster is described and compared with human antibiotic-associated pseudomembranous colitis . It is shown to be a caecal disease with proliferative mucosal changes and in this respect unlike the human counterpart . The bacteriology and toxicology, however, are identical . In addition, mucosal changes are described in animals on antibiotics but without established enterocolitis . As a result we suggest that there may be a spectrum of human disease ranging from mild antibiotic-associated diarrhoea to established pseudomembranous colitis . Therefore, despite the morphological variation, the hamster remains a good model for investigating the pathogenesis of pseudomembranous colitis and antibiotic-associated enteropathy in general. J Can Assoc Radiol, 1979 Jun, 30(2), 129 - 30 Primary pulmonary sporotrichosis; Naimark A et al.; The diagnosis of primary pulmonary sporotrichosis was made in a 53-year-old male alcoholic four years after initial presentation with cavitary lung disease . Clinical and radiologic awareness of this extremely rare entity will allow optimal study of bronchial secretions in the bacteriology laboratory . Important clues include: (1) exposure to thorny plants, (2) cavitary pulmonary disease resistant to both diagnosis and treatment, and (3) a history of alcoholism. Laryngoscope, 1979 Jun, 89(6 Pt 1), 857 - 65 Tracheostomy-related subglottic stenosis: bacteriologic pathogenesis; Sasaki CT et al.; Subglottic stenosis carries devastating consequences . Its pathogenesis, and therefore prevention, have thus far eluded precise definition . The following data suggest that tracheostomy results in a contaminated wound, secondarily infecting a larynx which may have been injured by prior intubation, fracture, or surgery . The interpretation of these data is based upon the tested assumption that infection prolongs healing of injured tissue and predisposes to scar and stricture formation . Therefore, the ability of control stomal contamination by the judicious use of topical or systemic antibiotics may play an important role in the prevention of complications in an organ functionally by-passed by the tracheostomy cannula. J S Afr Vet Assoc, 1979 Jun, 50(2), 123 - 33 Monitoring of bacteriological contamination and assessment of carcase surface growth by using direct and indirect contact examination techniques and various colony counting procedures; McCulloch B et al.; Two hundred and sixty nine beef, 230 sheep and 165 pig carcase surface were examined bacteriologically . Direct and indirect contact examination techniques were utilised . Colony counts per cm2 were expressed in geometric progression . Counting procedures, direct and indirect contact examinations, and effects of chilling were considered . Subsequently, results from an additional 489 beef, 520 sheep, and 408 pig carcases were employed to illustrate a count classification arrangement against which bacteriological monitoring assessments could be measured. Am Surg, 1979 Jun, 45(6), 374 - 7 Quantitative bacteriology in wound care; Shulman G et al.; Quantitative bacteriology in the management of wound sepsis provides an objective way to monitor the success or failure of wound care . The clinical appearance of a wound requiring skin grafting may be misleading . Grafting wounds that appeared clinically ready was unsuccessful when analysis showed bacteriological counts of 10(5) or greater organisms per gram of tissue . A rapid and simple method for quantitative tissue culture is described . Three cases are described illustrating the value of the results of the method. Vet Med (Praha), 1979 Jun, 24(6), 343 - 50 {Devitalization of Bordetella bronchiseptica in vitro using vapors of Persterile and triethyl glycol}; Doskocil O et al.; Using the method of bacterial carriers, the devitalizing effect was studied of Persteril and triethylene glycol vapours, acting in vitro, on a 24-hour culture of a mixture of 39 strains of Bordetella bronchiseptica, isolated from the nasal cavity of pigs which came from five stocks suffering from the clinical form atrophic rhinitis . After exposure of the carriers of Bordetella bronchiseptica to the action of spontaneously developing vapours o the mentioned chemicals, the devitalizing effect was determined by bacteriological examination . The vapours of the water solution of Persteril, containing 0.1% of peracetic acid, showed a 90.91 to 93.83% devitalizing effect after 48-hour exposure at room temperature . When the vapours of warmed concentrated triethylene glycol were used, a 98.57 to 100% devitalizingeff ect was obtained after a 72-hour exposure under the same temperature conditions . In experiements performed at a temperature of 37 degrees C, a 24-hour exposure sufficed for obtaining 91.67 to 100% devitalizing effectiveness . There is a discussion concerning the importance of the obtained results and the need for testing them experimentally by a methodically simple and cheap continual disinfection of the air and stable surfaces in premises for pig stocks affected by atrophic rhinitis. Am Rev Respir Dis, 1979 Jun, 119(6), 879 - 94 U.S . Public Health Service Cooperative trial of three rifampin-isoniazid regimens in treatment of pulmonary tuberculosis; Long MW et al.; A total of 822 patients with newly diagnosed pulmonary tuberculosis were assigned randomly to one of 3 daily rifampin-isoniazid (RIF-INH) regimens: 450, 600, or 750 mg of RIF in combination with 300 mg of INH . After an initial 20 weeks of therapy with RIF-INH, patients recieved 300 mg of INH and 15 mg of ethambutol (EMB) per kg of body weight for either 12 or 18 months after their sputum cultures became negative . The rate of bacteriologic conversion of sputum among the 3 RIF-INH regimens was compared for 552 patients who completed the 20 weeks of RIF-INH therapy . Apporximately 60 per cent of these patients also completed their assigned INH-EMB therapy and were examined for relapse for at least one year after therapy was stopped . There was no significant difference in the rate of sputum conversion or rate of relapse between the group of patients who received 600 mg of RIF and those who received 750 mg of RIF . However, the 450-mg RIF regimen was significantly less effective than the other 2 regimens, as manifested by a lower rate of sputum conversion and a higher rate of treatment failures . Further analysis showed that RIF dosages of less than 9 mg per kg of body weight per day may be inadequate for treatment of pulmonary tuberculosis . The acceptability of these regimens was high, and the incidence of adverse reactions requiring discontinuation of RIF-INH therapy was quite low (3.3 per cent) . A large proportion of patients (44 per cent) developed increased concentrations of transaminase during therapy with RIF-INH . These abnormalities were usually transient and, in most cases, of no clinical significance . In the relapse analysis, 12 months of chemotherapy after sputum conversion was shown to be as effective as 18 months of therapy after conversion of these RIF-containing regimens. J Hyg (Lond), 1979 Jun, 82(3), 425 - 41 A bacteriological investigation of two leisure centre swimming pools disinfected with ozone; Wyatt TD et al.; A bacteriological study was carried out on the first Leisure Centre swimming pools in the United Kingdom to be disinfected with ozone/chlorine . Results suggested that a free chlorine concentration of approximately 0.8 mg/l was necessary to maintain the pools in a bacteriologically satisfactory condition . This amount of free chlorine was similar to that required when the pool was disinfected with chlorine alone . However, the associated amount of combined chlorine was much lower when disinfection was by ozone/chlorine and this gave more acceptable bathing conditions . Implications for the manamgement of pools disinfected by this method are discussed. Bull Soc Pathol Exot Filiales, 1979 May-Jun, 72(3), 272 - 8 {Pathology in Malagasy lemurs and their relation to human pathology}; Coulanges P et al.; From researches conducted in Institute Pasteur in Madagascar and from bibliographical work, the authors try to draw up a general picture of the pathology of lemurs . Several aspects are developed (bacteriology, hematology, mycology, parasitology, virology), especially those which could be interesting for human pathology, for instance the relationships between lemurs and viruses because of the arbovirus programme in progress in Institute Pasteur . The authors emphasize on the possible use of lemurs, the only non human primate in Madagascar, as laboratory animals in order to develop colonies and, then, to promote their conservation. Surgery, 1979 May, 85(5), 586 - 8 Fungal infection of a vascular prosthesis; Pasternak BM et al.; Chronic debilitating hematological disorders and cytotoxic drugs may create conditions causing a predisposition to fungal infections of vascular grafts . Under such circumstances routine bacteriological investigations should be supplemented by specific fungal media cultures and microscopic examination of removed infected graft. Z Gesamte Inn Med, 1979 Apr 1, 34(7), 73 - 5 {Diagnostic problems of tuberculosis in old age}; Wurbs W; Among the present epidemiologic conditions postprimary tuberculoses gain importance due to the exazerbation of latent foci . The particularly concerns the generalised senile tuberculosis . The clinical picture of a generalisation tuberculosis deviates in comparison with the course which was formerly regarded as typical . It shows a protracted, at first undramatic phase with slowly progressing development, appears intermittently, is characterized by rich, variants with regard to form, course and localisation, withdraws from radiological demonstration for a long time and thus progresses occult in general . The 35 cases should remind of diagnostic basic patterns and should take into consideration the peculiarities of exacerbated generalised tuberculoses at old age . The observation of symptomatology and paraclinical findings, bioptic examinations of the liver, bacteriologic or histologic findings of the adequate substrate, the exclusion of other organic diseases and an experiment of an antituberculotic treatment when tuberculosis is supposed may become successful measures of making the