Streptococcal

Postgrad Med, 1985 Feb 15, 77(3), 187 - 93, 196-9
Pharyngeal infections . Causes, findings, and management; Mandel JH; Pharyngitis is one of the most common clinical problems . Its causes are multiple, two of the best known being streptococcal infection and infectious mononucleosis . Group A beta-hemolytic streptococcal infections are the focus of diagnostic and therapeutic efforts aimed at reducing the risk of both suppurative and nonsuppurative complications . Several non-group A infections are important to recognize as sources of pharyngitis . In addition, mycoplasmal and chlamydial pharyngitis may be more prevalent than is realized . The possibility of gonococcal pharyngitis should be given special attention because of the severity of complications . Recurrent pharyngitis is difficult to manage . Except for certain specific indications, tonsillectomy remains an unproven therapeutic approach.

J Dairy Sci, 1985 Feb, 68(2), 402 - 17
Environmental pathogens and intramammary infection during the dry period; Smith KL et al.; Rate of coliform and streptococcal intramammary infection during the dry period was studied in 168 dry periods . Coliform infection rate was influenced by stage of dry period, parity, and season during which dry periods occurred . Effects of dry cow therapy, immunization, or induced inflammation on coliform infection rate were minimal . Coliform infections originating in the first 50% of the dry period and persisting to lactation were predominantly other than Escherichia coli, whereas the majority originating in the last 50% of the dry period and persisting to lactation were Escherichia coli . Duration of streptococcal infections was greater than coliform infections . Dry cow therapy reduced streptococcal infection rate, and the effect was exerted primarily during the first 25% of the dry period . Effects of parity and season were not significant and likely masked by the positive effects of dry cow therapy . Results support the contention that all quarters of all cows should be dry treated for maximum reduction of new streptococcal infection during the dry period . Results suggest that methods other than conventional dry cow therapy are required for control of coliform infection during the dry period and streptococcal infection during the latter half of the dry period.

Clin Exp Immunol, 1985 Feb, 59(2), 276 - 84
Complement activation by circulating serum factors in human glomerulonephritis; Meri S; Factors with the ability to induce a minimum of 20% C3 conversion in normal human serum (NHS) were demonstrated in the sera of nine glomerulonephritis (GN) patients . The nature of these factors was heterogeneous allowing their division into at least three different groups . First, in three cases (membranoproliferative or acute GN) they exhibited the characteristics of C3 nephritic factor, an IgG autoantibody stabilizing the alternative pathway (AP) C3 convertase, C3bBb . Secondly, the serum of one patient (SLE like syndrome, mixed cryoglobulinaemia) with an activator of both pathways and profound hypocomplementaemia showed a temperature-dependent precipitation against autologous and homologous polyclonal IgG . Immunochemical analysis suggested this activity to be due to a monoclonal IgM kappa rheumatoid factor . By gel filtration the C3 converting activity was found in the high molecular weight fractions containing the cryoprecipitable IgM-IgG complexes . Finally, in five cases the exact nature of C-activating factors remained unknown . In four of these the factors were heat labile (30 min at 54 degrees C) C activators in association with post-streptococcal glomerulonephritis . The results suggest that the various C activating factors, possibly distinct from 'classical' immune complexes, are indicators of different types of pathogenetic mechanisms in certain forms of GN.

J Immunol, 1985 Feb, 134(2), 1065 - 72
Serologic and topographic characterization of idiotopes on murine monoclonal anti-streptococcal group A carbohydrate antibodies; Greenspan NS et al.; We have employed five spectrotypically distinct monoclonal anti-variable region antibodies in the definition and characterization of a set of idiotopes expressed on murine monoclonal antibodies specific for streptococcal group A carbohydrate (GAC) . By evaluating which of a panel of monoclonal anti-GAC antibodies were bound by the various anti-idiotopes, we observed four distinct reactivity profiles for the five anti-idiotopes ranging from highly restricted (binding of the homologous anti-GAC monoclonal antibody only) to broadly cross-reactive (binding of 18 of the 38 IgG3 anti-GAC antibodies) . With N-acetyl-D-glucosamine and soluble GAC used as haptens, this spectrum of reactivity profiles was paralleled by a gradient of susceptibility to hapten inhibition of anti-idiotope binding to idiotope . The degree of cross-reactivity exhibited by a given anti-idiotope was found to be inversely related to its susceptibility to hapten inhibition . The topographic relationships among the idiotopes, defined by the results of competitive binding assays, were suggestive of a linear idiotope map spanning the variable region from the antigen-binding site to the vicinity of the constant region . Additional data from competitive inhibition assays with isolated and recombined H and L chains from a prototype monoclonal anti-GAC antibody (HGAC 39), and from isoelectric focusing of whole or reduced and alkylated HGAC 39, suggested that one of the idiotopes was located, at least primarily, on the VL domain.

Proc Natl Acad Sci U S A, 1985 Feb, 82(4), 1064 - 8
Presence of two distinct regions in the coiled-coil structure of the streptococcal Pep M5 protein: relationship to mammalian coiled-coil proteins and implications to its biological properties; Manjula BN et al.; The complete amino acid sequence of Pep M5, a biologically active 197-residue fragment comprising nearly half of the group A streptococcal M5 protein, has structural features characteristic of an alpha-helical coiled-coil protein . Fourier analyses of the nonpolar residues show strong periodicities based on repeats of 7 residues (7/2 and 7/3) . Except for the nonhelical NH2-terminal 12-residue segment, the 7-residue periodicity in the distribution of nonpolar residues extends through the remainder of the Pep M5 molecule, with some discontinuities and irregularities . The molecule contains two distinct regions that differ in the pattern of distribution of the nonpolar and charged residues . The 7-residue pattern "a, b, c, d, e, f, g" in region 13-121 is atypical in that position "a" is predominantly occupied by asparagine, rather than nonpolar residues . On the other hand, the periodicity in region 122-196 is more typical of that found in other coiled-coil proteins, such as the myosin rod region, keratin, desmin, and vimentin, rather than tropomyosin . Although the periodicity in nonpolar residues is not highly regular, the predominance of basic and acidic residues in the inner "e" and "g" positions, respectively, suggests that ionic interactions between chains may contribute significantly to the stability of the coiled-coil . The distribution of charged residues in the outer positions within the two regions of the molecule is also distinct . The NH2-terminal region carries a significantly higher net negative charge than the COOH-terminal region, suggesting that the former region may play an important role in some of the biological functions of the Pep M5 molecule.

J Exp Med, 1985 Feb 1, 161(2), 277 - 89
Sera from patients with poststreptococcal glomerulonephritis contain antibodies to glomerular heparan sulfate proteoglycan; Fillit H et al.; Antibodies, found in human sera from patients with poststreptococcal glomerulonephritis, against proteoglycans (PG) derived from bovine and human glomeruli were investigated . PG were isolated by 4 M guanidine-HCl extraction of whole glomeruli, followed by DEAE-Sepharose CL-6B ion exchange chromatography . The anionic fractions were further purified by chromatography on Sepharose CL-4B . Biochemical analysis of the two resulting peaks revealed the presence of high molecular weight anionic material containing protein, uronic acid, glucosamine, and galactosamine . Enzymatic and chemical susceptibilities indicated the presence of heparan sulfate PG and a galactosamine-containing PG . Immunologic studies revealed the presence of anti-PG antibodies to both PG peaks of the Sepharose CL-4B column in glomerulonephritis sera . Inhibition studies using an ELISA demonstrated that heparan sulfate was a major antigenic determinant . Cross-reactivity with both mammalian and streptococcal hyaluronate was noted . Inhibition studies also indicated the presence of a second antigenic site containing N-acetylgalactosamine, possibly representing chondroitin or dermatan sulfate PG.

Immunol Lett, 1985, 11(2), 83 - 8
Production of cytotoxic factor into mouse peritoneal fluid by OK-432, a streptococcal preparation; Yamamoto A et al.; A cytotoxic factor was induced by the injection of LPS into the peritoneal fluids of mice which had been previously primed with a streptococcal antitumor preparation, OK-432 . No cytotoxic effect on L-929 cells was observed in the peritoneal fluids of mice singly treated with OK-432 or LPS . Various mouse and human tumor cell lines were effectively killed by this peritoneal cytotoxic factor, though normal cell lines were insensitive, which indicates that this factor is not species-specific . The highest level of cytotoxic activity was obtained when LPS was given to mice 5 days after the injection of OK-432 . The optimal time for collection of peritoneal fluids for the cytotoxic factor was 2 h following the LPS injection . Interferon activity was found to be negative by the plaque reduction test using L-929 cells with vesicular stomatitis virus . These results suggest that this cytotoxic factor is similar to the tumor necrosis factor (TNF) in the mouse serum.

Boll Ist Sieroter Milan, 1985, 64(4), 315 - 9
{Importance of anti-polysaccharide C titer in the diagnosis of streptococcal infections in children}; Mussi G; The research of antibodies for group A streptococcal polysaccharide (MSK) is affirming itself more and more for its value among serological researches of the streptococcal infection . Present work offers a compared evaluation between antipolysaccharidic C and antistreptolisinic titres, revealed during acute streptococcal infections, in paediatric practice . The study regards a group of a hundred children admitted in hospital for symptoms relating to streptococcal infection or upper respiratory tract infections of viral etiology (control group) . The research of antipolysaccharidic C titer resulted positive in 88% of the streptococcal infection cases, against the positivity of 62% of ASO . The determination of MSK, already well-known for its quick reply, has shown its full value between the age-range of 1-3: in half of the cases regarding children below the age of 3, the ASO titer remained negative, instead there was a quick reply of MSK in all the cases: it is confirmed the utility of inserting the MSK among the screening tests of fever diseases of suspected bacterial nature in children.

J Clin Apheresis, 1985, 2(3), 213 - 8
Peripheral blood lymphocyte numbers, lymphocyte proliferative responses in vitro, and serum immunoglobulins in regular hemapheresis donors; Braine HG et al.; Selected tests of lymphoid function were used to screen a population of volunteer hemapheresis donors . Testing included: 1) absolute lymphocyte numbers, and percentage of T-cell, B-cell, and mononuclear phagocytes, 2) serum immunoglobulins, and, 3) in vitro proliferative responses to lectin mitogens (phytohemagglutinin, concanavalin A, and pokeweed mitogen), soluble antigens (staphylococcal filtrate, candida, and streptococcal varidase), and cell-bound alloantigens (mixed lymphocyte culture) . A control population of first-time plateletpheresis donors was examined similarly . Regular donors manifested a small but statistically significant decrease in absolute lymphocyte counts (p less than 0.02), and IgM (p less than 0.02) compared to controls . Leukapheresis donors also manifested significant decreases in percentage of T cells (p less than 0.02) . These findings are qualitatively similar to changes reported following intensive lymphocytapheresis and indicate the need for conservative policies regarding donation frequency in hemapheresis programs.

Am J Nephrol, 1985, 5(3), 212 - 6
Rapidly progressive glomerulonephritis in a patient with rheumatoid arthritis during treatment with high-dosage D-penicillamine; Sadjadi SA et al.; A patient with advanced rheumatoid arthritis and severe clinical manifestations of rheumatoid vasculitis died of acute renal failure after 30 months of treatment with high-dosage D-penicillamine . She had had no signs of adverse drug reactions until the terminal illness . Although streptococcal pharyngitis was diagnosed late in her disease, penicillamine-induced immune complex glomerular damage is considered more likely than poststreptococcal glomerulonephritis, because her microscopic hematuria preceded diagnosis of pharyngitis . Postmortem examination disclosed findings suggestive of rapidly progressive glomerulonephritis of immune complex pathogenesis . The short period of microscopic hematuria and the rapidity of development of renal failure before death emphasize the need for frequent monitoring of renal function and prompt discontinuation of D-penicillamine treatment upon detection of otherwise unexplained hematuria . There is urgent need for early immunological evaluation, renal biopsy, and vigorous therapeutic measures.

J Int Med Res, 1985, 13(1), 59 - 67
Treatment of HBeAg-positive chronic hepatitis with a streptococcal preparation (OK-432); Ichida F et al.; Forty-two patients with hepatitis Be antigen (HBeAg)-positive chronic hepatitis were treated by intramuscular injections with OK-432, an immunopotentiator possessing interferon-inducing activity . They were monitored with serial measurements of virological parameters to evaluate therapeutic effectiveness, and compared with a group of seventy-five untreated patients (natural course group) . In the group receiving OK-432 therapy, twenty-seven patients (64.3% of the forty-two patients) became negative for HBeAg in an average observation period of 20.1 months . Of these, fourteen patients (33.3% of the forty-two patients) underwent seroconversion from HBeAg to anti-HBe antibody (anti-HBe) . In the natural course group, twenty-three patients (30.7% of the seventy-five patients) lost HBeAg reactivity in a mean follow-up period of 32.3 months, and thirteen patients (17.3% of the seventy-five patients) became seroconverted . Thus, the drug group showed significantly higher percentages of patients with disappearance of HBeAg and seroconversion, notwithstanding the shorter duration of the follow-up . Young males and females, females generally, or patients with high serum GPT levels were more likely to respond to the therapy . The serum GPT level tended to stabilize more in patients receiving OK-432.

Pediatr Infect Dis, 1985 Jan-Feb, 4(1), 36 - 41
Neonatal septicemia and meningitis in Göttingen, West Germany; Speer CP et al.; Data were analyzed from 181 infants treated for neonatal septicemia and/or meningitis between 1962 and 1974 (n = 88) and between 1975 and 1982 (n = 93) . In addition to an increase in the incidence of septicemia (1962 to 1974, 0.88 case/1000 live births (LB)/year; 1975 to 1982, 2.0 cases/1000 LB/year), there was also a change in the pattern of infection . Group B streptococcal infections were first observed in 1975 . Infections with Escherichia coli increased (1962 to 1974, 0.25 case/1000 LB; 1975 to 1982, 0.75 case/1000 LB), while those with Pseudomonas aeruginosa decreased (1962 to 1974, 0.15 case/1000 LB; 1975 to 1982, 0.1 case/1000 LB) . Although the incidence of meningitis was similar in both time periods (0.5 case/1000 LB), the relative number of cases declined (1962 to 1974, 51 of 88 patients; 1975 to 1982, 23 of 93 patients) . Case fatality also decreased during the second time period (1962 to 1974, 53%; 1975 to 1982, 29%) . The most common predisposing factors for septicemia were prolonged rupture of membranes (21 of 93 cases) and prematurity (41 of 93) . Blood analysis showed that the immature/total neutrophil ratio was more consistently abnormal (60% of the cases) than were total counts of white blood cells, neutrophils or immature neutrophils.

J Lab Clin Med, 1985 Jan, 105(1), 114 - 9
Specificity of persistence of antibody to the streptococcal group A carbohydrate in rheumatic valvular heart disease; Appleton RS et al.; The specificity of the persistence of antibody to the streptococcal group A carbohydrate for mitral valve disease induced by rheumatic fever was examined . Levels of the antibody were determined in serum samples of 30 patients with rheumatic mitral insufficiency, 30 patients with mitral valve prolapse, and an equal number of normal individuals and patients with congenital heart disease . Antistreptolysin titers and anti-deoxyribonuclease B titers were also assayed in all sera . There were no differences in the incidence of elevated antibody titers or in the geometric means of the antibody titers for the normal individuals, the patients with congenital heart disease, and the patients with mitral valve prolapse . In contrast, the frequency of elevated anti-streptococcal group A carbohydrate titers and the geometric means of these titers were significantly higher in the patients with rheumatic mitral valve disease than in patients with mitral valve prolapse . This confirms the specificity of the persistent elevation of anti-streptococcal group A carbohydrate to patients with mitral valve disease induced by rheumatic fever and also suggests that the persistence of this antibody in patients with rheumatic valvular disease is not a result of a functional abnormality of the mitral valve.

Auris Nasus Larynx, 1985, 12 Suppl 2, S161 - 5
Immunological basis and immunotherapy of nasopharyngeal carcinoma; Tsukuda M et al.; Clinically, the prognosis of nasopharyngeal carcinoma is very poor . It is considered that this depends on three factors . The first is the difficulty of early detection of this disease, because the symptoms of this cancer are latent . The second factor is the specificity of the histological character . The third is most important . This cancer cases fall into the extreme failure category of the immuno-surveillance mechanism . Immuno-responsiveness is extremely depressed . Immunological status has been examined and the clinical evaluation of immunotherapy with OK-432 (streptococcal preparation) and lymphocyte transfer has been made . Results are as follows: 1) Deficiencies of cellular immunity could be recognized through the various immunological parameters, such as subsets of peripheral blood lymphocytes . 2) Immunotherapy is indispensable in this cancer, for the above-mentioned reasons . Better results could be obtained with nonspecific immunotherapy, using OK-432 . On the other hand, new immunotherapy, using immunologically enforced lymphocytes with Interleukin-2 prevented micrometastasis, one of the worst characteristics of this cancer . Nasopharyngeal carcinoma is a systemic disease . Therefore immunotherapy is indispensable for the treatment of this cancer.

Surv Immunol Res, 1985, 4(4), 319 - 24
Role of the immune system in the etiology of rheumatic fever; Benderly A et al.; In order to summarize all the data regarding the immunological findings in RF we have elaborated the following theory about the pathogenesis of RF (fig . 1) . The disease will develop only after repeated beta-hemolytic group A streptococcal throat infection in susceptible individuals . In these people, who have a specific immune response to repeated streptococcal infection due to their DR region, a decrease in suppressor activity will develop . This will lead to an increased specific humoral and cellular immune response to streptococcal antigen which cross-reacts with specific human tissue as the heart or the brain . Alternatively or concomitantly specific autoantibodies against these tissues are made . These antibodies together with the cellular response will cause the clinical manifestation seen in RF . This is only a proposed theory and still much more work has to be done to solve the enigma regarding the pathogenesis of RF.

Mol Gen Genet, 1985, 198(2), 348 - 52
DNA sequences specifying the transcription of the streptococcal kanamycin resistance gene in Escherichia coli and Bacillus subtilis; Trieu-Cuot P et al.; The gene conferring resistance to kanamycin, aphA, and originating from the streptococcal plasmid pJH1 was inserted into a shuttle vector . Full expression of aphA was obtained in Escherichia coli and Bacillus subtilis . The starting point for aphA transcription, determined by S1 nuclease mapping, was located 340 base pairs upstream from the ATG translational initiator codon . The sequence of the promoter consists of the hexanucleotides TTGACA and TATCTT, with a spacing of 17 base pairs . The stability profile of a 600 base-pair-long DNA fragment containing the aphA promoter and the translational initiation site indicated that, as already reported for Escherichia coli, both structures are located in domains of weak stability.

