Bacillus

Am J Med Sci, 1977 Mar-Apr, 273(2), 177 - 84
Amikacin therapy of severe infections produced by gram-negative bacilli resistant to gentamicin; Valdivieso M et al.; Amikacin is a new aminoglycoside antibiotic related chemically to kanamycin . It has broad spectrum activity against most gram-negative bacilli . The most important advantage of this aminoglycoside is its activity against gram-negative bacilli which are resistant to gentamicin . Amikacin was given to 22 cancer patients with 24 serious infections produced by gram-negative bacilli resistant to gentamicin and 13 (54 per cent) were cured . Response to amikacin was related to the patients's neutrophil count at the time of infection; neutropenic patients having a lower response rate (30 per cent vs 71 per cent) . Side effects included nephrotoxicity (12 per cent) and audiotoxicity (5 per cent) . Amikacin is an effective new antibiotic for patients with severe infections produced by gram-negative bacilli resistant to gentamicin.

J Infect Dis, 1977 Mar, 135 Suppl, S49 - 53
In vitro activity and clinical efficacy of clindamycin in the treatment of infections due to anaerobic bacteria; Levison ME et al.; Clindamycin, rosamicin, josamycin, and metronidazole had similar inhibitory activity against 29 clinical isolates of Bacteroides fragilis, i.e., 100% of strains were inhibited by 0.8 microng of metronidazole or josamycin/ml and 100% by 1.6 microng of clindamycin or rosamicin/ml . Metronidazole was bactericidal against 97% of the isolates, and clindamycin or rosamicin (in concentrations of 1.6 microng/ml) was bactericidal against 80% . Erythromycin and josamicin were the least bactericidal agents in vitro . Thirty-two patients with pleuropulmonary and intraabdominal or pelvic infections caused by anaerobic bacteria were treated with clindamycin . Cure was achieved in 27 patients . In another group of 37 patients treated with parenteral clindamycin, diarrhea developed in 30% and was significantly more common in those patients with abdominal or pelvic infection . Only one patient developed pseudomembranous colitis . These observations suggest that clindamycin is an excellent and relatively safe antibiotic for treatment of infections caused by anaerobes when combined with surgery or with other antibiotics selected for activity against aerobic gram-negative bacilli.

Immunology, 1977 Mar, 32(3), 255 - 64
Biphasic pattern of activation of the reticuloendothelial system by anaerobic coryneforms in mice; Otu AA et al.; Macrophage activation as measured by increased rates of clearance of carbon was explored in five inbred and two outbred strains of mice pretreated with anaerobic coryneform bacilli . Constant differences were found according to strain from DBA (lowest response) to Sha-Sha (highest response) . The investigation was continued with mice of CBA strain which also provided highly reproducible and high-level responses . In this strain activation occurred in two phases: an early activation which reached maximum levels at 2 days and attributable to a lipid component of the bacteria, and a late phase reaching maximum at 14 days which appeared to coincide with greatly increased weight of the liver and spleen, due to infiltration by mononuclear cells . Evidence is provided that the early phase of macrophage activation is due to a lipid extract from the anaerobic coryneforms with chemotactic activity.

Geriatrics, 1977 Mar, 32(3), 63 - 70, 72
Why tuberculosis is still a health problem in the aged; Kasik JE et al.; Modern chemotherapy has made the treatment of tuberculosis effective and simple . What is required is a high index of suspicion for the disease, particularly in the older members of the population . When tuberculosis is suspected, a skin test should be performed and sputum examined for acid-fast bacilli . If the skin test is positive and the x-ray compatible, therapy with isoniazid and ethambutol should be initiated while evaluation of the patient continues . Therapy need not be complicated, and the patient can be returned to his usual environment promptly if a few simple rules are followed.

J Clin Microbiol, 1977 Mar, 5(3), 329 - 31
Smear results in the diagnosis of mycobacterioses using blue light fluorescence microscopy; Pollock HM et al.; Examination of 6,880 sputum specimens from untreated patients disclosed that 3.1% were positive for mycobacteria by fluorescence microscopy, and 92.5% of these has positive cultures . There was a positive correlation between the number of organisms seen on smear and growth on culture . All specimens with positive smears and negative cultures contained rare or few acid-fast bacilli on the smear . Eighty-two percent of the specimens with positive cultures and negative smears yielded less than 25 colonies, whereas there were greater than 25 colonies from 93% of the specimens with positive smears and cultures . In a low prevalence, general hospital population, the primary acid-fast smear continued to be a reliable diagnostic tool.

Infect Immun, 1977 Mar, 15(3), 737 - 44
Partial purification and properties of an antibacterial product of peritoneal exudate cell cultures from BCG-infected guinea pigs; Sharma SD et al.; Peritoneal exudates elicited in BCG-infected guinea pigs with caseinate yield cell cultures that have been shown to produce soluble material capable of sterilizing certain bacteria if the cultures are incubated with the specific antigen purified protein derivative or the lectin phytohemagglutinin . This material is now shown to have the following properties: (i) strongly adsorbable to glass; (ii) strongly adsorbable to cation- and not to anion-exchange resins but not elutable with mineral acid or solutions of high ionic strength; (iii) strongly adsorbable to cellulose nitrate membrane filter materials and quantitatively elutable with dilute HCl, providing a convenient method for partial purification; (iv) relatively stable over a wide range of pH and temperature; (v) antagonized by polyanions and by iron ions; (vi) active against the three gram-positive bacilli tested and not against the other organisms tested: (vii) more active in alkaline than in acidic media; and (viii) inactivated by proteolytic enzymes.

Am Rev Respir Dis, 1977 Mar, 115(3), 443 - 7
Stability of bacteriophage type of Mycobacterium tuberculosis: absence of variation caused by experimental chemotherapy in mice and analysis of spontaneous variation; Clavel S et al.; The bacteriophage typing of 54 strains isolated from the tissues of mice infected with the strain H37Rv of Mycobacterium tuberculosis and treated with isonazid and rifampin showed that the bacteriophage type did not change . The fluctuation analysis of populations of the tubercle bacilli demonstrated that the rate of mutation from sensitivity to resistance in respect to the bacteriophage DS6A was less than 1.3 X 10(-8) mutations per bacterium per generation.

Southeast Asian J Trop Med Public Health, 1977 Mar, 8(1), 7 - 12
Differentiation of nonfermentative gram-negative bacilli in the clinical laboratory; Thong ML; A rapid and simplified system for the differentiation of nonfermentative Gram-negative bacilli, encountered frequently in clinical specimens, is presented for use in the clinical laboratory . Nonfermentative bacteria can be grouped initially by the motility, oxidase and OF glucose reactions . This grouping simplifies the choice of additional tests for further identification . The additional tests included Gram stain, acid production from 10% lactose agar, nitrate reduction, arginine dihydrolase activity, fluorescein production, deoxyribonuclease activity, hydrolysis of aesculin, growth at 42 degrees C, gelatinase activity and susceptibility to antibiotics.

J Infect Dis, 1977 Mar, 135 Suppl, S35 - 9
A double-blind comparison of clindamycin with penicillin plus chloramphenicol in treatment of septic abortion; Chow AW et al.; The responses to therapy with either clindamycin alone or penicillin plus chloramphenicol in 77 patients with septic abortions were compared in a randomized, double-blind study . Although fever index and duration of hospitalization were similar for both groups of patients, significantly more patients in the group that received clindamycin developed major complications (P less than 0.05) . This is believed to result from clindamycin's lack of activity against aerobic gram-negative bacilli . Aggressive management that included early uterine evacuation and broad-spectrum antibiotics effective against both aerobic and anaerobic bacteria was the key to reduced morbidity and mortality rates in treatment of septic abortion . For patients treated with clindamycin, early uterine evacuation appeared more important than antibiotic therapy (P less than 0.005) . Bacteremia was documented in a total of 29 patients (38%) . Bacteremia was polymicrobial in eight patients (28%) and involved anaerobes exclusively in 18 (62%), aerobes exclusively in nine (31%), and both aerobes and anaerobes in two (7%) . The organisms most frequently isolated were Bacteroides (other than Bacteroides fragilis), Peptostreptococcus, and Escherichia coli.

Am J Pathol, 1977 Mar, 86(3), 623 - 33
Histochemical studies relating the activation of macrophages to the intracellular destruction of tubercle bacilli; Ando M et al.; Dermal tuberculous lesions, both primary and those of reinfection, were produced in rabbits with 14C-labeled BCG and biopsied once at various times . Macrophage activation was evaluated by the indolyl histochemical test for beta-galatosidase, the number of bacilli in macrophages by acid-fast staining, and the breakdown of bacilli by autoradiography . After the rabbits became tuberculin positive, the stongly activated macrophage population contained a) fewer parasitized cell, b) fewer bacilli in each parasitized cell, and c) more "free" 14C-label (not associated with intact bacilli) than the weakly activated macrophage population . These results suggest that the more highly activated macrophages had destroyed many of the bacilli that they once contained and that their power to do so was enhanced by immunologic mechanisms.

Tubercle, 1977 Mar, 58(1), 29 - 34
Cross-resistance in M . tuberculosis to kanamycin, capreomycin and viomycin; McClatchy JK et al.; Drug resistant mutants to streptomycin, kanamycin, viomycin, capreomycin, and rifampicin were isolated from four strains of Mycobacterium tuberculosis . The mutants isolated from each parent were then tested for evidence of development of cross-resistance to other drugs . There was no cross-resistance between either streptomycin or rifampicin and any of the other drugs . Complete cross-resistance between viomycin and capreomycin was found . Cross-resistance between kanamycin and capreomycin, and kanamycin and viomycin was variable . A review of the medical histories of 27 patients with kanamycin-resistant tubercle bacilli indicated that cross-resistance with capreomycin and viomycin occurs, but is unpredictable . Because of this variability in cross-resistance and the fact that kanamycin is a more toxic drug than capreomycin, it is suggested that capreomycin be used in the first retreatment regimen for tuberculosis when streptomycin resistance has been demonstrated.

J Immunol, 1977 Mar, 118(3), 957 - 62
Induction of cell-mediated immunity to chemically modified antigens in guinea pigs . I . Characterization of the immune response to lipid-conjugated protein antigens; Dailey MO et al.; Bovine serum albumin (BSA) conjugated with a lipid, dodecanoic acid, is capable of inducing strong delayed-type hypersensitivity (DTH) in guinea pigs . This paper reports experiments on the nature and specificity of this hypersensitivity . The response to lipid-conjugated BSA (L-BSA) was found to be classical DTH, as evidenced by its ability to be transferred passively by immune cells, but not by serum . In addition, special histologic examination of skin test sites demonstrated the characteristics of DTH rather than cutaneous basophil hypersensitivity . Similar results were obtained when lipid-conjugated purified protein derivative of tubercle bacilli (L-PPD) was used . The increased immunogenicity of L-BSA was not caused by the presence of protein aggregates, but seemed to be related to the hydrophobic nature of the conjugated side chains . A series of cross-reacting serum albumins was used for a study of the specificity of the antibody and DTH responses to BSA . It was found that the degree of enhancement of immunogenicity for DTH caused by lipid conjugation varied for different antigenic determinants on BSA.

Infect Immun, 1977 Mar, 15(3), 745 - 50
Antibacterial product of peritoneal exudate cell cultures from guinea pigs infected with mycobacteria, listeriae, and rickettsiae; Sharma SD et al.; In an in vitro model of cellular immunity, the antibacterial product of immunologically mediated mononuclear cell activation was studied from guinea pigs infected with listeriae and rickettsiae and compared with the product previously described from animals infected with mycobacteria . We found that this product, active against gram-positive bacilli, appeared to be identical in the three different infections with regard to its heat stability, its chromatographic adsorption and elution pattern, its susceptibility to inactivation by proteolytic enzymes, and its antibacterial spectrum

JAMA, 1977 Feb 7, 237(6), 562 - 4
Amikacin therapy for serious gram-negative infection; Pollock AA et al.; Amikacin sulfate was administered to 18 patients for the treatment of 19 severe infections . Seventeen infections were caused by gentamicin-resistant Gram-negative bacilli, and 13 patients were bacteremic . Bacteriologic cure was attained in all but one instance, and effective serum, bile, and pleural fluid drug levels were demonstrated . Drug-related fever occurred in one patient, and another experienced a maculopapular rash and monilial intertrigo . In three patients, reversible renal toxicity developed, but none had clinical evidence of ototoxicity . Amikacin sulfate in a dose of 15 mg/kg/day is an effective antibiotic for the treatment of serious Gram-negative infections, particularly those due to gentamicin-resistant organisms.

Aust Vet J, 1977 Feb, 53(2), 67 - 71
Tuberculin sensitivity of cattle inoculated with atypical mycobacteria isolated from cattle, feral pigs and trought water; Pearson CW et al.; Each of 12 cattle was inoculated either subcutaneously and intradermally or into a mesenteric lymph node with 1 of 8 species of liver atypical mycobacteria isolated from cattle, cattle trough water and feral pigs . Seventy-eight days after inoculation the cattle were tuberculin tested with bovine PPD, avian PPD and homologous heat-concentrated syntheic medium tuberculins . They were killed 85 days after inoculation . Organisms were cultured from caseous granulomas at all sites in cattle inoculated with M . avium serotype 2 . M . simiae was recovered from a granuloma at the subcutaneous site . Acid-fast bacilli were isolated from the mesenteric lymph node inoculated with trough water organisms . At 72 h, all the cattle had produced skin reactions of 4 mm or more to the homologous tuberculins and all except 1 produced a similar response to avian PPD . Only isolates of bovine origin sensitised cattle to bovine PPD to this degree, and these reactions were less than the corresponding response to avian PPD.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Feb, (2), 120 - 5
{Selecting a method of erythrocyte fixation for the passive hemagglutination test according to the nature of the sensitin}; Karal'nik BV et al.; Quantitative methods were applied to the study of the interaction of albumins, fraction I of Plague bacilli, diphtheria toxoid fractions differing by mol wt, flagellin of typhoid bacilli, 19S- and 7S-fractions of normal human, cholera horse, and paratyphoid B donkey sera with erythrocytes, fixed by 10 different methods . Fixation with acetaldehyde proved to be optimal for the binding of all the proteins, including flagellin, but the latter sensitized erythrocytes formalinized after Vainbach better . The significance of the method of erythrocyte fixation and of the nature of sensitin in the process of the erythrocyte loading without any utilization of the conjugating agents was demonstrated.

Am Rev Respir Dis, 1977 Feb, 115(2), 221 - 8
Rifampim-combined chemotherapy in coal worker's pneumoconio-tuberculosis; Dubois P et al.; Results of a retrospective study of rifampin-combined chemotherapy in 59 coal miners with pneumoconio-tuberculosis are reported . In 43 patients pneumoconiosis had attained the stage of progressive massive fibrosis . The follow-up period ranged from 24 to 78 months, except in 8 patients who died before the twenty-fourth month . Twenty-seven of the 59 patients were treated for the first time, and 32 were in retreatment . In none of them had rifampin been administered before . Although the objective was to administer rifampin in combination with one, 2, or even 3 companion drugs that had not been administered before and that had proved to be active on the patients' bacilli in vitro, this goal was fully reached only in the first treatment group; in 8 of the 32 retreated patients the drugs combined with rifampin were considered ineffective . The speed and rate of bacteriologic conversion were most impressive . Sputum conversion was obtained in 90 per cent of the patients; in the initial treatment group 100 per cent of the patients converted their sputum on culture at 5 months and in the retreatment group the corresponding figure was 84.4 per cent . These bacteriologic results are nearly as favorable as those obtained in cases of advanced pulmonary tuberculosis without pneumoconiosis treated with the same rifampin-containing drug regimens . It was concluded that rifampin-combined chemotherapy largely eliminates the handicap caused by the coexistence of tuberculosis and pneumoconiosis . Side effects due to rifampin were without practical significance . In 3 patients of 57 treated with ethambutol, visual impairment was observed . Mortality was high (27 per cent) but was caused by nontuberculous diseases, especially cardiorespiratory insufficiency . In 10 of the 16 patients who died, death occurred after bacteriologic conversion.

South Med J, 1977 Feb, 70(2), 208 - 12
Mammary tuberculosis: a rare modern disease; Ikard RW et al.; Tuberculosis of the breast has become a rare disease since the advent of antituberculous chemotherapy . The incidence of tuberculous mastitis at Vanderbilt Hospital for the last two decades was 0.025% of surgically treated breast disease . This probably reflects its prevalence in economically developed parts of the world . The pathologic diagnosis of mammary tuberculosis may be difficult . The only diagnostic proof is the demonstration of tubercle bacilli by microscopic smear of culture . Numerous cases have been incorrectly reported as mammary tuberculosis because of nonadherence to this criterion . Definite guidelines for treating breast tuberculosis are not available and may never become so because of its rarity . Drug therapy has been successful and should be tried in all cases . Adequate surgical removal is inevitably corrective of the local disease . Surgically treated patients should receive antituberculous drugs before and after their operations.

J Med Microbiol, 1977 Feb, 10(1), 63 - 8
Airborne infection with Mycobacterium leprae in mice; Rees RJ et al.; Although the portal of entry and mode of spread of M . leprae in human leprosy are still uncertain, it is widely held that direct person-to-person skin contact is important . This assumption has ignored the fact that patients with highly bacilliferous leprosy have nasal as well as dermal infection and that, since M . leprae is shed predominantly from the nose, leprosy might be an airborne infection . The present study was designed to investigate this possibility with mice exposed to airborne infection with M . leprae . The conditions are described in which thymectomised-irradiated CBA strain mice exposed to M . leprae aerosols sustained an immediate lung retention of 1 X 10(5) bacteria . Fourteen to 24 months later, 33% (10 of 30) of the mice had countable numbers of acid-fast bacilli (greater than 2 X 10(4)) with the characteristics of M . leprae in one or more homogenates prepared from ears, foot pads, nose or lungs . Evidence is presented from the distribution of M . leprae that the infection had arisen from systemic spresd of bacilli initially entering the lungs rather than from multiplication of organisms locally retained there, or in the nose, at the time of airborne infection . The relevance of these results to the possible route of infection of leprosy in man is discussed.

Br J Haematol, 1977 Jan, 35(1), 11 - 7
Monocyte recruitment in tuberculosis and sarcoidosis; Schmitt E et al.; Monocytopoiesis and blood monocytes were investigated in nine patients with active tuberculosis and in six patients with active sarcoidosis in order to obtain information on monocyte consumption in these two types of granuloma . All patients with tuberculosis demonstrated a marked increase in proliferation activity of monocytopoiesis and premature monocyte marrow release . These changes indicate a high monocyte consumption which probably is caused by a high macrophage death rate due to the high macrophage-toxicity of tubercle bacilli . Thus, tuberculous lesions are an example of a "high turnover granuloma" . In sarcoidosis monocytopoiesis showed no significant deviations from the normal . This indicates a low macrophage turnover or "low turnover granuloma" . Thus, any hypothetical agent assumed to be involved in the pathogenesis of sarcoidosis would have to possess low macrophage-toxicity.

J Clin Microbiol, 1977 Jan, 5(1), 75 - 80
Cardiobacterium hominis endocarditis: description of two patients and characterization of the organism; Savage DD et al.; Two cases of endocarditis caused by Cardiobacterium hominis are reported . In both instances infection was subacute and characterized by (i) implantation on abnormal valves, (ii) chronic course lasting weeks to months before recognition, and (iii) rapid clinical and bacteriological response to penicillin, as well as other antibiotics commonly used to treat infections caused by gram-negative bacilli . Our isolates of C . hominis are compared with strains in the National Institutes of Health culture collection . Optimal growth requires yeast extract and incubation at 37 degrees C with increased humidity and supplemental CO2 . The production of indole, a positive oxidase reaction, and characteristic sugar fermentation distinguish C . hominis from other slow-growing, gram-negative bacilli.

Chemotherapy, 1977, 23 Suppl 1, 180 - 8
A study of the levels of fosfomycin in the cerebrospinal fluid in adult meningitis; Drobnic L et al.; In order to determine the liquor concentration of fosfomycin, we chose 27 patients who were suffering from meningitis with different etiology . According to route, type of administration and doses employed, we classified the patients into five groups . Blood samples were taken from the patients 1 h after concluding the administration of the antibiotic and 2 h after the CSF sample . The concentration of fosfomycin in the serum and the CSF were then determined in the laboratory . In order to evaluate the results we divided our cases into three groups according to the state of their meningeal inflammation . In the first group of patients with active meningitis, we obtained an average concentration of fosfomycin in the serum of 65.20 mug/ml and in the CSF of 10.88 mug/ml . In the second group of patients with meningitis in the remission stage, the concentration of fosfomycin in the serum was 83.58 mug/ml and in the CSF it was 9.63 mug/ml . In the third group of patients with their meningitis cured, the concentration of fosfomycin in the serum was 66.45 mug/ml and in the CSF it was 4.95 mug/ml . On the basis of the concentrations obtained and with regard to the sensitivity in vitro, we concluded that fosfomycin can be useful in the treatment of meningitis caused by Pneumococcus, Staphylococcus, E . coli and other gram-negative bacilli.

Chemotherapy, 1977, Suppl 1, 104 - 11
Evolution of sensitivity to fosfomycin in bacteria isolated in 1973, 1974 and 1975 in the Servicio de Microbiologia y Epidemiologia of the 'Clinica Puerta de Hierro', Madrid; Damaso D et al.; The bacteriostatic activity of fosfomycin was studied in vitro against 1,243 clinical isolations of gram-positive cocci and 4,086 isolations of gram-negative bacilli that were obtained in 1973, 1974 and in the period from January to May of 1975 . MIC was determined by the agar diffusion method, quantifying it by means of the standard curve that was worked out with the strain of E . coli NCTC 10,418 . A slight increase in resistance was observed in the gram-positive cocci: 64 mug/ml were inhibitory for 63% of the 249 isolations obtained in 1973, 59.1% of the 716 isolations obtained in 1974, and 57.5% of the 278 isolations from 1975 . A slight loss of sensitivity was also observed in the gram-negative bacilli: the aforementioned concentration of fosfomycin inhibited 36% of the 742 isolations from 1973, 33.6% of the 2,387 isolations from 1974 and 32.6% of the 957 isolations from 1975 . 933 g of this antibiotic were consumed in our hospital in 1973, 4,203 g in 1974 and 957 g in 1975 . The consumption rate per patient per year was 0.15, 0.72 and 0.20 g, respectively . In conclusion, although no change was observed in the sensitivity of some bacterial strains to fosfomycin, the overall study indicates a slight decrease in the sensitivity, although it does not apparently have any relationship to the consumption of fosfomycin in our hospital.

Arch Immunol Ther Exp (Warsz), 1977, 25(6), 749 - 56
Comparative studies on activities of gentamicin, sisomicin, tobramycin and amikacin (BB-K8) against Pseudomonas sp; Dzierzanowska D; Activities of gentamicin, sisomicin, tobramycin and amikacin against 561 strains of Pseudomonas sp . bacilli were evaluated . Tobramycin was from two to eight times more active against Pseudomonas sp . than gentamicin . No strains resistant to amikacin were encountered . Correlation between the size of the growth inhibition zone and minimal inhibitory concentration was determined as regression lines for all the tested antibiotics . Sisomicin and tobramycin showed lowest correlation, and gentamicin and amikacin good correlation.

J Int Med Res, 1977, 5(2), 91 - 5
A comparative study of epicillin and chloramphenicol in the treatment of enteric fever; Hassau A et al.; One hundred patients with acute enteric fever were randomly assigned to treatment with either chloramphenicol 50 mg/kg body-weight or epicillin 1 g six hourly . Eighty-one patients had a positive blood culture for typhoid or paratyphoid bacilli and nineteen had a positive stool culture with a significant Widal titre . All fifty patients in the group treated with chloramphenicol responded, however there was one relapse with bacteraemia . In the group treated with epicillin, six from the total of fifty patients were considred treatment failures . Treatment was considred as a failure if the patient was febrile after ten days treatment or if there was a deterioration despite antibiotic therapy.

Arch Inst Pasteur Alger, 1977, 52, 37 - 53
{Bacteriological aspects of extrarespiratory tuberculosis}; Boulahbal F; 775 strains of extrapulmonary tubercle bacilli isolated during four years (1968-1972) were studied . Our results enabled us to confirm the paucibacillary nature of these tuberculous sites and the variety of their resistance to antibiotics . The comparison between the levels and types of primary resistance in pulmonary and extrapulmonary tuberculosis enabled us to better understand the transmission mechanisms of the tubercle bacilli in the community and its progress in the infected organism.

Infection, 1977, 5(4), 224 - 7
Beta lactamase resistance of newer cephalosporins and antimicrobial effectiveness against gram-negative bacilli; Farrar WE et al.; Three newer cephalosporins (cefamandole, cefoxitin and cefazaflur) were investigated, in comparison with three older agents (cephalothin, cephaloridine and cefazolin) to determine their stability to beta-lactamases of gram-negative bacilli, and to correlate this with their antibacterial activity . Nine of the 17 bacterial strains employed produced broadspectrum beta-lactamases; the remaining eight produced cephalosporinases . The cephalosporins were highly active against bacteria producing broad-spectrum beta-lactamases; they were less active against organisms producing cephalosporinases . All of the cephalosporinase-producing strains were resistant to cephalothin anc cephaloridine . With the other cephalosporins the correlation between hydrolysis by cephalosporinases and resistance of the organisms was poor . Four to eight cephalosporinase-producing strains were resistant to cefoxitin, which was completely resistant to hydrolysis by the beta-lactamases . Cefozolin, cefamandole and cefazaflur inhibited several of these strains in spite of destruction by the beta-lactamase . Several cephalosporins need to be used in antimicrobial susceptibility testing of gram-negative bacilli.

Adv Clin Pharmacol, 1977, 14, 59 - 65
{Evaluation criteria of antitubercular drugs from microbiological view}; Stur D et al.; In the years from 1954 to 74 sensitivity tests with about 12 000 strains of tubercle bacilli isolated from patients have been performed by the serial dilution method . From the results of the tests shown in the table one can see a remarkable shift in the frequency of strains sensitive against the so-called major drugs Streptomycin and INH, whereas only slight variations have occurred with the recent drugs Ethambutol and Rifampicin . The well known change of clinic and epidemiology of tuberculosis in the past two decades is indeed accompanied by changed results of microbiological tests . In conclusion the present chemotherapeutical situation proves much better than in 1954: to-day a more sensitive and even smaller reservoir of mycobacterium tuberculosis is facing twice as much highly effective drugs than formerly.

J Biol Stand, 1977, 5(2), 131 - 8
Approaches to the validation of animal test systems for assay of protective potency of BCG vaccines; Smith DW et al.; Three animal test systems, two in guinea-pigs and one in mice, have been examined to differentiate the ability of three BCG vaccines with respect to their ability to protect the animals against infection when challenged with virulent bacilli . One test system showed great promise and was examined in greater detail in order to explain the mechanism of protection . These studies are continuing in order to test a series of BCG vaccines that will be given to groups of children and their protective effect observed.

Z Erkr Atmungsorgane, 1977, 147(1), 3 - 17
{New aspects in the control of tuberculosis in GDR (AUTHOR'S TRANSL)}; Steinbruck P; The development of the epidemiology of tuberculosis in GDR from 1949 is evaluated . The factors deeply influencing incidence and prevalence of tuberculosis in GDR are: the socioeconomic development of a socialist society with continuous increase of living standard and social fonds, the state of the socialist public health system in general, and the special services and methods for the control of tuberculosis in the chest clinics and hospitals . Tuberculosis is no more a common disease in GDR . Tubercle bacilli are more ubiquitous, but are confined to distinct sources . Highest attention must be paid to the sources of infection, among them to those with tubercle bacilli already found by smear examination in the infectious cases . Microscopic examination is a very important method to find these cases . Cough and sputum exist in most cases of pulmonary tuberculosis already positive by smear examination . All these conditions must be regarded in the control of tuberculosis . The risk groups of tuberculosis (patients in the 5 years after treatment, patients with silicosis diabetes, long lasting treatment with corticosteroids, persons with contacts to infectios cases, and the so-called "Gesunde Befundtrager" (healthy carriers of lesions), persons older than 65 years) amount to 7% of the population but yield more than 50% of all new cases . BCG-vaccination is of no more high importance at an annual infection rate of only 0,25% (1975), but newborns will be vaccinated . Mass X-ray examinations are no more important for finding tuberculosis; but other pulmonary diseases including bronchial carcinoma are detected by this way . X-ray examinations will remain of value in the form of aimed examinations in intervals according to the risk of disease (for tuberculosis, bronchial carcinoma) . The most important method in the control of tuberculosis is the immediate treatment of all new cases . The results depend on the quality of therapy . It has to be still improved . It is the aim, to eliminate tuberculosis as a special problem of public health in GDR till 1982, 100 years after the discovery of the tubercle bacilli by ROBERT KOCH.

Mikrobiyol Bul, 1977 Jan, 11(1), 29 - 33
{The results in our tuberculosis laboratory with penicillin blood agar medium}; Kilicturgay K et al.; A comparison of Lowenstein - Jensen and penicillin blood agar media, which can be prepared in small laboratories, is made in routine diagnostic cultivations of Mycobacterium tuberculosis . Tuberculosis . Tubercle bacilli grown in Lowenstein - Jensen medium were inoculated in Lowenstein - Jensen and penicillin blood agar media in numbers of 100.000, 10.000, 1000 and 100 bacilli and their growth was detected in each medium . It was found that the growth in both media was the same Inoculations were made from 153 sputum specimens to each medium and 5 positive growth were obtained . 3 out of positive cultures were grown on both media, the other 2 positives were grown only on penicillin blood agar . None of the media showed contaminations . These findings suggest that the penicillin blood agar medium has at least the same, or even better qualities than the Lowenstein - Jensen medium.

