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| Am J Trop Med Hyg, 1975 May, 24(3), 485 - 95 Acedapsone (DADDS) treatment of leprosy patients in the Karimui of Papua New Guinea: status at six years; Russell DA et al.; Acedapsone (DADDS), a repository sulfone given by injection five times a year, has been used since 1967 for the treatment of all leprosy patients in the Karimui, an area of diffic-lt access . More than 460 patients have been treated, 336 beginning in November 1967 and continuing through the latest assessment 6 years later . The injections have been well received and they have been administered very regularly . Clinical observations were begun before 1967, as a base-line of assessments was available for the patients whose disease appeared before that time . The response to DADDS therapy has been satisfactory except in 5 of the 28 multibacillary patients in whose smears solid-staining Mycobacterium leprae have reappeared . M . leprae was isolated in mice from three of these patients; one strain has been proven to be completely susceptible to dapsone (DDS), and the other two very probably are . DDS levels in the plasma of these five patients were normal and well above the minimal inhibitory concentration . The most probable explanation is that a few viable M . leprae survived in the presence of inhibitory concentrations of DDS for the 4 to 6 years during which dead bacilli were disintegrating and disappearing from the tissues . The other 23 multibacillary patients responded satisfactorily . The decrease in the number of M . leprae in the skin smears has been most prompt in patients with low initial bacterial loads and in those with borderline lepromatous diagnoses . A high initial bacterial load and a fully lepromatous diagnosis were associated with a slow initial loss of M . leprae in the 1st year, followed by a more rapid loss the next year . All of the multibacillary patients have now been treated by the addition of a 90-day course of rifampicin. Ann Sclavo, 1975 May-Jun, 17(3), 267 - 70 {Morphological and physiological studies on schizomycetes . Morphogenesis and cytoarchitecture of microbial colony . III . B.subtilis}; Palmas F et al.; The B . subtilis exhibits a morphogenetic mechanism which is different from that observed in the other bacilli examined here . In fact it is distinguishable for the compactness of cellular bundles and the precociousness of the degenerative phenomena which render unrecognizable the internal structure of the colony even before the third day of growth. J Clin Microbiol, 1975 May, 1(5), 411 - 3 Use of cetylpyridinium chloride and sodium chloride for the decontamination of sputum specimens that are transported to the laboratory for the isolation of Mycobacterium tuberculosis; Smithwick RW et al.; A method is presented for the decontamination, liquefaction, and concentration of sputum specimens that are in transport more than 24 h . The method is inexpensive, and culture results compare well with those obtained with the accepted N-acetyl-L-cysteine and sodium hydroxide method for the isolation of tubercle bacilli . The working solution, 1% cetylpyridinium chloride and 2% sodium chloride, is mixed in equal volumes with sputum before the specimens are shipped . Tubercle bacilli remained viable after 8 days of exposure to this solution . Only Lowenstein-Jensen medium was used because the cetylpyridinium chloride in the inoculum remains active on 7H10 or other agar base media and partially inhibits the growth of tubercle bacilli. Can J Microbiol, 1975 May, 21(5), 694 - 702 Preservation of mycobacterial suspensions at -55 degrees C; Boulanger RP et al.; Suspensions in dilute Sauton's medium of 14 mycobacterial strains grown under identical conditions were prepared with bacilli harvested at their midlog phase of growth,and were frozen and stored at -55 degrees C . Survivals, estimated by CFU determinations after periodic intervals of storage, showed no adverse effect of freezing and thawing on any of the strains . Effectiveness of preservation, however, varied from strain to strain and no correlation existed between effectiveness and species of mycobacteria . No noticeable changes in the virulence of the H37Rv strain and in the immunizing activity of BCG were detected after prolonged storeage . Results of experimentsperformed with two strains suspended in seven diluents suggest that some are more suitable for long-term preservation, particularly so for the more sensitive one. Infect Immun, 1975 May, 11(5), 919 - 21 Immunological sequelae of Trichinella spiralis infection in mice: effect of viability and route of BCG administration on nematode-induced immunopotentiation; Molinari JA et al.; Mice were infected with 200 Trichinella spiralis 22 days preceding administration of 4 times 10-6 viable or heat-killed BCG . The effect of the route of BCG administration on the subsequent delayed hypersensitivity response to old tuberculin was investigated by injecting the bacteria either intravenously, intraperitoneally, or subcutaneously . Animals of the various groups were tested for delayed hypersensitivity footpad responses 28 days after BCG inoculation . Infection with T . spiralis was found to potentiate the ability of mice to respond to both viable and heat-killed BCG . In the case of heat-killed BCG, this potentiation appeared to be route dependent, since it could not be demonstrated when the bacilli were injected subcutaneously. Infect Immun, 1975 May, 11(5), 1110 - 21 Immunogenicity of an aerogenic BCG vaccine in T-cell-depleted and normal mice; Morrison NE et al.; Aerogenic infection of adult thymectomized, lethally irradiated, bone marrow-reconstituted (THXB) C57B1 times C3H F1 hybrid mice with 1 to 3,000 viable BCG Montreal was followed by an extended period of logarithmic growth to a maximum population of 5 times 10-6 bacilli by day 35 . The infection spread to the liver, spleen, and bone marrow with extensive multiplication in all test organs before the growth curves abruptly entered a stationary phase . Up to 30% of the THXB mice eventually died as a result of the ongoing BCG infection . There was no sign of an antimicrobial immune response in the THXB mice analogous to that seen in the control animals beginning about day 30 . The THXB mice developed considerable immediate but no delayed hypersensitivity to PPD . Intravenous challenge of the BCG-vaccinated THXB mice with 105 virulent Mycobacterium tuberculosis Erdman indicated that they were as susceptible to the tuberculous challenge as a group of unvaccinated controls . Visible surface lesions developed on the lung 90 days postinfection in the T-cell-depleted host with a sharp rise in counts to 175 per lobe on day 120 followed by a plateau for the remainder of the study . Control mice developed visible lesions about day 50, with 225 lesions per lobe by day 70 and a sharp decline to undetectable levels by day 90 . The histopathology of these changes was examined carefully, together with the rate of cellular proliferation (tritiated thymidine uptake) by lung and spleen cells as the BCG infection progressed in the THXB mice . Peak uptake by both organs was depressed during the early stages of the BCG infection in the T-cell-depleted mice, but later the incorporation rates were significantly elevated above control values as the infection progressed. J Biol Chem, 1975 Apr 10, 250(7), 2563 - 8 Amino acid sequence of tuberculin-active protein from Mycobacterium tuberculosis; Kuwabara S; The complete amino acid sequence of tuberculin-active protein from tubercle bacilli was determined . The sequences of residues of tryptic, chymotryptic, and peptic peptides were established by Edman degradation and dansylation (5-dimethylaminonaphthalene-1-sulfonyl) and by digestion with carboxypeptidases A and B . Certain peptides were further degraded using partial acid hydrolysis . The aspartyl and glutamyl residues at positions 70 and 73 are present as amides . There is one intrachain disulfide bridge linking residues 27 and 59; there are no free sulfhydryls. Bangladesh Med Res Counc Bull, 1975 Apr, 1(1), 32 - 8 Use of different saprophytic acid-fast bacilli in complement-fixation test for kala-azar; Rahman KM; Complement-fixation tests for kala-azar using antigenic extracts from 4 different saprophytic acid fast bacilli were carried out . It was observed that all the 4 extracts gave positive reactions with sera from kala-azar patients . However, Myco . phlei gave best results and next comes Kedrowsky's bacilli . These two are different strains of the same organism, Myco . phlei . Myco . smegmatis also gave satisfactory results but Myco . butyricum gave weak and false negative reactions in some cases . Last two organisms are the different strains of the same Myco . smegmatis. J Clin Microbiol, 1975 Apr, 1(4), 384 - 9 Characteristics of yellow-pigmented nonfermentative bacilli (groups VE-1 and VE-2) encountered in clinical bacteriology; Gilardi GL et al.; The morphological and physiological characteristics of 20 strains of motile, gram-negative, yellow-pigmented oxidative bacilli (groups VE-1 and VE-2) isolated in clinical bacteriology are described . Electron micrographs demonstrate the polar multitrichous flagella of group VE-1 and polar monotrichous flagella of group VE-2 . Data obtained from guanine plus cytosine ratio studies of 56.8% for VE-1 and 68.9% for VE-2 distinguish the two groups of bacteria. Lab Anim Sci, 1975 Apr, 25(2), 206 - 9 Runyon group III atypical mycobacteria as a cause of tuberculosis in a rhesus monkey; Latt RH; Bilateral draining fistulas which communicated with the cheek pouches were noted in the threat region of an adult femal Macaca mulatta receiving isoniazid for tuberculosis prophylaxis . Necrospy findings included enlargedregional lymph nodes and ulceration of cheek pouch mucous membranes . Acid-fast bacilli were demonstrated in tissue section . Cultures of the regional lymph nodes and cheek pouch mucous membrane yielded Runyon Group III mycobacteria . Intrapalpebral tuberculin tests with homologous mycobacterial