Pathology, 1979 Jul, 11(3), 401 - 15 Experimental granulomatous inflammation: I . Gross and light microscopical observations in freund adjuvant-sensitized Cavies following the injection of killed tubercle bacilli; Newhook CJ et al.; The tuberculous granuloma, induced by injection of microgram doses of killed mycobacteria into guinea pigs sensitized by injection of Freund adjuvant is immunologically mediated . Formation of the granuloma is preceded by development within 24 h of a lymphocyte-dominated mononuclear cell response typical of a delayed hypersensitivity (type IV immune response) reaction . About the sixth day, following a marked decrease in intensity of the cellular reaction, a nodule containing monocytes and macrophages develops at the injection site . With increasing numbers of monocytes and macrophages the nodule forms a non-caseating granuloma with giant cells but dominated by epithelioid cells and reaching a maximum size about 3 wk after injection . Thereafter the granuloma undergoes gradual demolition being replaced and surrounded by fibroblasts and collagen deposition . The very delayed nature of this immune response as well as its histological character appear clearly to separate it from classical cell-mediated and humoral immune responses . These facts justify the hypothesis of a third type of (usually protective) immune response characterized histologically by the development of an epithelioid cell granuloma and determined by the nature of the antigenic material and the reactivity of the host . The initial polymorphonuclear leucocyte reaction to injection of mycobacteria, being similar in sensitized and control animals, does not appear to be under immunological control. Lepr India, 1979 Jul, 51(3), 323 - 9 Assessment of Dharmendra antigen . III . Comparative study with Mitsuda antigen; Sinha S et al.; Four fractions each from Dharmendra and Mitsuda antigen have been obtained by step-wise centrifugation and sonication of the antigen . These fractions have been assessed for their capacity of inducing skin delayed hypersensitivity response . While, it has been noted that all fractions of both types of antigens can induce a good early reaction, the late skin reaction is only mounted by intact bacilli of both types of antigen . When compared at a constant bacillary concentration, Dharmendra antigen has produced better early skin reaction than Mitsuda antigen, whereas the intensity of late skin reaction is almost equal with both the antigens . The hypothesis has been put forward that the early, as well as the late reaction are produced by the same antigen and this antigen is located in the protoplasm of M . leprae. Lepr India, 1979 Jul, 51(3), 316 - 22 Assessment of Dharmendra antigen . II . Standardisation of the antigens; Sengupta U et al.; Dharmendra antigen with different bacterial counts (16, 12.5, 10, 7.5, 5 and 2.5 million/ml) have been utilized for determination of skin delayed hypersensitivity in leprosy patients . It has been noted that antigen with 10 million acid fast bacilli (AFB)/ml mounts a standard early (24 hrs) as well as late (3 weeks) reaction in patients . Lepromatous patients do not show any skin reaction with this dilution . Thus, a standard Dharmendra antigen has been prepared using a considerably smaller number of organisms as compared to the International standards for Mitsuda antigen. Am Rev Respir Dis, 1979 Jul, 120(1), 214 - 6 A cluster of Mycobacterium gordonae isolates from bronchoscopy specimens; Steere AC et al.; During a 2.5-year period, 52 patients at Yale-New Haven Hospital had Mycobacterium gordonae recovered from specimens obtained by suction at bronchoscopy; 2 of them also had smears positive for acid-fast bacilli . Almost all of the isolates came from patients bronchoscoped by the same physician, one of 4 who performed the procedure during that period . Only this physician added one drop of green dye, stored in a 100-ml bottle, to the cocaine used for topical anesthesia during the procedure; cultures of the dye yielded Mycobacterium gordonae . Contamination with this organism, a cause of positive acid-fast smears, may result in an initial inappropriate diagnosis of Mycobacterium tuberculosis. Am J Med, 1979 Jul, 67(1), 113 - 6 Lepromatous leprosy masquerading as disseminated tuberculosis; Weissman JB et al.; A patients with disseminated leprosy is described . A 57 year old man from Cuba presented with fever and pancytopenia . Bone marrow aspirate showed numerous acid-fast bacilli and a liver biopsy specimen contained multiple granulomas . The patient was considered to have tuberculosis and was treated with isoniazid and rifampin, with initial clinical improvement, only to have the fever recur and to show deterioration in hematologic and hepatic function . Failure to grow M . tuberculosis suggested a diagnosis of leprosy which was proved by skin biopsy . How lepromatous leprosy can masquerade as disseminated tuberculosis is discussed. Plast Reconstr Surg, 1979 Jul, 64(1), 41 - 6 Tropical ulcers; Oluwasanmi JO et al.; We present 87 cases of chronic leg ulcers . The ages and sexes of the patients, and the symptomatology and complications, are described . The term "tropical ulcer" is inappropriate for these cases--though the term may be appropriate for certain rare acute ulcers colonized by Vincent's bacilli . For most persistent leg ulcers in the tropics, however, a general term of chronic ulcer is better--because it stimulates one to look for the cause and to treat the patient accordingly. Lepr India, 1979 Jul, 51(3), 341 - 7 A study of scrotal biopsy in subsided cases of lepromatous leprosy; Ramu G et al.; Scrotal biopsies were obtained from 38 cases of lepromatous leprosy who were clinically subsided and had negative skin smears . Twenty six (68.4%) of these cases revealed bacilli in the dartos muscle . None except one showed a specific lesion in the dartos . Bacilli obtained from 2 out of 7 cases multiplied in the mouse foot-pad . Bacilli were found to be persisting in the dartos muscle despite prolonged treatment before as well as after clinical subsidence of the disease . The persisting bacilli in this situation could be a cause of relapses. Lepr India, 1979 Jul, 51(3), 33 - 5 Behaviour of macrophages to Mycobacterium leprae . A tissue culture study; Veliath AJ et al.; Macrophage culture was performed on 45 healthy adults who were initially categorised on the basis of their Lepromin reactivity using Dharmendra antigen . There were 25 individuals in the Lepromin positive group and 20 in the Lepromin negative group . The cultures were challenged with M . leprae and the macrophages studied at varying time intervals of culture . No difference was evident in the behaviour of cultured macrophages to M . leprae in both the groups . The Lepra bacilli were phagocytosed by the macrophages and retained essentially intact till the termination of culture . The Lepromin reactivity of a healthy individual was not reflected on the macrophage function in vitro . The observations suggested against the possibility of an intrinsic genetically determined macrophage defect in dealing with M . leprae. Ann Microbiol (Paris), 1979 Jul, 130B(1), 13 - 9 Identification of tubercle bacilli; Yates MD et al.; Initial screening of tubercle bacilli with 2-thiophene carboxylic acid hydrazide (TCH) or 2-furoic acid hydrazide (FAH) separates them into two groups . Resistant strains are Mycobacterium tuberculosis . Sensitive strains include M . tuberculosis, M . bovis and BCG which are separated by nitratase and oxygen requirement tests . Pyrazinamide sensitivity tests allow M . bovis and M . africanum to be identified . The niacin test is not used . Most strains of M . tuberculosis from Europeans are resistant to TCH and FAH and are in phage groups A and B, while most strains from Asians are sensitive and are in phage group I. Lepr India, 1979 Jul, 51(3), 348 - 57 Metabolic inhibitors of host-tissue origin in Mycobacterium leprae; Prabhakaran K et al.; It is not clear why host-derived bacteria are metabolically inert, compared to organisms grown in vitro . o-Diphenoloxidase is the only metabolic property proven to be present in Mycobacterium leprae separated from infected human as well as animal (mouse and armadillo) tissues . However, highly concentrated suspensions of M . leprae obtained from the organs of experimentally infected armadillos showed little or extremely low o-diphenoloxidase, while the organisms bound 14C-labeled dopa . When these preparations were diluted, they readily oxidized D-dopa to pigment . The activity remained unaltered by washing the suspensions with dilute alkali or acetone and ether, indicating that it is an intrinsic property of the bacilli . Treatment with different proteases relieved the inhibition, and resulted in a 100% stimulation of O-diphenoloxidase in the bacilli . Evidently, the M . leprae suspensions obtained from infected tissues contain an inhibitory material which is protein in nature, and the metabolic inertness sometimes observed in host-grown bacteria may not be due to loss of enzymes or metabolites from the organisms. J Clin Microbiol, 1979 Jul, 10(1), 104 - 5 Rapid presumptive bacteriological diagnosis of Legionnaires disease; Faine S et al.; A simple, relatively rapid silver impregnation stain has been found to stain Legionella pneumophila effectively in paraffin-embedded tissue sections while permitting visualization of histological detail . It may also be used to stain the organism in body fluids . The stain is not specific and thus must be confirmed by direct fluorescent-antibody technique or culture, but, in the absence of other bacilli demonstrable by Gram or other stain, visualization of typical bacillary forms in a patient with illness compatible with Legionnaires disease provides strong presumptive evidence supporting this diagnosis. Isr J Med Sci, 1979 Jul, 15(7), 592 - 600 Kawasaki's disease and infantile polyarteritis nodosa: is Pseudomonas infection responsible? Report of a case; Keren G et al.; A nineteen-month-old child presented with a febrile illness, skin rash, painful swelling of the joints, lymphadenopathy and hepatosplenomegaly . Pseudomonas was cultured from the blood during life and, subsequently, at autopsy . Autopsy revealed a generalized panarteritis involving the coronary, retroperitoneal and pulmonary arteries with thickening of arterial walls and narrowing of the lumina . Thrombi and foci of necrosis and infarcts were found in many organs . Numerous bacilli were present in fresh lesions, but not in the organizing lesions . Periodic acid-Schiff-positive deposits were found in occasional macrophages, in walls of affected vessels, in the marginal sinuses of lymph nodes and diffusely in epicardial and retroperitoneal adipose tissue . The findings suggest that some or even all cases of Kawasaki's disease and infantile polyarteritis nodosa may be caused by Pseudomonas sepsis . It is also suggested that the vasculitis and paucity of inflammatory reaction in many cases of Pseudomonas sepsis might be related to the fact that many strains of Pseudomonas produce high-molecular-weight levan (or another polysaccharide) . This compound is known to inhibit the inflammatory reaction and to increase bacterial pathogenicity. Lancet, 1979 Jun 30, 1(8131), 1361 - 3 Sputum-smear-negative pulmonary tuberculosis: controlled trial of 3-month and 2-month regimens of chemotherapy; Disseminated histiocytosis and intestinal malakoplakia . Occurrence due to Mycobacterium intracellulare infection; Disseminated histiocytic proliferation and intestinal malakoplakia due to Mycobacterium intracellulare occurred in a 2-year-old white boy . Light and electron microscopic examination of autopsy material disclosed disseminated histiocytosis and malakoplakia of the intestine with numerous intracellular acid-fast bacilli . The isolated organism produced a similar disseminated histiocytosis and finally death when injected into experimental animals . A review of the literature showed only 12 previously reported cases of disseminated histiocytosis due to M intracellulare infection . We were unable to find a previous report of malakoplakia due to nontuberculous mycobacterial infection. Clin Obstet Gynecol, 1979 Jun, 22(2), 361 - 71 Adult bacteremia caused by gram-negative bacilli; Craven DE et al.; Because gram-negative bacteremia is increasing in frequency, it is important for physicians to suspect, carefully evaluate, and initiate early appropriate therapy . Identification of the probable source of bacteremia and a knowledge of the hospital microflora are helpful in guiding antibiotic selection . The mortality of gram-negative bacteremia tends to vary with the severity of the underlying disease and, accordingly, tends to be low in obstetrical patients . Prevention is the most effective method of controlling these infections and, therefore, care and discretion when employing invasive devices is essential . With the increasing incidence of these infections and the increased threat of antibiotic plasmid resistance, future infection control in high-risk patients by immunoprophylaxis may be necessary. Tubercle, 1979 Jun, 60(2), 91 - 4 Hydroxylamine sensitivity and salt tolerance in screening and identifying mycobacteria; Collins CH et al.; Hydroxylamine sensitivity offered no advantage over p-nitrobenzoic acid in distinguishing between tubercle bacilli and other (opportunist and non-significant) mycobacteria . It was of limited use in identification procedures . Salt tolerance assisted in the identification of strains which may be Mycobacterium triviale and M . chelonei var borstelense. Tubercle, 1979 Jun, 60(2), 105 - 7 The flotation method for