Bacillus

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 responsive to chemotherapy were treated with BCG given intravenously . A single dose of lyophilized Pasteur BCG ranging from 2 X 10(7) to 3 X 10(8) viable units was given in 500 ml of saline infused in 5 to 6 h . Seven of the 16 evaluable patients benefited from treatment; 3 showed an objective regression of more than 50% of the original tumor volume, and 4 an arrest of tumor growth . The objective regressions lasted from 2 to 5 months, and 1 case had an arrest of tumor growth for 29 months . The regression rate was related to the BCG dosage: 2 X 10(8) viable units appears to be the dosage that gives severe but reversible toxicity and is able to induce objective regression . The most responsive lesions were skin and subcutaneous deposits (5 of 7) and lung metastases (1 of 4) . Toxic effects seem to be related to the number of bacilli injected . In the group of 10 cases treated with less than 10(8) units, toxicity was modest: 4 patients had fever (up to 38.5 degrees C) that lasted a few days, and in 3 cases it was associated with shivering during the infusion period and weakness . One case only had vomiting and jaundice . Toxicity was severe in the 9 patients that were treated with a dosage higher than 10(8): patients had fever and weakness for at least 4 days and shivering during the infusion . Two had adrenal insufficiency and 7 had liver enlargement and jaundice with return to normality by day 21 . In the whole series 8 patients had leucopenia and 5 thrombocytopenia for 2 to 3 days: only 1 patient required blood and platelet transfusion . No significant variations in immunoglobulin levels were observed . No variations of PPD or BCG skin tests were observed after treatment . Three patients expired; the first treated with 6 X 10(7) unit, had an intercurrent disease (autopsy showed a heart infarction); the second, treated with 1.8 X 10(8), showed a rapid growth of lung metastases and died 15 days after treatment; the death of the third patient was probably due to anaphylactic shock . All 3 patients had been previously treated with BCG, given by scarification or intranodular injection.

Lepr India, 1978 Jul, 50(3), 381 - 7
Evaluation of bacteraemia in leprosy patients; Sreevatsa et al.; Thirty five patients of leprosy have been screened for bacteraemia by haemolysis (HL), leucocyte adherence (LA) and buffy coat (BC) methods and the results have been compared . The HL method has yielded not only higher number of acid-fast bacilli (AFB) but also has detected more frequently AFB in blood of leprosy patients as compared to other methods . Further, it has been established that the skin over the cubital fossa does not play any significant role in contaminating blood samples while sampling blood by venepuncture.

Lepr India, 1978 Jul, 50(3), 375 - 80
Mycobacterium leprae in the striated muscle of tuberculoid leprosy patients; Koranne RV et al.; Striated muscle specimens from 24 untreated proved cases of tuberculoid leprosy and five healthy normal individuals were studied histopathologically for the evidence of leprous pathology . Atrophy or damage to the muscle fibre was not observed in any patient . Nineteen (79.16%) cases showed evidence of leprosy in striated muscles . Seventeen (70.83%) cases showed scanty histiocytic infiltrate between the muscle fibres . Thirteen (54.16%) cases had acid fast bacilli mostly inside the muscle . There was no correlation between the location of the bacilli and that of the histiocytes; in two cases, acid fast bacilli were seen without the histocyte . The bacilli were solidly staining and were lying singly in the undamaged muscle . There was no evidence of tuberculosis and, in the Control group, none showed any AFB or infiltrate . The presence of lepra bacilli did not depend upon the location of the muscle . Two of the muscle specimens not underneath the cutaneous lesions also had acid fast bacilli . 21.05% of these cases also showed simultaneous involvement of liver and lymph nodes . These are strong evidences of systemic nature of disease in tuberculoid leprosy as well.

Lepr India, 1978 Jul, 50(3), 352 - 5
Primary sulphone resistance . A preliminary report; Girdhar BK et al.; A case of lepromatous leprosy proven to be a primary sulphone resistant one, has been reported . Bacilli from the case were found to be resistant as checked by their continued growth in the foot pads of mice receiving diet containing 0.001% D.D.S . A study to identify such cases is being systematically persued.

Lepr India, 1978 Jul, 50(3), 345 - 57
The early cellular response to M . leprae . An ultrastructural study; Chandi SM et al.; The ultrastructural changes that develop in mouse peritoneal macrophages from 10 minutes up to 14 weeks after exposure to Mycobacterium leprae are presented . Phagocytosis occurred by a process of engulfment by cytoplasmic processes and incorporation into a phagosome, into which lysosomal enzymes were subsequently introduced . Electron transparent zones (E.T.Z.) were not observed around phagocytosed bacilli in this study, however discrete droplets of lipid-like material appeared in the cytoplasm of macrophages, between 2 and 4 weeks after ingestion of the micro-organisms . Phagosomes with double limiting membranes were observed in macrophages harvested as early as 40 minutes after exposure to M . leprae, contrary to the observations of Evans and Levy (1972).

Zh Mikrobiol Epidemiol Immunobiol, 1978 Jul, (7), 97 - 9
{Role of antibodies in protection from pseudotuberculous infection and intoxication}; Koroliuk AM; Lethal doses of virulent pseudotuberculosis bacilli and antipseudotuberculosis sera of different specificity were injected to albino mice simultaneously . A high neutralizing activity of antibodies against pseudotuberculosis intoxication was demonstrated . The type-specific antibodies proved to protect the mice from the toxins of the homologous types of the microbe only . Group antibodies of plaque antiserum and serum procured from the pseudoteburculosis convalescent produced a cross antitoxic action . The antiinfectious effect from the antibody administration was weak . Apparently in pseudotuberculosis the antibodies were the principal factor of the toxin neutralization and were of auxiliary significance in the protection from the developing infection . Neutralization of pseudotuberculosis toxins with plague antiserum served as an additional confirmation of cross immunity between plague and pseudotuberculosis.

Orthop Clin North Am, 1978 Jul, 9(3), 611 - 25
Gram negative sepsis and shock; Landesman SH et al.; PIP: In the modern hospital gram negative bacteremia and the associated condition of septic shock are common occurrences . In the United States the estimated incidence of gram negative bacteremia ranges from 71,000 to 330,000 cases annually . Fatalities attributed to this disease are between 18,000 and 132,000 each year . Sepsis is defined as a systemic disease caused by microorganisms or their products in the blood . Bacteremia is the presence of viable organisms in the circulation . Gram negative bacteremia in the critically ill patient is synonymous with gram negative sepsis . Septic shock is a clinical syndrome characterized by circulatory insufficiency and inadequate tissue perfusion . Septic shock is associated primarily although not exclusively with gram negative bacilli . Focus is on predisposing factors, microbiology, pathophysiology, and the 4 components of therapy -- antibiotics, volume replacement, steroids, and surgical drainage . The underlying illness of the patient is the primary factor determining the outcome of an episode of gram negative bacteremia . Patients with a life threatening disorder have a very poor prognosis, while sepsis in a previously healthy person carries a good prognosis . The overall mortality in gram negative bacteremia is 25% . When septic shock develops, the mortality increases to 50-60% . Appropriate antibiotics that are synergistic against the infecting organism can decrease the mortality, but the overwhelming infleunce of host factors in predicting the outcome suggests that prevention and early treatment are the best means of decreasing mortality .

Acta Paediatr Scand, 1978 Jul, 67(4), 519 - 23
Fatal BCG infection in an immunocompetent girl; Pedersen FK et al.; A 6-year-old girl developed progressive symptoms of increased intracranial pressure starting 5 months after BCG vaccination . Thirteen months later craniotomy revealed an epithelioid cell granuloma of the arachnoid occluding the foramen of Magendie . No tubercle bacilli were found on histological examination . Insertion of a Pudenz shunt relieved the symptoms . Six months later generalized BCG infection developed, and in spite of treatment with ethambutol, rifampicin and isoniazid for 10 weeks, death occurred during an episode of increased intracranial pressure . Mycobacterium BCG could be cultured from several organs . The patient showed no obvious evidence of immuno-deficiency as judged on the basis of previous disease history, particle concentration of granulocytes, B and T lymphocytes in peripheral blood, concentration of immunoglobulins in serum, response of lymphocytes to transformation with mitogens and antigens, and histological findings in the thymus and BCG granulomas.

J Clin Microbiol, 1978 Jul, 8(1), 110 - 1
Preparation of acid-fast microscopy smears for proficiency testing and quality control; Smithwick RW et al.; A method is presented for preparing smears for proficiency testing and quality control in acid-fast microscopy . The work was prompted by the increased demand for acid-fast bacilli positive smears with characteristic microscopic appearance and among-smear uniformity.

Br J Dis Chest, 1978 Jul, 72(3), 217 - 21
An assessment of the place of follow-up pulmonary tuberculosis; Hayden SP et al.; I n 1971--4 forty-four patients were found to have drug-susceptible tubercle bacilli in their sputum more than one year after a previous positive result . Comparison of their case records with those of 45 controls showed that inadequate chemotherapy was by far the most important cause of relapse . Most patients who have had adequate chemotherapy for pulmonary tuberculosis should be discharged . Patients who have certain risk factors or who have had inadequate or irregular chemotherapy should be followed up indefinitely.

Zh Mikrobiol Epidemiol Immunobiol, 1978 Jul, (7), 52 - 6
{Epiedmiologic significance of the distribution of corynephages in different collectives}; Markina SS et al.; Corynephage distribution was studied in the nasopharyngeal washings of 252 persons infected with C . diphtheriae of gravis type, toxigenic (21 patients and 147 carriers) and non-toxigenic ones (84 carriers), and in 468 uninfected persons in collective bodies under different epidemic conditions . Corynephages were isolated from the nasopharyngeal washings only in persons infected with toxigenic C . diphtheriae--in 4 (of 21) patients, and in 21% (of 147) carriers . Phages tox+ (4--6.2%) were revealed only in carriers of toxigenic C . diphtheriae with numerous bacteria in the nasopharynx and in diphtheria patients . Carriers of nontoxigenic diphtheria bacilli can become infected with phage tox+ only together with the toxigenic strains (reinfection) . The data obtained indicated that toxigenic and nontoxigenic C . diphtheriae strains were individual variants.

Int J Lepr Other Mycobact Dis, 1978 Jul-Dec, 46(3-4), 386 - 93
Comparison of various preparations of Mycobacterium leprae and other mycobacteria by lymphocyte stimulation; Bjune G; Peripheral blood lymphocytes were stimulated in vitro with different mycobacterial antigen preparations and responses were measured as incorporation of tritiated thymidine . Blood donors were 9 patients with lepromatous leprosy, 16 tuberculoid leprosy patients, and 6 healthy individuals with different degrees of exposure to leprosy . The results revealed a good correlation between the responses to M . leprae from human sources and bacilli from armadillos inoculated with human leprosy bacilli, although the latter were less potent stimulators . Responses to BCG and PPD did not correlate with lymphocyte responses to human M . leprae . Acid-fast bacilli grown on LA-3 medium inoculated with human leprosy bacilli stimulated responses which did not correlate with responses to human M . leprae when positive responses were compared, but showed a good correlation when inhibitory effects of the bacilli on thymidine incorporation were studied . The significance of the lymphocyte stimulation test for identification of microbes is discussed.

Int J Lepr Other Mycobact Dis, 1978 Jul-Dec, 46(3-4), 394 - 413
In vitro cultivation of leprosy bacilli in hyaluronic acid-based medium . 2 . Progress and developing concept of the role of hyaluronic acid suggested by culture and armadillo infection studies; Skinsnes OK et al.; Progress is summarized relating to the verification, identification of M . leprae and understanding of the process of adaptation the pathogen passes through before in vitro growth takes place . It is recognized that hyaluronic acid apparently does not serve as a source of energy but the possibility is presented that it plays a role in the reconstruction of M . leprae cell walls made "leaky" by constant intracellular life . This apparently occurs, in culture, initially by the development of coccoid forms which after a period of weeks finally give rise to acid-fast bacilli . If these understandings are correct and the bacillary cell walls are vitated by enzyme and other action occasioned by intra-macrophage existence, then cell wall antigenicity may also be vitiated or altered by intracellular parasitism and restored by in vitro cultivation . The possible importance of this hypothesis in the understanding of immunologic responses in leprosy, and in the possibilities for therapeutic use and vaccine development are discussed.

Appl Environ Microbiol, 1978 Jun, 35(6), 1128 - 35
Survival of bacillus licheniformis on human skin; Bibel DJ et al.; The colonization and survival of Bacillus species, members of the cutaneous microbial community of humans, were investigated by applying spores of Bacillus licheniformis to the forearms of volunteers . Four strains were tested, including the bacitracin producer ATCC 10716 and its bacitracin-negative mutant . Germination occurred within 24 h . Significant differences in survival population and duration were found among the test strains; however, ATCC 10716 and its mutant produced statistically similar survival curves . In general, an inoculum density of 10(4) colony-forming units per cm2 allowed survival for at least 2 weeks . Individual variation was extreme, for one subject harbored bacilli for over 2 months and another eliminated the microorganism within 3 days . Individuals could be differentiated into long-term (greater than 21 days) and short-term (less than 14 days) carriers . Eight of the 11 volunteers (73%) inoculated with ATCC 10716 carried it for 2 weeks, and 5 subjects (45%) continued to support the bacilli for 3 weeks . Spreading of the organism to other regions of the body occurred, but bacilli were not detected in these areas beyond 6 days.

Br J Surg, 1978 Jun, 65(6), 403 - 5
Abdominal tuberculosis in the 1970s: a continuing problem; Shukla HS et al.; Eight cases of abdominal tuberculosis (5 indigenous and 3 immigrants) treated in Cardiff in the 5-year period 1972-6 were studied to determine clinical presentation, errors in diagnosis and usefulness of investigations . The heterogeneous presentation is reflected in the 7 types of lesion seen in the 8 cases . Anorexia and weight loss were present in all cases and abdominal colic and post-prandial discomfort were common . No patient had diarrhoea, constipation or intestinal obstruction . The clinical diagnosis was wrong 7 out of 8 times . Investigations were unhelpful in the diagnosis and where a lesion was found on barium studies, a diagnosis of Crohn's disease or carcinoma was made . The same was true of the findings at laparotomy . The examinations most useful in the diagnosis were histopathological examination for caseation and demonstration of acid-fast bacilli by alcohol and acid-fast tissue stains, or by a culture technique . The need for a greater awareness of abdominal tuberculosis, not only in immigrants but also in the indigenous population of Britain, is apparent.

Zh Mikrobiol Epidemiol Immunobiol, 1978 Jun, (6), 103 - 6
{Immunohistochemical study of the accumulation of antibody-forming cells in the lungs following intrapulmonary and subcutaneous administration of apneumotropic antigen}; Shul'man-Satin BB et al.; Accumulation of the antibody-synthesizing cells in the lungs of guinea pigs in intratracheal and subcutaneous immunization was studied on a model of a complete typhoid bacilli antigen by means of Coons' method . Antibody-forming cells located in the interalveolar septi and in the peribronchial and perivascular connective tissue appeared with both method of the apneumotropic antigen administration . More of these cells accumulated in intrapulmonary application of the antigen . Repeated immunization by any method also led to the increase of their amount . The problem on the role played by the lungs in the immunogenesis is discussed.