diagnosis . Even nowadays tuberculosis must be included in the differential diagnosis of several organic diseases. Lab Anim, 1979 Apr, 13(2), 69 - 73 Chronic non-infective conjunctivitis in rabbits; Buckley P et al.; A high proportion (36%) of rabbits in a long-term experiment developed a severe chronic purulent conjunctivitis . Bacteriological examination failed to reveal an organism common to all cases, and the condition was only partially controlled by a neomycin and hydrocortisone eye ointment . Cutting down the possibility of hay dust entering the rabbits' eyes led to marked improvement: the conjunctivitis was virtually eliminated when hay was given in a specially-designed solid-sided hopper which prevented the release of dust during feeding and which, being detachable, could be refilled away from the rabbit rooms to minimize general atmospheric dust. Prax Klin Pneumol, 1979 Apr, 33 Suppl 1, 591 - 5 {Tuberculosis in Romania (author's transl)}; Anastasatu C et al.; The incidence of tuberculosis in Romania has decreased considerably over the past years, particularly since 1972 when the combined rifampicin-ethambutol-pyrazinamide therapy was introduced . During the period 1968-1977 it fell from 127.9 per 100,000 to 73.4 per 100,000 . The incidence of relapses fell at a slower rate . The most endangered are the 20-24 years age-group and old people; but here again the number of cases tends to fall . Childhood tuberculosis showed a yearly decline by an average of 20% . Bacteriological examinations and diagnosis are assuming increased importance. Cesk Gynekol, 1979 Apr, 44(3), 200 - 3 {Prolonged use of IUD and inflammatory diseases of the inner genitalia}; Citterbart K et al.; PIP: Recently, IUd usage has increased, and with that increase has come an awareness of the undesirable side effects of the device, notably infection . Infection risks can be minimized if clinicians observe aseptic and sterile procedures . Histological studies were conducted on the tissues adhering to the IUDs of 244 women . The women were aged 20-40, and had had the IUD in place for an average of 4 years . Histological rather than bacteriological studies were conducted because the presence of bacteria does not necessarily indicate that disease is present . Secretory endometrium was found in 54.8% of the women, proliferative endometrium in 32.2%, cellular debris in 4.9% and stromoglandular disassociation in 8.1% . Of the 19 women in whom disease states were detected, endometritis chronica was seen in 79% of the cases, E . purulenta in 10.5%, e . acuta in 5.25% and E . subacuta in 5.25% . All of these conditions vanished after removal of the IUD and antibiotic treatment . In none of the cases was the IUD associated with precancerous atypia . Prevention may be the best approach with respect to infectuous complications associated with IUD use . Colposcopy, culturing of cervical mucus, PAP smears, erythrocyte sedimentation and leukocyte counts should be performed on women prior to IUD insertion . These steps guard against introducing vaginal infections into the uterus . When a woman comes to a physician complaining of pain in the lower back, abdomen, or during intercourse, infection must be suspected . If infection is found, treatment to eliminate the offending organism needs to be initiated . The woman's partner may also need to be treated . J Infect Dis, 1979 Apr, 139(4), 409 - 17 Defective leukotaxis in monocytes from patients with pulmonary tuberculosis; Campbell PB; Because the accumulation of macrophages and their precursors, peripheral blood monocytes, in foci of infection is an important feature of the host reponse to mycobacterial challenge, the leukotactic responsiveness of monocytes from patients with active tuberculosis was evaluated . With a double-filter, in vitro technique, defective leukotaxis was demonstrated in monocytes from 19 of 20 untreated patients, whereas normal leukotactic responses were found in monocytes from 11 of 15 patients with chronic, nontuberculous pulmonary inflammatory diseases . This defect may be related to increased activity of a naturally occurring, heat-stable plasma substance with a molecular mass of approximately 2.3 x 10(5) daltons that inhibited leukotactic responsiveness . Monocyte leukotaxis improved and the leukotactic inhibitory activity of plasma disappeared in most patients while they were on therapy; these phenomena were unrelated to bacteriologic conversion or resolution of symptoms . In vitro studies with isoniazid, ethambutol, and rifampin excluded a direct effect of these drugs or their metabolites on monocytes or on the leukotactic inhibitor in plasma . Thus, defective leukotaxis of monocytes in patients with pulmonary tuberculosis may be an epiphenomenon of the local tissue reaction. Ann Intern Med, 1979 Apr, 90(4), 526 - 8 Early clinical differentiation between Legionnaires' disease and other sporadic pneumonias; Miller AC; Early diagnosis of Legionnaires' disease is difficult because other pathogens cause a similar clinical picture and microbiologic tests are usually only of retrospective value . Since May 1977, 17 patients with sporadic cases of Legionnaires' disease have been admitted, all previously well, the diagnosis being made with standard serologic or bacteriologic criteria . From the clinical, laboratory, and radiologic findings, we propose criteria that may enable the clinician to make a diagnosis earlier in many cases, differentiating them from other pneumonias . Within 24 hours of admission, any three of the following four features are strongly suggestive of Legionnaires' disease: {1} prodromal "viral" illness, {2} dry cough or confusion or diarrhoea, {3} lymphopenia without marked neutrophilia, {4} hyponatremia . Two thirds of cases had at least three of these features, and no false-positive diagnoses would have been made in other pneumonias that were serologically negative for Legionnaires' disease if these proposed criteria had been applied diagnostically . In the next few days the diagnosis is very likely if microbiologic tests are negative and if there is radiologic extension, abnormal liver function test results, or hypoalbuminemia. Am J Public Health, 1979 Apr, 69(4), 340 - 7 The Ottawa County project: a report of a tuberculosis screening project in a small mining community; Burke RM et al.; Following a retrospective review of tuberculosis cases reported from Ottawa County, Oklahoma, from 1969 through 1973, a selective tuberculosis screening project was implemented . Screening of a "target group" of the population, 519 former miners, greater than or equal to 50 years of age, resulted in the discovery of abnormal chest X-rays in 182; (103 with silicosis, 36 with silicotuberculosis, 12 with inactive tuberculosis, and 31 with other abnormalities) . Eighty-five of these persons had positive tuberculin skin tests . Preventive therapy was recommended for 50, and 36 completed the prescribed course of treatment . Eight new bacteriologically confirmed cases of tuberculosis were found and treated . A large number of persons (1,904) residing in the same area who were not part of the target group were also screened for tuberculosis . This group contained a large number of positive tuberculin reactors but very few were candidates for isoniazid preventive therapy . Thirteen persons in this group had abnormal chest X-rays consistent with inactive tuberculosis but 12 had been identified and given preventive therapy before the project began . These data suggest that selective approaches to screening for tuberculosis in a community which are based on an in-depth retrospective review of the tuberculosis case register can be highly successful. Ann Microbiol (Paris), 1979 Apr, 130A(3), 351 - 4 {Risk of contamination by pipetting bacterial culture broth with "Pasteur pipettes" (author's transl)}; Lambert NG et al.; Our experiments have shown that the cotton plug located at the top end of a "Pasteur pipette" allows aerosol to escape upon aspiration of a bacterial culture broth and may be the cause of contamination . In the following, we propose the use of a bacteriological filter system which insures greater safety. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1979 Apr-Jun, 28(2), 109 - 14 {Evaluation of initial supervised and integrated treatment of tuberculosis}; Arbore A et al.; The operational and technical efficiencies were evaluated, of the initial, intermittently administered chemotherapy, supervised and integrated by the general medical network . The treatment was applied in 160 patients detected in 53 rural medical districts . It was noted that under the operational aspect the treatment was applied in 100% of the eligible patients, and administration of all the necessary doses was achieved in 91,6% of the patients . Bacteriological negativation by the direct examination was obtained after three months and negative cultures were obtained in 93,3% of the patients at three months and in 97,4% of all patients after 9 and 12 months . Closure (filling) of the cavities was obtained in 75,4% of the cases after three months of treatment, and in 87,7% of all cases after 9 and 12 months . Finally the technical efficiency was completed by an assessment of the socio-professional recovery, that was achieved in 91,8% of the cases. Kinderarztl Prax, 1979 Apr, 47(4), 175 - 8 {Indications for antibiotic long term treatment of chronic and recurring bronchitis}; Dietzsch HJ; The formerly used long-term therapy with antibiotics in chronic bronchitis in adulthood has been nearly completely replaced by an intermittent treatment of the single attack . Therefore it seems necessary to check the appropriateness and the indications for an antibiotic long-term therapy in childhood . In the light of the greater importance of viral and bacteriological infections of the airways in children and in the light of the frequency of confirmed malformations of the tracheobronchial tree the further appropriateness for an antibiotic long-term therapy after a thorough bronchological examination is established . Also firstly established bronchiectases or severe cases of deforming bronchitis initially mostly require such a long-term treatment . Among the cases of a specialized dispensary care for chronic and