Immunol Lett, 1985, 10(3-4), 177 - 81
Activation of human blood lymphocytes and monocytes by the streptococcal preparation OK432: enhanced generation of soluble cytotoxic factors; Uchida A et al.; The streptococcal preparation OK432 augments natural cytotoxicity of human blood lymphocytes and monocytes . It also enhanced the production of natural killer soluble cytotoxic factors (NKCF) when the effector cells interact with K562 cells . There was a good correlation between the OK432-induced enhancement of NK cell-mediated cytotoxicity and the released NKCF activity . OK432-pretreated monocytes secreted higher amounts of monocyte cytotoxic factors (MCF) than the untreated monocytes . With the monocytes the enhanced generation of MCF was not always accompanied by the increase in direct cell-mediated lysis of K562 . OK432 treatment alone did not induce NKCF release from lymphocytes, and the presence of K562 in the culture was necessary . In contrast, monocytes generated MCF when exposed to OK432 . In the supernatants of cocultures of OK432-activated effectors and K562 the NKCF and MCF activity was elevated two- to ten-fold . The OK432-induced augmentation of natural cytotoxicity exerted by lymphocytes and monocytes may be mediated through an increase in the synthesis, activation and/or release of NKCF and MCF.

Dev Pharmacol Ther, 1985, 8(4), 209 - 18
Nonhomogeneous redistribution of mesenteric blood flow after tolazoline during group B streptococcal sepsis in piglets; Meadow WL et al.; The effect of tolazoline (Tz) on mesenteric blood flow was evaluated in a piglet model of group B streptococcal (GBS) sepsis . GBS infusion decreased cardiac output and mesenteric blood flow equivalently, while increasing systemic and mesenteric vascular resistance . At three doses between 2 and 25 mg/kg, Tz increased cardiac output and decreased systemic vascular resistance . However, at no dose did Tz improve the diminished mesenteric artery blood flow which accompanied GBS sepsis . The potential use of Tz in neonatal sepsis may be limited by its nonhomogeneous redistribution of blood flow.

Dev Comp Immunol, 1985 Spring, 9(2), 335 - 42
Regulation of the expression of a mammalian idiotype in chickens; Olson JC et al.; Id-1, an idiotype associated with rat anti-Group A streptococcal carbohydrate (anti-SACHO) antibodies has not been detected in any other tested species immunized with Group A streptococcal vaccine (GASV) . The immunization of chickens with rat Id-1 prior to challenge with GASV, however, induced the production of Id-1 and anti-Id-1 in some chickens . The concentrations of both idiotype and anti-idiotype were regulated by challenges with GASV . Thus, it appears that this non-mammalian species has the genetic potential to express the mammalian Id-1 network but such a potential is normally masked by regulatory pressures.

Int Arch Allergy Appl Immunol, 1985, 77(3), 372 - 3
Increased frequency of high serum IgM among mothers of infants with neonatal group-B streptococcal septicemia; Rundgren AK et al.; Total serum IgM levels were studied in 84 mothers of infants with group-B streptococcal (GBS) septicemia/meningitis and compared to IgM concentrations in 91 parturients who were urogenital carriers of GBS but nevertheless gave birth to healthy infants . In all, 22 (27%) in the study group showed IgM levels above the arbitrarily selected limit of 2.40 g/l, in contrast to 12 (13%) of 91 controls (p = 0.02) . Among the study group members whose infants were infected with GBS type III, 8 of 34 (24%) were high in serum IgM, compared to only 2 of 34 (6%) of the corresponding controls (p = 0.04) . The total serum IgG levels did not differ between the two groups.

Nephron, 1985, 39(4), 330 - 5
IgG, IgA and IgM rheumatoid factors in patients with glomerulonephritis; Endoh M et al.; Rheumatoid factors (RF), autoantibodies to IgG, have been postulated to have some pathogenetic role in the development of some types of glomerulonephritis . A simple and sensitive solid-phase fluorescence immunoassay was employed to determine whether IgG, IgA and IgM RF were detectable in sera from patients with various types of glomerulonephritis, rheumatoid arthritis (RA) and those with various streptococcal infections . IgG, IgA and IgM RF were significantly increased in the majority of patients with RA, lupus nephritis (SLE), acute poststreptococcal glomerulonephritis (APSGN) and various streptococcal infections . The titers of IgG and IgA RF were significantly higher in patients with APSGN than in those with simple pharyngitis . IgM RF was increated in patients with IgA nephropathy (IgA-N) and in those with membranoproliferative glomerulonephritis type I (MPGN) . No significantly high RF was observed in membranous nephropathy (MN) or chronic mesangial proliferative glomerulonephritis without IgA deposition (PGN) . It is suggested that some autologous immune mechanisms may be involved in the pathogenesis of some types of glomerulonephritis.

J Toxicol Environ Health, 1985, 15(1), 163 - 72
Effects of arsenic trioxide inhalation exposure on pulmonary antibacterial defenses in mice; Aranyi C et al.; The effects of single and multiple (5 and 20) 3-h inhalation exposures to aerosols of arsenic trioxide on the pulmonary defense system of mice were investigated . Arsenic trioxide mist was generated from an aqueous solution and dried to produce particulate aerosols of 0.4 micron mass median aerodynamic diameter . Aerosol mass concentration ranged from 125 to 1000 micrograms As/m3 . Effects of the exposures were evaluated by determination of changes in susceptibility to experimentally induced streptococcal aerosol infection and in pulmonary bactericidal activity to 35S-labeled Klebsiella pneumoniae . Significant increases in mortality due to the infectious challenge and decreases in bactericidal activity were seen after single 3-h exposures to 270, 500, and 940 micrograms As/m3 . Similarly, 5 or 20 multiple 3-h exposures to 500 micrograms As/m3 produced consistently significant increases in mortality and decreases in pulmonary bactericidal activity . At 125 or 250 micrograms As/m3, a decrease in bactericidal activity was seen only after 20 exposures to 250 micrograms/m3 . Results from earlier studies with an arsenic-containing copper smelter dust were compared to these data . The possibility of the development of adaptation during multiple exposures to arsenic trioxide is also considered.

Immunogenetics, 1985, 21(1), 1 - 10
Influence of paternal immunity on idiotype expression of offspring; Cooper-Willis CA et al.; The immune response of the rat to group A streptococcal carbohydrate (SACHO) and an associated idiotype, Id-1, was used to examine the effect of paternal immunity on Id-1 and SACHO-specific antibody expression by the offspring . First litters, conceived before immunization of the father, had significantly higher Id-1 levels than litters conceived by the same parental pairs after hyperimmunization of the father (P greater than 0.01) . Total anti-SACHO levels were not affected . The effect appeared to be independent of the level of Id-1 expressed by the father or grandfather . No significant difference in Id-1 production was found between offspring of actively immune, neonatally Id-1 suppressed fathers and fathers expressing high levels of Id-1 . We suggest that the paternal immunoregulatory influence acts via the maternal immune system to modify the idiotype repertoire expressed in the immune response of the offspring, and is not the result of genetic transmission of a trait acquired by the father . Some possible mechanisms of transmission are discussed.

Rev Stomatol Chir Maxillofac, 1985, 86(6), 439 - 45
{Antibiotic management in oral medicine}; Modai J; Although antibiotic therapy cannot replace surgical drainage of pus and ablation of necrotic tissue, it plays an essential role in the treatment of buccodental infections by preventing vascular dissemination responsible for bacterial endocarditis and infection of cardiovascular and hip prostheses . It also prevents complications due to local spread of infection (sinus cavernosus thrombosis, osteomyelitis, maxillary sinusitis, Ludwig's angina) . Bacteriology of stomatologic infections of dental origin is complex and usually reflects buccal endogenous flora . Infections due to anaerobic germs are increasing in frequency in line with streptococcal affections . The choice of effective antibacterial treatment is complicated by the difficulty in isolating responsible germs and the need for diffusion of the antibiotic into bone and tonsillar tissues . Penicillin G, ampicillin and amoxicillin, possibly combined with a betalactamase inhibitor, macrolide and imidaxole derivative, are products responding best to bacteriologic and pharmacokinetic criteria for treatment of buccodental infections.

Arch Oral Biol, 1985, 30(4), 359 - 63
Inhibition by cocoa extracts of biosynthesis of extracellular polysaccharide by human oral bacteria; Paolino VJ et al.; Extracts of defatted cocoa inhibited the biosynthesis of extracellular polysaccharide by both cell-free and cell-associated streptococcal glucosyltransferases, but did not affect growth or acid production . Both water-insoluble and water-soluble polysaccharide syntheses were inhibited, and the net result was a shift away from adherence-supportive polysaccharide . Inhibition was non-competitive with respect to sucrose . The inhibition of polysaccharide biosynthesis was observed also with Actinomyces species . The findings suggest that the inhibitory effects of cocoa on plaque accumulation and caries formation are due to inhibition of bacterial polysaccharide production.

Cancer Immunol Immunother, 1985, 20(1), 43 - 6
Decreased monocyte-mediated cytostasis of human cancer cell in patients with lung cancer; Nakata Y et al.; In vivo animal studies support the concept that monocytes and macrophages are important in the immune surveillance of oncogenesis and that in vitro activated murine macrophages are cytocidal for tumour cells . In this study, the tumour cell cytotoxic activity of human peripheral blood monocytes was examined by measuring the inhibition of 3H-thymidine uptake in the human cancer cell line, established in our laboratory from human squamous cell lung cancer . The monocytes from 8 of the 31 lung cancer patients (26%) showed a percentage growth inhibition of less than 69.8%, which exceeded the 95% confidence limits of the percentage growth inhibition observed with healthy control monocytes . On the other hand, among the 16 sarcoidosis and the 8 tuberculosis cases no value was below 69.8% . However, there was no significant difference between the growth inhibition and the clinical stages or histological type . When OK-432, a Streptococcal agent, was administered in vivo to patients with lung cancer, an elevation of the growth inhibition was observed in 7 out of 8 patients . It was confirmed that the tumour cell cytostatic activity of the monocyte is suppressed in patients with lung cancer, and these monocyte deficits hinder the inhibition of tumour growth and metastasis.

Microbiol Immunol, 1985, 29(4), 349 - 58
Dual effects of OK-432 on mitogenic response of splenocytes to concanavalin A; Tomioka H et al.; OK-432, a streptococcal preparation, was studied for its effect on the concanavalin A (Con A)-induced mitogenesis of the host spleen cells . When mice were given a single intraperitoneal injection of OK-432, there was a substantial increase in the mitogenic response of splenocytes, whereas multiple injections conversely resulted in a marked reduction of the mitogenic response, when the spleen cells were cultured at high cell densities of over than 5 X 10(5) cells/well . The reduced Con A-responsiveness in the latter was not restored by mixing spleen cells from mice given multiple OK-432 injections with those from normal mice . Moreover, splenic macrophages from OK-432-injected mice exhibited marked inhibitory activity against Con A-mitogenesis of normal splenocytes, while normal splenic macrophages failed to show such an effect . Splenic T cells from OK-432-injected mice also showed an inhibitory activity against Con A-mitogenesis of normal splenocytes and similar activity was also noted in normal splenic T cells . Therefore, the OK-432-spleen cells contain two types of suppressor cells; one is a newly elicited suppressor macrophage and the other is a suppressor T cell supposedly resident also in normal spleen cells . In the OK-432-injected spleen cells, accessory cell function for T cell Con A-mitogenesis was markedly reduced . On the other hand, it was noted that the interleukin 2-producing ability of the OK-432-splenocytes was augmented more than that of normal splenocytes, indicating that multiple OK-432 injections also cause an increase in the helper T cell activity of the host spleen cells.

Ter Arkh, 1985, 57(1), 90 - 3
{Problems of the prevalence and course of rheumatism under the ecological conditions of western Turkmenia}; Seitnepesov KN; It was shown by multi-factorial epidemiological survey of the prevalence of rheumatic fever in Western Turkmenia that in this region, it was higher than in the regions of Turkmenia with moderate climatic conditions . In Western Turkmenia, rheumatic fever still remains to be one of the prevalent diseases . The greatest disease incidence was revealed among the young population under 30 years of age . The rheumatic fever was mostly characterized by the latent onset (30.7%), predominance of minimal activity (75.9%), and high incidence of heart diseases (87.4%) . The streptococcal infection incidence was found to be high enough, being related to the prevalence of rheumatic fever . The described features of the prevalence and progress of rheumatic fever are likely to originate from the effects of a number of the local ecological factors: extremal climatic conditions, young age of the population with a large proportion of the organized community, predominance of large families, and so forth . On planning the program of the community health services for rheumatic fever it is necessary to take into account the ecological conditions of the individual regions of Western Turkmenia.

Int J Immunopharmacol, 1985, 7(6), 903 - 16
Dose-dependent suppression by the synthetic retinoid, 4-hydroxyphenyl retinamide, of streptococcal cell wall-induced arthritis in rats; Haraoui B et al.; We studied the effects of oral administration of the retinoid, 4-hydroxyphenyl retinamide (4-HPR), on group A streptococcal cell wall-induced polyarthritis in the rat, a model characterized initially by exudative inflammation of peripheral joints followed by chronic proliferative/erosive synovitis . Experimental arthritis was induced in female LEW/N rats by i.p . injection of streptococcal cell walls in saline (15 micrograms/g body weight) . Depending upon the experiment, continuous daily oral administration of the retinoid was begun either 14 days prior to induction of the disease, at the time of cell wall administration and/or 11 days and 31 days after cell wall injection . Dosage was either 1 or 2 mmol 4-HPR/kg of chow . During the course of the disease, severity of clinical illness was assessed by determination of clinical severity index, by histological or radiologic examination, and by measurement of production in vitro of collagenase and prostaglandin E2 by excised synovial tissue . In rats fed the retinoid prior to cell wall injection, both the acute and the chronic responses were suppressed . In rats given the retinoid at the time of cell wall injection, the acute inflammatory response was only partially suppressed on the diet containing 2 mmol 4-HPR/kg chow, but the chronic disease was impressively inhibited in a dose dependent manner . Similarly, in animals with established disease, the drug was also effective; however, the more advanced the illness, the less effective the drug . Clinical observations were paralleled by the histological, radiographical and biochemical analyses . Treated animals showed far less synovial proliferation and joint destruction, and synovial tissues taken from these rats produced lesser amounts of collagenase and prostaglandin E2 . No significant toxicity of the retinoid was noted . We conclude that oral administration of 4-HPR suppresses, in a dose and time dependent manner, both the acute and chronic stages of streptococcal cell wall-induced arthritis in rats without apparent significant toxicity . Our data suggest that studies of the effects of this retinoid on patients with chronic inflammatory synovitis are warranted.

Cancer Immunol Immunother, 1985, 19(3), 163 - 7
Autologous tumor killing and natural cytotoxic activity of tumor-associated macrophages in cancer patients; Yanagawa E et al.; Tumor-associated macrophages (TAM) isolated from pleural effusions and ascites fluids of cancer patients were tested for cytotoxicity against freshly isolated autologous tumor cells and K562 in a 4-h 51Cr-release assay, and in vitro effects of OK432 (a streptococcal preparation) and partially purified human leukocyte interferon (IFN) on their cytotoxicities were examined . Positive cytotoxicities against K562 were recorded for TAM samples from 2 of 23 pleural effusions and 3 of 10 ascites specimens . Tumor-associated macrophages were not cytotoxic to autologous tumor cells, while low but significant lysis was observed with tumor-associated lymphocytes (TAL) samples from 2 of 13 pleural effusions and 1 of 6 ascites specimens . In vitro treatment with OK432 resulted in an enhancement of natural cytotoxicity in 4 of 13 TAM and 10 of 15 TAL samples . An induction or augmentation of autologous tumor killing activity by OK432 was observed in 2 of 10 TAM and 8 of 11 TAL samples . In contrast, IFN failed to induce autologous tumor killing activity, although IFN-enhanced lysis of K562 was detected in 1 of 7 TAM and 2 of 9 TAL samples . These results indicated that autologous tumor killing and natural cytotoxic activities were defective in macrophages and lymphocytes at the site of the tumor growth, and both activities were strongly enhanced by OK432 rather than IFN.

Clin Rheumatol, 1984 Dec, 3(4), 541 - 5
Erosive group G streptococcal arthritis . Case report and review of the literature; Van Linthoudt D et al.; A case of Group G streptococcal arthritis in a previously healthy man is reported . The 2nd and 3rd metatarso-phalangeal joints of the left foot were simultaneously affected . Unusual erosive joint destruction occurred in spite of early therapy and clinical improvement . Circulating immune complexes were raised and were not completely normal at 1 year.

Hoppe Seylers Z Physiol Chem, 1984 Dec, 365(12), 1385 - 91
Murine V kappa 21A isotype sequence: monoclonal antibody 50S10.1 specific for the group A streptococcal polysaccharide; Aebersold R et al.; Antibody 50S10.1 is a hybridoma-derived gamma 3 kappa antibody of BAB-14 mouse strain origin, with specificity for N-acetylglucosamine beta 1----3 linked to L-rhamnose, the immunodeterminant of the streptococcal Group A polysaccharide . The VL50S10.1 amino acid sequence is the fourth complete one reported with this specificity and the first fully determined V kappa 21A structure . Furthermore it is the first V kappa 21A isotype sequence derived from an antibody with known antigen specificity . The V kappa region of this and the previously described monoclonal anti-streptococcal Group A polysaccharide antibodies 7S34.1, 2S1.3 and 17S29.1 are compared, showing that in monoclonal antibody 50S10.1 a V kappa germline gene is expressed which is unrelated to those previously shown to be expressed in antibodies of this specificity . V kappa 50S10.1 increases the variability of known murine V kappa regions and confirms stretches of V kappa 21A sequences previously established.

Hoppe Seylers Z Physiol Chem, 1984 Dec, 365(12), 1375 - 83
Murine V kappa 25 and V kappa 27 amino-acid sequences of C57B1/6 origin: monoclonal antibodies 17S29.1 and 22S25.1 specific for the group A-streptococcal polysaccharide; Aebersold R et al.; Antibodies 17S29.1 and 22S25.1 are monoclonal, hybridoma-derived gamma 3 kappa murine immunoglobulins with specificity for N-acetyl-glucosamine beta 1----3-linked to the L-rhamnose backbone structure, the immunodeterminant of the streptococcal Group A polysaccharide . The VL 17S29.1 amino-acid sequence is the third complete one reported from an antibody with this specificity, the second fully determined V kappa 25 structure and the first complete V kappa sequence of C57B1/6 origin derived from a carbohydrate-specific antibody . VL22S25.1 is a member of the V kappa 27 isotype of murine immunoglobulin VL regions . V kappa 17S29.1 and the determined part of the V kappa 22S25.1 sequence are compared to the previously described V kappa regions of streptococcal Group A polysaccharide-specific antibodies and to 12 selected partial and complete V kappa regions of antibodies with other specificities, predominantly to carbohydrate antigens . Both V kappa 17S29.1 and V kappa 22S25.1 increase the variability of known murine V kappa regions . They are the most homologous to the other V kappa regions derived from antibodies with streptococcal Group A polysaccharide specificity and share with them the amino-acid residue Arg74, so far characteristic for V kappa regions from antibodies with this specificity . The analysis of groups of independently expressed, highly homologous V kappa regions, namely V kappa 17S29.1 and V kappa 2S1.3 as one and V kappa 7S34.1 and V kappa 22S25.1 as a second group, offers the possibility of estimating the minimal number of V kappa germline genes involved in the immune response to the structurally defined streptococcal Group A polysaccharide antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

Int J Dermatol, 1984 Dec, 23(10), 656 - 7
Lymphedema in Noonan's syndrome; White SW; Chronic edema can be debilitating in Noonan's syndrome . Transient childhood lymphedema may be followed by elephantiasis as early as adolescence . Recurrent streptococcal cellulitis exacerbates this problem . Hygenic measures and prophylactic antiobiotic therapy may slow progression of lymphedema of the legs in Noonan's syndrome.