Jpn J Med Sci Biol, 1978 Jun, 31(3), 249 - 62
Antimycobacterial activity of lecithin-cholesterol liposomes in the presence of phospholipase A2; Kondo E et al.; Tubercle bacilli were preincubated with lecithin-cholesterol liposomes to be subsequently exposed to phospholipase A2 . After further incubation in the environment of acidic buffer, viable units in the final mixture were enumerated by inoculating the serial dilutions of an aliquot onto Kirchner agar medium containing horse serum in 5% . Another aliquot was used for lipid analyses to confirm hydrolysis of lecithin . In addition to this bactericidal type of experiments, bacteriostatic tests were also conducted with Kirchner semi-solid agar medium, into which liposome-treated bacilli were inoculated with the enzyme at a time . Various natural and synthetic lecithins different in constituent fatty acids were employed . The results indicated that toxic fatty acids released from lecithin acted to kill the bacilli or to inhibit their growth.

J Infect Dis, 1978 May, 137(5), 550 - 5
Conditions for bacille Calmette-Guérin-induced resistance to infection with Schistosoma mansoni in mice; Civil RH et al.; Intravenous administration of a lyphilized preparation of bacille Calmette-Guerin (BCG-Tice) into mice significantly protected these animals from infection with Schistosoma mansoni . The protective effect depended on the dose of BCG and required the administration of at least 2 X 10(7) viable organisms . The route of administration of BCG was also crucial, as only intravenous inoculation produced significant protection . The BCG-induced resistance was found to last for eight weeks . Significant inflammation of the lungs was observed in mice receiving either viable or heat-killed BCG; however, protection followed only the administration of viable bacilli . Expression of BCG-induced protection was dependent on the presence of significant numbers of viable organisms and may have been associated with pulmonary inflammation at the time of passage of the schistosomula through the lungs.

South Med J, 1978 May, 71(5), 602 - 4
Tuberculous otitis media with complications; Cawthon T et al.; Tuberculous otitis media, although uncommon today, is still a differential diagnosis of suppurative otitis media . Our patient's otitis progressed from a draining ear with hearing loss to include facial nerve paralysis and meningitis . Several surgical procedures including radical mastoidectomy were insufficient to halt progression of the disease . After culture of acid-fast bacilli from the aural drainage and the cerebrospinal fluid, antituberculous chemotherapy was started and the patient responded well to treatment.

J Med Microbiol, 1978 May, 11(2), 165 - 76
The identification of pseudomonads and related bacteria in a clinical laboratory; King A et al.; Non-fermenting, catalase-positive Gram-negative bacilli that grow on nutrient agar are often isolated in clinical laboratories . We have applied biochemical techniques appropriate to a typical clinical microbiology laboratory, and for the most part described in Cowan and Steel's Manual for the identification of medical bacteria (Cowan, 1974), to 428 clinical isolates and have evolved a scheme for their identification . Organisms were subdivided into groups on the basis of three tests, namely the glucose oxidation-fermentation test and tests for oxidase activity and motility . A choice was then made among other tests to produce indentification tables, containing only the most useful tests, for the various groups . The most complicated table has only 16 tests . This simple system identified 96.5% of the 428 organisms, as well as many subsequent isolates of the more common organisms.

Infect Immun, 1978 May, 20(2), 430 - 8
Immune response to persistent mycobacterial infection in mice; Collins FM et al.; Mycobacterium marinum has been recommended as a possible model of M . leprae for use in laboratory studies of antileprosy immunity . M . marinum introduced into the footpads of normal mice underwent a steady decline in viability, with less than 1% survival after a 30-day period . Small numbers of viable bacilli were recovered from the footpads of these mice up to 12 months later . Similarly, mice infected with M . simiae exhibited bacterial populations that persisted for up to 18 months with little change in viability . Injection of M . simiae into the footpads was followed by an extensive redistribution of the organisms in the tissues . Eventally, bacterial counts for footpads and draining lymph nodes stabilized, with small numbers of bacilli still present in the footpads 18 months later . Persistent growth, with little sign of any immune response, was also observed in mice infected with several strains of M . avium, as well as with one strain of M . intracellulare . Other strains of M . intracellulare, as well as M . vaccae and M . nonchromogenicum, failed to establish persistent infections in normal mice, regardless of whether they were introduced by an intravenous or subcutaneous (footpad) route . The relevance of these findings is discussed in relation to antileprosy immunity in experimental animals and in humans.

J Natl Cancer Inst, 1978 May, 60(5), 1097 - 106
In vitro induction of cell-mediated immunity to murine leukemia cells . III . Effect of methanol extraction residue fraction of BCG on the generation of cytotoxic lymphocytes against leukemia; Kedar E et al.; Effects of the methanol extraction residue (MER) fraction of tubercle bacilli (BCG) on the generation of cytotoxic lymphoid cells were studied in vitro with the use of unidirectional mixed lymphocyte-tumor cell cultures . These cultures consisted of splenocytes of lymph node cells from normal donor C57BL/6, BALB/c, and strain A mice and mitomycin C-inactivated leukemia cells of both syngeneic and allogeneic origin . Addition of small amounts of MER (0.2-5 microgram/ml) to the cultures potentiated appreciably the elicitation of cytotoxic reactivity (as measured by the 51Cr-release assay) of the sensitized cells, whereas higher quantities (10-40 microgram/ml) had a strong suppressive effect . MER also induced some cytotoxic capacity in normal murine and human lymphoid cells not exposed to specific tumor cell stimulation . The stimulatory and suppressive effects were noted only when MER was present during the initial 24-48 hours of the 6-day culture . With the nylon wool fractionation technique, it was apparent that MER affected primarily the nonadherent cell population . MER could also prevent the generation of nonspecific suppressor cells by splenocytes maintained for 3-6 days in tissue culture.

Stain Technol, 1978 May, 53(3), 173 - 6
The staining of acid fast bacilli in sections of glycol methacrylate embedded tissues; Pandolph C et al.; Acid-fast bacilli can be stained in tissue embedded in glycol methacrylate . Modification of the Ziehl-Neelsen technique, along with changes in the formula of the plastic embedding medium, allow production of 1 to 2 micron sections which retain their integrity throughout the procedure, and within which the bacilli are clearly visible.

Ann Microbiol (Paris), 1978 May-Jun, 129(4), 415 - 24
{Polyol dehydrogenases in mycobacteria (author's transl)}; Andrejew A et al.; Contrary to the the tubercle bacilli (H37Ra, BCG), Mycobacterium phlei, grown on Sauton medium, formed the NAD+ dependent dehydrogenases that catalyse the oxidation of ribitol, sorbitol and mannitol . These enzymes were separated by chromatography on DEAE-cellulose and Sephadex G-200 . In the present work we have principally studied the ribitol dehydrogenase . All the experiments for induction of the ribitol dehydrogenase in H37Ra or BCG were negative; whereas after the adaptation of M . phlei to ribitol, the specific activity of this enzyme increased in the supernatants more than 100 per cent . The ribitol dehydrogenase of M . phlei reduced NAD+ not only in the presence of ribitol but also (though to a lesser extent) in the presence of erythritol and glycerol . Other properties studied concerning this enzyme and the reaction it catalyses were: pH dependence, equilibrium constant, Km and sensitivity towards the inhibitors of the thiol groups.

Zh Mikrobiol Epidemiol Immunobiol, 1978 May, (5), 43 - 6
{Method of culturing typhoid microorganisms with automatic regulation of glucose feed}; Savranskaia SIa et al.; A system of oxygen-glucose inverse relationship is not acceptable for cultivation of typhoid bacilli with a high reproductive rate and glucose utilization . The elaborated method of automatic glucose supply during typhoid bacilli cultivation permits to lead the process under the optimal conditions by pH and the residual glucose concentration.

Lepr India, 1978 Apr, 50(2), 196 - 203
A histopathological study of lymphnodes in 43 cases of leprosy; Gupta JC et al.; Eighty cases of leprosy including 60 cases of lepromatous type and 20 cases of tuberculoid type, during the period of 1974-75, have been examined for evidence of lymphnode enlargement . Of the 52 cases of enlarged lymphnodes, lymphnode biopsy was done in 43 cases including 38 cases of lepromatous type and 5 cases of tuberculoid type . The lymphnodes have been studied for evidence of any pathological changes and presence of acid-fast bacilli . In cases of lepromatous leprosy, lepromas and acid-fast facilli were seen in 92.2 per cent of the cases and patchy fibrosis was noted in 23.6 per cent of the cases . No amyloid could be demonstrated . In cases of tuberculoid leprosy, only non-specific reticular hyperplasia was noted . No specific granuloma or acid-fast bacilli could be demonstrated . The findings have been described in detail and discussed in the light of previous published data.

Lepr India, 1978 Apr, 50(2), 181 - 4
Bone-marrow in tuberculoid leprosy; Koranne RV et al.; Twenty-four untreated patients of proved tuberculoid leprosy and five healthy controls were investigated for the involvement of bone-marrow . The cytology was essentially normal and no acid-fast bacilli was seen in the bone-marrow smears.

J Wildl Dis, 1978 Apr, 14(2), 222 - 8
Lesions of tuberculosis in mountain whitefish (Prosopium williamsoni); Lund JE et al.; Lesions of tuberculosis in mountain whitefish (Prosopium williamsoni) were present in all visceral organs . The tubercles were composed of large rounded macrophages which contained numerous intracytoplasmic acid-fast bacilli . The lesions were not encapsulated and mineralization was not observed.

Int J Lepr Other Mycobact Dis, 1978 Apr-Jun, 46(2), 160 - 6
Electron microscopic observations of cell division in Mycobacterium leprae by means of serial ultrathin sectioning; Hirata T; The division of Mycobacterium leprae in human skin was studied in the ultrathin sections at the electron microscopic level . A few dividing bacilli were observed . The division seemed to be accomplished by inward extension ob both the cell wall and the cytoplasmic membrane into the cytoplasm of the bacillary cell to form a septum . The intracellular membranous organelle (mesosome) is assumed to play a role in division.

Lepr India, 1978 Apr, 50(2), 144 - 55
Growth of the ICRC bacilli in the foot-pad of mice; Bapat CV et al.; The ICRC bacilli are acid-fast bacilli cultivated from M . leprae isolates of lepromatous tissue . The ICRC bacilli from C-44 in the conditioned medium were subjected to foot-pad test, in both normal and T/900r mice . The bacilli exhibits a limited multiplication in normal mice while a continuous growth in T/900r mice . The maximum yield for normal and T/900r mice was 10(7) and 10(9)/foot-pad, respectively . The infiltration of voluntary muscle tissue as the main localization site was common for both normal and T/900r mice with evidence of dissemination in the latter . The spread of AFB to sciatic nerve, induction of liver granuloma and the foot-drop was observed only in T/900r mice . These experiments show that the growth of ICRC bacilli in mouse foot-pad is very similar to that of M . leprae confirming a test for identification.

Arch Dermatol, 1978 Apr, 114(4), 564 - 6
Papulonecrotic tuberculid secondary to Mycobacterium bovis; Iden DL et al.; A patient with papulonecrotic tuberculid had a pruritic papular eruption associated with constitutional symptoms . The eruption flared whenever the patient received low doses of prednisone to control symptoms of temporal arteritis . A cervical lymph node biopsy specimen demonstrated acid-fast bacilli, and Mycobacterium bovis grew on the cultures . The eruption cleared completely with antituberculous therapy . This case demonstrated the clinicopathologic findings compatible with a diagnosis of papulonecrotic tuberculid . Skepticism regarding the existence of papulonecrotic tuberculid is probably a result of the current decreased prevalence of untreated tuberculosis, and the subsequently increased rarity of this entity.

Health Lab Sci, 1978 Apr, 15(2), 95 - 103
An identification scheme for gram-negative nonfermentative bacilli; Burdash NM et al.; A series of six flow charts have been developed to identify the Gram-negative nonfermentative bacilli most commonly isolated from clinical specimens . Colonial morphology and oxidase reactivity determine the pathway to be followed on the flow chart which then indicates the specific test to be performed . Most isolates can be identified within 24 hours using 3 to 5 tests . Each pathway was selected on the basis of 94-100 per cent confidence limits otherwise an alternate pathway is shown . Results of 2,788 nonfermenters identified by this scheme are discussed.

Int J Lepr Other Mycobact Dis . 1978 Apr-Jun;46(2):167.
Two methods of demonstrating leprosy bacilli in smears; Harada K et al.; Two methods, the carbol fuchsin with acetic acid differentiation and the periodic acid-carbol pararosaniline, were used for demonstrating leprosy bacilli in skin smears . Bacillary smears from 200 long-treated patients with tuberculoid, borderline and lepromatous leprosy were stained with periodic acid-carbol pararosaniline . There were significantly greater BI and MI determinations than with classic carbol fucsin staining . With the former stain bacilli were found in 69 of 96 skin smears in which no bacilli could be seen by the latter stain . It is suggested that under the action of antileprosy drugs some leprosy bacilli may lose their acid-fastness and become chromophobic; chromophobic bacilli can be restored to their staining with periodic acid pretreatment . Leprosy bacilli in their chromophobic form can survive in healing and apparently healed lesions even after prolonged chemotherapy and can be a possible source of relapse.

S Afr Med J, 1978 Mar 18, 53(11), 396 - 99
Gentamicin-resistant gram-negative bacilli in hospital patients . Part II . In vitro aspects including susceptibility to tobramycin and amikacin; Block CS et al.; A study of 259 clinical isolates of gentamicin-resistant Gram-negative bacili (GRNB) has revealed 99,2% crossresistance with tobramycin and 6,9% with amikacin . Resistance to all 3 drugs is transferable in vitro . Simultaneous transfer of resistance to ampicillin, carbenicillin, cephalothin, tetracycline, chloramphenicol, sulphonamides, co-trimoxazole, streptomycin and kanamycin was shown to occur, emphasizing the potential for the selection of aminoglycoside-resistant organisms by the use of many other drugs . All GRNB studied were multiresistant . While amikacin should prove useful for those infections caused by GRNB which require treatment, care should be exercised in its use, to minimize the emergence of large-scale amikacin resistance.

S Afr Med J, 1978 Mar 18, 53(11), 391 - 5
Gentamicin-resistant gram-negative bacilli in hospital patients . Part I . Preliminary epidemiological assessment; Block CS; Gentamicin-resistant Gram-negative bacilli (GRNB) have been isolated from specimens received from 23 hospitals in and around Johannesburg . Most isolates are fermentative in nature . A pilot survey among inpatients at the Johannesburg Hospital revealed an intestinal carriage prevalence of 14,3% . A prospective study of intestinal acquisition showed that GRNB are acquired in hospital, and that colonization is associated with prior antibacterial therapy . Analysis of clinical specimens received from the Johannesburg Hospital from 1 July to 30 September 1976 has indicated that intensive care and urology units are worst affected . An assessment of the overall prevalence of GRNB in October 1976 revealed that 16,1% of all Gram-negative bacilli were resistant to gentamicin . Major contributing factors are the widespread use of systemic aminoglycoside antibiotics, and a high rate of cross-contamination . Measures aimed at minimizing these factors have been introduced by the Johannesburg Hospital administration.