antigen (Battery strain PPD) and Kochs Old Tuberculin were performed in an unsuccessful attempt to identify additional infected monkeys . This case is considered significant because of the unusual manifestation of mycobacterial disease and its occurrence in an animal receiving isoniazid at levels considered sufficient for the prevention of tuberculosis. J Bacteriol, 1975 Apr, 122(1), 215 - 223 Regulation of the tricarboxylic acid cycle in gram-positive, facultatively anaerobic bacilli; Tanaka N et al.; The facultative anaerobes Bacillus polymyxa Hino G, B . polymyxa Hino J, and B.macerans were observed to have imcomplete tricarboxylic acid cycles . They were devoid of malate dehydrogenase and all had very low levels of alpha-ketoglutarate dehydrogenase . B . polymyxa Hino J was devoid of alpha-ketoglutarate dehydrogenase when grown aerobically and anerobically . Citrate synthase from B . polymyxa was inhibited by adenosine triphosphate but not reduced nicotinamide adenine dinucleotide and resembled enzymes from other gram-positive bacteria in this respect . Like the citrate synthases from gram-negative, facultative anaerobes and chemolithotrophs, the enzyme from B . polymyxa was inhibited by alpha-ketoglutarate . Inhibition by adenosine triphosphate was shown to be competitive with acetyl-coenzyme A and alpha-ketoglutarate inhibition was competitive with oxaloacetate. Arch Pathol, 1975 Apr, 99(4), 198 - 203 Malacoplakia in childhood . Case report with ultrastructural observations and review of the literature; Sinclair-Smith C et al.; Malacoplakia involving the adrenal gland and colon was found in a 6-week-old infant . To our knowledge, this is the first reported instance of adrenal involvement and it occurred in the youngest patient described to have malacoplakia . The adrenal gland was the site of a previous hemorrhage . Ultrastructurally, the cytoplasm of the malacoplakia cells contained numerous granular inclusions within which were tetrad-shaped particles resembling ferritin . A thorough search failed to show the presence of any bacteria . Several recent papers have suggested that malacoplakia represents a morphologic manifestation of altered host macrophage response and that Gram-negative enteric bacilli are the usual specific etiologic agents . The pathologic findings in the present case raise the possibility that the lesion in this instance represents an altered macrophage response to extravasated erythrocytes alone or to erythrocytes and bacteria. J Pathol, 1975 Apr, 115(4), 215 - 26 The histopathology of lepromatous leprosy in the nose; McDougall AC et al.; On the basis of clinical, histological and bacteriological assessments, 31 patients in Central India were selected and classified as having active but early lepromatous leprosy and 4 patients as having early borderline leprosy . From the nose of each patient an average of 4 biopsies were taken from particular sites of the septum and turbinates either by punch biopsy or dissection with a scalpel . The nasal tissues from all the lepromatous patients contained many acid-fast bacilli; no bacilli or abnormalities were seen in nasal tissues from the borderline patients . The histopathology of these highly bacilliferous tissues is described . Bacilli were universally seen in macrophages, but they were also seen in blood monocytes and polymorphs, fibroblasts, squamous and pseudo-columnar epithelium, keratin, peri- and endo-neurial cells of tiny nerve bundles, erectile tissue, vascular plain muscle, perivascular histiocytes and frequently and abundantly in the cytoplasm of endothelial lining cells of lymphatics and of small blood vessels and free within the lumina of these vessels . Five basic mechanisms of escape of bacilli from the submucosa on to the surface, and thus into the external environment, are described . Secondary infection, in the presence of an expansile lepromatous infiltrate, together with simple trauma to the surface epithelium, are the main factors in the discharge of bacilli . These histopathological observations are consistent with the findings from other recent studies on the nose in leprosy regarding (1) the large numbers of morphologically intact and viable Myco . leprae excreted in the nasal mucus of lepromatous patients; (2) the clinical changes observed in the nose of such patients, and (3) the similar nasal involvement and excretion of Myco . leprae from the nose of mice inoculated with leprosy bacilli of human origin . Of particular interest was the frequency and intensity of bacilli within the endothelial lining cells of small blood and lymph vessels and the presence of bacilli free within the lumina of these vessels or within monocytes and polymorphs . The possible dynamic significance of these observations in the pathogenesis of leprosy is discussed . The significance of all these observations in relation to (1) the spread of leprosy; (2) local factors in the nose which might favour the growth of Myco . leprae, and (3) the nose as a portal of entry, are discussed. Ann Intern Med, 1975 