Pediatr Res, 1984 Dec, 18(12), 1329 - 31
Efficacy of orally administered immune serum globulin against type III group B streptococcal colonization and systemic disease in an infant rat model; Kim KS et al.; We established an experimental animal model of the gastrointestinal colonization and systemic disease following oral challenge of type III group B streptococcal strain in 3-day-old newborn rats . Two type III group B streptococcal strains isolated from the cerebrospinal fluid of septic newborn infants produced colonization in 57-87% of the challenged animals and 13-31% of these colonized animals developed systemic disease . Using this new animal model, we evaluated the effect of orally administered human immune serum globulin on the colonization and systemic disease . This antiserum contained 21 micrograms/ml of type III group B streptococcal antibody of human IgG class . Animals fed with immune serum globulin developed significantly lower rates of colonization and systemic disease than those of control (albumin or saline) (23 versus 71%, p less than 0.001 for colonization; 7 versus 31%, p less than 0.05 for systemic disease) . However, rates of the development of systemic disease among the colonized animals were not significantly different between the two groups (33 versus 43%, p greater than 0.1) . These findings suggest that orally administered immune serum globulin is beneficial in the prevention of colonization and systemic disease in this rat model and that this protective effect of oral immune serum globulin occurs primarily at the mucosal level.

Clin Immunol Immunopathol, 1984 Dec, 33(3), 324 - 32
Cell populations and membrane attack complex in glomeruli of patients with post-streptococcal glomerulonephritis: identification using monoclonal antibodies by indirect immunofluorescence; Parra G et al.; Poststreptococcal glomerulonephritis (PSGN) had been thought to arise from renal deposition of immune complexes and as such is analogous to acute serum sickness . Recent studies of acute serum sickness in animals and PSGN in humans, however, have suggested a pathogenetic role for cellular immunity . To enlarge on these observations, cellular components of glomeruli were characterized by indirect immunofluorescence in 11 tissues from individuals with PSGN using monoclonal antibodies . These studies demonstrate infiltration of glomeruli by monocytes, granulocytes, and lymphoid cells . Focal accumulations of T lymphocytes were also observed adjacent to Bowman's capsule . Analysis of glomerular T-cell subpopulations revealed a predominance of cells reactive with OKT4 early and with OKT8 later in the course of disease . Proliferation of parietal and visceral epithelial cells was associated with increased binding of BA-1 and J5, respectively . The presence of the membrane attack complex of complement was demonstrated by glomerular reactivity with a monoclonal antibody (poly-C9 MA) which recognizes a neoantigen present in poly-C9 . Fluorescence was present along the glomerular basement membrane early and within the mesangium late in the course of disease, a distribution similar to that observed for C3 and C5 . These observations suggest that immune cells as well as terminal components of complement either provoke or mark tissue injury in PSGN.

Infect Immun, 1984 Dec, 46(3), 686 - 9
Persistence of HLA-B27 cross-reactive bacteria in bowel flora of patients with ankylosing spondylitis; Prendergast JK et al.; Previous studies have shown that antisera raised in rabbits to certain enteric bacteria (cross-reactive bacteria) are capable of specifically lysing in a 51chromium-release lymphocytotoxicity test the lymphocytes of HLA-B27-positive (B27+) patients with ankylosing spondylitis (AS) . This study investigated the clinical relevance of this finding by ascertaining whether Escherichia coli isolated from the rectal swabs of 20 B27+ AS patients (B27+ AS+) and 46 controls (35 B27- AS- and 11 B27+ AS-) were able to absorb the lymphocytotoxic activity of these antisera . All isolates from B27+ AS+ patients and one from a B27- AS- individual were capable of removing this activity . These organisms persisted in the bowel flora of five selected patients for at least 9 months . Cross-reactive bacteria were also found in a range of gram-positive organisms, including streptococcal, staphylococcal, and clostridial species . The relevance of these findings is discussed in terms of a pathogenetic concept relating the persistence of cross-reactive bacteria in the bowel flora of B27+ individuals to an early event in the development of AS.

Ann Trop Paediatr, 1984 Dec, 4(4), 207 - 11
The pattern of medical renal disease in children in a south Indian hospital; Date A et al.; A retrospective study of children admitted to a south Indian hospital during an 11 year period showed that 70% of the renal diseases encountered in children in this region are of types which have a good prognosis . Post-streptococcal glomerulonephritis was the most common . The relative prevalence of steroid-sensitive nephrotic syndrome and different histological types of idiopathic nephrotic syndrome was similar to that in developed Western countries . Haemolytic-uraemic syndrome complicating bacillary dysentery was the most common cause of acute renal failure.

Gene, 1984 Dec, 32(1-2), 129 - 34
New shuttle vectors for Escherichia coli and Bacillus subtilis . I . Construction and characterization of plasmid pHY460 with twelve unique cloning sites; Ishiwa H et al.; We have constructed chimeric plasmid vectors, pHY460 and pHY310, from the streptococcal tetracycline resistance (TcR) plasmid pAM alpha 1 (9.2 kb) and the Escherichia coli vector pACYC177 (3.7 kb) . These bifunctional plasmids can replicate and express the TcR gene in both E . coli and Bacillus subtilis . Plasmids pHY460 (7.0 kb) and pHY310 (4.8 kb) contain the TcR gene of pAM alpha 1 and the ampicillin resistance (ApR) gene of pACYC177 . Both plasmids showed high transformation efficiency in both host cells . pHY460 was maintained stably in B . subtilis and, thus, is a useful shuttle vector functioning in E . coli and B . subtilis . The PvuI, PstI, BglI and BanI sites in the ApR gene and the HpaI, BalI and EcoRV sites in the TcR gene can be used for selection of recombinant plasmids by insertional inactivation . In addition, plasmid pHY460 has unique sites for SacII, BstEII, XbaI, AvaI and BamHI.

Biochim Biophys Acta, 1984 Nov 13, 805(3), 235 - 44
Lectin-like molecules on the murine macrophage cell surface; Imamura T et al.; Lectin-like molecules on the surface of murine peritoneal exudate macrophages induced by thioglycolate or an anti-tumor streptococcal preparation, OK-432, were investigated and isolated . Furthermore, their sugar-binding specificities and their role in macrophage-mediated tumor cytotoxicity were examined . A neoglycoprotein, D-galactose (Gal)-bovine serum albumin, bound to these murine peritoneal macrophages . This binding of Gal-bovine serum albumin was inhibited by D-galactose, and by complex-type oligosaccharides (unit B) and high mannose-type oligosaccharides (unit A) prepared from porcine thyroglobulin . When thioglycolate-elicited macrophages were activated by lipopolysaccharide and/or the culture supernatant of concanavalin A-activated mouse spleen cells, they became tumoricidal and the number of the lectin-like molecules on the macrophage surface was found to increase . Since the binding and cytotoxic activities of these tumoricidal macrophages toward tumor cells were partially inhibited by D-galactose, the D-galactose-binding lectin-like molecules on the surface of tumoricidal macrophages might play an important role in macrophage-mediated cytotoxicity . These lectin-like molecules were then isolated from solubilized murine peritoneal exudate cells labeled with pyridoxal 5'-phosphate and sodium {3H}borohydride by affinity chromatography on columns of asialo unit B oligosaccharide-Sepharose 4B and/or beta-D-galactose-Bio-Gel P-100 . The proteins bound to the asialo unit B oligosaccharide-Sepharose 4B column and eluted specifically were found to have approximate molecular weights of 79 000 and 18 000, and the protein bound to and eluted from the beta-D-galactose-Bio-Gel P-100 column had an approximate molecular weight of 77 000 . These isolated proteins bound to the surface of glutaraldehyde-fixed tumor cells, and their binding was inhibited by D-galactose and also by D-mannose . Since most of the 77 kDa protein bound to the asialo unit B oligosaccharide-Sepharose 4B, this protein was assumed to be identical with the 79 kDa protein . These results suggest that the lectin-like molecules on murine macrophages have wide specificity and that one lectin-like molecule can bind both D-galactose and D-mannose.

Clin Exp Immunol, 1984 Nov, 58(2), 410 - 9
Detection of cross-reacting murine I-J like determinants on a human subset of T8+ antigen binding, presenting and contrasuppressor cells; Lehner T et al.; Murine I-J gene products have been found in T suppressor cells (SC) and factors, macrophages and contrasuppressor cells (CSC) . However, a human counterpart of the murine I-J has not been reported . As there is strong evidence that some murine anti-Ia antisera cross-react with human Ia antigens, the possibility was tested that mouse anti-I-J antibodies might cross-react with corresponding human class II determinants . Indeed, this revealed that three anti-I-J monoclonal antibodies (MoAb) and two antisera tested react with human mononuclear cells and that a significantly greater proportion of T8+ than T4+ cells or monocytes (Mo) react with the I-J antibodies . This was corroborated by autoradiography with significant inhibition of 125I-SA (streptococcal antigen) binding to T8+ cells but not to Mo by the MoAb or antisera to murine I-J . Functional reconstitution experiments of T4+ helper cells with the SA binding and presenting T8+ Vicia villosa adherent cells (VV-AC) and assessment of specific antibody forming cells to SA suggest that the antigen presenting function of this T8+ subset can be significantly inhibited by killing with the MoAb to I-J and complement . Furthermore, the subset of T8+ VV-AC also functions as CSC, for killing with MoAb to I-J and complement significantly inhibited the contrasuppressor function . This is consistent with the presence of I-J gene products in murine CSC . However, similar treatment of T8+ VV-NAC (non-adherent cells) or monocytes (Mo) failed to affect the suppressor or accessory helper function of these cells, respectively . Phenotypic characterization, inhibition of 125I-SA binding and reconstitution experiments for helper and suppressor functions, suggest that a subset of T8+ antigen binding, presenting and CSC may express determinants cross-reacting with murine I-J molecules.

Am Fam Physician, 1984 Oct, 30(4), 227 - 32
Erythema nodosum; Tierney LM Jr et al.; This self-limiting disease is characterized by painful, red, cutaneous and subcutaneous nodules, and is often a manifestation of a systemic illness . Sarcoidosis, tuberculosis, coccidioidomycosis, streptococcal infections, inflammatory bowel disease and several drugs can be associated . The lesions, usually on the lower extremities, evolve from raised and tender nodules to a bruised appearance to complete resolution . The prognosis of the skin lesions is excellent, but the clinician's attention must be directed toward the presence of an underlying disease process.

Isr J Med Sci, 1984 Oct, 20(10), 1009 - 12
Induction by streptococcal L-forms of two reproductive isolating mechanisms in Drosophila paulistorum; Somerson NL et al.; The six semispecies of the Drosophila paulistorum complex do not normally interbreed, but when hybrids are produced in the laboratory, the males are sterile . In earlier work, cytoplasmic components responsible for this sterility had been transferred by injection of streptococcal L-forms isolated from the Mesitas and Santa Marta flies . To extend these findings, and L-form from the Centro-American flies was injected into three semispecies . Transfer of L-form from one semispecies to another resulted in sterile male progeny . The L-form isolated from Mesitas was injected into all six semispecies . Results simulated "hybrid inviability," i.e., only the Mesitas semispecies produced the expected number of offspring, and the total number of progeny from the other five semispecies was considerably reduced . Despite the small numbers of males, reflecting induced inviability, there was evidence that the transfer of L-forms from one semispecies to another simultaneously caused sterility in male progeny.

Pediatr Res, 1984 Oct, 18(10), 960 - 5
Hemodynamic consequences of tolazoline in neonatal group B streptococcal bacteremia: an animal model; Meadow WL et al.; Using a piglet model of neonatal sepsis, we have determined that Group B streptococcal (GBS) bacteremia is associated with a state of vascular hyper-resistance in both the pulmonary and systemic circulations . This elevated vascular resistance is accompanied by a significant fall in cardiac output despite the assurance of constant intravascular fluid volume . Pulmonary artery pressure rises extensively while systemic blood pressure remains essentially unchanged during this GBS infusion protocol . We report here our attempts to relieve the vascular hyperresistance of GBS infusion by administration of an alpha-sympathetic antagonist, tolazoline (Tz) . We found that Tz, in a dose-related fashion, decreased both systemic and pulmonary vascular resistance over the entire range from 2 to 25 mg/kg . Further, at all doses tested, the resistance-reducing effect of Tz was equal in the systemic and pulmonary vascular beds . No selective pulmonary or systemic vasodilatory effect was demonstrated by Tz in this model of neonatal pulmonary hypertension . The reduction of systemic vascular resistance was accompanied by a significant elevation in total body cardiac output at all Tz doses . Compared to pre-Tz values, cardiac output rose by 24, 55, and 55% after Tz at 2, 8.3, and 25 mg/kg respectively . In addition, administration of Tz to septic normovolemic piglets reliably produced a transient decrease of systemic blood pressure . For Tz doses of 2 and 8.3 mg/kg, steady state systemic blood pressure returned to pre-Tz levels within 10 min . However, after Tz at 25 mg/kg, steady state systemic blood pressure remained significantly below pre-Tz levels.

Immunology, 1984 Oct, 53(2), 215 - 25
A comparative study of streptococcal antigen-binding human T8+ cells and monocytes, in relation to the HLA-DRw6 locus and the helper, suppressor and contrasuppressor functions; Lehner T et al.; Binding of streptococcal antigen was compared between T8+ cells and monocytes (Mo) from DRw6+ and DRw6- subjects . Both T8+ cells and Mo from DRw6- subjects bind streptococcal antigen (SA) specifically and almost entirely at a concentration of 1000 ng per 0.1 ml . However, the DRw6+, T8+ cells bind SA at a concentration of 1 ng but the DRw6+ Mo bind SA at both 1 and 1000 ng of SA per 0.1 ml . The HLA-DR-dependent shift in the binding concentration of SA applied to Mo as well as T8+ cells, except that the DRw6+ Mo showed a biphasic response (1 and 1000 ng) of SA binding . Comparative inhibition studies revealed that the antigen binding T8+ cells, unlike Mo, are inhibited with monoclonal anti-T8 and -T5 antibodies and anti-suppressor factor antiserum . Neither cell was inhibited by anti- T4, M1, F(ab), IgG, IgM, VH null cell or helper factor antibodies, and anti-T3 antibodies showed variable inhibition of SA binding to T8+ cells but no inhibition to Mo . A functional comparison was carried out between the antigen binding cells and helper and suppressor activities in unseparated mononuclear cells . T4-depleted and T8-depleted populations of cells . The concentration of SA binding to the T8+ cells was the same as that required to elicit helper activity but reciprocal to the broad range of SA concentrations necessary to induce suppressor cell activity . The results are interpreted on the basis of the hypothesis that the antigen binding T8+ cell functions as a contrasuppressor cell which prevents the major subset of the T8+ cells inhibiting the T4+ cells.

Br J Cancer, 1984 Oct, 50(4), 483 - 92
In vitro modulation of human natural killer cell activity by interferon: generation of adherent suppressor cells; Uchida A et al.; The in vivo and in vitro effects of human alpha-interferon (IFN) on blood natural killer (NK) cell activity were studied in patients with malignant melanoma . The initial response to an i.m . injection of IFN was a depression of blood NK cell activity, being detectable at 4 h and reaching a nadir at 12 h . Blood NK cell activity returned to or exceeded pretreatment levels within 24 h . The frequency of large granular lymphocytes among peripheral blood lymphocytes (PBL), however, remained unchanged during the first 24 h of IFN treatment . In a single cell cytotoxicity assay in agarose the number of lymphocytes forming conjugates with K562 target cells was not affected at 12-h points of IFN treatment, while the frequency of lytic conjugates with dead target cells was decreased by 12 h . Thus, the number of active NK cells was reduced by IFN administration . While in vitro exposure to IFN resulted in an augmentation of NK cell activity of PBL from untreated patients, IFN failed to enhance the activity of PBL obtained 12 h post IFN injection . When PBL obtained 12 h after IFN injection were cultured overnight, they recovered their responsiveness to NK-boosting effects of IFN . Blood monocytes obtained at 12-h points from IFN-treated patients suppressed IFN-induced enhancement of NK cell activity, although these monocytes did not inhibit the base line level of NK cell activity . In contrast, the streptococcal preparation OK432 was able to augment NK cell activity of PBL obtained 12 h post IFN administration and of control PBL even in the presence of suppressor monocytes . PBL obtained 24 h post IFN injection expressing enhanced NK cell activity were also unresponsive to IFN in vitro . However, monocytes obtained 24 h after IFN injection were no longer able to inhibit IFN-induced augmentation of NK cell activity . These results indicate that in vivo administration of IFN-alpha to cancer patients results in rapid and transient generation of suppressor monocytes capable of inhibiting IFN-dependent development of functional NK cell activity, which could be responsible for the initial and transient decline in blood NK cell activity.

Infect Immun, 1984 Oct, 46(1), 267 - 9
Unique and common protective epitopes among different serotypes of group A streptococcal M proteins defined with hybridoma antibodies; Dale JB et al.; A set of four monoclonal antibodies was produced against a highly purified pepsin extract of type 5 streptococcal M protein . Three of the four antibodies cross-reacted with purified M proteins from heterologous serotypes and opsonized the respective heterologous organisms . Our studies suggest that monoclonal antibodies may be useful in identifying subpeptides of various M proteins containing common, protective epitopes that are capable of evoking antibodies that would protect against several different potentially "rheumatogenic" serotypes.

J Vet Pharmacol Ther, 1984 Sep, 7(3), 213 - 7
A health index to evaluate clinically a beta-hemolytic streptococcal infectious disease model in the horse; Powers JD et al.; Quantification of the clinical manifestations of a disease has been a serious problem particularly as related to clinical trials or drug efficacy studies . Historically, this quantification has been limited to categorizing each patient into one of three or four groups, e.g . worse, no improvement, improved . This problem becomes serious when an investigation utilizes an experimentally induced animal disease model . A health index, which quantifies the clinical state of horses which have an experimentally induced beta-hemolytic streptococcal infection, is described . Aspects of experimental design and statistical analysis are also discussed in relationship to the use of the index for drug efficacy studies.

J Clin Microbiol, 1984 Sep, 20(3), 307 - 10
Recovery of Staphylococcus aureus from multiple body sites in menstruating women; Lansdell LW et al.; Because we suspected the number of women harboring Staphylococcus aureus perivaginally to be higher than previously reported, we undertook an examination of normal, healthy volunteers . Of 97 young women, 26% yielded S . aureus from the external labia at the time of menstruation . Toxin associated with toxic shock syndrome was recovered from 5 of 25 subjects with positive genital cultures . Approximately one-half of the women with positive genital cultures yielded positive cultures from the posterior cervical fornix . These 12 women with positive vaginal cultures formed a distinct subgroup that was characterized by positive labial and tampon cultures, higher incidence of previous streptococcal infections, and more frequent vaginal insertion of their own fingers or those of a partner . Tampons were used by all but one woman in the group with positive labial cultures and all but one woman in the group with positive vaginal cultures . We concluded that the presence of S . aureus in the vagina involves mechanisms other than the use of tampons . Insertion of fingers and perhaps some aspect of immunological status appear to play a role.