recurrent bronchopulmonary diseases such an antibiotic long-term therapy is indicated in nearly 8 to 10 per cent of all patients. Arch Intern Med, 1979 Apr, 139(4), 482 - 3 Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis; Wing EJ et al.; A case of polymicrobial sepsis occurred in a patient who had a permanent indwelling hyperalimentation catheter . Because it was undesirable to remove the catheter, quantitative bacteriologic techniques were used to determine whether the catheter was the source of sepsis . Blood drawn from a peripheral vein had 25 colonies per milliliter whereas blood drawn through the catheter had more than 10,000 colonies per milliliter . On the basis of these results, the catheter was removed . The catheter tip was found to be infected with the same organisms that were present in the blood . Quantitative bacteriologic techniques may prove useful in diagnosing catheter-related sepsis when it is undesirable to remove the catheter. Dtsch Med Wochenschr, 1979 Mar 30, 104(13), 477 - 9 {Treatment of open cavernous pulmonary tuberculosis (author's transl)}; Kittel H; In two groups, each of 40 patients, with previously untreated cavernous pulmonary tuberculosis the following treatment schemes were compared in a randomised clinical study: isoniazid, ethambutol, and rifampicin (control group) and isoprodian with rifampicin (study group) . Bacteriologic and radiographic parameters showed that in the study group the results were at least as good as in the control group . Symptoms of drug intolerance were equally rare in both groups. Med J Aust, 1979 Mar 10, 1(5), 151 - 3 Solitary liver abscess: a continuing medicosurgical problem; Kune GA et al.; The management problems of 22 patients with solitary liver abscess are reviewed . To achieve earlier diagnosis, and reduce the high mortality rate of this condition (32% in this series), clinicians need to change their data base of the clinical presentation and also to incorporate liver imaging as part of the routine investigation of a patient with pyrexia of uncertain origin . The problems associated with operative diagnosis, and with methods of surgical drainage are discussed . The need for careful bacteriological cultures is emphasized, and the use of the most appropriate antibiotics is described . While in many cases the cause of the liver abscess remains unknown, in Australia the possibility of the abscess being amoebic or an infected hydatid cyst should be kept in mind. Practitioner, 1979 Mar, 222(1329), 383 - 5 The changing pattern of sexually transmitted diseases in adolescents; Donald WH; PIP: The factors associated with the rising incidence of sexually transmitted diseases in adolescents in England and Wales are both social and medical . Among the social factors is the large part played by sex in periodicals, advertisements, the theater, radio, and television . Also playing their part are increased mobility of populations, particularly moves from rural to urban areas, increased affluence, increased alcohol comsumption and leisure time together with greater personal freedom . The medical factors include the prevalence of asymptomatic infection mainly in women but also in men, the high incidence in homosexual men who may be asymptomatic and very promiscuous, and the fact that modern treatment is simple and effective reduces the fear of infection . Furthermore, modern contraceptive techniques such as the IUD and oral contraceptives (OCs) offer no barriers to infection unlike the condom and diaphragm . Syphilis is no longer a problem in the UK, as the incidence has remained at a low level of 2-3 cases/100,000 population for the past 20 years . Gonorrhea has become a problem in its place reaching almost epidemic proportions by 1975, although the incidence is now showing some sign of leveling off . Nonspecific urethritis in men and nonspecific genital infection in women, and the virus condition of herpes genitalis and genital warts have all continued to increase in incidence . In most clinics 40-50% of female patients with gonorrhea are under the age of 20 . Changing patterns of sexual behavior have altered the pattern of disease . Oral coitus, both fellatio and cunnilingus, have become more prevalent and can lead to pharyngeal gonorrhea which can be symptomless in both heterosexuals and homosexuals . Rectal gonorrhea occurs in women as well as in male homosexuals and can be a cause of failure of initial treatment . The diagnosis of gonorrhea is a bacteriological diagnosis, and smears and cultures must be taken from the urethra and cervix in the female . It is gradually becoming routine pratice in many clinics to swab the rectum and pharynx as well as the genital tract to exclude gonorrhea in those areas . Complications of gonorrhea have become common again . Salpingitis has increased in incidence . Gonococcal arthritis has reappeared . Nonspecific genital infection in both sexes is a considerable problem . In men, the incidence of nonspecific urethritis is greater than that of gonorrhea . In women, nonspecific vaginitis, cervicitis, and salpingitis increases in incidence year by year and can be difficult to treat . As many as 40% of all women suffering from gonorrhea also have an infection with Trichomonas vaginalis, which will cause symptoms . Virus infection continues to be on the increase . This is particularly the case with genital warts and herpes genitalis, which have doubled in incidence over the past 10 years . It is always important when dealing with these conditions to examine the sexual partner, or partners, for evidence of a similar infection . Quad Sclavo Diagn, 1979 Mar, 15(1), 124 - 32 {The antibiogram in hospital practice . Its necessity and usefulness}; Gambella O; The A . examined 525 biologic samples that reached the Laboratory for normal bacteriological research . From those samples 625 bacterial species have been isolated, which have been tested with six antibiotics of commoner use, according to the method of Kirby-Bauer, employing two sorts of medium, the Mueller-Hinton Agar and the Brain Heart Infusion Agar . From these sensitivity-tests there resulted a very high rate of antibiotic resistance to of the six antibiotics examined . Several reasons have been invoked to explain the phenomenon but the most plausible explanation is that, it is due to the genetic modifications that the bacteria have undergone. J Chir (Paris), 1979 Mar, 116(3), 193 - 200 {Acute calculous cholecystitis (author's transl)}; Dalmas H et al.; The authors studied 333 acute cholecystitis out of 2,200 operated on for lithiasis of the gall-bladder, 186 bacteriological tests were carried out on the vesicular liquid and wall . They insist on the main anatomo-pathological characteristic: early, partial or total destruction of the mucous together with acute inflammatory lesions of the wall and even sometimes necrosis . This irreversible lesion is due to the acute obstruction of the gall-bladder by blockage of a calculus . Acute cholecystitis are practically always aseptic at the beginning . Sepsis is a secondary complication . These anatomo-pathological and bacteriological elements have two therapeutic corollaries: 1 . The patient has to be operated very early at the aseptic stage . 2 . Preliminary antibiotherapy becomes useless . Under these conditions there is practically no death before the age of 65 . Mortality concern old people, operated late and suffering from other disease. Trop Geogr Med, 1979 Mar, 31(1), 53 - 6 Prednisolone in the treatment of pneumococcal meningitis; Bademosi O et al.; The results of a steroid on 52 Nigerians (27 males, 25 females, aged 10 to 59 years) with bacteriologically proven pneumococcal meningitis are presented . Twenty-four of the patients were treated with steroids in addition to a standard regime . The clinical features on admission in the two groups were comparable and management other than steroid administration identical . Personality change with impairment of intellect was more frequent and mortality higher in the steroid-treated group although the differences wre not statistically significant . It is concluded that steroids apparently have no beneficial effect and may worsen the prognosis in pneumococcal meningitis. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir, 1979 Mar-Apr, 28(2), 137 - 9 {Primary splenic abscess ruptured into the peritoneal cavity (peritonitis in 3 stages)}; Popovici Z et al.; The authors present a case with peritonitis following rupture of a splenic abscess in a female aged 18 years . Peritonitis developed in three stages . The diagnosis before surgery was of pelvic peritonitis . Bacteriologic examination revealed the presence of B . colli . Splenectomy was followed by complete recovery of the patient . The site of the primary infection could not be determined . The authors stress the usefulness of exploration of the splenic lodge in the so-called "primary" generalized peritonitis, in pelvic peritonitis or in all cases when the origin of the peritoneal infection is not known. Clin Orthop, 1979 Mar-Apr, (139), 150 - 5 Routes of infection . A study of using "tracer particles" in the orthopedic operating room; Wiley AM et al.; Wound irrigates and tissue samples were cultured from clean orthopedic wounds at the conclusion of 280 orthopedic operations . The surgeons used a laminar flow unit and took extra precautions against wound contamination although personnel exhaust systems were not used . It was possible to culture residual organisms but difficult to trace the source of these by bacteriological methods . Artificial or "tracer" particles which could be applied to patient or surgeon were retrieved from the wound and suitably stained . Using albumin microspheres it was possible to identify and differentiate "patient-derived particles" from "surgeon-derived particles" in the majority of all wounds . Contamination from the surgeon was significant even under near optimum operating room conditions . These techniques are useful for development of control measures for residual wound contamination in orthopedic operating rooms. Am J Trop Med Hyg, 1979 Mar, 28(2), 396 - 400 The investigation of related cases for the control of diarrhea in cities in developing countries; Koopman JS; An example of how