detection of tubercle bacilli in sputum smears; Contijo Filho PP et al.; Both the flotation smear examination and culture techniques yielded results for detection of tubercle bacilli which were superior to either direct smear examination or to examination of smear from liquefied or liquefied-centrifuged sputum specimens. J Clin Microbiol, 1979 Jun, 9(6), 654 - 6 Characterization of anaerobic gram-negative bacilli by using rapid slide tests for beta-lactamase production; Bourgault AM et al.; A total of 175 isolates of anaerobic gram-negative bacilli were tested for beta-lactamase production by using a slide test modification of the chromogenic cephalosporin (Nitrocefin, Glaxo, Middlesex, England) assay and the iodometric slide test . Included isolates were Bacteroides melaninogenicus (46), B . fragilis (78), other Bacteroides isolates (21), Fusobacterium (25), and other gram-negative bacilli (5) . Both slide tests detected 25 B . melaninogenicus isolates that were beta-lactamase producers (minimal inhibitory concentration of penicillin was greater than 0.78 micrograms/ml) . beta-Lactamase produced by the other gram-negative anaerobes could only be detected by the Nitrocefin assay . This assay was positive in 70 or 77 B . fragilis against which the minimal inhibitory concentration of penicillin was greater than 0.78 micrograms/ml . Ten of 11 other species of Bacteroides against which the minimal inhibitory concentration of penicillin was greater than 0.78 micrograms/ml were also Nitrocefin test positive . Minimal inhibitory concentrations of penicillin against all isolates of Fusobacterium and unidentifified gram-negative bacilli were less than or equal to 0.78 micrograms/ml and were Nitrocefin assay negative . beta-Lactamase-producing strains of B . melaninogenicus can be differentiated because both the slide iodometric and Nitrocefin assays will be positive, whereas beta-lactamase produced by other Bacteroides will only be detected by the Nitrocefin assay . Such penicillin-resistant isolates could be detected and reported to clinicians before final identification. Med Microbiol Immunol (Berl), 1979 May 15, 167(2), 71 - 5 Use of casein, tyrosine, and hypoxanthine in the identification of nonfermentative gram-negative bacilli; Kurup VP et al.; Four hundred and five (405) strains of nonfermentative gram-negative bacilli (NFB) were identified using conventional tests . The NFB studied include 323 originating from clinical specimens, 37 from environmental samples, and 45 authentic strains from other workers and from our culture collections . All these strains were studied for their ability to degradate casein, tyrosine, and hypoxanthine . It was found that these tests are useful in identifying NFB within 24 to 48 h when used with other tests. Experientia, 1979 May 15, 35(5), 599 - 600 Specific inhibition of formation of acid-fastness in mycobacteria by 3,3'-di-O-methylellagic acid; Kondo Y et al.; 3,3'-Di-O-methylellagic acid obtained from Euphorbia adenochlora selectively inhibited the formation of acid-fastness in mycobacteria without retardation of their growth . Gross reductions in contents of wax D, cord factor and free mycolic acids were found in the nonacid-fast bacilli compared with the normal ones. Ann Immunol (Paris), 1979 May-Jun, 130C(3), 367 - 72 {Influence of the irritant used to provoke the peritoneal exudate used in the macrophage migration inhibition test (author's transl)}; Fray A et al.; The effect of the irritant chosen to provoke the peritoneal exudate in donors of cells for the in vitro migration inhibition test was studied . Guinea-pigs with delayed hypersensitivity to tubercle bacilli were used . Irritants studied included starch, Bayol and thioglycollate medium . The exudates obtained with thioglycollate were found to show greater inhibition than those obtained with the other irritants in the in vitro response to PPD, Inhibition of migration was seen when 1 microgram/ml of PPD was added to the culture medium; with this dose the inhibition of migration was 53% . The state of activation of macrophages caused by the irritant thus appears to have some importance for their responsiveness to factors liberated by specifically sensitized lymphocytes. Chest, 1979 May, 75(5), 569 - 70 Antimicrobial activity of antituberculosis agents against anaerobic bacteria; Thadepalli H et al.; Anaerobic infections may coexist with tuberculosis, and can be mistaken for one another . The effect of therapy with antituberculosis chemotherapeutic agents against anaerobic bacteria (with the exception of rifampin) is unknown . We therefore examined the in vitro efficacy of certain commonly used antituberculosis agents (rifampin, isoniazid, and ethambutol) against 370 strains of anaerobic bacteria, including 86 isolates of Bacteroides fragilis . Rifampin at a concentration of 2 microgram/ml inhibited 91 percent of all anaerobic isolates . Both ethambutol and isoniazid were totally ineffective against any of the anaerobes tested, even at 64 microgram/ml . Therapy with rifampin in an unsuspected anaerobic infection can be misdiagnosed for tuberculosis . Therefore, when tuberculosis is suspected, isoniazid and ethambutol can be used and rifampin withheld until the acid-fast bacilli are demonstrated by additional diagnostic procedures, such as transtracheal aspiration. Clin Exp Immunol, 1979 May, 36(2), 214 - 20 Immunological changes observed in indeterminate and lepromatous leprosy patients and Mitsuda-negative contacts after the inoculation of a mixture of Mycobacterium leprae and BCG; Convit J et al.; This investigation was carried out to study the possibility of eliciting favourable immunological changes in small groups of Mitsuda-negative patients with indeterminate leprosy, lepromatous patients who were bacteriologically negative after prolonged treatment with sulphones, and in Mitsuda-negative contacts by means of stimulation with a mixture of autoclaved tissues from Mycobacterium leprae-infected armadillos and living BCG . A radical change was observed in the specific immunological activity of the indeterminate group, all of whom initially had occasional bacilli in cutaneous nerves in biopsies taken from hypopigmented spots, and in the persistently Mitsuda-negative contacts . The 48 hr and 30 day reactions to lepromin, the 48 hr reaction to supernatant antigen from lepromin, the test for bacillary clearence and in vitro lymphocyte transformation (LTT) to M . leprae from human and armadillo lesions all became positive . Of the lepromatous patients studied, only one became positive to all the criteria mentioned above . In the others, the 48 hr reaction to supernatant antigen, the LTT to antigen from a humn source, and the clearance test remained negative, while the Fernandez and Mitsuda reactions became positive . These results are discussed in terms of the possible use of this stimulation procedure in the prevention and immunotherapy of leprosy. Med Trop (Mars), 1979 May-Jun, 39(3), 301 - 6 {Ocular lesions in leprosy (author's transl)}; Carrica A et al.; Modern authors estimate from 47 p . 100 to 78 p . 100 the frequency of ocular lesions in leprosy . This frequency varies according to the duration and type of the disease . These lesions may result from a paralysis of the V or VII cranial nerves, or from a bacteremia, but, more probably, from a spreading of the bacilli from the nasal cavity through the lacrymal ducts . The various lesions of each ocular structure are described with reference to the T . or L . type of leprosy. J Clin Microbiol, 1979 May, 9(5), 615 - 26 Development of a chemically defined liquid medium for growth of Legionella pneumophila; Pine L et al.; A chemically defined liquid medium has been developed for the study of the physiology and antigen production of the Legionnaires disease bacterium . The medium contains basal salts, vitamins, alpha-ketoglutaric acid, pyruvate, 0.05% l-cysteine, 0.05% glutathione, and a mixture of 20 additional amino acids, each of 0.01% final concentration, except serine, which was at 0.1% . The medium in shake culture at 37 degrees C with increased CO2 at pH 6.5, supports the maximum rate of growth, the highest cell yields, and the maximum cell surface antigen as distinguished by specific fluorescein isothiocyanate-conjugated antibody . Studies during the development of this medium showed that CO2, pyruvate, and alpha-ketoglutarate strongly stimulated growth; that cysteine and methionine were required for growth; and that serine, threonine, histidine, tyrosine, and tryptophane were energy sources . Glutathione substituted for cysteine, but cystine did not . The organisms did not use glucose and polysaccharides, as judged by cell yields when these carbohydrates were present or absent . The chelators malate, citrate, and ethylenediaminetetraacetic acid totally inhibited growth . Beta-mercaptoethanol, thioglycolate, dithiothreitol, and Tween 80 (0.05%) inhibited growth strongly or completely . Catalase activity was extremely weak or absent . Morphology varied, depending upon conditions and phases of growth . In general, filamentous forms became chains of cigar-shaped bacilli fragmenting to pairs and becoming coccoidal in the late stationary pha-e of growth . The organism grew at 25, 30, and 37 degrees C . Although they varied in their growth characteristics, 10 isolates were passed for five transfers in the chemically defined broth, giving maximum rates of growth, cell yields, and antigen production. Br J Dis Chest, 1979 Apr, 73(2), 113 - 20 An analysis of the first 300 fibreoptic bronchoscopies at the Brompton Hospital; Knight RK et al.; We report the results of the first 300 fibreoptic bronchoscopies carried out at the Brompton Hospital . Positive cell typing was possible in only 36% of the visible carcinomas in the first 150 patients, but in 74% of the second 150 . The reasons for this difference are discussed . We suggest that fibreoptic bronchoscopy be carried out in district referral hospitals where sufficient experience can be gained to produce good results . Our results suggest that the trap specimen should be examined routinely for acid-fast bacilli, for malignant cells only if biopsy is negative and not at all for other bacteria . With experience good results can be obtained by physicians and the expertise gained is invaluable in the investigation and treatment of a wide range of patients, many of whom do not need surgical treatment. Cancer, 1979 Apr, 43(4), 1493 - 6 Axillary lesions in patients with acute leukemia: evaluation of a preventive program; Murillo J et al.; Axillary skin lesions can cause significant morbidity in patients with acute nonlymphocytic leukemia . The incidence in relation to the level of circulating granulocytes and the microbiology of 15 such lesions among 150 patients over a three year period were determined . Lesions occurred predominantly during periods of profound granulocytopenia (0-499 cells/microliter) . Gram-negative bacilli were the most common pathogens isolated from these lesions . The initiation of a supervised preventive program for 84 patients over 19 months which includes the regular swabbing of each axilla with povidone-iodine cotton sticks in addition to measures to avoid skin trauma has virtually eliminated inflammatory axillary lesions in this high risk patient population. J Clin Microbiol, 1979 Apr, 9(4), 511 - 6 Comparison of the Minitek system with conventional methods for identification of nonfermentative and oxidase-positive fermentative gram-negative bacilli; Wellstood-Nuesse S; The Minitek system was compared with conventional test methods for identifying a wide range of nonfermentative and oxidase-positive fermentative gram-negative bacilli . A total of 230 isolates representing 33 species and biotypes were tested against 12 Minitek substrates and the corresponding conventional tube media . In addition, supplementary tests were included for 141 (61.3%) of the isolates . Overall, 88% of the positive reactions agreed, and negative reactions agreed 95.5% . Anaerobic dextrose, maltose, lactose, and citrate were responsible for 62.4% of the 93 discrepant positive reactions, and 51.8% of the 83 discrepant negative reactions involved the aerobic dextrose, nitrate, and citrate disks . Some discrepancies were related to specific organisms . The system and supplementary tests correctly identified 88.3% of the isolates to species level and 92.6% to correct genus . No particular organism or substrate was responsible for misidentification errors . In a test challenge with 19 selected organisms, 3 were incorrectly identified to species and 4 were misidentified to genus level . Most of the errors responsible for these incorect identifications were due to factors other than the Minitek disks and pointed out the importance of using appropriate supplemental data, and the need for a coding manual and a more enriched broth for certain types of isolates. Am Rev Respir Dis, 1979 Apr, 119(4), 579 - 85 Clinical trial of six-month and four-month regimens of chemotherapy in the treatment of pulmonary tuberculosis; Autopsy diagnosis of Legionnaires' disease in immunosuppressed patients . A paleodiagnosis using Giemsa stain (Wohlbach modification); A diffuse pneumonia characterized by short Giemsa-stained, gram-negative rods that were not cultured was diagnosed at autopsy in the fall of 1975 in three immunosuppressed patients who had had renal transplants . An acute fibrinous exudate was found, with macrophages, neutrophils, and numerous short bacilli in each inflamed alveolus as shown by Giemsa's stain (Wohlbach modification) . Transplantation was stopped for 1 month . The institutional infection control committee discussed the cases, and increased observation . After the Legionnaires' disease agent was identified in 1977, the bacteria were stained by Dieterle's method and identified as Legionnaires' disease bacteria by direct fluorescent antibody test . No further cases have been identified in the succeeding 62 renal transplantations at this medical center . Although Wohlbach's modification of Giemsa has given consistently good staining of the Legionnaires' disease bacterium in our cases, unclarified factors may interfere with good staining, and the May-Grunwald Giemsa stain was unsatisfactory. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1979 Apr-Jun, 28(2), 85 - 93 {Epidemic of tuberculosis in a maternity hospital triggered by congenital tuberculosis in a newborn infant}; Mihailescu P et al.; The development of several cases of miliary tuberculosis in infants aged 3--4 months, born in the same maternity led to an epidemiological investigation . On this occasion it was discovered that one of the patients that had been discharged immediately after delivery had pulmonary granulia a monthlater . The immature newborn was left in the maternity and died after one month with a diagnosis of "pulmonary microabscesses" . The histopathologic examination of the lungs showed the presence of necrotic foci without any cellular reaction . Five months after the death of the infant a new examination of a pulmonary fragment was performed and Ziehl-Neelsen staining evidenced a large number of acido-resistant bacilli filling the lung alveoles . It was shown in this way that the infant with tuberculosis was the primary source of infection . All the 8 children that had developed the disease had been hospitalized in the same ward with the sick child . The transmission of the bacilli was done indirectly, through the feeding tubes that had not been sufficiently serilised, and the penetration ronte was the digestive tract . In two cases an otic primary focus was discovered and in one case an intestinal one was found on necropsy. Acta Leprol, 1979 Apr-Jun, (75), 35 - 47 Cholesterol dynamics in macrophages implication for the bacteriology and pathology of leprosy; Kato L; M . leprae in the host multiplies abundantly in macrophages rich in cholesterol . Host-grown leprosy bacilli have an extremely high cholesterol content and in this respect they occupy a unique place among procariotic cells . M . leprae takes up cholesterol from the environment and it is not clear whether it can synthesize cholesterol and if so from which precursors . Mycobacteria can be grown from leprous tissues in primary cultures only in the presence of cholesterol . These strains quickly adapt to in vitro substrates and are able to synthesize cholesterol from still-unknown chemical entities, which are also sources of carbon and energy . These still unknown substrates will probably have to be discovered before cultivation of these elusive microorganisms is achieved and we approach a better understanding of the chemical mediators in the cellular defence and/or pathology of leprosy. Can J Microbiol, 1979 Apr, 25(4), 462 - 74 {Transmissible modification induced in Mycobacterium tuberculosis and Mycobacterium bovis in vitro}; Lafont P et al.; A biologically active material (fraction "S") is isolated from cultures of scotochromogenic mycobacteria . Mycobacterium tuberculosis, or Mycobacterium bovis by disrupting the cells, sedimentation through 2.2 M sucrose, and ultrafiltration . The fraction "S" induces the modification of tubercle bacilli into non acid-fast bacteria forming smooth colonies on nutritive glycerol agar within 24-36 h of incubation . Three new phenotypes are thus obtained; two proved to be stable upon subculturing . Frequently the phenomenon occurs with a very large part of the Koch's bacillus population exposed to the inducing agent effect . It can be reproduced with crude preparations of DNA obtained from the fraction "S." It is inhibited by concanavalin A . The observed modification does not correspond to a transfer of characteristics of the inducing agent from the donor mycobacteria; furthermore it can be manifested even in the strain used for the preparation of the fraction "S." Z Erkr Atmungsorgane, 1979 Apr, 153(1), 132 - 8 {The efficiency of cold staining methods at the light microscopical evidence of acid fast bacilli (author's transl)}; Noack K; Comparing studies has been demonstrated wether or not the cold staining of acid fast bacilli is qualitative and quantitative better than the Ziehl-Neelsen-method . The hot staining was superior to all cold staining methods and their modifications tested . If a cold staining is necessary two methods are recommended, the Kinyoun method and the staining with carbolfuchsin which chloroform is added to . Thin smear and homogeneous material provide better results . Additional investigations concerning decolorizations have shown, that 10% sulfuric acid is as effective as hydrochloric acid-ethanol mixture. Acta Neurol Scand, 1979 Mar, 59(2-3), 127 - 34 Tuberculous meningitis; Kovanen J et al.; Ten patients with confirmed tuberculous meningitis were seen at Meilahti Hospital, University of Helsinki, in 1966--1977 . Six of the patients had a positive CSF culture for M . tuberculosis, and a positive CSF smear for acid-fast bacilli was found in one case . On admission, seven patients had an altered state of consciousness, five complained of headache, and nuchal rigidity was noted in two . Five patients recovered completely, three had persistent late sequelae, and two of the patients died . The most important fact influencing the prognosis was an early institution of adequate antituberculous chemotherapy. Vet Pathol, 1979 Mar, 16(2), 215 - 22 Feline histiocytic colitis . A case report with electron microscopy; Van Kruiningen HJ et al.; A 5-year-old cat with clinical colitis had histiocytic inflammation of colonic mucosa . Light and electron microscopy demonstrated bacilli, 0.7 x 3.0 micrometers, in various stages of degradation within macrophage cytoplasm . The disease is similar to histiocytic granulomatous bowel disease of other species . The cat responded to long-term treatment with antibiotics. J Bacteriol, 1979 Mar, 137(3), 1263 - 70 Growth yields and fermentation balance of Bacteroides fragilis cultured in glucose-enriched medium; Frantz JC et al.; Bacteroides fragilis is an obligate anaerobic bacterium classified with the gram-negative, non-sporeforming bacilli and is the Bacteroides species most frequently isolated from human infections . In the present study, experiments were designed to investigate growth characteristics of B . fragilis in a complex medium . In a minimal defined medium, which was employed for comparison purposes, B . fragilis grew with a generation time of 2 h . Growth of the organism in glucose-enriched medium used in the present study was superior . Maximum generation time was 60 min . Total and viable cells (colony-forming units) were 8.9 x 10(9) and 2.1 x 10(9), respectively, at maximum measurable growth . The molar growth yield (Ym) was 51.5 . Growth yields were found to reach a maximum 2 to 3 h before maximum growth and to vary with respect to the phase of growth . Estimates of the fermentation products indicated that glucose was the sole energy substrate . Major products included acetic acid, propionic acid, lactic acid, and succinic acid . Other products included ethyl alcohol, pyruvic acid, and fumaric acid . No attempt was made to recover CO2 or formic acid . The OR balances from two experiments were 0.013 and -0.093 and the respective carbon recoveries were 6.268 and 6.241 . The results of the present study show that B . fragilis is capable of rapid rates of growth in vitro by using glucose as the sole energy source. Medicine (Baltimore), 1979 Mar, 58(2), 159 - 70 A randomized comparative trial of three aminoglycosides--comparison of continuous infusions of gentamicin, amikacin and sisomicin combined with carbenicillin in the treatment of infections in neutropenic patients with malignancies; Keating MJ et al.; Continuous infusions of gentamicin, amikacin or sisomicin combined with carbenicillin were compared in a randomized study in the treatment of 572 febrile episodes in 281 patients with cancer . The three treatments (C+A, C+A and C+S) were equally effective with no significant differences in response rate overall (67%, 68%, 67%) or in any infection, except septicemia where C+G had a significantly lower response rate than the other two groups . Pneumonia, the most common infection, had the lowest response rate for all three groups (45-50%) . Klebsiella spp . were the most common pathogens and showed a lower response rate than other gram-negative bacilli (P = 0.003) . Patients with persistent severe neutropenia had a response rate of 56% . Azotemia was significantly less common in patients with documented infection treated with C+A than in the C+S group . Combinations of carbenicillin plus an aminoglycoside antibiotic are effective for the treatment of infections in neutropenic patients. South Med J, 1979 Mar, 72(3), 313 - 8 Methotrexate-induced diffuse interstitial pulmonary fibrosis; Bedrossian CW et al.; Three patients received respectively 190 mg, 175 mg, and 196 mg of methotrexate and developed bilateral pulmonary infiltrates without evidence of peripheral blood eosinophilia . Sputum in the three cases failed to reveal acid-fast bacilli, pathogenic fungi, or opportunistic organisms by cultures and appropriate stains . Despite discontinuance of the drug and/or institution of corticosteroid therapy, progressive respiratory failure led to death . In all three cases, autopsy revealed gross and microscopic features indistinguishable from those seen in the Hamman-Rich syndrome, and methotrexate hepatotoxicity was present in one . Pulmonary eosinophilia or granulomas, classically seen in previously reported cases of methotrexate pneumonitis, were not observed . It is suggested therefore that methotrexate be added to the list of agents capable of inducing diffuse interstitial pulmonary fibrosis . Conversely, diffuse interstitial pulmonary fibrosis should be considered in the differential diagnosis of patients receiving methotrexate who develop bilateral pulmonary infiltrates seen on chest roentgenograms. Rev Infect Dis, 1979 Mar-Apr, 1(2), 337 - 41 Antibody response to anaerobic bacteria; Sonnenwirth AC; Anaerobes, especially the gram-negative non-spore-forming bacilli of the indigenous biota, are recognized as important agents of clinical infection; however, information regarding human antibodies to anaerobes is limited . Sporadic work, employing agglutination, gel diffusion, passive hemagglutination, and immunofluorescence, demonstrated antibody response to various Bacteroidaceae in patients with infections caused by Bacteroides or Fusobacterium . Because of the need for using homologous (autologous) isolates and the apparent antigenic heterogeneity of strains, there has been no general clinical application of these findings . Increased concentrations of antibodies to anaerobic intestinal organisms in chronic inflammatory bowel diseases have been found; however, it is unclear whether these are the effect or cause of these conditions . Natural antibodies to Bacteroidaceae, primarily of the IgM class, are widely distributed in normal humans; thus for serologic diagnosis IgG antibodies should be sought . Radioimmunoassays and various immunoelectorphoretic methods for detection of both antibody and antigen are presently being evaluated for diagnostic use in infections due to anaerobic bacteria. Infect Immun, 1979 Mar, 23(3), 787 - 94 Induction of cell-mediated immunity to Mycobacterium leprae in guinea pigs; Mehra V et al.; Guinea pigs immunized with intact or disrupted armadillo-grown human Mycobacterium leprae administered in aqueous or oil vehicles were tested with various dilutions of M . leprae suspended in saline, water-soluble M . leprae extract, purified protein derivative, and a water-soluble extract of normal armadillo tissue . The results demonstrated the following . (i) Under no conditions was any skin test reactivity found to normal armadillo tissue extract . (ii) Positive sensitization to both M . leprae and its water-soluble extract was achieved by sensitizing guinea pigs with M . leprae suspended in Hanks solution or saline . Autoclaved M . leprae in Hanks solution or saline inoculated intradermally was an effective immunogen . Oil suspensions or emulsions were effective at sensitization, but appeared to be no better and, in general, slightly weaker, than simple inoculation in aqueous suspension . (iii) Living BCG failed to reveal a significant adjuvant effect on sensitization to M . leprae . However, cord factor appeared to potentiate slightly the sensitization to M . leprae in aqueous suspension . (iv) The minimum dose required for sensitization with M . leprae in aqueous suspension was 55 micrograms of purified bacilli . (v) Animals inoculated with M . leprae in saline or with M . leprae together with BCG showed positive skin test reactivity to the first skin test application made fully 1 year after the initial sensitization . The efficacy of autoclaved, irradiated M . leprae in aqueous, oil-free medium suggests a relatively safe approach to human vaccination studies. Cancer, 1979 Mar, 43(3), 1095 - 100 High dose methotrexate with and without BCG therapy in advanced head and neck malignancy; Buechler M et al.; Twenty-three patients with advanced recurrent head and neck carcinoma were randomized to receive either high dose methotrexate with calcium leucovorin rescue (HDMTX) or HDMTX in combination with bacilli Calmette Guerin (HDMTX/BCG) . An additional eight patients were