Vet Pathol, 1978 Mar, 15(2), 196 - 207
Pathological evaluation of paratuberculosis in naturally infected cattle; Buergelt CD et al.; Thirty-two of 51 cattle infected with Mycobacterium paratuberculosis had chronic enteritis, chronic lymphangitis or mesenteric lymphadenopathy, or all three, at slaughter . Granulomatous inflammatory lesions were mild to advanced and predominantly involved the distal small intestine . Rectal involvement was seen only in five cattle . Fourteen had microgranulomas in the liver . There were three cytological forms of macrophages: histiocytic, polygonal and epithelioid . The latter two types had engulfed moderate numbers of acid-fast bacilli . The histiocytic macrophages usually were packed with acid-fast bacilli . Except in the liver and occasionally its nodes, remote lesions of paratuberculosis were not found in other organs . One animal had endocardial and aortic calcifications . Most cattle with signs of diarrhea had globule leukocytes in or around myenteric ganglion cells . The thymus of 3- to 8-year-old cattle with clinical signs frequently had mild to advanced involution . The thymus of similarly aged infected animals without clinical signs, and of paratuberculosis-negative animals, had not involuted.

Biol Bull Acad Sci USSR, 1978 Mar-Apr, 5(2), 246 - 7
Radiosensitivity of bacteriophages of aerobic spore-forming microorganisms; Polkhovskii VA; Under conditions of the direct action of radiation on seven original phages of aerobic spore-forming bacteria and four standard phages of E . coli, it was established that they possessed different sensitivity to gamma radiation and were distributed into four groups . The phages of E . coli of the T series, especially T2 phage, proved the most sensitive . The phages of aerobic spore-forming bacilli were characterized by greater resistance to the action of gamma radiation, which is evidently associated with the lower content of DNA of the phages of Bacillus in comparison with T phages.

No Shinkei Geka, 1978 Feb, 6(2), 153 - 9
{Combined treatment of intravenous immunoglobulin and antibiotics for severe postoperative meningitis (author's transl)}; Shimizu T et al.; Incidence of postoperative meningitis by gram-negative bacilli infection, so called "opportunistic infections", has recently increased in the neurosurgical field . The opportunistic infection is caused by suppression of the host's immunity and consequently limitation of the host defense mechanisms . Based on the results obtained from 4 cases of postoperative severe meningitis presented here, the authors concluded as follows: 1) Special care must be taken for intrathecal injection of antibiotics because of causing paralytic ileus, convulsion and paraparesis of the lower limbs . 2) The combined use of intravenous immunoglobulin (Gamma-Venin) and antibiotics produced potentiated effects . Accordingly, the amplification of the host's immunity is of major importance for the treatment of severe meningitis . 3) Using immunoadherence hemagglutination test of patient's CSF and the serum, it is considerably easier to determine whether or not to withdraw antibiotics.

Jpn J Exp Med, 1978 Feb, 48(1), 17 - 26
Pathogenicity of cultivated murine leprosy bacilli Hawaiian-Ogawa strain in mice . 1 . The pathogenicity of bacilli from rough colonies; Kawaguchi Y et al.; This paper deals with the pathogenicity of cultivated murine leprosy bacilli from rough colonies of Hawaiian-Ogawa strain in mice . This strain was isolated by Ogawa, in 1970, on Ogawa's 1% egg yolk medium {1}, from mice previously inoculated with Hawaiian strain of murine leprosy bacilli which has been maintained by passages from mice to mice . The pathogenicity of Hawaiian-Ogawa strain was found to belong to the same pattern as Hawaiian strain when the subcutaneous inoculation test was carried out in C57BL/6 and C3H mice, the former being representative of the benign type and the latter being representative of the malignant type . In KK mice of the intermediate type with Hawaiian bacilli, however, Hawaiian-Ogawa bacilli produced the lesions with malignant features in almost all the male mice, while the female mice were divided into two groups roughly half showing the intermediate or malignant type . In DDD mice of the benign type with Hawaiian bacilli, some cases of the male mice showed the malignant features, whereas almost all the female mice were of the benign type in the same experimental conditions . The pathogenicity of Hawaiian-Ogawa bacilli in mice did not revert into that of Hawaiian bacilli even after serial mouse passage . There are slight but definite differences in the mouse pathogenicity between Hawaiian-Ogawa and Hawaiian strains.

Ann Immunol (Paris), 1978 Feb-Mar, 129(2-3), 255 - 65
Enhancing effect of passive immunization with mycobacterial antibodies on humoral and cellular immunity in BCG-infected mice; Forget A et al.; The present paper is an attempt to get insight about the mechanisms involved in the enhancing phenomenon that occurs in bacterial infections . Mice infected with small doses of the BCG strain of M . bovis and treated with a M . tuberculosis H37Rv antiserum investigated at various intervals for their capacity to synthesize haemagglutinating antimyco-bacterial antibodies and to develop delayed hypersensitivity to PPD . As controls, BCG-infected mice were treated with the antiserum freed from its mycobacterial antibodies . It was found that the passive immunization of BCG-infected mice promotes the growth of bacilli in their spleen and induces a late formation of antimycobacterial antibodies which do not seem to be related to the development of delayed hypersensitivity.

J Clin Pathol, 1978 Feb, 31(2), 185 - 8
Staining clinical specimens for acid-fast bacilli by means of a mechanical conveyor system; Heimer GV et al.; A Cyto-Tek staining machine designed for Papanicolau staining of cervical smears has been adapted for auramine staining of smears of sputum and other clinical specimens for acid-fast bacilli . The results compared favourably with those obtained by a manual method of staining . Contamination of negative smears by acid-fast bacilli from positive smears was not found . Since this study the machine has continued to be in routine use with a considerable saving in labour.

Infect Immun, 1978 Feb, 19(2), 613 - 20
Granuloma formation by synthetic bacterial cell wall fragment: muramyl dipeptide; Emori K et al.; A synthetic muramyl dipeptide, N-acetylmuramyl-L-alanyl-D-isoglutamine, which possesses the same structure as that of a part of the peptidoglycan monomer of wax D of tubercle bacilli or bacterial cell walls was found to induce, when injected in water-in-oil emulsion, massive granulomas often accompanying abscesses in the site of injection and draining lymph nodes of guinea pigs and rats . The granulomas were composed mainly of epithelioid cells 2 weeks after injection and were indistinguishable from those induced by tubercle bacilli . The granulomas induced in rats were less mature than those induced in guinea pigs . Allergic reaction appeared to play no important role in the development of the muarmyl dipeptide-induced granuloma.

Exp Hematol, 1978 Feb, 6(2), 172 - 84
The contribution of intestinal endotoxin to mortality in hosts with compromised resistance: a review; Walker RI; Sepsis, particularly with endotoxin-containing Gram-negative bacilli, is a serious complication in hosts whose defenses are compromised . This review examines work from our laboratory and others concerning infectious processes which may be critical to the survival of compromised individuals . Several avenues for control of sepsis are proposed . Gram-negative bacteria and their endotoxins can escape from the intestines of compromised animals to contaminate normally sterile host tissues . Endotoxins are especially toxic to compromised hosts because essential components of their inflammatory responses are missing (i.e., leukocytes and platelets in irradiated animals) . Therefore, regulation of host responses to endotoxin is no longer possible . It is recommended that sepsis be controlled in compromised individuals through elimination of endogenous microbial agents . Should infection occur in these individuals, they should be transfused with blood cells necessary for clearance of bacteria and endotoxin and restoration of homeostasis.

Recent Results Cancer Res, 1978, 68, 387 - 92
Malignant melanoma (stage 1): a clinical trial of adjuvant BCG immunotherapy; Paterson AH et al.; A prospectively controlled randomized clinical trial of adjuvant BCG immunotherapy in patients with stage 1B malignant melanoma (Clark's level 3--5) is described . The combination of intradermal and oral BCG allows approximation of the bacilli to any microscopic foci of residual disease . The trial was activated in May 1975 and to date 107 patients have been admitted to the trial, 49 patients being randomil entered patients, there have been five relapses of 49 patients in the treatment group and ten relapses of 58 patients in the control group . This encouraging trend is not yet statsitically significant at the 5% level (P = 0.17) . If evaluable patients with Clark's level 3 and 4 lesions are assessed separately, there is a significant trend in favour of the immunotherapy group (P less than 0.05) with three relapses in the treatment group and ten relapses in the control group.

Ann Chir Gynaecol, 1978, 67(3), 109 - 11
Oestrogenic activity associated with ovarian cystadenomas after the menopause; Vesterinen E et al.; In a group of 59 patients over the age of 55 years with ovarian serous and mucinous cystadenomas, a total of 29 (49%) showed moderate or strong oestrogenic activity as determined by maturation index in vaginal cytologic smears, in contrast to nine (13%) of 70 control patients with other gynecological disorders than ovarian tumours . The bacterial flora was dominated by Doderlein type bacilli in 24 of the 27 test patients with an elevated maturation index, also reflecting the abnormal oestogenic activity in these patients . When the serous and mucinous cystadenoma groups were compared, a striking difference was found: of the 30 patients with mucinous cystadenomas, 23 (77%) displayed moderate of strong oestrogenic activity, while this was the case with only six (21%) of the 29 patients with serous cystadenomas . These findings stress the importance of an abnormal oestrogenic activity, revealed by an elevated cytologic maturation index, as memento for the possibility of post-menopausal ovarian cystadenoma.

Eur Urol, 1978, 4(4), 269 - 73
Treatment of renal tuberculosis . II . Microbiological study of 271 renal tuberculous cavities; Mallo N et al.; 271 renal cavities from 94 nephrectomies were studied with fluorescence stain and Lowenstein-Jensen medium cultures . The degree of the sterilization of the lesions is demonstrated by the existence of Koch's bacilli into the cavities . The latter have been classified in different development stages according to their contents and the histological aspect of the wall . The results of this study showed that a reduced healing time allows a better conservation of the parenchyma . The in vivo rifampicin + isoniazid + ethambutol association produces the best and quickest stabilization of the cavities.

Med Pediatr Oncol, 1978, 4(2), 149 - 57
Nonbacterial thrombotic endocarditis in cancer patients: comparison of characteristics of patients with and without concomitant disseminated intravascular coagulation; Bedikian A et al.; Thirty-one cases with malignant neoplasm and nonbacterial thrombotic endocarditis (NBTE) were studied . A threefold increase in the incidence of NBTE over the five-year period ending in 1976 was noticed . Seventy-one percent of patients with NBTE had concomitant disseminated intravascular coagulation (DIC) . Adenocarcinomas of the lung or ovary were the most common tumors (48%), followed by hematologic malignancies (25%) . Five patients had acute leukemia, two of whom had received bone marrow transplantation . Sudden changes in the status of cardiovascular and central nervous systems were the most common manifestations of NBTE and its complications . The possible predisposing factors included disseminated malignant neoplasms and infection with gram-negative bacilli . Identification of high-risk patients and early administration of preventive measures including anticoagulation might decrease the morbidity and mortality related to NBTE.

Zentralbl Chir, 1978, 103(6), 364 - 6
{Surgical hand disinfection with "Fesia cito" (author's transl)}; Richter J et al.; Furbringer's classical method of scrubbing has been compared with the procedure of embrocation of Fesia cito after Kanz . Concerning the reduction of bacilli both methods are equivalent.

Folia Microbiol (Praha), 1978, 23(2), 137 - 9
Degradation by Eco R1 endonuclease of DNA isolated from phages infecting Bacillus licheniformis and Bacillus thuringiensis; Tobek I et al.; DNA was isolated from lytic phages of two strains, Bacillus licheniformis, a producer of bacitracin, and Bacillus thuringiensis forming protein paracrystals with pronounced insecticidal effects . Its sensitivity to Eco R1 restriction endonuclease was determined . It was the aim of the work to find out whether these phages could serve as vectors in the transfer and possible amplification of genes of the two important industrial species of bacilli . Approximate values of the molecular weight of DNA of the two phages were determined after degradation of the phage DNA by Eco R1, followed by comparison of electrophoretic mobility of individual fragments with that of the Eco R1-degraded DNA of phage lambdab2.

Am Rev Respir Dis, 1978 Jan, 117(1), 39 - 45
A comparative study of tuberculous and other mycobacterial infections and their associations with malignancy; Ortbals DW et al.; We reviewed 162 cases of bacteriologically proved mycobacterial disease . Nontuberculous acid-fast bacilli were responsible for 27 per cent of the infections, a higher frequency than has previously been reported, and Mycobacterium kansasii and Mycobacterium avium-intracellulare were isolated with equal frequency . This indicates that Mycobacterium avium-intracellulare may be a significant agent of disease in the Midwest as well as the Southeast . There are no useful clinical, radiographic, or laboratory features to distinguish between tuberculous and other mycobacterial infections . Mycobacteria act as opportunistic pathogens in persons with malignant diseases . The attack rate was 607 of 100,000 persons verus 95 of 100,000 persons in our general hospital population . Mycobacterium tuberculosis and the nontuberculous mycobacteria were of equal virulence in this regard.

Arzneimittelforschung, 1978, 28(9), 1599 - 602
Chemotherapeutic effect of cefoxitin on experimental pyelonephritis in rats . Comparative study with cefazilin; Une T et al.; Ascending pyelonephritis was successfully produced in rats by means of direct inoculation with a virulent strain of Escherichia coli into the bladder enclosing a glass ball . 3-Carbamoyloxymethyl-7-alpha-methoxy-7-{2(2-thienyl)-acetamido}-3-cephem-4-carboxylic acid (cefoxitin) or cefazolin as a control drug was applied to the affected rats characterized by purulent inflammation in pelvis and medulla sometimes accompanied with abscess formation in medulla and/or coretex 3 days after challenge . The treatments were performed at an i.v . dose of 40 mg/kg 3 times a day for 5 consecutive days . The improvement of the disease, that is disappearance of the bacilli in the kidney, improvement of BUN value and of histopathological findings in cefoxitin-treated animals was approximately equal to that in cefazolin-treated ones . Both antibiotics exhibited great effectiveness against purulent pyelonephritis, however, not sufficiently effective against medullar and cortical abscesses . Chemotherapeutic effect of cefoxitin on experimental pyelonephritis was discussed with special reference to its distribution into the affected tissues.

Pathology, 1978 Jan, 10(1), 27 - 44
Relationship between lymphocyte emigration and vascular endothelium in chronic inflammation; Nightingale G et al.; Small blood vessels within areas of chronic inflammation which contain large numbers of lymphocytes develop unusually thick walls . Combined histological and electron microscope study shows that the thickening is due to hypertrophy of endothelial cells which come to resemble the endothelium of post-capillary venules in lymphoid tissue . Vessels of this type have been found in experimental granulomas induced by injection of Freund's adjuvant or killed tubercle bacilli and in human biopsy material from cases of rheumatoid arthritis and Hashimoto's disease of the thyroid . Comparison with the developing Peyer's patch in young rats shows that the unusual vessels in granulomas are very similar in endothelial cell size, pattern of distribution, extent of lymphocyte migration and degree of carbon leakage to post-capillary venules of the immature Peyer's patch . Study of the time at which lymphocytes appear in large numbers within the granuloma or developing Peyer's patch and the time at which thickened vessels are first seen suggest tha the endothelial changes are a consequence and not a cause of lymphocyte emigration . The stimulus to endothelial hyperthrophy appears to be massive sustained migration of lymphocytes, but the functional significance of this change in vascular structure is not clear.