Antibiotiki, 1984 Sep, 29(9), 643 - 5
{Use of adsorbents for optimizing the process of isolating nisin from the culture broth}; Baranova IP et al.; The results of the study on optimization of the process of nisin isolation from the cultural liquid are presented . Different adsorbents, streptococcal cells, medium solid particles (biomass fermentalysates) and silica gel, were used for antibiotic adsorption.

Eur J Immunol, 1984 Sep, 14(9), 814 - 9
Sequential development of helper and suppressor functions, antibody titers and functional avidities to a streptococcal antigen in rhesus monkeys; Lehner T et al.; Sequential development of antibody titer, functional avidity, helper and suppressor activities were investigated in rhesus monkeys . These were immunized with a single dose of 0.1 microgram to 10 mg of a streptococcal protein antigen (SA) in aluminium hydroxide . The IgG antibody titers followed the classical pattern first established in mice, of high-dose and low-dose tolerance with intermediate doses of immunity . This was correlated with a similar pattern of functional avidity of IgG antibodies, as measured by a dissociation assay . Helper and suppressor functions were assayed in parallel by inducing the corresponding factors from monkey lymphocytes in Marbrook flasks and testing the factors which cross the species barrier in cooperative cultures with CBA mouse spleen B cells . A progressive modulation of helper and suppressor activities was elicited by the increasing doses of SA, during the initial 28 days after immunization . Thus, dominant suppressor with minimal helper activity, IgG antibody titer and functional avidity were elicited by 0.1 microgram SA . However, 1 or 10 micrograms SA induced dominant helper with minimal or transient suppressor activity and high IgG antibody titers and functional avidity . Somewhat intermediate responses were elicited by 100 micrograms SA, but 1 mg and especially 10 mg SA induced dominant suppressor and minimal helper activity, with low IgG antibody titers and functional avidities . When the immune response was established, about 28 days after immunization, the intermediate dose of SA elicited IgG antibodies with high titer and functional avidity, high T cell helper but low suppressor activities . In contrast, both high- and low-dose SA induced partial tolerance, with low IgG antibody titer, functional avidity and T cell helper activity . These studies suggest cyclical development of helper and suppressor functions during the 4 weeks after immunization . The emergence of a dominant helper or suppressor function is antigen dose dependent.

J Chromatogr, 1984 Aug 3, 297, 37 - 48
Application of reductive dihydroxypropylation of amino groups of proteins in primary structural studies: identification of phenylthiohydantoin derivative of epsilon-dihydroxypropyl-lysine residues by high-performance liquid chromatography; Acharya AS et al.; The general utility of reductive alkylation of amino groups of proteins with glyceraldehyde (2,3-dihydroxypropionaldehyde) in the presence of sodium cyanoborohydride, i.e . dihydroxypropylation, as an aid in generating arginine peptides of proteins by tryptic digestion has been investigated . The dihydroxypropylation of the amino groups of ribonuclease A and the streptococcal Pep M5 protein proceeds predominantly to the stage of monoalkylation . The derivatized lysine namely, epsilon-dihydroxypropyl-lysine is stable to acid hydrolysis, and is eluted slightly ahead of histidine in the amino acid analyzer . The peptide bonds of epsilon-dihydroxypropyl-lysine residues are resistant to tryptic digestion . The arginine peptides of dihydroxypropylated ribonuclease A, and dihydroxypropylated streptococcal Pep M5 protein have been isolated by reversed-phase high-performance liquid chromatography (HPLC) of the tryptic digest of the derivatized proteins . The phenylthiohydantoin (PTH) derivative of epsilon-dihydroxypropyl-lysine has been prepared . It is eluted at a position intermediate to that of the PTH derivatives of proline and tryptophan in reversed-phase HPLC on DuPont Zorbax ODS columns . Thus the PTH-epsilon-dihydroxypropyl-lysine could be identified during the sequence studies of the dihydroxypropylated peptides . The presence of dihydroxypropyl groups on the epsilon-amino groups of lysine residues in the dihydroxypropylated peptides does not interfere with the Edman degradation studies . The ease of the dihydroxypropylation reaction, the resistance of the peptide bonds of epsilon-dihydroxypropyl-lysine residues to trypsin, and the identification of the PTH derivative of epsilon-dihydroxypropyl-lysine residues by reversed-phase HPLC makes the dihydroxypropylation procedure a valuable addition to the arsenal of procedures for limiting the tryptic digestion to the arginine residues of proteins and peptides.

Eur J Obstet Gynecol Reprod Biol, 1984 Aug, 17(6), 377 - 82
Transient increase of early-onset group B streptococcal septicemia; Belfrage P et al.; Since 1976, all cases of neonatal group B streptococcal (GBS) septicemia/meningitis have been registered at two Swedish University Hospitals . A significant increase in the number of infants contracting early-onset GBS-septicemia was noticed at one clinic in 1981, from 1-3 cases per yr to 8 cases . Six months prior to this increase the number of deliveries increased from about 1500 per yr to nearly 3000 per yr . It is suggested that external factors, e.g., subtle changes in the nursing combined with an extended disadvantage at the ward might influence the development of early-onset GBS septicemia.

Clin Nephrol, 1984 Aug, 22(2), 97 - 101
Persistent anti-DNA antibodies and DNA-anti-DNA complexes in post-streptococcal glomerulonephritis; Vilches AR et al.; Two patients with the typical clinical, serological and pathological features of acute post-streptococcal glomerulonephritis were found to have elevated serum concentrations of DNA-anti-DNA complexes, and, in one case, of anti-DNA antibody, both single and double stranded . The DNA-anti-DNA complexes were found to persist for 15 and 21 months respectively following the initial illness, despite rapid resolution of the clinical features and severe renal dysfunction . It is suggested that the DNA-anti-DNA complexes may have a pathogenetic role in post-streptococcal nephritis, or alternatively act as a marker of those patients who will develop nephritis after a streptococcal infection.

J Immunol, 1984 Aug, 133(2), 969 - 74
Purification and some properties of streptococcal protein G, a novel IgG-binding reagent; Bjorck L et al.; Protein G, a bacterial cell wall protein with affinity for immunoglobulin G (IgG), has been isolated from a human group G streptococcal strain (G148) . Bacterial surface proteins were solubilized by enzymatic digestion with papain . Protein G was isolated by sequential use of ion-exchange chromatography on DEAE-cellulose, gel filtration on Sephadex G-100, and affinity chromatography on Sepharose 4B-coupled IgG . The presence of protein G in various pools and fractions during the isolation was followed by their ability to inhibit the binding of radio-labeled IgG to G148 bacteria . A highly purified protein G was obtained . On polyacrylamide gel electrophoresis in sodium dodecyl sulfate, the apparent m.w . was 30,000, and on agarose gel electrophoresis the purified protein gave rise to a single band in the alpha 1-region . Protein G was found to bind all human IgG subclasses and also rabbit, mouse, and goat IgG . On the IgG molecule, the Fc part appears mainly responsible for the interaction with protein G, although a low degree interaction was also recorded for Fab fragments . IgM, IgA, and IgD, however, showed no binding to protein G . This novel IgG-binding reagent promises to be of theoretical and practical interest in immunologic research.

Crit Care Med, 1984 Jul, 12(7), 596 - 9
Two-dimensional echocardiographic demonstration of acute myocardial depression in septic shock; Ozier Y et al.; A 50-yr-old woman exhibiting streptococcal neck cellulitis developed severe septic shock with low cardiac output, which was reversed by infusion of dopamine plus dobutamine . Two-dimensional echocardiography performed at the bedside demonstrated severe myocardial failure . The patient's condition remained dependent on inotropic drug support for 2 days and ultimately improved . Two-dimensional echocardiography repeated on the fourth day corroborated the disappearance of transient myocardial failure.

Pathology, 1984 Jul, 16(3), 291 - 9
Humoral immunity in experimental immune carditis; Anand IS et al.; An experimental model of carditis has been produced in the rhesus monkey by giving 12 weekly injections of a streptococcal membrane antigen . There was histological evidence of focal myocarditis, subendocardial infiltration with lymphomononuclear cells and in one animal myocardial granuloma formation . No valvular lesions were seen . Humoral immune responses monitored throughout the experiment showed that anti-heart antibodies appeared in circulation after the 2nd injection, attained maximal titres by the 6th injection, and thereafter the titres declined . The anti-membrane antibodies appeared slightly later and these titres kept rising till sacrifice . By the 6th injection there was evidence of complement consumption and appearance of circulating immune complexes . It is concluded that these immunological responses might have a role to play in the pathogenesis of carditis.

JPEN J Parenter Enteral Nutr, 1984 Jul-Aug, 8(4), 453 - 5
Inadvertent intravenous administration of enteral diet; Stellato TA et al.; Needle catheter jejunostomy feedings were instituted in a 64-yr-old man on postoperative day 1 following subtotal gastrectomy for carcinoma of the antrum . Several days later, the enteral tube catheter was inadvertently connected to the patient's peripheral intravenous cannula which resulted in the intravenous administration of the enteral formula solution . The administration was stopped immediately when recognized, but 4 hr later the patient became febrile, hypotensive, and tachycardic . Cultures from the enteral solution demonstrated Streptococcal viridans and yeast; the patient's blood cultures similarly demonstrated S . viridans . Broad spectrum antibiotics, hemodynamic monitoring, and intravascular support with crystalloid solutions resulted in a favorable outcome . Prevention of the complication could be assured by adopting luer connectors for enteral feeding sets which cannot be connected to intravenous cannulas . Until these are available, the addition of methylene blue to the tube feeding formula or utilization of color coded distal connecting tubing may prevent accidental intravenous administration of tube feeding formulas . The potential for this complication must be recognized by those dealing with enteral feeding.

J Immunol, 1984 Jul, 133(1), 465 - 70
Influence of the immunoglobulin heavy chain locus on expression of the VK1GAC light chain; Fulton RJ et al.; The VK1GAC light chain represents the dominant V kappa structure employed in the antibody response of A/J mice to streptococcal group A carbohydrate ( GAC ) . Two anti-idiotypic antisera, anti- Id5 and anti- Id20 , with specificity for the VK1GAC light chain were used to examine anti- GAC antibody responses in a series of inbred mouse strains that differ at the heavy chain constant region ( IgCH ) allotype locus . Both idiotypes were expressed in normal and immune sera from mice of most IgCH allotypes, except IgCHb (C57BL/6J) and IgCHf (CE/J) . C57BL/6J mice expressed Id5 , but not Id20 , whereas CE/J mice did not express either idiotype . Testing of recombinant inbred strains between BALB/c and C57BL/6 indicated that the pattern of idiotype expression did not correlate with IgCH allotype . The C X B recombinants expressed all three idiotype patterns that were observed in the panel of inbred strains . Testing of allotype congenic mice between BALB/c and C57BL/6 showed that CB.20 and BC.8 mice were Id20 -, whereas BAB-14 mice were Id20 +, indicating that both VH and background (V kappa or regulatory) loci must be derived from BALB/c to obtain Id20 expression . The difference in the frequency of idiotype expression observed between BALB/c and BAB-14 mice indicates that the IgCH locus may exert a quantitative influence on the expression of this light chain . To examine the Id20 -, Id5 + antibodies of C57BL/6 mice, anti- GAC hybridomas were prepared . Of 16 C57BL/6-derived anti- GAC monoclonal antibodies, six were reactive with anti- Id5 and not with anti- Id20 . Isoelectric focusing of the purified kappa light chains from three of these antibodies revealed two distinct spectrotypes that co-migrated with the two known VK1GAC spectrotypes observed with A/J anti- GAC light chains . Idiotypic analysis of in vitro recombinants between the heavy and light chains of A/J and C57BL/6 monoclonal antibodies demonstrated that the C57BL/6 light chains were idiotypically similar to A/J light chains when they were free in solution or paired with A/J heavy chains . These results demonstrate that C57BL/6 mice can express a light chain that is very similar, if not identical, to the VK1GAC light chain, although the light chain is expressed in lower frequency and is paired with a distinct VH structure, which can mask expression of one of the VK1GAC idiotypes . These effects on V kappa expression map to at least three genetic loci: VH, CH, and an unlinked locus.

Pediatr Cardiol, 1984 Jul-Sep, 5(3), 205 - 7
Coronary aneurysms in a patient with atypical Kawasaki syndrome and a streptococcal infection; Reller M et al.; We report a patient who presented with a prolonged febrile illness and evidence of an acute streptococcal infection . The development of thrombocytosis led to the suspicion of Kawasaki syndrome despite the fact he did not fulfill the usual clinical criteria . A two-dimensional echocardiogram demonstrated bilateral coronary artery aneurysms.

Vet Immunol Immunopathol, 1984 Jul, 6(3-4), 341 - 51
Comparative effect of selected adjuvants on the response in the bovine mammary gland to staphylococcal and streptococcal antigens; Opdebeeck JP et al.; The effect of 4 adjuvants on the response in the lactating bovine mammary gland to an antigenic stimulus was examined . Fifty four lactating Holstein Friesian cows were randomly allocated to 6 groups . Four of these groups received a staphylococcal and streptococcal bacterin-toxoid vaccine administered systemically in association with an adjuvant preparation . The adjuvants used were: aluminum hydroxide gel, Freund's incomplete adjuvant, a metabolizable lipid emulsion and Bordetella pertussis . Two further groups serving as controls received saline, or the vaccine suspended in saline only . The immunoglobulin G response specific for each of 3 vaccine antigens, was monitored in the milk by means of enzyme-linked immunosorbent assay for a period of 23 weeks . The results indicated that high levels of antibody may be maintained in the milk, throughout the average lactation, if cows are vaccinated in the region of the supramammary lymph node with an optimum dose of antigen emulsified in Freund's incomplete adjuvant.

Am J Med Sci, 1984 Jul-Aug, 288(1), 43 - 5
Anaphylaxis due to chloramphenicol; Palchick BA et al.; A patient with group B Streptococcal meningitis and a history of penicillin allergy sustained an anaphylactic reaction following intravenous chloramphenicol . The purity of the infusate was confirmed by reverse-phase high-speed liquid chromatography . Anaphylaxis is a rare event following chloramphenicol administration, but physicians should be aware of this complication, especially in patients with prior exposure to the drug.

Mol Immunol, 1984 Jul, 21(7), 577 - 80
Allotypic determinants (Igh-3) associated with the IgG2c subclass of rat immunoglobulins; Leslie GA; Rat antibodies to group A streptococcal carbohydrate are primarily of the IgM and IgG isotypes . Hyperimmunization often results in antibodies of a restricted molecular heterogeneity of the IgG2c isotype . An allotypic marker, designated Igh-3a, was detected on the heavy chains of the IgG2c isotype from Copenhagen rats . Igh-3b was detected on the heavy chains of IgG2c from SHR rats . A strain distribution of the Igh-3 determinants as well as inheritance patterns for their expression are presented.

Pediatrie, 1984 Jul-Aug, 39(5), 371 - 8
White blood cells and acute phase reactants in neonatal sepsis; Philip AG; No single diagnostic test for neonatal sepsis is both rapid and reliable . Combining leukocyte (wbc) counts with acute phase reactants (APR) enhances diagnostic accuracy . The most helpful wbc counts are leukopenia (less than 5.0 x 10(9)/l), increased immature/total neutrophils (greater than or equal to 0.2) and profound neutropenia (less than 1.0 x 10(9)) . Of the APR, C-reactive protein responds most rapidly, but alpha 1-acid glycoprotein (orosomucoid), haptoglobin and mini-ESR (greater than or equal to 15 mm/h) are also useful . Rapid, quantitative determinations of APR are now available with nephelometric techniques . Abnormal wbc counts frequently appear before APR changes in group B streptococcal infection . Sequential determinations of wbc counts and APR may provide valuable diagnostic and prognostic information.

J Dairy Sci, 1984 Jun, 67(6), 1227 - 35
Enumeration and presumptive identification of bacteria from the small intestine of sheep; Nicoletti JM et al.; Microflora of the small intestine of sheep was examined . Samples of tissue and digesta were taken from four sites along the small intestine (3, 8, 13, and 18 m from the pylorus) and maintained under anaerobic conditions . The pH of the digesta taken at the 3rd, 8th, 13th, and 18th m sections were 5.44, 6.37, 7.24, and 6.79 . Digesta and tissue samples were diluted serially and plated within the anaerobic glove box on complex medium containing rumen fluid . In addition, each sample was plated on the same medium and incubated aerobically . As determined by growth under anaerobic conditions, viable counts of the digesta ranged from 5 X 10(4) to 7 X 10(6) cells/g, whereas counts for the tissue ranged from 2 X 10(2) to 4 X 10(4) cells/g . Viable counts determined aerobically for the digesta ranged from 1 X 10(4) to 5 X 10(6) cells/g, whereas the counts for the tissue ranged from 5 X 10 to 6 X 10(4) cells/g . Tentative identification of 50 isolates from samples of tissue and digesta in the 13th m section revealed a predominance of streptococcal organisms and rod shaped organism morphologically similar to Propionibacterium . An indigenous population of acid-tolerant bacteria with the ability to ferment simple sugars and starch was in the small intestine.

J Natl Cancer Inst, 1984 Jun, 72(6), 1365 - 70
Activation of cytotoxic polymorphonuclear leukocytes by in vivo administration of a streptococcal preparation, OK-432; Watabe S et al.; Injection ip of a streptococcal preparation, OK-432, into WKA and DONRYU rats induced in vitro cytotoxicity of polymorphonuclear leukocytes (PMN) against tumor cells in terms of their cytostasis and cytolysis . PMN were obtained from peritoneal exudates of WKA and DONRYU rats . Cytotoxicity of activated PMN was immunologically nonspecific, although a certain target selectivity was observed in PMN cytotoxicity . The titer of cytotoxicity of PMN was dependent on the dose of injected OK-432 and on the number of PMN in the cytotoxicity assay . Activated PMN appeared very early (6 hr) after OK-432 injection, and the cytotoxic titer of PMN decreased from 24 hours and disappeared at 96 hours after injection of the reagent . In vitro culture of PMN with OK-432 also evoked cytotoxicity of PMN.

J Dairy Sci, 1984 Jun, 67(6), 1331 - 5
Efficacy of a latex teat sealer; McArthur BJ et al.; In the first of two experiments, efficacy of a latex teat sealer product was tested under field conditions on 32 cows that had one side of the udder dipped with the test product and the other left as the control . Number of new coliform, staphylococcal, or streptococcal infections in treated quarters was not reduced from controls . In a second experiment, effectiveness of this product as a protective sealer was investigated on six cows dip challenged with a broth containing 1 million Escherichia coli/ml . On sealed teats the challenge was applied on top of the dried film . The challenge organism was recovered from 33% of treated quarters and 42% of control quarters 6 h after exposure . Organisms were recovered from none of the quarters by 31 h postchallenge.