Infect Immun, 1977 Jan, 15(1), 230 - 8
Hemagglutinating activity of Fusobacterium nucleatum; Falkler WA Jr et al.; Gingival isolates of oral Fusobacterium nucleatum strains (gram-negative anaerobic fusiform bacilli) have shown the characteristic ability to hemagglutinate a variety of erythrocytes (RBC) of human and animal origin . Other members of the genus tested (F . necrophorus, F . varium, and F . mortiferum) displayed little if any ability to hemagglutinate RBC . The hemagglutination (HA) activity could be observed in the F . nucleatum strains with the whole cells and in most instances with sonicated preparations of the organisms . The HA activity was observed in cell wall preparations of the organism and appeared dependent upon a heat-labile protein component of the cell wall . In decreasing order, the RBC that would hemagglutinate with the smallest concentration of HA preparations were rabbit, monkey, human, sheep, horse, and ox . No differences in HA activity of the preparations with cells from the various human blood types were noted . Absorption of the HA preparation of one strain with human cells removed HA moiety was bound to the cells via a Ca2+ binding site interaction since ethylenediaminetetraacetic acid and ethylene glycol-bis-N,N'-tetraacetic acid inhibited binding, and HA could be reestablished by the addition of Ca2+ but not Mg2+ . Rabbit antisera to the F . nucleatum strains inhibited HA activity when tested with the HA preparation in the standard test, whereas anti-Leptotrichia buccalis sera or normal rabbit sera had no effect . A tanned-cell passive HA test with rabbit anti-F . nucleatum sera displayed reactivity between the homologous strains but little reactivity with the other Fusobacterium species tested.

Microbios, 1977, 19(76), 117 - 23
In vitro resistance test of human leprosy bacilli to anti-leprous drugs; Ishihara S et al.; Sensitivity to anti-leprous drugs of M . leprae isolated from an L-type leprosy patient was tested using M--Y 14b liquid medium by direct and indirect methods . The results revealed that the strain, SR61-L74, was almost completely resistant to DDS, and responded only to the long-term administration of Streptomycin and Isoniazid . However, the strain was completely sensitive to rifampicin which had never been administered previously . The subsequent administration of rifampicin resulted in a rapid improvement of the patient's clinical symptoms . It can be concluded that the in vitro method, both direct and indirect, to test the sensitivity of M . leprae to anti-leprous drugs is economic, and accordingly available practically as one of the routine examinations in the laboratory of ordinary leprosaria . This must be very beneficial to the treatment of leprosy patients.

Arch Immunol Ther Exp (Warsz), 1977, 25(4), 497 - 502
The role of easily released substances (ERS) from bacteria in physiologic solution in natural immunity . VI . Induction of opsonins for different genera of bacteria by ERS from Staph . aureus oxford; Grzybek-Hryncewicz K; ERS obtained from Staph . aureus by mild extraction with physiologic saline solution possess activity of inducing nonspecific opsonins which react with homologous bacteria and with related Gram-negative bacteria . ERS from Staph . aureus weakly stimulated precipitins and antibodies active in passive hemagglutination and induced a marked rise in agglutinin titers especially for the homologous strain and Gram-negative S . typhimurium bacilli . N-acetyl-D-glucosamine absorbed the opsonizing factor for various bacteria with heterologous activity.

ORL J Otorhinolaryngol Relat Spec, 1977, 39(1), 1 - 13
The role of plasma cells in scleroma . Electron-microscopic study; Toppozada HH et al.; Three cases of rhinoscleroma in the granulomatous stage were examined under the electrom microscope . The rough endoplasmic reticulum of plasma cells in scleroma displayed cisternal dilatations forming Russell bodies and cytoplasmic vacuolations containing viable and degenerated bacilli forming Mikulicz cells . Thus, they play a double role, producing antibodies and providing protection for the intracellular bacilli . New ultrastructural findings of Klebsiella rhinoscleromatic bacilli were described.

Lepr India, 1977 Jan, 49(1), 54 - 8
The infectivity of drug resistant cases; Desai AC et al.; The present study shows that leprosy bacilli resistant to dapsone, multiply in mouse foot-pad as equally as the dapsone sensitive bacilli would multiply suggesting that the dapsone resistant case will be as infective as the dapsone sensitive case.

Arch Immunol Ther Exp (Warsz), 1977, 25(1), 69 - 78
Immune processes in the course of infection with dysentery bacilli . III . Protective activity of spleen cells and serum from mice immunized with killed dysentery bacilli; Kowalewska D et al.; Killed dysentery bacilli induce immunity in mice which can be transferred to other mice with serum . Spleen cells do not transfer this immunity, in contrast to spleen cells from mice immunized with live dysentery bacilli . The results of this and previous studies 5,17 suggest that immunity in mice infected with dysentery bacilli depends on two coexisting effector mechanisms--cell-mediated and humoral immunity . Live bacilli induce both, however killed bacilli stimulated humoral immunity and protect mice equally effectively against lethal infection with dysentery bacilli.

Dermatologica, 1977, 154(3), 147 - 55
Prolongation of Bacillus firmus survival on human skin by a spore inoculum; Bibel DJ et al.; A case report is presented of an individual who carried vegetative cells of Baccillus firmus on multiple sites of his body for over a year . With the aim of investigating the survival mechanisms of Bacillus species on human skin, vegetative cells or spores of this microorganism were applied to the forearms of volunteers . Whereas vegetative cells were rapidly eliminated, the bacillus was recovered up to 2 weeks following an inoculum of spores . Persistence was not passive since germination, growth, and possible sporulation were demonstrated . We observed strong individual differences in the carriage of bacilli.

Jpn J Antibiot, 1977 Jan, 30(1), 69 - 75
{Clindamycin-2-phosphate and surgical infections (author's transl)}; Ishibiki H et al.; Blood levels of clindamycin-2-phosphate in dog at dosis of 10 mg/kg body weight showed the maximum of 21 mug/ml 30 seconds after one-shot i.v . administration . Continuous infusion of the antibiotic at the infusion speed of 150 and 300 ml/hour/10 kg b.w . with 6 mg/ml solution maintained blood levels of 30 and 170 mug/ml respectively . It may be recommended clinically to use lower concentration than 6 mg/ml to avoid cardiocirculatory disturbances . Four cases of surgical mixed infections with gram-positive cocci, gram-negative bacilli and anaerobes were treated with clindamycin-2-phosphate at a daily dosis of 1,200 mg intravenously and 2 of 4 cases revealed good clinical response . There was none of the haematological, hepatic, nephrontic, cardiocirculatory and allergic side effects.

Chemotherapy, 1977, 23 Suppl 1, 133 - 40
Fosfomycin and plasmidic resistance; Baquero F et al.; 60 fosfomycin-resistant strains of gram-negative bacilli are submitted to conjugation experiments using as recipient cell E . coli K12 which is nalidixic acid resistant . After mating, the number of fosfomycin-resistant E . coli K2 colonies growing on selection plates containing nalidixic acid and fosfomycin never surpassed the normal rate of mutation for fosfomycin-resistance of the recipient strain . In 65% of the experiments, plasmidic resistance to other antimicrobials was transferred to E . coli K12, but was never accompanied by demonstrable fosfomycin resistance . High rate of normal mutation of recipient strain is signaled as the main problem for detecting the plasmidic nature of fosfomycin resistance . With our criteria regarding this fact we have been unable to confirm the plasmidic nature of fosfomycin resistance.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1977 Jan-Mar, 26(1), 39 - 42
{Frequency of isolation of tuberculous bacilli as a function of some mechanical factors in patients with pulmonary tuberculosis}; Ticau S et al.; A series of mechanical factors, such as postural changes and every day movements, favour mobilization of bronchoalveolar secretions and, hence, offer greater chanses of detecting the tuberculosis bacillus . It is recommended to collect, in out-patient units, two sputum samples, one in the morning and the second several hours later, after beginning the day's work.

Immunology, 1977 Jan, 32(1), 33 - 41
Immunologically mediated macrophage aggregation in monolayers of peritoneal cells from BCG-sensitized mice; Preston PM et al.; Aggregation of cultured macrophage monolayers derived from BCG-sensitized mice was produced if nonadherent cells and specific antigen (tuberculin) were present, particularly if the antigen was renewed in the form of tubercle bacilli . The evidence indicated that antigen-stimulated BCG-sensitized lymphocytes in these cultures produced a soluble factor, which in the presence of the renewed supply of antigen caused the aggregation . The phenomenon was irreversible and followed by death of the macrophages . The 'overlays' of aggregated monolayers would aggregate normal macrophages, provided that the recipient cultures contain-d their own (normal) lymphocytes as well as antigen; this suggested that cultures of BCG-sensitized peritoneal cells produced a factor able to effect aggregation via the activity of normal lymphocytes . Overlays from aggregated monolayers were able also to inhibit the migration of normal mouse macrophages; this and other evidence suggested a similar origin for the inhibition factor, but the latter's identity with the aggregation factor remains undecided . We conclude that the aggregation factor depends upon the presence of specific antigen both for its formation and its expression.

Arch Immunol Ther Exp (Warsz), 1977, 25(4), 521 - 8
Inductive influence of macrophages on cytotoxic properties of lymphocytes; Nowosielska-Roszkowska E; Normal rat lymphocytes preincubated over syngeneic peritoneal macrophages derived from rats sensitized to tuberculous bacilli and then cultured with PPD showed a cytotoxic effect on sheep red blood cells coated with PPD . This effect was antigen specific and did not involve the nonspecific influence of macrophages.

Lepr India, 1977 Jan, 49(1), 10 - 33
Recent advances in microbiology in leprosy; Dharmendra; The recent advances in microbiology of leprosy are reviewed . Till now the leprosy bacillus had not been cultivated in laboratory media; the recent claims of success have not been confirmed . There has been a breakthrough in the experimental transmission of leprosy to experimental animals--the white mice, the immune depressed white mice, and the nine-banded armadillo . Apart from providing definite proof for the causative relationship of the bacillus discovered by Hansen and the disease leprosy, the experimental transmission to animals have considerably advances our knowledge about the disease . The mouse has provided a suitable model for screening of antileprosy drugs, detecting development of drug resistance, ascertaining viability of the bacilli and determining the genuineness of a supposed culture of the leprosy bacillus . The armadillo has provided a model for making basic studies of the disease as it occurs in man . Further, the generalised infection in armadillo has provided large amounts of leprosy bacilli for preparing standardised lepromin, for preparing a specific skin-testing antigen containing the active protein fraction of the bacillus, and a step towards the production of a vaccine against leprosy . It is interesting to note that the fact that the protein fraction of the bacillus was responsible for the positive lepromin reaction was discovered by Dharmendra far back in 1941.

Int J Lepr Other Mycobact Dis, 1977 Jan-Mar, 45(1), 49 - 51
A modified allochrome procedure for demonstrating mycobacteria in tissue sections; Harada K; A modified allochrome staining procedure is presented as being the most reliable and sensitive method for demonstrating mycobacteria in tissue sections . The technic is as follows: Deparaffinize formalin fixed sections, oxidize in 10% periodic acid for 24 hours, differentiate in 1% HCl-70% ethanol, stain in Weigert's iron hematoxylin nuclear stain, and counterstain in picro-methyl glue . Mycobacteria stained brilliant red in contrast with the allochrome-stained background tissues, and apparently otherwise chromophobic bacilli are demonstrated.

Chemotherapy, 1977, 23(6), 424 - 35
Carfecillin: antibacterial activity in vitro and in vivo; Basker MJ et al.; Carfecillin, the alpha-phenyl ester of carbenicillin, hydrolyses rapidly in the presence of serum or body tissues to liberate carbenicillin but hydrolysis is less rapid in aqueous solution . The activity of carfecillin in antibacterial tests in vitro depends upon the extent of hydrolysis to carbenicillin, and in conventional serial dilution tests carfecillin shows an antibacterial spectrum generally similar to that of carbenicillin due to extensive hydrolysis . However, in tests in which the extent of hydrolysis is reduced, carfecillin displays lesser activity than carbenicillin against gram-negative bacilli and greater activity against gram-positive cocci . In the presence of serum carfecillin is hydrolysed rapidly to carbenicillin and the activity shown is solely that of carbenicillin . Unlike carbenicillin, carfecillin is well absorbed in mice after oral administration, producing significant carbenicillin blood concentrations and the compound is as effective by the oral route in the treatment of various experimental mouse infections as is parenteral carbenicillin.

Lancet, 1976 Dec 25, 2(8000), 1379 - 82
Penicillinase-producing Gonococci in Liverpool; Percival A et al.; Gonococci, which had acquired a TEM-type of penicillinase widely distributed among gram-negative bacilli, appeared in February, 1976, and soon accounted for 9% of isolates at a clinic in Liverpool . In 45 patients infected by such gonococci, the frequency of complications did not suggest reduced communicability or invasiveness, and usual forms of treatment with penicillins always failed . Spectinomycin succeeded in 21 (95%) of 22 patients treated, blt tetracyclines succeeded in only 13 (68%) of 19 . Appropriate laboratory tests for recognising penicillinase-producing gonococci must be used since such gonococci have already been transferred to other parts of the U.K . Penicillinase-stable cephalosporins were active in vitro and could prove to be the future treatment of choice.

Oral Surg Oral Med Oral Pathol, 1976 Dec, 42(6), 731 - 7
Sarcoidosis with mandibular involvement . Report of a case; Betten B et al.; A case of mandibular involvement in sarcoidosis is presented . The diagnosis was based on positive chest roentgenograms, involvement of superficial and mediastinal lymph nodes of epithelioid tubercles, negative tuberculin test, and negative results of an examination with respect to tubercle bacilli . Mandibular involvement was diagnosed tentatively roentgenographically and verified by histopathologic examination . The mandibular lesion was treated surgically, and the defect healed uneventfully after less than 1 year . Almost complete normalization of the pulmonary lesions had taken place after 2 years.

Chest, 1976 Dec, 70(6), 719 - 25
The P blood group system in pigeon breeders and pigeon breeder's disease; Effler D et al.; A blood group P1-like antigen has been found in gram-negative bacilli isolated from pigeon droppings, in pigeon serum, and on pigeon red blood cells . As a probable resident of the environment of the pigeon loft, the antigen stimulated formation of anti-P1 antibody in eight of 11 pigeon breeders who belonged to the P2 blood group . Only one of 11 random hospitalized patients with the P2 blood phenotype had a detectable titer of anti-P1 antibody (P less than 0.01) . The titer of anti-P1 antibody was not significantly different in symptomatic vs asymptomatic breeders . The presence or absence of anti-P1 antibody could not be correlated with any band of immunoprecipitates formed between pigeon breeder's serum and crude extract of pigeon droppings . The P antigen was identified in pigeon-dropping extracts of breeders with the P2 blood phenotype by inhibition of hemagglutination . We conclude that anti-P1 antibodies appear to be a component of the immunologic response to avian antigens of pigeon breeders but are probably unrelated to the pathogenesis of pigeon breeder's disease.

Acta Pathol Microbiol Scand {C}, 1976 Dec, 84C(6), 465 - 70
Effect of sodium-salicylate on the function of cultured, human mononuclear cells; Viken KE; The in vitro effect of Na-salicylate on some functions of human mononuclear cells was studied . In therapeutical concentrations the drug was found to interfere both the function of lymphocytes and monocytes/macrophages . Na-salicylate in concentrations of 400-800 mug/ml slightly inhibited the digestion of yeast particles . When the drug was present in the culture medium in doses above 160 mug/ml during the cell differentiation period from 90 minutes to the 8th day of culture, a reduction in the number of adhesive, viable cells was recorded . The remaining cells, however, were found to have a normal phagocytic function . A strong and dose dependent inhibition of the ability of lymphocytes to proliferate after antigenic stimulation with BCG bacilli was recorded . The inhibitory effect on the PHA response, however, was less prominent . The results presented indicate that Na-salicylate has a direct inhibitory effect on lymphocyte proliferation and monocyte differentiation and phagocytosis, which may be part of the explanation of the anti-inflammatory effect of the drug.

Tubercle, 1976 Dec, 57(4), 275 - 99
Transmission of tubercle bacilli: The effects of chemotherapy; Rouillon A et al.; The important differences in the infectivity of the various forms of tuberculosis can be explained by quantitative data concerning the behaviour of the tubercle bacillus in man and the number of bacilli in the lesions and sputum . Patients in whom tubercle bacilli can be detected by direct examination of the sputum smear are the main sources of transmission . Moreover the individuals infected by them break down more often with the disease . In the individual patient, the use of antibacterial drugs completely changes the natural history of the disease: not only do patients no longer die but they are cured; their period of infectivity is considerably reduced, relapses are avoided, chronicity disappears . The drugs used prophylactically in individuals of high risk groups prevent development of the disease . The impact of chemotherapy is reflected by a two-to-three-fold increase in the speed of decline of the risk of infection, a decline which had started before the introduction of the drugs . While patients given the right combination of drugs lose their infectivity in a few weeks (probably most often in less than two weeks), treatment must of course be continued much longer and regularly in order to ensure the maintenance of conversion and the absence of relapse . This stresses the importance of providing means to ensure the taking of the drugs by all patients . The future reduction of transmission will essentially depend on the maintenance of an adequate system ensuring the early diagnosis and correct treatment of cases, which will inevitably continue to appear among the already infected portion of the population . Epidemiological surveillance is mandatory as well as the surveillance of the delivery of services, particularly of the quality of diagnosis and therapeutic services . The roles of public health authorities and perhaps still more that of the practising physician, specialized and not specialized, remain considerable both from an epidemiological point of view and from the point of view of the relief of all the suffering still created by the disease.

J Clin Microbiol, 1976 Dec, 4(6), 522 - 3
Inoculation of API-20E from positive blood cultures; Blazevic DJ et al.; The API-20E system (Analytab Products, Inc., Plainview, N . Y.) was inoculated from 4- to 6-h tryptic soy broth cultures that had been inoculated from positive blood cultures containing gram-negative bacilli . This method gave the same genus and species identification for 139 of 140 organisms (47 patient and 96 simulated positive cultures) when compared to the Analytab Products, Inc., recommended method of inoculation.

Infect Immun, 1976 Dec, 14(6), 1369 - 74
Granulomagenic activity of serologically active glycolipids from Mycobacterium bovis BCG; Reggiardo Z et al.; The granulomagenic properties of serologically active glycolipids A1, B2, B3, and C isolated from Mycobacterium bovis BCG were studied . Glycolipid A1, dissolved in olive and injected intradermally in guinea pigs, was able to elicit a granulomatous response that seemed to be of the nonallergic type . This granulomagenic activity was quite striking since only 2 mug was necessary to elicit the reaction . The B and C glycolipids were milder granulomagenic agents . Glycolipid A1, dissolved in olive oil and injected intraperitoneally, was toxic for mice . Mice lost weight after the injection of as little as 10 mug of A1, although not even a dose of 100 mug was lethal . Glycolipid A1 failed to immunize mice against aerogenic infection with virulent tubercle bacilli.

Acta Pathol Microbiol Scand {B}, 1976 Dec, 84B(6), 379 - 85
Acquired resistance against Listeria monocytogenes in red mice and CF1 mice immunized with strains of BCG or Mycobacterium tuberculosis; Jespersen A; Groups of red mice and CF1 mice immunized intravenously with varying doses of a weak or a strong strain of BCG or a strain of Mycobacterium tuberculosis were challenged 3 weeks after immunization with 0.1 or 0.2 ml 10(-2) Listeria monocytogenes injected intravenously, simultaneously with a non-immunized control group . The acquired resistance was determined on the basis of the number of survivors and the survival times of the animals that died spontaneously . In the red mice, the strong BCG strain induced a definitely higher resistance than the weak strain, and the M . tuberculosis strain a slightly higher resistance than the BCG strains . As in red mice, the resistance of CF1 mice was higher in animals immunized with M . tuberculosis than in those immunized with the BCG strains . However, the difference in the survival times of mice immunized with the two strains of BCG was much less than in red mice, and was only clearly significant as regards one of the doses used . The relationship between the virulence of a mycobacterial strain and its ability to induce acquired resistance against an infection with listeria or against an infection with virulent tubercle bacilli is discussed . It is concluded that red mice are more suitable than CF1 mice for evaluation of the protective potency of a BCG strain.

J Infect Dis, 1976 Dec, 134(6), 531 - 9
Role of B-lymphocytes in nonspecific resistance to Klebsiella pneumoniae infection of endotoxin-treated mice; Parant M et al.; Lipopolysaccharides (LPS) of gram-negative bacilli are known to protect mice against unrelated bacterial infections and to be nonspecific mitogens of murine bone marrow-derived (B-) lymphocytes . For assessment of the role of these cells in the mechanism of LPS-induced resistance to infection with Klebsielia, various nontoxic mitogens were assayed . In contrast to LPS or lipid A, the nontoxic mitogens did not protect mice . Experiments were also performed with LPS in nude mice and in mice treated with immunosuppressants . Stimulation by LPS was decreased after administration of hydrocortisone or cyclophosphamide under conditions that inhibited the in vitro activation of lymphocytes by mitogens . Moreover, nude mice and mice treated with 6-mercaptopurine were more resistant to Klebsiella than were control mice.

Eur J Pediatr, 1976 Nov 3, 123(4), 243 - 54
Septicemia in the newborn due to gram-negative bacilli . Risk factors, clinical symptoms, and hematologic changes; Tollner U et al.; The case histories of 17 newborns developing septic shock due to gram-negative bacilli were studied for pre- and perinatal risk factors, clinical symptoms, and hematologic changes . Immaturity, resuscitation procedures, and hypothermia on admission were found to be the risk factors most frequently preceding septicemia . A skin color fading and changing from reddish-pink to yellow-green was the most early noticeable clinical symptom in all patients . The total leukocyte counts as well as the relative proportion of bands increased significantly at the onset of illness . When septicemia advanced, a marked drop of leukocytes was found, while the relative proportion of bands increased further . Only 1 in 12 cases showed a decrease in the platelet counts at the height of septicemia . A procedure for the early diagnosis of a neonatal septicemia is proposed: (1) Registration of perinatal risk factors . (2) With perinatal risk factors a skilled and attentive clinical observation is necessary . Particular attention should be paid to changes of skin color . (3) White blood cell picture: (a) every day in patients with perinatal risk factors and (b) every 6 h in patients showing suspicious symptoms.

Acta Radiol Diagn (Stockh), 1976 Nov, 17(6), 845 - 55
Radiologic aspects of BCG-osteomyelitis in infants and children; Mortensson W et al.; An account is given of results of the radiologic examination of 29 infants and children with bone tuberculosis caused by the Bacilli Calmette-Guerin (BCG) as a complication to intradermal vaccination . The diagnosis is based on radiologic appearances, microscopy and bacteriologic examination of specimens obtained from the bone lesions . The radiologic appearance of the bone lesions is in most cases characteristic and differs decisively from that of pyogenic osteomyelitis and malignant disease.

J Am Vet Med Assoc, 1976 Nov 1, 169(9), 920 - 7
Tuberculosis in captive exotic birds; Montali RJ et al.; Avian tuberculosis was studied clinically and pathologically in 137 affected birds from the National Zoological Park during a 7-year period (1969-1975) . Twelve of 22 orders exhibited were affected by the disease, and the highest annual mortality was 4% (in 1975) . Antemortem diagnosis of early cases of the disease, based on tuberculin testing, and serologic, hematologic, and radiographic studies, was inconsistent and often not conclusive . Pathologically, the diseases primarily involved digestive organs and spleen . There was a spectrum of lesions consisting of nodules of large foamy histiocytes packed with acid-fast bacilli to giant cell-containing granulomas that were often caseous but not cavitated or calcified . Amyloidosis was seen in approximately 20% of the cases . Mycobacterium avium serotype 1 was isolated from 30 tuberculous birds cultured . There was no sex predilection, and most of the affected birds were adults ranging from 1 to 10 years of age.

J Am Vet Med Assoc, 1976 Nov 1, 169(9), 912 - 4
Mycobacterium tuberculosis infection in two East African oryxes; Lomme JR et al.; Tuberculous lesions were observed at necropsy of 2 East African oryxes (Oryx gazella beisa) at a municipal zoological park in Jackson, Ms . Microscopic examination revealed granulomas containing acid-fast bacilli in the lungs and liver of both animals, as well as in the uterus and mediastinal lymph nodes of 1 animal . Mycobacterium tuberculosis was isolated from the tissues of both oryxes and from fluid aspirated from the mammary gland of 1 oryx; the organism was pathogenic for guinea pigs but not for rabbits.

J Infect Dis, 1976 Nov, 134 SUPPL, S433 - 40
Comparative effectiveness of combinations of amikacin with penicillin G and amikacin with carbenicillin in gram-negative septicemia: double-blind clinical trial; Klastersky J et al.; Preliminary results are presented for an ongoing, double-blind, clinical trial, in which the efficacy of amikacin plus penicillin G (Amik-Pen) and amikacin plus carbenicillin (Amik-Carb) is compared in treatment of severe gram-negative infections superimposed on serious underlying disease . All clinical isolates were sensitive to amikacin in vitro (minimal inhibitory concentration, less than 12 mug/ml) . Results in 50 patients with cancer and documented gram-negative infection, 29 of which involved septicemia, were analyzed . In the Amik-Pen group, 40% of 15 cases of septicemia responded favorable to therapy, as compared with 86% of 14 cases of septicemia in the Amik-Carb group; this difference is statistically significant (P less than 0.02) . When all patients were considered together, the outcome appeared more favorable (1) in infections caused by pathogens sensitive to both antibiotics used then in those caused by organisms sensitive to amikacin only (83% vs . 43%); (2) when the combined antibiotics demonstrated synergy in virto against the offending pathogen than when the combination was nonsynergistic (83% vs . 38%); and (3) when the peak serum antimicrobial dilution titer was larger than or equal to 1:8 than when titers were lower . The results of this study suggest that routine use of an antibiotic combination that has demonstrable in vitro synergy against the offending pathogen should be considered for the treatment of proven or suspected severe infections due to gram-negative bacilli.

Am J Public Health, 1976 Nov, 66(11), 1101 - 6
Tapering off of tuberculosis among the elderly; Myers JA; Tuberculosis has long been prevalent among elderly people . When tubercle bacilli first enter human bodies they usually remain through the rest of their hosts' lives and are capable of causing clinical disease any time, even in old age . In 1900, a large percentage of people of all ages were harboring tubercle bacilli and high mortality and case rates obtained among elderly people . The only way to solve the problem among future old people was to protect infants, children, and youths from becoming infected and remain so throughout life . As far as possible that was accomplished by isolating and treating tuberculosis patients in sanatoriums and hospitals, with anti-tuberculosis drugs after 1946, and controlling the disease among cattle . In due time, large numbers of children entered adulthood uninfected . From year to year, they replaced those heavily infected as they advanced in years . By 1973 the mortality rate was only a fraction of 1.0 per 100,000 among people under 34 years but of those of 65 to 84 years it was 9.7 . The case rate was 28.1 for those older than 45 years . Although tuberculosis among the elderly has tapered off phenomenally, much time and work are necessary to accomplish eradication.

Lepr India, 1976 Oct, 48(4 Suppl), 703 - 8
Clinical trial with clofazimine in leprosy; Ganapati R et al.; This paper summarises our clinical experience with clofazimine in the treatment of 25 cases of reactive states of lepromatous and borderline leprosy and 7 lepromatous patients not responding to dapsone . Corticosteroids, which had to be given for the control of reactions, could be withdrawn and daspone therapy reintroduced during the period of administration of clofazimine . A schedule for the management of moderately severe reactions is recommended . The results of clofazimine treatment were also equally impressive in the group of patients, possibly harbouring dapsone resistant bacilli (in view of their lack of improvement in spite of administration of dapsone under controlled conditions) . Clinical regression was associated with a fall in the mean levels of morphological index from 6.8 to 0.5 . The need to realise the real indications of this highly useful drug in the treatment of leprosy is stressed.

Pediatrics, 1976 Oct, 58(4), 561 - 3
Hemolytic-uremic syndrome: absence of circulating endotoxin; van Wieringen PM et al.; In children with hemolytic-uremic syndrome endotoxin determinations were carried out in the peripheral circulation in order to get evidence for the hypothetical role of endotoxin in the pathogenesis of the disease . For this purpose the Limulus test was used to determine endotoxin activity in 16 patients with hemolytic-uremic syndrome . In the plasma of these patients no endotoxin could be detected above the lower detection limit of 100 pg/ml, although in all patients with septicemia due to gram-negative bacilli the test was positive.

Int J Lepr Other Mycobact Dis, 1976 Oct-Dec, 44(4), 435 - 42
Oxidation of 3,4-dihydroxyphenylalanine by connective tissue constituents . Identification of Mycobacterium leprae not related to phenolase activity; Kato L et al.; The oxidation of 3,4-dihydroxyphenylalanine (DOPA) was studied by spectrophotometric methods at pH 6.8 . In the presence of L- or D-DOPA, a color development occurred in the presence of the following substances as measured by increase in absorption both at 540 nm and 480 nm: hyaluronic acid, trypsinized human skin and umbilical cord extract, trypsin treated rat tissue from subcutaneous rat leproma, trypsin treated M . lepraemurium isolated from rat lepromata, and trypsinized M . leprae isolated from non-treated lepromatous leprosy cases . Normal human skin and connective tissue extract and nontrypsinized connective tissue of rat leprosy granuloma did not oxidize DOPA . While the trypsin-treated partially purified M . leprae suspension oxidized DOPA at both wave-lengths, the hyaluronidase-treated same suspension of M . leprae failed to oxidize these phenolic compounds . Mushroom tyrosinase oxidized D-DOPA, L-DOPA, epinephrine and norepinephrine at 480 nm . Hyaluronic acid also oxidized epinephrine and norepinephrine at both wave-lengths . Since it is known that M . leprae in the human host is closely associated with the presence of the acid mucopolysaccharides of the skin, and since acid mucopolysaccharides and skin constituents strongly oxidized DOPA, and since the hyaluronidase treated M . leprae failed to oxidize DOPA, it became evident that hyaluronic acid and not M . leprae is responsible for DOPA oxidation, and phenolase activity is not associated with the metabolism of M . leprae . Evidence is presented that DOPA is not a unique characteristic of the human leprosy bacillus . For instance, trypsin-treated murine leprosy bacilli from the rat strongly oxidized DOPA . The reaction of DOPA oxidation, therefore, must be rejected as a test for the identification of M . leprae . The obtained results confirmed the pertinent findings of Skinsnes and his co-workers.