Int J Lepr Other Mycobact Dis, 1978 Jan-Mar, 46(1), 42 - 6
Hepatic lesions in asymptomatic children of leprosy patients; Mittal MM et al.; Forty-two asymptomatic children of leprosy patients were studied for possible hepatic lesions . Hepatic lesions were observed in 47% while acid-fast bacilli in the liver were found in 9.5% . The most frequent lesions encountered included granuloma in 9.5%, focal areas of necrosis in 14%, portal triaditis in 17%, and Kupffer cell hyperplasia in 33% . Occasionally more than one lesion was observed in a biopsy . No correlation with the occurrence of the various hepatic lesions could be made with a history of BCG vaccination or results of skin tests done with tuberculin and lepromin.

Int J Lepr Other Mycobact Dis, 1978 Jan-Mar, 46(1), 1 - 8
Liver lesions in experimental lepromatoid leprosy of the armadillo . A histopathologic study; Job CK et al.; A retrospective study of liver lesions was made in 13 armadillos infected intracutaneously with 10(7) M . leprae from the same inoculum, to evaluate the pathogenesis of the experimental disease . Survival times ranged from 13 to 55 months . In seven armadillos the liver lesions were markedly less severe than in six of these animals . The extent of the lesions was unrelated to the duration of the infection and was interpreted as reflecting individual differences in resistance . In contrast to man, leprosy bacilli were found in the liver cells of both groups of armadillos but to a lesser extent in those of the more resistant armadillos . The latter also had no obvious changes in the liver tissue except for round cell infiltration and prominent Kupffer's cells which contained M . leprae . These lesions can be compared to indeterminate leprosy in humans . The lesions in the more susceptible (lepromatoid) armadillos were initiated in Kupffer's cells . Later, large collections of bacillated macrophages infiltrated the liver lobules . The liver cells heavily loaded with M . leprae developed a pale granular cytoplasm which became foamy in the late lesions . In three of the lepromatoid livers, lesions compatible with erythema nodosum leprosum were seen.

Arch Immunol Ther Exp (Warsz), 1978, 26(1-6), 595 - 601
Immune processes induced by dysentery bacilli in mice; Kowalewska D et al.; Studies on immune reactions induced by dysentery bacilli revealed that mice immunized orally or intravenously develop the specific general resistance against reinfection with the microorganisms . Antibodies circulating against bacilli were the indicators of humoral immune response and the activated T lymphocyte detected in the spleen of immunized mice were the indicators of the cell mediated immunity.

Scand J Infect Dis, 1978, 10(3), 203 - 7
The significance of serum-sensitive bacilli in gram-negative bacteremia; Elgefors B et al.; Clinical findings from 76 patients (median age 67 years) with gram-negative bacteremia were analysed and related to the sensitivity of the blood isolates to the bactericidal activity of normal human serum . 28 strains (37%) were resistant, an equal number intermediately sensitive and 20 markedly sensitive (26%) . No correlation was found between serum sensitivity and origin of the bacteremia, presence of fever or blood granulocyte count . The frequency of shock in immunocompromised patients with serum-resistant strains was 60% (6/10); in those with intermediately or markedly sensitive strains it was 44% (8/18) . In the non-immunocompromised patients with resistant strains the frequency of shock was 33 (6/18) versus 10% (3/30) in those without such strains . Thus the risk of developing shock with gram-negative bacteremia seems to depend on both parasite and host factors, although in this study only the latter were statistically significant . We conclude that serum-sensitive strains can invade the blood stream in spite of the serum bactericidal activity and cause severe disease in some patients.

Poumon Coeur, 1978, 34(2), 139 - 42
{Acute, lethal miliary tuberculosis due to Mycobacterium bovis}; de Labarthe B et al.; The authors report a case of lethal acute miliary with bovine tuberculous bacilli . They stress the main characteristics of this exceptional observation :--difficulties in isolating and identifying,--favourable disposition linked to age and to a depressed cellular immunity,--pathogenic interest in the mechanisms of late endogenous reinfestation and of suffocating acute evolution.

Hokkaido Igaku Zasshi, 1978, 53(2), 133 - 46
{Electron microscopic study on the focal immune response in the choroid (author's transl)}; Ariga K; Pigmented rabbits were sensitized by subcutaneous injection of BCG together with Freund's complete adjuvant and heat killed tubercle bacilli together with adjuvant . After the titer of serum antibody to BGG was elevated or tuberculin skin test became positive, choroiditis was induced in these eyes by an injection of BGG or PPD directly through the posterior sclera in the vicinity of the optic nerve . The eyes were enucleated at various intervals and the choroid was studied by light and electron microscopy . In the choroid challenged with BGG, infiltrates such as polymorphonuclear leukocytes and lymphocytes were seen, in early stages, invading in the posterior segment and peripheral area near the ciliary body . These cells decreased in number within a few days, and after one week a few plasma cells were detected in the posterior uvea . In the choroid challenged with PPD, infiltration of monocytes and lymphocytes was seen in early stages, reaching its peak in 48 hours . After 4 and 5 days lymphocytes decreased in number, but monocytes showed mitotic and phagocytotic activity, and accumulated near the sclera . After one week typical epithelioid cells were detected along the suprachoroidal space . These events were restricted within the choroid . The results obtained suggest, that in the focal immune reaction of the choroid, the cellular sequence of events and the range of tissue involved are different depending upon the kinds of antigen used . It may indicate humoral immunity on one side and cell-mediate immunity on the other.

Lepr India, 1978 Jan, 50(1), 38 - 44
Study of apparently uninvolved skin in leprosy as regards bacillary population at various sites; Kaur S et al.; Slit smears form 16 LL and 4 BL patients were taken from scalp, axilla, inguinal regions and apparently involved skin patch . The bacilli were found in 100% LL and 75% BL patients at all sites . Scalp showed AFB in all LL and 3 out of 4 BL cases . No lesions were seen on the scalp . Bacterial morphology showed no uniform pattern . Contrary to belief, no immune zones were found on the skin as judged by results of bacteriological examination . Our studies do not support the view that the leprosy bacillus has a predilection for sites with relatively low temperature as far as human leprosy is concerned.

Lepr India, 1978 Jan, 50(1), 26 - 37
Persistence and distribution of Mycobacterium leprae in Aedes aegypti and Culex fatigans experimentally fed on leprosy patients; Narayanan E et al.; Laboratory reared Aedes aegypti and Culex fatigans were experimentally fed on untreated lepromatous leprosy patients and the proboscides, guts and faeces of the mosquitoes were examiend at 12 hour intervals to determine the persistence and distribution of Mycobacterium leprae . In A . aegypti, bacilli persisted in proboscis till 156 hours, in gut 96 hours, and in faeces 72 hours after feeding . In C . fatigans--proboscides 144 hours, gut 96 hours and faeces 72 hours after feeding . In A . aegypti solid bacilli were present in proboscis upto 96 hours; in gut 48 hours and in faeces 42 hours after feeding . Corresponding figures for C . fatigans were: 144 hours for proboscis, 48 hours for gut, solid bacilli being absent in faeces . The results are discussed from the point of view of arthropod transmission.

Int J Lepr Other Mycobact Dis, 1978 Jan-Mar, 46(1), 30 - 4
Mycobacterium leprae found in epidermal cells by electron microscopy; Okada S et al.; Leprosy bacilli were found in a keratinocyte of the epidermis by the electron microscopic observation of the ultrathin section of a leproma . The possibility of discharge of leprosy bacilli from the skin should be considered even if the lepromatous patient does not have any ulceration.

Infect Immun, 1978 Jan, 19(1), 79 - 86
Elicitation of endotoxemic effects in C3H/HeJ mice with glucocorticoid antagonizing factor and partial characterization of the factor; Moore RN et al.; C3H/HeJ mice were used to study the origin and nature of endotoxin-induced glucocorticoid antagonizing factor (GAF) . In conventional mice GAF is believed to be responsible for a variety of effects that occur as a result of an injection of endotoxin, including the inhibition of hormonal induction of hepatic phosphoenolpyruvate carboxykinase and of glyconeogenesis . Responses in such animals are seen whether the endotoxin is extracted with phenol-water or with trichloroacetic acid . C3H/HeJ mice do not respond (or produce GAF?) after an intravenous injection of phenol-water lipopolysaccharide, but they react normally (produce GAF?) when given a trichloroacetic acid preparation . They also behave the same as conventional animals when injected with serum from poisoned normal mice, especially when the reticuloendothelial system of the donors has been activated by prior injections of Zymosan or heat-killed tubercle bacilli . The C3H/HeJ mice have been used, therefore, as assay animals to establish that peak levels of GAF appear in donor serum about 2 h after an injection of lipopolysaccharide, and it is produced intraperitoneally in C3H/HeJ mice given a mixture of endotoxin and peritoneal exudate cells derived from responder mice . GAF elutes from Sephadex G-200 along with markers of known molecular weight in the region of 100,000 to 200,000 . It is inactivated by trypsin and by heating at 75 degrees C for 1 h.

Am Rev Respir Dis, 1978 Jan, 117(1), 103 - 9
Immunization of mice after airborne infection with various strains of BCG; Lefford MJ; The growth of 6 strains of bacillus Calmette-Guerin (BCG) in the lungs of mice was compared after direct implantation into those organs . Bacilli of the Connaught, Pasteur, Phipps, and Tice strains multiplied appreciably in the lungs and disseminated into the spleen In contrast, BCG Birkhaug and Glaxo strains did not replicate in the lungs or spread to the spleen . The immunizing ability of 3 of these strains was examined in more detail . Aerosol infection with BCG Glaxo, Pasteur, or Phipps strains produced resistance to subsequent pulmonary challenge with Mycobacterium tuberculosis RIRv . Such immunity was significantly greater in mice immunized with the Pasteur and Phipps strains and was not attributable to nonspecific resistance . Spleen cells from mice immunized with these 3 strains of BCG conferred similar degrees of immunity to intravenous challenge with M . tuberculosis on syngenic recipients . It was concluded that growth of BCG in the lungs influenced the degree of local immunity but not the degree of systemic immunity.

Isr J Med Sci, 1978 Jan, 14(1), 51 - 9
Effects of prophylactic treatment with the methanol extraction residue fraction of tubercle bacilli (MER) on the development of Rous sarcomas of chickens following challenge with the Rous sarcoma virus; Markson Y et al.; Three-month-old chickens were treated with the methanol extraction residue fraction of tubercle bacilli (MER) under different conditions, and subsequently challenged with living Rous sarcoma virus . The birds developed progressively growing sarcomas following viral challenge . A substantial proportion of the hosts which had been pretreated with MER under optimal circumstances (38 to 58%) showed complete and long-lasting regression of the neoplasms, and the survival of many of the animals that did succumb to progressively growing tumors was prolonged . An absolute condition for prophylactic efficacy of MER treatment in this model system was injection of the agent into the same body area (wing) into which subsequent viral challenge was introduced . The quantity of MER employed and the timing of the prophylactic administration were also decisive variables.

Arch Inst Pasteur Alger, 1978-79, 53, 291 - 8
{Critical analysis of practical sensitivity tests in the evaluation of the primary resistance rate of tuberculosis bacilli to antibiotics}; Boulahbal F et al.; Tuberculosis bacilli strains isolated from patients with pulmonary tuberculosis were tested to antituberculosis drugs in our laboratory since 1967 with the same method and by the same staff . However, there was a great fluctuation in the primary resistance rates calculated from one year to another and from one area to another . The analysis of strain sample showed that the main reasons were : the unprecision of patients questionnary, the preselection of strains sent to the laboratory and the unrespect of sanitary sectorisation.

Microbios, 1978, 22(89-90), 143 - 53
Mycobacterium leprae and phenoloxidase activity; Kim SJ et al.; Our earlier studies indicated that the enzyme o-diphenoloxidase was absent in Mycobacterium leprae separated from depromatous human tissues . At that time the bacilli were not available from any other source . The existence or absence of this enzyme in M . leprae recovered from infected armadillo tissues were reinvestigated . The intact cells which were metabolically active, failed to oxidize DOPA . Likewise, DOPA and its derivatives were not oxidized by the enzymatically active cell-free preparations from M . leprae . Upon incubation of DOPA for more than 2 h with whole cell suspensions or particulate fractions, there was no development of colour with an absorption maximum of 540 nm as has been reported for an intermediate of DOPA oxidation . However, DOPA and several phenolic compounds were very actively oxidized by mushroom tyrosinase . The results suggested that M . leprae is deficient in o-diphenoloxidase, and this enzyme is not an intrinsic characteristic of this mycobacterium.

Microbios, 1978, 22(87), 27 - 34
Lysosomal enzymes and microbicidal capacity of activated macrophage; Chandrasekhar S; A relation was sought between acid phosphatase contents and the presence of tubercle bacilli inside the peritoneal exudate cells (PEC) of normal guinea pigs and those immunized with BCG . This was done to investigate the role lysosomal enzymes play in the microbicidal capacity of the cell . In both normal and immune animals tubercle bacilli were present only in those PEC that contained acid phosphatase . Cells without acid phosphatase did not contain bacilli . Thus, only activated cells ingested bacilli . Under the conditions of these experiments, macrophage activation, as indicated by the presence of acid phosphatase, was not related to the immune status of the animal . Similarly, stimulation by ingestion of tubercle bacilli was not significant . Also, the number of acid phosphatase grains/cell did not influence the number of bacilli/cell . Thus, the acid phosphatase content of the cell did not correlate with the number of bacilli inside the cell . It was concluded that acid phosphatase may not be one of the factors that contribute to the microbicidal capacity of the cell.

Acta Microbiol Pol, 1978, 27(3), 277 - 85
Studies on the morphology of colonies of bacilli of BCG-Poland substrain . II . Dissociation of BCG-Poland substrain on Löwenstein-Jensen egg medium; Lipinska R et al.; The dissociation of colonies of the substrain BCG-Poland on Lowenstein-Jensen medium has been studied . It had been stated previously (Lipinska and Rzucidlo, 1974) that BCG-Poland substrain undergoes a process of dissociation which manifests itself in the appearance of smooth colonies alongside typical rough colonies . Attempts have been made to obtain pure culture of both colony types . Pure cultures composed of smooth or rough colonies respectively were obtained . The morphology and diameter of the smooth colonies depended on the size of the seed inoculum spread on the medium.

Acta Microbiol Pol, 1978, 27(3), 267 - 76
Studies on the morphology of colonies of bacilli of BCG-Poland substrain . I . The influence of iron on the type of BCG-Poland colonies; Lipinska R et al.; The influence of iron concentration in Sauton's medium solidified with agar on the type of colonies of BCG-Poland substrains, BCG-Rio de Janeiro, BCG-France, BCG-Denmark and BCG-Japan substrains has been examined . Of all the studied BCG substrains only the BCG-Poland substrain formed rough (R) and smooth (S) colonies . In the investigated substrains rough colonies became smaller with the decrease of iron concentration but they retained their characteristic surface roughness . The smooth colonies which in the same conditions appeared only in BCG-Poland substrain did not display such dependency on iron concentration . When the incubation period was prolonged secondary rough colonies appeared among the smooth ones, regardless of the iron concentration in the medium.