follow-up of related cases of diarrhea by epidemiologically-oriented health promoters can result in important public health measures is described . The follow-up of related cases involved a search for an outbreak in which a population with a high attack rate could be defined in order to increase the likelihood of a successful investigation by means of a cross-sectional retrospective study design . Then, through standard epidemiologic techniques, the risk factors to be studied were selected and a questionnaire was designed and executed . The results of this investigation demonstrate that greater meticulousness in pursuing epidemiologic principles is required for success in diarrhea outbreak investigations in developing countries than in developed countries despite the fact that controllable contaminations discoverable by these techniques are much more frequent in the former . In the present investigation it was found that flavored drinks packaged in plastic by a process assuming increasing importance in food distribution were causing diarrhea because of unhygienic manufacturing procedures . A concomitant bacteriologic study helped confirm the epidemiologic findings, and bacteriologic cultures at different points in the manufacturing process suggested a solution to the contamination problem found. An Esp Pediatr, 1979 Mar, 12(3), 245 - 56 {Cytological and bacteriological study of the vagina in newborn in a hospital environment (author's transl)}; Serrano Luna JL; An attempt has been made to ascertain the percentage of bacteriological transmission in the vaginal cavity, in a series of 98 studied cases between mother and daughter . All these findings have been correlated with the hormone quantities shown in smear tests . As a result of the work carried out it has been proved that transmission does not necessary take place, from the bacteriological point of view, in spite of the fact that E . coli is the bacteria most frequently found in cultures of smears from the vagina of both mothers and their newborn daughters . Similarly it was confirmed that differences between indices and percentages of cells from the vaginal epithelium of mothers and daughters is significant and are influenced by the presence of germs, among other factors. Jpn J Antibiot, 1979 Mar, 32(3), 342 - 5 {Experience with CS-1170 in gynecological infections (author's transl)}; Matsuoka I et al.; CS-1170 was used in gynecological cases of infection, and the following satisfactory results were obtained . 1 . The drug was markedly effective in 3 of 12 cases, effective in 7, and ineffective in 2, being the efficacy rate 83.3% . 2 . It was highly effective even in the cases in which cefazolin (CEZ) and sulbenicillin (SBPC) were ineffective . 3 . The results of the bacteriological examinations turned to negative in 7 cases, but continued to be positive in 2, being the bacteriological efficacy rate 77.7% . It is noteworthy that E . coli completely disappeared by the administration of CS-1170 in 2 cases in which CEZ was ineffective . 4 . No side effect attributable to CS-1170 administration was observed. Am J Med, 1979 Mar, 66(3), 463 - 7 Occult dental infection as a cause of fever of obscure origin; Levinson SL et al.; Three patients with prolonged unexplained fevers were ultimately found to have deep-seated dental infection . After initial examination failed to elicit symptoms or signs of dental infection, and extensive in-hospital evaluation was nonproductive, dental consultation with roentgenograms provided the diagnosis . All three patients underwent dental extractions with periapical or peridontal debridement; following a brief postoperative febrile period, all three responded with defervescence, without subsequent recurrence of fever . These cases emphasize the importance of periapical and peridontal infection as causes of fever of obscure origin . The pathogenesis, characteristics and bacteriology of periapical abscess are discussed. Chest, 1979 Mar, 75(3), 334 - 9 Incidence of ruptured chordae tendineae in the mitral valvular prolapse syndrome: an echocardiographic study; Chandraratna PA et al.; Echocardiographic studies were performed in 190 consecutive patients with mitral valvular prolapse . All patients had either midsystolic posterior motion of the mitral valve or holosystolic hammock-like movement of the valve in systole . Thirteen patients (7 percent) were noted to have ruptured chordae tendineae . In four patients, a combination of abnormalities was observed . Five patients had clinical and bacteriologic evidence of infective endocarditis, two of whom had severe intractable pulmonary edema consequent to acute mitral regurgitation which required mitral valvular replacement . At surgery, one of these patients had ruptured chordae tendineae to both leaflets, and the other had chordal rupture of the posterior leaflet . The other patients probably had spontaneous rupture of the chordae tendineae . A spectrum of clinical findings was noted . Six patients had marked mitral regurgitation, while two had isolated systolic clicks . Thus, chordal rupture does not always result in severe hemodynamic deterioration . Serial echocardiographic studies will be of value in studying the natural history and progression of disease in patients with chordal rupture. Ann Otol Rhinol Laryngol, 1979 Mar-Apr, 88(2 Pt 1), 166 - 71 Adenoids and otitis media with effusion; Ruokonen J et al.; At adenoidectomy specimens for bacteriological, virological, and histological investigation were obtained from the adenoids of 144 children, 53 of whom suffered from otitis media with effusion, or frequently recurring otitis media . Comparison of findings in children with ear diseases with those obtained in the rest of the material showed that Hemophilus influenza was cultured from 50% of the specimens from the children with ear diseases, while only 14% of the cultures from the other children yielded H . influenza . Virus isolates were made from 17 adenoids . In children with ear diseases a virus was isolated from 28% of the specimens, whereas positive isolates were obtained in only 3% of the rest of the speciemens . Both findings are statistically significant and support the view that the adenoid tissue may play an important role in the etiology of otitis media with effusion . The infected adenoid may be the direct source of the primary infections, or continuous microbial irritation in the nasopharynx may indirectly be the cause of otitis media with effusion, as persistent infection and edema maintain chronic dysfunction of the eustachian tube . Thus adenoidectomy may be beneficial in the treatment of frequently recurring otitis media, preventing otitis media with effusion from developing. Rofo, 1979 Mar, 130(3), 332 - 7 Angiography in synovitis of the knee; Grepl J et al.; In inappropriately treated synovitides of the knee joint with shift towards a villonodular inversion, an inflammatory angiographic symptomatology may be expected which is different according to the seriousness of the illness including (1) local hyperaemia, (2) deviation of arteries, (3) morphologic and formative vascular inversions and (4) diffusion of the contrast material into synovitic conglomerates and (5) shunts . From these findings the stadia of synovitis may be evaluated, including the extent and place of the villonodular inversion in the clinically or arthrographically inaccessible sites . Differential-diagnostic contributions to the origin of the synovitis cannot be expected from angiography and biochemical as well as bacteriological methods (cultivation) remain necessary . Despite this, angiography has its supplementary value in all cases where an analysis of synovitis is impossible by other means and also in all cases, where the extent of the synovitic changes must be evaluated for an operative treatment. Tijdschr Diergeneeskd, 1979 Mar 1, 104(5), 221 - 7 {Bacterial skin infections in the dog (author's transl)}; Willemse A; The most common bacterial skin conditions in dogs are reviewed in the present paper . An introductory part on the pathogenesis of pyoderma and some universal morphological dermatological concepts is followed by a systematic study of superficial and deep forms of pyoderma . In addition to the bacterial diagnosis, the results of bacteriological examination of fifty-three dogs with pyoderma submitted to the University Clinic of small animal medicine are reported . Moreover, a guide to the institution of adequate therapy is suggested. Afr J Med Med Sci, 1979 Mar-Jun, 8(1-2), 61 - 70 A double-blind comparative study of cimetidine and placebo in adult Nigerian duodenal ulcer patients with special reference to gastroduodenal mucosal morphology and intestinal bacterial activity; Falaiye JM et al.; Twenty-seven adult Nigerian patients with endoscopically proven active duodenal ulcers have received in a double-blind trial either the histamine H2 - receptor antagonist cimetidine 1g daily or placebo tablets of identical appearance for 4 weeks . Fifty-six per cent of the cimetidine patients and 18% of those receiving placebo had endoscopically completely healed ulcers and total pain relief at the completion of trial . This response amounted to clinical cure . An additional 19% of patients in the cimetidine group experienced clinical improvement either in endoscopic or symptomatic reassessment but not in both, thus leading to a disparity between clinical cure rate (56%), healing rate (69%), and pain relief (64%) . Though therefore significantly better than placebo, this less favourable response to cimetidine in this study may be due to the short trial period, the disparity between healing and pain relief rates or to co-existing and persistent antroduodenitis in ulcer patients as shown on gastroduodenal mucosal biopsies taken at the time of the clinical investigation . There were no untoward clinical laboratory side effects with the exception of the one cimetidine patient who experienced diarrhoea and a small number who showed slight, asymptomatic rise in plasma creatinine level . Of particular interest to the reported occurrence of diarrhoea with cimetidine therapy is the finding in the bacteriological studies of intestinal aspirates and biochemistry estimations for indicanuria in the