treated with escalating doses of HDMTX ranging from 1 to 7 g of methotrexate . Of 12 patients receiving HDMTX, one complete response and two partial responses were noted . Of 11 patients in the HDMTX/BCG group, one complete response and two partial responses were observed . Only one partial response was noted in eight patients receiving escalating doses of the drug . Responses were brief and no significant difference in response duration was seen in any particular group . Toxicities in all groups were tolerable . BCG did not improve response rate, median duration of response, or median survival in these patients . Reported experiences with high dose methotrexate have been reviewed and again, responses to "high dose methotrexate" were found to be of brief duration . Despite acceptable toxicity, the brief duration of response and cost of such therapy raises serious question on the usefulness of chemoimmunotherapy utilizing high dose methotrexate with leucovorin rescue and BCG in the management of advanced recurrent carcinomas of the head and neck region. Invest Ophthalmol Vis Sci, 1979 Mar, 18(3), 250 - 5 Intraocular levels of cefamandole compared with cefazolin after subconjunctival injection in rabbits; Barza M et al.; We compared the intraocular pharmacokinetics of cefazolin with those of cefamandole, a recently marketed cephalosporin with enhanced activity against gram-negative bacilli . Following subconjunctival injection of 12.5 mg into infected eyes (S . aureus endophthalmitis) of pigmented rabbits, both drugs reached peak concentrations greater than 100 microgram/gm in cornea, sclera, and choroid-retina . The half-life was markedly shorter in sclera and choroid-retina than in cornea . Levels in the aqueous humor rose and fell more slowly than those in ocular tissues, reaching a maximum of only 5 to 10 microgram/ml . The pharmacokinetics of the two drugs were virtually identical in most intraocular sites . When cefazolin, which was less irritating than cefamandole by the subconjunctival route, was given in a dosage of 100 mg, levels in ocular tissues were increased by twofold to fourfold and in aqueous humor by 15-fold, compared to the concentrations produced by the 12.5 mg dosage . Levels in the vitreous humor were exceedingly low with both drugs; mean peak concentrations were 0.24 microgram/ml after the 12.5 mg dosage of cefamandole and less than 1.6 microgram/ml after the 100 mg dose of cefazolin. Tubercle, 1979 Mar, 60(1), 49 - 54 Direct migration inhibition test with leukocytes as indicator of mycobacterial antigens in the human body; Trnka L et al.; In 32 patients with newly detected pulmonary tuberculosis positive on smear and culture, included in a controlled clinical trial, a significant correlation between diminishing inhibition of leukocyte migration (induced by PPD) and reduction of mycobacterial population in the sputum during the course of chemotherapy has been demonstrated . The changes of mycobacterial population in the host have been assessed in two ways: an indirect assessment was made from the time taken to achieve sputum smear and culture negativity; a direct assessment was based on repeated quantitative determinations of tubercle bacilli in the sputum . The direct migration inhibition test with peripheral buff-coated leukocytes, is an easy and reliable correlate of delayed hypersensitivity to mycobacterial antigens in the human body . It is suggested that its use in individual patients could indicate changes in mycobacterial population, particularly after microbiological negativity has been obtained, and thus could be helpful in estimating the optimum duration of chemotherapy. Med Trop (Mars), 1979 Mar-Apr, 39(2), 149 - 54 {Present state of resistance to antibiotics by tuberculous bacilli in Africa (author's transl)}; Rey JL et al.; Tuberculous bacilli isolated from recently infected patients from various african countries, are resistant to the main specific antibiotics . The present study analyses these resistances which are frequent and mainly directed against INH and streptomycin . Resistance against INH is frequently associated, and is due to inadequate monitoring of the treatment . The resistance against streptomycin is probably due in part to the frequent use of streptomycin against common non-tuberculous infections . The high frequency of thiacetazone resistance is associated with the geographical distribution of M . africanum . Given the situation, it is necessary to consider discarding this drug and replacing it . Unfortunately however, the most recent antibiotics, which have not yet generated resistant strains, are often too expensive. Tubercle, 1979 Mar, 60(1), 31 - 6 Evaluation of the chloride and bromide salts of cetylpyridium for the transportation of sputum in tuberculosis bacteriology; Tazir M et al.; The usefulness of cetylpyridium chloride and cetylpyridium bromide, at a final concentration of 1% in 1% solution of sodium chloride, for the transportation of sputum in tuberculosis bacteriology, was evaluated . It was found that these compounds did not alter the staining properties nor the viability of the tubercle bacilli for at least 14 days. JAMA, 1979 Feb 2, 241(5), 478 - 80 False-positive Gram-stained smears; Hoke CH Jr et al.; The rate per 1,000 smears showing nonviable Gram-negative bacilli (false-positive smears) increased from a baseline of 10.8 to 38.5 following purchase of new culture-collection devices; the rate decreased to 8.0 following replacement of contaminated culture sets . False-positive reports led to changes in therapy for five patients . In addition to being sterile, commercial culture-collection devices should be certified by the manufacturer as being free of stainable microorganisms or as unsuitable for preparation of Gram-stained smears. Gastroenterology, 1979 Feb, 76(2), 362 - 4 Colonic tuberculosis diagnosed by colonoscopic biopsy; Franklin GO et al.; A patient with pulmonary tuberculosis and a constricting transverse colon lesion on barium enema was found at colonoscopy to have a 1.5 X 3.0 cm ulcer with irregular, edematous borders . Multiple colonoscopic biopsies of the ulcer revealed acid-fast bacilli with absence of granulomas . Previously, the diagnosis of colonic tuberculosis had been thought to require laparotomy for confirmation . The authors now suggest that colonoscopic biopsy may be a desirable alternative in selected cases. J Clin Microbiol, 1979 Feb, 9(2), 194 - 6 Comparison of four culture media for isolation of Mycobacterium avium complex from porcine tissues; Thoen CO et al.; The efficiency of four culture media was compared for the isolation of Mycobacterium avium complex from 197 procine tissues . In 82 tissues with microscopic granulomas and acid-fast bacilli, a significantly greater number of isolates were obtained on Middlebrook 7H10 medium with sodium pyruvate than on Stonebrink medium, Herrold egg yolk agar medium, or Lowenstein-Jensen medium (P=0.01) . In 46 tissues in which no microscopic granulomas or acid-fast bacilli were observed, a significantly greater number of isolates were made on Middlebrook 7H10 medium or Herrold egg yolk agar medium than on Stonebrink medium or on Lowenstein-Jensen medium (P=0.01) . The time required to grow M . avium complex on Lowenstein-Jensen medium was significantly greater than the time required to observe growth on Stonebrink, Middlebrook 7H10, or Herrold egg yolk agar medium (p=0.001). Br J Surg, 1979 Feb, 66(2), 132 - 4 Ascaris lumbricoides and perforation of the ileum: a critical review; Ihekwaba FN; Ileal perforation due to typhoid bacilli is the commonest cause of peritonitis in the Tropics . Perforation due to Ascaris lumbricoides is rare . Three cases of ileal perforation believed to be due to A . lumbricoides are presented and the evidence critically reviewed . It is suggested that signs of heavy infestation with A . lumbricoides make a diagnosis of intestinal perforation more likely in a patient with an acute abdomen. J Clin Microbiol, 1979 Feb, 9(2), 180 - 5 Accuracy and reproducibility of the Oxi/Ferm system in identifying a select group of unusual gram-negative bacilli; Nadler H et al.; The Oxi/Ferm (O/F) identification system was compared in a double-blind study to a conventional test battery for the characterization of 96 reference and clinical strains consisting of 83 nonfermentative and 13 oxidase-producing, fermentative gram-negative bacilli . The O/F tube and supplemental tests correctly identified 84% of the nonfermentative and 77% of the oxidase-producing, fermentative bacilli . However, when the supplemental tests were excluded and the biochemical profiles generated by all nine O/F tube reactions were examined, the profile accuracy reached 95% (79 of 83) for the nonfermentative and 93% (12 of 13) for oxidase-producing, fermentative bacilli . Seven of the nine O/F substrate reactions demonstrated less than or equal to 89% agreement with conventional reactions, whereas the urea and arginine reactions provided 82 and 85% agreement, respectively . Replicate O/F tests with six selected organisms demonstrated 97% identification reproducibility and 84% overall substrate reproducibility . The mean O/F identification time was 2.6 days as compared to 3.3 days for the conventional system . Although this study suggests that the O/F system is a convenient, rapid, and accurate alternative to conventional identification methods, several modifications are recommended. Am J Med Technol, 1979 Feb, 45(2), 143 - 5 New motility medium for nonfermenting bacilli; Bennett M et al.; Researchers compared use of a semisolid agar plate to wet mount examinations of broth cultures (16 to 18 hours) for the detection of motility of 96 reference and clinical strains of gram-negative rods . In this double blind study, 83 nonfermentative and 13 oxidase-producing, fermentative bacilli were tested by the two methods . Overall accuracy of the semisolid agar motility test was 96.8 percent compared to 89.6 percent for the broth method . Reproducibility of agar plate tests using selected reference strains was 100 percent in contrast to 90 percent for broth examinations . These findings indicate that the semisolid agar plate offers a convenient and more accurate method than wet mount examination for determining motility of unusual gram-negative bacilli. Infect Immun, 1979 Feb, 23(2), 360 - 5 Adjuvants in the induction of suppressor cells; Neta R et al.; The effect of different mycobacterial adjuvants on the parameters of delayed hypersensitivity was investigated in strain 13 guinea pigs . The composition of the tubercle bacilli and the type of vehicle in which the antigen was presented determined the presence and extent of suppressor cell activity . When antigen was introduced in complete Freund adjuvant, both adherent and nonadherent cells had suppressive properties, with the suppressive effect demonstrable in vitro from 1 to 5 weeks after sensitization . Suppressor activity was indicated in vivo by a reduction of delayed footpad hypersensitivity in animals presensitized with complete Freund adjuvant. Dtsch Zahnarztl Z, 1979 Feb, 34(2), 222 - 4 {Acute necrotizing-ulcerative gingivitis in young men}; Pollmann L et al.; Acute necrotizing ulcerative gingivitis is a disease in which the bacilli of the flora normally found in the buccal cavity (fusiform bacilli and spirochetae) play a role . This type of gingivitis occurs relatively frequently in young men . The frequency of the disease tends to peak in the winter . We examined 72 young men between the ages of eighteen and twenty-one with acute necrotizing ulcerative gingivitis, fever and swelling of the regional lymph nodes for possible noxas . All of the individuals were smokers: approximately 3/4s of the group smoked more than 60 cigarettes per day . Roughly half of the individuals examined showed extremely poor oral hygiene or underlying psychological or physical stress at the onset of the disease . Dentitio difficilis and alcohol abuse however appeared to be less important factors . Symptomatic measures, such as mouthwash and oral hygiene, proved to be effective therapy . Diseases and disorders of internal structures of the body could not be diagnosed in any of these individuals. J Dent Res, 1979 Feb, 58(2), 660 - 4 Serologic reactions of oral gram negative anaerobic bacilli; Hawley CE et al.; Serological reactions were performed using hyperimmune rabbit antisera and antigenic preparations of Leptotrichia buccalis, Fusobacterium fusiforme, and Fusobacterium polymorphum . All tests indicated that there was serologic cross reactivity between the two Fusobacterium species . No cross reactivity could be detected between the Fusobacterium species and L . buccalis . The findings suggest that F . fusiform and F . polymorphum are similar in their immunogenicity, and that the grouping of these two organisms as F . nucleatum may be justified. Boll Ist Sieroter Milan, 1979 Jan 31, 57(6), 713 - 7 {Antibacterial activity of amikacin towards gentamicin-resistant, Gram-negative bacilli}; Nicoletti G et al.; Antibacterial activity of amikacin with regards to gentamicin resistant, Gram-negative bacteria was evaluated . Probable systems of enzymatic inactivation of antibiotic were postulated for amikacin and other aminoglycosides. J Neurol Sci, 1979 Jan, 40(1), 3 - 10 Electromyographic recording and muscle biopsy in lepromatous leprosy; Sebille A et al.; The aim of this study was to detect early muscular changes in lepromatous leprosy using simultaneously electromyography and muscle biopsy . In 13 subjects a single clinically normal muscle innervated by the popliteal nerve was studied . Three were found to be normal . All the others were electromyographically