J Infect Dis, 1984 Jun, 149(6), 851 - 60
Potentiation of virulence by group B streptococcal polysaccharides; Levy NJ et al.; The ability of group B streptococcal (GBS) capsular polysaccharides to potentiate virulence was examined . Incubation of soluble type Ia or III polysaccharide in hypogammaglobulinemic human serum inhibited classical complement-dependent opsonophagocytic killing of type Ia strain 515 . When functional complement components were measured, C1 activity increased in sera with added polysaccharide whereas C4 activity decreased 80%-90% . Incubation of purified C1 with type Ia polysaccharide inhibited lysis of EAC4 cells in a C1 transfer assay . In a mouse lethality model, tail-vein injection of 50 micrograms of type Ia or III polysaccharide decreased the 50% lethal dose (LD50) from 3.2 X 10(6) to 2.2 X 10(5) . Total hemolytic complement levels in mice immediately after polysaccharide injection were increased over levels in control mice, but this difference was not seen 30 min later . The LD50 in mice depleted of C3 (with cobra venom factor) was 6 X 10(5) and simultaneous injection of polysaccharide did not further lower the LD50.

Ann Emerg Med, 1984 Jun, 13(6), 440 - 8
Early treatment of streptococcal pharyngitis; Lowe R et al.; The concept of treating presumed streptococcal pharyngitis prior to obtaining throat culture results remains controversial . We review the rationale for early treatment and the predictive ability of current techniques for rapidly estimating the probability of streptococcal pharyngitis . Decision analysis is combined with clinical and microscopic predictive tests to provide an approach for early treatment of presumed streptococcal pharyngitis . Our unified approach supports the treatment of presumed streptococcal pharyngitis prior to obtaining culture results when specific clinical or microscopic criteria are met.

Am J Dis Child, 1984 Jun, 138(6), 536 - 9
Erythromycin therapy for group A streptococcal pharyngitis . Results of a comparative study of the estolate and ethylsuccinate formulations; Ginsburg CM et al.; One hundred two children with group A streptococcal pharyngitis were treated on a randomized basis with either 15 mg/kg of erythromycin estolate or 25 mg/kg of erythromycin ethylsuccinate given twice daily for ten days . Twelve patients, including 11 erythromycin ethylsuccinate-treated patients and one erythromycin estolate-treated patient, were dropped from the study at the request of their parents because of abdominal cramping and/or nausea and vomiting that occurred 15 to 45 minutes after ingestion of drug . Eighteen other patients (12 treated with erythromycin ethylsuccinate and six treated with erythromycin estolate) had similar gastrointestinal (GI) tract symptoms that resolved or abated . Excluding patients with reinfections with new streptococcal serotypes and those with resistant strains, the bacteriologic failure rates were 4.3% and 17.5%, and the total failure rates were 6.4% and 35.3% with erythromycin estolate therapy and with erythromycin ethylsuccinate therapy, respectively . The high rate of GI tract intolerance associated with the erythromycin ethylsuccinate appears to be dose related.

J Infect Dis, 1984 Jun, 149(6), 841 - 50
Suppression of cellular reactivity to group A streptococcal antigens in patients with acute poststreptococcal glomerulonephritis; Reid HF et al.; Lymphocyte reactivity to group A streptococcal antigens was studied in patients with acute poststreptococcal glomerulonephritis (AGN) in Trinidad . When compared with controls, patients with AGN had significantly lower responses . This finding was most prominent in the patients who were greater than 10 years of age at onset of disease . The total number of T lymphocytes was found to be decreased in patients with AGN, and in particular, the percentage of cells bearing Fc receptors for IgG (T gamma) was low . Removal of the T gamma-cell population abrogated the lymphocyte response to streptococcal antigens . However, removal of the adherent cells resulted in enhancement of the response to the level of the normal control population . The presence of suppressor activity in the adherent cell population of older patients with AGN may be an important factor in progression of AGN to chronic disease.

Clin Exp Immunol, 1984 Jun, 56(3), 683 - 93
The role of MHC class II antigenic determinants in the function of human antigen binding T8+ cells, monocytes and helper and suppressor factors; Lehner T et al.; The role of MHC class II antigens was investigated in the process of antigen binding by T8+ cells and monocytes (Mo) and in the functions of helper factor (HF) and suppressor factor (SF) . Monoclonal antibodies (MoAbs) to HLA-DR, DC and SB determinants were used in immunofluorescence, inhibition of antigen binding and affinity chromatography of HF and SF . Indirect immunofluorescence studies suggest that T lymphocytes from peripheral blood of healthy subjects have a small proportion of cells expressing HLA-DR, beta chain determinants (1.4-3.8%) . These belong predominantly to the T8+ subset of cells (4.6-8.8%), with only a very small proportion in the T4+ cells (0.1-1.8%) . However, DC1 on DRw6+ T cells and SB2,3 on any HLA typed cells were found in significantly greater proportion than the DR antigens in both T8+ and T4+ cells, though this was again greater on T8+ (30 and 25%) than T4+ (8.3 and 14.4%) cells . Although Mo had a greatly increased proportion of cells with DR-beta chain determinants (27-45%) than the T8+ cells, the converse was found with DC1 and SB2,3 determinants (13.9 and 11.4%) . Inhibition of 125I-streptococcal antigen (SA) binding to T8+ cells and to Mo by MoAbs to the class II antigens showed that DR-beta chain monomorphic or polymorphic antibodies and DC1 antibodies inhibited binding to both cell types by 66-94% . However, MoAbs to DR-alpha chains or to the SB2,3 determinant failed to yield significant inhibition . Affinity chromatography studies of HF and SF revealed that the DR-beta chain monomorphic and DC1 antibodies bound HF and SF activities and that this was not found with the DR-beta chain polymorphic or SB2,3 antibodies . The results of inhibition of 125I-SA binding to T8+ cells and Mo, and absorption of HF and SF by affinity chromatography with MoAbs suggest four categories of recognition of human MHC class II antigenic determinants . (1) Class II determinants shared by the T8+ cells, Mo, HF and SF and recognized by MoAbs to monomorphic beta chains (DA6.231) and to DC1 . (2) Class II determinants shared only by the SA binding T8+ cells and Mo and recognized by the MoAbs to a polymorphic beta chain (DA6.164) and to a monomorphic DR determinant (OK.Ial) . (3) Class II determinants shared only by the HF and SF and recognized by the MoAbs to one of the alpha chains (TAL.1B5) . (4) Class II determinants not detected on the two cells or the two T cell factors.

Am J Dis Child, 1984 May, 138(5), 476 - 8
Occurrence and prevention of rheumatic fever among ethnic groups of Hawaii; Chun LT et al.; To assess the occurrence of acute rheumatic fever (RF) among the ethnic groups of Hawaii, the case records of hospitalized children with RF in Oahu were reviewed for the period from October 1976 to September 1980 . One hundred four of the records met the modified Jones criteria . Incidence rates per 100,000 children were as follows: Japanese, 0; white, 9; Filipino, 9.1; Hawaiian and part-Hawaiian, 27.2; and Samoan, 96.5 . Carditis was most common among Samoan children; it occurred in nine of 18 children . A streptococcal, throat culture program for children with respiratory infections was in progress in 60% of Oahu's public schools during this period of time . Children with positive cultures were excluded from school until the start of treatment . However, RF occurred with equal frequency in participating and nonparticipating schools . Rheumatic fever continues to be a substantial problem among Polynesian children in Hawaii, and it is apparent that the school-based primary prevention program used in Hawaii to control streptococcal disease has not altered the frequency of RF among them.

J Invest Dermatol, 1984 May, 82(5), 465 - 70
Dermal and epidermal involvement in the evolution of acute eruptive guttate psoriasis vulgaris; Brody I; A light and electron microscopic study of the evolution of acute eruptive guttate psoriasis vulgaris (AEGP) following penicillin-treated streptococcal throat infection is presented . The earliest recognizable changes, distinguished in clinically normal psoriatic skin (CNPS) from patients with psoriasis of 2 days' duration, comprised mast cell degranulation (Type I MCD), a vascular pattern showing endothelial cell gaps in postcapillary venules and postcapillary venules with endothelial cell hypertrophy and compressed lumen as well as epidermal involvement with punctiform spongiotic areas (PSAs) . These early dermal and epidermal changes suggest that Type I MCD represents a primary morphologic event . Inflammatory infiltrate of mononuclear cells and exocytosis of mononuclear cells into the PSAs appeared when the concomitant overt psoriasis was 5-21 days old, and these changes were persistent in psoriatic lesions (PLs) of 2 days' duration . They are suggested to be precursors of overt psoriasis . In 2-day-old PLs, MCD (Types I and II) was a prominent feature . It was associated with (1) more extensive vascular changes, (2) inflammatory infiltrate of mononuclear cells and scanty polymorphonuclear leukocytes, (3) epidermal hyperplasia, and (4) migration of a few polymorphonuclear leukocytes through the epidermis with formation of Munro microabscesses in parakeratotic areas of stratum corneum . From the morphologic viewpoint, the progression from 2-day-old to fully evolved PLs seemed basically to be quantitative . The demonstration of MCD as a salient feature in the evolution of AEGP may have future therapeutic and preventive implications for psoriasis.

J Invest Dermatol, 1984 May, 82(5), 460 - 4
Mast cell degranulation in the evolution of acute eruptive guttate psoriasis vulgaris; Brody I; Clinically normal psoriatic skin (CNPS) and psoriatic lesions (PLs) were studied for mast cell degranulation (MCD) in patients with acute eruptive guttate psoriasis vulgaris (AEGP) following penicillin-treated acute streptococcal throat infection . The clinically manifest duration of psoriasis at the time of the biopsies was 2, 5, 10, 14, or 21 days . Two types of MCD were distinguished . Type I was characteristic for those portions of the CNPS in which vascular and epidermal changes were detected, while the PLs showed both Type I and Type II MCD . In Type I MCD the extruded granules (MCGs) in the immediate vicinity of the mast cells appeared as intact bodies encased in a distinctly trilaminar membrane . Around subepidermal and subpapillary blood vessels, in stratum papillare without proximity of blood vessels, beneath the epidermal-dermal junction, in lamina lucida, and in intercellular space of strata basale and spinosum the MCGs appeared partly as intact structures and partly in more or less disintegrated form . In Type II MCD the MCGs were extruded without perigranular membranes . The data here presented showed that MCD is an early and constant feature in the evolution of AEGP.

South Med J, 1984 May, 77(5), 643 - 5
Hematogenous group B streptococcal osteomyelitis in an adult; Gordon DM et al.; We have reported a case of group B streptococcal vertebral osteomyelitis in a 55-year-old alcoholic man . This may be the first reported case of group B streptococcal osteomyelitis in an adult that was not secondary to surgery, ischemic peripheral vascular disease, or a contiguous infection.

Laryngol Rhinol Otol (Stuttg), 1984 Apr, 63(4), 203 - 5
{Indications for tonsillectomy in childhood from the current viewpoint}; Gastpar H; Any discussion of tonsillectomy must necessarily be based on the function and pathophysiology of the palatine tonsils . Their unique anatomic structure illustrates their main immunological function: to recognize and process the transgressors from the environment, to transfer the resulting immunological information to the entire lymphatic system and, therefore, to contribute to the immuno-defensive mechanism of the infant organism . In spite of the abundance of lymphocytes of the T- and B-type in the reticular zone of their epithelium, the tonsils seem to be dispensable because the lympho-epithelial tissue of the pharyngeal mucosa has the same immunological function and, moreover, tonsillectomy does not result in any persistent immunologic defect . However, tonsillectomy in infants up to an age of 4 years should be recommended with great reluctance if at all, since up to this age the tonsils play an important part in the immunological "learning process" . Some bacterio-virological aspects are equally important for the indication of tonsillectomy in individual cases as the differentiation between chronic and recurrent tonsillitis . In the treatment of the secondary cervical lymphadenitis, too, such differentiation is mandatory . Chronic tonsillitis in terms of a "focal disease" is a rare event in infants, and tonsillectomy is recommended only in such exceptional cases where recurrent streptococcal infections resulted in rheumatism or glomerulonephritis.

J Pediatr, 1984 Apr, 104(4), 560 - 3
Predictive value of fractional excretion of filtered sodium for hypertension in acute post-streptococcal glomerulonephritis; Mota-Hernandez F et al.; The course of acute post-streptococcal glomerulonephritis was followed in 81 children, 66 of whom were hypertensive on admission . Sixty-one hypertensive patients were available for follow-up; in seven (11.5%), hypertension recurred 1 to 9 days after initial blood pressure elevation had returned to normal . Thirteen initially normotensive patients were available for follow-up; six (46%) developed hypertension 1 to 9 days after admission . Initial FENa was less than or equal to 0.5 in all 13 patients with recurrence of initial hypertension or who developed initial hypertension while under observation, and in another 25 patients who did not have this course . On the other hand, FENa was greater than 0.5 in 36 patients, none of whom had recurrence of initial hypertension or developed hypertension while under observation . Therefore, an admission FENa less than or equal to 0.5 seems to be an accurate predictor for development of hypertensive episodes.

Exp Mol Pathol, 1984 Apr, 40(2), 235 - 45
Elastin fiber-associated glycosaminoglycans in beta-aminopropionitrile-induced lathyrism; Pasquali-Ronchetti I et al.; Ruthenium red and toluidine blue O precipitates were described associated with lathyritic elastic fibers in aortas of chickens treated with beta-aminopropionitrile fumarate (I . Pasquali-Ronchetti, C . Fornieri, I . Castellani, G . M . Bressan, and D . Volpin (1981) . Alterations of the connective tissue components induced by beta-aminopropionitrile . Exp . Mol . Pathol . 35, 42-56) . In this report evidence is given that these precipitates reveal the presence of proteoglycans, as they are completely removed by 5 M guanidine-HCl incubation and by specific enzymatic digestions . In particular, proteoglycans associated with the poorly cross-linked lathyritic elastin can be removed by testicular hyaluronidase, chondroitinase ABC, heparitinase, and nitrous acid treatments, whereas they are rather resistant to streptococcal hyaluronidase and chondroitinase AC . On the contrary, proteoglycans of the matrix or associated with collagen fibers are particularly sensitive to these latter enzymatic treatments . The conclusion is reached that glycosaminoglycans associated with beta-aminopropionitrile-induced lathyritic elastin (i) are different from those of the matrix or associated with collagen, and (ii) include mainly dermatan and heparan sulfates.

Chest, 1984 Apr, 85(4), 471 - 5
Factors affecting survival in prosthetic valve endocarditis . Review of the effectiveness of prophylaxis; Santinga JT et al.; We review factors affecting survival of 44 episodes of prosthetic valve endocarditis occurring in 39 patients from 1965 to 1982 . The mortality was 31.8 percent (14/44), and 21.6 percent (8/37) if the fungal cases are excluded . The development of a new murmur of valvular regurgitation in 18 patients led to valve replacement or death in every patient . Streptococcal endocarditis in 11 patients resulted in no deaths and only two valve replacements; staphylococcal infections had a mortality of 27.1 percent (6/22) . Length of medical therapy before valve replacement did not relate to a successful outcome . Eight cases of early staphylococcal endocarditis occurred in which the organism was susceptible to the prophylactic antibiotic therapy . Changes in prophylaxis have led to no cases of early endocarditis over the past three years in 261 valve replacements.

Br J Oral Maxillofac Surg, 1984 Apr, 22(2), 123 - 8
Prominent fungiform papillae in guttate psoriasis; Stankler L et al.; Three patients presented with widespread guttate psoriasis of explosive onset which involved the palms and soles (exanthematic guttate psoriasis) and followed, in each case, a haemolytic streptococcal throat infection . At the height of the effluorescence the lingual fungiform papillae were very numerous, red and prominent and their subsequent course paralleled that of the skin lesions . This oral finding has not been reported previously in patients with psoriasis.

Proc Natl Acad Sci U S A, 1984 Apr, 81(7), 2203 - 7
Epitope-specific protective immunogenicity of chemically synthesized 13-, 18-, and 23-residue peptide fragments of streptococcal M protein; Beachey EH et al.; The ability of chemically synthesized subpeptides of type 24 streptococcal M protein to evoke protective antibodies in rabbits was investigated . We synthesized copies of the COOH-terminal 13, 18, and 23 amino acid residues of cyanogen bromide fragment 7 (CB7) of pepsin-extracted type 24 M protein, except that methionine was substituted for homoserine as the COOH-terminal residue . An additional residue of cysteine was added at the COOH terminus of the 13-residue peptide . Each of the peptides, designated S-CB7-(23-35)-Cys, S-CB7-(18-35), and S-CB7-(13-35), when conjugated to lysylated tetanus toxoid with glutaraldehyde, was capable of stimulating formation of protective anti-type 24 M protein antibodies in rabbits . The smallest peptide, S-CB7-(23-35)-Cys, elicited immune responses equally as strong, if not stronger, than those to the longer peptides . A single Lys/Gly substitution in this 13-residue peptide resulted in its failure to stimulate protective antibodies . None of the antisera reacted with heterologous serotypes of M protein and none reacted with frozen sections of human heart tissue . These results indicate that a chemically synthesized peptide fragment corresponding to as few as 13 amino acid residues of streptococcal M protein is capable of evoking protective anti-streptococcal antibodies without evoking antibodies crossreactive with cardiac tissue.

Br Med J (Clin Res Ed), 1984 Mar 17, 288(6420), 816 - 7
Myocardial depression in streptococcal cellulitis; Edwards JD et al.; A previously healthy woman developed streptococcal cellulitis of the leg after falling and lacerating her knee . On admission her blood pressure was unrecordable and her respiratory rate greater than 60 beats/minute . Mechanical ventilation was necessary, and plasma volume expansion was started, with little effect . Infusion of dopamine restored the blood pressure to 150/90 mm Hg, but interrupting the infusion for as little as 30 seconds resulted in profound hypotension . Insertion of a second central venous catheter allowed the dopamine to be given continuously, and the infusion was stopped successfully four days after her admission . She eventually made a complete recovery . This case highlights the need for intensive supportive treatment in many streptococcal infections and, in particular, the need for inotropic support.

Int J Cardiol, 1984 Mar, 5(3), 376 - 9
Group C streptococcal endocarditis associated with intubation-induced tracheal stenosis; Jack CM et al.; We describe a 44-year-old woman with Group C haemolytic streptococcal endocarditis who developed tracheal stenosis as a result of endotracheal intubation . She recovered fully following valve replacement for continuing left ventricular failure due to mitral and aortic incompetence and subsequent resection of the stenosed tracheal segment with reanastomosis of the trachea.

J Am Acad Dermatol, 1984 Mar, 10(3), 511 - 7
An appraisal of measures to prevent and control psoriasis; Farber EM et al.; Prevention in a broad sense refers to limiting the progress of disease at any stage of its course; control refers to reduction in frequency and/or severity of a disease in a population . Measures to prevent and control psoriasis require a knowledge on behalf of both the physician and the patient to recognize genetic and environmental components in the onset and course of the disease . Triggering factors include streptococcal throat infection, injury, drugs, low humidity, and emotional stress . From a study of 102 severely affected psoriasis patients, the "Three-P Concept" for the management of psoriasis has evolved encompassing: (1) prevention of injury, (2) persistence in avoiding overtreatment, and (3) pauses or rest periods in the course of treatment with sedation, emolliation, and humidification . Educating psoriasis patients about their disease and encouraging them to take responsibility for self-care will lessen the morbidity.