consenting patients which showed that orally administered cimetidine 1g daily for 4 weeks neither produced demonstratable alterations in the bacterial content of the small bowel not pathological indicanuria, thereby excluding bacterial overgrowth syndrome as a therapeutic hazard in the clinical application of cimetidine. Vet Med (Praha), 1979 Mar, 24(3), 143 - 8 {Effect of bovine hypodermosis on various health indicators of milk in first-calvers}; Riha J et al.; The effect of the last developmental phase of the warble fly (Hypoderma bovis de Greer) larvas was studied as exerted on some health indices of milk in 20 experimental (treated) and 18 control (untreated) first-calvers of the Pinzgau breed at two localities of an area affected by bovine hypodermosis in the period from May to June, 1975 . The preparation Hypocid, at a dose of 15 ml per 100 kg of body weight, was applied externally in the lumbosacral region to the experimental animals in November, 1974 . Throughout the experimental period (61 days) the milk was repeatedly examined bacteriologically and cytologically, the content of chlorides and the milk electric conductivity were determined . In none of the followed health indices of milk were significant differences in the values obtained from experimental and control first-calvers proved statistically. Lancet, 1979 Feb 24, 1(8113), 425 - 8 Viruses in drinking-water . Reconsideration of evidence for postulated health hazard and proposals for virological standards of purity; Gamble DR; Stringent virological standards for drinking-water have been proposed by the World Health Organisation and by others, but there is no evidence of the spread of virus infection by drinking-water that has been adequately treated to conventional bacteriological standards . There is evidence for waterborne transmission of hepatitis and viral gastroenteritis but the case for the introduction of virological standards is critically examined . It is concluded that there is no evidence that drinking-water in the U.K . contributes to the spread of virus infection, and that the introduction of virological standards for drinking-water could not at present be justified . Moreover, in the absence of any information relating the degree of viral contamination to disease, there is no logical basis on which to set the level of a practical virological standard. Nouv Presse Med, 1979 Feb 17, 8(8), 573 - 6 {The prognosis and treatment of pneumococcal meningitis in Africa . 402 cases (author's transl)}; Cadoz M et al.; Over a period of 5 years (1973--1977), 1083 patients were hospitalised in the Infectious Disease Clinic of the Dakar University Hospital Centre with bacteriologically confirmed purulent meningitis . The pneumococcus was responsible in 462 cases (42.6%) . Analysis of 402 records showed that 234 patients (58.2% of cases) died, 123 were completely cured (30.6%) whilst there were neurological sequelae in 45 cases (28% of the survivors) . The chief factors in poor prognosis were the existence and depth of changes in conscious level, age over 20 years, a CSF cell count of less than 500 per mm3, a CSF protein level greater than 2 g per 1 and I CSF antigen level over 8 microgram per ml . From a therapeutic standpoint, the percentage mortality was similar with chloramphenicol and with penicillin G, but complete cures were statistically more frequent in the patients treated initially with chloramphenicol. Acta Neuropathol (Berl), 1979 Feb 15, 45(2), 153 - 7 Acute ascending poliomyelomalacia after treatment of acute lymphocytic leukemia; Reznik M; This paper reports the case of a 16-year-old girl with acute lymphoblastic leukemia who received chemotherapy including intrathecal injections of methotrexate and preventive irradiation of the brain, but not of the spinal cord . Several months later, she died from an acute ascending poliomyelitic syndrome evolving during 10 days . Clinical, bacteriological, and viral investigations failed to demonstrate any pathological agent . Autopsy revealed an acute ischemic lesion involving both anterior horns of the whole spinal cord and extending from the lower segment up to the mesencephalic region, without significant alteration of the white matter . Neither tumoral invasion, nor vascular obstruction was found . The pathogenesis of this yet undescribed lesion remained unclear but a metabolic disorder seemed the most plausible pathological factor. Vet Rec, 1979 Feb 10, 104(6), 123 - 5 A three-month study of environmental mastitis in a dairy herd; Allison CJ et al.; During the autumn/winter of 1976, a study was made of a severe mastitis outbreak which occurred in a herd of 96 cows . Forty-four cows and 61 quarters were clinically infected with new infections between September and mid-December . Escherichia coli was isolated in 84 per cent of clinical samples submitted for bacteriological examination. Am J Vet Res, 1979 Feb, 40(2), 280 - 4 Experimentally induced synovitis of chickens with Mycoplasma synoviae: effects of dexamethasone treatment; Kume K et al.; Specific - pathogen - free chickens were inoculated in the right tibiometatarsal joint with a synovitis-derived Mycoplasma synoviae strain before or during dexamethasone treatment . Development of synovitis in chickens inoculated during the drug treatment was apparently delayed in comparison with development of synovitis in non-treated chickens . Severity of clinical synovitis in chickens inoculated before the drug was given was apparently less than that in chickens not treated or in chickens treated with dexamethasone . Histopathologic changes in the early stage of the infection (1 to 2 weeks) were not modified by dexamethasone treatment, although those changes in the succeeding stage (6 to 7 weeks) were greatly lessened . A relationship was observed between the dosage of dexamethasone and the severity of synovitis, as well as the kinds of cells that infiltrated into the joint lesions . Although serum antibody titers in chickens treated with an excessive dose of dexamethasone were markedly lower, clinical, bacteriologic, and histopathologic observations in chickens treated with dexamethasone were similar to those previously found in surgically thymectomized chickens . These results may support the theory that multiple synovitis of chickens caused by M synoviae infection develops mainly because of an immune response, especially by thymus-dependent functions. Am J Vet Res, 1979 Feb, 40(2), 241 - 4 Comparison of vaccination and treatment in controlling naturally occurring infectious bovine keratoconjunctivitis; Hughes DE et al.; A vaccination study for infectious bovine keratoconjunctivitis was conducted on 108 newborn Hereford calves in the US Department of Agriculture Meat Animal Research Center cattle herd at Clay Center, Nebraska . Groups were allocated so that age of calf, sex of calf, and age of dam were equally distributed between the 54 vaccinated (group I) and the 54 nonvaccinated (group 2) control calves . The dams of both groups of calves were monitored as group 3 controls . An autogenous Moraxella bovis bacterin (formalin-killed, whole cells) was given IM at birth and at approximate intervals of 2 weeks for a total of 3 doses . Bacterial isolation rates for the cattle in groups 1, 2, and 3 during the summer were 92.6%, 92.6%, and 54.1%, respectively, and disease rates were 100%, 96.3%, and 70.6% . The rates were significantly (P less than 0.05) different between calves and cows . Vaccination of calves at birth permitted serum antibodies to develop before the calves were extensively exposed to infection; however, immunity to the disease did not develop . In a treatment study of other animals in the same herd, but in another pasture, the same criteria were used for allocation of 107 cow-calf pairs . Eye spray was applied to treated principals (group 4, 52 calves; and group 6, 53 cows) each week after examination and sample collection . Controls consisted of 54 calves (group 5) and 54 cows (group 7) that were examined and cultured bacteriologically in the same manner . The bacterial isolation and disease rates were less (P less than 0.05) in the treated calves (group 4) than in the nontreated controls (group 5) . The differences in bacterial isolation rates between groups 6 and 7 were not significant, but group 6 had less (P less than 0.05) grade III lesions than did group 7 . Weekly treatment appeared to be more effective in reducing the incidence of disease than did vaccination. Arch Surg, 1979 Feb, 114(2), 154 - 7 Bacteriologic and systemic effects of intraoperative segmental bowel preparation with povidone iodine; Arango A et al.; A technique for intraoperative segmental preparation of the large bowel, using 10% povidone iodine, was evaluated in 25 patients undergoing elective colon resection . Qualitative and quantitative bacteriology was obtained from the normal bowel content and from segments of colon treated with povidone iodine or normal saline . Forty-five of 50 segments treated with povidone iodine demonstrated no growth, whereas the segments injected with normal saline maintained bacterial counts of 3.5 x 10(8) colony forming units per milliliter . There were no septic complications in this group of patients and the levels of triiodothyroninc and thyroxin remained unchanged despite a substantial absorption of iodine, as demonstrated by protein-bound iodine determinations . Intraoperative segmental preparation of the colon with 10% povidone iodine is a simple technique that may be useful in the enhancement of other methods of bowel preparation by further reducing the endogenous bacterial inoculum at the time of transection of the colon. Am J Epidemiol, 1979 Feb, 109(2), 205 - 17 Extrapulmonary tuberculosis in the United States; Farer LS et al.; In recent years, the decrease in reported tuberculosis in the United States has been due almost entirely to a drop in the number of cases of pulmonary disease . There has been little change in the average number of extrapulmonary cases reported . A retrospective survey of extrapulmonary tuberculosis has shown that it differs from pulmonary tuberculosis with regard to sex and race distribution, diagnosing physician's speciality and proportion of cases bacteriologically confirmed . There is