Apr, 82(4), 489 - 92 Decreasing reliability of acid-fast smear techniques for detection of tuberculosis; Boyd JC et al.; The ability of any screening test to correctly identify diseased patients is directly related to the prevalence of the disease in question . The continuing use of smears for the detection of acid-fast bacilli when the prevalence of tuberculosis is declining will produce increasing numbers of false-positive results . To determine the usefulness of smear techniques, we carried out a retrospective study of approximately 10 000 consecutive smears and cultures . Positive smears were classified as true- or false-positive on the basis of whether the corresponding cultures grew mycobacteria . The overall incidence of false-positive smears was 0.7%; however, the ratio of the number of false-positive to total positive smear was about 0.5 . Thus, for each true-positive result, one false-positive result was obtained . Patients in the true-positive group had clinical and radiological evidence to support the diagnosis of tuberculosis, while those in the false-positive group had new findings of the disease . These data suggest that the smear is a poor screening technique in a population where the prevalence of tuberculosis is low. J Mol Evol, 1975 Mar 24, 4(4), 307 - 15 Sequence studies on 16S ribosomal RNA from a blue-green alga; Woese CR et al.; The 16S ribosomal RNA of the blue green alga Anacystis nidulans has been characterized in terms of the oligomers generated by digestion with T1 ribonuclease . A . nidulans by this criterion is definitely a procaryote; being no more distant from Bacilli or Enterics than the latter two are from one another . A . nidulans appears to be somewhat more closely related to the Bacilli than to the Enterics. Monatsschr Kinderheilkd, 1975 Mar, 123(3), 97 - 9 {Epidemiology of Tuberculosis in Children from 1968 til 1973 in Schleswig-Holstein (author's transl)}; Simon C et al.; In Schleswig-Holstein 271 children (131 boys, 140 girls) were treated for tuberculosis between january 1968 and June 1973; 84% were aged 5--14 years, 14% between 1--4 years and 29% between 0--1 year . Each year, nearly the same number of infections occurred in the various districts of the country . In 246 children a primary form of tuberculosis was diagnosed (in 11 cases with pleurisy) . 11 patients tuberculous meningitis, 3 patients miliary tuberculosis and 5 patients another form of the disease, 18 of 271 patients (7%) had been vaccinated against tuberculosis as newborns; in 4 of these children tubercle bacilli could be isolated . BCG vaccination had been done 8--12 years before disease in 11 cases and 1--5 years before disease in 7 cases . None of these vaccinated children had a hematogenous tuberculosis or died . Of the non-vaccinated children two patients had meninogencephalitis and died . The other children were cured by chemotherapy, 12 children by additional surgery . The morbidity of tuberculosis in Schleswig-Holstein was 7--10 per 100000 children . Therefore, further BCG vaccination, chemoprophylaxis or preventive chemotherapy seems necessary . Early recognition of tuberculosis in old persons may be of practical value to prevent infections in children. Biull Eksp Biol Med, 1975 Mar, 79(3), 66 - 8 {The effect of polysaccharide from typhoid bacteria on hemopoietic stem cells}; Gordeeva MS et al.; A study was made of dynamics of the content of colony-forming units (CFU) in the spleen and the bone marrow of the nonirradiated F1 (CBA times C57BL) mice to which polysaccharide (PS) from typhoid bacilli was administered . A method of exogenous colony formation was used in this work . A single PS administration increased the CFU count in the bone marrow (2-2 1/2 times) and in the spleen (3 times) . Repeated (6- and 9- time) administration of PS was not more effective than a single one . Apparently PS acted as an inductor which caused proliferation of the stem hemopoietic cells and maintained this process for a definite period of time automatically. Am J Vet Res, 1975 Mar, 36(3), 255 - 7 Age of cattle as related to resistance to infection with Mycobacterium paratuberculosis; Larsen AB et al.; Two 1-month-old calves, four 9-month old calves, and 4 adult (5 to 11 years old) cattle were exposed to Mycobacterium paratuberculosis . At 150 days after exposure, all cattle were killed and necropsied, and at that time, tissues of the 1-month-old calves had more bacilli and lesions than did tissues of the 9-month-old calves or the adult cattle . All cattle responded to immunologic tests during the experiment. Tubercle, 1975 Mar, 56(1), 27 - 36 Tuberculosis of the cervical lymph nodes : a clinical, pathological and bacteriological study; Huhti E et al.; Biopsies taken from the lymph nodes of 59 consecutive patients with cervical lymph node tuberculosis were examined bacteriologically and histologically . The series consisted of 18 men (mean age 40 years) and 41 women (mean age 46 years) . Mycobacteria were isolated from 41 specimens (69 per cent), M . tuberculosis