Am Rev Respir Dis, 1977 Dec, 116(6), 1101 - 7
Megaesophagus and pneumonia associated with Mycobacterium chelonei . A case report and a literature review; Burke DS et al.; The case of a 37-year-old woman who developed a subacute, bilateral, noncavitary pneumonia 5 years after a colon interposition esophagoplasty is presented . Mycobacterium chelonei, subspecies abscessus, was assigned a pathogenic role based on the findings of (1) a clinical and roentgenographic picture consistent with tuberculosis, (2) sputum smears showing acid-fast bacilli, (3) repeated sputum cultures yielding heavy growths of Mycobacterium chelonei, subspecies abscessus, and (4) a 12-mm by 12 mm-skin test response to homologous antigen (purified protein derivative-CL) with no response to an equivalent dose of purified protein derivative-S . The patient recovered fully without significant antituberculous chemotherapy . A survey of the literature revealed 11 similar case reports featuring a documented association between megaesophagus and pulmonary infection with rapidly growing mycobacteria.

Am Rev Respir Dis, 1977 Dec, 116(6), 1057 - 64
Sources of Mycobacterium avium complex infection resulting in human diseases; Meissner G et al.; Human disease caused by organisms in the Mycobacterium avium complex occur virtually worldwide . A 20-year ongoing study conducted in Western Germany has been analyzed to elucidate the ecologic and epidemiologic characteristics of these infections in man . Organisms included in this investigation have been cultured from man, from domestic and wild animals and fowl, and from a variety of environmental sources . In addition to the usual taxonomic studies of these bacilli, infrasubspecific typing by seroagglutination has enabled identification of 3 distinct serogroups: the classical Mycobacterium avium strains (serovars avium 1, 2, and 3), the intermediate group (avium serovars 4, 5, 6, 8, 9, 10, and 11), and the less frequently encountered organisms, the 11 remaining avium serovars (7 and 12 through 21) . Analysis of the number of strains in each of the 3 serogroups, derived, respectively, from man, from animals, and from the environment, has enabled us to draw some conclusions regarding reservoirs and sources of human infection with these agents.

Br J Dermatol, 1977 Dec, 97(6), 689 - 92
The successful treatment of tropical fish tank granuloma (Mycobacterium marinum) with co-trimoxazole; Black MM et al.; Three cases of tropical fish tank granuloma caused by Mycobacterium marinum (balnei) are described . Abundant acid fact bacilli were demonstrated in homogenates prepared from the fish thus providing early confirmation of the suspected clinical diagnosis: acid fast bacilli could not be demonstrated in biopsy material from the patients' lesions through M . marinum grew on culture . The infection responded to oral co-trimoxazole.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Dec, (12), 88 - 91
{Disruption of the mechanisms of natural immunity in the initial stage of adjuvant disease in rats and guinea pigs}; Davydova TV et al.; Similar changes in the nonspecific immunity indices were noted in experiments on rats and guinea pigs with adjuvant disease: depression of blood serum bactericidal activity and increase of the lysozyme and complement level, as well as inhibition of the phagocytic activity of leukocytes and production of normal antibodies to O- and Vi-antigens of typhoid bacilli in rats . Changes in disturbances of natural immunity factors in adjuvant disease correlated with the severity of the process in both animal species.

Arch Ophthalmol, 1977 Dec, 95(12), 2190 - 2
False-positive results with the radioactive phosphorus test; Shammas HF et al.; A chorioretinal granuloma that contained acid-fast bacilli and a choriodal nevus that consisted of benign nevus cells yielded false-positive radioactive phosphorus tests . The beta emission exceeded that of the control areas by more than 100% in each case . The granuloma had infiltrated the sclera, permitting inflammatory tissue to be in closer proximity to the counting probe than was the normal choroid . The reason for the increased metabolic activity of the nevus cells remains unexplained.

Jpn J Exp Med, 1977 Dec, 47(6), 467 - 74
Septicemic infection in nude mice caused by a virulent strain of Mycobacterium bovis; Ueda K et al.; Following i.v . infection with 2.3 to 2 X 10(6) viable organisms of Mycobacterium bovis strain Ravenel, congentitally athymic nude (nu/nu) mice of BALB/c background died earlier than their heterozygous (nu/+) counterparts, showing necrotic nodules in the heart and kidney with the involvement of liver and spleen . Pulmonary lesions in nu/nu mice, however, were less severe than those of dead nu/+ mice . In the reticuloendothelial organs of nu/nu mice, macrophages loaded numerous acid fast bacilli were transiently proliferated and later, necrotic-exudative lesions were produced without epithelioid granuloma formation, while necrotic lesions appeared at very early stage of infection in the other organs as well as adipose tissues . After thymocyte-reconstitution nu/nu mice were capable of developing epithelioid granulomas as seen in nu/+ mice, though having more numerous bacilli in granulomas than those of nu/+.

Infect Immun, 1977 Dec, 18(3), 654 - 9
Induction of cell-mediated immunity to Mycobacterium lepraemurium in susceptible mice; Lefford MJ et al.; A mouse strain (CB6) that is highly susceptible to Mycobacterium lepraemurium was infected with 10(8) bacilli into the hind footpad . These mice developed cell-mediated immunity to M . lepraemurium, as expressed by the development of a granulomatous lesion at the site of inoculation in normal but not in T-lymphocyte-depleted mice, a proliferative response in the paracortical zone of the draining lymph node, delayed-type hypersensitivity to a sonic extract of M . lepraemurium, and immunopotentiation of the delayed hypersensitivity response to sheep erythrocytes . Resistance to a second challenge infection with M . lepraemurium was not demonstrated.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Dec, (12), 101 - 8
{Use of serologic reactions for determining the concentration of the determinants of an antigen and its valence}; Levi MI et al.; By the serological tests with the erythrocytic diagnostic agents it is possible to estimate the concentration of the determinants in the antigenic preparation under study . For this purpose it is necessary to have at one's disposal the data on the molecular weight and concentration of the reference antigen, valence of erythrocytes loaded with the antigen or antibodies, and antibody heterogeneity index . If these values are known, then one can calculate the concentration of antigenic determinants in terms divided by the valence of the reference antigen . With the aid of pure antibodies preparation obtained with the immunosorption procedure it is possible to measure the determinant concentration of the antigen tested and the valence of the reference antigen . For the capsular antigen of plaque bacilli the valence was estimated by two independent methods and in both cases it was close to 10 . The valence of the reference capsular antigen permits to calculate the concentration of the antibody molecules in the hyperimmune sera without isolation of pure antibodies.

Mayo Clin Proc, 1977 Nov, 52(11), 694 - 700
Antituberculosis agents: isoniazid, rifampin, streptomycin, ethambutol; Van Scoy RE; Effective antituberculosis drugs have radically improved the prognosis of the patient with active tuberculosis . Surgical therapy is rarely needed, and sanatoria have largely vanished . Initially, triple-drug therapy is indicated in cavitary pulmonary disease and severe renal disease and it is generally used in miliary tuberculosis and meningitis . Use of one of the three drugs may be discontinued after there is evidence that the bacillary population has been decreased . Two-drug therapy is indicated for other active disease . Isoniazid alone is adequate for prophylaxis . The major cause of therapeutic failure is failure of the patient to take the antituberculosis medication regularly . The second major cause of treatment failure is resistance of tubercle bacilli to the antimicrobials used . When treatment failure is apparent, careful reassessment by experienced physicians is indicated . A single drug should never be added to a failing regimen.

Chest, 1977 Nov, 72(5), 601 - 4
Death-producing hemoptysis in tuberculosis; Middleton JR et al.; Massive hemoptysis in patients with tuberculosis is reported infrequently and then virtually always in association with cavitary disease or aspergilloma . In contrast, we describe herein five cases characterized by hemoptysis on admission, bilateral pulmonary disease, samples of sputum positive for acid-fast bacilli by Ziehl-Neelsen stain, and no obvious cavitary disease . In each, hemoptysis subsided and then suddenly recurred in prodigious amounts, leading to death, probably from asyphyxiation . In patients hospitalized with tuberculous hemoptysis of any amount, with or without an obvious cavity, aggressive diagnostic evaluation, including bronchoscopic examination, may define the site of bleeding, thus permitting rapid surgical intervention if the hemoptysis increases.

J Natl Cancer Inst, 1977 Nov, 59(5), 1527 - 35
Mycobacterium bovis (BCG) infection of the lymph nodes of normal, immune, and cortisone-treated guinea pigs; Collins FM et al.; Strain-2 inbred guinea pigs were infected intradermally with 10(5)-10(7) viable BCG (Pasteur) organisms by means of multiple scarifications of shaven midflank skin . The spread of the BCG to the draining lymph nodes and on to the spleen was followed quantitatively for 28 days . The population of bacilli at the inoculation site increased as much as tenfold the first 14 days . The number of viable BCG organisms recovered from the primary draining superficial dorsal axillary and inguinal lymph nodes varied from 0.1 to 1.0% of the inoculum, with a further tenfold to 100-fold drop in counts for the secondary subclavian and lumbar lymph nodes . The bacterial counts for the various nodes increased substantially the first 14 days . By 28 days, as many as 1,000 viable bacilli were recovered from the spleen . Increasing the inoculum size or the number of inoculation sites increased the primary node counts and promoted a more extensive and rapid spread by the BCG population to the secondary lymph nodes and spleen . Prior vaccination of the host with living BCG decreased the spread of the BCG inoculum from the scarification site to the various draining lymph nodes . Multiple injections of cortisone tended to reverse this effect.

Antibiotiki, 1977 Nov, 22(11), 1015 - 7
{Sensitivity of Sherman's propionic acid bacilli to antibacterial preparations and vitamin B12 synthesis}; Sidorchuk II; Sherman propionic acid bacilli were sensitive to benzylpenicillin, ampicillin, ceporin, tetracyclines, oleandomycin, oletetrin, tetraolean, sigmamycin, levomycetin and furadonine . Methicillin, oxacillin, monomycin, kanamycin, polymyxin and furazolidone had an insignificant effect on the above organism . The subbacteriostatic concentrations of methicillin, oxacillin, streptomycin, monomycin, kanamycin, neomycin, tetraolean, sigmamycin, polymyxin M and ristomycin increased the biosynthesis of vitamin B12 by Sherman propionic acid bacilli, while benzylpenicillin, ampicillin, tetracyclines, oleandomycin, oletetrin, levomycetin and furadonine in the subbacteriostatic concentrations inhibited this process.

Parazitologiia, 1977 Nov-Dec, 11(6), 474 - 9
{Effect of the digestive process on the survival of the plague agent in Xenopsylla gerbilli Minax fleas}; Vashchenok VS et al.; Hystological investigations of experimentally infected X . gerbilli minax have shown that at the early stages of the digestion, while in the intestine compact clots of non-digested blood, are preserved, proceeds the reproduction of the plague agent . With the decay of the alimentary clot it changes into the dying off of the microbe population and after the ceasing of digestion the accumulation of bacteria renews again . Simultaneously with the changes in the number of microbes their morphology varies . At the initial stage of blood digestion bacilli typical for the agent are dominant . With the decay of the alimentary clot they are replaced by ovoid and spheroid forms . After the ceasing of the digestion cycle the microbe mass is represented by small coccobacteria . During the decrease in the plague agent abundance bacteria are absent mostly often from the midgut and posterior parts of the alimentary canal . Most favourable conditions for their preservation exist in this period in the proventriculus and in adjoining to it oesophagus part.

Can Med Assoc J, 1977 Oct 22, 117(8), 912 - 4
Infection of the skin by Mycobacterium marinum: report of five cases; Brown J et al.; Five patients 6 to 47 years of age had bacteriologically confirmed Mycobacterium marinum infections of the skin . In four patients the initial lesions were chancriform and were on a finger or a hand; ascending lymphadenitis followed . The other patient had nodular inflammatory lesions on one cheek . Biopsies were performed in four patients; all specimens showed a granuloma, and acid-fast bacilli were identified in one of the four . Four of the five patients were untreated; the fifth was given antituberculous drugs . In all five patients the condition was chronic, with progressive resolution of the lesions during follow-up periods of 1 to 6 years . M . marinum infections of the skin are rare in Canada . This may be due in part of lack of clinical awareness or failure to identify the organism . Biopsy specimens should be obtained under sterile conditions and nondigested material should be inoculated into the footpads of mice.

Eur J Biochem, 1977 Oct 17, 80(1), 153 - 63
Structure of the cell wall of Bacillus species C.I.P . 76-111; Leduc M et al.; An unusual type of bacterial cell wall was encountered in a Bacillus strain referred to as Bacillus sp . C.I.P . 76-111 . The major constituent of this cell wall is a high-molecular-weight anionic protein non-covalently associated to a peptidoglycan-polysaccharide complex . The cell wall appeared as a multilayered structure when sections of whole cells or of isolated cell walls fixed with glutaraldehyde and postfixed with osmium tetroxide were examined by electron microscopy . The correlation between the observed morphological features and the biochemical data suggested that a thin central electron-dense layer identifiable with the peptidoglycan-polysaccharide complex is located between two similar thick layers of protein . Furthermore, negative staining of isolated cell walls revealed that the outer protein layer has a regular surface array of subunits with hexagonal symmetry . Several structural properties of the cell wall peptidoglycan were investigated and were found to resemble those of other bacilli . Further characterization of the autolytic system showed that an N-acetylmuramyl-L-alanine amidase and a glycosidase, presumably a N-acetylmuramidase, were associated with the peptidoglycan-polysaccharide complex . It was also established that this strain is devoid of membrane teichoic acid.

S Afr Med J, 1977 Oct 15, 52(17), 680 - 3
Disseminated tuberculosis, bone marrow necrosis and lymphoma: a case report; Staples WG et al.; Tuberculosis often complicates lymphoma, and bone marrow necrosis has been described in disseminated tuberculosis . However, the association of lymphoma, disseminated tuberculosis and bone marrow necrosis is rare . We report a patient with this triple association . After a 3-week influenza-like illness the patient was admitted to hospital semicomatose with pancytopenia and hyponatraemia . During routine examination a bone marrow trephine biopsy revealed diffuse lymphomatous infiltration with scattered necrotic foci . On Ziehl-Neelsen staining these foci exhibited numerous acid-fast bacilli . The patient subsequently died and at autopsy was found to have widely disseminated non-reactive tuberculosis.

Zentralbl Bakteriol {Orig A}, 1977 Oct, 239(2), 270 - 4
In vitro and in vivo studies on the role of dimethylsulfoxide (DMSO) in resensibilization of bacterial strains resistant to antibiotics and chemotherapeutic agents; Szydlowska T; Resensibilization in vitro to seven antibiotics under the influence of DMSO was studied in 624 resistant strains of five species of bacteria (E . coli, S . typhi, S . pyogenes, S . viridans, S . aureus), 61 strains of tubercle bacilli resistant to isonicotinic acid hydrazide (INH) and 19 strains of tubercle bacilli resistant to rifampicin (RMP) . DMSO in concentrations of 0.1-10.0% caused reversion of sensitivity in strains of E . coli, S . pyogenes and S . viridans . Reversion in vivo of sensitivity to INH of tubercle bacilli was studied in experimental tuberculosis of guinea pigs . Tubercle bacilli previously resistant to INH recovered complete sensitivity to the drug, enabling animals infected with the INH-resistant strain of bacilli to be treated with INH.