Lab Anim Sci, 1976 Oct, 26(5), 807 - 10
Chromobacterium violaceum infection in a nonhuman primate (Macaca assamensis); McClure HM et al.; Chromobacteriosis caused by Chromobacterium violaceum was diagnosed as an Assam macaque, Macaca assamensis, that died 4 days after receipt of the Yerkes Primate Center, It was received from a primate facility in Florida where it has been housed with a group of rhesus monkeys for 5 years . The animal died suddenly without showing any signs of clinical illness . Necropsy findings included extensive hepatic necrosis with the formation of multiple large cavitary lesions . Foci of necrosis were also found in the lungs and lymph nodes . Numerous gram-negative bacilli were demonstrable in the lesions and Chromobacterium violaceum was isolated from the blood, liver, lungs, spleen and kidneys.

Am Rev Respir Dis, 1976 Oct, 114(4), 807 - 11
Dynamics of submerged growth of Mycobacterium tuberculosis under aerobic and microaerophilic conditions; Wayne LG; When Mycobacterium tuberculosis is grown in detergent-containing medium under continous agitation, multiplication is known to follow a logarithmic mode . When the cultures are not continuously shaken, but only agitated a few times a week to resuspend the bacilli and permit turbidity to be measured, the net increase suggests an arithmetic growth mode . It is shown here that a single pulse of aeration of an unshaken submerged culture of M . tuberculosis causes an almost instantaneous acceleration of growth, followed rapidly by a cessation of growth . Whether or not the bacilli will subsequently resume growth depends on the bacillary population density of the cuture at the time of application of the pulse of aeration . If the bacilli are permitted to grow in the depths of Dubos Tween Albumin broth without any agitation, they exhibit net arithmetic growth and attain a maximal population density greater than is seen in cultures exposed to occasional pulses of aeration . By the use of isotopically labeled cells, it has been shown that replication occurs ar a logarithmic rate amoung the small proportion of the bacilli that remain suspended in nonagitated cultures . This replication is balanced by settling of cells, resulting in a net appearance of arithmetic multiplication . The cells that have settled into the sediment replicate at a very slow rate, if at all, but do retain their viability for 4 weeks or longer . This suggests a possible analogy to quiescent tubercle bacilli in vivo.

Lepr India, 1976 Oct, 48(4), 413 - 8
Bacillaemia in reactive states of leprosy; Padma MN et al.; 35 cases of lepromatous and near-lepromatous cases of laprosy in Reaction have been investigated for the presence of acid-fast bacilli in blood at the height of the reaction as well as at its subsidence . Only 3 cases exhibited bacillaemia during reaction . It is therefore unlikely that dissemination of the disease is accentuated during reaction as commonly believed . Further, the immune complexes demonstrated to be circulating during reaction are possibly formed by bacillary products and not by whole or fragmented bacilli.

Lepr India, 1976 Oct, 48(4), 391 - 7
Correlation of morphology with viability of Mycobacterium leprae; Desikan KV; A concept has been developed in the recent years that the evenly stained 'solid' bacilli are living and the 'non-solid' forms are degenerate and dead . This communication presents the findings in experimental mice inoculated with material containing 1 to 10% solid evenly stained M . leprae and also with material containing 0% solid organisms . There was multiplication of the bacilli in both the groups . Quantitatively, the yield also was not significantly different . These fundings do not support the belief that the non-solid bacilli are necessarily dead . The non-solid bacilli were further classified on the basis of their morphology to the following forms:-- (a) short but evenly stained (b) indented (c) beaded (d) dumb-bell shaped (e) coccoid and (f) fragmented . Material without solid bacilli, but containing different proportions of the above types of bacilli also gave similar results, making it diffcult to say which types of morphological forms are non-living . It appears, therefore, that the recognition of the living status of M . leprae by its morphology is highly equivocal and subject to error.

Int J Lepr Other Mycobact Dis, 1976 Oct-Dec, 44(4), 431 - 4
A simplified hyaluronic acid based culture medium for mycobacteria isolated from human lepromata; Kato L et al.; Acid-fast bacilli multiplied in liquid culture media containing hyaluronic acid when inoculated with mycobacteria from a lepromatous leprosy nodule . The culture was readily subcultured at ten day intervals in the homologue media, but failed to grow in the Dubos, Middlebrook and Lowenstein media . These findings confirm the results of Skinsnes et al (1975) . Identification of this culture is not yet available, however it gives positive immunofluorescence with authentic anti-M . leprae serum . The obtained culture also grows as a chromogenic culture at 34 degrees C on a simple medium prepared from trypsin digested human umbilical cord, yeast extract powder and glycerol . This medium can be sterilized in an autoclave, but filter sterilized sheep, bovine or horse serum must be added aseptically as an essential ingredient . The medium does not differ considerably from the hyaluronic acid medium proposed by Skinsnes et al, but it is easier to prepare, it is inexpensive and permits a logarithmic growth within seven days of the so far unidentified culture isolated from leprotic nodules.

Int J Lepr Other Mycobact Dis, 1976 Oct-Dec, 44(4), 427 - 30
Activity of ascorbic acid in inhibiting the multiplication of M . leprae in the mouse foot pad; Hastings RC et al.; Ascorbic acid was fed to mice in concentrations of 0.05%, 0.15%, and 0.45% w/w in the diet . Six months after inoculation of M . leprae into the foot pads, there were significantly fewer acid-fast bacilli harvested from animals receiving 0.15% and 0.45% w/w ascorbic acid than from control mice . On the other hand, M . leprae did multiply in mice fed ascorbic acid while no multiplication at all was observed in animals fed dapsone, clofazimine or rifampin . No toxic effects of ascorbic acid were noted in these mice.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1976 Oct-Dec, 25(4), 229 - 36
{Results of intermittent treatment with antitubercular agents in cavernous pulmonary tuberculosis in adults}; Moisescu V et al.; The effectiveness of the intermittent treatment (2/7) with Rifampicin + Etambutol, administered over periods of 3 to 24 months, was tested in a log of 229 out-patients suffering from tuberculosis (bacilli carriers) . Negativation of the cultures was obtained in 88.4% of the cases, most of the failures being recorded in the aged patients from rural areas, suffering from various other associated diseases and in those who did not cooperate . As these patients raise particular problems concerning the therapeutical attitude, the authors consider they should be admitted to hospital, at least during the critical periods of the disease.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1976 Oct-Dec, 25(4), 209 - 16
{Current incidence of tubercular infection in children in the Dolj district}; Golli V; A lot of 122459 children under the age of 14 were tested intradermally with 2 U PPD . Most of them had been vaccinated at birth and some revaccinated later during the 1966-1967 period, which does not represent interpretation of the prevalance of tuberculosis today, bearing in mind the low postvaccinal allergy of young children and the interval after the last vaccination, only the children with a reaction of more than 10 mm in diameter were taken into consideration as they represented the highest probability of the actual spread of the infection . In the age group up to 6 years 6.82% of the children were infected and 17.12% of the school children of grades II to VIII, i.e . less than the mean values recorded in the whole country . This was attributed to the intensive specific chemotherapy applied within the area . The prevalence gradually increased from 3.93% at the age of l year to 4.90% at 3 years, then sharply to 6.93% at 4 years (when the child's relations are extended) and 10.46% at 5 years . The proportion of infections was of 12--13% in grades II--IV (7-9 years), 16.63% in grade V, 20% in grade VI and 23.21% in grade VIII (13-14 years) . The present values are much lower than those recorded in 1966 . The present risk of infection is of 1%, with an annual decrease rate of 7%, starting in 1956 . By comparison with the published data it is considered that neutralization by chemotherapy of all bacilli carriers will accelerate the rate of decrease of infection.

Jpn J Microbiol, 1976 Oct, 20(5), 365 - 73
In vitro studies on the mechanism of acquired resistance to tuberculous infection . II . The effects of the culture supernatants of specifically stimulated-sensitized lymphocytes on the growth of tubercle bacilli within macrophages; Muraoka S et al.; Immune lymph node cells were obtained from mice immunized with bovine gamma globulin (BGG) in complete Freund's adjuvant or allogeneic MH134 tumor cells . They showed the capacity of conferring bactericidal activity on macrophages infected with Mycobacterium tuberculosis, H37Rv, when they were incubated on macrophage monolayers together with the corresponding antigen, i.e., BGG or solubilized cellular antigen of the tumor cells . However, such capacity was lower than that of tubercle bacilli-immune lymph node cells . Culture supernatants were harvested after incubation of tubercle bacilli-immune, BGG-immune or allogeneic tumor-immune lymph node cells with the corresponding antigen for 24 hr . Macrophages were altered so as to suppress intracellular bacillary growth when macrophage monolayers were exposed to the supernatants for more than 2 days . When normal lymph node cells were incubated on normal macrophage monolayers together with a mitogen such as PHA or concanavalin A, growth of tubercle bacilli within the macrophages was slightly but difinitely suppressed . The mechanism of elicitation of cellular immunity to the infection with tubercle bacilli is discussed on the basis of results presented in this and the preceding paper.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol, 1976 Oct-Dec, 21(4), 227 - 32
{Typhoid bacilli resistant to chloramphenicol and multiresistant to antibiotics isolated at the beginning of 1971}; Duca E et al.; The sensitivity of chloramphenicol (C) of 286 S . typhi strains, isolated during the last 15 years in Moldavia, was tested . The minimum inhibitory concentration (MIC) of C with regard to most of the strains ranged between 1.5 and 3 mcg/ml . The following stains were identified: strain W isolated from the feces of a carrier in 1971, with a ACKSSuT-Cl2Hg resistance spectrum transferable to E . coli K12(MIC of C less than or equal to 200 mcg/ml), 2 strains (phage type A and C1, isolated from patients, one from the feces in 1972 and the other haemoculture in 1973) with a non-transferable CSu resistance spectrum (MIC of C less than or equal to 6 and less than or equal 12 mcg/ml respectively), and 18 strains (13 phage type D9, 3 phage type Ci and 2 phage type A), isolated from 3 epidemic foci, which proved to contain variants selectable in vitro by C (MIC up to 50 mcg/ml) . The resistance spectrum of the variants was not CSU transferable . Conclusions are drawn concerning the necessity of a restricted utilization of chloramphenicol.

J Clin Pathol, 1976 Oct, 29(10), 931 - 3
Comparison of machine and manual staining of direct smears for acid-fast bacilli by fluorescence microscopy; Clancey JK et al.; Comparisons were made in Lusaka and in London between manual staining and staining in an automatic machine with auramine-phenol of direct smears of sputum and other types of specimen for acid-fast bacilli . No evidence was obtained of carry-over of acid-fast bacilli from positive to negative smears during machine staining . There was improved contrast between bacilli and the background in smears prepared with the machine.

Infect Immun, 1976 Oct, 14(4), 919 - 28
Immunity to Mycobacterium leprae infections in mice stimulated by M . leprae, BCG, and graft-versus-host reactions; Shepard CC et al.; Infections of mice with Mycobacterium leprae in one rear foot pad immunized them against a second infection in the other rear foot pad . Purified bacilli harvested from the first infection also produced immuniy when injection into the foot pads of previously uninfected mice . Injections of BCG afforded similar protection, but had no adjuvant effect on M . leprae . M . duvali, a cultivable mycobacterium that is reported to be more closely related antigenically to M . leprae than BCG is, provided much less protection against M . leprae challenge than BCG did . Moreover, when M . duvali was mixed with BCG, it was not any more effective than BCG alone . Graft-versus-host reactions, induced by injections of parental spleen cells into F1 hybrids, provided no protection against M . tuberculosis and M . marinum challenge . They gave moderate protection against M . leprae in one experiment but not in another with a different schedule . Allogenic spleen cells had a protective effect when injected locally into the infected foot pad . The effect produced by these injections of spleen cells was a delay in the appearance of bacterial growth; however, there was no decrease in the rate of logarithmic growth when it did appear and no reduction in the eventual plateau level.

Acta Neuropathol (Berl), 1976 Sep 15, 36(1), 31 - 8
Whipple's disease of the central nervous system; Silbert SW et al.; Whipple's disease presenting as a neurological disease without gastrointestinal symptoms is an unusual occurrence . A 40 year old man suffered hypersomnia, memory loss and progressive ophthalmoplegia for 6 months prior to death . The nature of this disease was not established during life . Extensive granulomatous inflammation affecting the hypothalamus, hippocampus and periaqueductal gray matter of the brain was found to represent Whipple's disease by electron microscopy . Characteristic lesions were also present in spleen, mesenteric lymph nodes, small intestine and myocardium . Bacillary bodies and membranous inclusions similar to those seen in visceral lesions of Whipple's disease were present in macrophages . The findings supported the theory of direct involvement of the central nervous system by bacilli rather than a metabolic origin for the lesions.

Southeast Asian J Trop Med Public Health, 1976 Sep, 7(3), 411 - 4
Absence of plague in certain mammals from Java and Kalimantan (Borneo); Van Peenen PF et al.; Antibodies against plague were lacking in 237 wild mammal sera from Java and 103 from Kalimantan . Wild mammal spleens, 114 from Java and 18 from Kalimantan were negative for plague bacilli . A variety of mammalian species and areas was examined.

Z Erkr Atmungsorgane, 1976 Sep, 146(3), 251 - 62
{Results of the systematic control of tuberculosis in the People's Republic of Poland according to the development of the epidemiological data till 1975 (author's transl)}; Leowski J et al.; After the second World War a marked improvement of the epidemiological situation in the field of tuberculosis has been achieved in Poland . In 1952 the incidence of tuberculosis amounted to 490 per 1000 000 of the population; the prevalence to 1400 . The mortality rate was 105.8 in 1950 . In 1974 the incidence rate has been reduced to 81.4 (among them 49.4 excretors of tubercle bacilli), the prevalence rate was only 248.9 (among them 78.3 with excretion of tubercle bacilli and 11.7 with chronic tuberculosis--persons excreting tubercle bacilli for more than 2 years) . The mortality rate from tuberculosis amounted to 13.8 at this time . The most sensible reduction of all indices was found among children 0-14 years old . Tuberculosis in Poland is still a problem of medico-social importance in adults and before all in old people, being that part of the population in past times only in a low degree vaccinated or revaccinated and in a higher degree exposed to severe infections with tubercle bacilli . The comprehensive complex programme of tuberculosis control passed by the Sejm of the Polish People's Republic, includes three approaches since 1960: the epidemiological, the integrating and the phthisiopneumological direction . Prerequisites for the scheduled realisation of the programme are the case-finding as early as possible, the quick and correct diagnosis and the immediate onset of a specific treatment, further on the dispensary care of all contacts of the patient (his surroundings) and optimal prophylactic measures against tuberculosis.

Stain Technol, 1976 Sep, 51(5), 255 - 60
The nature of mycobacterial acid-fastness; Harada K; Phenol is not essential to acid-fast staining, for it will occur in the absence of phenol where such lipoid-soluble basic dyes as night blue, Victoria blue B or Victoria R are used; it is essential for acid-fast staining with water soluble basic dyes such as basic fuchsin . When phenol is added to the staining solution, such water soluble basic dyes behave in effect like their lipid-soluble counterparts . The loss of mycobacterial acid-fastness with carbol-fuchsin after bromination or chromation indicates that this phenomenon is related to the presence of unsaturated lipids in the bacterial cells . Within the cells these acid-fast lipids are bound in such a way that they are easily removed from all mycobacteria by hot dilute HCl; from leprosy bacilli alone they are easily removed with hot pyridine . From the results of various blocking reactions it appears that carboxyl and especially hydroxyl groups of these cellular lipids are essential to the acid-fast reaction of mycobacteria.

Tubercle, 1976 Sep, 57(3), 207 - 25
A system for the examination of tubercle bacilli and other mycobacteria; Marks J; Methods are described for the examination of mycobacteria cultured from clinical specimens . In the "screening" procedure used for new isolates tubercle bacilli are non-pigmented, do not grow at 25 degrees C and are sensitive to p-nitrobenzoic acid as well as normally to anti-tuberculosis drugs . Classification is extended when necessary by the use of four tests--temperature requirements, pigmentation, oxygen preference and Tween hydrolysis . These define 15 species or groups meeting the needs of clinical bacteriology . Drug-sensitivity tests are described which relate the end-points of titrations to the modal response of normal wild strains of M . tuberculosis . They are used not only as a guide to chemotherapy but also to support and amplify classification.

Lancet, 1976 Aug 14, 2(7981), 357 - 9
Tuberculosis in the Potteries 1971-74; Prowse K et al.; Notification rates of all forms of tuberculosis have increased in all age-groups in the Potteries, in a stable population which includes only a small immigrant community . The increase is greatest in both males and females over the age of 65 years and under 15 years . High notification rates have been recorded in workers in the pottery and mining industries and were unrelated to pneumoconiosis . Discrepancies have been found between the numbers of notified cases and the numbers of laboratory isolates of tubercle bacilli, particularly in cases of non-respiratory disease . This indicates that not all proven cases of tuberculosis are notified . The study has revealed serious deficiencies in the contact-tracing procedure in certain areas of the Potteries consequent upon the closure and reorganisation of outlying chest clinics.

No Shinkei Geka, 1976 Aug, 4(8), 785 - 90
{Two cases of craniolacunia associated with meningocele and meningoencephalocele (author's transl)-a1}; Shigemori M et al.; Craniolacunia (lacunar skull, Luckenschadel) is characterized by multiple, round or oval, radiolucent defects, sharply separated by dense strip of bone (honey comb like configuration) which tend to cluster in the cranial vault on plain skull film . Craniolacunia is present at birth and frequently associated with myelomeningocele, encephalocele or other congenital abnormalities of the central nervous system . Patients with carniolacunia have high mortality due to these associated lesions, and to the secondary effects of these neurological lesions . Recently, it is interested that the presence of carniolacunia can be used as an early indicator of intellectual capacity or recommendation of early indicator of intellectual capacity or recommendation of early surgery for associated lesions . Two cases of craniolacunia with meningocele in the lumbar region and encephalocele in the frontal region are presented and the etiology, clinical significance, prognosis of craniolacunia are discussed . Case 1 (Fig . 1, 2, 3), who had a soft tumor in the lumbar region since birth, was admitted to Saiseikai Yahata Hospital under the diagnosis of meningocele on October 26, 1973 . The circumference of the head was 32.5 cm, and the lumbar tumor was infant fist growth, oval, brownish and soft in appearance . The patient had no neurological positive signs or other abnormalities including chest, abdomen and extremities . Plain skull film showed typical craniolacunia in the parietal, frontal and occipital region of the vault . Three days after admission, the patient had opisthotonus like posture at times and convulsive seizure of extremities . Suspected of meningitis, ventricle tap was performed . From the findings of obtained cloud xanthchromic cerebrospinal fluid which was revealed pleocytosis and many Klebsiella or other Gram (-) bacilli on bacterial culture, the diagnosis of ventriculitis was made...

South Med J, 1976 Aug, 69(8), 979 - 85
The diagnosis and treatment of leprosy; Jacobson RR et al.; Leprosy is a complex disease, but recent research and the Ridley-Jopling classification which emphasize its immunologic aspects have greatly aided our understanding of and approach to the problem . The diagnosis should be considered whenever skin lesions and sensory loss occur . Dapsone remains the treatment of choice, but several newer drugs show great promise, especially in those cases whose bacilli have become sulfone resistant . Immunotherapy may play an increasingly prominent role in the future . Reactive episodes continue to be a serious complication, but the availability of thalidomide to control erythema nodosum leprosum has markedly improved the prognosis . Physicians of the US Public Health Service Hospital at Carville, Louisiana, are available at all times for consultation on these and other matters related to leprosy.

Am J Med, 1976 Aug, 61(2), 277 - 82
Tuberculous arthritis: A report of two cases with review of biopsy and synovial fluid findings; Wallace R et al.; Two cases of tuberculous arthritis with synovial fluid findings are presented, and the major series with culture results and synovial fluid analyses are reviewed . Synovial fluid cultures are positive for tuberculosis in almost 80 per cent of proved cases . Specimens obtained by open synovial biopsy are positive by histology or culture in over 90 per cent of proved cases . Little experience with closed needle biopsy has been published . About one-fifth of the patients with tuberculous arthritis will have a positive synovial fluid acid-fast smear for tubercle bacilli . The tuberculous synovial effusion invariably has an elevated protein level, fair to poor mucin clot formation and usually a low joint fluid sugar level . The synovial fluid white cell count is usually in the range of 10,000 to 20,000 cells/mm3, but it varies widely . Most fluids exhibited a predominance of polymorphonuclear leukocytes . The importance of bacteriologic or histologic study of the synovial fluid and membrane in establishing the diagnosis is emphasized . In general, this disease is different from tuberculous involvement of serous membranes both in the frequency of positive cultures and in the difference in cellular response.

Cutis, 1976 Aug, 18(2), 221 - 3
Lupus vulgaris: recovery of living tubercle bacilli 35 years after onset; Schmitt CL et al.; Recovery of living tubercle bacilli in a lesion of 35 years' duration is intriguing if not novel, and creates many possible rationalizations relative to the relentless progressive course of lupus vulgaris . That the histopathological picture is not always diagnostic is exemplified in this case.

Jpn J Med Sci Biol, 1976 Aug, 29(4), 199 - 201
A suggested role of a host-parasite lipid complex in mycobacterial infection; Kondo E et al.; On the basis of our previous observations and related literatures, was assumed tht cholesterol esters of host origin and phthiocerol dimycocerosate of bacterial origin are located as a lipid mixture around the periphery of pathogenic mycobacteria growing in vivo, probably within the phagocytic vacuole of macrophages . To examine the role of such a postulated lipid complex in mycobacterial infection, a model experiment was made in which tubercle bacilli grown in vitro were "coated" with both lipids and then suspended homogenously in water to serve as an inoculum to infect mice intravenously . Their fate in mouse tissue was compared with that of untreated control bacilli . The results indicated that the lipid "coating" had an infection-promoting effect as revealed by the longer persistence of the treated avirulent bacilli at higher levels of viable counts . When virulent tubercle bacilli were "coated" with the lipid mixture, they became less sensitive to the protective mechanism of BCG-immunized mice.

Am Rev Respir Dis, 1976 Aug, 114(2), 353 - 8
Phage type of tubercle bacilli isolated from patients with two or more sites of organ involvement; Bates JH et al.; To evaluate the possibility of separate pulmonary infections in human beings by different strains of Mycobacterium tuberculosis, a search for multiple phage types within a single host was under-taken . Culture isolates from 2 or more distinct anatomic sites of infection in the same patient were obtained from 87 persons . In 3 subjects, 2 distinct phage types were found . The possible explanations for 2 types in the same patient and the epidemiologic implications are discussed.

Am Rev Respir Dis, 1976 Aug, 114(2), 407 - 9
A new heat-stable acid phosphatase test for mycobacteria; Saito H et al.; The heat-stable (70degrees C) acid phosphatase test performed by the method of Kind and King is a simple method for differentiating Mycobacterium kansasii, M . marinum, M . gastri, M . nonchromogenicum, and M . triviale from other slowly growing mycobacteria, and M . fortuitum from other rapidly growing acid-fast bacilli.

Zh Mikrobiol Epidemiol Immunobiol, 1976 Aug, (8), 66 - 9
{Blood groups of the ABO system of chronic carriers of typhoid bacteria and typhoid patients in Uzbekistan}; Nevskii MV et al.; Blood groups of the ABO system were studied in 186 chronic carriers of typhoid bacilli and in 392 patients with typhoid fever from various districts of the Uzbek SSR . In comparison with control (healthy persons), carriers displayed a higher percentage of persons with A (II) blood group (50.88 and 42.64 against 37.51 and 32.13 in control) and a lesser percentage of persons with the O (I) blood group (21.05 and 22.48 against 32.93 and 32.07 in control) . These data demonstrated that predisposition of persons with the A (II) blood group to chronic typhoid carrier state was characteristic of the Asian part of the country . In comparison with control, there were significantly less persons with the O (I) blood group and more with the AB (IV) blood group . Possible correlative mechanisms between the blood group and the typhoid infection and the development of chronic typhoid carrier state is discussed.

South Med J, 1976 Aug, 69(8), 993 - 6
Recent advances in experimental leprosy; Kirchheimer WF; Within the last 15 years we have learned to identify Mycobacterium leprae, determine its viability, screen the efficacy of antileprosy drugs, and monitor the bacilli for drug sensitivity . We have evidence that subclinical infections occur frequently among contacts of patients with leprosy and that the different manifestations of leprosy reflect differences in resistance to M leprae . We are developing hypotheses about the mechanism of these differences . We have experimentally transmitted lepromatous leprosy to normal armadillos, and from these we can obtain amounts of leprosy bacilli which fully substitute for harvests from in vitro cultures . Furthermore, if susceptibility of armadillos can be determined without infecting them and if we can breed them under controlled conditions, we would have an animal model for investigating fundamental and applied areas of leprosy which otherwise are intractable . How much our knowledge has advanced is illustrated by a project of the World Health Organization which calls for the preparation of pure, specific antigens from the now available abundance of leprosy bacilli, which might become valuable as diagnostic and epidemiologic tools and as immunoprophylactic and even immunotherapeutic weapons.

No Shinkei Geka, 1976 Jul, 4(7), 707 - 13
{Successfully operated case of posterior fossa tuberculoma in childhood (author's transl)}; Ottomo M et al.; A case of intracerebellar tuberculoma is described in which a tuberculoma was removed successfully through the administration of antituberculous agents, and a full recovery was obtained . The patient was a 3-year-old boy who had been receiving antituberculous agents for about 4 months because of acute inflammation followed by osteomyelitis of his right big toe, which was suspected to be tuberculous, and because of pulmonary tuberculosis diagnosed in a chest roentgenogram taken about 1 month after osteomyelitis was cured . While his osteomyelitis was being treated, disturbance in his gait, due to progressive spastic paraparesis, was not iced, and thereafter left cerebellar symptoms with impairment of equilibrium appeared additionally . Then, he was reffered to our clinic for further neurosurgical examination, and was admitted on November 1, 1974 after right carotid and vertebral angiography was performed via the right axillar artery, in which findings suggesting left cerebellar tumor and internal hydrocephalus were obtained . After he was admitted to our clinic, a diagnosis of tumor of the left cerebellum and internal hydrocephalus was more precisely confirmed by pneumoventriculography . Suboccipital craniectomy was then carried out and the tumor, weighing 60 gm, was completely removed from the left cerbellar hemisphere . The tumor was confirmed as tuberculoma not only by histological findings but also by the vertification of tuberculous bacilli in it . Though, moderate fever lasted for about 2 weeks postoperatively, no obvious meningitic signs or new neurological deficits were noted . The patient showed marked improvement especially in his gait disturbance, and was discharged ambulatory 40 days after the operation, and has since been asymptomatic except for slight ataxic gait . The antituberculous agents have been continuously administered postoperatively.

Avian Dis, 1976 Jul-Sep, 20(3), 587 - 92
Isolation of Mycobacterium avium serotype 3 from a white-headed tree duck (Dendrocygna viduata); Thoen CO et al.; Tuberculous lesions were observed at necropsy in the liver of 1 of 10 White-headed Tree ducks (Dendrocygna viduata) imported from Nigeria . Microscopic examination revealed granulomas with acid-fast bacilli; Mycobacterium avium serotype 3 was isolated . Two chickens inoculated intraperitoneally with the isolant had gross and microscopic granulomas in the liver at necropsy 62 days after inoculation . Isolants from chickens were serologically similar to the strain isolated from the duck.

Res Vet Sci, 1976 Jul, 21(1), 117 - 8
Aggregation and anticomplementary activity of an antigen used in the complement fixation test for Johne's disease; Morris JA et al.; Exhaustive lipid extraction of the Johne's bacilli before preparing the Maltaner-Wadsworth antigen removed both the anticomplementary activity of the preparation and its ability to fix complement . Gel filtration temporarily removed anticomplementary activity but tended to reduce the antigenic activity of the extract . Sonication significantly reduced the anticomplementary activity of the antigen without affecting its capacity to fix complement but the effects were only temporary . It is suggested that the antigen exists as micelles which gradually aggregate and re-arrange thereby exposing anticomplementary sites hitherto masked in the dispersed micelles.

Crit Care Med, 1976 Jul-Aug, 4(4), 211 - 4
Airway maintenance in patients with long-term endotracheal intubation; Comer PB et al.; Long-term endotracheal intubation in seriously ill patients is frequently complicated by nosocomial infection of the tracheobronchial tree, especially with aerobic gram negative bacilli . A further complication is drying of pulmonary secretions unless the medical gases given are humidified . The performance characteristics of humidifying system used in spontaneously breathing, intubated patients is described . This system possesses the potential to decrease infection, provides physiologic humidification without nebulization, and, by avoiding air dilution, allows the administration of a precisely regulated FIO2.

Arch Ophthalmol, 1976 Jul, 94(7), 1173 - 4
Penetration of tobramycin sulfate in the aqueous humor of the rabbit; Uwaydah MM et al.; The intraocular penetration of tobramycin sulfate, a new aminoglycoside antibiotic, was evaluated in rabbits following subconjunctival injection . The mean tobramycin sulfate concentration in the aqueous humor 60 minutes after a single 5-mg dose was 5.5 mug/ml, as compared to a mean concentration of 6.7 mug/ml following a single 10-mg dose . These levels exceed the minimal inhibitory concentration (MIC) for most Pseudomonas species and a variety of other Gram-negative bacilli recovered from clinical infection . No anterior segment changes that may be attributed to the antibiotic could be demonstrated in the injected eye.

Ann Intern Med, 1976 Jul, 85(1), 64 - 6
Transbronchial lung biopsy via the fiberoptic bronchoscope in sarcoidosis; Koonitz CH et al.; In a prospective study at two medical centers, 42 consecutive patients with suspected sarcoidosis underwent transbronchial lung biopsy during fiberoptic bronchoscopy . Transbronchial biopsy revealed noncaseating granulomas in 24 of the 38 cases (63%) in which adequate tissue was obtained . Special stains and cultures for acid-fast bacilli and fungi were negative, and sarcoidosis was subsequently diagnosed in all 42 cases . Positive biopsies were obtained in 11 of 20 patients with radiographic stage I disease, in 11 of 15 with stage II disease, and in 2 of 3 with stage III disease . There was a higher probability of a positive biopsy in patients with high symptom scores for cough, wheezing, and dyspnea, and in those with a vital capacity of less than 80% of predicted . The only complication was one small pneumothorax, which spontaneously resolved . Transbronchial lung biopsy is an attractive initial procedure for obtaining histologic confirmation of sarcoidosis.