denervated . Histopathologic findings included only 3 cases of fascicular atrophy . In 8 cases inflammatory nodules were observed in the connective tissue of the muscle and acid-fast bacilli were present in Virchow cells in 5 . In only one patient were intact acid-fast bacilli found in muscle cells . It was concluded that electromyography was the better method of detecting early denervation, while muscle biopsy was the better examination to detect "lepromatous myositis" . In practice these techniques are complementary in the study of muscle data in lepromatous leprosy. ORL J Otorhinolaryngol Relat Spec, 1979, 41(1), 51 - 8 Electron microscopic study of previously irradiated scleroma; Gaafar H et al.; Nasal biopsies from 2 scleroma patients who had received previous X-ray therapy were investigated under the electron microscope . In the lamina propria, the majority of Mikulicz cells contained numerous small vacuoles . This was attributed to the effect of X-ray therapy causing temporary suppression of the inflammatory process followed by new granuloma formation . The vacuoles of the Mikulicz cells contained some fine granular and fibrillar material of unknown origin . Rounded electron-dense bodies with microprojections on their surface were present near some Mikulicz cells . These structures were considered to be Russell bodies . Occasional small lymph vessels with obstructed lumina were seen . This might indicate the rare spread of Klebsiella rhinoscleromatis bacilli to regional lymph nodes. Trans R Soc Trop Med Hyg, 1979, 73(4), 432 - 7 Investigation of Nigerians with diffuse radiographic pulmonary shadowing; Onadeko BO et al.; During a five-year period, 45 Nigerians with radiographic appearances of diffuse pulmonary infiltration with at least six sputum specimens negative on culture for tubercule bacilli were investigated at University College Hospital, Ibadan . The value of pulmonary function studies and open or closed lung biopsy in discovering the cause of diffuse lung disease was examined . Cryptogenic fibrosing alveolitis was the most common cause (13 cases) . Other diagnoses included malignant disease (11 cases), sarcoidosis (three cases), progressive systemic sclerosis (three cases), miliary and non-caseating tuberculosis (three cases) and pulmonary alveolar microlithiasis (one case): this last is believed to be the first case diagnosed in Africa South of the Sahara . This study emphasizes the fact that, even in developing countries where tuberculosis is highly prevalent, there are other causes of diffuse pulmonary infiltration. Pol Arch Weter, 1979, 22(1), 9 - 17 {Antigenic and allergenic properties of various atypical Mycobacteria and Mycobacterium avium . I . Immunoelectrophoretic analysis of antigens in water extracts}; Skwarek P et al.; 4 strains of acid-resistant bacilli were examined: M . kansasi, scotochromogenic bacilli of Nicolas strain, M . fortuitum and M . avium D4 . Water extracts prepared from these strains according to Whiteside and Baker method were used as antigens in the immunoelectrophoresis reaction and were also used to obtain specific serums on rabbits which were hyperimmunized according to Tuboly's method . In the immunoelectrophoresis reaction water extracts were examined against nonsaturated serums, as well as cross-saturated extracts of the investigated bacilli . It was found that M . kansasi and M . avium possessed 9 antigen components each and bacilli of scotochromogenic strain Nicolas and M . fortuitum 5 each . The degree of antigen relationship between the examined bacilli was expressed with 1-4 common antigen components. Pol Arch Weter, 1979, 22(1), 19 - 27 {Antigenic and allergenic properties of various atypical Mycobacteria and Mycobacterium avium . II . Skin reactions to homologous and heterologous PPD preparations in artificially sensitized guinea pigs}; Skwarek P et al.; Albino guinea-pigs were artificially sensitized to M . kansasi, scotochromogenic bacilli of Nicolas strain, M . fortuitum and M . avium and after 4 to 10 weeks 4,20 and 100 homological and heterologous units of PPD preparations were injected intradermally . It was shown that the studied bacilli had sensitizing properties too and PPD preparations obtained from them differ in biological activity and specificity . Sensitine made from M . kansasi was characterized by the greatest sensitizing strength . Bacilli of Nicolas strain had weak sensitizing properties and sensitine obtained from them was fairly active but poorly specific . A certain correlation was found between the degree of antigen relationship of bacilli determined with the help of the immunoelectrophoresis reaction and the intensity of cross allergic reactions occurring in sensitized animals . No connection was found, however, between the bacilli sensitizing capability and activity of PPD preparations obtained from them. Arch Immunol Ther Exp (Warsz), 1979, 27(5), 715 - 26 Immunity to tetanus and diphtheria in various age groups of the Polish population; Galazka A et al.; The concentration of tetanus and diphtheria antitoxins was determined in 279 sera of 18 to 81-year-old women and 509 sera of 22 to 46-year-old men . Tetanus antitoxin content was determined also in 246 samples of fluid from human placentas and 428 lots of commercial human normal immunoglobulins . Immunity to tetanus was clearly age-dependent: in younger age groups the percentage of immunized persons amounted to 90%-100%, in middle-age groups to about 80%, and at age above 60 to about 25% . The findings are in agreement with age-dependent incidence of tetanus, which has become now in Poland a disease primarily of older people . Two groups of the population are now protected against diphtheria: a younger group under 20, and an older one above 40 . Immunity in younger age groups was induced by artificial immunization, and among older persons by natural immunization through contact with diphtheria bacilli during severe diphtheria epidemics in the past . Between these groups, gaps exist including 20-30 years of age, who are sensitive to diphtheria. Respiration, 1979, 38(4), 227 - 32 Pulmonary function in rabbits with BCG-induced lung disease; McGovern RP et al.; This study was performed to determine whether the lung histological changes which occur in rabbits following intravenous injection of killed Bacilli Calmette-Guerin (BCG) are accompanied by measurable changes in pulmonary function . We measured pulmonary function in New Zealand white rabbits 3 weeks after intravenous injection of BCG and in normal rabbits . After a tracheostomy and carotid artery catheterization was performed, each anesthetized rabbit was placed in a body plethysmograph for pulmonary function testing . Following the measurements, the lungs were removed for weighing and histological evaluation . In the BCG-treated rabbits, the lung weight/body weight ratios were 152% greater, the pulmonary resistance was 104% higher, dynamic compliance was 45% lower, minute ventilation was 28% greater, and the delta AaPO2 gradient was 13 torr higher than in the normal control rabbits . Histological evaluation of the BCG-treated animals revealed diffuse pulmonary involvement with non-caseating granulomas. Chemotherapy, 1979, 25(5), 254 - 60 Concentration of thiamphenicol in the human prostate and testis; Plomp TA et al.; The concentration of thiamphenicol in prostatic tissue, testicular tissue and serum after a single intravenous injection of 1 g thiamphenicol glycinate ester was investigated . The prostatic and testicular specimens were obtained by prostatectomy and plastic orchidectomy, respectively, from patients with adenomas and carcinomas of the prostate . 2 h after dosing, the prostatic tissue concentration ranged from 2.1 to 15.1 microgram/g (mean value 5.7 microgram/g) and the testicular tissue from 3.4 to 8.4 microgram/g (mean value 6.1 microgram/g) . At the same time the thiamphenicol serum levels varied in the patients with prostate adenomas from 4.6 to 14.5 microgram/ml (mean 8.9 microgram/ml) and in the prostate carcinoma patients from 5.2 to 10.4 microgram/ml (mean 8.5 microgram/ml) . Several factors influencing the diffusion of thiamphenicol into the prostate and testis are discussed . The levels of thiamphenicol in the prostate and testis suggest that the antibiotic may be valuable for the treatment of infections of the prostate and testis caused by gram-positive and gram-negative cocci, but is of questionable value for the treatment of infections caused by gram-negative bacilli. Lepr India, 1979 Jan, 51(1), 65 - 73 The association of leprosy and pulmonary tuberculosis; Nigam P et al.; The association of leprosy with pulmonary tuberculosis was seen in 20 cases during January 1972 to October 1977 . Of these 20 cases, 15 were of lepromatous, 3 of dimorphous and 2 of tuberculoid leprosy . Maximum number of cases were from 3rd decade of life with male to female ratio of 3 : 1 . Patients were suffering from the disease for a very long time (8 cases of lepromatous leprosy with duration of illness 10-15 years) . The symptoms of leprosy seemed to have preceded to the symptoms of pulmonary tuberculosis . Duration of tuberculosis in most of them was within 6 months (55%) . The predominent presenting symptom was cough with expectoration (100%) and fever (80%) . Anaemia (75%) and crepitations (60%) were the presenting physical sign mainly . Radiologically bilateral extensive pulmonary lessons were seen in 14 cases (70%) . Sputum for acid fast bacilli was positive in 80% of cases . The general condition and nutritional status was poor and death was resulted in 4 cases (3 of lepromatous and 1 of dimorphous leprosy). Am Rev Respir Dis, 1979 Jan, 119(1), 11 - 8 Tuberculosis in immigrants to Canada . A study of present-day patterns in relation to immigration trends and birthplace; Enarson D et al.; The influences of immigration on tuberculosis morbidity in Canada were examined . The pattern of immigration has changed markedly in recent years, increasing proportions of immigrants being from areas other than Europe . Morbidity rates varied widely according to country of birth and were highest among persons born in Asia and lowest among those born in northwestern Europe and the United States . These rates were generally parallel to those reported in the countries of birth, although somewhat lower . Differences in patterns of disease by birthplace were noted, particularly the preponderance of lymphadenitis in Asians and genitourinary tuberculosis in Italians . Although the frequency of drug-resistant bacilli was higher in Asians than in other groups, the vast majority of bacilli in all groups were drug-sensitive . For purposes of tuberculosis control, immigrants from high-incidence countries constitute a high-risk group, and physicians should be aware of this when dealing with patients from these countries. Rev Infect Dis, 1979 Jan-Feb, 1(1), 144 - 51 Comparative studies of cefoxitin and cephalothin: an overview; Neu HC; A comparative study of the efficacy and safety of cefoxitin and cephalothin in the treatment of serious infections was carried out by 21 investigators . A total of 320 patients were treated with cefoxitin, and 276 patients were treated with cephalothin . In each group 50% of patients could be evaluated . Patients were randomly allocated to groups in open fashion, and final analysis showed that the groups were comparable in terms of sex, age, severity of illness, and duration of therapy . The majority of pathogens isolated were susceptible to both agents, although 13% of gram-negative bacilli and anaerobes were susceptible to cefoxitin alone . The overall percentage of patients cured or improved by cephalothin was 93%; for cefoxitin the proportion was 91% . No statistical differences in response by type of organism or site of infection were shown . Cefoxitin was effective in treating infections and in eradicating the pathogenic bacteria . Cefoxitin was as well tolerated as cephalothin and produced no more adverse reactions or abnormal laboratory findings than did cephalothin . The results of this study demonstrate that cefoxitin is as effective in achieving bacteriologic and clinical cures as is cephalothin and also is effective in treatment of infections due to cephalothin-resistant bacteria. Clin Exp Neurol, 1979, 16, 277 - 93 Lepromatous leprosy as a model of Schwann cell pathology and lysosomal activity; Dastur DK et al.; A brief illustrated account is presented of the light microscopic pathology, histochemistry of lysosomal enzymes, and fine structural changes in the nerves of patients with untreated or treated lepromatous leprosy . Predominant bacillation of the Schwann cells of unmyelinated fibres, degeneration of their axons, prominence of phagolysosomes, and disappearance of these cells with endoneurial collagenosis were observed on electronmicroscopic examination of the index branch of the radial cutaneous nerve . Although there were changes in the blood vessels and proliferation of perineurium, bacillation of endothelial or perineurial cells was much less conspicuous . Intact and degenerating forms of M . leprae were found in both treated and untreated patients, fragmenting or crumpled forms being more frequent in the treated . Both groups of patients also showed increased lysosomal enzyme activity, evidenced by single or paired paranodal spots of acid phosphatase and beta-glucuronidase in Schwann cells in histochemical preparations of the nerve . There was lesser activity, and activity in fewer cells, in the case of beta-glucuronidase than of acid phosphatase . Diffuse beta-glucuronidase activity was found in the wall of empty-looking oval chambers in the Schwann cells, and acid-fast