Tohoku J Exp Med, 1977 Oct, 123(2), 191 - 6
Evaluation of surgical treatments for the major lesion of bilateral silicotuberculosis; Sadakata S et al.; The present communication deals with the follow-up study of 24 patients with bilateral silicotuberculosis in whom only unilateral operation was carried out for major lesions . The operative procedure consisted of pulmonary resection, thoracoplasty or combined operation such as cavernostomy, intracavitary filling of a pedunculated muscle flap and thoracoplasty . The follow-up period ranged 1 year to 12 years and 5 months . The results of surgical treatment for unilateral major lesions and their effect on the contralateral minor lesions were clinically assessed by alterations in the chest x-ray findings and tubercle bacilli in sputum . In 16 of 24 patients (67%) alleviation was obtained, whereas no change occurred in 3 (13%) and aggravation in 5 (21%) . The surgical treatment for unilateral major lesion brought about 41% of improvement in the contralateral minor lesions . Contralateral minor lesions remained unchanged in 46% of patients and aggravated in 14% . This shows a value of the surgical threatment for bilateral silicotuberculosis . It should be emphasized that surgical treatments more aggressive than have been heretofore practiced can be employed.

Anesthesiology, 1977 Oct, 47(4), 353 - 8
The anesthesia machine and circle system are not likely to be sources of bacterial contamination; du Moulin GC et al.; Patients who had upper respiratory tract gram-negative bacillary colonization and noncolonized patients were followed through surgical procedures to determine what bacterial organisms would be deposited in anesthesia apparatus . Anesthesia machines were cultured for bacteria in many locations before and after each surgical procedure . Six machines in routine operating room use were studied after use on six colonized patients and nine uncolonized patients . Sixteen corrugated tubes from unopened packages served as controls . The results indicated that the machines remained free of bacteria of patient origin . Levels of contamination were only slightly higher in the expiratory tubing, and the bacterial species most commonly recovered were environmental in origin . Even after periods of anesthetic administration as long as six hours in patients heavily colonized with gram-negative bacilli, contamination of the anesthesia apparatus with the colonizing organisms did not occur . Intentional contamination of a sterilized anesthesia machine with two gram-negative organisms confirmed the clinical observations . Analysis of oxygen and nitrous oxide gas sources for bacteria had negative results . Basic hygienic management of anesthesia machines will ensure safety from the standpoint of cross-infection.

Lepr India, 1977 Oct, 49(4), 467 - 71
Electromicroscopic study of histoid leprosy with special reference to its histogenesis; Job CK et al.; Biopsies from 2 patients clinically diagnosed and confirmed by histopathological studies as histoid leprosy were examined using and electronmicroscope . The cells that form the nodule are found to contain far more solid bacilli and much less electron transparent substance than those in lepromatous lesions . They have the characteristics of both macrophages and fibroblasts . It is reasonable to conclude that they are histiocytes produced by local multiplication in response to stimulation by rapidly proliferating M . leprae rather than from accumulation of blood monocytes at the site of inflammation as lepromatous lesions.

Acta Pathol Microbiol Scand {B}, 1977 Oct, 85B(5), 329 - 33
Infection of Clethrionomys G . glareolus Schreb . (red mice) with Mycobacterium tuberculosis and Mycobacterium bovis injected subcutaneously; Jespersen A; Groups of red mice were injected with doses from 10 mg to 10(-8) mg semidried culture of a strain of M . tuberculosis and with doses from 10(-1) to 10(-8) mg of a strain of M . bovis . Some animals were killed about 1 1/2 and 3 months after injection and the remainder lived until death occurred spontaneously . The number of tubercle bacilli in the organs was evaluated by microscopy of smears, in some cases by quantitative culture . Among the mice injected with M . tuberculosis in doses of up to about 2 million viable units, not one case of death occurred which could be attributed to tuberculosis . The autopsy findings consisted exclusively of lesions at the site of injection and in the regional lymph glands . Quantitative culture showed growth of a few viable units in the lymph glands, spleen or lungs, but no sign of progressive infection . Out of 10 mice injected with a giant dose of 3 X 10(7) viable units, only two died of tuberculosis . M . bovis provoked fatal tuberculosis in all animals injected with doses from 6.9 million to 7 viable units . Severe caseous lesions developed at the site of injection, in the lymph glands, in the lung, and often also in liver and spleen . The number of bacteria in the organs was enormous, particulary in the spontaneously dead animals . The survival times, which were dependent on dosage, varied from 51 to 159 days.

Lepr India, 1977 Oct, 49(4), 510 - 5
Tissue lipids in leprosy; Verma KC et al.; A total of 30 cases of leprosy (15 lepromatous and 15 tuberculoid) were studied by histochemical procedures for lipids in the morbid skin . The possible origin and relation of lipids to the presence of lepra bacilli in the lepra cells is discussed.

Lepr India, 1977 Oct, 49(4), 472 - 84
Comparative study of skin reactions in leprosy patients to M . leprae-lepromin and to ICRC-in, an antigen from cultivable acid-fast bacilli from M . leprae isolated from lepromatous nodules; Bapat CV et al.; Skin test antigens (Dharmendra type) were prepared from fresh M . leprae (lepromin) and from a culture of strain C-44 ICRC bacilli (ICRCin) grown 'in vitro' from M . leprae isolate from lepromatous nodules . Comparative study of skin reactivity to lepromin and ICRCin--both "early" and "late" reactions in 76 leprosy patients was conducted . In 29 lepromatous (LL) cases, 25 exhibited totally negative reaction at the end of third week . In tuberculoid (TT) 22 and 23 out of 31 were positive (greater than 4.5 mm) at 3 weeks to lepromin and ICRCin respectively . In the 16 BB group, the reactions were comparable in the same patient . The cellular reaction in tuberculoid cases consisted of lymphocytic infiltration, epitheloid giant cells and Langhan type cells and indistinguishable from each other . These data with characteristic total lack of reaction in 25/29 lepromatous leprosy cases and identical cellular reaction in TT patients, provide strong evidence that ICRC bacillus strain C-44 is antigenically identical with M . leprae.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1977 Oct-Dec, 26(4), 249 - 52
{Evaluation of the epidemiological potential of patients eliminating Koch bacilli demonstrable by direct microscopic examination}; Deutsch M et al.; A retrospective epidemiological study was carried out on the patients in evidence since 1972-1973, following up the contacts from that time . From the data obtained it results that the proportion of contacts who contracted the disease was of 1.06% of the subjects coming in contact with cases negative at the direct microscopic examination and in cultures, 1.1% of the subjects in contact with cases negative at the direct examination but positive in cultures, and 3.9% (four times greater proportion) of the subjects in contact with bacilli eliminators, at the direct examination . The authors emphasize the simplicity and greater output of the microscopic examinations in tuberculosis.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1977 Oct-Dec, 26(4), 193 - 205
{Intermittent chemotherapy from the beginning or only after a period of daily administration? Quantitative bacteriological study at the initial phase of chemotherapy with INH + RMP + EMB in daily or intermittent administration}; Histochemistry of B663 pigmentation: ceroid-like pigmentation in macrophages; Histochemical studies were made of pigmented cutaneous lesions from three cases of lepromatous leprosy treated with B663 to determine the nature and histogenesis of the brown pigmentation which develops as a side effect of the drug . One case of DDS-treated leprosy and four cases of untreated leprosy were also investigated histochemically as controls . The brown pigmentation of the skin is due to deposition of a ceroid-like substance in the macrophages, which is a yellowish-brown, acid-fast lipid pigment . It is insoluble in fat solvents and accepts lipid dyes even after lipid extraction by fat solvents . The macrophages in the B663-treated leprosy contain more neutral fat and less phospholipid than the untreated lepromatous leprosy tissues . Ceroid in the macrophages probably originated from unsaturated fatty acids of the leprosy bacilli through oxidation or their binding with the drug . Crystals of the drug were not found in the macrophages in this series, even on the tissues embedded in carbowax or frozen sections.

J Clin Microbiol, 1977 Oct, 6(4), 414 - 9
Simplified silver-plating stain for flagella; West M et al.; Rhodes' silver-plating technique for staining flagella was tested for its reliability and convenience as a routine procedure in the clinical laboratory . Modifications were made in the stain preparation and the procedure of staining and were tested with smears of known motile gram-negative nonfermentative bacilli . The stain has proved to be accurate and reliable and can be easily utilized with a minimum of training.

Med J Aust, 1977 Sep 10, 2(11), 351 - 3
Leprosy in Sydney: a brief account; Boughton CR; Individuals with leprosy and those incubating the disease continue to enter New South Wales from endemic areas . With early diagnosis and treatment, the prognosis is good . The diagnosis should be considered in any patient who has lived or worked in a leprosy endemic country and who presents with an unusual or persistent skin erpution (especially if there is associated hypoaesthesia) and/or mononeuritis or mononeuritis multiplex . Occasionally the disease presents inother guises; biopsy of the appropriate tissue and staining for acid-fact bacilli, as well as haematoxylin and eosin, will usually indicate the correct diagnosis.

JAMA, 1977 Sep 5, 238(10), 1037 - 40
Transtracheal aspiration in diagnosis of sputum-smear--negative tuberculosis; Thadepalli H et al.; Of 4,200 patients admitted to an acute-care county hospital, 126 (3%) were proved to have pulmonary tuberculosis, among whom 35 (28%) had several sputum smears negative for acid-fast bacilli . On transtracheal aspiration, 31 to 35 had acid-fast bacilli in the aspirate . Eighteen of these 35 (51%) patients had associated infections caused by aerobic or anaerobic bacteria . Tuberculin skin tests were negative in 14 of 35 patients with negative sputum specimens (40%) . Ten of 18 patients (56%) with associated bacterial infections had negative skin tests to purified protein derivative . Smear and culture of transtracheal aspirate for tubercle bacilli may be invaluable in establishing the diagnosis when pulmonary tuberculosis is suspected.

Tubercle, 1977 Sep, 58(3), 137 - 41
Thermal and ultraviolet light inactivation of Mycobacterium africanum; David HL et al.; Mycobacterium africanum Yaounde and Rwanda were more heat-resistant than the tubercle bacilli . The ultraviolet susceptibilities of M . africanum strains were within the range usually found in the mycobacteria (e-1 doses), however marked differences were found in the intersept numbers of the Yaounde and the Dakar types.

Tubercle, 1977 Sep, 58(3), 143 - 5
Methods and medium for the culture of tubercle bacilli; Zaher F et al.; A brief account is given of methods recommended for the culture of tubercle bacilli and improved media are described appropriate for each . The chief changes suggested are reductions in the phosphate and dye content of media previously devised for alkaline inocula.

J Infect Dis, 1977 Sep, 136(3), 439 - 43
Host-parasite relationships in experimental airborne tuberculosis . VI . Influence of vaccination with Bacille Calmette-Guérin on the onset and/or extent of hematogenous dissemination of virulent Mycobacterium tuberculosis to the lungs; Harding GE et al.; Guinea pigs vaccinated with bacille Calmette-Guerin (BCG) and unvaccinated guinea pigs were challenged by the respiratory route six weeks or six months after vaccination and sacrificed at various intervals after challenge . The six lobes of the lung were cultured separately, and the percentage of culture-positive lobes was calculated, as well as the log10 number of virulent bacilli recovered . The latter was subjected to an analysis of variance, which compared the fate of bacilli in the four largest lobes with the fate of those in the two smallest lobes . The results indicated no difference between the six-week and six-month intervals between vaccination and challenge . In the longer intervals between challenge and sacrifice, small numbers of secondary lesions could be seen on the lobes of the BCG-vaccinated animals . It was concluded that vaccination with BCG retarded the onset and/or reduced the extent of hematogenous dissemination of virulent mycobacteria to the lungs.

Infect Immun, 1977 Sep, 17(3), 528 - 30
Synchronized replication of Mycobacterium tuberculosis; Wayne LG; When Mycobacterium tuberculosis was grown in Tween-albumin broth without any agitation, the bacilli replicated in the upper, oxygen-rich portion of the medium at a rate that was just balanced by the rate at which the bacilli settled toward the bottom of the tube . When the organisms that accumulated in the sediment were suspended and diluted into fresh medium, they exhibited synchronous replication . The bacilli initiated ribonucleic acid synthesis immediately upon suspension, but marked deoxyribonucleic acid synthesis was not apparent until after the first cellular division was completed, about 14 h after suspension.

Can J Microbiol, 1977 Sep, 23(9), 1245 - 51
Mast cell response during the early phase of tuberculosis: an electron-microscopic study; Ratnam S et al.; Guinea pig lungs were infected with Mycobacterium tuberculosis by intratracheal route and examined under electron microscope to investigate the morphological alterations of the organisms, if any, and the response of the host tissue . The bacilli showed no changes in their morphology, while the host tissues revealed several cells containing many electron-dense intracytoplasmic granules . These cells were predominantly seen during the 1st week of infection . The electron-dense bodies of these cells may be the ones observed by earlier workers and suggested to be the altered forms of tubercle bacilli . The present investigation, however, revealed them to be the granules of the mast cells . These cells were observed to respond to tuberculous infection during the first few days by appearing in large numbers crowded with intracytoplasmic granules and soon disintegrating as the result of subsequent degranulation . The above observation is presented and its significance discussed.

Pediatrics, 1977 Sep, 60(3), 364 - 6
Effect of systemic antibiotics on the microbial flora of the external ear canal in hospitalized children; Ostfeld E et al.; The effect of antibiotic therapy and hospitalization on the external ear canal flora was investigated in 131 children . Fifty-eight percent of the patients receiving antibiotic therapy had Gram-negative bacilli or yeasts in their external ear canal, compared with 17% of the patients who were hospitalized for ten days or longer and only 3% of the patients who were hospitalized for short periods . Antibiotic therapy is the major factor in determining the colonization rate of the external ear canal with potentially pathogenic flora . Children under 1 year of age seem to be the most susceptible group to this shift of flora.

Rev Can Biol, 1977 Sep, 36(3), 299 - 300
Mycobacteria from leprous tissue of an armadillo cultivated on a hyaluronic acid based medium; Kato L et al.; Mycobacteria were isolated from pooled leprous tissues of an armadillo . The suspensions of acid fast bacilli obtained were inoculated into a culture medium composed of umbilical cord extract, supplemented with yeast extract powder and glycerol with sheep serum added . Incubation temperature was 34 degrees C . An abundant growth of mycobacteria was observed in the primo culture in four weeks . The culture was easily sub-cultured on the homologous media . The primo culture did not grow on Loewenstein medium . The identity of the cultures of mycobacteria obtained is not yet established . The same strain of mycobacteria was cultured in media inoculated with suspensions of M . leprae decontaminated with sodium hydroxide-citrate solution . We confirm the findings of Skinsnes et al . (1975) that mycobacteria from human and animal leprous tissue can be cultured repeatedly on a hyaluronic based medium.

JAMA, 1977 Aug 22, 238(8), 886 - 7
Tuberculosis bacteriologic reliability . Sputum specimens submitted by mail; Dutt AK et al.; The reliability of examining mailed specimens of sputum for tubercle bacilli was studied by dividing 132 sputum specimens . One half of each specimen was examined on the same day as collection (fresh); the other half was examined after a delay of from one to eight days (mailed) . There were a few discrepancies, but no advantage was shown for use of the fresh portion of the specimens . The rate of contamination was slightly greater in the mailed portions (6.6%).