Am J Vet Res, 1976 Jul, 37(7), 775 - 8
Tuberculosis in brood sows and pigs slaughtered in Iowa; Thoen CO et al.; Mycobacterium avium was isolated from 21 of 23 lymph nodes with lesions collected from 23 brood sows and from 17 lymph nodes with lesions of 17 pigs slaughtered at an abattoir in north central Iowa . Mycobacterium avium serotype 2 accounted for more than 65% of the isolations in sows and in pigs . Granulomas with acid-fast bacilli were found in 15 of 23 tissues from brood sows and in 13 of 17 lymph nodes from pigs . Similar microscopic lesions were observed in the sows and pigs.

Int J Lepr Other Mycobact Dis, 1976 Jul-Sep, 44(3), 346 - 58
The role of protein malnutrition in the pathogenesis of ulcerative "Lazarine" leprosy; Skinsnes LK et al.; 1 . Clinical and necropsy observations in lepromatous leprosy associated with severe emaciation and accompanying hypoproteinemia suggest that protein deprivation may be of pathogenic significance in the ulcerative phenomenon that is designated "Lazarine leprosy" . 2 . An experimental utilizing Wiersung rats infected with Mycobacterium lepraemurium and maintained on a protein-free diet was developed for the purpose of studying the effect of protein starvation on the course of chronic mycobacterial disease similar to lepromatous leprosy with respect to pathogen and host inflammatory response . 3 . It was possible to maintain the experimental animals on a protein-free diet for up to 18 weeks of concomitant M . lepraemurium infection . This was long enough for the infection to disseminate to a degree that was evident in control animals only several weeks later . 4 . The protein-deprived animals showed decreased inflammatory response to the pathogen, presented more rapid dissemination of the infection and harbored more bacilli per macrophage than did animals similarly infected but maintained on a protein adequate diet . This indicates impairment of native cellular immunity by protein deprivation through decrease in ability of macrophages to inhibit bacillary multiplication . 5 . There was no evidence of impairment of macrophage ability to phagocytose the pathogens . 6 . Morphologically the increased dissemination of pathogens and decrease in inflammatory response was similar to the increase in number and extent of visceral lesions seen in Lazarine leprosy . Decreased ability to dispose of the infecting bacilli was similar in the two models, human and animal . The animal model does not, as does lepromatous leprosy, involve the skin in the infection . Hence comparable ulcerative phenomena were not replicated in the animals . 7 . It is suggested that Lazarine leprosy may result from enhanced lepromatous leprous infection occurring as a result of protein malnutrition . The pathogenic mechanism appears to be impairment of cellular immunity probably enhanced by concomitant impairment of humoral antibody immunity resulting also in decreased resistance to pyogenic and other secondary pathogens . The tissue edema attendant on decreased serum osmotic pressure due to lowering of the serum protein fractions enhances the probability of ulceration.

Proc Natl Acad Sci U S A, 1976 Jul, 73(7), 2510 - 4
Prevention of phagosome-lysosome fusion in cultured macrophages by sulfatides of Mycobacterium tuberculosis; Goren MB et al.; Intracellular parasites (e.g., Mycobacterium tuberculosis, Toxoplasma gondii, and some Chlamydiae) may promote their survival within the host by acting from within phagosomes to prevent phagolysosome formation, thus avoiding exposure to the lysosomal hydrolases . The present studies demonstrate that when sulfatides of M . tuberculosis (anionic trehalose glycolipids largely responsible for the neutral red reactivity of virulent strains) are administered to cultured mouse peritoneal macrophages, they accumulate in the secondary lysosomes, which are rendered incompetent for fusion with phagosomes containing suitable target particles such as viable yeasts . This antifusion effect is also exhibited when small amounts of sulfatide are introduced directly into phagosomes by attachment to the target yeasts prior to their ingestion . The sulfatides evidently exert a selective inhibitory influence on membrane fusion, analogous to what occurs typically when macrophage cultures are infected with tubercle bacilli . This effect may be due to ionic interaction between the polyanionic micelles of bacterial sulfatide and organelle membranes, modifying the latter and inducing dysfunction.

Health Lab Sci, 1976 Jul, 13(3), 179 - 83
Three simple tests as an adjunct to the niacin test for the small mycobacteriology laboratory; Gruft H; With the change in the management of tuberculosis, many bacteriology laboratories should be prepared to examine sputum for the presence of acid-fast bacilli . The niacin test is the most reliable test that can be performed in any mycobacteriology laboratory to differentiate Mycobacterium tuberculosis from the other acid-fast bacilli, but it is not perfect . Other tests can be used to supplement it are cord formation, growth at 24 C, and the catalase test at 68 C . Incompletely identified strains should be submitted to a reference laboratory.

Int J Lepr Other Mycobact Dis, 1976 Jul-Sep, 44(3), 319 - 31
Separation of M . leprae from human leproma and the development of a cytoplasmic skin test antigen from purified bacilli; Elliston EP et al.; A successful method for purification of M . leprae from human leproma without subjection to heat has been developed . The "floater" phenomenon has been described which consists of bacillary tendency to float in the supernate when bacilli which are not autoclaved are separated from tissues by enzymatic digestion . A method for preparing cytoplasmic fractions from purified M . leprae has been developed for the production of a skin test antigen for leprosy . The cytoplasmic fraction of M . leprae elicited positive skin test responses in people with tuberculoid leprosy and negative responses in lepromatous leprosy . Cytoplasmic preparations from purified M . leprae had little cross-reactive relationship with the organism BCG . The small particulate fraction elicited positive reactions in PPD-S negative as well as BCG vaccinated individuals.

Mikrobiologiia, 1976 JUL-AUG, 45(4), 710 - 6
{Characteristics of the microflora of soddy-podzol soil during single-crop cultivation of agricultural plants and during crop rotation}; Berestetskii OA et al.; Structural organization of microbial populations in soddy-podzolic soil was studied during growth of agricultural plants in monoculture and in crop rotation . The content of bacteria and their biomass decreased when plants were grown in monoculture . The content of actinomycetes, bacilli and oligonitrophilic microorganisms increased in soil during crop rotation as compared with monocultures, suggesting a higher rate of mobilization processes . The content of microscopic fingi in soil increased when lupine was grown in monoculture . Growth of plants in monoculture affects the cenotic structure of soil microflora . The composition of active soil microflora was characterized by a wider spectrum of microbial forms during crop rotation of monocultures.

Int J Lepr Other Mycobact Dis, 1976 Jul-Sep, 44(3), 366 - 8
The use of non-deparaffinized tissue sections for staining leprosy bacilli; Harada K; Reduced acid-fast staining of leprosy bacilli occurs during the dewaxing of paraffin sections by xylene and alcohols; the older and more decrepit bacilli being especially affected . By the use of non-deparaffinized sections, the leprosy bacilli which could not be stained with the usual carbol fuchsin are strongly stained . Moreover, non-deparafinized sections can be used for the periodic acid-carbol pararosanilin stain or methenamine silver stain for demonstrating mycobacteria.

Jpn J Med Sci Biol, 1976 Jun, 29(3), 139 - 50
A new biological assay method for histamine-sensitizing factor using survival time as a response; Ishida S et al.; A new biological assay method using survival time of mice as a graded response after histamine challenge has been developed for the histamine-sensitizing factor of pertussis bacilli . The method is relatively precise and reproducible in estimation and fairly sensitive in the validity tests of biological assay . Effect of endotoxin on the estimation by the proposed method was also investigated in case the method is applied to the control test of pertussis vaccine.

Jpn J Med Sci Biol, 1976 Jun, 29(3), 109 - 21
An attempt to cultivate mycobacteria in simple synthetic liquid medium containing lecithin-cholesterol liposomes; Kondo E et al.; An attempt was made to cultivate mycobacteria in a simple synthetic liquid medium containing lecithin-cholesterol liposomes . This lipid complex showed a marked growth-promoting effect on the submerged growth of M . tuberculosis and M . bovis . The role of lecithin as nutrient was suggested . The bacillary growth in such environment retained good viability, strong acid-fastness, and high virulence in mice . An avirulent strain of tubercle bacilli, H37Ra, did not respond to lecithin-cholesterol liposomes unlike the parent virulent strain, H37Rv . However, this was not a general rule for virulence, as a highly virulent strain of M . bovis (Ravenel) and an attenuated strain (BCG) both grew well in the presence of lipsomes . Lipid analysis showed that cholesterol in the liposome medium was esterified to some extent during the bacterial growth . It was discussed that the culture in the liposome-containing medium may present an experimental model for the study of interaction between mycobacteria and the macrophage membrane.

Jpn J Exp Med, 1976 Jun, 46(3), 167 - 80
Susceptibility to murine leprosy bacilli of nude mice; Kawaguchi Y et al.; Comparative observations were made on the development of experimental murine leprosy in various inbred strains of mice, including nude mice of congenital thymic aplasia . The susceptibility of these strains of mice to murine leprosy bacilli was evaluated by the development of leproma at the subcutaneous infection site and also by the involvement of visceral organs . Nude mice developed a much more severe disease than C3H mice which is the representative of the malignant type . Their high sensitivity was also demonstrated in the case of intraperitoneal infection . The observations in nude mice and other mouse strains confirmed our concept that experimental mouse leprosy can be classified into three clinical types, benign, intermediate and malignant, and suggested that such mouse strain differences are related with their cell-mediated immunity.

Appl Environ Microbiol, 1976 Jun, 31(6), 977 - 85
Electron transport components of the MnO2 reductase system and the location of the terminal reductase in a marine Bacillus; Ghiorse WC et al.; The response of MnO2 reduction by uninduced and induced whole cells and cell extracts of Bacillus 29 to several electron transport inhibitors was compared . MnO2 reduction with glucose by uninduced whole cells and cell extracts was strongly inhibited at 0.1 mM dicumarol, 100 mM azide, and 8 mM cyanide but not by atebrine or carbon monoxide, suggesting the involvement of a vitamin K--type quinone and a metalloenzyme in the electron transport chain . MnO2 reduction with ferrocyanide by uninduced cell extracts was inhibited by 5 mM cyanide and 100 mM azide but not by atebrine, dicumarol, or carbon monoxide, suggesting that the metalloenzyme was associated with the terminal oxidase activity . MnO2 reduction with glucose by induced whole cells and cell extracts, was inhibited by 1 mM atebrine, 0.1 mM dicumarol, and 10 mM cyanide but not by antimycin A, 2n-nonyl-4-hydroxyguinoline-N-oxide) (NOQNO), 4,4,4-trifluoro-1-(2-thienyl),1,3-butanedione, or carbon monoxide . Induced cell extract was also inhibited by 100 mM azide, but stimulated by 1 mM and 10 mM azide . Induced whole cells were stimulated by 10 mM and 100 mM azide . These results suggested that electron transport from glucose to MnO2 in induced cells involved such components as flavoprotein, a vitamin K-type quinone, and metalloenzyme . The stimulatory effect of azide on induced cells was explained on the basis of a branching in the terminal part of the electron transport chain, one branch involving a metalloenzyme for the reduction of MnO2 and the other involving a metalloenzyme for the reduction of oxygen . The latter was assumed to be the more azide sensitive . Spectral studies showed the presence of a-, b-, and c-type cytochromes in membrane but not in soluble fractions . Of these cytochromes, only the c type may be involved in electron transport of MnO2, owing to the lack of inhibition by antimycin A or 2n-nonyl-4-hydroxyquinoline-N-oxide . The terminal MnO2 reductase appears to be loosely attached to the cell membrane of Bacillus 29 because of cell fractionation it is found associated with both particulate and soluble fractions . Electron photomicrographs of bacilli attached to synthetic Fe-Mn oxide revealed an intimate contact of the cell walls with the oxide particles.

Fortschr Med, 1976 May 20, 94(15), 890 - 6
{Amyloidosis as a manifestation and origin of presenile and senile degeneration}; Schwartz P; 1 . All essential attributes of the amyloidosis in aged persons ("senile amyloidosis") correspond to the condition which in younger individuals develops after infections, particularly following tuberculosis and lymphogranulomatosis, as so-called secondary amyloid degeneration, and also manifests many features of the so-called primary amyloidosis, not connected with infections . 2 . Amyloid depositions in the brain, cardiac muscle, and in pancreatic islets (the "senile amyloidotic triad") dominate the morbid anatomic aspect . However, we know no organ or tissue which necessarily remains spared . The number of involved organs and tissues, in general, increases with the progressive aging of the patients . In those persons living long enough, amyloidosis affects every individual and probably all organs and tissues . 3 . Contrary to the so-called secondary amyloidosis, in many cases of senile amyloidosis the spleen, liver and kidney remain intact . 4 . In the so-called Alzheimers disease, in which both clinically and pathoanatomically a particularly destructive cerebral amyloidosis in relatively young persons prevails, just as in the common senile dementia of aged persons, the brain condition is associated with a systemic amyloid degeneration of many other organs . 5 . Several cerebral and cardiac lesions due to amyloid accumulations can probably be diagnosed electrographically . Thus, through these already known morbid anatomical observations we have the promise of an essential enrichment of diagnostic perspectives . 6 . In general, the etiologic manifoldness of amyloidosis presently seems to be incomparable . Infections, ionizing radiation, traumatic lesions in human pathology, the introduction of chemically definable substances, infections, and stress consequent to social burdening, proved effective in spontaneous and experimental amyloid degeneration of animals . 7 . The demonstration of a tuberculous infection with the help of postmortem radiographs, as well as with the employment of histologic and microbiologic procedures to provide the evidence of acid fast bacilli in calcified remnants of pulmonary foci, proved to be eminently successful methods in the exploration of causes of senile tuberculosis and amyloidosis: Tuberculosis, after its invasion of the organism in early childhood, with its toxic and immunobiologic influences, holds it under its spell for an entire, even very long life and can be considered the most frequent cause of senile amyloidosis . 8 . Chromosomal disturbances, with their hereditary manifestations, or, as in cases of mongoloid idiocy, associated with individual deformations, may present as amyloidoses . 9 . Amyloid deposits in human pathology may develop by the transformation of normal structures, like cartilage, osteoid tissue, vascular elastic fibers, and also from scar hyalin and from fibrin . 10 . We observed the disappearance of cerebral and cardiac amyloid accumulations producing typical defects . 11 . Amyloidosis represents one of the most frequent spontaneous diseases of animals...

Radiology, 1976 May, 119(2), 307 - 12
Lung carcinoma superimposed on pulmonary tuberculosis; Ting YM et al.; Review of patients with active pulmonary tuberculosis over a three-year period showed an increased incidence of bronchogenic carcinoma (5%) . There had been considerable delay in establishing diagnosis of coexistent carcinoma which was attributed to finding of acid-fast bacilli and relative ease of ascribing all findings to that cause . Suspicious roentgen signs are reviewed and the importance of sputum cytology is also stressed.

Z Erkr Atmungsorgane, 1976 May, 145(2), 220 - 6
{Treatment of new and chronic tuberculous patients with ethambutol and Rifampicin (author's transl)}; Pregowski W et al.; In patients with chronic pulmonary tuberculosis the results of chemotherapy between drug regimens containing ethambutol or rifampicin were compared . Patients in both groups were randomized selected . After 4 months of chemotherapy negativization was reached to 100% in the RMP-group compared to 80% of the patients in the EMB-group . In 98 chronics EMB was added to the chemotherapy regimen and resulted in 90% of negativization . In a small subgroup RMP was added to the regimen and 100% negativization could be obtained . Among 220 patients with chronic pulmonary tuberculosis, treated with RMP in 9 hospitals according to our protocoll, in 205 patients (93.2%) the excretion of bacilli was cessated . In 54 new cases treated with EMB and another combination and in 20 new cases treated additionally with RMP the sputum converted to negative in 100% of the patients . But the the negativization was reached 24 days earlier on the average in the group treated with RMP . Antituberculotic drugs are administered in our clinic according to the body weight.

Z Erkr Atmungsorgane, 1976 May, 145(2), 169 - 74
{Development of the tuberculosis situation in Czechoslovakia in 1966--1974 (author's transl)}; Trefny J et al.; There were declining trends of main epidemiological indices of tuberculosis in Czechoslovakia from 1966 to 1974 (Fig . 1 and 2) . The smallest average yearly decrease of 4.9% was in the incidence of newly detected cases of active tuberculosis, the largest one of 21.6% in the prevalence of "tuberculous chronics" excreting tubercle bacilli in the last two years or longer . The total of newly detected cases of active tuberculosis and relapses per 100,000 inhabitants of corresponding groups of sex and age decreased in 1966--1974 in nearly all age groups of both sexes, the highest rates being in persons aged 45 years and over (Fig . 3) . The participation of corresponding groups of population in BCG vaccination procedures was very high at the national scale during 1966--1974 . The highest relative number of active cases of respiratory tuberculosis newly detected by photofluorography per 100,000 examinees of the appropriate group was found in persons with "fibrotic" lung lesions, less in persons investigated for their symptoms, still less in contacts with tuberculosis cases and least in persons not registered for lung lesions and investigated in mass X-ray examinations . The number of beds in institutions for special care of tuberculosis and respiratory diseases per 1,000 population by the end of the corresponding year decreased in Czechoslovakia from 1.1 in 1966 to 0.8 in 1974 . The decrease of rates of tuberculous patients was accompanied by a decrease of the number of cases under ambulatory chemotherapy of tuberculosis . At the same time there was an increase in the number of cases treated for nontuberculous respiratory diseases in out-patients' and in-patients' departments of tuberculosis and respiratory diseases . In spite of the favourable epidemiological development of tuberculosis there remain large groups of the population -- especially in middle and higher age groups -- infected with tuberculosis in the past in which new cases of active tuberculosis may appear.

Hum Pathol, 1976 May, 7(3), 265 - 75
Current taxonomy and identification of nonfermentative gram negative bacilli; Blazevic DJ; In recent years significant advances have been made in the characterization and taxonomy of nonfermentative bacilli as well as in the recognition of their pathogenic potential for man . In addition, certain other infrequently isolated bacteria that may be fermentative have been recognized, and improved methods for their identification have been developed . This discussion attempts to present a practical approach to the identification of these micro-organisms in the clinical microbiology laboratory.

Laryngoscope, 1976 Apr, 86(4), 549 - 58
Tuberculosis of the larynx; Travis LW et al.; Tuberculosis of the larynx, once a common disease, has become quite rare with the advent of anti-tuberculous chemotherapy . In the pre-antibiotic era two modes of laryngeal infection were recognized; bronchogenic and hematogenous . The literature is briefly reviewed . Thirteen patients in the past 15 years in whom tuberculous laryngitis was diagnosed upon indirect laryngoscopy by members of the University of Michigan Department of Otorhinolaryngology are presented . Bronchogenic infection was present in 11, and in two patients the disease was consistent with hematogenous spread . Tissue biopsy from a case of bronchogenic contamination demonstrated epithelioid tubercles, while numerous subepithelial acid-fast bacilli without typical tuberculous histological change were present in a case of hematogenous laryngeal infection . A case of cicatricial laryngeal stenosis was successfully treated surgically by laryngofissure, excision of fibrosis with arytenoidectomy, and free mucous membrane grafting . Finally, the initial subtle presentation of many of our patients emphasizes the importance of a consideration of tuberculosis in the differential diagnosis of chronic laryngitis.

J Clin Microbiol, 1976 Apr, 3(4), 453 - 5
Mycobacterium resembling Mycobacterium fortuitum that produces brown pigment; Hawkins JE et al.; Two cultures of acid-fast bacilli with characteristics most closely resembling those of Mycobacterium fortuitum were recovered as casual isolates from sputa of a patient with an apparent brochogenic tumor . One of the cultures was consistenly cream colored to rosy buff . The other, however, changed from buff to rust to dark brown and had the gross appearance of a fungus culture.

Naturwissenschaften, 1976 Apr, 63(4), 185 - 9
{Immunobiology of tuberculosis}; Kallos P; R . Koch showed in 1882 in his so-called fundamental experiment that tuberculous guinea pigs exhibit a vigorous immunity against re-infection . In investigations in 1930--40 we showed that this immunity is not mediated by humoral antibodies . It is a cellular process, a local and general activation of the macrophage system (the system of mononuclear phagocytes) . The tuberculous granuloma consists of activated macrophages and their descendants (epitheloid and giant cells), which inhibit the growth and spreading of tubercle bacilli . The role of the specific and unspecific activation of the macrophage system could be demonstrated in experiments on rats, infected with Bartonella muris ratti . These early results are related to the recent knowledge concerning cellular immunity and granulomatous inflammation, especially to the cooperation between the lymphatic and macrophage system.

Appl Environ Microbiol, 1976 Apr, 31(4), 562 - 8
Ultrastructure of rumen bacterial attachment to forage cell walls; Akin DE; The degradation of forage cell walls by rumen bacteria was investigated with critical-point drying/scanning electron microscopy and ruthenium red staining/transmission electron microscopy . Differences were observed in the manner of attachment of different morphological types of rumen bacteria to plant cell walls during degradation . Cocci, constituting about 22% of the attached bacteria, appeared to be attached to degraded plant walls via capsule-like substances averaging 58 nm in width (range, 21 to 84 nm) . Many bacilli appeared to adhere to forage substrates without distinct capsule-like material, although unattached bacteria with capsules were observed occasionally . Certain bacili appeared to be attached to degraded tissue via small amounts of extracellular material, but others apparently had no extracellular material . Bacilli with a distinct morphology due to an irregularly folded, electron-dense outer layer or layers (about 15 nm thick) and without fibrous extracellular material consituted about 37% of the attached bacteria and were observed to adhere so closely to degraded plant walls that the bacterial shape conformed to the shape of the degraded zone . In the rumen ecosystem, bacteria appeared to adhere to plant substrates during degradation by capsule-like material and by small amounts of extracellular material, as well as by the other means not observable by electron microscopy.

J Trop Med Hyg, 1976 Apr, 79(4), 83 - 4
Peritoneal tuberculosis presenting as pyrexia of unknown origin in immigrants; Perry W et al.; Three immigrant patients with peritoneal tuberculosis seen over a three year period are discussed . All three patients presented with fever and minimal abdominal signs . One patient developed ascites while under investigation . In all cases, the fever was prolonged, liver enzymes were elevated and the ESR was raised . Two patients required laparotomy to make the diagnosis, and in the third tubercle bacilli were grown from the ascitic fluid . The difficulties in diagnosis are discussed.

Jpn J Microbiol, 1976 Apr, 20(2), 115 - 22
In vitro studies on the mechanism of acquired resistance to tuberculous infection . I . The relationship between lymphocytes and macrophages in cellular immunity to tuberculous infection; Muraoka S et al.; The relationship between lymphocytes and macrophages in cellular immunity against tuberculous infection was studied by means of an in vitro cell culture system without addition of streptomycin . The peritoneal macrophages were obtained from normal mice or mice immunized with heat-killed tubercle bacilli in paraffin oil, boosted with live BCG and infected with H37Rv cells in vitro . The infected monolayers of macrophages were cultivated for 48 hr with immune lymphoid cells obtained from immunized mice . The intracellular growth of H37Rv cells 3,5 and 7 days after infection was examined by counting tubercle bacilli within infected macrophages under a microscope . 1) The increase of bacilli within macrophages derived from immunized mice was slightly smaller than that in normal macrophages . 2) The addition of immune lymph node cells to the macrophage monolayers resulted in a marked decrease in the number of bacilli within both normal and "immune" macrophages . Conversely, normal lymph node cells exhibited an enhancing effect on the intracellular bacillary growth . 3) Immune lymph node cells showed a higher capacity to cause macrophages to suppress intracellular growth of bacilli than that of splenic lymphoid cells or thyrmocytes after addition to macrophage monolayers . 4) The treatment of lymphoid cells with inhibitors of protein synthesis, cycloheximide or streptovitacin A, resulted in a remarkable reduction of the ability of sensitized lymphocytes to cause macrophages to suppress multiplication of intracellular bacilli.

Isr J Med Sci, 1976 Apr-May, 12(4-5), 468 - 71
Methanol extraction residue fraction of tubercle bacilli (MER) and other mycobacterial extracts as systemic immunity adjuvants in cancer immunotherapy; Mathe G et al.; Four mycobacterial extracts--two water soluble and two water insoluble--were tested for their immunostimulatory and antitumor activities: MER, the methanol extraction residue fraction of tubercle bacilli (insoluble); HIU I, an insoluble component of the membrane of whole cells of bacillus Calmette-Guerin (BCG); HIU II, a soluble component of BCG; AND Lederer's WSA, a soluble extract of Mycobacterium smegmatis . In a hemolytic plaque-forming cell assay, MER, HIU II and WSA showed immunostimulatory activity . However, only MER was active in the immunoprophylaxis of L1210 leukemia and of the solid Lewis tumor . The loss of antitumor activity does not seem to be related to water solubility, but appears rather to occur during purification.

Isr J Med Sci, 1976 Apr-May, 12(4-5), 384 - 7
Effect of treatment with the methanol extraction residue fraction of killed tubercle bacilli (MER) on the development of spontaneous pulmonary metastases from syngeneic implants of tumor 3LL in C57B1 mice; Treves AJ et al.; Treatment of C57B1 mice with the methanol extraction residue fraction of killed tubercle bacilli (MER) shortly before or after surgical removal of a syngeneic implant of lung carcinoma 3LL reduced the incidence of spontaneous, fatally progressing pulmonary metastases in a large number of instances . Under certain conditions, the protective action of MER was pronounced and statistically significant . Small quantities of MER (0.2 mg) were optimally effective, when administered i.p . two days before or one day after excision of the initial implant.

Am Rev Respir Dis, 1976 Apr, 113(4), 427 - 32
Computer files and analyses of laboratory data from tuberculosis patients . II . Analyses of six years' data on sputum specimens; Blair EB et al.; Laboratory data on sputum specimens from patients with pulmonary mycobacterioses between 1968 and 1973 were analyzed . Specimens were cultured on Middlebrook 7H10 and/or 7H11 medium; blue light fluorescence microscopy was used to examine specimen smears . An admission series of 6 sputum specimens detected 94.7 per cent of all culture-positive patients . Only 62 per cent of patients who were culture positive in the admission series would have been detected by smear alone . Quantitative agreement of smear and culture results was seen only in the smear-numerous (more than 2 bacilli per high-power field), culture-numerous (more than 100 colonies per plate) category . Qualitative agreement of smear and culture was 71 per cent . A total of 123 smear-positive and culture-negative specimens, representing 9 per cent of the total number of positive smears, was found among 6,251 sputum specimens from 270 culture-positive ptients . At least one smear-positive and culture-negative specimen was obtained from 23 per cent of the patients evaluated . During this period, improved housekeeping measures and drying of culture plates reduced the culture contamination rate from 9.8 to less than 5 per cent.

Lepr India, 1976 Apr, 48(2), 157 - 62
A modified method of harvesting M . leprae from foot-pads of mice; Desikan KV et al.; A modified technique of harvesting M . leprae from the foot-pads of mice is described . The method is simple and takes less time for its performance than the conventional techniques . The yield of bacilli is also better . No difficulties have been encountered in its application in these laboratories.

Arch Pathol Lab Med, 1976 Apr, 100(4), 182 - 5
Hepatic granulomas in leprosy . Their relation to bacteremia; Chen TS et al.; A clinicopathologic study of liver disease was conducted on 28 patients with leprosy who lived in Taiwan . None of the patients exhibited symptoms or signs of liver disease . Hepatic granulomas were found in 21 patients . Histologically, the infiltrates were epithelioid, foam cell, and histiocytic in type . Hepatic dysfunction was absent, except for mild sulfobromophthalein elevations in the severely infected cases . Hepatic granulomas correlated with the cutaneous reactions in lepromatous leprosy, but the association was poor for other stages of disease . Hepatic involvement varied with the severity of cutaneous infection and with the frequency and intensity of bacteremia . An estimated 1,000 to 10,000 acid-fast bacilli/ml of blood was required to generate the hepatic infiltrates.

Arch Pathol Lab Med, 1976 Apr, 100(4), 175 - 81
Infection of armadillos with Mycobacterium leprae . Ultrastructural studies of peripheral nerve; Balentine JD et al.; Peripheral nerves of armadillos were studied 16 to 30 months after intradermal or intravenous inoculation with Mycobacterium leprae . Numerous bacilli were found within macrophages, Schwann cells, and perineurial cells; endothelial cells, pericytes and fibroblasts were involved as well . The bacilli were characteristically contained in membrane-limited vacuoles that were interpreted as being phagosomes . Some of the phagosomes contained granular, membranous, and vesicular debris considered to be bacillary degradation products, suggesting that lysosomal activity was present within the phagosomes . Multivesicular bodies, a few of which contained bacilli, were abundant in macrophages and perineurial cells . An unusual proliferation of irregular tubulovesicular profiles was noted, especially in Schwann and perineurial cell cytoplasm, surrounding and within phagosomes containing bacilli . The pattern of cellular involvement of neural structures with M leprae was similar to that observed in lepromatous leprous neuritis in humans.

Br J Exp Pathol, 1976 Apr, 57(2), 217 - 42
The action of iron on local Klebsiella infection of the skin of the guinea-pig and its relation to the decisive period in primary infective lesions; Miles AA et al.; The infectivity of 16 strains of Klebsiella spp . and its modification by systemic and local ferric iron were tested in the skin of the guinea-pig . The in vivo proliferation of 11 strains was enhanced in varying degrees by Fe+++ (E + strains); 5 strains (Eo) were not enhanceable even by large doses of Fe+++ . Of 10 strains examined in detail, 6 were E + and 4 were E0 . Guinea-pig and human sera were consistently bacteriostatic for E + strains and bactericidal for Eo strains . Both Fe+++ and microbial iron-chelators abolished the bacteriostasis of E + strains but did not affect the lethal effect on Eo strains . Both effects were diminished by heating the sera to 56 degrees for 30 min and by the anticomplementary substance Liquoid; neither appeared to be due to specific antibody . Virulence, as measured in the skin and by intravenous injection, was roughly associated with degree of enhanceability by iron, the EO strains being among the least virulent . The volume of plasma exudate entering the skin during the first 5 h was sufficient to kill a large proportion of the infecting doses of Eo strains and to inhibit the growth of infecting doses of E + strains . Enhancement of the latter by Fe+++ is predominantly the result of inhibition of the non-specific bacteriostasis exerted by the extravascular plasma . Lesions by E + strains aged 4 h or more are insusceptible to systemic Fe+++ and only moderately susceptible to large doses of local Fe+++ . The insusceptibility appears to be due to segregation of the infecting bacilli within exudate leucocytes . Klebsiella infections accordingly provide another example of an initial decisive period of action of the antibacterial defences-in this case non-specific and humoral-which cease to be locally effective after the first few hours . Besides enhancing lesions due to E + strains, systemic Fe+++ has an opposite, apparently anti-inflammatory action on klebsiella lesions, slightly decreasing their size . It was evident with all the strains tested, whether dead or alive, but not in E + lesions in circumstances when they were susceptible to enhancement by the Fe+++.