bacilli were seen in these chambers . In teased fibre preparations, both axonal degeneration and segmental demyelination were found . In semi-thin araldite sections, the myelinated fibre density was either preserved or reduced; large diameter fibres were more frequently depleted, with tall peaks of smaller fibres seen on plotting diameter spectra. Biochimie, 1979, 61(4), 573 - 5 {Dehydrogenases reducing NAD+ in the presence of D (-) 3- phosphoglycerate in mycobacteria (BCG, H37Ra, M . phlei)}; Andrejew A; Referring to the elution volume on a Sephadex G-150 column only one specific peak is obtained, the same for the BCG, H37Ra and Mycobacterium phlei strains grown on Sauton synthetic medium . Some properties of these partially purified dehydrogenases are studied (conservation and dialysis in media of different salt concentrations, equilibrium constant, Km, heat stability) . All enzyme preparations from tubercle bacilli (BCG, H37Ra) are readily inactivated by heat and are very unstable in solutions of low ionic strength . In contrast, under the same experimental conditions, all enzyme samples from M . phlei are, comparatively, much more stable towards these factors {heat, salt (potassium phosphate, NaCl) concentration}. Lepr India, 1979 Jan, 51(1), 8 - 22 The significance of changes in the nasal mucosa in indeterminate, tuberculoid and borderline leprosy; Chacko CJ et al.; A study of nasal biopsies from 137 leprosy patients classified on the basis of clinical, microbiological and skin biopsy as Indeterminate, Tuberculoid, Borderline-tuberculoid and Borderline-leproma was undertaken . Changes suggestive of leprosy viz., nerve and smooth muscle inflammation with a few acid fast bacilli in a proportion of the biopsies were seen in all groups of patients examined . This suggests, that even in Indeterminate and Tuberculoid leprosy the disease becomes generalised by the time clinical manifestations appear in skin . Tuberculoid granuloma was seen in two nasal biopsies from Borderline-tuberculoid leprosy patients, one of which was located in the wall of a vein, suggesting the possibility of intravascular dissemination of the disease even in non-lepromatous leprosy . 33 of the patients were children 15 years and below and they also showed changes such as nerve and smooth muscle inflammation but bacilli were seen only in the Borderline group . These findings suggest involvement of the nasal mucosa early in the course of the disease as 70% of the children had the skin lesion for less than one year . The nasal mucosa offers favourable conditions for the growth of the organisms and is readily accessible to infection by droplets, and therefore, it could be one of the primary sites of involvement in leprosy. Scand J Immunol, 1979, 9(2), 175 - 82 Antibody response in rabbits to Mycobacterium bovis BCG; Mshana RN et al.; The specificity of the immune response after immunization with Mycobacterium bovis BCG was studied by crossed immunoelectrophoresis with intermediate gel in a BCG/anti-BCG system, in which the reaction against thirty distinct components of BCG was recorded . After a single injection of total sonicate of 3 mg (dry weight) bacilli, the antibody response was markedly similar in eight rabbits . Th earliest and strongest response was directed against nine components of BCG; all but one of these belonged to the group of thirteen components that cross-react extensively with other mycobacteria . After repeated immunization with sonicate from about 0.8 microgram of BCG bacilli, five components still induced a marked antibody response . All but one of these components are among the most widely cross-reacting BCG components, and the observations made after subsequent challenge with the higher dose of BCG indicate that low-zone tolerance was induced against other components of the bacilli . The implication of these findings concerning formation of anti-mycobacterial antibodies in normal individuals and during mycobacterial infection is discussed. Chemotherapy, 1979, 25(1), 30 - 9 Antibacterial activity and synergy, in vitro and in vivo, of a combination of amoxycillin and flucloxacillin; Comber KR et al.; The antibacterial activity of a combination of equal parts of amoxycillin and flucloxacillin was compared in vitro and in vivo with that of amoxycillin and flucloxacillin against a range of gram-positive and gram-negative bacteria . The combination generally showed additive effects against bacteria sensitive to the individual penicillins and there was no evidence of antagonism, but synergistic effects were observed between amoxycillin and flucloxacillin against certain amoxycillin-resistant gram-negative bacilli . The extent of synergism varied according to the particular bacterial species under test and synergy was observed only against bacteria with chromosomally-mediated beta-lactamases and not against bacteria with R-factor-mediated beta-lactamases . In general, amoxycillin + flucloxacillin demonstrated activity against experimental mouse infections in good agreement with demonstrated activity against experimental mouse infections in good agreement with its in vitro activity, and synergy was produced against a range of gram-negative bacilli in vivo . The data suggest that clinical trial with amoxycillin + flucloxacillin in the treatment of selected infections including those due to some amoxycillin-resistant bacteria may well be justified. Rev Int Trach Pathol Ocul Trop Subtrop, 1979, 56(2), 15 - 78 {Experimental trachoma}; Verin P; During half a century, the agent of trachoma could be mainly demonstrated by inoculation to the conjunctiva of animals; by this mean the cycle of the agent could be revealed . There was a huge progress when T'ANG for these studies inoculated embryonated chicken eggs . However, experimentally infected animals are used at present time not only in trachome countries where do not exist laboratories: monkeys, guinea pigs, rabbits, rats and mice allow modern studies of chlamydial infection . Monkeys living in the countries where trachoma is endemic were selected because of their cheapness (orangoutan in Java, macaques in Northern Africa and in Taiwan, baboons in Africa) . The monkeys selected by American workers are coming from South America . First pioneers (NICOLLE, CUENOD and NATAF, PAGES, JULIANELLE) have demonstrated the infectivity of animals and the place of the agent of trachoma on taxonomic point of view . As PAGES, we have demonstrated that infection could be regularly provoked when inoculating macaques; moreover a pannus could appear when adding hydrocortison drops or when infiltrating the cornea with tuberculin . Cultures of WEEKS bacilli were introduced in the eyes of trachomatous animals; we could observe an aggravation of the disease . If biology of trachoma is better known at present time, experimental trachoma is until now fundamentally important . It permits immunological studies especially for the purpose of vaccination; one can check terapeutical means for instance antibiotics; studies are performed to demonstrate cross immunizations or enhancement of defence (with levamisole) . Experimental trachoma is hitherto and again for a long time commonly requested for the study of trachoma. J Hyg Epidemiol Microbiol Immunol, 1979, 23(3), 307 - 17 Comparison of auramine-rhodamine B and acridine orange for staining of acid-fast bacteria; Kalich R et al.; In cooperation of 6 laboratories in Czechoslovakia and in the GDR, the efficiency of auramine-rhodamine B (AR) and acridine orange (AO) (short-time method) for staining of acid-fast bacilli was compared . Whereas a former comparison of AR and AO (original method) pointed out the superiority of AR, the investigation of both methods used as short-time procedures showed significantly more acid-fast rods after using AO . The number of "false positive" results was somewhat higher on AR staining . However the results depend not only on the method used but also on the procedure of staining and the optical equipment, and they are essentially influenced by the experience and proficiency of the microscopist . Taking into account the results of both studies both auramine-rhodamine B and acridine orange can be proposed for the staining of slides for microscopical detection of acid-fast rods . In case of AO, the short-time method is superior to the original long-time procedure. Acta Anat (Basel), 1979, 104(4), 406 - 13 Peritoneal macrophages introduced into mouse foot pads enter the germinal center of regional lymph nodes nonspecifically; Kotani M et al.; Male mice were injected into their foot pads with sheep erythrocytes (SRBC) to form lymph follicles in the germinal centers in the popliteal lymph nodes . 4 weeks later, peritoneal macrophages labeled with carbon from syngeneic donors sensitized with SRBC or typhoid-paratyphoid bacilli (TAB) were separately injected into the foot pads as well . The popliteal lymph nodes were histologically examined at 6 h to 5 days after injection . Labeled macrophages appeared in the marginal sinus, migrated straight across the cortex from the marginal sinus to the lymph follicles and then entered the germinal centers . There was no difference in the mode of appearance, migration and localization of labeled macrophages in the regional lymph nodes between the mice given labeled macrophages from SRBC-sensitized donors and those given macrophages from TAB-sensitized donors . The entrance of lymph macrophages into the germinal centers of the regional lymph nodes would be immunologically nonspecific . After the injection of Pelikan ink into the foot pads, the macrophages which have taken up carbon in the peripheral tissue reached the regional lymph nodes via the afferent lymphatics and then entered the germinal centers, mainly through the medullary pole of the lymph follicles, after migrating along their immediate exterior from their marginal sinus to their medullary pole. Chest, 1978 Dec, 74(6), 635 - 9 Quantitative tracheal bacteriologic and cytologic studies in patients with long-term tracheostomies; Bartlett JG et al.; Quantitative aerobic and anaerobic cultures were performed on 28 tracheal aspirates from 16 clinically stable patients with tracheostomies . There were an average of six isolates per specimen, and the mean bacterial concentration was 106.9 organisms per milliliter . The numerically dominant bacteria were aerobic and facultative gramnegative bacilli . Anaerobic bacteria were recovered from just nine specimens (32 percent); and, when present, these organisms were found in relatively low concentrations . Repeat cultures obtained 30 to 60 days later from the same patients showed substantial changes in flora, but the numerically dominant species tended to persist . Cultures of saliva and throat swabs collected at the time of tracheal aspiration showed that there was little correlation between the bacteriologic findings from the upper and lower airways . Cytologic studies indicated a mean of 12,900 cells per cubic millimeter of tracheal aspirate, with polymorphonuclear leukocytes being the predominant forms . No correlation could be found between the concentrations of polymorphonuclear leukocytes and quantitative bacterial counts . These studies indicate that tracheal aspirates from patients with stable tracheostomies harbor a complex, predominantly aerobic flora which is subject to change and bears little relationship to the flora of the adjacent upper airways . Our results also suggest that neither quantitative bacterial cultures nor cytologic analysis of these specimens would be helpful in distinguishing colonization from overt infection requiring antibiotic treatment. Jpn J Exp Med, 1978 Dec, 48(6), 533 - 43 Progressive and fatal infection with attenuated Mycobacterium bovis (BCG) in nude mice; Ueda K et al.; Congenitally athymic nude mice (nu/nu) were infected intravenously with Mycobacterium bovis BCG Japanese strain under specified pathogen-free (SPF) or germ-free (GF) conditions . SPF euthymic litter mates (nu/+) serving as controls were found to tolerate the infection well, while SPF nu/nu mice following infection of 3 X 10(7) organisms died by week-36 . Animals having received a very small dose (3 X 10(0) of organisms and their non-infected cage mates showed no evidence of infection at week 37 post-infection . Time-course observations carried out on SPF and GF nu/nu mice following infection with 10(5) or 10(6) organisms revealed that the number of organisms in the liver and spleen reached 10(6) to 10(7) viable units per organ at week 12 and this level was maintained for 50 weeks post-infection . Bacillary counts in the kidney and lung increased progressively and reached a level of 10(7) to 10(8) at the terminal stage of infection . In the liver, spleen and lymph nodes of nu/nu mice, granulomas were noted 12 weeks postinfection . The granulomas were composed of macrophages and accompanied by slight infiltration of lymphocytes, plasma cells and a small number of polymorphonuclear leucocytes . In later infection stages, small aggregations of pigmented macrophages packed with acid-fast bacilli were present in the liver, spleen and lymph nodes . Lesions with large foci of bacilli-laden macrophages developed progressively in the kidney, lung and subcutaneous and periosteal connective tissues . Periosteal granulomatous lesions, sometimes accompanied by exudation, intruded occasionally into the bone marrow, resulting in extensive granulomatous osteomyelities. Br J Exp Pathol, 1978 Dec, 59(6), 551 - 7 Experimental lepromatous leprosy in the white-handed gibbon (Hylobatus lar): successful inoculation with leprosy bacilli of human origin; Waters MF et al.; Leprosy bacilli of human origin were inoculated