Br Med J, 1977 Aug 13, 2(6084), 430 - 3
Antibodies against BCG antigen 60 in mycobacterial infection; Harboe M et al.; A sensitive specific radioimmunoassay was developed to measure antibodies against BCG antigen 60, a prominent antigenic component of BCG bacilli which cross-reacts with similar components in many mycobacterial species including Mycobacterium leprae and M tuberculosis . A lepromatous serum pool had anti-BCG-60 activity with a titre of 10(5) and the tuberculoid pool a titre of 10(4) . Testing of individual sera showed striking variations within groups of patients with lepromatous and tuberculoid leprosy . In five of the 20 tuberculoid leprosy sera the anti-BCG-60 activity was above the median for the lepromatous group . The current view that antibody formation against mycobacterial antigens is very low in tuberculoid leprosy thus no longer appears to be tenable . Sera from eight patients with active pulmonary tuberculosis also showed a striking variation in anti-BCG-60 content, and the median value of this group was even higher than in those with lepromatous leprosy.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Aug, (8), 20 - 6
{Characteristics of the morphology and ultrastructure of the typhoid bacteria under limited and excess glucose conditions}; Dubinina GP et al.; The authors present the results of the study of morphology and physico-biochemical indices of periodic and continuous population of typhoid bacilli under conditions of glucose limit and excess in the medium . Changes in the parameters of cell distribution by length proved to reflect the physiologico-biochemical processes in the population . The results of the study of the ultrastructure of typhoid bacilli of the "aerobic" and "anaerobic" population in continuous cultivation are presented . A possibility of application of morphological tests for the assessment of stability, homogeneity, and viability of the population is discussed.

J Neurosurg, 1977 Aug, 47(2), 228 - 35
A prospective study of tracheobronchial bacterial flora in acutely brain-injured patients with and without antibiotic prophylaxis; Goodpasture HC et al.; The authors observed prospectively 28 brain-injured patients, who required respiratory tract intubation, to determine the effect of antibiotic prophylaxis on bacterial flora, the rate of flora change, and the appearance of infection . Antibiotics not only failed to alter the rate of abnormal colonization but were associated with an earlier appearance of Gram-negative bacilli, the organisms that produced the most severe infections . Although more infections occurred in patients initially untreated with antibiotics, these infections were usually mild and caused by organisms susceptible to highly effective and relatively safe drugs . Although highly reproducible as a laboratory determination, the nitroblue tetrazolium dye test score showed no consistent relationship with the presence or absence of bacterial infection . Regular and extensive clinical and laboratory observations, including cultures of the respiratory tract helped to make the antibiotic administration in these patients specific, appropriate, and reasonable . Broad spectrum antibiotic prophylaxis does not prevent and may enhance the development of severe pulmonary infection in these patients.

S Afr Med J, 1977 Jul 2, 52(1), 12 - 4
Tuberculous mastitis . A review of 34 cases; Cohen C; During a review of 67 cases of mastitis, 34 were diagnosed as cases of tuberculous mastitis . The majority of the patients with tuberculous mastitis were Black women . The mean age of the patients was 34 years . One patient was lactating and several were of postmenopausal age . All presented with unilateral breast masses, thought to be inflammatory in 10 and neoplastic in 10 . In none was tuberculosis suspected clinically . The diagnosis of tuberculosis was based on the histopathological demonstration of tubercles, caseation and a granulomatous inflammation, with acid-fast bacilli in 5 instances . The differential diagnoses included duct ectasia, a foreign-body giant-cell reaction with fat necrosis, foreign material or an abscess, granulomatous mastitis, fungal mastitis, sarcoidosis and a syphilitic gumma.

S Afr Med J, 1977 Jul 2, 52(1), 14 - 6
Granulomatous mastitis . A review of 5 cases; Cohen C; A review of 67 cases diagnosed as granulomatous, tuberculous or fungal mastitis revealed 5 cases which were similar, clinically and histopathologically, to the new entity of granulomatous mastitis described by Kessler and Wolloch . The 5 patients were young women of childbearing age, 4 with breast lesions clinically simulating carcinoma of the breast . Histopathological examination showed granulomata and abscess formation confined to the breast lobules . No acid-fast bacilli or fungi were demonstrated . Granulomatous mastitis may be caused by a chemical reaction associated with contraceptive pill therapy, or may have an auto-immune or infective aetiology.

Ann Immunol (Paris), 1977 Jul-Oct, 128C(4-5), 811 - 6
High resistance induced by young live Bacillus Calmette-Guérin (BCG) to Schistosoma mansoni infection in mice; Bout D et al.; Intravenous inoculation of "young" bacilli of Calmette-Guerin 14 days before challenge with Schistosoma mansoni highly protect the mice against this infection.

J Infect Dis, 1977 Jul, 136(1), 132 - 6
Spontaneous leprosy-like disease in a chimpanzee; Donham KJ et al.; The clinical and laboratory findings of a spontaneous disease, resembling human leprosy, in a chimpanzee are described . The disease was a chronic progressive dermatitis characterized by nodular thickenings of the dermis and involving the ears, eyebrows, nostrils, and lips . A maculopapular rash was also present . Numerous acid-fast organisms were found in nasal swabs and in dermal lesions, including nerves . Attempts to culture acid-fast organisms in artificial media have failed . At this time, the only features of the etiologic agent of this disease that are inconsistent with those of Mycobacterium leprae are failure of the organisms to oxidize 3, 4-dihydroxyphenylalanine and failure to pyridine to remove the acid-fast staining property of the bacilli.

South Med J, 1977 Jul, 70(7), 855 - 61
The cephalosporin antibiotics in pediatric practice; Ross S et al.; The efficacy of the cephalosporins against gram-positive cocci and some of the gram-negative bacilli together with their relative safety make this family of antibiotics potentially useful in treating pediatric infections, particularly in instances of penicillin hypersensitivity . Newer cephalosporins have broadened the antimicrobial spectral range and may offset some of the previous drawbacks to their use in children . Of potential interest to the pediatrician is the highly active inhibitory effect against Hemophilus influenzae by cefamandole, one of the newer cephalosporin congeners.

Am Heart J, 1977 Jul, 94(1), 112 - 4
Bacterial shock; Shubin H et al.; Bacterial shock due to Gram-negative bacilli is best managed by prompt control of the infection with appropriate antibiotics and surgical drainage or excision . Corticosteroids for purposes of controlling systemic reactions to bacteria and their toxins constitute adjunctive therapy . Volume repletion and respiratory support may be of the greatest importance for temporary support of these critically ill patients . Vasoactive drugs including dopamine and isoproterenol should be used very sparingly and only as very temporary expedients.

Vet Pathol, 1977 Jul, 14(4), 297 - 313
Spontaneous listeric encephalitis and neuritis in sheep . Light microscopic studies; Charlton KM et al.; Sixteen of 17 sheep with spontaneous listeric encephalitis had neuritis characterized by diffuse and focal intrafascicular and perineural accumulations of lymphocytes, plasma cells, macrophages and neutrophils in one or more cranial nerves . Nine sheep had extensive trigeminal neuritis which was usually unilateral . Brain lesions were mainly in the stem and were foci of macrophages or neutrophils or both, malacia, neutrophilic neuronophagia, vascular cuffing, and meningitis . Lesions in the brain and trigeminal ganglia were most severe on the same side as the affected trigeminal nerve . Gram-positive bacilli were in proximal parts of cranial nerves in foci of inflammatory cells and occasionally in morphologically intact nerve fibers . Organisms in the brain were in phagocytes in areas of inflammation and in scattered neurons and axons . The results were consistent with centripetal migration of the infectious agent along one or more branches of the trigeminal nerve to the brain and dissemination in the brain stem occurring, at least partly, along fiber tracts . Intraaxonal movement of bacteria probably is a mechanism involved in the pathogenesis of this disease.

Lepr India, 1977 Jul, 49(3), 360 - 3
Hydnocarpus oil as an antileprotic agent in footpad technique; Desai AC et al.; Hydnocarpus oil alone and mixed with dapsone in food and fed to the mice infected with Mycobacterium leprae; showed inhibition of the growth of the lepra bacilli, both sensitive and resistant to dapsone . There was an additive inhibitory effect of the combination of dapsone and oil on the growth of bacilli.

Int J Lepr Other Mycobact Dis, 1977 Jul-Sep, 45(3), 266 - 72
Culture and phagocytic characteristics of Schwann cells in vitro . A possible model substrate for cultivation of M . leprae; Lalitha VS et al.; Tissue cultures of five acoustic and four spinal schwannomas demonstrated good growth and migration of Schwann cells within two to four days . Two types of cells corresponding to Antoni type A tissue and Antoni type B tissue were clearly recognized . Both these cell types showed avid phagocytosis when the cultures were inoculated with mycobacteria, either ICRC bacilli or M . leprae . The phagocytic index was 95% at the end of two hours . The Schwann cells grown in vitro also showed intense acid phosphatase reaction with Gomori's stain, suggesting lysosomal activity . Neither this nor any phagocytosis was evidenced by fetal fibroblasts cultured similarly . Cells from two spinal neurofibromas grew and migrated slowly in vitro and were mainly fibroblasts.

Int J Lepr Other Mycobact Dis, 1977 Jul-Sep, 45(3), 248 - 54
Freeze-etching study of human and murine leprosy bacilli; Nishiura M et al.; Morphologic features of the electron transparent zone (ETZ) material around human and murine leprosy bacilli were examined by a freeze-etching technic . The ETZ around human leprosy bacilli is composed of spherical droplets of hydrophobic material . These are always liquid at body temperature and they never show crystalline lamellar structure even at the temperature of liquid nitrogen . The ETZ around murine leprosy bacilli is composed of ribbon-like or membranous crystalline structures . This material is solid and crystalline at the body temperature of mice, and this solid material is the chief cause of the random arrangement of murine leprosy bacilli inside the cytoplasm of murine lepra cells . This crystalline structure has also been observed around murine leprosy bacilli grown on cell-free culture media.

Nouv Presse Med, 1977 Jun 25, 6(26), 2319 - 22
{Extensive apical pulmonary fibrosis complicating ankylosing spondylitis . 2 cases (author's transl)}; Touraine R et al.; The authors describe two cases of pulmonary fibrosis in patients suffering from ankylosing spondylitis . The diagnosis of tuberculosis was rejected on the basis of negative studies for tubercle bacilli and the total ineffectiveness of specific therapy . No evidence of microbial or parasitic infection was found . This fibrosis was associated with a considerable worsening in general condition . Nevertheless, the first patient remains alive 15 years after the onset of this pathological manifestation . The second patient died but autopsy was not possible . A wide review of the literature is undertaken in the light of these two cases.

Br J Surg, 1977 Jun, 64(6), 420 - 3
Acute ischaemic enteritis in Goa; Gupta SD et al.; Acute ischaemic enteritis is an uncommon condition which mainly affects young people . It is characterized by ischaemic changes in the small or large bowel which may be reversible in the early stages . The exact aetiology is not known . The condition may be due to toxins produced by either roundworms or Gram-negative bacilli or may be due to a localized allergic reaction . It is possible to make a preoperative diagnosis in most cases from the presence of abdominal pain, bloody diarrhoea and shock . Conservative treatment may be best in early cases but surgery is necessary in those cases where gangrene or perforation has occurred.

Am J Med, 1977 Jun, 62(6), 945 - 8
Amikacin treatment of pulmonary infections involving gentamicin-resistant gram-negative bacilli; Bartlett JG; Twelve patients with pulmonary infections presumably involving gentamicin-resistant gram-negative bacilli were evaluated for their response to amikacin therapy . All patients had hospital-acquired infections for which they had been previously treated and were considered therapeutic failures with gentamicin or tobramycin . Assessment of response to amikacin therapy showed objective evidence of clinical improvement in 11 . The gentamicin-resistant organism was eradicated in nine patients although, in the majority, other gram-negative bacilli persisted in respiratory tract secretions both during and after treatment . There was one clinical failure.

Helv Chir Acta, 1977 Jun, 44(3), 431 - 8
{Hyperbaric oxygenation in gas gangrene therapy}; Bahr R et al.; Gas gangrene which is caused by gram-negativ rod-shaped bacilli appeared longtime in war only . Now an increase of infection is noted by heavy traffic accidents . Reporting about 18 patients and treatment results we suggest for therapeutic proceeding: excision of wounds without primary amputation followed by hyperbaric oxygenation . In our opinion, surgical intervention and hyperbaric oxygenation should not be rival but complementary treatment of equal value.

Afr J Med Med Sci, 1977 Jun, 6(2), 103 - 8
Laboratory diagnosis of tuberculosis in a developing country 1968-1975; Alausa KO et al.; The paper records the results of a retrospective study of laboratory findings on samples sent for diagnosis of possible tuberculosis among patients attending or admitted to hospital during the 8 years, 1968-1975 . Out of a total of 23 419 such samples, 2479 were positive for tubercle bacilli: both direct microscopy and cultural examinations were carried out, except in the case of many sputum samples which were strongly positive on direct film examination . It was found that the simple examination of stained smears would detect 77% of positive sputa, but was unsatisfactory for other specimens, where cultural examination was essential . Among the positive samples, only sixty-nine came from children under 15 years old: this low figure probably represents selection in hospital attendance or submission of samples, rather than a true comparison with the incidence of clinical tuberculosis in adults . The type of infections evident in children differed from that apparent for all age groups combined, in the high proportion of cases of tuberculous meningitis among the younger age group . The yearly figures give little indication of a fall in the incidence of clinically significant tuberculosis over the past 8 years . A vigorous effort is required for case finding and treatment if there is to be substantial improvement over the next 8 years.

Tubercle, 1977 Jun, 58(2), 91 - 6
Occult tuberculous infection in children; Fox TG; Three hundred and fifty New Zealand children with occult tuberculous infection are reviewed . Ninety four had received BCG vaccine previously . Three hundred and forty were admitted to hospital and 3 gastric aspirations were obtained from each child and cultured for tubercle bacilli . Mycobacterium tuberculosis was isolated from 1 or more aspirates in 29 (8.5%) of the children . Excluding those who had received BCG the isolation rate was 10.9% . Mycobacterium bovis was not cultured from any child . X-rays of the chest which were initially normal showed calcification after 2 to 5 years in 73 (20.8%) cases . The 350 children were treated with 2 drugs, during the early years isoniazid and PAS and in the past 3 years isoniazid and rifampicin in standard dosage for either 12 or 18 months . The reasons for treating these children are discussed.

An Esp Pediatr, 1977 Jun-Jul, 10(6-7), 577 - 82
{Congenital tuberculosis (author's transl)}; Hawkins F et al.; The present case report concerns a term infant, born of a mother with an undiagnosed tuberculosis, which was proved by inguinal lymph node biopsy to have numerous acid-fast bacilli; sequence of events supports the thesis that infant had acquired infection transplacentally . Literature is reviewed and diagnosis, prophylaxis, chemotherapy of this infrequent disease with a grave prognosis is commented, emphasizing success of chemotherapy in this infant.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Jun, (6), 95 - 9
{Interrelationship between toxigenic and non-toxigenic diphtheria microbes in the epidemic process}; Kravchenko NA et al.; A study of the circulation of toxigenic and nontoxigenic diphtheria bacilli was carried out in several carrier state foci under conditions of a natural course of the epidemic process . There were 2623 persons under observation . A total of 32158 analyses were carried out, and 2271 strains were isolated and studied . No formation of the toxigenic variants of diphtheria bacillus as a result of phage conversion was revealed in the foci of carrier state despite the wide spread in them of nontoxigenic lysosensitive cultures capable of acquiring the toxigenic properties under experimental conditions, and of the cultures which had converting corinephages . Thus, autonomy of the circulation of the toxigenic and nontoxigenic diphtheria bacilli occurred in the carrier state foci; the leading role in the change of the diphtheria bacillus type belonged to reinfection.