Am J Dis Child, 1976 Apr, 130(4), 433 - 6
Fatal disseminated BCG infection . An investigation of the immunodeficiency; Passwell J et al.; A 2-year-old boy had a fatal disseminated BCG infection . Immunologic assessment showed a normal humoral response and normal numbers of E rosettes, normal thymus weight and histological features, but an abnormal response of lymphocytes in vitro and negative skin tests . Histological examination showed the presence of Gram-negative acid-fast bacilli within the macrophages . The possible mechanisms of immunodeficiency in this patient are discussed.

Proc Soc Exp Biol Med, 1976 Apr, 151(4), 637 - 41
Effect of rifampin, clofazimine, and B1912 on the viability of Mycobacterium leprae in established mouse footpad infection; Holmes IB et al.; Continuous dietary administration of rifampin to mice with an established Mycobacterium leprae footpad infection reduced the bacillary solid ratio, with an estimated survival half-life of 5-6 days . In rifampin-treated immunosuppressed animals the survival half-life of solid bacilli, in the absence of host immunity, was 12-13 days . Clofazimine and B1912 produced a significant effect on solid ratio only after a lag period of apparently 100 days . The rate of action was considerably slower than that of rifampin . Intermittent (once monthly) administration of both drugs produced effects similar to those of continuous administration.

J Invest Dermatol, 1976 Apr, 66(4), 248 - 51
Skin exfoliation and purulent conjunctivitis in a new mutant-the exfoliative mouse; Kent RL et al.; A spontaneous autosomal recessive mutation has been named the exfoliative mouse (genotype ex/ex) . Exfoliative mice suffer a transient purulent conjunctivitis in their 3rd week and an exfoliative skin disease in their 4th week . Gram-negative bacilli are present in blood and cerebrospinal fluid during the conjunctivitis stage, and in skin during the exfoliative period . The mutant can be differentiated from the ichthyotic mouse mutant.

Infect Immun, 1976 Apr, 13(4), 1132 - 8
Studies of mycobacterial antigens, with special reference to Mycobacterium leprae; Kronvall G et al.; Eight individual antigens were detected in soluble antigen preparations from Mycobacterium leprae bacilli by using pools of serum samples from lepromatous leprosy patients as antibody reagents in crossed immunoelectrophoresis . Two of these antigens were analyzed further . Antgent no . 1 gave an elution pattern on Sephadex G-200 corresponding to a molecular weight of 285,000 . This antigen was also present in three slow-growing and eight fast-growing mycobacterial species . There was a reaction of complete identity in immunological tests using lepromatous serum pools as well as with rabbit antisera raised against M . leprae and M . smegmatis . Antigen no . 21 of M . leprae showed antigenic heterogeneity when compared with other species . Three types of antigenic determinants were detected; one, called 21A, was shared by all mycobacteria, another, called 21B, was limited to antigen no . 21 of M . leprae; a third, called 21C, was present in all mycobacteria except the leprosy bacillus . This submolecular heterogeneity may indicate a separate taxonomic position of M . leprae among the mycobacteria.

J Bacteriol, 1976 Apr, 126(1), 13 - 23
Nutritionally defined conditions for germination of Streptomyces viridochromogenes spores; Hirsch CF et al.; Spores of Streptomyces viridochromogenes were removed from the surface of solid media with glass beads and suspended in a buffer-detergent solution . Addition of yeast extract and glucose resulted in rapid loss of refractility of the spores . Appearance of germ tubes followed . Germination was accompanied by a decrease in the optical density (OD) of the suspension . The OD decrease was used as an assay for germination . A defined germination medium (DGM) comprised of L-alanine, L-glutamic acid, adenosine, para-aminobenzoic acid, and calcium and magnesium ions provided a germination rate nearly equal to that of complex media . The germination rate was essentially the same if D-alanine and D-glutamate replaced the L-isomers . The optimum pH and temperature for germination were 7.0 and 35 C . Germination was absolutely dependent on the presence of CO2 . Spores harvested after growth for longer periods than the usual time (10 days) became less germinable in DGM . The same was observed for spores grown at 37 C as compared with 30 C . Spores incubated in DGM for various time periods before being transferred to a buffer solution did not continue to germinate . Spores harvested after growth of eight species of Streptomyces did not show a decrease in OD when incubated in yeast extract medium . Another strain of S . viridochromogenes did exhibit an OD decrease in the medium . Comparative properties of spores of streptomycetes, fungi, and bacilli are discussed.

Clin Orthop, 1976 Mar-Apr, (115), 220 - 4
Giant synovial cyst of the calf and thigh in a patient with granulomatous synovitis; Iacono V et al.; A giant synovial cyst with granulomatous synovitis was removed from the thigh and calf in an 80-year-old woman . The lesion included necrotizing, epitheloid cell granulomata with Langhans' type giant cells . Chest X-ray, tuberculin testing, cultures for Acid Fast bacilli, as well as aerobic, anaerobic and fungal cultures were all negative . The treatment consisted of synovectomy and total knee arthroplasty with an uneventful recovery . A giant calf cyst, usually associated with rheumatoid arthritis, but in this situation, noted in granulomatous synovitis seems not to have been reported previously.

Boll Ist Sieroter Milan, 1976 Mar, 55(71), 75 - 9
Primary resistence of mycobacteria in tuberculosis patients; Daddi G et al.; Primary mycobactria resistance especially in some countries may be a serious obstacle to a successful therapy and the number of patients carrier of primary resistant mycobacteria remains almost at the same level in spite of the chemotherapeutic treatments and the usually rapid recover of the newly diagnosed cases . This may probably be attributed to the fact that the number of chronic patients, spitting resistant tubercle bacilli has remained almost the same, because these patients are eliminated little by little . In our country there is a constant regression of the morbidity, but not so rapid as expected, The newly diagnosed patients are generally young and, if well treated, they heal quickly and well; moreover, they are usually not so richly bacillised as they used to be once and the severity of their disease, globally evaluated, appears also reduced . The cultural positivity at the first admission into hospital is also diminishing . From all the above facts it is obvious that in order to eradicate tuberculosis it is necessary: First - to avoid creatin chronic patients; in order to reach this goal the treatment must be the most effective possible from the very beginning: INH and Rifampin . Second - to try to cure the chronic patients and to render them abacillary of, at least, to treat them intensively, with the purpose of inducing in the infecting flora a polyresistance which reners the mycobacteria hypovirulent, especially if it includes a R/AMP resistance over 40-gamma . Third - the role of the primary resistance in the epidemiology and the evolution of tuberculosis in the various countries and in the single patients, may be very different.

Am Rev Respir Dis, 1976 Mar, 113(3), 281 - 6
Distribution of mycobacteria grown in vivo in the organs of intravenously infected mice; Collins FM et al.; Suspensions of 35-day-old Mycobacterium tuberculosis H37Rv prepared from stirred liquid cultures and injected intravenously into CD-1 mice accumulated in the lungs at a significantly higher concentration that that seen with logarithmically growing cells . Mice were infected with logarithmic 8-day-old or stationary phase 35-day-old suspensions of H37Rv, and 24 hours later, the bacilli within pooled lung and splenic homogenates were recovered by differential centrifugation . The bacilli were then homogenized in Tween saline and injected intravenously into fresh mice . The partitioning of the 4 inocula into the lungs and spleens of the secondary recipients was compared to that for the original suspensions grown in vitro . There was a significant increase in the number of lung-adapted H37Rv that could again be recovered from the lungs of the secondary recipients compared to that observed for the corresponding splenic preparations . This effect was not due to bacterial clumping or to size differences in the organisms grown in vivo . Homogenation of H37Rv with normal lung increased the relative accumulation of viable bacilli in the lungs compared to the spleens of recipient mice.

Immunology, 1976 Mar, 30(3), 401 - 7
Suppression of the primary immune response in vivo to sheep red blood cells by B-cell mitogens; Diamantstein T et al.; Polyacrylic acid (PAAC), lipopolysaccharide (LPS), dextran sulphate (DS) and purified protein derivative of tubercle bacilli (PPD), compounds mitogenic for B lymphocytes in vitro, suppressed the immune response of mice to SRBC in vivo, when injected 4-2 days before immunization . The same compounds enhanced the immune response when injected half an hour before immunization of the animals with a suboptimal antigen dose . A subsequent injection of PAAC given shortly before immunization, abolished the immunosuppressive effect expected by pretreatment of the animals with either PAAC or LPS . A second injection of LPS abolished the immunosuppressive effect of LPS only . The results indicate that when B lymphocytes react with a mitogen in the absence of a particular antigen, they temporarily lose their capacity to respond to antigen.

Ann Immunol (Paris), 1976 Mar-Apr, 127(2), 173 - 86
Increased resistance to virus infections of mice inoculated with BCG (Bacillus calmette-guérin); Floc'h F et al.; CD-1 or OF-1 mice were inoculated intravenously with 1 mg per mouse (i.e . about 10(6) live bacilli) of Pasteur Institute BCG and challenged 15 to 31 days later with the following viruses introduced by various routes: encephalomyocarditis, murine hepatitis, type 1 and 2 herpes simplex, foot-and-mouth disease and A0 and A2 influenza viruses . In most cases, BCG-inoculated mice exhibited a significantly higher resistance to these lethal infections than control mice (overall survival in control: 18%; in BCG-inoculated mice: 41%) . Enhancement of resistance by BCG was especially marked in infections with encephalomyocarditis, herpes simplex type 1 and influenza A2 viruses . Intercurrent infection of BCG-inoculated mice with non lethal doses of viruses did not abrogate their resistance towards subsequent challenge with lethal doses of an unrelated virus . The possible mechanisms of this enhancing effect of BCG on host's resistance are discussed in the light of the known effects of this immunostimulating agent on the various facets of the immune response and of the respective roles the latter play in the defence against virus infections.

Microsc Acta, 1976 Mar, 78(1), 21 - 7
Staining mycobacteria with carbolfuchsin: properties of solutions prepared with different samples of basic fuchsin; Harada K et al.; Acid fast staining of mycobacteria in the form of beadings is obtained by means of a carbolfuchsin solution (Ziehl-Neelsen stain) prepared from pararosaniline or from certain kinds of basic fuchsin . After such acid-fast stains, the intensity of the bacilli's colouring was rather poor and unstable, so that some bacilli lost their acid-fast stain . In contrast, an acid-fast staining of mycobacteria in rod form results by using a carbolfuchsin prepared from rosaniline or from other basic fuchsins included new fuchsin . The spectrophotometric and thin-layer chromatographic data indicate that the main component of those basic fuchsins showing beady staining may be pararosaniline, whereas the main ingredient of basic fuchsin with staining the bacteria in rod form may be its higher homologues . Neither chloride nor acetate of the fuchsin could affect the appearance and number of stained bacilli . The commercially available "basic fuchsin" is either the chloride or acetate of pure pararosaniline or consists of variable mixtures of it with higher homologues . Consequently, only a basic fuchsin which has an absorption maximum at lambda greater than or equal to 552 nm could be employed for the acid-fast stain of mycobacteria in a stable manner . Pararosaniline included some basic fuchsins, composed mainly from pararosaniline, should not be selected for the preparation of the carbolfuchsin formula.

Can J Microbiol, 1976 Feb, 22(2), 138 - 49
Morphological, physiological, and biochemical characteristics of some violet-pigmented bacteria isolated from seawater; Gauthier MJ; Sixteen violet-pigmented heterotrophic bacilli were isolated from Mediterranean coastal waters . Morphological and physiological studies showed that they have a number of characteristics specific to the genus Chromobacterium . However, the absence of catalase, the presence of oxidase, and, more especially, the low percentage of bases guanine and cytosine in their DNA exclude them from the genus . The specificity of some characters assigned to Chromobacterium can thus be discussed . Several features allow us to consider such bacteria as being related to the genus Alteromonas; their consistency within the 16 strains investigated leads us to consider them as a single species, for which the specific name Alteromonas luteo-violaceus (sp . nov.) is proposed.

J Clin Invest, 1976 Feb, 57(2), 478 - 84
Rapid diagnosis of anaerobic infections by direct gas-liquid chromatography of clinical speciments; Gorbach SL et al.; Current methods to isolate and identify anaerobic bacteria are laborious and time consuming . It was postulated that the short-chain fatty acids (SCFA) produced by these organisms might serve as microbial markers in clinical material . 98 specimens of pus or serous fluid were analyzed by gas-liquid chromatography, and findings were compared with culture results . Good correlations were found for the recovery of anaerobic Gram-negative bacilli and the presence of isobutyric, butyric, and succinic acids . 19 of 20 specimens with significant amounts of these acids (greater than 0.01 mumol/ml) yielded bacteroides or fusobacteria . Culture of the single "false-positive" specimen failed to grow anaerobic Gram-negative bacilli, although clinical data and Gram-stain suggested their presence . 77 of 78 specimens which has insignificant concentrations of the marker acids failed to yield anaerobic, Gram-negative bacilli in culture . The single "false-negative" specimen yielded Bacteroides pneumosintes, an organism which does not ferment carbohydrates . It is concluded that direct gas-liquid chromatographic analysis of clinical specimens provides a rapid presumptive test for the presence of anaerobic, Gram-negative bacilli.

Chest, 1976 Feb, 69(2), 231 - 2
Median sternotomy wound infection and anterior mediastinitis caused by bacteroides fragilis; Cerat GA et al.; The first reported case of median sternotomy infection and mediastinitis caused by Bacteroides fragilis is described . Several positive blood cultures led to diagnostic anaerobic cultures of the wound and administration of clindamycin therapy . This anaerobic infection should be suspected whenever Gram smears of exudates show gram-negative bacilli and aerobic cultures are sterile.

Infect Immun, 1976 Feb, 13(2), 425 - 37
Comparison of antigens in sonic and pressure cell extracts of Mycobacterium tuberculosis; Janicki BW et al.; Comparisons were made of the yield, chemical content, and biological activity of filtrates and extracts obtained by sonic and pressure cell disruption of bacilli from 4- and 8-week-old Proskauer and Beck cultures of the H37Rv strain (TMC no . 102) of Mycobacterium tuberculosis . The culture filtrates were dialyzed, freeze-dried, reconstituted in saline, and sterilized by membrane filtration . The viable bacilli were washed and resuspended in distilled water and subsequently disrupted either by sonication in the cold for 15 or 30 min or by treatment at 20,000 or 40,000 lb/in2 in a pressure cell . The resulting extracts were clarified by centrifugation, concentrated, and sterilized by filtration . All preparations were adjusted to contain 10 mg of solids (dry weight)/ml and were analyzed quantitatively for protein, deoxyribonucleic acid, ribonucleic acid, polysaccharide, and lipid content . Separation patterns obtained by gradient acrylamide gel electrophoresis, as well as by one- and two-dimensional immunoelectrophoresis, provided the basis for qualitative comparisons of the culture filtrates and cell extracts . Three-point dose-response curves also were used to compare the preparations for skin test reactivity in BCG-vaccinated guinea pigs . It was concluded that, although there were no consistent differences in chemical content or biological activity between the preparations, a 15-min sonic treatment appeared to be the most suitable method for preparation of bacillary extracts based on yield of active components and ease of preparation.

Thorax, 1976 Feb, 31(1), 101 - 6
Miliary tuberculosis following homograft valve replacement; Anyanwu CH et al.; Postoperative septicaemia with infective endocarditis is a recognized complication of open-heart surgery, in particular homograft or prosthetic replacement of cardiac valves . Several infective organisms, both bacterial and fungal, have been incriminated but infection due to tubercle bacilli has not, to our knowledge, been reported . The clinicopathological features of this condition are discussed . During a five-year period, over 800 homograft replacements in the aortic and/or mitral positions have been performed at Harefield Hospital . Seven cases of miliary tuberculosis following homograft valve replacement are descrbied here . In three, there was a past history suggestive of tuberculosis infections but necropsy failed to reveal any caseous or other tuberculous lesion apart from recent miliary tuberculosis . Vegetations on the homograft valves contained microcolonies of acid-fast bacilli in most cases . Tubercle bacilli of the human type were recovered by culture or guinea-pig inoculation in six of the seven cases, and in three the diagnosis was established during life; two of these survived on antituberculosis chemotherapy . The onset of symptoms varied from a few weeks to 12 months after operation . The main presenting symptom was intermittent pyrexia . In two patients the diagnosis was made on radiological and clinical grounds and in both, tubercle bacilli were grown from drill biopsy specimens of lung tissue . The source of infection was presumed to be the homograft valves contaminated in the postmorten room . The antibiotic mixture used in the sterilization of the homografts was not effective against tubercle bacilli.

J Infect Dis, 1976 Feb, 133(2), 137 - 44
Host-parasite relationships in experimental airborne tuberculosis . V . Lack of hematogenous dissemination of Mycobacterium tuberculosis to the lungs in animals vaccinated with Bacille Calmette-Guérin; Fok JS et al.; The influence of bacille Calmette-Guerin (BCG) on the pathogenesis of experimental airborne tuberculosis was studied . In a model that approximates the conditions under which man is vaccinated and infected, BCG-vaccinated and unvaccinated guinea pigs were infected by the respiratory route with an inoculum that resulted in the inhalation and retention (by each animal) of approximately three virulent tubercle bacilli (Mycobacterium tuberculosis strain H37Rv) . Hematogenous seeding of the lungs occurred in unvaccinated animals about three weeks after aerosol infection but did not occur in BCG-vaccinated animals . Furthermore, the lungs of BCG-vaccinated animals failed to kill H37Rv that was introduced intravenously; however, evidence of mycobacteriostatic activity was found throughout the lungs . In view of the importance of hematogenous dissemination to the apex of the lungs in the establishment of pulmonary tuberculosis in man, the foregoing observations suggest a means by which vaccination with BCG may confer acquired resistance to tuberculosis.

Infect Immun, 1976 Feb, 13(2), 480 - 6
Systemic Mycobacterium lepraemurium infection in mice: differences in doubling time in liver, spleen, and bone marrow, and a method for measuring the proportion of viable organisms in an inoculum; Brown IN et al.; Counts of acid-fast bacilli were made on homogenates of whole liver, whole spleen, and two femurs of CBA mice killed at various time intervals after intravenous infection with Mycobacterium lepraemurium . The growth curves so obtained showed that the bacillus multiplied faster in bone marrow than in liver or spleen . No evidence of redistribution during the early part of infection was obtained . The time of appearance of significant numbers of bacilli (10(7)) in the bone marrow was used to make estimates of viability of M . lepraemurium suspensions . Several applications of the techniques described are discussed.

Am Rev Respir Dis, 1976 Jan, 113(1), 67 - 72
Relapse in pulmonary tuberculosis; Pamra SP et al.; Five hundred forty-three patients with bacteriologically confirmed pulmonary tuberculosis who successfully completed treatment were followed for 5 years to determine relapse rates and to see whether any factors could be said to predispose to relapse . Practically the entire treatment of these patients had been carried out in their homes . The cumulative relapse rate during a 5-year period was 11.60 per cent . Relapse rates were low during the first 2 years of follow-up . Of the various factors considered in the analysis, age, sex, initial extent of disease or cavitation, and presence of initial or emergent drug-resistant bacilli did not influence the relapse rate . Patients who achieved complete radiographic clearing at the time treatment was stopped and those who were regular in treatment had comparatively low relapse rates . Cured patients included in the study were asked to report at least once annually for a checkup, and immediately if they developed any symptoms suggestive of relapse . Only one fourth of the cases of relapse were detected during routine annual checkup; in the remaining cases, the patients attended ahead of the next due visit because of symptoms . This casts doubt on the utility of keeping cured patients under prolonged routine surveillance.

Am J Epidemiol, 1976 Jan, 103(1), 101 - 11
Some bacteriologic aspects of the epidemiology of pulmonary and extrapulmonary tuberculosis; Siddiqi SH et al.; A study was carried out to investigate the drug resistance patterns of the prevalent tubercle bacilli in pulmonary and extrapulmonary tuberculosis in and about the city of Lahore, Pakistan . This report includes 168 strains of Mycobacterium tuberculosis isolated from the same number of pulmonary tuberculosis cases (100 untreated cases, defined as patients either having no history of anti-tuberculous therapy or having had chemotherapy for not more than 10 days; 68 treated, defined as having had chemotherapy for more than 10 days), and 162 strains from the same number of extrapulmonary tuberculosis cases (77 untreated, 38 treated and 47 doubtful) . The proportion method of drug susceptibility assay was employed . According to the procedures used in this study and with 1% as the critical proportion for resistance, bacterial resistance was found to be very prevalent in pulmonary tuberculosis . Even among those cases in which no history of previous treatment was elicited, 46% were found to be excreting populations of tubercle bacilli having some degree of resistance to one or more of the primary drugs--isoniazid, streptomycin and para-aminosalicylic acid . In treated cases, 86.8% were found to have some resistance to one or more drugs . Overall, resistance to streptomycin was found to be commonest . Drug resistance was observed to be somewhat less common in extrapulmonary than in pulmonary tuberculosis, with streptomycin resistance predominating . Although both catalase-positive and catalase-negative isoniazid-resistant strains of M . tuberculosis were isolated from patients with pulmonary disease, no catalase-negative strains were isolated from patients with extrapulmonary disease, suggesting limited pathogenic potentialities of catalase-negative strains for man . Epidemiologic aspects of these observations are discussed.

Int Arch Allergy Appl Immunol, 1976, 51(1), 117 - 30
Differences between lymphoid cell populations of guinea pigs and mice as determined by the response to mitogens in vitro; Ben-Efraim S et al.; The stimulation of guinea pig lymphocytes by phytohemagglutinin (PHA), concanavalin A (ConA), methanol-extracted residues of tubercle bacilli (MER), purified protein derivative of tubercle bacilli (PPD), dextran sulphate (DS) and E . coli lipopolysaccharide (LPS), was determined and compared with that of mouse lymphoid cells . The sources of lymphocytes tested were spleen, thymus, lymph nodes and bone marrow . The degree of activation of DNA synthesis by PHA and ConA was higher in guinea pig thymocytes and lymph node cells than in corresponding sources of mouse lymphocytes . The optimum degree of stimulation by PHA and ConA was approximately the same in guinea pig thymocytes, while ConA was by far a better stimulator than PHA for mouse thymocytes . All four B-cell mitogens tested (MER, DS, PPD and LPS) activated DNA synthesis in mouse lymphoid cells while only MER and DS were effective in guinea pig lymphocytes . A guinea pig spleen cell population depleted from B cells was not stimulated, neither by DS nor by MER, while it still responded to PHA and ConA . These results indicate that the proliferative response due to MER and DS occurs in the B-cell compartment . It is suggested that the differences between guinea pigs and mice with respect to their ability to develop a cell-mediated type immunity and to respond to T-independent antigens are related to differences in the relative proportions and degrees of maturation of T- and B-cell subpopulations, as reflected by the selective responsiveness to various mitogens.

Ann N Y Acad Sci, 1976, 278, 249 - 59
Transmissibility of sarcoid-specific granulomas in the footpads of mice; Iwai K et al.; Homogenate of 30 sarcoid lymph nodes was injected into the footpads of mice and 42% of the mice showed epitheloid-cell granulomas in the sites . However, the control lymph-node homogenates obtained from nonsarcoid patients also provoked similar granulomatous changes, although the positive rate was somewhat lower . In the granulomas a small amount of dust pigment remained, but no polarizing crystals were found in the sites or in the homogenate of either groups . No acid-fast bacilli, fungi, or other aerobic organisms were cultivated from the homogenate . Granuloma-formation activity remained after the homogenate had been sterilized in several ways and it existed in sediments of centrifugation of less than 2200 x g, but not in the supernate . The results seem to indicate that the granuloma formed in the footpads were the result of a local immunological reaction to the degenerated heterogenic protein of the injected and persistent homogenate.

ORL J Otorhinolaryngol Relat Spec, 1976, 38(6), 350 - 7
Rhinoscleroma: a scanning electron-microscopic study; Gaafar H et al.; Nasal biopsies from 6 patients with rhinoscleroma were studied by scanning electron microscopy . Numerous bacilli of different sizes were found on the epithelial surface . Few bacilli with thin spiral terminal cilia were seen over the surface of large protruding non-epithelial cells . These cells appeared to be the Mikulicz cells migrating from the tunica propria to the epithelial surface through small ulcerations . In the tunica propria, Mikulicz cells containing numerous bacilli were observed . In 4 patients, round bodies and long tubular structures were found on the epithelial surface . These bodies were suggested to be fungi, yet their exact nature and their relation to Klebsiella rhinoscleromatitis bacilli need further investigation.

Zh Mikrobiol Epidemiol Immunobiol, 1976, (12), 99 - 103
Participation of the thymus in the mechanism of bacterial discharge in carriers of typhoid bacteria}; Lerenman MIa et al.; Typhoid carrier state was reproduced in 54 rabbits by the injection of typhoid bacilli into the bone marrow of the femoral bone . The animals were divided into 3 groups . Those in the 1st and 2nd group were hydrocortisone and ATC before the infection, respectively, whereas the 3rd group served as control . The data obtained pointed to the great incidence of prolonged persistence of typhoid bacilli in the bone marrow . A much greater vital disharge of the causative agent with the feces was noted in the animals which before the infection were given hydrocortisone and ATC preparations depressing the functional activity of the thymus . In the second experimental series it was shown that ATC administration to rabbits on the 85th day after their intraosseous infection with typhoid bacilli promoted vital discharge of the causative agent with the feces . Problem of participation of the thymus in the mechanism of bacterial discharge in the carriers of typhoid bacilli are discussed.

Pharmazie, 1976, 31(12), 856 - 9
Synthesis of 1.4-naphthoquinones-4-aryl(aroyl)hydrazones of potential antimicrobial activity; Roushdi IM et al.; The isolation of phthiocol (3-hydroxy-2-methyl-1.4-naphthoquinone) from the acetone-soluble fat fraction of tubercle bacilli {1, 2} and the confirmation that it had antituberculous activity against H-37 R.V . strain {20} in vitro and in mice {12}, prompted the synthesis of some 2-alkyl-3-hydroxy-1.4-naphthoquinone-4-aryl(aroyl)hydrazones as possible tuberculostatic agents.

Z Erkr Atmungsorgane, 1976, 145(3), 373 - 8
{Results of catheter biopsy and catheter aspiration in various lung diseases (author's transl)}; Szymanski A; Results of 415 catheter biopsies and catheter aspirations in patients with various lung diseases are reported . Among 263 patients with suspected carcinoma of the lung, in 79% neoplastic cells could be obtained histologically from catheter biopsy specimens . Among 52 patients with suspected pulmonary tuberculosis but without positive sputum, tubercle bacilli were found in 23% by aspiration biopsy . The bacteriological examination of bronchial secretion in various lung diseases showed a prevailing growth by diplococcus pneumoniae, and more sterile conditions in the peripheral bronchial airways of 56 patients . Catheter biopsy proves to be a valuable diagnostic method for the detection of peripheral bronchial carcinomas and the catheter aspiration for the bacteriological examination in specific and non-specific lung diseases.

Arch Immunol Ther Exp (Warsz), 1976, 24(4), 575 - 7
Comparative studies on the influence of dimethylsulfoxide (DMSO) on reversion to sensitivity to isonicotinic acid hydrazide (INH) and rifampicin (RMP) in resistant strains of tubercle bacilli; Szydlowska T et al.; Results of continuing studies on the influence of dimethylsulfoxide (DMSO) on reversion of sensitivity to rifampicin (RMP) and isonicotinic acid hydrazide (INH) in tubercle bacilli are reported . Nineteen strains of RMP-resistant bacilli, and 61 strains of IHN-resistant bacilli were studied . Reversion to INH sensitivity was obtained in 19 of the 61 resistant strains examined . Ten strains reverted completely, and 9 partly . All 19 RMP-resistant strains reverted to complete sensitivity.

Poumon Coeur, 1976, 32(4), 149 - 52
{Gram-negative bacterial lung diseases in an internal medicine department}; Offredo-Hemmer HC et al.; In a department of internal medicine in Paris, the pneumonopathies with Gram negative "wild" bacilli represent about the third of recognized bacterial pneumonopathies . If started before the results of bacterial tests are known, the treatment should always include a drug active on Gram negative bacteria . Together with KLASTERSKY (1972) we think that synergic associations including the use of Gentamicin are the most effective . Once the responsible germ isolated and its sensitivity to antibiotics determined, therapy can be modified accordingly . With an appropriate antibiotic and by treating an unfavourable background and the initial localization, prognosis is favourable in most cases . This contrasts with the heavy mortality of pulmonary infections with Gram negative bacilli pertaining to hospital.

Adv Tuberc Res, 1976, 19, 1 - 63
Recent studies in the epidemiology of tuberculosis, based on the risk of being infected with tubercle bacilli; Sutherland I; This review describes recent epidemiological studies, based upon the risk of infection with tubercle bacilli . In the Netherlands the risk of infection has been decreasing steeply and exponentially for many years, but in some developing countries there was little secular trend in the absence of intensive control measures . Variations in the risk of infection with age are being examined . A comprehensive statistical analysis has shown that the major risk of development of tuberculosis is following a recent primary infection; the risk is smaller following reinfection of a previously infected subject, and is very small indeed, in the absence of reinfection, if the primary infection took place more than 5 years previously.