Am J Med, 1984 Mar, 76(3), 367 - 75
Group B streptococcal arthritis in adults; Small CB et al.; Group B streptococcal arthritis in adults is uncommon . This report describes seven cases seen at these institutions over the past five years and reviews the previous 17 documented cases . Of seven adults, three were diabetics, three had prosthetic hips, and one had undergone splenectomy . Six had undergone no prior dental, genitourinary, or gastrointestinal procedures . The most common clinical presentation was fever and acute joint pain . Five patients had monoarticular arthritis; two had multiple joint involvement . Underlying joint abnormalities included osteoarthritis (two), prosthetic hip (three), and neuropathic joint (one) . Bacteremia was documented in three and suspected in the remaining four patients, often without a primary source . Therapy included parenteral antibiotics, usually penicillin G, and drainage of the involved joint . Two of three patients with prosthetic implants required Girdlestone procedures; the third was apparently cured . The three diabetic patients died, one with resolution of group B streptococcal arthritis . The seventh patient was cured . Group B streptococcal arthritis is a serious infection in adults with diabetes and late prosthetic hip infections.

J Dairy Sci, 1984 Mar, 67(3), 606 - 13
Inhibition of mastitic bacteria by bovine milk apo-lactoferrin evaluated by in vitro microassay of bacterial growth; Nonnecke BJ et al.; An in vitro microassay was developed to evaluate antimicrobial properties of bovine apo-lactoferrin . The growth of coliform, staphylococcal, and streptococcal bacterial strains in a defined synthetic medium was inhibited by bovine apo-lactoferrin (.5 to 30.0 mg/ml) . Addition of iron-saturated lactoferrin to the synthetic medium did not inhibit growth of test strains . Inhibition by apo-lactoferrin was greater for coliform than Gram-positive strains for all concentrations of apo-lactoferrin evaluated . No concentration of apo-lactoferrin proved bactericidal for either coliform or Gram-positive strains . Inhibition of two coliform strains by apo-lactoferrin (10 mg/ml) was abolished by addition of ferric iron to the assay system, indicating an iron-dependent nature of apo-lactoferrin induced inhibition of bacteria . Bicarbonate supplementation of the growth system containing apo-lactoferrin (1 mg/ml) increased inhibition of three coliform strains by apo-lactoferrin . Addition of increasing concentrations of citrate (2.0 mg/ml) to an assay system containing apo-lactoferrin (5 mg/ml) resulted in a concomitant reduction of growth inhibition of three coliform strains . These data indicate a potential relationship between the molar ratio of citrate to lactoferrin of the lacteal secretion and its capacity to inhibit coliform strains associated with mastitis.

Infect Immun, 1984 Mar, 43(3), 800 - 3
Monoclonal antibodies to immunodeterminants of lipoteichoic acids; Jackson DE et al.; Murine hybrid cell lines producing monoclonal antibodies directed against determinants present on lipoteichoic acids were generated . Hapten inhibition studies showed that one group of monoclonal antibodies was inhibited by deacylated cardiolipin, and the second group was inhibited by kojibiose . Thus, antibodies directed against the polyglycerophosphate chain, which is common to the lipoteichoic acids of many gram-positive species, and against the streptococcal group D antigen were obtained.

JAMA, 1984 Feb 24, 251(8), 1049 - 52
Recurrent cellulitis after coronary bypass surgery . Association with superficial fungal infection in saphenous venectomy limbs; Baddour LM et al.; Certain patients who have undergone coronary artery bypass grafts suffer from episodes of acute cellulitis, often repeatedly, in the saphenous vein donor extremity . We describe nine patients with this entity, five of whom suffered recurrent attacks (range, two to greater than 20) . The mean interval between surgery and the initial bout of cellulitis was 15 months (range, two to 46 months) . A characteristic clinical syndrome was present in the majority of patients that included the abrupt onset of chills, followed by fever (generally greater than 38.8 degrees C), prostration, and obvious cellulitis . Seven patients also suffered from tinea pedis; in two instances, measures to control the dermatophytosis were instituted and attacks ceased . The pathogenesis of the entity may involve complex interactions between fungal and bacterial agents . Factors such as direct bacterial infection, hypersensitivity to streptococcal exotoxins, and id reactions to dermatophytes are probably involved in varying combinations.

Arch Otolaryngol, 1984 Feb, 110(2), 127 - 9
Cryosurgery and OK 432 in the treatment of malignant melanoma; Enomoto T et al.; We used concomitant therapy that consisted of cryosurgery and injection of OK 432 (a hemolytic streptococcal preparation) in the treatment of a giant malignant melanoma that primarily arose from the hard palate to the alveolar process in a 69-year-old man . The tumor consequently disappeared completely . One and a half years later, there are no signs of relapse.

Circulation, 1984 Feb, 69(2), 223 - 32
Prosthetic valve endocarditis; Ivert TS et al.; Fifty-three (3.6%; actuarially 4.1% at 48 months) of 1465 consecutive in-hospital survivors of valve replacement from 1975 to July 1979 (aortic, mitral, or aortic and mitral, only one untraced) developed prosthetic valve endocarditis (PVE) . Incremental risk factors for developing PVE were native valve endocarditis (p less than .0001), black race (p = .0001), mechanical prosthesis (vs bioprosthesis) (p = .005), male sex (p = .04), and longer cardiopulmonary bypass time (p = .09) . In general, the hazard function for developing PVE was greatest at 3 weeks after valve replacement . Patients with native valve endocarditis had a tendency to develop PVE early after valve replacement, as did patients in whom mechanical prostheses were used . PVE associated with Staphylococcus epidermidis tended to appear within 6 months of valve replacement, whereas streptococcal PVE tended to appear later after valve replacement . PVE took an atypical form in some patients, but patients with possible PVE (n = 6) had the same findings as those with certain PVE (n = 47) . In 11 patients bacteriologic confirmation of PVE was not obtained . The typical prosthetic and periprosthetic characteristics of PVE were present in 30 of the 40 cases in which observations were possible . PVE is a serious condition; 34 (64%) of our 53 patients died . Most deaths occurred within 3 months of the first evidence of PVE . Recovery of some patients is possible with appropriate medical and surgical treatment, but more intense preventive measures are indicated.

J Surg Oncol, 1984 Feb, 25(2), 92 - 7
Impairment of thymus-derived lymphoid cell function in patients with basal cell carcinoma; Dellon AL et al.; The host-tumor relationships in 34 patients with basal cell carcinoma was investigated by characterizing thymus-derived (T) and bone marrow-derived (B) lymphoid subpopulations in the blood by cell surface markers and lymphoid function in vitro by proliferative responses to mitogenic and antigenic stimulation . Results were correlated with tumor stage . In patients with tumor present, the data demonstrate significantly (P less than .02) decreased responsiveness of T cells to the lectin mitogens phytohemagglutinin and concanavalin A, and further demonstrate significantly decreased responsiveness of T cells to antigens (P less than .001 for Candida antigen, P less than .05 for Staphylococcal filtrate and Streptococcal varidase) . In patients who were grossly disease free after resection of tumors, there was no significant difference in these responses from normal . These results document, for the first time, impaired T-cell function in patients with basal cell carcinoma and suggest that the functional impairment is tumor induced.

Appl Environ Microbiol, 1984 Feb, 47(2), 343 - 9
Differentiation of lactic streptococcal phages into phage species by DNA-DNA homology; Jarvis AW; Twenty-five lactic streptococcal bacteriophages were differentiated by DNA homology into four species . Complete correlation was found between DNA homology groups and morphological characteristics of the phages except that two phage types, which differed in only the presence or absence of a collar, were one species by DNA homology . These findings were supported by serological data and differences in DNA molecular weights of the proposed species . The complete lack of homology between these phage species indicates that they are unlikely to have a recent common phage ancestor and that one morphological type of phage has not been derived by mutation from a phage of another morphological type.

Int J Oral Surg, 1984 Feb, 13(1), 7 - 15
Effects of intradermal administration of streptococcal preparation OK-432 on interferon and natural killer cell activities in patients with oral cancer; Sato M et al.; The streptococcal preparation OK-432 was used by intradermal administration as an immunotherapy in 18 patients with oral cancer, and the sera from patients during OK-432 treatment were serially assayed for interferon (IFN) activity by the plaque-reduction method with vesicular stomatitis virus in FL cells derived from human amniotic membrane . The type of serum IFN was characterized by acid-treatment and neutralization test with anti-IFN-alpha and anti-IFN-beta antisera . IFN-gamma was expressed for its titer as the residual IFN activity after neutralization with both antisera . An intradermal injection of OK-432 transiently induced IFN activity and 3 patterns in the type and level of the produced IFN were observed . Although most of the patients induced IFN-gamma and acid-stable IFN or only IFN-gamma, 2 patients seemed to be unresponsive to OK-432 . When we examined the relationship between natural killer (NK) activity and IFN titer, a sharply declined NK activity was found immediately post OK-432 administration, and then NK activity stayed around the pretreatment level . Most of the tested patients' induced IFN-gamma, preceding the step toward the gradual increase in NK activity, decreased with OK-432 . However, even in the patients showing no IFN induction with OK-432, a significant decrease of NK activity occurred.

Cancer, 1984 Jan 15, 53(2), 248 - 53
Clinical value of immunotherapy for lung cancer by the streptococcal preparation OK-432; Watanabe Y et al.; A streptococcal preparation, OK-432 was employed as the adjuvant immunotherapeutic agent for lung cancer . To evaluate the clinical efficacy of the OK-432, patients admitted between 1975 and 1979 were randomized into two groups: (1) an immunochemotherapy group and (2) a chemotherapy, or control, group . For evaluation of long-term survival, there were 108 cases in the immunochemotherapy group and 103 cases in the chemotherapy group . When comparing the prognosis of the two groups, the survival rate was statistically higher in the immunochemotherapy group than the control group . The resected cases in Stages I and II showed better prognosis with immunochemotherapy than the cases in the same stages treated with chemotherapy alone . Among the resected cases in the more advanced stages, mostly Stage III and a few cases in the Stage IV, the cases treated with immunochemotherapy also showed more favorable prognosis than the cases treated with chemotherapy alone . In terms of the cell type of the lung cancer, the cases with epidermoid carcinoma in Stages I and II showed significantly better prognosis with immunotherapeutics than the control group . The cases with positive reaction to the streptococcal polysaccharide skin test apparently showed better prognosis than those with negative reaction.

Postgrad Med J, 1984 Jan, 60(699), 73 - 4
Acute post-streptococcal glomerulonephritis following ear piercing; Ahmed-Jushuf IH et al.; A case of post-streptococcal glomerulonephritis following ear-piercing is reported . It illustrates a rare but life-threatening complication of a cosmetic procedure carried out under unhygienic conditions.

Obstet Gynecol, 1984 Jan, 63(1), 105 - 9
Neonatal passive immunization by maternal vaccination; Amstey MS et al.; An old concept--passively immunizing a fetus by actively immunizing (vaccinating) its mother--is reevaluated in light of 50 years of data . The history and data reviewed here suggest that this concept is one whose time has come for active modern research and clinical use . In Third World countries, this concept already has provided significant reduction in morbidity and mortality from neonatal infections such as tetanus . Some other neonatal and infant infections--heretofore life-threatening--may now have a practical method for prevention . These include group B beta-streptococcal sepsis and Hemophilus influenzae meningitis.

Proc Natl Acad Sci U S A, 1984 Jan, 81(1), 282 - 5
Streptococcal L-forms isolated from Drosophila paulistorum semispecies cause sterility in male progeny; Somerson NL et al.; The Drosophila paulistorum complex contains six semispecies that do not normally interbreed . In the laboratory, crosses between semispecies produce fertile daughters and sterile sons . Microbial endosymbionts have been observed in all D . paulistorum flies that display this male sterility . Streptococcal L-forms have been isolated from the Andean-Brazilian (Mesitas) and Transitional (Santa Marta) semispecies and cultured in artificial medium . Transfer of these L-forms from their native hosts into reciprocal semispecies resulted in sterile male progeny . When L-forms were inoculated into the semispecies from which they had been isolated, most of the male progeny were fertile . Control streptococcal L-forms did not show this sterility pattern.

Cancer Immunol Immunother, 1984, 17(1), 1 - 6
Natural cytotoxicity of lymphocytes from lymph nodes draining breast carcinoma and its augmentation by interferon and OK432; Yanagawa E et al.; Lymphocytes isolated from axillary lymph nodes draining breast carcinoma were tested for natural killer (NK) activity against K562 in a 4-h 51Cr-release assay, and the in vitro effects of interferon (IFN) and OK432 (a streptococcal preparation) on their cytotoxicity were examined in comparison with NK activity of autologous peripheral blood lymphocytes (PBL) . The levels of NK activity were lower in lymph node lymphocytes (LNL) than in PBL of the same patients . Significant levels of LNL-mediated lysis were recorded in 14 of 42 (33%) lymph node samples and in nine of 14 (64%) patients . Purification of large granular lymphocytes (LGL) from lymph node cells by discontinuous Percoll density gradient centrifugation resulted in an induction or enhancement of cytotoxic activity, with no reactivity in LGL-depleted, small T-lymphocyte populations . Positive reactions were observed with 10 of 13 (77%) LGL samples . The low reactivity of LNL was not attributable to coexistent suppressor cells for NK function, since lymph node cells failed to suppress NK activity of normal PBL . Partially purified human IFN and OK432 augmented NK activity of patients' PBL in approximately 70% and 90% of the cases, respectively, while LNL-mediated lysis was augmented in only 7% and 36% of the lymph node samples by IFN and OK432, respectively . These results indicate that K562-reactive NK cells and/or their precursors may frequently be present at subthreshold levels in the lymph nodes draining breast carcinoma, and that the augmentation of LNL-mediated cytotoxicity by OK432 might provide a local potentiation of natural immune function at the host-tumor interface rather than IFN.

EMBO J, 1984 Jan, 3(1), 185 - 91
Evolution of a multigene family of V kappa germ line genes; Joho R et al.; We have isolated a series of related V kappa germ line genes from a BALB/c sperm DNA library . DNA sequence analysis of four members of this V kappa 24 multigene family implies that three V kappa genes are functional whereas the fourth one (psi V kappa 24) is a pseudogene . The prototype gene (V kappa 24) encodes the variable region gene segment expressed in an immune response against phosphorylcholine . The other two functional genes (V kappa 24A and V kappa 24B) may be expressed against streptococcal group A carbohydrate . The time of divergence of the four genes was estimated by the rate of synonymous nucleotide changes . This implies that an ancestral gene has duplicated approximately 33-35 million years ago and a subsequent gene duplication event has occurred approximately 23 million years ago.

Mol Gen Genet, 1984, 194(3), 362 - 7
Evolutionary relationships of the Bacillus licheniformis macrolide-lincosamide-streptogramin B resistance elements; Israeli-Reches M et al.; Naturally occurring erythromycin (Em) resistance was found in 11 of the 18 Bacillus licheniformis isolates tested but was absent from a wide variety of other Bacillus strains . The Em resistance elements confer inducible macrolide-lincosamide-streptogramin B (MLS) resistance and are related to ermD , an MLS resistance element previously cloned from the chromosome of B . licheniformis 749 . The MLS sensitive B . licheniformis strains and the other sensitive Bacillus strains tested, lack sequences with detectable homology to ermD . The sensitive B . licheniformis strains do exhibit homology to sequences which flank ermD in B . licheniformis 749 . The relative sizes of the homologous DNA fragments suggest that the sensitive strains are lacking a 3.6 kb segment which contains ermD . It is shown that ermD is homologous to chromosomal DNA from Streptomyces erythreus ATCC 11635, an Em producing organism . These observations suggest to us that MLS resistance may have arisen in the Streptomyces and spread to B . licheniformis, another gram positive bacterium found in soil . It is further proposed that ermD is or was located on a transposon-like element and has spread and evolved further to yield a variety of related Staphylococcal and Streptococcal MLS determinants.

Int Surg, 1984 Jan-Mar, 69(1), 75 - 80
An experimental study on cellular immunity and protein-calorie malnutrition; Miyoshi T et al.; The effect on cellular immunity of the administration of the non-specific immunopotentiator BCG and/or a streptococcal agent was studied in 90 non-cancer bearing Wistar rats under different nutritional support . The number of immunocompetent cells and the non-specific function of the immunocompetent cells significantly decreased in acute malnutrition . The non-specific immunopotentiator BCG and streptococcal agent activated the peritoneal macrophages, to a remarkable extent, but depressed spleen cell blastoid transformation, thymus index and peripheral lymphocyte count in the starved rat group . In rats who received BCG under intravenous hyperalimentation (IVH), the absolute macrophage counts went down as the quantity of amino-acid administered decreased . The acquired immunodeficiency due to acute malnutrition is evident and the effect obtained with an immunopotentiator is considered to be related to the nutritional status of the host . The adequate administration of protein-calorie is required for the effective use of the immunopotentiator.

Int Arch Allergy Appl Immunol, 1984, 74(1), 21 - 8
Streptococcal preparation OK-432-induced interferon in human leukocytes: purification and characterization; De Ley M et al.; Interferon production was induced in leukocyte suspensions from human buffy coats after stimulation with the streptococcal preparation OK-432 . At day 2-3 the induced interferon reached a maximal level of 0.9 units/1,000 cells . By a combination of batch adsorption/elution on silicic acid, batch adsorption to DEAE-Sephacel, affinity chromatography on concanavalin A-Sepharose and on poly(U)-Sepharose, this interferon could be purified to a specific activity of 10(7.5) units/mg protein . The antiviral activity was characterized as being solely due to gamma-type interferon by a variety of physicochemical, biochemical and serological criteria . Its molecular weight as determined by gel filtration amounted to 53,000 daltons, and its activity was completely neutralized by highly specific antisera to human gamma-type interferon (45K) . The OK-432-induced interferon, as the crude supernatant of stimulated leukocytes, and at several stages of its purification, was found to stimulate the natural killer cell activity of fresh human lymphocytes.

J Exp Med, 1984 Jan 1, 159(1), 179 - 92
Multiple VH gene segments encode murine antistreptococcal antibodies; Perlmutter RM et al.; Most mouse strains are able to mount a diverse antibody response against group A streptococcal carbohydrate (GAC) . We have previously reported that murine anti-GAC antibodies are for the most part restricted to IgM and IgG3 subclasses . In addition, despite extensive heterogeneity in their isoelectric focusing patterns, greater than 50% of A/J anti-GAC antibodies share a common light chain defined by spectrotypic and idiotypic (VK1GAC) criteria . We have used protein and DNA sequencing strategies to examine the genetic basis of diversity in murine anti-GAC antibodies . In particular, we report that, (a) multiple, closely homologous VH gene segments contribute to the generation of anti-GAC antibodies, (b) a common framework sequence, related to the VK27 subgroup, probably defines VK1GAC, and (c) the A/J anti-GAC VH regions and BALB/c anti-inulin VH sequences are 95% homologous at the protein level and are likely encoded by overlapping VH gene families . Lastly, we discuss the genetic mechanisms that might permit the evolution of multiple, closely homologous germline VH gene segments in the context of highly divergent flanking region sequences.