from 40 patients and a mycobacterium of the M . avium-M . intracellulare complex from one . All the M . tuberculosis strains were sensitive to streptomycin, isoniazid and PAS . No mycobacteria were isolated from the biopsy specimens of the 10 patients who had received anti-tuberculosis drug previously . Mycobacteria were isolated equally often from caseating and non-caseating lymph nodes . In 10 specimens acid-fast bacilli could be demonstrated by staining, but attempts at isolation were unsuccessful . Nine of these 10 patients had been treated with anti-tuberculosis drugs previously . Histological examination of the specimen from which a growth of 'atypical' mycobacteria had been obtained failed to show any distinctive features . The results of treatment are given over a follow-up period of 2 years . Primary chemotherapy was not entirely successful . Of 52 patients treated in this way only 38 responded well . By contrast 19 patients were treated by a combination of chemotherapy and surgery and the outcome was satisfactory in all but one. J Antibiot (Tokyo), 1975 Mar, 28(3), 215 - 21 Biological studies of amiclenomycin; Kitahara T et al.; The action of amiclenomycin (AM) in inhibiting growth of microorganisms is specific against mycobacteria in vitro, but the antibiotic does not show a therapeutic effect against tubercle bacilli in vivo . The action of AM is reversed by biotin, desthiobiotin (DTB) and 7,8-diaminopelargonic acid (DAPA), but not by 7-keto-8-aminopelargonic acid (KAPA), pimelic acid and glutaric acid . In the presence of AM, cultures of Mycobacterium smegmatis and Bacillus sphaericus accumulated KAPA, whereas the formation of DTB decreased . Therefore, AM is thought to inhibit KAPA-DAPA transamination in biotin biosynthesis . In M . smegmatic and B . sphaericus the conversions of KAPA to DAPA and of DTB to biotin were rate limiting in biotin synthesis . Accordingly, the synergistic antibiotic activity of AM, inhibiting the former, and actithiazic acid, inhibiting the latter reaction, would be simply explained. Southeast Asian J Trop Med Public Health, 1975 Mar, 6(1), 10 - 7 Pseudomonas pseudomallei: II . Laboratory and experimental studies in animals; Jayanetra P et al.; The cultural, biochemical characteristics and antibiotic sensitivity of strains of Pseudomonas pseudomallei isolated from four cases of melioidosis admitted to Ramathibodi Hospital are described . The organisms were gram-negative bacilli often with bipolar staining . The colonies were wrinkled when incubated for long periods . The characteristic non-specific uptake of dye from media into the colonies and their musty or earthy odour rendered them easily distinguishable from other organisms . All strains were sensitive to chloramphenicol and all but one were sensitive to tetracycline . All strains were resistant to colimycin and gentamicin . The pathogenicity of the strain isolated from a fatal case of peritonitis was studied in guinea pigs . The findings showed that following a large inoculation intraperitoneally, the animal developed acute septicaemia and died shortly afterwards . Only a few micro-abscesses were found on the surface of the liver . Chronic infection of longer duration occurred when a small number of organisms were introduced through a cutaneous abrasion . The lesions included pneumonitis and multiple abscesses of various organs including subcutaneous tissue, liver, spleen and mediastinum. Biochim Biophys Acta, 1975 Feb 17, 376(2), 210 - 8 Variations in the pathways of malate oxidation and phosphorylation in different species of Mycobacteria; Prasada Reddy TL et al.; Mycobacterium tuberculosis H37Rv, the slow-growing human pathogenic strain of tubercle bacilli and Mycobacterium smegmatis and Mycobacterium phlei, the fast-growing saprophytes, have shown variations regarding the type of dehydrogenase that initiates malate oxidation in the respiratory chain . M . tuberculosis H37Rv is characterized by having a malate oxidase system (designated MALNAD pathway) in which malate oxidation is mediated by the NAD+-dependent malate dehydrogenase (EC 1.1.1.37) but not by FAD-dependent malate-vitamin K reductase . M . smegmatis possesses a different malate oxidase system (designated MALFAD pathway) in which malate oxidation is exclusively carried out by the FAD-dependent malate-vitamin K reductase because NAD+-dependent malate dehydrogenase is absent in this organism . M . phlei has a mixed system of malate oxidase (designated MALNAD+FAD pathways) in which both the NAD+-and FAD-dependent dehydrogenases take part . In all the three systems, the rest of the electron transport chain is common. HNO, 1975 Feb, 23(2), 35 - 42 {Light and electron microscopy of rhinoscleroma (author's transl)}; Balazs M et al.; The authors report the case of a 50 year old male patient whose rhinoscleroma, localized to the upper respiratory tract, was demonstrated by the isolation of Klebsiella bacilli and histologically . Electron microscopically the Mikulicz cells were characterized by fused vacuoles occupying