variation within extrapulmonary cases according to specific anatomic site with regard to the above characteristics as well as age distribution . These epidemiologic differences in tuberculosis of different sites are unexplained. Chest, 1979 Feb, 75(2), 115 - 9 Pulmonary mycobacterial infections due to Mycobacterium intracellulare-avium complex . Clinical features and course in 100 consecutive cases; Rosenzweig DY; One hundred consecutive cases of pulmonary infection due to Mycobacterium intracellulare-avium seen during a 3 1/2-year period qualified for review on the basis of a compatible chest x-ray film, repeated isolations from cultures of sputum, and follow-up of three to eight years . Infections with M intracellulare-avium represented 27 percent of all mycobacterial infections seen during this period, including those due to M tuberculosis . The cases of disease due to M intracellulare-avium were predominantly in men with preexisting pulmonary disease, with a peak incidence in the sixth decade, but nearly one-third of the cases were in younger persons free of coexisting disease . The disease was chronic and indolent in most cases, and only a few showed a progressive course . A stable course was frequently observed despite prolonged persistently positive cultures of sputum . A favorable prognosis was most often found in those with previously treated tuberculosis . Poor prognosis was often due to a serious associated disease, such as cancer, rather than to advancing mycobacterial infection itself . Age, sex, or race was unrelated to prognosis . Conversion to negative status on culture was attained in one-half of the cases . Those with extensive radiographic involvement or cavitation were more likely to have treatment fail bacteriologically . No combination of chemotherapy appeared to be particularly effective, including the use of five or more drugs in eight cases demonstrating progressive disease . Surgery, too, was ultimately disappointing in that recurrence appeared in six of 18 carefully selected cases. J Bone Joint Surg Br, 1979 Feb, 61(1), 47 - 55 Pyogenic non-tuberculous spinal infection: an analysis of thirty cases; Digby JM et al.; Thirty patients with non-tuberculous pyogenic osteomyelitis of the spine are reported in all of whom the diagnosis was confirmed bacteriologically, histologically or serologically . The clinical and radiological features and investigations are analysed . Back pain, localised to the level involved, was the predominant symptom . The erythrocyte sedimentation rate was raised in all cases, and a characteristic sequence of radiological features is described. Chest, 1979 Feb, 75(2), 126 - 30 Thoracoscopy . Early diagnosis of interstitial pneumonitis in the immunologically suppressed child; Rodgers BM et al.; Interstitial pneumonitis in immunosuppressed patients demands prompt diagnosis and treatment . In an effort to achieve a simple yet highly accurate method of diagnosis, we have evaluated the usefulness of thoracoscopic examination . Twenty-seven procedures have been performed in 24 patients between the ages of 17 months and 18 years . All patients were immunosuppressed, most for treatment of malignant processes . All procedures have been performed under anesthesia with intravenously administered ketamine, without endotracheal intubation . A definitive diagnosis has been made in every case, with pneumonia due to Pneumocystis carinii being identified in 18 instances . Complications have been minimal and include four minor pneumothoraces, two instances of bleeding, and two instances of prolonged air leak . Mortality attributable to the procedure has been nil, although five patients have died due to their underlying diseases within 30 days of the thoracoscopic procedure . Thoracoscopy has proven to be a rapid and safe technique for providing accurate histologic and bacteriologic diagnoses in these critically ill children. J Reprod Med, 1979 Feb, 22(2), 106 - 8 Hemophilus influenza septicemia and midtrimester abortion; Ogden E et al.; A case of midtrimester septic abortion due to Hemophilus influenza is discussed on the basis that the pathogeneses of the septic abortion was due to the hematogenous spread of the organism orginating from upper respiratory infection . The absence of ruptured membranes and the elevated antibody titer at the onset of the pelvic infection were in keeping with this hypothesis . Additional data on the bacteriology of this organism and the probability of the occurrence of a type b organism with original ampicillin resistance are presented. Ann Allergy, 1979 Jan, 42(1), 44 - 8 Bronchial asthma and pathological processes in the nasopharynx . I . Clinical analysis during remission and attack; Obtulowicz K et al.; In 54 patients with bronchial asthma and a control group of 15 subjects laryngological, bacteriological and cytological examinations of the nasopharynx were performed . This region was found to be inflamed in 38% of the patients with asthma; in a group of asthmatic patients hypersensitive to aspirin, the percentage rose to 87% . In the asthmatic patients, as compared with the control group, there was a diminished neutrophilic exudate, a marked epithelial desquamation reaction and an abundant lymphocyticosinophilic exudate in a considerable percentage of cases. Arch Geschwulstforsch, 1979, 49(7), 613 - 7 {The galactophoritis--a cytological symptom of mastopathy (author's transl)}; Wunderlich M et al.; In cytological examinations of 7,739 women with nipple discharge 90 cases of galactophoritis were found . Additional diagnostic methods, especially galactography in 24 patients could classify the galactophoritis as a symptom of mastopathy . Cytophotometrical and bacteriological examinations of the galactophoritical discharge supported this . Based on enlarged galactographical-histological comparative investigations milk duct cysts and dilatations in the galactograms were shown to be typical roentgenmorphological signs of mastopathy . It was therefore possible to classify the cytological picture of the galactophoritis. Arch Exp Veterinarmed, 1979, 33(6), 951 - 6 {Experience in identification and control of mycoplasma in dairy cattle stock under routine laboratory conditions}; Wehnert C; Exacting demands have to be met by milk testing routine laboratories where mycoplasma species are to be cultured from milk samples . Cleanliness of sampling, immediate cold storage, and no-delay transport of the milk samples to the testing centre are of greatest importance to the informative value of all mycoplasma tests . In the summer season, it is recommended to freeze the milk samples immediately after sampling . Mycoplasma broth should not be inoculated to animals of the herd from which the samples had been taken . A modified mycoplasma culturing medium is described in this paper . It will enable wider introduction of mycoplasma diagnosis by more Regional Institutes of Veterinary Medicine . Also reported in this paper are diagnosis and successful control of enzootic mastitis caused by Acholeplasma laidlawii and Acheloplasma axanthum . Repeated bacteriological testing of milk and secretion of all cows in the herd helped in picking out all bacteriologically positive animals and isolating them from the negative individuals . All animals that had produced positive responses to bacteriological testing were killed, notwithstanding clinical udder and general milk findings . Definite success of any control action undertaken against mycoplasmic mastitis will depend strongly on no-delay bacteriological testing of milk and secretion samples from all cows of the given herd, as early as in the acute phase of mastitis caused by mycoplasma. Ann Med Interne (Paris), 1979, 130(11), 569 - 76 {Results of bronchial scrapings in interstitial pulmonary diseases in immunodeficient children (author's transl)}; Lavaud J et al.; Endobronchial scraping was used in 53 immunodeficient children, aged 4 months to 15 years, and divided into three categories (37 receiving immunosuppression treatment, 8 with marasmus, and 8 with immunodeficiency), in order to determine the etiology of their interstitial pneumopathy . The examination was made under blind conditions in 21 cases using an intubation tube (under assisted ventilation), and with bronchoscopy under general anesthesia in the other 32 cases . Three scrapings were required for cytological, bacteriological, and virological and mycological examinations . In 32 cases (60%), the etiology of the interstitial pneumopathy was discovered; in 18 patients it was due to pneumocystis carinii, in 10 cases to bacterial infection, in 7 cases a viral infection, and in 3 others a fungal infection . An association of infective agents was reported in 6 cases . The major incident observed was a pneumothorax in 17% of the cases, more especially in 45% of the children under 20 months of age . Bronchial scraping is a valid examination the results and complications of which compare well with other non-vascular methods of diagnostic evaluation of such lesions. Postgrad Med J, 1979, 55 Suppl 4, 56 - 8 Cefaclor therapy in acute exacerbations of chronic bronchitis; Wernstedt L et al.; Twenty-four patients with acute exacerbations of chronic bronchitis were treated with cefaclor at a dose of 500 mg every 8 hours for 10 days . Studies included volume, appearance and bacteriological examination of sputum, and haematological and virus serology tests . The response to therapy was judged on the reduction in sputum volume or the conversion of its character from purulent to mucoid . Nineteen of 24 patients improved and in 4 of 5 failures, positive serology for influenza virus was found . Growth of Pseudomonas occurred in one sputum . Minor side effects were seen in 3 patients, and no haematological or biochemical abnormalities were found. Vet Med Nauki, 1979, 16(9), 71 - 4 {Enzootic erysipeloid in pheasants}; Lulov R et al.; Epizootological, clinical, bacteriological and pathomorhological studies on enzooty of erysipelas in a flock of 11 000 pheasants were made . The clinical symptoms of sick pheasants and the pathologoanatomical and patho-histogical changes observed in dead pheasants are described . The pathogen of erysipelas was isolated and differentiated . The disease was