Z Erkr Atmungsorgane, 1976, 144(1), 33 - 8
{Peracetic acid as a disinfectant in the fight against tuberculosis--experimental data-- (author's transl)}; Sachse H; M . tuberculosis is susceptible to peracetic acid as a Disinfectant . However, there is no unanimity how the transmission of Mycobacteriaceae can be prevented and which quantitative requirements are necessary for its action . In practical work protein-like substances and varying numbers of tubercle bacilli are important in the efficacy of sputum disinfection . The tuberculocide effect of peracetic acid is scarcely influenced by such admixtures or by the number of test organisms . A preliminary attempt for killing M . tuberculosis in sputum by means of peracetic acid was successful.

Farmakol Toksikol, 1976 Jan-Feb, 39(1), 90 - 3
{Experimental therapy of burn infection caused by pyocyanic bacilli}; Girich AF et al.; The chemotherapeutic effect of di-N-quinoxaline oxide derivatives--quinoxidine and diaxidine, as contrasted to that of carbenicillin and hentamycin with their 3- and 10-day application, was studied on a model of a burn in mice infected with Pseudomonas eruginosa . The results achieved by the quinoxidine and dioxidine medication proved much better than those obtained by the use of carbenicillin and hentamycin.

J Gen Virol, 1976 Jan, 30(1), 91 - 7
Evidence for host-dependent modification and restriction of bacteriophage DNA in Mycobacterium tuberculosis; Rado TA et al.; Wild isolates of Mycobacterium tuberculosis may be divided into the three internationally recognized phage types on the basis of susceptibility to mycobacteriophages DS6A, BK1 and D34 . Strains of type A are lysed at high efficiency by DS6A only; type B is lysed by BK1 grown on Mycobacterium smegmatis ATCC607 and DS6A, while type C is lysed additionally by D34 grown on atypical Mycobacterium F130 . Propagation of D34 on a C-strain (D34-C) or BK1 on a B-strain (BK1-B) has no effect on viral host-range . D34-C has an efficiency of plating (e.o.p.) of 10(-5) on type B strains and 10(-7) on A strains . BK1-B plates on A strains at an e.o.p . of 10(-5) . BK1 recovered from and repropagated on an A strain (BK1-A) has an e.o.p . of 1-0 on strains of all classes . D34-B has an e.o.p . of 1-0 on strains of type B and C, while D34-A plates with high efficiency on types B and C and displayed an e.o.p . of 10(-4) on type A . Repropagation of these viruses on the M . tuberculosis strains originally lysed by them results in the restoration of their previous host range . Variations in plating efficiency cannot be explained by differences in viral absorption alone . These findings suggest that the three phage types of human tubercle bacilli are related by a hierarchical pattern of DNA restriction and modification in which the C pattern is included in the B, and both patterns are included in A-modified DNA . Viruses such as DS6A which are equally virulent for strains of all classes are not susceptible to host dependent restriction.

Lepr India, 1976 Jan, 48(1), 42 - 7
Bacteremia in leprosy and its relation to distribution of M . leprae in skin; Ganapati R et al.; Evidence of bacillaemia through examination of heparinised blood smears was obtained in 17 of the 20 cases (85%) of untreated leprosy cases belonging to the spectrum ranging from BT to LL . Among 17 cases whose blood smears were positive for AFB, the endothelial cells of blood vessels in skin lesions showed AFB in 11 instances (64.7%) and in 7 (41.2%) of these cases biopsies obtained from apparently normal skin also showed bacilli in the blood vessels . The fact that blood smears may show AFB even in patients belonging to types classifiable as BT-BB in the Ridley Jopling scale (a child aged 3 1/2 years showed this feature) emphasises the importance of investigations to assess thoroughly the extent of bacillation in leprosy patients.

Int Arch Allergy Appl Immunol, 1976, 52(1-4), 417 - 21
Production of migration inhibitory factor in inbred rats; Ruscetti SK et al.; Strains of genetically inbred rats representative of the known Ag-B groups produced migration inhibitory factor in response to immunization with live bacillus Calmette-Guerin bacilli and intracardiac challenge with old tuberculin; the assays were performed by both in vitro and in vivo methods . None of the strains immunized in this fashion developed delayed hypersensitivity skin reactions to purified protein derivative.

Arzneimittelforschung, 1976, 26(8), 1543 - 7
{Chemotherapeutically active nitro compounds . 2nd communication: Nitrodiphenyl sulfones (author's transl)}; Winkelmann E et al.; A number of new 4-nitro-4'-amino-diphenyl sulfones and related compounds were prepared and investigated as to their therapeutic activity . They showed a good systemic activity against tubercle bacilli (M . bovis, NMRI mouse) and plasmodia (P . berghei, NMRI mouse) . The test results reveal that the 4-nitro-4'-amino-diphenyl sulfones possess a spectrum of activity similar to that of diamino-diphenyl sulfone (DDS) . It is assumed that 4-nitro-4'-amino-diphenyl sulfones in vivo are converted into DDS derivatives by reduction . The advantages of the new compounds, however, were too insignificant as compared to DDS to justify further extensive trials.

Scand J Infect Dis, 1976, 8(4), 229 - 35
Colonization and clinical superinfection with gram-negative bacilli in influenza; Jarstrand C et al.; Among 197 influenza A patients admitted to Roslagstull Hospital, abundant growth of gram-negative bacilli was found in 74 cases (38%) . When assays for antibodies with the patients own strains as antigen were performed on paired sera with the indirect immunofluorescence technique, titre increases were obtained in 21 out of 55 patients (38%) . In this last group signs of secondary infection, as secondary pneumonia, prolonged or recurring fever or late occurrence of leukocytosis and granulocytosis, were significantly more common than in patients without gram-negative findings . An analysis of possible interference by other bacteria did not invalidate the observations . Findings of gram-negative bacilli occurred most often in patients more than 50 years of age . The bacteria were probably hospital acquired in 32 out of 55 patients . Antibody responses took place both in the IgM and the IgG fraction.

ORL J Otorhinolaryngol Relat Spec, 1976, 38 Suppl 1, 78 - 84
{Rhinoscleroma with sinuso-orbitary invasion}; Lehmann W et al.; The authors present the case of an 11-year-old child with a slowly progressive tumoral invasion resulting in bilateral nasal obstruction, massive facial deformation, and an exophthalmos of the left eye . There was no impairment of the child's general health . The histological investigation revealed the presence of Mikulicz' cells and von Frisch's bacilli . The resultant diagnosis was rhinoscleroma.

Ann N Y Acad Sci, 1976, 277(00), 195 - 208
Chemoimmunotherapy of syngeneic mouse mammary carcinomas employing methanol extraction residue; Cohen D et al.; Isografts of two mammary carcinomas, one spontaneously arising in a BALB/cfC3H female infected with MTV and one free of MTV (tumor D7T4S), were removed surgically from Balb/c (MTV free) female hosts, and fragments of each tumor were immediately reimplanted in situ (simulated local recurrence challenge) . The animals were then subjected to treatment with the MER fraction of tubercle bacilli, with one of three chemotherapeutic drugs (5-FU, cyclophosphamide, and methotrexate), or with both MER and one of the chemotherapeutic agents (chemoimmunotherapy) . The incidence of progressively developing recurrence tumors and the longevity of the animals were determined . The therapeutic effects of treatment with MER alone were ascertained by comparing groups of mice that received the fraction by various schedules with saline-injected control groups; the efficacy of chemoimmunotherapy was assassed by comparing groups that received MER plus one of the drugs with groups subjected to drug intervention by itself . MER administered alone did not reduce the incidence of recurrent tumors but was consistently efficacious in prolonging the lives of animals challenged with the MTV (+) carcinoma, although considerably less so in animals tested with the weakly immunogenic tumor D7T4S . A negative effect by MER on tumor frequency did not occur and was seen only once with regard to host life duration . Combined intervention with MER and 5-FU proved to be significantly and consistently superior to similar treatment with only 5-FU in animals challenged with the MTV(+) carcinoma . No such additive action by MER plus 5-FU was seen in mice challenged with D7T4S, however, nor did the other two chemoimmunotherapeutic regimens differ significantly in therapeutic efficacy from the corresponding chemotherapy alone in most of the trials with both tumors.

Ophthalmologica, 1976, 173(5), 375 - 9
Ocular infections caused by unusual gram-negative bacteria; Francois J et al.; The isolation of 24 strains of gram-negative bacilli from eye infections is discussed . The primocultures were obtained at an incubation temperature of 25 and 30 degrees C, but never at 37 degrees C . These observations show that we have to look for these germs at 30 degrees C in every case of eye infection.

Med Pediatr Oncol, 1976, 2(1), 99 - 108
Therapy of infections in neutropenic patients: results with gentamicin in combination with cephalothin or chloramphenicol; Valdivieso M et al.; Gentamicin in combination with cephalothin (Gent-Ceph) or with chloramphenicol (Gent-Chloro) was utilized in the treatment of 55 infections occurring in 49 cancer patients . Responses were obtained in 78% of the infections treated with Gent-Ceph and in 64% of those treated with Gent-Chloro . Pneumonia and septicemia were the most common infections in this study . Among the cases of penumonia, 64% responded to Gent-Ceph and 67% to Gent-Chloro . Among the cases of septicemia, 88% responded to Gent-Ceph and 50% to Gent-Chloro . All of the identified organisms producing infection were gram-negative bacilli . Of these, E . coli was the most common . All organisms were resistant to cephalothin in vitro, and only 41% of them were resistant to chloramphenicol . However, resistant organisms responded significantly better to the Gent-Ceph combination (p less than 0.025) . Also, response to therapy among patients with severe neutropenia (less than 100 neutrophils/mm3) was better for those patients treated with Gent-Ceph (p = 0.07) . The combination of gentamicin with cephalothin or with chloramphenicol did not increase the frequency of side effects expected from gentamicin alone . No significant hematological toxicity was seen among those patients treated with chloramphenicol . Gentamicin in combination with cephalothin or chloramphenicol is an effective and safe antibiotic combination against gram-negative bacilli infections occurring in cancer patients . The efficacy of Gent-Ceph in patients with severe neutropenia is particularly advantageous.

Microbios, 1976, 16(65-66), 183 - 9
Adenosine 3',5'-monophosphate in Mycobacterium phlei and Mycobacterium tuberculosis H37Ra; Padh H et al.; Adenosine 3',5'-monophosphate (cAMP) is present in slow growing as well as fast growing mycobacteria . Apparently there does not seem to be any direct relationship between either intra- or extracellular cAMP content with the growth rate of bacilli . As compared to that of E . coli grown on a similar energy source, cAMP content is much higher in mycobacteria . cAMP content inside the cells remains unaltered throughout the growth period and this may be due to lack of complete utilization of the major energy source, glycerol . Glucose when added to the cells, suspended in phosphate buffer, caused a remarkable decrease in intracellular cAMP content, a phenomenon well established in other bacteria.

J Infect Dis, 1976 Jan, 133(1), 37 - 45
Effects of IgM and IgG antibody in patients with bacteremia due to gram-negative bacilli; Zinner SH et al.; Earlier studies, which indicated that high titers of O-specific antibody to the patient's infecting organism in acute-phase serum specimens were not associated with a decrease in the frequency of subsequent shock and death in bacteremia due to gram-negative bacilli, were reexamined for evaluation of the protective activity of specific IgG and IgM antibody . Titers of hemagglutination antibody and levels of IgM, determined by indirect immunofluorescent staining of the patient's infecting organism, as well as hemagglutination titers after reduction of serum with 2-mercaptoethanol and IgG levels, correlated closely (P less than 0.001) . High titers of IgG antibody to the patient's infecting organism in acute-phase specimens were associated with a significant reduction in the frequency of shock and death in bacteremia . In contrast, high titers of IgG antibody were not associated with a diminution in the frequency of shock and death . The previously demonstrated protective activity of antibody to an antigen, Re lipopolysaccharide, shared by most gram-negative bacilli was reconfirmed and shown to be independent of the protective activity of O-specific IgG antibody.

Z Lebensm Unters Forsch, 1975 Dec 16, 159(5), 297 - 304
{Microorganisms in gums . IV . Microbial degradation of plant exudates and seaweed extracts (author's transl)}; Souw P et al.; The three plant exudates gum traganth, gum arabic, and gum karaya and the two seaweed extracts carrageenan and alginate were degraded by five different Bacilli which were isolated from these gums: Bacillus coagulans, B . lentus, B . cereus, B . licheniformis, and B . firmus . After 14 days all the gums have been degraded by these Bacilli to a different extent after addition of trace elements . The fractions of degraded gums by TLC, GLC, and IR-spectroscopy have been examined with the following results: 1 . Except the already known monomers of the above mentioned gums no other monosaccharides could be found . 2 . The microbial degradation of gum karaya and alginate resulted in products with a high molecularweight . Monomers could not be determined . 3 . Carrageenan has been degraded to oligosaccharides with molecularweights of about 500, 3,6-anhydrogalactose has been partly identified . 4 . Gum arabic has been partly degraded to rhamnose and arabinose . 5 . Gum traganth has been partly degraded to arabinose and xylose and partly to polysaccharides with molecularweights under 3000.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Dec, (12), 30 - 3
{Seeding efficiency of the causative agent of dysentery as an index of the intensity of the epidemiologic process}; Solodovnikov IuP et al.; A study was made of the character and extent of interrelationship between the indices of dysentery morbidity and the indices of the seeding efficiency of dysentery bacilli persons who did not apply for medical aid . Establishment of such interrelationship permitted the authors to suggest the use of a more objective index of the seeding efficiency of dysentery bacilli, along with morbidity indices, for the assessment of the intensity of the epidemic process in this infection . On the basis of investigations carried out the authors came to the conclusion that a tendency to the increase of dysentery incidence the last few years chiefly bore a "statistical" character and was due to the improved detection of patients and carriers.

J Allergy Clin Immunol, 1975 Dec, 56(6), 464 - 72
Delayed-type hypersensitivity reaction in the lungs of guinea pigs due to potassium dichromate; Miyamoto T et al.; Potassium dichromate was inhaled by guinea pigs previously immunized by potassium dichromate until strong positive patch tests were obtained . No obvious respiratory changes were noted during and after inhalation . Histologically, however, mononuclear cells infiltrated the interstitial spaces in large areas of the lung, producing considerable thickening of the alveolar spaces in 24 to 48 hr after inhalation . Polymorphonuclear cells were predominant initially . These changes were similar to the delayed-type hypersensitivity reaction in the lung elicited by the inhalation of purified protein derivative (PPD) in the guinea pigs immunized by an injection of dry-killed tubercle bacilli . A less marked reaction was observed in guinea pigs passively sensitized with peritoneal exudate cells and lymph node cells . Consequently, the pulmonary changes were thought to be elicited by delayed-type hypersensitivity reaction due to a simple chemical . The clinical implications of delayed-type hypersensitivity reaction in the lung due to simple chemicals are discussed.

Am Rev Respir Dis, 1975 Dec, 112(6), 757 - 63
Tuberculosis care in general hospitals: Arizona's experience; Dandoy S et al.; In June 1973 the state of Arizona transferred all in-hospital care of patients with tuberculosis from the State Sanatorium to general hospitals . Eleven general hospitals, 2 extended care facilities, and 30 physicians are under contract; the state pays billed charges after payment from any third-party insurers . Admission to the Tuberculosis Hospitalization Program is controlled by the state and requires real evidence of need for hospital care; there are no residency or indigency requirements . During the first 2 years of the program, 279 patients were admitted for hospital care . The average length of stay was 23.6 days; a marked decrease from the 93-day average in the sanatorium in 1971-1972 . Of the 274 patients discharged during the first 2 years, 232 had a final diagnosis of tuberculosis; 105 of these were discharged with sputum smears positive for acid-fast bacilli . Although the cost per patient day was higher than in the sanatorium, the average cost of hospitalization per patient was lower because of the decrease in length of stay . Thirty-five per cent of the patients had some insurance coverage and/or Medicare . An employee skin testing program was required in all hospitals participating in the program . Although there was a 3.5 per cent conversion rate among all hospital employees, there were only 5 converters among employees exposed to patients with tuberculosis under the program . None of the employees was found to have tuberculosis . Of 70 patients with active tuberculosis who have been followed 12 to 24 months, 65 are bacteriologically negative . The general hospital program has been well accepted by patients, physicians, hospitals, and the public.

Arch Dermatol, 1975 Dec, 111(12), 1571 - 4
Apparently normal skin in lepromatous leprosy: histopathological findings; Rea TH et al.; Biopsy specimens of apparently uninvolved skin from 34 patients with lepromatous leprosy were studied histologically . Bacilli were found in 30 of 31 specimens from clinically polar or near-polar lepromatous patients but not in the three from nonpolar patients . A predominantly perivascular distribution of infiltrate and bacilli is consistent with a hematogenous spread of infection . Subclinical, diffuse lepromatous leprosy is found in patients with nodular lesions and may precede the development of nodules . Study of apparently uninvolved skin may be helpful in classifying patients, in interpreting immunologic responses, and in elucidating the natural history of the illness.

Ann Intern Med, 1975 Dec, 83(6), 790 - 800
Amikacin therapy for serious gram-negative bacillary infections; Meyer RD et al.; Amikacin is a new aminoglycoside antibiotic pharmacologically similar to kanamycin . It has a wide range of activity against Gram-negative bacilli, including many resistant to gentamicin . Thirty-six serious Gram-negative bacillary infections were treated with amikacin . Twenty-nine patients (80-6%) responded (cured or improved) . Twelve of 13 patients with gentamicin-resistant pathogens responded . Minor ototoxicity occurred in 6 patients and was associated with prolonged therapy or previous aminoglycoside therapy . Possible nephrotoxicity with amikacin was found in 6 patients . Amikacin should be used primarily to treat suspected or known gentamicin-resistant pathogens.

J Natl Cancer Inst, 1975 Dec, 55(6), 1337 - 43
Stimulation of lymphoid cells by components of BCG; Mitchell MS et al.; BCG was fractionated into a delipidated mycobacterial cell fraction (DMC) and lipid by exhaustive chloroform-methanol extraction . The effects of these fractions were tested on mouse spleen cells, nonadherent spleen cells (lymphocytes), thymus cells, and adherent spleen cells (macrophages) in vitro and were compared with effects of the whole bacilli and a methanol-extraction residue (MER) . Tritiated thymidine incorporation into spleen cells, purified spleen lymphocytes, and thymus cells was measured as an indicator of activity on these cells; lymphocyte-activating factor (LAF) production was used to measure activation of macrophages . DMC and MER were at least equivalent to, and often exceeded, whole BCG in their stimulation of spleen cells and spleen lymphocytes . DMC was a poor thymic mitogen in contrast to MER, which was as strong as BCG in this regard . Lipid was far less effective a mitogen for all cells tested, and failed to augment the effectiveness of DMC on thymus cells when both were present in the incubation mixture . LAF production was significantly increased by whole BCG (18-fold above controls), whereas each fraction increased production threefold to sixfold . These in vitro results seemed to reflect the known in vivo activity of BCG and its components and suggest further antitumor applications.

Br J Exp Pathol, 1975 Dec, 56(6), 579 - 85
Preliminary taxonomic studies on the leprosy bacillus; Stanford JL et al.; Antigens extracted from leprosy bacilli obtained from infected human and armadillo tissues have been examined by immunodiffusion analysis with serum samples from lepromatous patients and with immune sera raised in rabbits . Using the best combinations of serum and antigen extracts, 12 antigenic constituents were found in the leprosy bacilli . Six of these were antigens common to all mycobacteria and nocardiae, 4 were specific to the leprosy bacillus and the position of 2 could not be determined . Groups ii and iii antigens (i.e . those associated with the slow growing and fast growing subgenera of mycobacteria) were not found in theleprosy bacillus, suggesting some relationship with M . vaccae and similar strains, in which these antigens are also missing . Lymphocyte transformation tests performed on lymph node cells of mice infected or immunized with leprosy bacilli also showed the leprosy bacillus to have a closer relationship with M . vaccae than with other mycobacteria.

J Neurol Sci, 1975 Dec, 26(4), 587 - 92
A study of the cerebrospinal fluid in atypical presentations of tuberculous meningitis; Virmani V et al.; Atypical clinical and CSF profiles encountered in TBM are highlighted . Acid-fast bacilli (AFB) were isolated from the CSF of 7 patients in spite of the complete absence of any cellular response and also from another 3 patients who had no clinical evidence of meningitis . M . flavescens was cultured from the CSF in 4 patients.

Infect Immun, 1975 Dec, 12(6), 1295 - 306
Host-parasite interactions with peritoneal macrophages of mice and rats in vitro and in vivo; Wagner WH; This paper deals with the intracellular multiplication of mycobacteria in peritoneal macrophages from mice and rats immunized with tubercle bacilli or pretreated with Triton WR 1339 . If unstimulated macrophages were used, almost unrestricted multiplication of mycobacteria was observed in macrophages from both vaccinated and pretreated hosts after infection of the cells in vitro . Only when the infection of the cells was perfored in the peritoneal cavity of vaccinated hosts did the macrophages display a high degree of inhibition . This striking difference in the behavior of macrophages infected in vitro and in vivo is explained by the local inflammation caused by the intraperitoneal infection, which leads to an influx of T-cell mediators . When macrophages from hosts pretreated with Triton WR 1339 were used, inhibition of the multiplication of mycobacteria within cells infected in vitro or in vivo was very slight, though this compound displayed a marked protective effect in the host . Addition of streptomycin to the culture medium caused a strong inhibition of intracellular mycobacteria even in small concentrations; there was no difference between normal and "immune" macrophages . When rats were infected with virulent tubercle bacilli, they were initially fully susceptible to the infection but showed rapid onset of a strong immune response.

Am Rev Respir Dis, 1975 Dec, 112(6), 773 - 87
Laboratory services for mycobacterial diseases; Kubica GP et al.; The philosophy of the recently proposed "Levels of Laboratory Service" program, which will be so vital to the conduct of a successful outpatient tuberculosis treatment and control program, is presented . The hallmark of this program is the decentralization of the diagnostic/monitoring services as they involve laboratory participation . In the long run this could mean more efficient operation, more reliable reporting, and probably less work for the participating laboratories . The greater emphasis on smear examination (Level I) as a monitoring tool will mean fewer cultures, thereby lessening the load for those laboratories that once went through countless clinically requested exercises of repetitively proving by culture the existence of M . tuberculosis in a given patient . Doubtless, the bulk of the work will be conducted in Level II laboratories; but here, too, identification of the most easily defined pathogen, M . tuberculosis, will minimize the over-all workload for these investigators while decreasing their concern about mycobacteria other than tubercle bacilli . Expertise gained in frequent repetitions of a limited number of tests (niacin, nitrate reduction, and pH 7/68 degrees C catalase) will ensure reliable speciation of the clinically most important Mycobacterium . The work of Level III laboratories should eventually be reduced primarily to organisms other than M . tuberculosis, thereby ensuring that a number of highly competent reference institutions will not only attain proficiency in taxonomic aspects of mycobacteria, but will also reflect the regional picture of the changing patterns in mycobacterial pathogens of man . Participation of laboratories in proficiency testing programs will encourage top-level performance in all areas . Additionally, such testing programs will serve a teaching role; a laboratory need not feel "locked in" at a given service level, but may increase its proficiency and move up a step in terms of the service it provides . In contrast, no laboratory need feel compelled to increase its activities; if daily workloads limit the extent of their involvement with mycobacteria, these laboratories can be confident that other institutions are providing needed services . The success of the entire "Levels of Laboratory Service" program depends on the recognition by individual laboratories of their own workload limitation, the directed motivation of personnel, and the maintenance of a free and open pipeline of communication to laboratories at the next higher level of service.

South Med J, 1975 Dec, 68(12), 1507 - 11
Current status of treatment of pneumonia; Sabath LD; Proper treatment of pneumonia is dependent upon a correct diagnosis . Pneumonia may be due to infectious agents, allergic phenomena, or chemical causes . Treatment regimens are outlined for the various types of pneumonia--pneumococcal, staphylococcal, fungal, and pneumonia due to gram-negative and anaerobic gram-negative bacilli, to Blastomyces dermatitidis, and to the parasite Pneumocystis carinii . In discussing current concepts of treatment, several well-known methods are emphasized, as well as newer developments, knowledge of which is essential for optimal treatment of pneumonia.

Boll Ist Sieroter Milan, 1975 Nov 20, 54(5), 367 - 77
{Cellular lysis and dissociative phase of the genus Bacillus}; Mastrandrea V et al.; The sensitivity of the dissociative variants "R", "RS" and "S" of the spore-forming bacilli to some lytic agents (lysozyme, sodium lauryl sulphate, lipase, trypsin and some of their associations) has been studied . The research has been carried out on 32 strains: 14 "R", 14 "RS" and 4 "S" of different species of the genus Bacillus . The results have shown that the sensitivity to the studied lytic agents is strictly correlated, not to the species, but to the dissociative phases: these results are in accordance with those obtained in previous researches, carried out by the same Authors, on other characters, both morphological and biological, of the same variants . Thus, also through this way, it is possible to reach the conclusion that within this genus, there is more similarity among the different species of the same dissociative phase than among different dissociative variants of the same species . The results obtained in the present study allow to advance hypothesis, based also on the data of the literature, about the composition of the cell walls of the three above mentioned dissociative variants of the strains belonging to the genus Bacillus.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Nov, (11), 96 - 100
{New findings concerning the spread of natural foci of infection in the transpolar region of eastern Siberia}; Kornilova GV et al.; New materials are presented on the presence of the foci of anthropozoonozes in the Extreme North . For the first time there was established the existence in the subarctic tundra of the Taimyr peninsula of the arbovirus foci of the tick-borne encephalitis complex . A virus of the tick-borne encephalitis complex was isolated in 1973 from the gamasida ticks Haemogamasus ambulans Thorel . and Hirstionyssus isabellinus Oudms . and the nests of the Siberian lemming Lemmus lemmus L . This pointed to the existence in the Transpolar region of the foci or arboviruses in the nest-hole biocenoses of the lemmings outside the bird colonies . Cultures of tularemia bacilli (which proved the etiology of the epizootic among the lemmings observed in 1973 and also the presence of the lemming natural foci of tularemia and their combination with the arbovirus foci) were isolated from the lemmings at the same territory . The results of serological examination of the local population and of the animals pointed to the circulation in the Transpolar region of the causative agents of leptospirosis, toxoplasmosis, Q-fever and of the Asian tick-borne rickettsiosis.

Cesk Patol, 1975 Nov, 11(4), 180 - 6
{Importance of moulds in the morphogenesis of pulmonary changes in chronic infantile granulomatosis}; Vortel V et al.; A brief clinical and a rather detailed histological decription is given of three male siblings suffering from chronic granulomatosis . Two types of granulomas were indentified . One of them occurring extrapulmonally resembled the specific tuberculous granuloma with caseation, but tuberculous bacilli not demonstrated . The other type of granuloma was found in the lungs and was composed of a leucocytic core surrounded by an epithelioid cellular rim containing giant cells . In all the three cases such granulomas were shown to contain mould filaments of the aspergillus type.

Dis Colon Rectum, 1975 Nov-Dec, 18(8), 685 - 93
Intestinal and peritoneal tuberculosis: report of two cases; Fraki O et al.; One hundred and seven cases of abdominal tuberculosis were analyzed . There were no specific laboratory or x-ray findings pathognomonic of abdominal tuberculosis . Leukopenia was often found, but was nonspecific . An abdominal tumor was often palpable . A great rarity in our series was profuse hemorrhage from a jejunal tuberculous ulcer; the patient had to be subjected to an emergency operation . In another case tuberculosis appeared in a side-to-side small intestinal anastomosis and in its blind ends, which had developed as a late complication . The diagnosis of abdominal tuberculosis must be confirmed by histologic examination of biopsy specimens; if the results are inconclusive, acid-fast bacilli must be seen or culture should be positive . Guinea-pig inoculation is rarely positive, probably owing to the low virulence of the tuberculous bacteria in abdominal tuberculosis . Good results are obtained with chemotherapy in both intestinal and peritoneal tuberculosis . The complications, obstruction being most usual, must be surgically treated . Resection of the affected segment is the best surgical procedure . For ileocecal tuberculosis, right hemicolectomy was performed . According to the authors, roentgenographic evidence of tuberculosis in the abdomen must always be confirmed by operation, because differentiation from carcinoma and other inflammatory lesions is impossible . For good results after operation, anti-tuberculosis chemotherapy is mandatory.

J Bacteriol, 1975 Nov, 124(2), 905 - 17
Ultrastructural study of the reversion of protoplasts of Bacillus licheniformis to bacilli; Elliott TS et al.; The reversion of protoplasts of Bacillus licheniformis 6346 His- on a medium containing 2.5% agar has been studied in sectioned material after reaction with a ferritin-conjugated antibody specific to the peptidoglycan isolated from the walls of the bacilli . Freeze etching has also been used . Fibrils of material reacting with the antibody have been detected emerging from isolated areas of the protoplasts after 3 h of incubation . This material gradually covers the cell and can eventually (at 6 h) be seen in freeze-etched preparations as a fringe of up to 400 nm around the cells and covering the surfaces with particles that can be removed by lysozyme . At later stages the wall begins to take on a compact, well-defined appearance that can be seen in sections; however, the cells are still grossly deformed . A transitory emergence, beyond the wall of long fibers of 6 nm in diameter, takes place after about 12 h of incubation . These fibers react with the conjugated antibody and after freeze etching show a regular banded structure . They are probably indentical with the fibers isolated elsewhere (Elliott et al., 1975) and shown to contain all the wall constituents (i.e., peptidoglycan, teichoic acid, and teichuronic acid) . These fibers are not detectable in the final stages of reversion.