Am Rev Respir Dis, 1977 Jun, 115(6), 1066 - 9
Automatable radiometric detection of growth of Mycobacterium tuberculosis in selective media; Middlebrook G et al.; The formulation of media for selective, automatable, radiometric detection of growth of Mycobacterium tuberculosis in vitro is described . Palmitic-1 acid labeled with carbon-14 and formic-14C acid were compared as substrate sources of {14C}O2 in media deficient in carbohydrate and containing appropriate antimicrobial agents that are not active against tubercle bacilli . A preliminary clinical laboratory study of a medium containing 4 microCi palmitic-1-14C acid per ml showed that this method might provide the basis for practical laboratory use.

S Afr Med J, 1977 May 28, 51(22), 779 - 83
Pulmonary disease associated with mycobacteria other than tubercle bacilli in miners; Nel EE et al.; Five patients with lung disease caused by mycobacteria other than tubercle (MOTT) bacilli are described . Mycobacterium kansasii was the causative organism in 4 patients and M . scrofulaceum in 1 patient . The species were repeatedly isolated from sputum specimens cultured on Lowenstein-Jensen medium . The clinical features, mycobacterial isolations, bacteriological properties of the pathogens and the therapeutic problems encountered are discussed.

C R Acad Sci Hebd Seances Acad Sci D, 1977 May 23, 284(20), 2043 - 5
{Enzymatic differences in mycobacteria . Ribitol dehydrogenase}; Andrejew A et al.; Contrary to the tubercle Bacilli (H37Ra, BCG), Mycobacterium phlei has a ribitol-NAD dehydrogenase (that also oxidizes, although to a lesser extent, erythritol and glycerol) . This difference is observed with the Bacteria grown on Sauton's medium, as well as after their adaptation to ribitol . The extracts of all these Mycobacteria reduce, NADP in the presence of glycerol, ribitol or erythritol, though very slowly.

Am J Trop Med Hyg, 1977 May, 26(3), 520 - 4
Inhibition of the immune response to whooping cough and tetanus vaccines by malaria infection, and the effect of pertussis adjuvant; Tarzaali A et al.; Plasmodium yoelii infection of mice depressed their capacity to build up humoral immune response to diphteria vaccine and protective immunity against tetanus toxin . This immunodepression was overcome by Freund's complete adjuvant or killed pertussis bacilli (whooping cough vaccine) . These results suggest that vaccines should be given in association in malaria endemic area.

Tijdschr Diergeneeskd, 1977 May 1, 102(9), 571 - 4
{Tuberculosis among Japanese deer in a deer-park in Goes (author's transl)}; Tesink J et al.; Severe infection with tubercle bacilli of the avian type was detected among Japanese deer in Goes . All animals were disposed of and post-mortem studies were done, which showed that only two specimens were culturally negative . After thorough cleaning and decontamination of fecings and cages and burning of the mown grass during the period from August 1971 to April 1972, the park was repopulated with deer free from tuberculosis . The herd was continued to be free from tuberculosis ever since . Well over one hundred children who occasionally visted the deer-park as well as the attendants of the deer were examined twice (at a four-month interval) using avian tuberculin, the results of the tests being negative.

Clin Otolaryngol, 1977 May, 2(2), 139 - 48
Bronchial findings in pulmonary tuberculosis; Jokinen K et al.; A total of 297 bronchoscopies were performed on 238 patients with pulmonary tuberculosis at the Paivarinne Chest Hospital during the period 1967--1973 . The tuberculous process was deemed active in 172 patients and inactive in 66 . Active endobronchial tuberculosis was diagnosed in 20 patients, 11.6% of the active cases, whereas inactive sequelae of endobronchial tuberculosis appeared in 7% of the total material . Bronchography was performed on 163 patients; a normal bronchogram was obtained in 54% of the cases with minimal changes, 35% of the moderately advanced cases, 13% of the far advanced and 23% of the inactive cases . Sputum samples were more often positive for tubercle bacilli than the bronchial aspirates, and bacterial cultures from sputum samples were less reliable indicators of infection than were cultures from bronchial aspirates . Cytological smears revealed no difference between these two sampling methods.

Rev Cubana Med Trop, 1977 May-Aug, 29(2), 85 - 8
{Homogenization of samples for the culture of mycobacteria . A comparative study of samples with and without centrifugation}; Perez Amarillo J; A homogenization method for sputum samples for the culture of acid-fast bacilli that omits the use of centrifugation, passage test tubes and balances is described . 10% sodium phosphate was used as decontaminating substance . This method facilitates the laboratory work since the samples so treated are incubated at 37 degrees C up to the next day when they are then cultured . 676 samples prepared according to this method were compared with samples prepared according to the standard method; a 6,21% positivity in the former compared to a 5,47% in the latter as well as a lower percentage of contamination were obtained . Contamination occurred in 9,91% of samples without centrifugation and in 14,35% of centrifuged samples.

Microsc Acta, 1977 May, 79(3), 224 - 36
Staining mycobacteria with periodic acid-carbol-pararosanilin: principle and practice of the method; Harada K; Mycobacteria may be acid-fast, non-acid-fast or even chromophobic in staining under different conditions . The pretreatments with oxidants including periodic acid increase effectually the acid-fastness of acid-fast bacilli . This is caused by additional free carboxyl groups resulting from non-acid-fast wax in the cell walls by demethylation with oxidants . Only by prolonged periodic oxidation the aldehyde groups formed as oxidation products of 1-amino-2-hydroxy groups in the cells can be demonstrated with carbol-fuchsin stain . This reaction is most probably attributable to the formation of Schiff's bases between fuchsin and aldehydes . Since pararosanilin is the active molecule in the diphenamine reaction, periodic acid (10%, 24 hours) followed by carbol-pararosanilin stain is a most sensitive and selective method to demonstrate mycobacteria including chromophobic forms.

Lepr India, 1977 Apr, 49(2), 187 - 96
Haematological profile in leprosy . Part I--general findings; Karat AB et al.; Haematological studies in 904 adult leprosy patients with different types of leprosy, in various stages of the disease and treatment are described . Haemoglobin, packed cell volume, serum albumin and serum iron are significantly lower among lepromatous leprosy patients as compared with non-lepromatous patients . The serum B12 levels were significantly higher among the lepromatous group . Acid fast bacilli have been demonstrated in skin smear negative leprosy patients with indeterminate and tuberculoid leprosy, suggesting occurrence of bacillaemia in these groups of patients.

Int J Lepr Other Mycobact Dis, 1977 Apr-Jun, 45(2), 167 - 70
A histopathologic study of renal biopsies in fifty cases of leprosy; Gupta JC et al.; Renal biopsies from 50 cases of leprosy, including 45 cases of lepromatous and 5 cases of tuberculoid, have been studied in detail histopathologically with special reference to any specific leprosy lesion such as the presence of leproma or granuloma, the presence of acid-fast bacilli and the occurrence of amyloid deposit . Leproma or granuloma, acid-fast bacilli and amyloid deposit could not be detected in any of these cases . Pathologic features of nephritis of various types were seen in only 40% of cases . Similar observations made by previous authors have been reviewed . The question is raised as to why kidney tissue should escape from developing specific leprosy lesions in either type of leprosy when other tissues such as liver, striated muscles and lymph nodes are known to develop such lesions . A greater immunologic resistance of the renal tissue to lepra bacilli or local physiochemical factors which may render renal tissue an unfavorable site for the settling and multiplication of lepra bacilli are considered as possible related factors.

Jikken Dobutsu, 1977 Apr, 26(2), 123 - 9
{An outbreak of "wet tail" in hamsters due to Tyzzer's organism (author's transl)}; Magaribuchi T et al.; In a colony of Golden hamsters, many animals were found to show signs of "wet tail", and spontaneous deaths occurred during two months . With this outbreak of wet tail and death, etiologic and pathologic studies were made on 11 cases supplied from the colony . Gross pathologic examination disclosed hemorrhagic enteritis in 10 and necrotic foci in the liver in 5 out of 10 cases examined . A number of bacilli morphologically suggestive of Tyzzer's organisms were detected on smears of cut surfaces of the affected intestines and livers . After inoculation with homogenate of the intestines from the moribund cases into hamsters by oral route, the same clinical manifestations as observed in spontaneous cases were reproduced, and the inoculated animals died in 10 to 14 days with numerous Tyzzer's organisms in their intestines and livers . When apparently healthy hamsters were introduced into contaminated cages with soiled bedding which were allowed to stand at room temperature for about 2 months, most of them developed signs of wet tail and died in 5 to 19 days having liver necrosis characteristic of Tyzzer's disease.

Int J Lepr Other Mycobact Dis, 1977 Apr-Jun, 45(2), 101 - 6
A study of alleged leprosy bacillus strain HI-75; Stanford JL et al.; Subcultures of strain HI-75 of Skinsnes leprosy bacillus received in Antwerp and London have been studied bacteriologically and compared . Both contained moderately large acid-fast bacilli readily subcultured and maintained on ordinary mycobacteriologic media . These organisms were found to be a variety of Mycobacterium marianum (syn . serofulaceum) and were considered likely to be a laboratory contaminant . The earlier subculture studied also contained numbers of a much smaller mycobacterium (of a similar size to M . leprae) which appeared to be dead and which did not grow on the ordinary media . Skin tests and immunodiffusion analyses performed with extracts of the earlier subculture failed to demonstrate the presence of the specific antigens of leprosy bacilli . Similar studies on other cultures of Skinsnes bacillus must be performed to confirm or refute its identity as M . leprae.

Lepr India, 1977 Apr, 49(2), 181 - 6
Transfer of leprosy bacilli from patients to mouse footpads by Aedes aegypti; Narayanan E et al.; Aedes aegypti mosquitoes which were first allowed to feed on untreated lepromatous leprosy patients, and then to refeed on mouse footpads were found to transfer Mycobacterium leprae to the footpads as seen by the subsequent multiplication of the bacilli in the footpads . Results presently available are insufficient to come to any conclusion about the actual role of mosquitoes in the transmission of leprosy in the field.

Zentralbl Bakteriol {Orig A}, 1977 Apr, 237(4), 530 - 5
Parallel study of two techniques for identification of gram negative anaerobic bacilli; Nadaud M et al.; The authors have used two different methods for the identification of 45 strains of stric anaerobic gram negative rods: a study of biochemical characters by the API 20 anaerobic kit, and system proposed by SUTTER and FINEGOLD (susceptibility to discs loaded with antibiotics associated with some simple biochemical characters) . A good correlation has been observed between those two techniques . However, a precise diagnostic can be given only by a whole study of biochemical characters, as proposed by the system API 20 Anaerobic.

J Clin Microbiol, 1977 Apr, 5(4), 439 - 43
Rapid identification of Bacteroides fragilis with bile and antibiotic disks; Draper DL et al.; A simple screening test is described for separating Bacteroides fragilis from other anaerobic gram-negative bacilli . The test utilizes filter paper disks impregnated with 25 mg of oxgall (Difco), tested in conjunction with antibiotic identification disks . The bile disks and antibiotic disks are placed on a supplemented brucella blood agar plate which has been inoculated by swabbing with a standardized cell suspension . After 24 h at 35 degrees C in a GasPak jar, resistance to kanamycin and bile is taken as a presumptive identification of B . fragilis . Susceptibility to one or both disks indicates the need for further identification and additional biochemical tests are required . Those strains that produce insufficient growth within 24 h are not likely to be B . fragilis . The reliability of the bile disk method was tested by comparing results with 100 clinical isolates versus results with bile in thioglycolate broth, peptone-yeast extract-glucose broth, and tryptic soy agar . All four bile test methods gave equilvalent results, but the broth media required much longer periods of incubation.

J Immunol, 1977 Apr, 118(4), 1154 - 8
Cyclic antibody formation to polyglycerophosphate in normal and injected rats; Bolton RW et al.; Normal adult Sprague-Dawley rats were bled serially over a 30-week period and their sera were examined for antibodies to polyglycerophosphate (PGP) by a standardized passive hemolysis test . Levels of "natural" antibodies to PGP fluctuated during this period with a majority of animals exhibiting pronounced cycling of serum antibody levels, however, the individual cycles were not synchronized with each other . Feeding of radiolabeled Gram-positive bacilli to these animals and examination of lymphoid tissue by liquid scintillation counting revealed that the antigen persisted mainly in the mesenteric lymph nodes . A second group of rats was injected i.v . with radiolabeled Gram-positive bacilli and tissues were examined for plaque-forming cells (PFC) of PGP specificity, and the sera were examined by passive hemolysis . Cycling of both anti-PGP antibodies and PFC became synchronized in the injected animals with peaks of serum antibody evident at 16 and 28 days post-injection and splenic PFC peaks at 4 and 16 days post-injection . Cycling was also observed in the mesenteric lymph nodes and bone marrow Examination of lymphoid tissue from the rats injected i.v . revealed that antigen introduced by this route also perisisted mainly in the mesenteric lymph nodes, This report demonstrates individual cycling of natural responses to environmental antigen and to the same determinant in secondary responses, indicating its importance as a regulatory mechanism.

Int J Lepr Other Mycobact Dis, 1977 Apr-Jun, 45(2), 114 - 9
Cytochrome-linked respiration in host grown M . leprae isolated from an Armadillo (Dasypus novemcinctus, L.); Ishaque M et al.; The bacilli were isolated from an armadillo (Dasypus novemcinctus, L.) and cytochrome systems as well as oxidation of succinate and NADH by M . leprae were studied . Cell-free extracts of M . leprae contained cytochromes of the a + a3, b, c and o type . Whole cell suspensions catalyzed the oxidation of succinate . The process was unaffected by rotenone but was markedly inhibited by thenoyltrifluoroacetone, antimycin A and cyanide . Cell-free preparations of M . leprae also oxidized NADH with oxygen as the terminal electron acceptor . Although NADH oxidation was completely inhibited by rotenone, the process was inhibited to only 50% by 5 millimols cyanide . The results indicated that complete respiratory system is present in M . leprae isolated from leprous tissues of an armadillo . The effect of inhibitors on succinate and NADH oxidations showed that the respiration in host-grown M . leprae is mediated through the cytochrome system with oxygen as the final electron acceptor.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1977 Apr-Jun, 26(2), 91 - 8
{Non-culturable Koch bacilli during antitubercular chemotherapy}; Moisescu V et al.; The authors have performed 58435 microscopic examinations, of which 3813 were positive, and found 209 (5,48%) cases of non-cultivable Koch bacilli . The major bacteriological, clinico-evolutive and therapeutical aspects are examined . Most of the cases showing a syndrome of positive homogenate with a negative culture were rather recent ones (an evolution of less than 2 years in 73,68% of the total) and the highest frequency was found in those in which the treatment was in its first year . No direct relationship could be demonstrated between the number of germs (the Gaffky scale) and the frequency of the syndrome . The factors influencing the occurrence and the development of the syndrome are: the structure of the lesions, the method of bacteriologic examination, the therapy applied, and a certain immunologic reactivity . According to the authors the significance of this syndrome is positive in most of the cases, indicating a regression that has not been completed . The most reasonable attitude is a differentiated one, depending on each case, integrating the data obtained by the bacteriological examination in the therapeutic and evolutive clinico-radiologic context.

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