Mol Gen Genet, 1984, 194(1-2), 52 - 6
Group A streptococcal phage T12 carries the structural gene for pyrogenic exotoxin type A; Johnson LP et al.; The structural gene for group A streptococcal pyrogenic exotoxin (SPE) type A was cloned into E . coli . DNA fragments used for cloning the toxin gene were isolated from bacteriophage T12 . Toxin, present in cell lysates of E . coli clones, immunoprecipitated with antisera raised against purified SPE type A and formed a line of identity with streptococcal-derived A toxin . The cloned toxin shared the following biological activities with streptococcal A toxin: Pyrogenicity; enhancement of host susceptibility to lethal endotoxin shock; nonspecific lymphocyte mitogenicity; and alteration of immunoglobulin production . The physical location of the toxin gene on the phage T12 genome was determined.

Pediatr Infect Dis, 1984 Jan-Feb, 3(1), 10 - 3
The effect of penicillin therapy on the symptoms and signs of streptococcal pharyngitis; Nelson JD; The effect of antibiotic therapy on the rate of resolution of signs and symptoms of streptococcal pharyngitis in children has not been previously evaluated in a placebo-controlled study . Patients were randomly assigned to penicillin or placebo therapy and reevaluated after 48 hours, at which time benzathine penicillin G was given to all patients . Rates of improvement in treated (17 patients) or control (18 patients) cases significantly favored treatment with regard to resolution of pharyngeal injection, tender cervical lymph node and total duration of fever . Symptoms of sore throat and the parents' assessment of the well-being of their children also significantly favored treatment . This study confirmed the clinical impression of physicians that specific antibiotic therapy promptly alleviates symptoms in most children with streptococcal pharyngitis.

Clin Exp Immunol, 1984 Jan, 55(1), 115 - 24
Antibody to streptococcal cell wall peptidoglycan-polysaccharide polymers in seropositive and seronegative rheumatic disease; Johnson PM et al.; An ELISA has been developed for serum antibodies to streptococcal cell wall peptidoglycan-polysaccharide polymers (PG-GSP) . A significantly increased prevalence of serum anti-PG-GSP antibody was found in juvenile chronic arthritis and both seropositive and seronegative rheumatoid arthritis (RA), compared with ankylosing spondylitis, systemic lupus erythematosus, myeloma and healthy controls . Anti-PG-GSP antibody was always of the IgG class and there was no correlation of anti-PG-GSP levels with C reactive protein, rheumatoid factor (RF) or anti-streptolysin O titres . There was no direct cross-reaction of RF with PG-GSP, nor did the presence of IgM-RF significantly interfere with the assay . Examination of paired serum and synovial fluid samples offered no evidence for local production of anti-PG-GSP antibody in synovial tissue . These data are compatible with an increased systemic immunization by bacterial fragments in RA.

Cancer Immunol Immunother, 1984, 18(3), 215 - 22
Antitumor and therapeutic effects of spleen cells from tumor-bearing mice cultured with T cell growth factor and soluble tumor extract; Kan N et al.; Spleen cells of BALB/c mice that had been inoculated with syngeneic plasmacytoma MOPC 104E were cultured for 11 days in T-cell growth factor (TCGF) and ultrasonicated tumor extract (USE) . Cultured lymphocytes (MOPC-CL) possessed three-fold more lytic units than normal spleen cells cultured in TCGF without USE (N-CL) . Moreover, the in vivo neutralization assay suggested that MOPC-CL were composed of at least two populations, one possessing tumor-specific and the other nonspecific antitumor activity . When 2 X 10(7) of MOPC-CL were administered IP to mice that had been inoculated IP with 10(5) MOPC 104E cells 5 days previously marginal prolongation of survival was observed . This effect was not augmented by the single injection of a larger number (5 X 10(7} of CL, but was augmented by the repeated daily administration for 4 days (from day 5 to day 8 after the inoculation) of the same total number (5 X 10(7} of CL . In addition, IP injection of the streptococcal preparation OK432 before the transfer of CL significantly enhanced the therapeutic efficacy, and resulted in a cure rate of 20% . The mechanism of this combined effect appears to involve the effect of OK432 on interleukin 2 (IL-2) regulation systems in vivo . Our culture system with TCGF and USE and our therapy system with OK432 and CL allow the clinical application of adoptive immunotherapy for the many types of solid cancers.

Cancer Immunol Immunother, 1984, 18(1), 5 - 12
Intrapleural administration of OK432 in cancer patients: augmentation of autologous tumor killing activity of tumor-associated large granular lymphocytes; Uchida A et al.; Ten patients with carcinomatous pleural effusions were treated with single intrapleural (i.pl.) injections of the streptococcal preparation OK432 on day 0 and the effects of i.pl . OK432 on the lysis of fresh or cryopreserved autologous tumor cells isolated from the pleural effusions were observed on day 7 . In eight patients tumor cells in the effusions had decreased or disappeared by day 7 . The other two patients, however, had no clinical evidence of therapeutic benefit from i.pl . OK432 . Effusion tumor cells were relatively resistant to lysis by autologous lymphocytes when tested in a 4-h 51Cr-release assay . Positive reactions were recorded for blood and effusion lymphocytes in two of ten untreated patients . Injection of OK432 i.pl . resulted in an induction or augmentation of cytotoxicity against autologous tumor cells and K562 in the effusions of seven of ten subjects by day 7 . In contrast, autologous tumor killing activity of blood lymphocytes was not always modified by i.pl . OK432 . Purification of large granular lymphocytes (LGL) by discontinuous Percoll gradient centrifugation enriched autologous tumor killing activity, with no reactivity in LGL-depleted, small T lymphocytes . Significant lysis of autologous tumor cells was observed with effusion LGL from seven of ten untreated patients . Seven days after i.pl . OK432 injection, effusion LGL expressed enhanced cytotoxicity against autologous effusion tumor cells, whereas T cells were still not cytotoxic to autologous tumor cells on day 7 . The frequency of LGL among effusion lymphocytes was not altered by i.pl . OK432 . Adherent effusion cells were not involved in lysis of autologous effusion tumor cells in either untreated or OK432-treated patients . In vitro treatment of blood and effusion lymphocytes with OK432 induced an enhancement of autologous tumor-killing activity in patients who subsequently responded to i.pl . OK432 treatment . OK432 augmented in vitro autologous tumor killing activity of LGL, whereas T cells failed to lyse autologous tumor cells even after in vitro activation with OK432 . These results indicate that i.pl . administration of OK432 to cancer patients will result in an augmentation of autologous tumor killing activity of LGL in the pleural effusions, and that this could be responsible for the antitumor activity of i.pl . OK432 therapy.

Mol Biol (Mosk), 1984 Jan-Feb, 18(1), 189 - 96
{Cloning of genetic material in Bacillus}; Rabinovich PM et al.; Plasmid vectors capable for propagation of Bacillus subtilis DNA fragments containing riboflavin genes were constructed . Cloning of rib operon using pUB110 derivatives was performed in recE4 strain by using sequentional rescue of plasmids containing subfragments of the operon . Also, rib operon was cloned on the vectors containing DNA repeats . It was shown that the presence of direct and inverted repeats within plasmids allows to transform B . subtilis cells by monomers of plasmid DNA . Vectors that contained repeated sequences of DNA and ensured efficient cloning of genetic material in B . subtilis recipient cells were constructed . The use of streptococcal plasmid pSM19035 allowed to obtain vectors which were suitable for cloning large DNA fragments (6 MD and even more) in B . subtilis . A model of B . subtilis transformation by various types of plasmid DNA is presented . The model is in agreement with the general conception of chromosomal DNA transformation.

Clin Nephrol, 1984 Jan, 21(1), 82 - 5
The future of nephrologic research: significance and urgent problems; Lange K; The problems in the diagnosis and especially the pathogenetic mechanism of IgA nephropathy are discussed and suggestions are made that this entity may not be a renal disease of primary renal immunogenetic origin but may be a disease of disturbed mesangial transport mechanism for IgA . Suggestions are made for intensive studies on the pathogenesis and differential diagnosis of focal glomerulosclerosis vs . minimal change disease (lipoid nephrosis) especially by immunohistology and T Cell sub-set abnormalities . It is suggested to study minimal change disease from the viewpoint of a T Cell immunodeficiency with lymphokines as a permeability changing factor . Depressed antibody formation in such partially immunodeficient patients may be important for differential diagnosis from other nephrotic stages . The immunology of acute glomerulonephritis as caused by cytoplasmic streptococcal antigens requires further study together with resultant chronic glomerulonephritis on an auto-antibody basis . The disputed merits of plasmapheresis require further detailed studies . The investigation of the suggested importance of nephrectomies on the renal function of kidney donors is of utmost importance in view of its relation to the future of live donor transplantations.

Cancer Immunol Immunother, 1984, 16(3), 131 - 6
Natural cytotoxicity of lymphocytes and monocytes and its augmentation by OK432 in melanoma patients; Yanagawa E et al.; Lymphocytes and monocytes from the peripheral blood of 30 patients with malignant melanoma were tested for natural cytotoxicity against K562 cells in a 3-h 51Cr-release assay, and the effects of OK432 (a streptococcal preparation) on the cytotoxicity were examined . The lymphocyte cytotoxicity of melanoma patients was similar to that of normal donors and control patients with benign skin disease . Furthermore, the lymphocyte cytotoxicity of melanoma patients was not correlated to the stage of the disease . Similarly, lysis of K562 cells by monocytes isolated by adherence to autologous serum-coated plastic dishes in melanoma patients was comparable to that of controls and not associated with the stage of the disease . Positive monocyte reactions were recorded in 10 of 30 (33%) melanoma patients, seven of 21 (33%) normal donors and three of 10 (30%) control patients . There was no correlation between lymphocyte cytotoxicity and monocyte cytotoxicity . Overnight treatment of monocytes and lymphocytes with OK432 resulted in an increase in cytotoxicity . Significant augmentation of cytotoxicity by OK432 was observed in 28% of the monocyte samples and 86% of the lymphocyte samples, while partially purified human interferon augmented cytotoxicity in 63% of the monocyte samples and all the lymphocyte samples . These results suggest that neither lymphocyte nor monocyte cytotoxicities are depressed in melanoma patients as compared with normal donors and patients with benign disease and that OK432 has a stronger stimulatory effect on lymphocytes than on monocytes.

Biochem Biophys Res Commun, 1983 Dec 16, 117(2), 359 - 66
Epitope specific immunity elicited by a synthetic streptococcal antigen without carrier or adjuvant; Jolivet M et al.; A polypeptide fragment of type 24 streptococcal M protein (pep M24) has been shown to raise protective anti-streptococcal antibodies in rabbits and humans when administered with adjuvants . More recently, such protective antibodies were shown to be evoked by a synthesized 35-residue sub-peptide fragment (S-CB7 synthetic cyanogen bromide fragment 7) of pep M24 . We now show that the weak pep M24 immunogen induces high titers of long lasting antibodies when associated with murabutide, a synthetic derivative of MDP (NAcMur-L-Ala-D-Gln-n-butyl-ester) which is currently undergoing clinical trials . We demonstrate also that the polymerized synthetic S-CB7 administered without adjuvant or carrier evokes a strong epitope specific, protective immune response in mice primed with the parent pep M24 . A booster dose of polymerized S-CB7 induced antibodies directed specifically against the S-CB7 structure whereas a booster dose of pep M24 evoked antibodies recognizing additional determinants of the whole pep M24 molecule.

Can Med Assoc J, 1983 Dec 15, 129(12), 1289 - 90
Group B streptococcal septicemia and delayed-onset congenital right-sided diaphragmatic hernia; Akierman AR et al.; A case is reported of fulminant early-onset group B streptococcal septicemia and delayed-onset congenital right-sided diaphragmatic hernia in a neonate . The latter condition should be considered when early-onset group B streptococcal disease is followed by increasing respiratory distress, right-sided pleural effusion and partial or complete opacification of the right side of the thorax.

J Rheumatol, 1983 Dec, 10(6), 845 - 51
Hypothesis: in vitro evidence for the invasive and tumor-like properties of the rheumatoid pannus; Hamilton JA; It is often considered that the inflammatory processes in the rheumatoid synovium are due to an immune response to an as yet unknown antigen; the resultant pannus has been referred to as "aggressive, invasive, proliferative and tumor-like." Data are presented which show that arthritogenic group A streptococcal cell walls stimulate human monocyte-macrophages to elevate the plasminogen activator (PA) activity of human synoviocytes . By analogy with other cellular systems, it is suggested that the monocyte-macrophage mediated elevation of synoviocyte PA activity can contribute to the tissue remodelling and cell migration found in the rheumatoid pannus . It is also proposed that the active moiety from the stimulated monocyte-macrophages is able to mimic, to some extent, the effects of transforming viruses and tumor promoters on cell function . This concept of a "tumor-like" synoviocyte transformation is suggested as being consistent with the descriptions of the rheumatoid pannus as "aggressive, invasive and tumor-like." Perhaps similar cellular interactions occur in other inflammatory diseases involving connective tissue turnover and cellular hyperplasia.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Dec, 91(6), 401 - 6
Solid-phase radioimmunoassay of immunoglobulin G antibodies to Staphylococcus aureus peptidoglycan in patients with staphylococcal infections; Christensson B et al.; A solid-phase radioimmunoassay (SPRIA) for determination of antibodies against S . aureus peptidoglycan was used for serological diagnosis of staphylococcal infections . Elevated IgG antibody levels were found in 21/21 patients with S . aureus endocarditis and in 10/24 patients with S . aureus septicemia . Two patients with streptococcal and one patient with pneumococcal septicemia showed elevated antibody levels as well, probably due to cross reactions between peptidoglycans of different bacterial species . In cases of chronic osteomyelitis caused by S . aureus, 12/33 patients showed elevated antibody levels while all patients with recurrent furunculosis had normal antibody levels . Anti-peptidoglycan antibodies were also found in all healthy controls (n = 160) but at lower levels . This might explain the rapid booster response of IgG antibodies found in 73 per cent of patients with S . aureus endocarditis already within 10 days after the first symptoms . The best clinical value of the assay seems to be in separating S . aureus endocarditis from uncomplicated septicemia.

Arch Intern Med, 1983 Dec, 143(12), 2316 - 7
Pseudorheumatoid subcutaneous nodules and the poststreptococcal state . A case report; Dagan B et al.; A 10-year-old girl with an acute illness fulfilling the Jones criteria for rheumatic fever is described . She had subcutaneous nodules, arthritis, an elevated ESR, and serologic evidence of a recent streptococcal infection . Her clinical course was benign and at ten weeks, the nodules disappeared, the joint pains had subsided, and the ESR was normal . Thus, there was little to support a diagnosis of rheumatic fever . We hypothesize that the patient had pseudorheumatoid subcutaneous nodules coincidental with poststreptococcal arthritis . A revision of the Jones criteria disallowing subcutaneous nodules as an independent major sign of rheumatic fever is proposed.

Clin Pediatr (Phila), 1983 Dec, 22(12), 798 - 801
Incidence of acute rheumatic fever . A suburban community hospital experience during the 1970s; Schwartz RH et al.; The incidence of acute rheumatic fever has declined remarkably in the past three decades, but the disease has not been eradicated, as some physicians believe . This study documents the diagnosis of the disease in 23 middle-class children from Fairfax County, Virginia, during the 11-year-period from 1970 through 1980 . This county has one of the highest median family incomes in the United States . The annual age-adjusted incidence rate of initial attacks of acute rheumatic fever per 100,000 Fairfax County children declined from 3.0 in 1970 to 0.5 in 1980 . In six of the 23 children, carditis accompanied by monarticular arthritis or arthralgia was present . Another seven children had carditis plus polyarthritis . Two patients had Sydenham's chorea . None of the children had erythema marginatum or rheumatoid nodules . In two children, symptoms of acute rheumatic fever developed two weeks after they finished a 10-day course of penicillin for Group A streptococcal pharyngitis . The remaining 21 children had not been considered ill enough to be brought to medical care prior to development of symptoms of acute rheumatic fever.

Arthritis Rheum, 1983 Dec, 26(12), 1442 - 51
The pathogenesis of group A streptococcal cell wall-induced polyarthritis in the rat . Comparative studies in arthritis resistant and susceptible inbred rat strains; Wilder RL et al.; This report addresses the host mechanisms which regulate susceptibility and resistance to group A streptococcal cell wall-induced polyarthritis in the rat . We have compared cell wall tissue distribution and persistence following a single intraperitoneal injection of an aqueous suspension of the cell walls into arthritis susceptible LEW/N and resistant F344/N female rats . Selected aspects of the induced inflammatory reaction were also compared . Our results suggest that development of chronic erosive polyarthritis in this model is dependent, in variable degrees, upon 1) deposition and persistence of the cell walls in synovial tissues, and 2) a relative inability of arthritis susceptible rats to neutralize the proinflammatory properties of the cell walls.

Clin Nephrol, 1983 Dec, 20(6), 271 - 9
Cationic antigens in poststreptococcal glomerulonephritis; Vogt A et al.; Antigen charge is an important factor in the pathogenesis of experimental immune complex glomerulonephritis . Its potential role in man was investigated in post-streptococcal glomerulonephritis, a disease where the causative agent is known . Cationic, extracellular streptococcal antigens were detected in 8 of 18 renal biopsies from patients with acute poststreptococcal glomerulonephritis (APSGN) . The antigen was found mainly in earlier biopsies in which both IgG and IgM were present . Patients' sera taken at the time of biopsy contained antibody to cationic, streptococcal antigens . Cationic moieties are known to have affinity for the glomerular basement membrane and it is possible that the type of antigen described here initiates APSGN via in situ immune complex formation.

Jpn Circ J, 1983 Nov, 47(11), 1293 - 7
Anti-streptococcal cell membrane and anti-human glomerular basement membrane titers in sera of patients with poststreptococcal acute glomerulonephritis and anaphylactoid purpura; Okuhara K et al.; To clarify the immunological mechanisms in poststreptococcal acute glomeulonephritis (PSAGN) and anaphylactoid purpura (AP), anti-streptococcal cell membrane (anti-SCM) and anti-human glomerular basement membrane (anti-GBM) titers in the sera of patients with PSAGN and AP were determined by passive hemagglutination with chromic chloride-treated sheep erythrocytes . Sodium lauryl sulfate (SLS) soluble SCM and collagenase soluble GBM were used as soluble antigens . Positive anti-SCM titers (greater than 1:8) were demonstrated in 10 of 14 patients (71.4%) with PSAGN and in 4 of 9 patients (44.4%) with AP with evidence of antecedent streptococcal infection . Two of 4 patients with AP without evidence of antecedent streptococcal infection had positive anti-SCM titers . No correlation was noted between anti-streptolysin O (ASO) titers and anti-SCM titers in patients with PSAGN or AP, but many patients with high ASO titers also had high anti-SCM titers . No positive anti-GBM reactions were detected in patients with PSAGN or AP . No cross-reactions were noted between SLS soluble SCM and collagenase soluble GBM.