the largest portion of the cytoplasm and displacing the damaged cytoplasmic organelles . Phagosomes and dense bodies reminiscent of Russel bodies also occurred in the Mikulicz cells, in the vacuoles of which formations representing Klebsiella rhinoscleromatis were demonstrated . A light halo was visible around some of these formations . It could not be, however, decided whether these halos represented the mucous sheath of the bacillus or an artifact only . In the plasmacells the authors observed the bag-like dilatation of the ergastoplasm and the presence of Russel bodies . Transitory forms were not seen among the plasma and Mikulicz cells . As a result of the treatment, Klebsiella disappeared from the nasal mucosa of the patient . The authors wish to follow by means of electron microscopy the changes of the granulation tissue and pathogens following antibiotic therapy. Immun Infekt, 1975 Feb, 3(1), 36 - 47 {The diangostic value of skin tests with tissue-extracts, especially in lepra and sarcoidosis (author's transl)}; Hoppe JE et al.; The immunological aspects of lepra (India, Germany) and Sarcoidosis are presented under consideration of cutaneous reaction to lepromin and Kveim-extracts . Patients with lepra, erythema nodosum, sarcoidosis and different dermatoses have been tested with lepromin, Kveim-Antigen and tuberculin . The specifity of the results has been discussed . Patients with tuberculoid lepra did not react on Kveim-test, but patients with sarcoidosis can give positive reaction on lepromin . Patients with erythema nodosum without clinical signs of sarcoidosis are Kveim negativ and a positive lepromin-test is an exception . The positive Kveim-test is bound to a histological examination . The positive lepromin-test in non lepraendemic countries should be interpreted also by histological examination . Granulomatous dermatoses can show positive lepromin-tests, but the histological picture is different from the lepromin reaction in tuberculoid lepra . The positive reactions on tissue extracts are not combined with positive immunfluorescence results . Intracutaneous injection of lepra-bacilli in lepromin extract can be presented days to weeks after intracutaneous application in biopsies. J Pathol, 1975 Feb, 115(2), 73 - 9 The testis in mice infected with Mycobacterium leprae; Rees RJ et al.; Following inoculation either locally or intravenously with Mycobact . leprae of human origin, the histopathology and bacteriology of the testis in experimental mice is described . Normal mice, and mice rendered immunologically deficient by thymectomy and whole-body irradiation, were studied . Attention is drawn to a heavy bacillation of the testis in mice from both groups . Bacilli were found in and beneath the tunica albuginea, but mainly in interstitial cells and in macrophages surrounding the tubules . The percentage of solidly staining bacilli was high, and globi were frequent . The study showed that the testis in mice is particularly favourable for the lodgement and multiplication of Mycobact . laprae following either local or intravenous inoculation . The significance of this in relation to the metabolism of the leprosy bacillus and to the frequent occurrence of testicular damage in the lepromatous male patient is discussed . This work was supported by grants to A . G . M . Weddell and A . C . McDougall from the Medical Research Council and the British Leprosy Relief Association (LEPRA). J Med Microbiol, 1975 Feb, 8(1), 205 - 8 Lysis enhancement: a novel form of interaction between beta-lactam antibiotics; Greenwood D et al.; A novel form of synergy has been observed to occur between cephalexin and certain other beta-lactam antibiotics . In the presence of cephalexin a reduction was found in the concentration of other beta-lactam agents needed to induce lysis of Escherichia coli; the effect was particularly marded when cephalexin was allowed to act for a short time before the addition of the second agent . The basis of this type of synergy--which is not likely to be of therapeutic value--is discussed in terms of a theroy perviously put forward, whcih suggests that penicillins and cephalosporins have two distinct sites of action in Gram-negative bacilli. J Clin Pathol, 1975 Feb, 28(2), 146 - 8 Isolations of aerobic sporing bacilli from the tips of indwelling intravascular catheters; Freeman R et al.; Following previous reports of the isolation of aerobic sporing bacilli from intravenous catheters and infusion sets, it was decided to analyse a series of catheter tip cultures to ascertain the significance of these isolations . Those catheters from which aerobic sporing bacilli were isolated behaved statistically differently from other catheters from which organisms were isolated, but were statistically similar to sterile catheters . Using the nitroblue tetrazolium (NBT) test no significant difference was found between patients with isolates of aerobic sporing bacilli and those with sterile catheters . The NBT test readily distinguished those patients from whom other