J Bacteriol, 1975 Nov, 124(2), 623 - 32
Formation of cell wall polymers by reverting protoplasts of Bacillus licheniformis; Elliott TS et al.; The biosynthesis of peptidoglycan and teichoic acid by reverting protoplasts of Bacillus licheniformis 6346 His-, in cubated at 35 C on medium containing 2.5% agar, is detectable after 40 min . The amount of N-acetyl-{1-14C}glucosamine incorporated into peptidoglycan and teichoic acid on continued incubation doubles at the same rate as the incorporation of {3H}tryptophan into protein . At the early stages of reversion the average glycan chain length, measured by the ratio of free reducing groups of muramic acid and glucosamine to total muramic acid present, is very short . As reversion proceeds, the average chain length increases to a value similar to the found in the wall of the parent bacillus . The extent of cross-linkage found in the peptide side chains of the peptidoglycan also increases as reversion proceeds . At the completion of reversion the wall material synthesized has similar characteristics to those of the walls of the parent bacilli, containing peptidoglycan and teichoic and teichuronic acids in about the same proportions . Soluble peptidoglycan can be isolated from the reversion medium, amounting to 30% of the total formed after 3 h of incubation and 8% after 12 h . This amount was reduced by the presence in the medium of the walls of an autolysin-deficient mutant; they were not formed at all by reverting protoplasts of the autolysin-deficient mutant itself . Analysis of the soluble material provided additional evidence for their being autolytic products rather than small unchanged molecules . When protoplasts were incubated on medium containing only 0.8% agar, 53 to 67% of the peptidoglycan formed after 3 h of incubation was soluble, and 21% after 12 h . Fibers that appeared to be sheared from the protoplasts at intermediate stages of reversion on medium containing 2.5% agar were similar in composition to the bacillary walls.

Acta Pathol Microbiol Scand {A}, 1975 Nov, 83(6), 693 - 703
Experimental murine leprosy . 8 . Ultrastructural features of the inflammatory exudate and bacterial morphology in C3H and C57BL mice after foot-pad inoculation with Mycobacterium lepraemurium; Haugen OA et al.; Mice of the inbred strains C57BL and C3H were inoculated in the foot-pads with Mycobacterium lepraemurium (MLM) and the inflammatory reaction was studied using light and electron microscopy . In C57BL mice a granulomatous reaction developed 3-4 weeks after inoculation . The inflammatory exudate at this stage showed numerous lymphocytes, monocytes and macrophages . The latter cell type often contained many lysosomes and appeared activated . The bacilli which were all within phagosomes showed extensive electron dense aggregates of the cytoplasm suggesting severe damage . Lymphocytes and macrophages in close contact with each other were often observed . In macrophages which contained damaged bacilli, spherical lipid-like bodies surrounded by granular endoplasmic reticulum were observed . It is suggested that this cell product could be of some significance for the bactericidal function of the macrophage . Contrary to these findings, the cellular infiltrate developing in C3H mice showed no lymphocytes and consisted exclusively of macrophages . These were all heavily loaded with bacilli . The vast majority of bacilli encountered in this strain was morphologically intact and presumably viable . Lipid-like bodies similar to those observed in infected C57BL macrophages were not encountered in C3H mice . It is concluded that unless the infected macrophages become immunologically activited they are unable to cause bacterial damage or to inhibit the growth of MLM.

Acta Pathol Microbiol Scand {A}, 1975 Nov, 83(6), 683 - 92
Experimental murine leprosy . 6 . Cellular reactions in the draining lymph node after injection of Mycobacterium lepraemurium into the foot-pads of mice; Haugen OA et al.; The reaction patterns of the draining lymph nodes were studied in C3H and C57/BL mice after foot-pad inoculation of Mycobacterium lepraemurium (MLM) . Bacilli were found in the lymph nodes of both strains already a few days after inoculation, but any marked reaction did not occur until approximately 3 weeks later and then only in the lymph nodes of C57/BL mice . The reaction involved enlargement, epithelioid cell granuloma formation and proliferation of pyroninophilic blast cells in the T-cell area . The lymph nodes in these animals remained large and showed a reactive pattern for up to 230 days . At this stage, bacilli were relatively few . In C3H mice, no reactive changes developed and it was not until much later that they became significantly enlarged . In the advanced stage, normal lymph node structures were replaced completely by giant macrophages loaded with acid-fast bacilli . C3H and C57/BL mice are polar as regards the lymph node reaction against MLM; in C3H mice it resembles the advances stages of human leprosy while it in C57/BL mice mimics the situation in the BT-TT region . Immunofluorescence studies did not reveal any early proliferation of Ig-containing cells and the lack of cellular immune reaction against MLM in C3H mice cannot be explained as an early B-cell reaction to interfere with the development of cell mediated immunity.

J Lab Clin Med, 1975 Nov, 86(5), 741 - 5
Further studies on the effect of lung antibodies on the pathogenesis of tuberculosis; Burrell R et al.; A study was made to further clarify the role of lung reactive antibodies in tuberculous infection . Following intravenous infection with viable tubercle bacilli, mice received mouse anti-mouse lung antibodies for three weeks . Control groups consisted of tuberculous mice receiving non-lung antibody containing fluid and uninfected mice . A method was developed for quantitating tuberculous infection in these different groups by expressing the number of lesions produced per unit of cross-sectional surface area of the lung . Passive administration of lung antibodies was found to significantly potentiate the number of tuberculous lesions . It was concluded that the antibody in some way lowered the resistance of the tissue to invasion.

Rev Epidemiol Med Soc Sante Publique, 1975 Oct-Dec, 23(7-8), 417 - 28
{Epidemiology and prevention of tuberculous contamination in bacteriology laboratories . Results of a survey on 23 laboratories}; Carbonnelle B et al.; The authors have carried out a survey of 23 bacteriology laboratories to investigate tuberculous contaminations which took place from 1967 to 1972 in these laboratories . They have reviewed 20 accidents in 74 technicians who performs searches for tuberculous bacilli, and 29 accidents in the total amount of 379 technicians working in these 23 laboratories . A comparison of these results with the previous published investigations shows a rather high number of cases reported in our country . A review of the possible causes of contaminations leads to suspect bacterial aerosols and to put forward the use of laminar flow enclosures as a prevention . The authors have tested several vertical flow instruments built to different patterns . All three convenient enclosures have an architectural characteristic: their blowing ceiling overhangs the working plane . As these instruments have been under examination for three years in a laboratory where contaminations are very likely to happen, they have obtained interesting results.

J Clin Pathol, 1975 Oct, 28(10), 775 - 8
A comparison of the in vitro activity of metronidazole, tinidazole, and nimorazole against Gram-negative anaerobic bacilli; Reynolds AV et al.; The in vitro activities of metronidazole, nimorazole, and tinidazole were compared against 69 strains of obligately anaerobic Gram-negative bacilli . Geometric mean MICs were 0-34, 1-05, and 0-28 mug/ml respectively . Thirty-six strains were also tested by the disk method . Correlation between MIC and diameter of the zones of inhibition was poor.

Br J Cancer, 1975 Oct, 32(4), 483 - 90
Effect of treatment with the MER tubercle bacilli fraction on the survival of mice carrying mammary tumour isografts: injections of MER at the tumour site or at a distal location; Cohen D et al.; Strain BALB/c female mice bearing syngeneic implants of 2 mammary adenocarcinomata were treated with MER, x-irradiation or both . MER was administered either subcutaneously at a site contralateral to the neoplastic growth or both into such a site and directly at the tumour location . None of the treatments effected cures but many of the treated animals survived significantly longer than did the saline injected controls . There was no evidence that introduction of MER into, or directly adjacent to, a tumour is a generally more efficacious route of administration than application at only a distal site and there was, indeed, the strong contrary impression that distal treatment alone bestowed survival protection more often and to a greater extent . In no instance was there a shortening of survival time following administration of MER at a location away from the tumour implant.

Chest, 1975 Oct, 68(4), 596 - 8
Reactivation of pulmonary tuberculosis due to trauma; DuBrow EL et al.; A 53-year-old man developed pulmonary tuberculosis, presumably reactivation, with ten days of sustaining multiple fractured ribs . Tuberculous bronchopneumonia developed in the right lung adjacent to the site of injury and spread to the contralateral lung . Sputum smears were positive for acid-fast bacilli three weeks after trauma . Theories for the reactivation of pulmonary tuberculosis secondary to trauma are reviewed.

Infect Immun, 1975 Oct, 12(4), 706 - 13
Experimental murine leprosy: induction of immunity and immune paralysis to Mycobacterium lepraemurium in C57BL mice; Closs O; Two series of reinfection experiments were carried out using C57BL mice . In the first series, the mice were inoculated with Mycobacterium lepraemurium (MLM) in one hind footpad and reinoculated in the contralateral footpad, two or four weeks later . Compared with normal mice of the same strain, the mice reinoculated after four weeks showed an increased local reaction to the bacilli and the bacilli did not multiply at the injection site . The responses of mice reinoculated after two weeks were intermediate to those of the other two groups . In the second series, a systemic infection was established by intraperitoneal innoculation of either a large or small dose of MLM . Twenty-two weeks later the mice were reinoculated in one of the hind footpads . Upon reinoculation, mice receiving the small intraperitoneal dose reacted more strongly than normal mice to MLM, whereas mice receiving the large dose were unable to mount any local reaction to the mycobacterium . The experiments have shown that the local reaction which develops in the C57BL strain of mice approximately four weeks after subcutaneous injection of MLM is accompanied by the onset of systemic immunity . Such systemic immunity lasted for more than 20 weeks after intraperitoneal injection of a small dose of bacilli, but was completely abolished during the course of a heavy systemic MLM infection.

Ann Rheum Dis, 1975 Oct, 35(5), 389 - 97
Adjuvant arthritis in the rat . Distribution of fluorescent material after footpad injection of rhodamine-labelled tubercle bacilli; Vernon-Roberts B et al.; Adjuvant disease in the rat may represent a cell-mediated response to tuberculous material disseminated from the original injection site, but previous studies have provided only indirect evidence for this dissemination . In the present experiments tubercle bacilli labelled in vitro with rhodamine isothiocyanate (RITC) were injected into a footpad as Freund's complete adjuvant . Serial studies showed two varieties of fluorescent material in the tissues (1) intracellular and extracellular intact and fragmented bacilli, and (2) amorphous intracellular material . Both types of material were identified in the injected foot and draining lymph nodes . Bacilli were also identified in the contralateral knee joint, peritoneum, pleura, lung, and liver, while amorphous material alone appeared in the spleen . The presence of intact bacilli was confirmed by positive Ziehl-Nielsen staining of the organisms, but the amorphous intracellular material did not stain positively by this method . The use of RITC-labelled organisms considerably reduced the severity of adjuvant disease . Most of the organisms identified in sites distant from the injected limb were not situated within foci of inflammation . Marked differences in processing of the tuberculous material (and lack of dissemination of intact bacilli) were noted when labelled organisms were injected in saline instead of in oil.

Infect Immun, 1975 Oct, 12(4), 851 - 7
Macrophage migration inhibitory activity of mycobacterial growth inhibitory factor and the effect of a number of factors on mycobacterial growth inhibitory factor activity; Cahall DL et al.; Mycobacterial growth inhibitory factor (MycoIF), which inhibits the intracellular multiplication of virulent tubercle bacilli within normal peritoneal macrophages in vitro, was tested for its ability to inhibit the migration of normal peritoneal exudate cells . The migration of peritoneal exudate cells was not inhibited by MycoIF . It was also shown that normal peritoneal macrophages infected with virulent Mycobacterium tuberculosis, strain H37Rv, required 72 h of incubation with spleen cell culture supernatant fluids containing MycoIF in order to inhibit intracellular bacillary multiplication . Treatment of infected macrophages with trypsin before their exposure to MycoIF abolished the ability of MycoIF to inhibit intracellular mutiplication of tubercle bacilli . Incubation of infected macrophages with goat anti-mouse globulin before their exposure to MycoIF also blocked the action of MycoIF.

Am J Med, 1975 Oct, 59(4), 497 - 504
Infections in cancer patients on a protected environment-prophylactic antibiotic program; Bodey GP et al.; A total of 102 studies were conducted on 89 patients receiving cancer chemotherapy while on a protected environment-prophylactic antibiotic program . Major infections occurred during 22 studies . The majority of both minor and major infections originated during the first five weeks after the patients entered the protected environment units . The frequency of infectious complications was inversely related to the circulating neutrophil count . The majority of infections were cases of cellulitis, pharyngitis, pneumonia and septicemia . Most of the infections were caused by gram-negative bacilli . The majority of organisms causing infection had persisted in the patients after their entry into the protected environment units despite the use of prophylactic antibiotics.

J Am Vet Med Assoc, 1975 Oct 1, 167(7), 639 - 45
Mycobacterium avium infection in three rhesus monkeys; Sesline DH et al.; Naturally occurring Mycobacterium avium infection in 3 rhesus monkeys was characterized clinically and pathologically by intestinal and lymphoreticular involvement . Blood lymphocyte rosette formation and phytomitogen responses were depressed, whereas serum beta and gamma globulin concentrations were increased . Slow-growing, acid-fast, nonchromogenic bacilli isolated from lymph nodes taken at necropsy were identified as M avium serotypes 4, 18, and double types 1 and 8.

Int J Lepr Other Mycobact Dis, 1975 Oct-Dec, 43(4), 348 - 55
A histopathologic study of striated muscle biopsies in leprosy; Gupta JC et al.; Histopathologic changes in striated muscle biopsies in 50 cases of leprosy were studied; 40 being the lepromatous type and 10 the nonlepromatous type . All the biopsies were obtained from midportions of normal looking biceps muscles and paraffin embedded . Sections cut in transverse and longitudinal planes were stained by hematoxylin and eosin, Masson's trichrome, Mallory's PTAH, Gomori's silver impregnation, and Ziehl-Neelsen's technic . Lepromas, focal or confluent, in the endomysium, perimysium, muscle fibers and perineurally, constituted the most common pathological lesion, being observed in 34% of all cases with a higher frequency in the lepromatous type . Acid-fast bacilli could be demonstrated in some of these lepromas . These nodules were observed even in younger patients and increased in frequency as the age of patient advanced . Three cases of nonlepromatous leprosy showed granulomas . Other changes noted in varying proportions were loss of striations, hyaline change, fatty change, sarcolemmal changes, along with endomysial thickening, muscle necrosis and fibrosis . Bacillemia in leprosy and the possible route of muscle invasion resulting in subsequent production of leprous nodules with associated degenerative changes, indpendent of nerve involvement, have been postulated.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1975 Oct-Dec, 24(4), 231 - 4
{Bacterio-epidemiological significance of diabetes mellitus-pulmonary tuberculosis syntropy}; Tomosoiu M; The author discusses infectivity before and after complex treatment with the classical tuberculostatics in 42 diabetics with chronic pulmonary tuberculosis of the total of 78 subjects followed up for three years, the other 36 subjects being compensated metabolically and pulmonarily . Although the number of negative cases increased fourfold there remained a high proportion of bacilli eliminators, the diabetics becoming negative at a much slower rate.

Int J Lepr Other Mycobact Dis, 1975 Oct-Dec, 43(4), 339 - 47
Acid-fast properties and pyridine extraction of M . leprae; Skinsnes OK et al.; The reportedly unique pyridine extractability of acid-fastness as an identifying characteristic for M . leprae was examined in the leprosy bacilli and in eight other strains of mycobacteria . The initial findings were, in general, in accord with previous reports except that M . smegmatis and M . phlei likewise demonstrated two hour pyridine extractability of acid-fastness . Perhaps, more significantly, it was found that this characteristic in M . leprae is related to aged, probably nonviable bacilli . Some other strains of mycobacteria when tested in aged cultures showed the same phenomenon while M . leprae cultivated in vitro in a recently developed medium resisted pyridine extraction up to three weeks of growth, but thereafter as the culture aged pyridine extractability became characteristic . It is concluded that this pyridine extractability of acid-fastness is a characteristic of aging or nonviable bacilli . As such it is not definitive in the determination of whether or not in vitro cultivation of M . leprae has been achieved.

Circulation, 1975 Oct, 52(4), 722 - 31
De subitaneis mortibus . XIV . Bacterial arteritis in Whipple's disease; James TN et al.; Although Whipple's disease is clinically recognized for its features of arthritis and diarrhea, pericarditis and cardiac valvular disease are frequently present and a significant number of such patients die suddenly and unexpectedly . This report includes special postmortem cardiovascular examinations in a 55-year-old man who died of Whipple's disease . Pericarditis and valvular disease were extensively present . There was also focal myocardial degeneration, including the sinus node, A-V node and His bundle . Typical Schiff-positive bacilli were found in the tunica media and endothelium most numerously in the small coronary and hepatic arteries, less in splenic and renal arteries, and least in small pulmonary arteries . Large coronary arteries and the aorta were not involved . Three stages of bacterial invasion of the arteries included a noninflammatory phase in which the bacilli were most numerous, a pancreatic phase in which bacilli were distinctly less numerous, and a healed scarring of arteries previously damaged . The combination of pericarditis, valvular disease of the heart, coronary and systemic bacterial arteritis and focal myocardial degeneration and myocarditis is unusual for Whippl'e disease . Studies of other cases are warranted to determine whether bacterial arteriopathy and arteritis have previously been overlooked or if the present case is unique . Evidence that the conduction system of the heart may be involved indicated that careful attention to cardiac rhyth and conduction is merited in future studies of patients with Whipple's disease.

Infect Immun, 1975 Oct, 12(4), 833 - 40
Conditions for production, and some characteristics, of mycobacterial growth inhibitory factor produced by spleen cells from mice immunized with viable cells of the attenuated H37Ra strain of Mycobacterium tuberculosis; Cahall DL et al.; Mycobacterial growth inhibitory factor (MycoIF), found in supernatant fluids of mouse spleen cell cultures that have been stimulated in vitro with homologous antigen, inhibited the intracellular multiplication of virulent tubercle bacilli within normal mouse peritoneal macrophages in vitro . Antigenically stimulated H37Ra-immunized mouse spleen cells required 72 h of incubation to produce supernatant fluids that would cause intracellular inhibition . Supernatant fluids from 48-h mouse spleen cell cultures were not able to produce intracellular inhibition . Investigation of the culture conditions showed that at lease 1.0% human serum was required in the tissue culture medium for the production of MycoIF by spleen cells from immunized mice . MycoIF activity was noted only in supernatant fluids from spleen cell cultures incubated with antigen for 72 h . MycoIF was nondialyzable and unaffected by freezing, lyophilization, or incubation at 60 C for 30 min . However, MycoIF was inactivated after incubation at 80 C for 30 min . MycoIF was unaffected by low hydrogen ion concentrations (pH 7 to 12), but exposure to higher hydrogen ion concentrations (pH 6, pH 5) significantly decrease MycoIF activity, and exposure to pH 4 to 2 abolished all activity . Supernatant fluids diluted 1:32 were still able to produce significant intracellular inhibition of growth of virulent tubercle bacilli.

J Gen Microbiol, 1975 Sep, 90(1), 21 - 31
Identification of Chromobacterium violaceum: pigmented and non-pigmented strains; Sivendra R et al.; The classification and, therefore, identification of Chromobacterium violaceum has been based upon its ability to produce a violet pigment . Although the organism may yield non-pigmented variants when subcultured on artificial media, the isolation of non-pigmented strains from pathological tissues or from nature had not been reported . With a method established for the identification of C . violaceum regardless of violet pigmentation, non-pigmented strains were isolated from nature . The presence of non-pigmented strains of C . violaceum in nature is of significance to taxonomy and clinical bacteriology . Pigmentation cannot be held as an essential characteristic of the definition of the genus Chromobacterium and gives credence to the suspicion of Sneath (1960, 1966) that the genus is not a natural one . Non-pigmented strains may have been isolated from clinical material but wrongly identified as belonging to other genera of non-pigmented Gram-negative bacilli and regarded as not being pathogenic.

Rev Asoc Argent Microbiol, 1975 Sep-Dec, 7(3), 81 - 5
{Immunological examination of patients with undetermined leprosy}; Flies EL et al.; The immunological competence of eleven patients with undetermined leprosy was compared with that of ten normal volunteers of the same age and sex distribution; these controls have not had previous contact with leprosy . The following parameters were studied in peripheral blood cells: 1) percentage of lymphocyte bearing surface immunoglobulins, as revealed by immunofluorescence; 2) percentage of lymphocyte bearing complement receptors, as studied by antibody and complement coated erithrocyte rosetting; 3) percentage of T cells, as revealed by spontaneous sheep erithrocyte rosettes; 4) blastogenic and mytogenic response of cultured lymphocytes to PHA and 5) cell migration inhibition test using lepromine (80 x 10(6) bacilli/ml) as antigen . Skin reactions to lepromine were also assayed . In the six lepromine-positive patients with undetermined leprosy, no major immunological alterations could be detected . On the contrary, the five lepromine-negative patients showed important alterations which could well be considered as precursors of lepromatous leprosy.

Br J Pharmacol, 1975 Sep, 55(1), 151 - 5
The penetration of dapsone, rifampicin, isoniazid and pyrazinamide into peripheral nerves; Allen BW et al.; 1 Dapsone, rifampicin, isoniazid and pyrazinamide were shown to penetrate readily into the sciatic nerves of the dog and sheep . 2 These findings suggest that the continued persistence of viable drug-sensitive leprosy bacilli in the peripheral nerves of patients treated for long periods with either dapsone or rifampicin is not due to inadequate intraneural drug penetration.

Am J Surg, 1975 Sep, 130(3), 359 - 61
Successful management of miliary tuberculosis after renal transplantation; Rattazzi LC et al.; Miliary tuberculosis is the most lethal form of tubercular disease . If dissemination of tubercle bacilli occurs without therapy, death is almost certain . The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory . The presence of a life-threatening infection in these patients requires aggressive antimicrobial therapy and discontinuation of the immunosuppressive drugs until the infectious process is under control; the presence of an impaired immunologic response is responsible for the life-threatening infection and the lack of an acute rejection reaction.

Infect Immun, 1975 Sep, 12(3), 480 - 9
Experimental murine leprosy: growth of Mycobacterium lepraemurium in C3H and C57/BL mice after footpad inoculation; Closs O; Forty-three female C57/BL and C3H mice were inoculated with 2.7 X 10(6) Mycobacterium lepraemurium into each hind footpad . The foot thickness and the number of acid-fast bacilli in the footpad and popliteal and inquinal lymph nodes were recorded . In addition the morphological index and the mean bacillary length were determined in the footpad and in the popliteal lymph node . The bacilli multiplied in both strains during the first 4 weeks after inoculation . After that time no further increase in acid-fast bacilli was observed in the C57/BL strain; the bacilli became elongated and the morphological index decreased . These changes were preceded by a local swelling of the footpad due to the onset of an immune reaction . Thus, under the present conditions, C57/BL mice were able to resist experimental infection with M . lepraemurium by developing an immune response . In C3H mice no indication of an immune reaction was detected, and the bacilli continued to multiply throughout the observation period . The mouse footpad model seems to provide an excellent basis for the use of experimental murine leprosy to study immunity to mycobacterial infections . Certain aspects of the present model are discussed in relation to the mouse footpad model as used in the study of M . leprae infection in mice.

Tubercle, 1975 Sep, 56(3), 211 - 7
Reappraisal of the activity of morphazinamide against M . tuberculosis; Bravo TC et al.; Morphazinamide was shown to have an in vitro activity similar to an equimolar concentration of pyrazinamide . This activity was not due, as had been previously assumed, to pyrazinamide formed by hydrolysis from morphazinamide, since it was demonstrated in slide cultures containing tubercle bacilli which were incubated with freshly prepared dilutions of morphazinamide in acid medium for several successive periods of only 1 hour, during which time little hydrolysis occurred . A new method was used for measuring morphazinamide and pyrazinamide separately in plasma . In man, the estimated in vitro antibacterial activity was similar after approximately equimolar oral doses of morphazinamide or pyrazinamide . However, it is uncertain whether the in vivo activity of morphazinamide is the same as its in vitro activity.

J Bacteriol, 1975 Sep, 123(3), 1157 - 62
Mode of cell wall synthesis in gram-positive bacilli; Fan DP et al.; Ultrastructural experiments on plasmolyzed cells suggested that the information for the position and orderly synthesis of septa is not determined by the attachment of cell membrane to previously formed wall . These experiments, in conjunction with others on cells disrupted by the freeze-fracture technique, are most consistent with wall growth over the entire surface of the rods, with wall material gradually moving from a position next to the cell membrane to a position at the outer surface of the cell.

Cancer Lett, 1975 Sep, 1(1), 49 - 53
Rejection of sarcoma cells at the site of an inflammatory reaction: macrophages are not the only effector cells; Parr IB et al.; Purified protein derivative (PPD) (a soluble protein from tubercle bacilli), when injected together with sarcoma cells into syngeneic mice that had been immunized previously with Bacillus Calmitte-Guerin (BCG), prevents tumour toxic to sarcoma cells {4} . However, non-adherent mononuclear peritoneal exudate cells from BCG-treated mice were also found on addition of PPD to become cytotoxic to sarcoma cells . In vivo assays indicate that such cells may play a major role in the in vivo destruction of tumours at the site of a delayed hypersensitivity reaction.

J Clin Pathol, 1975 Sep, 28(9), 744 - 5
Effect of decalcifying agents on the staining of Mycobacterium tuberculosis; Anderson G et al.; Lymph nodes from guinea pigs inoculated with Mycobacterium tuberculosis were fixed in buffered formalin, then treated for the recommended times in Gooding and Stewart's fluid, EDTA, aqueous nitric acid, von Ebner's fluid, and rapid decalcifier (RDC) . The blocks were processed to paraffin wax and sections were stained by the Ziehl-Neelsen technique . Only in sections of the blocks treated with RDC were no acid alcohol fast bacilli demonstrable . Hydrochloric acid is a known constituent of RDC and it was found that Myco . tuberculosis is altered by treatment with 2-5M solutions of hydrochloric acid and above and cannot subseuqently be demonstrated by the Ziehl-Neelsen stain . From these results it is recommended that calcified tissue from patients in whom there is a suspicion of tuberculosis should be decalcified with an agent other than RDC.

Gut, 1975 Sep, 16(9), 719 - 26
Gastric pH and microflora of normal and diarrhoeic infants; Maffei HV et al.; The microflora and pH of gastric contents were determined in breast-fed and in bottle-fed normal infants, in well nourished infants with acute diarrhoea and in infants with chronic diarrhoea and protein-calorie malnutrition . The last group of infants was reevaluated after recovery from diarrhoea and protein-calorie malnutrition . A bactericidal pH effect below 2-5 was observed . Bottle-fed controls had low pH values and low bacterial concentrations, whereas infants with chronic diarrhoea and protein-calorie malnutrition had high pH values and bacterial overgrowth, essentially of Gram-negative bacilli . After recovery, the only remaining alteration was the frequent isolation of yeast-like fungi in low concentrations . Infants with acute diarrhoea, except for the isolation more frequently of yeast-like fungi, presented no alterations; this seems to indicate that pH alterations and Gram-negative bacilli overgrowth occurred during the evolution of the disease to a chronic state . Breast-fed normal infants had hydrogen-ion concentrations similar to those of the chronic diarrhoea group, but without Gram-negative bacilli overgrowth, suggesting that other factors, besides pH, regulate bacterial growth in the gastric contents of these groups of infants.

Schweiz Med Wochenschr, 1975 Aug 2, 105(31), 987 - 91
{Lung diseases due to atypical mycobacteria}; Favez G; The epidemiology, symptoms, diagnosis, and treatment of mycobacterioses are reviewed . In the Canton of Vaud, Switzerland, the incidence of mycobacterioses approximates to 1% of infectious tuberculosis cases . Non-pathogenic typical mycobacteria have been identified in 2.8% of non-infectious chronic respiratory disorders, in 1.2% after culture conversion of respiratory tuberculosis, and mixed with tubercle bacilli in 4% of cases.

Jpn J Microbiol, 1975 Aug, 19(4), 319 - 25
Studies of Mycobacterium lepraemurium in cell culture . II . Pathogenicity of Mycobacterium lepraemurium maintained in mouse foot pad cell culture and interaction of the bacilli with the infected cells; Matsuo Y; A serially diluted bacterial suspension of the Kurume-42 strain of Mycobacterium lepraemurium maintained for 1255 days in a mouse foot pad (MFP) cell culture was inoculated in mice subcutaneously . The ID50 value was estimated at more than 10.7 and less than 85 organisms, indicating that pathogenicity of the organism had been maintained well in a long-term cell culture . The cells infected and maintained for a long period in the cell culture showed all the stages of cell mitosis . This suggests that the bacterial increase in cell cultures of M . lepraemurium is not only due to rephagocytosis of the bacilli released from the infected cells but also to a constant intracellular growth cycle of the bacilli accompanied by mitosis of the infected cells . In acid phosphatase activity, no appreciable differences were noted between the infected and uninfected cells as far as the present cell culture system was concerned . Most of the bacilli within the cells were ultrastructurally normal . Solid bacilli in phagosomes were surrounded by less electron-dense clear zones.

Immunology, 1975 Aug, 29(2), 231 - 6
Further characterization of antigen-dependent migration inhibition factor in mice; Hochova B et al.; Antigen-dependent MIF was produced in inbred mice . Lymph node cells from mice sensitized to tubercle bacilli were incubated with small quantities of antigen . The supernatant contained antigen-dependent MIF and its activity when tested on mouse and rabbit spleen was minimal unless PPD was added to the supernatant . The production of the antigen-dependent MIF was T cell-dependent, as shown by the use of anti-theta serum . Its molecular weight was in the range of 50--100,000 and it was concluded that the factor is different from conventional antibodies or antigen-antibody complexes.

Am J Clin Pathol, 1975 Aug, 64(2), 263 - 70
Cutaneous infection due to a rough variant of Mycobacterium marinum; Smith AG et al.; Spreading lesions clinically resembling lymphangitic sporotrichosis developed on the right arm and chest of a 60-year-old man with chronic lymphocytic leukemia . Acid-fast bacilli were seen in exudates from lesions and in biopsies, and were cultured from them . The isolant grew initially as a yellowish-orange scotochromogen on Lowenstein-Jensen medium at room temperature and at 35 C., but failed to grow at 37 C . It failed to grow on 7-H-10 medium . On repeated subculturing over a 2-year period it gradually converted to a photochromogen . Histologically, there was ulceration with extensive acute and chronic inflammation with fibrosis . Organisms occurred intracellularly as dense, compact, cigar-like packets resembling lepara bacilli . The appeared to have a predilection for the nucleus . The patient was anergic to PPD S, B, Y and G, and lacked antibodies to BCG phosphoglycolipids . The mycobacteriosis was alleviated by combined INH and ethambutol therapy . The isolant was identified as a rough variant of Mycobacterium marinum . It may have been transmitted by an insect vector.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Aug, (8), 30 - 5
{Study of the reasons for a decrease in the inoculability of diphtheria bacteria}; Kriukov VIu et al.; It was shown that the seeding efficacy of diphtheria bacilli depended not only on the state of the epidemic process, but also on the correct methodical approach to the examination . A combination of the qualitative and epidemiological choice of the groups of population for bacteriological examination with the use of blood tellurite media permitted to increase the efficacy of investigations, with a considerable reduction of the number of analyses.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Aug, (8), 25 - 30
{Patterns of antimicrobial immunity in carriers of toxigenic diphtheria bacteria}; Sukhorukova NL et al.; It was shown in the passive hemagglutination test (PHAT) with a type-specific somatic antigen on 147 carriers of toxigenic diphtheria bacilli that the PHAT titres of 1/80 and over were determined in 64% of bacteria . In the process of carrier state of toxigenic bacteria antimicrobial antibodies were detected in 79% of the children; after the release from the carrier state, the percentage was from 57 to 26, depending on the time lapse after it . Among the carriers of nontoxigenic diphtheria bacilli the PHAT titre of 1/80 and over was established in up to 20% of children, and only in those which were in the focus of toxigenic bacilli carriers . The applied test could be used for epidemiological purpose to determine the spread of the carrier state of toxigenic bacteria in a collective body.