reproduced experimentally in 15 pheasants from another fram where no cases of the disease were encountered . The source of infection remained unknown . It was established that, as is the case in other animals and birds, erysepelas in pheasants is characterized clinically and morphologically by the symptoms of septicaemia. Vet Med Nauki, 1979, 16(5), 59 - 66 {Atypical course of cholera in poultry}; Tsonev TsS et al.; Atypically developing chicken septicemia was studied at 3 farms in Bulgaria . In one of the observed centers of chicken septicemia infection no pathologic anatomical changes were evident while in the other two centers of infection serofibrinose and serofibrinose vitelline peritonitis, as well as pleurisy were present . In the bacteriological investigation carried out on 2969 samples 233 strains of chicken septicemia were isolated . Identification of 84 of them by the aid of the specific bacteriophage P . multocida 115 and of sugar and alcohol fermantation revealed that they can be classified as P . multocida . They are lyzated by a phage but do not reproduce it . Chicken septicemia cultures are virulent for white mice . In intramuscular injections of pullets these cultures prove not virulent, but their intravenous application kills the pullets in 5--10 days and the initial strain is isolated from all inner organs . The biological test on pullets is suitable for determining chicken septicemia culture virulence. Ann Acad Med Singapore, 1979 Jan, 8(1), 63 - 6 Treatment of chancroid with Bactrim; Rajan VS et al.; Bacterim in either oral or intramuscular injection forms were given to 67 patients with Chancroid . It was found that after one week of treatment, clinical cure rate was 46.3% and bacteriological cure rate was 73.1% . After two weeks, the clinical cure rate was 77.6% . Three patients (4.5%) had persistent sores at the end of two weeks and only one of these (2.5%) was bacteriologically active . Twelve patients defaulted . Adverse side-effects were observed in five patients . The effectiveness of Streptomycin, Sulphonamide and Tetracyclines, the other commonly used therapeutic agents, was discussed and compared with Bactrim . It was concluded that Bactrim was a safe and effective drug to use, and recommended as an alternative to Streptomycin and Sulphonamides in the management of Chancroid. Poumon Coeur, 1979, 35(4), 185 - 8 {Non suppurative acute "bacterial" pneumonia in alcoholics . Study of 54 cases (author's transl)}; Ricome JL et al.; Pneumonia in alcoholics are frequent and often severe . A retrospective study, including two groups of patients, 25 in internal medicine and 29 in intensive care, was undertaken to define the main clinical, prognostic and therapeutical characters of these pneumonias . Death rate was very high in patients admitted to intensive care units (60%) but nil in patients in internal medicine . The principal elements of the prognosis were the existence of a neutropenia at the beginning, the condition of denutrition of the patient, failure to recognize the responsible germ because of an antibiotic treatment given blindly, and the delay of the treatment . The pneumococcus was the most frequently encountered germ (77%) . After discussing the mechanisms of the quantitative and qualitative involvement of the neutrophilic leukocytes, the authors stated the measures which would lower the death rate and stressed the value of transtracheal puncture enabling an early bacteriological diagnosis. J Int Med Res, 1979, 7(2), 127 - 31 Amoxycillin injection in the treatment of pyogenic meningitis in children; Maguire MJ et al.; An open trial of the use of amoxycillin injection in the treatment of pyogenic meningitis in children showed similar results to previous trials here of penicillin-chloramphenicol combinations . It is felt that, in developing countries at least, treatment of pyogenic meningitis in children should be with the latter combination, but where rapid and accurate bacteriology is available amoxycillin may be valuable non-toxic alternative to chloramphenicol with similar activity to ampicillin. Acta Otolaryngol, 1979, 88(1-2), 122 - 6 Myringotomy in the treatment of acute otitis media in children; Puhakka H et al.; The treatment of acute otitis media was studied in 158 children . All children (mean age 4 years) received penicillin orally 80 000--100 000 IU per day for 10 days . Myringotomy was performed on 68 children at the time of the diagnosis . The other 90 children were treated with penicillin and ear drops . The bacteriological findings from the nasopharynx at the time of diagnosis were equivalent in both groups . After 2 weeks, 42% of the children without myringotomy and 71% of the children with myringotomy were cured . The children who were not cured were treated with amoxicillin for 10 days . Four weeks after diagnosis 71% and 90% of the children respectively were cured . The differences between the two groups are significant . The observations indicate that myringotomy clearly accelerates the recovery from acute otitis media. Med Trop (Mars), 1979 Jan-Feb, 39(1), 9 - 15 {Agents of mycetomas: a bacteriological and parasitological study (author's transl)}; Peloux Y et al.; Microscopic agents responsible of Mycetomas are reviewed . They may be bacteria belonging to the Actinomycetalae order (Nocardia, Actinomadura, Streptomyces) or very various fungi belonging to the classes of Adelomycetes or Ascomycetes (Madurella, Leptosphaeria, Neotestudina, etc.) . Though the procedures for collecting and transporting samples are the same, direct microscopic examination gives possibility to choose among the selective culture media the most appropriate ones to isolate either fungi or Actinomycetalae . Technics of identification for the most important bacterial agents are given, but fungi can be identified in only very specialized laboratories . Immunological methods may bring valuable indications for helping diagnosis or treatment supervision. Scand J Plast Reconstr Surg, 1979, 13(1), 73 - 5 Gas gangrene as a complication of burns; Davies DM; Gas gangrene infection in burnt patients is a rare but often fatal complication . It may however, be successfully treated by the use of hyperbaric oxygen and later judicious amputation of dead tissues . Five cases of bacteriologically proven gas gangrene, three of whom survived, occurred out of a total of one thousand and sixty-four burns patients treated since 1964 in the McIndoe Burns Unit, and these we describe. Neurosurgery, 1979 Jan, 4(1), 18 - 29 Autogenous skull cranioplasty: fresh and preserved (frozen), with consideration of the cellular response; Prolo DJ et al.; Every craniotomy requires immediate replacement of a fresh autograft of skull or, in the presence of cerebral swelling, delayed reimplantation of preserved autogenous skull . Resumption of osteogenesis, the index of viability, determines the effectiveness of these segments of calvaria in protecting the brain and restoring skull conformity . The cellular response in skull replaced either at the end of craniotomy or after frozen preservation was studied by light and fluorescence microscopy, skull roentgenograms, and radionuclide scintigraphy . In 5 patients eventual total remodeling of skull was found at the time of a second craniotomy performed from 1 to 19 years after the first . In 12 patients skull sections removed aseptically at craniotomy were frozen and stored for 1 to 35 months at -20 degrees C in bacitracin . This cytotoxic preservative method fixed the tissue, which appeared unchanged on light microscopy and was sterile on bacteriological and fungal cultures . In 53 patients who underwent autogenous cranioplasty with skull stored frozen for 3 weeks to 19 months, 48 operations were totally successful . Complications included infections in 2 patients, resorption in 2 infants, and incomplete restoration in 1 adult . In 10 patients the sequential dynamics of skull revitalization were found to be: revascularization, resorption, and accretion . The repair of membranous skull is similar to that of endochondral bone of the skeleton . Skull is metabolically intensely active after reimplantation and is the ideal material for cranioplasty. Scand J Gastroenterol, 1979, 14(3), 333 - 6 The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth; Rhodes JM et al.; The lactulose hydrogen breath test has been evaluated as a diagnostic test for small-bowel bacterial overgrowth using the 14C-glycocholate breath test for comparison . Twenty-seven patients with suspected bacterial overgrowth and 37 control patients were studied . The lactulose test was positive in 8 out of 9 patients with Subsequently proven bacterial overgrowth, all of whom had positive 14C-glycocholate tests . However, 6 patients with ileal disease or resection had positive 14C-glycocholate tests but negative lactulose tests . subsequent bacteriological study of duodenal juice from these patients was negative . Negative results were obtained by both tests in the remaining 12 patients, none of whom were subsequently shown to have bacterial overgrowth . All 37 control subjects had negative lactulose tests . The lactulose breath test is a simple and promising diagnostic test for the detection of small-bowel bacterial overgrowth and, unlike the 14C-glycocholate test, has the advantage of being able to distinguish bacterial overgrowth from ileal disease. Infection, 1979, 7 Suppl 2, S211 - 5 {Infections caused by the so-called atypical mycobacteria (author's transl)}; Jakschik M; A number of cases of patients in whom the so-called atypical mycobacteria were identified in our institute are presented briefly in this report . Predisposing factors such as occupation and existing tissue damage, particularly in prolonged respiratory tract diseases, play a significant role in the establishment of the infection in the host organism . The bacteriological culturing, testing and typing of these organisms is an important adjunct to the clinical picture. J Int Med Res, 1979, 7(1), 52 - 6 Magnapen treatment of infections in the elderly; Middleton RS et al.; Magnapen is a combination of two well-proven semi-snythetic penicillins which together offer the theoretical advantages of a broad spectrum of activity, good bioavailability and a