organisms were isolated . In a small number of instances some evidence of a possible pathogenic role for the aerobic sporing bacillus was found, but the results clearly indicate that in most cases these organisms can be regarded as contaminants. Am J Pathol, 1975 Feb, 78(2), 243 - 60 Capillary density in developing and healing tuberculous lesions produced by BCG in rabbits . A quantitative study; Courtade ET et al.; Dermal tuberculous lesions were produced in rabbits by the intradermal injection of BCG . At various times after infection, anesthetized animals were perfused with a gelatin-colloidal carbon medium via the abdominal aorta . The capillary density of the nonnecrotic granulation tissue in the lesions was determined quantitatively by counting the capillaries under an ocular grid of a microscope . The capillary density in normal skin near the lesions was 3.8 plus or minus 0.5 in millimetersof capillary lengths per square millimeter in 250-mu tissue sections . The capillary density of the nonnecrotic tissue in BCGlesions averaged 6.1 plus or minus 0.6 mm/sq mm, an increase of 60% . The capillary density remained more or less constant as the BCG lesions grew and then regressed . The development of delayed hypersensitivity seemed to increase the capillary density, but this increase may have been a response to an extension of the necrosis at the time delayed hypersensitivity developed . Capillary densities in tuberculin reactions resembled those in BCG lesions . In the early stages, the increaseed capillary network of dermal BCG lesions was derived mainly from the subpapillary vascular plexus of the deep dermis supplied branches that surrounded the lower half of the caseous necrotic center and anastomosed with capillaries from the subpapillary plexus supplying the upper half . When the necrotic center extended, nearby capillaries thrombosed and in turn became necrotic . Peripherally, new capillaries formed and anastomosed with existing capillaries . From these vessels, mononuclear phagocytes emigrated, destroyed the tubercle bacilli, and enabled the lesion to heal . In the BCG lesions at all stages of development and healing, the capillary network in the nonnecrotic areas seemed adequate to supply and nourish the defense cells controlling the infection. J Exp Med, 1975 Feb 1, 141(2), 346 - 59 Primary demyelination as a nonspecific consequence of a cell-mediated immune reaction; Wisniewski HM et al.; Primary demyelination occurs in a variety of human and experimental diseases known to be associated with the presence of inflammatory cells . However, the mechanism of demyelination remains unclear . The possibility that myelin can be damaged as a nonspecific consequence of a specific delayed type of hypersensitivity reaction directed at nonnervous tissue antigens was investigated . Guinea pigs were sensitized to tuberculin with Freund's complete adjuvant, and were challenged in the central and peripheral nervous system either with live or killed sonicated tubercle bacilli, Old Tuberculin, or tuberculin purified protein derivative (PPD) . Local inflammatory reactions were invariably produced and primary demyelination was a constant feature of the lesions . The morphological picture was rather similar to that observed in human neurotuberculosis and early tuberculoid leprosy, and in experimental allergic encephalomyelitis and distemper encephalitis in animals . The infiltrates consisted predominantly of mononuclear cells with some polymorphonuclear cells as well . Vesicular disruption of the myelin sheath in the immediate vicinity of the inflammatory cells and stripping of the myelin lamellae by the histiocytes without axonal damage were the leading features of the lesion . The results indicate that cell-mediated immune reactions to a variety of nonbrain antigens could be responsible for a component of the demyelination seen in some inflammatory demyelinating conditions, and suggest that this system may serve as a useful model for studying the immunopathology of demyelinating disease. Thorax, 1975 Feb, 30(1), 26 - 30 Analysis of results of catheter tip cultures in open-heart surgery patients; Freeman R et al.; A statistical analysis of 628 consecutive catheter tip cultures is presented . All were from patients undergoing open-heart surgery . The previously noted effects of early removal are shown to be significant . The possible effects of stasis, flushing, handling, and place of insertion are discussed . The unresolved significance of isolations of aerobic sporing bacilli is noted, and a decreasing incidence of postoperative infective endocarditis in the same group of patients is an encouraging sign. Br J Exp Pathol, 1975 Feb, 56(1), 14 - 6 Some observations on the effects produced in white mice following the injection of certain suspensions of corroding bacilli; Robinson JV et al.; Strictly anaerobic and facultatively anaerobic strains of "corroding bacilli" failed to produce any pathological symptoms when injected into white mice and no viable organisms could be