into a white-handed gibbon by the i.v . and i.p . routes, and also locally into ears, testis and around an ulnar nerve . The animal was observed closely during a period of nearly 15 years and did not exhibit any clinical evidence of cutaneous or neurological disease . At death, a wide range of tissues was taken for bacterial counts and histological examination, and a disseminated and progressive infection was demonstrated . Acid-fast bacilli were found in many sites; their morphological appearance distribution in nerves, and pattern of multiplication in mouse foot-pads, and also the presence of anti-mycobacterial antibody in the serum and the absence of specific lymphocyte transformation were all in keeping with an infection by Mycobacterium leprae, at an early lepromatous stage . This is probably the first fully documented report of experimental lepromatous infection in a primate . The findings are discussed in relation to the long incubation period of le promatous leprosy and the difficulties of diagnosing the disease at an early stage in man. South Med J, 1978 Dec, 71(12), 1524 - 5 Erroneous diagnosis of meningitis due to false-positive gram stains; Ericsson CD et al.; During a two-month period, 6% of Gram stains of predominantly CSF specimens revealed gram-negative bacilli with no growth . The source of the false-positive Gram stain results was an alcohol storage bath from which slides were taken and flamed to remove residual alcohol . All 11 patients in the outbreak had further diagnostic tests or changes in therapy . In the laboratory, false-positive slides could be created by contaminating a slide bath with 10(5) bacilli/ml, flame drying, and staining . In addition, contaminated crystal violet caused a false-positive result when applied to a warm but not to a cool slide . To prevent false-positive Gram stain results, the storage of slides in alcohol baths should be abandoned, slides should not be flamed to remove alcohol, and specimens should be Gram-stained only when the heat-fixed slide has thoroughly cooled. Res Vet Sci, 1978 Nov, 25(3), 284 - 9 Effect of repeated injections of iron dextran on the haematological, serological and pathological changes in experimental avian tuberculosis; Smith IM et al.; Eight intramuscular injections of 200 mg/kg of iron (DFe), given as iron dextran twice weekly in the week before and the three weeks after intravenous infection with about 10(7.5) colony-forming units of Mycobacterium avium, significantly prolonged (by about 11 days) the mean 'time-to-death' of immature male fowl (Gallus domesticus) compared with corresponding regimes using dextran (Dx) only or saline, When a proportion of the birds were examined 21 days after infection many of the abnormalities associated with the disease, including a marked hypochromic anaemia, were less severe in DFe-treated than in the Dx- or saline-treated chicks and there were about 10- to 85-fold fewer viable tubercle bacilli in the liver and spleen of the DFe-treated birds. Zentralbl Bakteriol {Orig A}, 1978 Nov, 242(1), 132 - 6 Isolation of tubercle bacteria using Ogawa egg medium modified by addition of Tween 80; Saito H et al.; A modified medium was developed by altering the composition of 3 per cent Ogawa egg medium and adding Tween 80 . Isolation of tubercle bacilli using this medium, in general, showed better growth and colines became visible earlier than the original medium, but there was no improvement in the positive rate. Zh Mikrobiol Epidemiol Immunobiol, 1978 Nov, (11), 41 - 7 {Parathyphoid B-antigen containing a complex of protective surface antigens}; Stepanova LK et al.; The authors obtained a complex antigen from paratyphoid B bacilli containing complete O-, K- and H-antigens . The preparation was nontoxic and was characterised by marked antigenic properties . In intravenous and oral administration it stimulated production of specific O-, K-, and H-antibodies in high titres . Complex paratyphoid B antigen possessed a marked protective activity and provided intense immunity in subcutaneous and oral administration to experimental animals. Biochem J, 1978 Oct 15, 176(1), 197 - 203 Calcium accumulation during sporulation of Bacillus megaterium KM; Hogarth C et al.; Accumulation of Ca2+ in Bacilli occurs during stages IV to VI of sporulation . Ca2+ uptake into the sporangium was investigated in Bacillus megaterium KM in protoplasts prepared in stage III of sporulation and cultured to continue sporulation . These protoplasts and whole cells exhibit essentially identical Ca2+ uptake, which is compared with that of forespores isolated in stage V of sporulation . Ca2+, uptake into both sporangial protoplasts and isolated forespores occurs by Ca2+-specific carrier-mediated processes . However, protoplasts exhibit a Km value of 31 micrometer, and forespores have a Km value of 2.1 mM . Sporangial protoplasts accumulate Ca2+ against a concentration gradient . In contrast, Ca2+ uptake into isolated forespores is consistent with downhill transfer in which both rate and extent of uptake are affected by the external Ca2+ concontration . Dipicolinic acid has no effect on Ca2+ uptake by isolated forespores, apart from decreasing the external Ca2+ concentration by chelation . A model for sporulation-specific Ca2+ accumulation is proposed, in which Ca2+ is transported into the sporangium, resulting in a concentration of 3--9 mM in the mother-cell cytoplasm . This high concentration of Ca2+ enables carrier-mediated transfer down a concentration gradient into the forespore compartment, where a low free Ca2+ concentration is maintained by complexing with dipicolinic acid. Can Med Assoc J, 1978 Oct 7, 119(7), 722 - 4 Bordetella pertussis serotypes in Canada; Toma S et al.; A study was done to determine the major antigenic factors of Bordetella pertussis strains isolated throughout Canada and whether these isolates have the same antigenic structure as the bacilli in the currently used vaccines . Testing for the major pertussis antigens, factors 1, 2 and 3, was conducted with 440 freshly isolated strains of B . pertussis received from seven canadian provinces between August 1976 and February 1978 and six batches of pertussis vaccine or immunizing agents containing pertussis vaccine . With the aid of specific antisera prepared in rabbits, the antigenic factors were detected by a slide agglutination technique . Almost all (98.9%) of the pertussis strains examined were serotype 1,3.All six batches of pertussis vaccine or immunizing agents containing pertussis vaccine proved to be rich in each of the three main pertussis agglutinogens. Postgrad Med J, 1978 Oct, 54(636), 678 - 9 Tuberculous abscess of the brain; Mohanty S et al.; A bacteriologically confirmed case of tuberculous abscess of the brain is reported . Tuberculous brain abscess unlike tuberculoma does not exhibit the typical granulomatous changes and the diagnosis is confirmed by demonstration of tubercle bacilli either by staining or culture . An antituberculous regime should be started immediately the diagnosis has been established. Biull Eksp Biol Med, 1978 Oct, 86(10), 462 - 5 {Immune response in rats and mice with adjuvant disease}; Davydova TV et al.; There were phasic changes of immune response in rats and mice with adjuvant disease: an increase of antibody production on the 7th day after the injection of complete Freund's adjuvant and its depression on the 21st day; there was also observed suppression of normal antibody production to O- and Vi-antigens of typhoid bacilli. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1978 Oct-Dec, 27(4), 241 - 6 {Current incidence and clinical significance of non-culturable bacilli or those culturable with difficulty}; Golli V et al.; An analysis of 246 patients with positive smear present bacilli and negative cultures revealed that in only 9% of the cases no organized previous treatment had been applied, although almost half of these had benefited from short courses with streptomycin associated with penicillin before an exact diagnosis of tuberculosis had been made . Since the remaining 91% had had 1--2 months of chemotherapy, which frequently included rifampicin, the authors stress that microscopically detectable germs are frequently incapable to develop on culture media . These are frequently non-viable bacteria and in such conditions no subsequent modifications of the currently applied therapy scheme should be attempted . The authors show that only 26,2% of the germs from 519 positive cultures have developed after 21 days from the seeding . At 30 days the overall proportion increased to 71,2% while at 45 days 22,7% more positive cultures appeared and an additional 6,1% cultures became positive at 60 days . Tubercle bacilli become increasingly demanding and slower growing . If at 21 days only one colony was evident in 6% of the cases, while an infinite number of colonies were present in 58% of the cultures at 60 days a single colony was found in 42% of the cases, in contrast with only 9% cases with an infinite number of colonies (P less than 0,001) . The delay in the growth of bacilli was parallel with the duration of chemotherapy . The results are compared with data from the literature. J Thorac Cardiovasc Surg, 1978 Oct, 76(4), 469 - 72 Coexistent bronchogenic carcinoma and active pulmonary tuberculosis; Mok CK et al.; Sixty-four cases of coexistent bronchogenic carcinoma and active pulmonary tuberculosis were diagnosed between 1969 and 1976 . The majority were male chronic cigarette smokers in their fifth and sixth decades . Human bacilli were isolated in 48 patients (88.9 percent) and atypical bacilli in six patients (11.1 percent) . All of the atypical bacilli and 8.3 percent of the human bacilli were found to be resistant to the first line antituberculous drugs . All patients, except two who died following resection, were given a course of antituberculous drugs with 93.8 percent successful sputum conversion . Uncontrolled or disseminated tuberculous infection was not observed . Forty-five patients (70.3 percent) underwent pulmonary resection . Median survival time of those who had curative resection was 14.3 months with a 5 year survival rate of 13.2 percent . Median survival times of those treated by palliative resection plus anticancer chemotherapy and by anticancer chemotherapy alone were 8.3 months and 11.1 months, respectively . None of these patients survived more than 30 months . It appears that, clinically, each disease runs its own course with little effect on the other. Am Rev Respir Dis, 1978 Oct, 118(4), 701 - 4 Primary antituberculous drug resistance in Hawaii, 1957 to 1977; Pien FD et al.; A study of primary antituberculous drug resistance in Hawaii was conducted from 1957 to 1977 to determine the incidence of primary resistance with respect to time . A total of 1,869 initial cultures of Mycobacterium tuberculosis submitted to Leahi Hospital in Honolulu were screened to identify drug resistance . Of 256 patients who excreted resistant bacilli, only 55 had no history of previous antituberculous chemotherapy . The frequencies of primary drug resistance from July 1957 to July 1977 were as follows: streptomycin, 0.86 per cent; isoniazid, 1.2 per cent; para-aminosalicylic acid, 1.5 per cent . No strains were resistant to ethambutol or rifampin . A slight decrease in the incidence of drug resistance during a 20-year period was observed . This was especially significant because Hawaii's tuberculosis problem is principally confined to its foreighn-born population . Although no serious primary drug resistance problem was discovered, Hawaii possesses both the highest immigration rate and the highest incidence of tuberculosis in the United states . Therefore, there is a need for continued periodic monitoring of drug resistance in Hawaii. Health Lab Sci, 1978 Oct, 15(4), 215 - 20 Evaluation of mycobacteriology laboratories: the acid-fast smear; Gruft H; In a proficiency testing program, slides bearing acid-fast bacilli were sent to laboratories in New York State . The most reliable results were obtained in laboratories using the Ziehl-Neelsen method . Cold staining procedures were less reliable . The auramine-rhodamine fluorescent stain, which produced many false positives, should be confirmed by the Ziehl-Neelsen procedure . The testing program described can be used to determine whether laboratories perform the acid-fast stain effectively. Sem Hop, 1978 Sep 8-15, 54(21-24), 755 - 7 {Pleuro-pulmonary complications of typhoid fever . 