low incidence of side-effects . It is of particular value in treating infections in the elderly . In this study the theory is borne out in practice in a population presenting special problems for which this combination seems particularly appropriate . Ninety-six patients have been treated with a course of Magnapen syrup . Of the total entered into the study, 73% of patients were clinically cured following therapy, with a further 19% improved . Clinical failure occurred in 8% of patients . Fifty-two patients were bacteriologically assessable, forty-seven of whom (90%) had infecting organisms cleared by therapy . Side-effects occurred in four patients (4%), one of whom had to discontinue therapy. J Int Med Res, 1979, 7(6), 531 - 4 A general practice trial of an amoxycillin/flucloxacillin combination (Suprapen) in proven bacterial infections; Kritzinger NA; Ninety-three cases of proven bacterial infection occurring in general practice were treated with an amoxycillin/flucloxacillin combination . There was a satisfactory clinical response in 98% of patients and an overall bacteriological success rate of 95.7% . Eleven patients (9.1%) complained of side-effects but withdrawal of the combination was necessary in only one patient who developed a rash. Infection, 1979, 7 Suppl 5, S507 - 512 Studies on aminopenicillin developments . Proceedings of a symposium . Concluding remarks; Bergan T; This symposium has focused on the bacteriological, pharmacokinetic, therapeutic, and adverse effects of the aminopenicillins . The compounds which are currently being assessed are primarily amoxycillin, ampicillin, bacampicillin, pivampicillin, and talampicillin . The three last mentioned are prodrugs which upon gastrointestinal absorption are rapidly split to yield circulating ampicillin . Pharmacokinetics and side-effects are reasons why one may narrow the selection of most suitable compounds within this group down to three . Ampicillin and amoxycillin are primary choices for parenteral dosage, and amoxycillin and bacampicillin the most suitable for oral therapy. Infection, 1979, 7 Suppl 5, S456 - 7 Clinical pharmacological evaluation of aminopenicillins; Mattie H et al.; To establish the clinical value of antibiotics, clinical trials are necessary . Both bacteriological and clinical-pharmacological data are helpful when designing a proper clinical trial . The difference between amoxicillin and ampicillin preparations cannot be defined on pharmacokinetic grounds alone . The difference in absorption between ampicillin and either pivampicillin or bacampicillin shows the latter two to be superior. Scand J Infect Dis Suppl, 1979, (19), 35 - 41 Anaerobic infection of the liver and biliary tract in experimental common duct occlusion; Justesen T et al.; The pathogenicity of single anaerobic, single aerobic, and mixed anaerobic and aerobic bacterial inocula was studied in 3 groups of 12 rabbits with biliary tract obstruction . B . fragilis, ss . fragilis and E . coli serotype 01:K1:H7 were used . The investigation was made 7 days after bacterial inoculation and included bacteriological studies of the liver and bile as well as studies of liver function and morphology of the liver and biliary tract . Inoculation of 10(5)--10(6) E . coli did not cause biliary tract infection, liver abscesses or death . Inoculation of 10(9) B . fragilis caused biliary tract infection in 83 per cent and liver abscesses in 17 per cent of the animals inoculated, without any mortality . Combined inoculation with B . fragilis and E . coli in reduced doses significantly increased mortality (42 per cent) and frequency of liver abscesses in surviving animals (86 per cent) . All abscesses, however, yielded pure culture of B . fragilis only . 84 per cent of the animals inoculated with B . fragilis alone or with B . fragilis in combination with E . coli developed biliary tract infection with B . fragilis, the bile yielding from 10(7)--)0(9) B . fragilis per ml, gall bladder bile yielding significantly higher bacterial counts than common duct bile . E . coli was never recovered from bile in surviving animals but from both bile and blood in animals not surviving the experimental period. Curr Med Res Opin, 1979, 5(10), 790 - 2 Mezlocillin in gonorrhoea: a pilot study; Fowler W et al.; A pilot study was carried out in 50 patients with uncomplicated, untreated gonorrhoea to asses the effectiveness of mezlocillin, a new semi-synthetic penicillin . Patients received a single intravenous injection of 2 g mezlocillin and were followed-up for periods up to 101 days . Four patients defaulted immediately . Clinical and bacteriological findings showed that only 1 of the 46 patients followed-up had failed to respond to treatment, indicating a cure rate of 97.8% . Five (10.8%) male patients had developed post-gonococcal urethritis when seen 3 weeks or later in the follow-up period. Clin Exp Immunol, 1979 Jan, 35(1), 45 - 52 A placebo controlled clinical trial of transfer factor in lepromatous leprosy; Faber WR et al.; The effects of repeated injections of transfer factor over a period of 20 weeks were investigated in fourteen bacteriologically positive patients at the lepromatous side of the leprosy spectrum . All patients showed negative (0 mm induration) skin tests to M . leprae antigens (i.e . leprolin and lepromin) . Of these patients, seven were treated with transfer factor with a total of 9 units (1 unit being equivalent to 5 x 10(8) lymphocytes) and seven with a placebo . Maintenance treatment with clofazimine was continued . Transfer factor was prepared from the lymphocytes of donors who showed positive skin tests to M . leprae antigens (i.e . leprolin greater than or equal to 12 mm induration, average 15.5 mm or lepromin greater than or equal to 8 mm induration, average 13.6 mm), as well as a positive lymphocyte transformation in vitro to M . leprae (the average transformation being higher than the average transformation of lymphocytes of tuberculoid leprosy patients) . No differences were found between the two groups as regards the clinical course of the disease, the histopathological and bacteriological evaluation of skin biopsies, changes in skin test reactivity to various antigens (i.e . lepromin, leprolin, PPD, Mumps, C . albicans, Tr . rubrum and Varidase), as well as the lymphocyte transformation in vitro to various mitogens (i.e . PHA, PWM, Con A) and antigens (i.e . M . leprae, leprolin, PPD, BCG, Mumps, C . albicans, Trichophyton and Varidase) . No evidence was found to suggest that transfer factor is a valuable adjuvant in the treatment of lepromatous leprosy patients or that it increases cell-mediated immune reactivity towards M . leprae. Dermatologica, 1979, 158(1), 46 - 54 Evaluation of treatment of lepromatous leprosy patients in the Netherlands; Faber WR et al.; The results of treatment of the group of leprosy patients at the lepromatous side of the leprosy spectrum registered at the Department of Dermatology of the University of Amsterdam in the years 1950-1976 were studied . The average duration of treatment to obtain bacteriologically negative skin biopsies in patients who were untreated at the time of registration, was 5 years . A substantial number of patients suffered a relapse; the main reasons for these relapses were discontinuation of treatment and DDS treatment in low dosage. J Reprod Fertil Suppl, 1979, (27), 343 - 9 Epidemiological observations on contagious equine metritis in Kentucky, 1978; Bryans JT et al.; Contagious equine metritis, introduced by importation of 2 comtaminated stallions from France, affected 54 Thoroughbred brood mares during the 1978 breeding season in Kentucky . The infection was diagnosed bacteriologically and by the use of a complement fixation test . Although lateral spread to stallions, and probably to a few mares, occurred through human agency in the breeding sheds of 2 stud farms, control measures instituted early in the epidemic confined the disease to brood mares bred by stallion on only these farms. J Reprod Fertil Suppl, 1979, (27), 337 - 42 Contagious equine metritis in Australia; Hazard GH et al.; Contagious equine metritis (CEM) was first diagnosed in Australia in August 1977 and it has since been found on 6 farms in 3 states, having been isolated from about 24 mares and 2 stallions . Details are given of the epidemiology and control procedures used to combat CEM on one farm . Difficulty was experience in successfully treating one infected stallion; this was thought to be associated with inadequate cleaning and treating of the diverticulum of the urethral fossa . Introduction of the disease has had far-reaching consequences and may well result in the adoption of routine bacteriological tests on stallions and mares of unknown or dubious breeding history and other measures to minimize the possibility of spread between farms. J Reprod Fertil Suppl, 1979, (27), 331 - 5 The epidemiology of contagious equine metritis (CEM) in England 1977--1978); Powell DG et al.; Following an outbreak of CEM in England during 1977 a Code of Practice was introduced to control the disease in 1978 . The Code recommended a bacteriological screening programme for Thoroughbred mares and stallions and improved standards of hygiene on the stud farm . As a result of the implementation of the Code a number of asymptomatic carrier mares was detected . Stallions which had transmitted CEM in 2977 and were treated did not transmit the disease during 1978 . Two small outbreaks of CEM were reported during the 1978 breeding season. Rev Chil Obstet Ginecol, 1979, 44(5), 237 - 44 {Endouterine fibrinolytic activity in users of intrauterine devices}; Gayan P et al.; PIP: A study of 51 endometrial samples extracted from 142 IUD users was made; 92 of these users had normal menstrual cycles and 50 had polymenorrhea or hypermenorrhea . 71 samples were extracted during menstrual bleeding and 71 during the intermenstrual period . The IUD and endometrial samples were set down in fibrin plaques and maintained at 37 degrees Celsius for 18 hours . The fibrinolytic activity was evaluated in degrees from 0-4 . Bacteriologic and histopathologic analysis was made in 13 of 21 endometrial samples extracted in the intermenstrual period from polymenorrheic women . The