Ann Rheum Dis, 1975 Aug, 34(4), 326 - 31
Assessment of anti-inflammatory drugs in the rat using subcutaneous implants of polyurethane foam impregnated with dead tubercle bacilli; Clarke AK et al.; The fluid and cellular phases of inflammatory resonse have been measured using a technique employing subcutaneous implantation of polyurethane foam cubes impregnated with heat-killed Mycobacterium tuberculosis . Phenylbutazone, azathioprine, aspirin, cyclophosphamide, and prednisolone suppressed fluid response, whereas sodium aurothiomalate, hydroxychloroquine, and D-penicillamine had no effect . All the drugs used suppressed the infiltration of inflammatory cells into the cubes.

Br J Surg, 1975 Aug, 62(8), 610 - 7
Abdominal tuberculosis: demonstration of tubercle bacilli in tissues and experimental production of hyperplastic enteric lesions; Das P et al.; Material obtained from 35 cases of abdominal tuberculosis waps studied and an attempt was made to demonstrate tubercle bacilli by special staining of histological sections, culture and guinea-pig inoculation . Acid fast bacilli could be demonstrated in 80 per cent of cases . The remaining cases were also possibly due to tuberculous infection because granulomas with Langhans's type of giant cells and caseation or calcification of lymph nodes were present . The bacilli were demonstrated in bowel tissue showing non-specific histology in 1 case . In 2 other cases with non-specific lesions in the bowel the bacilli were demonstrated in lymph nodes . Guinea-pig inoculation studies showed that hypertrophic lesions of the bowel with a non-specific type of reaction could develop after intraperitoneal injection of tubercular material . Although it cannot be said on the basis of this study that Crohn's disease is caused by tuberculous infection, it can be concluded that tuberculous infection can give rise to a Crohn's type of lesion.

Infect Immun, 1975 Aug, 12(2), 267 - 9
o-Diphenoloxidase of Mycobacterium leprae separated from infecected armadillo tissues; Prabhakaran K et al.; We reported earlier the occurrence of a unique o-diphenoloxidase in Mycobacterium leprae recovered from lepromatous human tissues . No other source of M . leprae fro biochemical studies was available at the time . In the present report, properties of phenoloxidase in M . leprae separated from infected armadillo tissues are presented . The results show that the o-diphenoloxidase remains unaltered in the passage of the bacilli from the human to the the animal host, indicating that the enzyme is an intrinsic characteristic of the leprosy bacteria.

Jpn J Antibiot, 1975 Aug, 28(4), 549 - 57
{Influence of schizophyllan, streptomycin and rifampicin on histopathological changes in mice infected with tubercle bacilli (author's transl)}; Komatsu N et al.; Experimental tuberculosis in mice infected with streptomycin-resistant Mycobacterium tuberculosis SCHACHT strain was treated with streptomycin or rifampicin alone and in combination with schizophyllan . The histopathogical tests of various organs of the treated mice were carried out . 1) In the group of mice treated with streptomycin alone, the moderate focal proliferation of RE cells were seen at the beginning of infection . However, durable activation of RE cells and the prolongation of life-span could not be recognized as compared with control animals . 2) The treatment with streptomycin-schizophyllan combination appeared to be somewhat more effective than schizophyllan alone, the phagocytic capacity being more strongly stimulated . 3) In the group treated with rifampicin alone, the therapeutic effect could be exhibited by the direct antibacterial action of rifampicin, but the activation of RE cells was slight . When rifampicin was discontinued, the growth of tubercle bacilli was rapidly resumed, and the durable therapeutic effect seemed not to be expected . Degeneration of hepatic cells tended to develop . 4) In the group treated with rifampicin-schizophyllan combination, the antibacterial effect of rifampicin appeared to be potentiated by the strong activation of RE cells by schizophyllan, showing the durable therapeutic effects.

J Am Vet Med Assoc, 1975 Jul 15, 167(2), 152 - 3
Swine tuberculosis in South Dakota; Mitchell MD et al.; Mycobacteria were isolated from 195 of 200 lesions in lymph nodes identified as granulomatous by meat inspectors at 4 abattoirs in South Dakota . Mycobacterium avium serotypes 1 and 2 accounted for 89% of the isolants . Mycobacteria were isolated more frequently from lesions than acid-fast bacilli were observed on microscopic examination (P less than 0.001) . The frequency with which mycobacteria was isolated was similar to the occurrence of granulomatous lesions . The numbers of the various kinds of mycobacteria isolated at each of the 4 abattoirs and for the 3 meat inspection disposition classes were not significantly different.

Lancet, 1975 Jul 12, 2(7924), 69 - 72
Sulphone resistance in leprosy . A review of one hundred proven clinical cases; Pearson JM et al.; An account is given of the first hundred consecutive proven cases of sulphone resistance in leprosy, detected in Malaysia between 1963 and 1974 . Proof of resistance was clinical in eighty patients and was obtained by drug-sensitivity testing in mice in ninety-six patients; 76 cases were proved both clinically and experimentally, and there was no discrepancy between the two methods . Sulphone resistance was confined to patients with lepromatous-type leprosy--i.e., patients with a large bacterial population . Clinical evidence of relapse due to drug resistance appeared 5-24 years after the start of sulphone treatment . Low dosage favoured the appearance of resistance; therefore regular treatment of lepromatous leprosy with dapsone in full dosage is recommended . The attainment of "skin smears negative for leprosy bacilli" is no test of cure of lepromatous leprosy.

Int J Lepr Other Mycobact Dis, 1975 Jul-Sep, 43(3), 252 - 5
Complement determinations in the synovial fluid and serum of a patient with Erythema nodosum leprosum; Louie JS et al.; Simultaneous serum and synovial fluid CH50, C1, C4, C2, C1 esterase inhibitor and C3 protein were determined in a patient with acute erythema nodosum leprosum . The pattern of synovial fluid complement activity coupled with the demonstration of multiple lepra bacilli free and within histiocytes is more consistent with an infectious than an immune complex induced synovitis.

Int J Lepr Other Mycobact Dis, 1975 Jul-Sep, 43(3), 226 - 33
Comparison in leprosy patients of Fernandex and Mitsuda reactions using human and armadillo antigens . A double-blind study; Millar JW et al.; The Mitsuda and Fernandez reactions to bacilli prepared from lesions of human patients and bacilli from infected armadillos were studied in 112 leprosy patients . It was observed that there is no substantial difference when armadillo lepromin is used instead of human lepromin except that a larger induration occurs with the use of the armadillo lepromin in a majority of cases . The number of those reporting a burning sensation at the armadillo lepromin injection site was slightly higher in lepromatous patients; whereas the burning sensation was observed at the human lepromin injection site by the tuberculoid cases . With the significant information compiled in this study, it is concluded that lepromin prepared from bacilli obtained from infected armadillos is as effective as that prepared from bacilli obtained from the lesions of leprosy patients.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Jul, (7), 20 - 4
{Stimulation of primary immune response by the activation of autoimmune processes}; Klemparskaia NN et al.; Experiments were conducted on 220 female mice weighing 20--24 g, with the use of 3 types of antigens (sheep erythrocytes, vaccines from the intestinal and paratyphoid bacilli) . There proved to be an increase on the 7th and the 14th day of the formation of specific antibodies under the effect of subcutaneous injection of a homologous blood (0.1--0.3 ml per mouse) 2 hours after the antigen immunization . Hemostimulation not only intensified the antibody-genesis, but also increased the resistance to the infection with the living microbial culture . The stimulating action of the blood injection persisted in irradiation of the mice with gamma-rays in a dose of 300 r . Hemostimulation produced an activation of the normal autoantibody system capable of influencing the function of cells necessary for the antigen assimilation.

Am J Trop Med Hyg, 1975 Jul, 24(4), 649 - 55
Experimental infection of anole lizards (Anolis carolinensis) with Mycobacterium ulcerans by the subcutaneous route; Marcus LC et al.; To test whether herpetofauna could be a laboratory model for Mycobacterium ulcerans, 21 anole lizards were inoculated subcutaneously with viable M . ulcerans, 21 with autoclaved organisms, and 14 with an aqueous solution of 0.01% Tween 80 . M . ulcerans was recovered in culture from the slowly progressive lesions which developed at the inoculation site in lizards receiving the viable bacteria . Progressive lesions did not occur in the two control groups . Three patterns of inflammatory response to viable M . ulcerans were observed: 14 lizards developed a diffuse, granulomatous reaction in which acid fast bacilli (AFB) were predominantly intracellular; 1 developed focal, encapsulated granulomas; 5 developed a diffuse, necrotizing granulomatous response in which most AFB were extracellular--similar to the characteristic lesion found in human infections.

Am Rev Respir Dis, 1975 Jul, 112(1), 119 - 23
Primary pulmonary sporotrichosis complicated by perirectal abscess; Khan FA et al.; A 48-year old, retired mounted policeman was followed for 4 years through 4 hospitalizations for progression of his bilateral, cavitary lung disease . His sputum was always negative for acid-fast bacilli and fungi . Subsequently, a painful perianal swelling appeared that was incised and drained of purulent material . Five years after first seen, sputum and rectal drainage revealed Sporothrichum schenckii in many cultures . Serologic evidence of sporotrichosis was also present . With amphotericin B therapy, the patient showed marked clinical improvement . Unfortunately, he died from an episode of acute respiratory failure . Although most patients with primary cutaneous or primary pulmonary sporotrichosis are horticulturists, the writers believe that this disease should be considered in any undiagnosed, chronic, cavitary lung disease, even in the absence of this occupational history.

Br J Cancer, 1975 Jul, 32(1), 1 - 4
A preliminary report on the effects of methanol extraction residue of BCG (MER) on cancer patients; Robinson E et al.; Twenty-seven patients with malignant neoplasia were injected intradermally with the methanol extraction residue (MER) fraction of tubercle bacilli . Two schedules of treatment were used: every other week and once a month; 1-10 courses of MER were administered to the patients . The skin reactivity to 3 recall antigens, as well as to the injected MER itself, was used to monitor the immune response . Improvement of skin reactivity occurred in 9 of 18 patients tested with recall antigens . Five of 6 patients treated every other week improved in their immune capacity whereas only 4 of 12 patients improved on the monthly schedule . Thus, repeated injections given every other week were more effective in increasing the cutaneous reactivity than monthly injections of MER . The side-effects of MER treatment were tolerable.

Acta Cytol, 1975 Jul-Aug, 19(4), 330 - 3
Study correlating endometrial biopsies and vaginal cytology in one hundred tubectomized women; Mehta P; PIP: Menstrual irregularities are believed to often follow the tubectomy operation, possibly because the ovarian blood supply is altered and horm onal imbalance results . This study was designed to determine, with the help of hormonal colpocytology and endometrial histology, whether hormon al imbalance occurs after tubectomy . Subjects were 100 women attending the tubectomy follow-up clinic . All had been tubectomized 2 or more years earlier . On the 5th and 6th days of their menstrual cycles, a group was treated with an antibiotic vaginal pessary consisting of .25 gm of Chloramphenicol . From the 8th to the 24th day, serial vaginal sme ars were taken . The maturation index (MI), maturation value (MV), and k aryopyknotic index (KI) were evaluated . Endometrial biopsies were taken on Day 24 of the menstrual cycles . Of the 100 women, 98 had ovulatroy c ycles as shown by endometrial biopsy . The 2 having anovulatory cycles w ere in the treated group . Their MVs and KIs were low . None showed evid ence of hyperestrogenism either in their colpocytogram or endometrial hi stology . Disturbed ovarian function was not shown . Prior anitbiotic tr eatment is essential for hormonal cytology, as in the majority of untrea ted women the presence of Doderlein bacilli, debris, and leukocytes in the follicular phase renders preparations unsatisfactory for hormonal ev aluation . Chloramphenicol has no direct effect on the vaginal epitheliu m but tetracyclines cause massive desquamation .

Zh Mikrobiol Epidemiol Immunobiol, 1975 Jul, (7), 92 - 5
{The effect of neuraminidase of C . diphtheriae on the functional capacity of the peritoneal exudate cells of guinea pigs to diphtheria bacilli}; Maslova TN et al.; A study was made of the effect of neuraminidase preparation containing no diphtheria toxin admixtures and hyaluronidase on the phagocytic activity of macrophages . Neuraminidase produced a stimulating effect on the cells of the developing macrophage culture . The macrophages treated with the enzyme increased their capacity to digestion of nontoxigenic diphtheria bacilli.

Res Commun Chem Pathol Pharmacol, 1975 Jul, 11(3), 487 - 90
Growth inhibition of tubercle bacilli after pulsed exposures to combinations of antituberculous drugs; Beggs WH; All possible pairs of drugs chosen from the primary antituberculous agents including isoniazid, streptomycin, rifampin, and ethambutol were compatible and inhibited growth after administration to tubercle bacilli in a single 7 hr pulsed exposure . In general, combined drug effects could be best described as additive.

J Pediatr, 1975 Jul, 87(1), 43 - 9
Tuberculous meningitis in children during the isoniazid era; Sumaya CV et al.; Fifty-nine cases of tuberculous meningitis in children seen at the Charity Hospital at New Orleans since the addition of isoniazid to the therapy in 1952 are reviewed . Fourteen of the children died during hopsitalization . At discharge 21 children had complete or nearly complete clinical recovery . Follow-up of 21 available long-term survivors revealed a significant number with neurologic and social disabilities . The endemicity of tuberculous infections in the households of the children and factors responsible for transmission of tubercle bacilli from an adult source are reported . The importance of chemoprophylaxis and public health measures in eliminating this disease are stressed.

J Gen Microbiol, 1975 Jul, 89(1), 124 - 32
Comparison of polysaccharides produced by Myxococcus strains; Sutherland IW et al.; Exopolysaccharides were prepared from cultures of four Myxococcus strains grown on solid and in liquid media, and also from the fruiting bodies . Lipopolysaccharides could be extracted with aqueous phenol from the vegetative bacteria, but were absent from microcysts . Mannose and D-glucose were present in all the exopolysaccharides and three of the lipopolysaccharides examined . Other monosaccharides identified in the exopolysaccharides were D-galactose, N-acetylglucosamine and N-acetylgalactosamine . The composition of the lipopolysaccharides was more complex than that of the exopolysaccharides and, in addition to the neutral hexoses and amino sugars, rhamnose was identified in two preparations and ribose in another . No lipopolysaccharide preparations contained O-methyl xylose or heptose . The polysaccharides secreted by the bacillary forms grown on solid or in liquid media closely resembled the polysaccharides isolated from the fruiting bodies, in which they provided a matrix surrounding the microcysts . Each pair of polysaccharides contained the same monosaccharides, although in slightly different proportions . Differences were found in preparations from different strains . These results suggest that in the development cycle of the genus Myxococcus, considerable use is made of pre-existing enzyme systems to synthesize the precursors necessary for polysaccharide synthesis . Any specific difference between the polysaccharide produced by the bacilli and that surrounding the microcysts may lie in the fine structure, rather than in the individual components.

J Exp Med, 1975 Jul 1, 142(1), 1 - 16
Phagosome-lysosome interactions in cultured macrophages infected with virulent tubercle bacilli . Reversal of the usual nonfusion pattern and observations on bacterial survival; Armstrong JA et al.; Tubercle bacilli of the pathogenic human strain H37Rv had previously been shown to multiply, after ingestion by cultured mouse peritoneal macrophages, within phagosomes that tended to remain unfused with secondary lysosomes . Means were sought therefore for promoting experimentally a modification of the host response so as to attain a high level of phagolysosome formation, enabling tests to be made of any effects on the course and outcome of the intracellular infection . This was achieved by exposing viable bacilli to specific rabbit antiserum before their ingestion . Quantitative assessments, using electron microscopy, now showed that a majority of the phagosomes containing intact bacilli had fused with ferritin-labeled lysosomes, and frequently the fusion was massive . Bacterial viability studies established that the serum pretreatment was not itsel bactericidal . In the course of progressive infections with strain H37Rv, monitored by counts both of viable bacterial units and of intracellular acid-fast organisms, no appreciable difference was found between the intracellular growth rates of control and antiserum-treated bacilli . Concurrent electron microscopy showed that bacilli could remain intact and multiply both in phaagolysosomes and in unfused phagosomes, ruling out the possibility of selective growth of antiserum-pretreated bacilli within the minority of phagosomes that remained unfused . It was concluded that "turning on" phagosome-lysosome fusion in normal macrophages did not influence the outcome of infection with virulent M . tuberculosis; lysosome contents manifestly failed to exercise an antibacterial effect on this organism . Nevertheless, the possibility remains that the lysosomes of specific immune macrophages have antituberculous potentiality . In that case the experimental "turning on or off" of fusion could be a decisive factor in the outcome of a virulent challenge . Should it not be, the antibacterial capabilities of immune cells would need to be ascribed to factors other than lysosomal attack, the latter being essentially for disposal of the dead organisms.

Int J Lepr Other Mycobact Dis, 1975 Jul-Sep, 43(3), 210 - 7
Biochemical properties of cultivated Mycobacterium lepraemurium; Mori T; 1 . Dehydrogenase activity of whole cell of cultivated M . lepraemurium is accelerated with sodium laurate, but not with the other substrates . 2 . Dehydrogenase activity of cell free extract of cultivated M . lepraemurium is accelerated with citrate or malate . 3 . There is no acceleration of oxygen consumption corresponding to added substrates in the respiration activity of whole cells of cultivated M . lepraemurium, but endogenous QO2 is 1.7 mul . 4 . Cell free extract of cultivated M . lepraemurium shows slight acceleration of oxygen consumption with NADH, but does not with citrate or alpha-ketoglutarate . 5 . NADH is not oxidized rapidly with the particle fraction of cultivated M . lepraemurium . 6 . Type b1 cytochrome having an absorption peak at a wave length of 561 mmu and type a2 cytochrome having an absorption peak at 625 mmu are detected in an oxidoreductive difference spectrum or particle fraction of cultivated M . lepraemurium, but type c cytochrome having the absorption peak at 550 mmu is not seen . Since the other cultivable acid-fast bacilli always have type c cytochrome, nondetection of type c cytochrome is characteristic for M . lepraemurium . 7 . These cytochromes are reduced with NADH . 8 . M . lepraemurium produces a red pigment which emits a red fluorescence with ultraviolet light on its 1% Ogawa yolk medium . This phenomenon is a characteristic of M . lepraemurium, M . avium and M . intracellulare.

Int J Lepr Other Mycobact Dis, 1975 Jul-Sep, 43(3), 193 - 203
In vitro cultivation of leprosy bacilli on hyaluronic acid based medium . 1 . Preliminary report; Skinsnes OK et al.; In vitro cultivation is reported of Mycobacterium leprae on a medium (designated LA-3) based on hyaluronic acid with additional ingredients of yeast extract, bovine albumin and glycerin together with phosphate buffer . The medium is also incorporated with agar or agarose (designated LA-3P) to serve as culture plates . Initial growth in LA-3 in test tubes required about six weeks but subsequently this was speeded up to about two weeks utilizing large quantities of media with aeration by shaking twice a day . Growth on LA-3P yields numerous small orange-yellow colonies in two to three weeks . Facets of the emerging aspects of the life cycle of M . leprae under cultivation are given preliminary report . The bases for the allegation of M . leprae identity of the cultured bacilli are essentially the following six determinations . 1 . Pathologic and experimental determined rationale for the essential M . leprae nutrient requirement . 2 . Several cultures having the same characteristics have been isolated from LL patients widely separate in time and by geography . 3 . Failure of culture isolates to subculture on the usual media employed in the cultivation of mycobacteria at both 37 degrees C and room temperature . 4 . 1 degree cultures in liquid medium successfully transferred to 2 degrees liquid medium and to 2 degrees agar medium plates . 5 . Bacillary isolates and bacilli of 1 degree and 2 degrees liquid medium cultures all stain with pooled LL serum, FITC coupled, M . leprae specific antibody with which a broad range of other mycobacteria do not react . 6 . M . lepraemurium also presents good growth on this medium.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1975 Jul-Sep, 24(3), 153 - 5
{Radiophotographic detection in evaluation of the incidence of tuberculosis}; Galan V et al.; In a territory with a population of over 120,000 inhabitants, of which 86% in rural environment, with a high tuberculosis endemic rate, four integral detections were organized in 12 districts and three in the other 12 base units of the area between 1969 and 1973 . In most of the districts the incidences varied, in the years when integral detections were carried out the index being the double and in some cases 4-5 times higher, than in the years when this investigation was not performed . If annual incidences are computed for the entire area, excluding the cases detected by radiophotography the morbidity indexes appear by 50% lower . If for the whole territory anual incidences are calculated, excluding the cases that have been detected by radiophotography, morbidity indexes appear to be by 50% lower . From the viewpoint of the forms of disease radiophotographic detection brings to the dispensary two-thirds of the oligo- and asymptomatic cases . Subjects eliminating Koch bacilli, representing 44% of the patients that had been betected in a "passive" way, totalized 19% of the cases detected by radiophotography . The cost of detecting a new case was of 2210 lei and the costs for integral detections, related to the population of the area, represented less than one lei per inhabitant.

Tubercle, 1975 Jun, 56(2), 157 - 9
Bone abscess due to Mycobacterium xenopi; Marks J et al.; Destructive infection of a cuneiform bone due to M . xenopi is described . The organism was isolated and its significance established by a strong skin reaction to xenopi antigen and by demonstration of bacilli in the lesion with fluorescence microscopy . This evidence of metastatic disease suggests that an alimentary route of infection as an alternative to inhalation could be considered.

Tubercle, 1975 Jun, 56(2), 113 - 27
Studies of tuberculosis in man in relation to infection in cattle; Sjogren I et al.; A study has been made in Sweden to investigate whether the risk of tuberculous infection and its trend with time in man in different areas were related to varying prevalences of tuberculous infection in cattle . It was found that the level of the infection risk in man was related to the prevalence of tuberculous infection in cattle, varying from 3-4 per cent in 1935 at age 15 in counties with less than 2 per cent infected cattle to 5-8 per cent in counties with 20 per cent infected cattle or more . However, the downward trend to the risk of infection with time was not to found be associated with the prevalence of tuberculous infection in cattle . The correlation between the risk of infection in man and the prevalence of infection in cattle in the 24 Swedish counties was positive and highly significant (+0-79) . The relationship between cattle tuberculosis and tuberculosis in man was further studied by correlating infection in cattle with tuberculosis mortality and morbidity in man . The correlation with mortality was negative and highly significant (-0-77), i.e . counties with little cattle tuberculosis had a high tuberculosis mortality in man, and vice versa . There were similar large negative correlations with measures of tuberculosis incidence . When variations between the counties in relevant environmental factors, namely capital, urbanization and overcrowding, were taken into account, a strong positive association remains between the prevalence of infected cattle and the risk of tuberculous infection in man, but the associations with tuberculous mortality and morbidity, though they remain negative, become weaker . It is suggested that the probable explanation of these findings is the long-term protection against adult infection with human tubercle bacilli conferred by bovine infection in childhood.

Tijdschr Diergeneeskd, 1975 Jun 1, 100(11), 604 - 15
{ A case of avian tuberculosis with exudative characteristics in a horse (author's transl)}; Van Dijk JE et al.; A case of avian tuberculosis in a horse, with fatal course, is reported . The animal was imported from Poland and became ill after some weeks, in the beginning showing non-specific symptoms which became more severe until death supervened . Post-mortem examination showed a generalised form of tuberculosis . The most important lesions were seen in the lungs, liver, kidneys, spleen, intestinal tract, bones, bone marrow, and the internal lymph nodes . Beside chronic proliferative tuberculosis of the organs, many exudative foci were found with remarkably abundant acid fast bacilli . Mixed lesions were seen, too . Mycobacterium avium was isolated in microbiological examination . The pathogenesis of the infection, the predisposing factors leading to this generalised and open form of tuberculosis and the increasing importance of avian tuberculosis for animals and man are discussed.

Am J Epidemiol, 1975 Jun, 101(6), 495 - 501
Colonization of intensive care unit patients with gram-negative bacilli; Rose HD et al.; A prospective study of 64 patients admitted to a medical intensive care unit and 86 patients admitted to a surgical intensive care unit was done to determine the frequency of pharyngeal, intestinal, and tube site colonization with Gram-negative bacilli . Studies were carried out over a 13-week period . The pharyngeal carrier rate among the surgical patients increased by a total of 34 strains compared to 14 strains among medical patients . Similarly, the intestinal carrier rate increased by 35 strains compared to 12 strains . The increased carriage in surgical patients was related more to the presence of indwelling tubes and colonization of multiple sites in the same patient than to the use of antimicrobial drugs . Pharyngeal and rectal colonization in medical patients was related to antibiotic therapy . Indwelling tubes were used predominately in surgical patients and were a significant reservoir of these organisms.

Z Erkr Atmungsorgane, 1975 Jun, 143(3), 219 - 23
{The value of guinea pig inoculation for the detection of tubercle bacilli in the patients specimens (author's transl)}; Grigelova R et al.; 5912 specimens were examined by culture and animal experiment and the presence of tubercle bacilli was established with one or the other with both methods . An analysis of the results showed, that guinea pig tests in 29.1% of the cases were more accurate than were cultural methods . Experimental inoculation is, therefore, still an essential part of the laboratory diagnosis of tuberculosis . Materials which are either difficult to obtain, or are suspected to contain few mycobacteria only should be tested further by guinea pig inoculation.

Acta Pathol Microbiol Scand {B}, 1975 Jun, 83(3), 211 - 8
Bacteraemia in red mice (Clethrionomys g . glareolus Schreb.) after intraperitoneal injection of large doses of tubercle bacilli; Jespersen A; Romer (1903) has demonstrated that white mice injected intraperitoneally with large doses of tubercle bacilli isolated from man survived longer than mice injected with tubercle bacilli isolated from cattle . The blood of the spontaneously dead animals contained large numbers of tubercle bacilli . In the present study, red mice are injected intraperitoneally with 10 mg doses of different species of mycobacteria, and the number of bacilli in the blood is estimated at various intervals within the first 24 hours after the inoculation . The number of bacteria is considerably higher in the blood of mice injected with M . bovis, but, in contrast to M . bovis, M . avium disappears rapidly from the blood stream . Supplementary experiments show that red mice injected with M . bovis have a shorter survival time than mice injected with M . tuberculosis, and that the bacteraemia induced by M . bovis into white mice is clearly less pronounced than in red mice.

Acta Pathol Microbiol Scand {B}, 1975 Jun, 83(3), 201 - 10
Infection of Microtus arvalis (common vole) with Mycobacterium tuberculosis and Mycobacterium bovis; Jespersen A; The aim of the study has been to ascertain whether Microtus arvalis (common vole) is strongly susceptible to M . bovis but resistant to M . tuberculosis, as is the case with other members of the vole family, or whether it is susceptible to both species as demonstrated by Robert Koch . Groups of common voles have been injected subcutaneously or intraperitoneally with varying doses of finely dispersed suspensions of a virulent strain of M . bovis or M . tuberculosis . M . bovis multiplies strongly in the vole organism and a dose as small as 8 viable units provokes a progressive infection with rapid fatal outcome . Autopsy shows considerable processes at the site of injection and in the lymph glands . Tubercles are observed quite frequently in the lungs, bur seldom in the liver, spleen and kidneys . The organs contain a large number of tubercle bacilli, the caseous lymph glands enormous numbers . In contrast, the virulence of M . tuberculosis is low . None of the doses used, the highest being 6 x 10(6) viable units, provokes progressive infection in the animals injected subcutaneously and only in a few of those injected intraperitoneally . The macroscopical findings are inconsiderable, and it is characteristic of the M . tuberculosis infection that the lymph glands are seldom enlarged and have become caseous in exceptional cases only . The number of bacteria in the organs is small, except in the few animals in which the infection becomes progressive . The conclusion drawn from the experiment is that Microtus arvalis is susceptible to M . bovis but strongly resistant to M . tuberculosis, and in this respect resembles other members of the vole family examined hitherto.

Dtsch Med Wochenschr, 1975 May 2, 100(18), 990 - 5
{Pneumonia as a cause of death in children (author's transl)}; Simon C et al.; The yearly death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per ten thousand (1969-1973) . At the same time, total death-rate in the same age group has fallen from 14.5 to 9.3 per ten thousand children . The proportion of pneumonia in the total death-rate was 5.3% in 1971-1973, 1.6% in the first month of life and, after the sixteenth year, 2.3% . Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in those more than one month old . The death-rate due to pneumonia had not fallen between 1954 and 1973, varying between 10% and 12% . While death-rate of "primary" pneumonia (without other underlying disease) had fallen from 5.7% (1954-1958) to 1.1% (1969-1973), the death-rate of "secondary" pneumonia rose from 16.8% to 21.4% during the same period . The total number of children aged between two months and 15 years treated for pneumonia fell by two thirds from 1954-1973 (1245 to 406) . The incidence of "primary" pneumonia during the same period fell to about a quarter, that of "secondary" pneumonia to one half . The unsatisfactory result in the treatment of "secondary" pneumonia is probably due to the underlying primary disease or a weakening of defence mechanisms by treatment or the occurrence of unusual causative organisms (pneumocystis carinii, tubercle bacilli, Candida, Aspergillus), demonstrated only after death.

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