1case}; Bouvier B et al.; The authors report a case of typhoid fever with pleuro-pulmonary complications and recall their characteristics: Usually early (second week), may appear under treatment, whereas the disease evolves normally . Characterised by the absence of infective phenomena, the multiple manifestations, the fleeting course and the favourable prognosis . This corresponds to the pleuro-pulmonary typhus syndrome described long ago, which is probably due to immunological phenomena . Sometimes late, evolving towards suppuration, abscess formation and empyema with presence of typhoid bacilli, rarely seen nowadays. Acta Pathol Jpn, 1978 Sep, 28(5), 751 - 8 Disseminated atypical mycobacteriosis in a child--a case of Mycobacterium sculoflaseum; Yun K et al.; A case of disseminated mycobacterial disease caused by mycobacterium sculoflaceum is presented in a three-year-old female . Atypical acid-fast organisms were found in cultures from the tissue of lymph node and bone marrow, gastric juice and feces . Histologically the mesenteric lymph nodes contained numerous large macrophages which had large numbers of acid-fast bacilli . Caseation necrosis was absent . Distinguishing features are the extensive involvement of lymph nodes and bones and the preference for intracellular presence of acid-fast bacilli . Up to the present in Japan there are only 17 reported cases of atypical mycobacteriosis in children. Postgrad Med, 1978 Sep, 64(3), 97 - 102, 104 Prudent use of the aminoglycosides; Gregory D et al.; Kanamycin, gentamicin, tobramycin, and amikacin are potent aminoglycoside antibiotics useful in treatment of infections with aerobic Gram-negative bacilli . For many bacteria, no other effective agents exist . These antibiotics must be used prudently . Prescribing physicians have a responsibility to avoid unnecessary therapy with agents that have the potential of causing serious ototoxic and nephrotoxic effects and to avoid indiscriminate use that may encourage the emergence of resistant organisms . These medications are much too valuable to be rendered ineffective by unwise use. Rev Cubana Med Trop, 1978 Sep-Dec, 30(3), 153 - 60 {Verification of Lassen's modified method for the identification of gram negative bacilli}; Buesa Munoz FP et al.; Eighty strains of gram-negative bacilli, according to Lassen's modified method, and the conventional methods for their identification are studied . Lassen's original dichotomic keys, with which satisfactory results were obtained in relation to conventional methods, are presented . Reliability and greater accurateness of such a modification were shown. Rev Cubana Med Trop, 1978 Sep-Dec, 30(3), 147 - 51 {Modified Lassen's method for the identification of gram negative bacilli}; Buesa Munoz FP et al.; A variation of the components of media used by Lassen for the identification of clinically significant gram-negative bacilli is performed in pursuit of an economically accessible method that can be introduced in daily laboratory work. Acta Pathol Jpn, 1978 Sep, 28(5), 697 - 703 Immunohistochemical observation of lysozyme in macrophages in leprosy; Yamashita K et al.; Lysozyme activities of skin granulomas of 24 patients in leprosy were studied . Lepra cells of all 15 lepromatous leprosy showed strong lysozyme activity in cytoplasma . In the specimens stained with lysozyme and Ziehl-Neelsen's carbolfuchsin double stain conspicuous lysozyme activity around M . leprae were observed . One borderline case was negative . Lysozyme of epithelioid cells and giant cells of 10 tuberculoid types were completely negative . These results suggest that lysozyme plays only a small role in the disposal of M . leprae in macrophages and other mechanisms than bacteriolytic function of lysozyme are responsible for the defence against these bacilli. Am J Trop Med Hyg, 1978 Sep, 27(5), 1019 - 29 Electron microscopy of peroxidase and acid phosphatase in leprous and uninfected armadillo macrophages: a macrophage subpopulation contains peroxisomes and lacks bacilli; McKeever PE et al.; Lepromatous tissue from armadillos inoculated 24--36 months earlier with Mycobacterium leprae was obtained for electron microscopic studies . Cytochemically stained lepromas revealed a subpopulation of macrophages containing peroxisomes . These peroxidase reactive macrophages were not infected with bacilli . Acid phosphatase was present in macrophages and many of these were infected with bacilli and contained vacuoles and lipid globules . Within the membrane-bound vacuoles, acid phosphatase surrounded bacilli . However, the reaction product ended abruptly at a 15--40 millimicron thick zone of low electron density surrounding intact bacilli . Acid phosphatase was more intensely reactive and localized less precisely in heavily infected and vacuolated macrophages than in lightly and non-infected cells . The effectiveness of this bacillary barrier and the numerous infected macrophages with substantial acid phosphatase argue against the ability of acid phosphatase to protect host cells from leprosy bacilli . Evidence suggests a protective action of peroxidase or the rapid turnover of macrophages within lepromas . Granular and membranous debris were commonly seen within vacuoles of infected macrophages . A portion of the debris was ultrastructurally similar to bacillary matrix and was nonreactive for peroxidase and acid phosphatase . Following homogenization and centrifugation, similar materials banded with bacilli above 60% sucrose . Another portion of the debris was ultrastructurally similar to host lysosomal matrix and was reactive for acid phosphatase . Results support the concept of dual host and parasitic origins of the debris found in phagolysosomes of infected macrophages . Transparent, oval Epon defects remained eccentric to the majority of intact bacilli in centrifuged fractions . Apparently, an intrinsic property of leprosy produced these Epon defects. Arch Pathol Lab Med, 1978 Sep, 102(9), 483 - 9 Delayed hypersensitivy and experimental interstitial pneumonitis; Fleming GM et al.; The effects of prior sensitization with killed H37Ra tubercle bacilli on the pulmonary reaction to intravenous (IV) challenge with complete Freund's adjuvant (CFA) have been studied and were compared to reactions in nonsensitized CFA-challenged controls . Rabbits that died within 24 hours of challenge demonstrated acute arteritis prior to granuloma formation . Sensitized rabbits had a greater number of exudative cells in the pulmonary lavage fluid and a larger volume of parenchymal infiltrate than did comparable, nonsensitized controls at two and eight weeks . The exudate and infiltrate were diminished in both sensitized and nonsensitized rabbits at eight weeks . An obliterative, granulomatous arteritis was observed in both sensitized and nonsensitized groups receiving IV CFA and was not affected by the state of sensitivation . Granulomatous and collagenous parenchymal lesions regress in both sensitized and nonsensitized groups between two and eight weeks. Br J Ophthalmol, 1978 Aug, 62(8), 516 - 24 Ocular histopathology in animals experimentally infected with Mycobacterium leprae and M . lepraemurium . 1 . Mycobacterium leprae and M . lepraemurium infections in the mouse . 2 . Mycobacterium leprae infections in the 9-banded armadillo (Dasypus novemcinctus L.); Hobbs HE et al.; At varying periods of time following the successful establishment of systemic infections with Mycobacterium leprae or M . lepraemurium in the mouse and the nine-banded armadillo eyes were examined by light microscopy . Inoculation of bacilli was by the intravenous or intraperitoneal route or directly into the hind footpads; eyes were not directly inoculated in this study . During periods of up to 3 years under laboratory conditions no animal showed evidence of impaired vision or blindness, and the external appearance of both eyes was normal . The ocular histopathology and the sites of accumulation of bacilli are described . In immunologically normal mice infected with M . lepraemurium bacilli were much commoner in extraorbital tissues, but they were, nevertheless, found in various tissues within the orbit, including the ciliary body and sclera . In immunologically normal mice (and one rat) injected with M . leprae of human origin no bacilli were found in the eye, but in mice immunologically depressed by thymectomy and total body irradiation considerable numbers of bacilli were present in the iris and ciliary body and also in the limbal cornea . In the armadillo bacilli were found in large numbers in virtually all tissues except the lens, retina, optic nerve, and aqueous and vitreous humours, but the uveal tract was heavily involved . Findings are discussed in relation to the great frequency of ocular involvement and the importance of immune-complex disease in patients with lepromatous leprosy, and to factors wihch may favour the localisation and multiplication of Mycobacterium leprae in the eye. Am Rev Respir Dis, 1978 Aug, 118(2), 219 - 28 Controlled trial of 6-month and 8-month regimens in the treatment of pulmonary tuberculosis . First report; Host-parasite relationships in experimental airborne tuberculosis . VII . Fate of Mycobacterium tuberculosis in primary lung lesions and in primary lesion-free lung tissue infected as a result of bacillemia; Evidence suggests that in humans tuberculous disease usually arises at apical or subapical sites in the lungs seeded as a consequence of an early bacillemic phase of the infection . This study examined the fate of bacilli transported via the bloodstream to metastatic sites in the lungs of guinea pigs after aerosol infection with approximately two viable virulent Mycobacterium tuberculosis . The results revealed that, even after logarithmic-phase multiplication of bacilli in primary lesions had been terminated, bacilli seeded via the bloodstream to metastatic sites in the lung were able to multiply . These observations, made in an animal model that mimics the conditions under which tuberculosis develops in human subjects, challenge the relevance of systemic macrophage activation in experimental airborne tuberculosis in guinea pigs. Arch Dermatol Res, 1978 Jul 28, 262(2), 205 - 17 The ultrastructure of mycobacterium marinum granuloma in man; Marsch WC et al.; 3 biopsies of 3-5 week-old nodular lesions in 2 patients with so-called swimming-pool (aquarium-) granuloma have been examined by electron microscopy . The cytohistological spectrum simultaneously comprises acute exudative as well as chronic proliferative phenomena . Epithelioid cells and collagen producing fibroblasts are already conspicious in 3 week-old granuloma . According to the cytological composition the Mycobacterium marinum granuloma represents a high-turnover granuloma with immunogenic origin . It is comparable to mycobacterial diseases in the presence of well developed cell mediated immunity (Lupus vulgaris, tuberculoid leprosy) . Degrading mycobacteria have been rarely detected in phagocytes and are compared with viable bacilli in macrophages of experimentally infected mice . Curved and annular parallel membranes ("worm-like structures") in the cytoplasm of transformed macrophages and in fibroblasts presumably originate from the membranes of endoplasmic reticulum . Cord-like structures with transverse bands (periodicity 170-180 A) in the lumen of RER of some fibroblasts are interpreted as intracellularly aggregated collagen precursors. Ann Microbiol (Paris), 1978 Jul, 129B(1), 63 - 70 {Production of a photo-sensitive lipid antibiotic by the marine diatom Chaetoceros lauderi (Ralfs) (author's transl)}; Gauthier MJ et al.; A lipid antibiotic was extracted from whole cells of the marine diatom Chaetoceros lauderi (Ralfs) and roughly identified as an unsaturated fatty acid by thin layer chromatography . A number of Gram-positive terrestrial bacteria and several Gram-negative marine bacilli were sensitive to this antibiotic, whereas Gram-negative enteric bacteria were resistant . Solar irradiation led to its partial disappearance and to the production of more polar antibiotics with a stronger antibacterial activity . This observation is compared to similar data culled from literature, and its significance in a natural environment is discussed. Ann Microbiol (Paris), 1978 Jul, 129B(1), 49 - 56 {Homogeneous suspensions of mycobacteria: application to the evaluation of bactericidal activity (author's transl)}; Cremieux A et al.; This work describes a technique of emulsification of mycobacterial cells (including tubercle bacilli) in order to obtain homogeneous suspensions containing up to 10(8) cells/ml . The suspensions are used in a modified AFNOR method for the evaluation of bacterial activity: within five min virulent strains are more resistant than are avirulent ones but, within 30 min and in the presence of proteins, the behaviour of all strains is quite similar. Lepr India, 1978 Jul, 50(3), 392 - 5 Syndrome of crocodile tears caused by lepra bacilli; Sinha HK et al.; A case of the syndrome of crocodile tears as a result of tuberculoid type of leprosy is reported to lend support that the syndrome may be caused by this disease after a long period of its onset. Zh Mikrobiol Epidemiol Immunobiol, 1978 Jul, (7), 99 - 4 {Immunogenic and antigenic properties of continuously cultured typhoid bacteria}; Zhdanova LG et al.; It was shown that in continuous cultivation of typhoid bacilli, by changing the rate of dilution and the regimens of carbohydrate and oxygen supply it was possible to determine conditions under which the most highly immunogenic vaccines were obtained and the maximal synthesis of antigens was observed . The regimen optimal for obtaining the highly immunogenic typhoid vaccines (D = 0.4 h-1; So = 5 g/l; pO2 = 50%) coincided with the regimen at which the maximal O-antigen synthesis was seen, and failed to coincide with the regimens necessary for the greatest synthesis of Vi- and H-antigens. J Wildl Dis, 1978 Jul, 14(3), 333 - 6 Mycobacteriosis in mountain whitefish (Prosopium williamsoni) from the Yakima River, Washington; Abernethy CS et al.; Mycobacteriosis was found in mountain whitefish (Prosopium williamsoni) taken from the Yakima River near Richland, Washington in 1975 and 1976 . The disease appeared to affect about 8% of the population sampled . Gross lesions were present in most visceral organs, but were most common in the kidney, liver and pyloric caeca . Microscopically, the lesions consisted of large numbers of macrophages containing numerous intracellular bacilli . An organism was isolated and has been tentatively classified as Mycobacterium sp., Runyon group III. Tumori, 1978 Jul-Aug, 64(4), 437 - 43 Intravenous administration of BCG in advanced melanoma patients; Orefice S et al.; From June 1975 to August 1977, 19 patients with distant metastases of malignant melanoma of the skin that were no longer respons