recovered after 7 days . However, when these same strains were coupled with certain other living bacteria or certain sterile bacterial extracts, lesions developed from which corroding bacilli could be isolated even after 21 days. Can Med Assoc J, 1975 Jan 25, 112(2), 166 - 9 Osteomyelitis in children: comparison of hematogenous and secondary osteomyelitis; Fitzgerald RH et al.; Summary: A review of osteomyelitis in 54 patients treated at the Dr . Charles A . Janeway Child Health Centre over a 4-year period revealed equal frequencies of secondary and hematogenous osteomyelitis . Although the clinical picture in patients with hematogenous osteomyelitis was classic, patients with secondary osteomyelitis presented with an altered clinical response . Patients with secondary osteomyelitis have a history of an antecedent puncture wound or an inadequately treated contiguous focus of infection; antistaphylococcal antimicrobial therapy was ineffective for most because gram-negative bacilli were isolated in this group of patients . In contrast to patients with hematogenous osteomyelitis, who frequently respond to intensive antimicrobial therapy, those with secondary osteomyelitis will frequently require surgical intervention to eradicate the infection. Vet Rec, 1975 Jan 18, 96(3), 59 - 63 Naturally-occurring Tyzzer's disease (Bacillus piliformis infection) in horse foals; Harrington DD; Spontaneous Tyzzer's disease is described in quarter horse foals which died suddenly with no clinical history of apparent illness . Significant gross findings included icterus, focal paletan areas in the liver and catarrhal entercolitis . Focal dark red lesions were present in the small intestine of one foal, and the mesenteric lymph nodes of another were enlarged and hyperemic . Histopathologically, the liver showed multiple discrete and confluent foci of necrosis, fatty change, sinusoid congestion and haemorrhage . Bundles of intracytoplasmic bacilli were demonstrated in hepatocytes at the margin of liver lesions using special stains . Infiltration of the portal triads with inflammatory cells and biliary duct hyperplasia and degeneration were also observed . Lesions in the intestine were characterised by mucosal necrosis with inflammatory cell infiltration, increased mucus production, submucosal lymphoid hyperplasia and, in one foal, submucosal haemorrhage . Necrosis of lymph follicles, congestion and haemorrhage were also present in the spleen and mesenteric lymph nodes. Med Cutan Ibero Lat Am, 1975, 3(3), 199 - 208 {Reactional status of leprosy}; Alonso AM; Reactional leprosy is studied according to its clinical forms A) Lepromatous a) Acute lepromatization: encroaching and invasive nature; the patient becomes more and more lepromatous ; bad prognosis . b) Erythema nodosum: "contusiform dermatitis"; variable prognosis not so bad as it is in the preceding case; allergic nature and its evolution is usually detained and therapeutics efficient . c) Erythema multiform . d) Lucio's phenomenon: vascular lesions and consequently necrosis as a complication of the "erythema necrotisans" (beautiful leprosy) . B) Tuberculoid Reactional tuberculoid is the only one in this benign type, the Mitsuda's test must always be positive and prognosis consequently good . C) Dimorphous or "Borderline" whose Mitsuda's test is mostly negative, sometimes positive, but not stable . The lesions may stimulate the tuberculoid leprids but they invade mucous membranes, are impregnated by pigmentation, may present the Unna's band, and other characteristics of the Lepromatous type . Are associated (fever, asthenia and emaciation) . Prognosis not very good, because of the possibility of lepromatization, according to its tendency . Evolution slower and frequent relapses . Besides there are nodular lesions . Pathogeny 1) Perifocal allergic reaction (Jadassohn) . Similar to epituberculosis and Herxheimer reaction . 2) Septicemia . Sensitized tissues inside or outside the lesions, are invaded by the bacilli and so the allergic reaction takes place . Even without culture resources, Mycobacterium leprae has been found in the blood by direct examination . 3) Autoimmunization (Waldenstrom, Matthews and Trantman, 1965) . Based upon the similarity between both humoral syndromes, in leprosy reactions and collagenous, diseases, as to: hypergammaglobulins, hypercryoproteins, antigammaglobulins, serological reactions (Wassermann, Kahn, Kline, VDRL) positives, Antistreptolysin O, protein C reactive, antinuclear factors, latex and Wadler-Rose test positives (rheumatoid tests) lowering of complement . If leprosy reaction is like this, it should be the less agressive of the autoimmune diseases . a) Its eruptions are cyclic not of long standing duration, as a general rule . b) Its prognosis has been recognized as good, except lately, because of the use of corticoid therapy which has been fatal, in many cases . After some years the leprosy reaction cures spontaneously . Treatment (see article)
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