Jpn Circ J, 1983 Nov, 47(11), 1290 - 2
Annual changes of upper limit of ASO titer in school children; Fujikawa S et al.; ASO titers of school children were studied during a period from 1975 to 1981, and the annual difference of this titer was investigated . As reported by many authors, the upper limit of normal ASO titer was 250 units and values of 333 units or more should be considered abnormal in our series of children, because 15 to 20% of the population had an antibody titer of 333 units or more . The upper limit of the normal titer was the highest in 1975 when 19.7% of the children showed more than 500 units, and the lowest in 1980 when 20.1% of the children showed more than 80 units . Thus, there was a six-dilution difference in the normal upper limit between these 2 years . We must consider the annual changes of the normal upper limit of streptococcal antibody titer in order to make an accurate diagnosis.

Infect Immun, 1983 Nov, 42(2), 796 - 801
Cutaneous inflammatory reactions to group A streptococcal cell wall fragments in Fisher and Lewis inbred rats; Allen JB et al.; Systemic administration of an aqueous suspension of group A streptococcal cell wall fragments induces severe, chronic erosive polyarthritis in LEW/N female rats, but rarely in F344/N female rats . In the present study, we attempted to exclude unresponsiveness to the cell walls as a mechanism for arthritis resistance in F344/N females . Cutaneous inflammatory reactions were assessed in both strains at various time points after direct injection of cell wall fragments of three different average molecular weights . Fragments of all sizes induced an acute inflammatory reaction, with infiltration of polymorphonuclear leukocytes and a few mononuclear cells . Small fragments (approximately 5 megadaltons) induced a transient response which resolved by day 14 . Large fragments (approximately 500 megadaltons) induced severe inflammation characterized by prominent mononuclear leukocyte infiltration, whereas the intermediate-sized fragments (approximately 50 megadaltons) induced inflammation of intermediate intensity and duration . The intensity and severity of the lesions paralleled the persistence of cell wall antigens at the site of deposition . F344/N female rats responded acutely to the cell walls, with an intensity equal to or greater than that of LEW/N female rats, but the lesions tended to resolve more rapidly . These findings indicate that severity and chronicity of streptococcal cell wall-induced inflammation are dependent on the size of the fragment and provide evidence that arthritis resistance in F344/N female rats does not result from a completely unresponsive state to the proinflammatory effects of the cell walls.

J Infect Dis, 1983 Nov, 148(5), 795 - 801
Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease . I . Epidemiologic rationale; Boyer KM et al.; Between 1973 and 1981, 61 cases of neonatal group B streptococcal early-onset disease occurred among 32,384 infants born at Michael Reese Hospital and Medical Center, Chicago . Forty-one (67%) of the 61 affected infants were bacteremic at birth, implying intrapartum acquisition of infection . No significant deviations from the overall attack rate of 1.9 per 1,000 live births were associated with maternal demographic factors, but increased attack rates were associated with birth weights of less than or equal to 2.5 kg (7.9 per 1,000), rupture of amniotic membranes greater than 18 hr before birth (7.6 per 1,000), and intrapartum fever (6.5 per 1,000) . Forty-five (74%) of the 61 affected infants and 15 (94%) of the 16 with fatal outcome had one or more of these three perinatal risk factors . Based on an intrapartum vaginal carriage rate of 16.7% among parturients with perinatal risk factors, an attack rate of 45.5 per 1,000 was estimated for infants born to colonized "high-risk" parturients, a subgroup comprising approximately 3% of our obstetric population . These findings provide a compelling epidemiologic rationale for trials of selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease.

J Rheumatol Suppl, 1983 Nov, 10, 54 - 8
Immunogenetic analysis of rheumatoid arthritis; Sasazuki T; Statistical association between rheumatoid arthritis (RA) and the HLA-D region antigen, HLA-DR4-MT3, was confirmed . HLA-linked immune suppression genes (Is-genes) were demonstrate, which controlled proliferative T cell response to streptococcal cell wall antigen or IgE response to cedar pollen antigen in vitro . The absence of such genes may predispose to autoimmune diseases or allergy . An HLA-linked Is-gene in negative linkage disequilibrium with HLA-DR4-MT3 was proposed to be one of the most likely genetic factors determining the resistance to RA.

J Exp Med, 1983 Nov 1, 158(5), 1727 - 32
Type-specific immunogenicity of a chemically synthesized peptide fragment of type 5 streptococcal M protein; Dale JB et al.; We determined the antigenic specificity and protective immunogenicity of two chemically synthesized peptides of type 5 streptococcal M protein . The synthetic peptides, designated S-M5(1-20) and S-M5(20-40), represent the amino-terminal amino acid sequence of the native pepsin-extracted M5 molecule, which is known to contain at least one heart cross-reactive epitope . Initial studies showed that neither of the synthetic peptides was able to bind purified heart-reactive M5 antibodies . In addition, S-M5(1-20), but not S-M5(20-40), contained type-specific antigenic determinants as measured by enzyme-linked immunosorbent inhibition assays . When covalently linked to tetanus toxoid, S-M5(1-20), but not S-M5(20-40), evoked significant levels of type-specific, opsonic (and presumably protective) antibodies in rabbits without evoking heart cross-reactive antibodies.

Virology, 1983 Oct 30, 130(2), 514 - 22
A DNA substitution in the group A streptococcal bacteriophage SP24; Spanier JG et al.; When the group A streptococcal bacteriophage SP24 was propagated on an unrelated host strain CS112, it underwent a DNA rearrangement: the rearrangement involved a substitution of unique DNA (2.5 kb) from an unrelated endogenous prophage carried by strain CS112 . This substitution event occurred reproducibly upon infection of strain CS112, as DNAs from a number of independent isolates were found to contain similar, but not identical, DNA sequences . Restriction endonuclease mapping suggested that recombination between homologous sequences shared by the infecting phage and the prophage produced the rearrangement . The recombinant phage was shown to adsorb more rapidly to CS112 cells than did wild type SP24 phage particles: It therefore has a selective advantage during multiple rounds of infection.

Virology, 1983 Oct 30, 130(2), 502 - 13
A restriction map and analysis of the terminal redundancy in the group a streptococcal bacteriophage SP24; Spanier JG et al.; The DNA isolated from the group A streptococcal bacteriophage SP24 is a linear double-stranded molecule 42.0 kb in length . The DNA has been characterized by electron microscopy, and by agarose gel electrophoresis after cleavage with the restriction endonucleases SalI, BglII, XbaI, PvuI, HindIII, and BamHI . Analysis of SalI digests indicates that two fragments are present in submolar amounts and exist as a subset of sequences present in another SalI fragment . Moreover, overlapping endonuclease fragments suggested that the physical map is circular . This was confirmed when homoduplex phage DNA revealed circular structures with single-stranded tails that were 7.7% of the circumference of the genome length molecule . Tails were observed to be separated by as much as 42% of the circular homoduplex structure . These results indicate that the phage SP24 genome is terminally redundant and circularly permuted; and the data are consistent with a model in which DNA packaging into phage heads is initiated at a specific site on concatermeric DNA and proceeds sequentially to package up to five "headfuls" of DNA per concatemer.

J Clin Microbiol, 1983 Oct, 18(4), 765 - 9
Tetrazolium reduction as an aid for streptococcal growth detection with agar dilution susceptibility testing; Coudron PE et al.; A dye reduction method for determining a definitive endpoint with agar dilution susceptibility testing has been developed . Bacterial growth was determined by applying to the inoculum spot a dye solution containing 2-(p-iodophenyl)-3-(p-nitrophenyl)-5-phenyltetrazolium chloride and phenazine methosulfate . Viable colonies reduced the tetrazolium salt to a visible red color within 3 to 5 min . The minimum inhibitory concentrations of six antimicrobial agents tested against 167 clinical streptococcal isolates were recorded before and after the addition of the tetrazolium-phenazine methosulfate solution . A total of 252 discrepancies (25%) were observed, and of these, 30 (12%) differed by more than one tested antibiotic concentration . Endpoint reproducibility of the dye procedure was assessed by four technologists in a double-blind study . A 2.7-fold reduction in disagreement was observed when the dye was used . Use of the tetrazolium-phenazine methosulfate solution involves little deviation from standard antimicrobial susceptibility test procedures and yields more accurate, as well as reproducible, susceptibility results.

Immunopharmacology, 1983 Oct, 6(3), 177 - 89
Activation of macrophage function by intraperitoneal administration of the streptococcal antitumor agent OK-432; Kawaguchi T et al.; Motility, adhesiveness, IL1 production, and inhibition of tumor cell growth in vitro were examined in murine peritoneal macrophages obtained after intraperitoneal injection of a streptococcal preparation OK-432, heat-inactivated OK-432 (HI-OK-432), and thioglycollate medium (TG) . By varying the interval between intraperitoneal injection of OK-432 and the harvest of peritoneal macrophages, it was found that OK-432 induced a time-dependent multi-step alteration of these properties: step I increased motility on day 1: step II increased adhesiveness on day 2; and step II increased inhibition of tumor cell growth and IL1 production . During step III, the peritoneal macrophage population, including Ia-bearing cells, increased dramatically in the peritoneal cavities of OK-432-treated mice . In contrast, injection of either HI-OK-432 or TG, which lack antitumor activity in vivo, initiated steps I and II, but not step III . The Ia-bearing macrophages induced by OK-432 showed high ability of IL1 production, but low growth inhibitory activity against tumor cells . Based on these results, OK-432 seems to be performing a dual function: eliciting a new population of macrophages to the site of injection (heat stable function), and inducing two different populations of antitumor macrophages and Ia-bearing macrophages (heat unstable function).

Br J Cancer, 1983 Oct, 48(4), 515 - 25
Effect of a streptococcal preparation (OK432) on natural killer activity of tumour-associated lymphoid cells in human ovarian carcinoma and on lysis of fresh ovarian tumour cells; Colotta F et al.; The streptococcal preparation OK432 was studied for its effects on natural killer (NK) activity of peripheral blood lymphocytes (PBL) from normal donors and from ovarian cancer patients, and of tumour-associated lymphocytes (TAL) from peritoneal effusions . OK432 augmented NK activity against the susceptible K562 line and induced killing of the relatively resistant Raji line . Freshly isolated ovarian carcinoma cells were relatively resistant to killing by unstimulated PBL and TAL . OK432 induced significant, though low, levels of cytotoxicity against 51Cr-labelled ovarian carcinoma cells . Augmentation of killing of fresh tumour cells by OK432 was best observed in a 20 h assay and both autologous and allogeneic targets were lysed . PBL were separated on discontinuous Percoll gradients . Unstimulated and OK432-boosted activity were enriched in the lower density fractions where large granular lymphocytes (LGL) and activity against K562 were found . Thus, OK432 augments NK activity of PBL and TAL in human ovarian carcinomas and induces low, but significant, levels of killing of fresh tumour cells . Effector cells involved in killing of fresh ovarian tumours copurify with LGL on discontinuous gradients of Percoll.

J Natl Cancer Inst, 1983 Oct, 71(4), 673 - 80
Lysis of fresh human tumor cells by autologous peripheral blood lymphocytes and pleural effusion lymphocytes activated by OK432; Uchida A et al.; Lymphocytes from peripheral blood (PBL) and from pleural effusions (PEL) of cancer patients were tested for cytotoxicity against tumor cells freshly isolated from carcinomatous pleural effusion of the same patient . Significant lysis of autologous tumor cells was recorded for 4 of 28 PBL samples and for 5 of 28 PEL cases when investigated in a 4-hour 51Cr release assay . In vitro treatment of lymphocytes for 20 hours with the streptococcal preparation OK432 resulted in an induction or augmentation of cytotoxicity against autologous tumor cells in 21 of 28 PBL and PEL specimens . OK432-induced cytotoxicity required active cell metabolism, RNA and protein syntheses, but not DNA synthesis of lymphocytes . Supernatants of OK432-stimulated lymphocytes, and interferon and interleukin 2 failed to induce autologous tumor killing . Nylon wool-nonadherent lymphocytes were involved in both spontaneous and OK432-induced lysis of fresh autologous tumor cells . OK432-activated lymphocytes from normal donors and cancer patients caused lysis of fresh allogeneic tumor cells and also K562 cells.

Jpn J Exp Med, 1983 Oct, 53(5), 235 - 41
Effects of immunostimulants on the in vitro generation of cytotoxic lymphocytes against cervical cancer cell lines; Mashiba H et al.; Human peripheral blood lymphocytes were sensitized in vitro against cervical cancer cell lines and the effect of immunostimulants, such as BCG, streptococcal preparation (OK-432), yeast cell wall, and Concanavalin A, on the generation of cytotoxic lymphocytes was examined . The cytotoxic activity of sensitized lymphocytes was augmented by the addition of OK-432 (0.01 KE/ml) during in vitro sensitization, but the induction of sensitized lymphocytes was inhibited by the addition of yeast cell wall (10 micrograms/ml) . When the lymphocytes from cervical cancer patients free from tumor after surgical operation were stimulated on the autologous tumor cell monolayer, the cytotoxic lymphocytes could be generated . In vitro primed lymphocytes could be reactivated following the stimulation with OK-432 (0.01 KE/ml) for 48 hr and the requirement for a proliferative trigger seems to be important for the in vitro generation of cytotoxic lymphocytes . The role of nonspecific stimulation by LD-like products in the in vitro generation of cytotoxic lymphocytes was discussed.

Isr J Med Sci, 1983 Oct, 19(10), 906 - 9
Epidemiology of group B streptococcal colonization in pregnancy; Regan JA; These data support the conclusions that: 1) An intrapartum screening program for GBS colonization favorably affects the outcome of GBSD, with mortality decreased to 10% . 2) Four risk factors--ABO blood group B, unregistered status, PROM and premature labor at less than 32 weeks--identify 83% of mothers whose infants develop GBSD . 3) There is no association between internal monitoring and mode of delivery and the vertical transmission of GBS . 4) Duration of membrane rupture does not affect vertical transmission or development of early-onset disease . This differs from previous findings . 5) Lastly, our findings regarding the natural history of asymptomatic infant carriers suggest that these infants play a previously unsuspected role in the epidemiology of GBS in the entire population.

Boll Ist Sieroter Milan, 1983 Sep 30, 62(4), 333 - 43
{Streptococcal seroepidemiology: comparison of 3 methods}; Angela GC et al.; Streptococcal antibodies survey in adult population . In a series of 1609 hospitalized adult patients, without symptoms of acute or chronic streptococcal rheumatism, the level of antistreptococcal antibodies was measured, using three technical methods: the traditional one, i.e., antistreptolysim titer (ASLO); streptozyme titer (STZ) and the anti-C-polysaccharide technique (Microstreptokit, MSK); by the mutual comparison of these three antigens it was possible to ascertain some differences of the antibody response . In a mass survey it appears useful the use of two methods, i.e., ALSO and MSK; in investigations aiming at recognizing the cases with cardiac or rheumatic silent lesions the couple MSK-STZ appears to be more reliable . To ensure a more sure covering of the whole field of streptococcal silent infections, the three methods should be used together.

Z Gesamte Inn Med, 1983 Sep 15, 38(18), 502 - 5
{Ampicillin associated acute interstitial nephritis with renal insufficiency--case report}; Barnick P et al.; It is reported on a 20-year-old male patient, in whom during the treatment of a streptococcal infection with ampicillin an exanthem and an acute interstitial nephritis with acute renal insufficiency appeared . The temporary connection between the application of the medicament and the occurrence of the clinical symptoms and the sensitization to ampicillin proved by the lymphocyte transformation test speak for an ampicillin-induced interstitial nephritis . The discontinuation of the treatment with ampicillin and the application of prednisolone led to a complete involution of the clinical picture . Since ampicillin is frequently used in the clinic one should take into consideration in the indication that possibly an acute renal insufficiency may appear due to an acute interstitial nephritis.

Clin Pediatr (Phila), 1983 Sep, 22(9), 622 - 6
Applicability of a scoring system in the diagnosis of streptococcal pharyngitis; Funamura JL et al.; The usefulness of a scoring system, developed in a private pediatric practice, for the early diagnosis of streptococcal pharyngitis has been evaluated in a teaching hospital . The system, evaluated in 892 patients, appears most useful in predicting culture-negative patients (80%) . A false positive rate of 20 per cent precludes the use of the scoring system in the decision to initiate antibiotic therapy at our institution.

Am Rev Respir Dis, 1983 Sep, 128(3), 516 - 22
Human alveolar macrophage support of lymphocyte responses to mitogens and antigens . Analysis and comparison with autologous peripheral-blood-derived monocytes and macrophages; Ettensohn DB et al.; Observations from animal studies and investigations using human peripheral-blood-derived macrophages may not be representative of human alveolar macrophage functions . Thus, we extensively examined and compared accessory cell functions of autologous human alveolar macrophages and peripheral-blood-derived monocytes and macrophages obtained from healthy, nonsmoking volunteer subjects . The alveolar and peripheral-blood-derived cells differed in ability to enhance mitogen- and antigen-stimulated transformation responses of purified autologous lymphocytes . Peripheral-blood-derived cells supported greater lymphocyte responses to optimal concentrations of several mitogens, but alveolar macrophages supported much greater responses to suboptimal concentrations of the mitogen phytohemagglutinin . Peripheral-blood-derived macrophages supported, but alveolar macrophages did not support, lymphocyte responses to streptococcal and influenza virus antigens . Such relative accessory cell functions of the different macrophages and monocytes were not due to different kinetics of response, nor were they due to differences in the proportion of macrophages required to support the lymphocyte responses . These data indicate that human alveolar macrophages have functional characteristics different from autologous peripheral-blood-derived monocytes and macrophages . Such differences may be important in both pulmonary immune homeostasis and in the pathogenesis of pulmonary disease.

J Immunol, 1983 Sep, 131(3), 1326 - 31
Monoclonal antibodies to streptococcal group A carbohydrate . II . The VK1GAC light chain is preferentially associated with serum IgG3; Fulton RJ et al.; A kappa-light chain variable region (V kappa) dominantly employed in the serum antibody response of A/J mice to streptococcal group A carbohydrate (GAC) has been termed VK1GAC . Examination of in vitro recombinants between the isolated heavy and light chains of VK1GAC+ and VK1GAC-anti-GAC hybridomas and non-GAC-binding myeloma proteins indicated that two antisera (anti-Id5 and anti-Id20) recognized the VK1GAC light chain when it was free in solution or paired with several heterologous heavy chains . Screening of a panel of A/J anti-GAC monoclonal antibodies with these antisera showed almost complete concordance between Id5 and Id20 expression and the presence of VK1GAC light chain as detected by its unique isoelectric focusing spectrotype . These antisera were used to examine serum expression of the VK1GAC light chain in normal and hyperimmune serum of A/J mice . Normal A/J serum contained from 20 to 100 micrograms Id5/ml serum, whereas only 1 to 10 micrograms Id20/ml serum was detected . The levels of both VK1GAC idiotypes increased dramatically 10- to 20-fold after hyperimmunization of mice with group A vaccine . When serum IgG from normal and immune mice was fractionated into the IgG subclasses (IgG1, IgG2a, and IgG3), it was found that the VK1GAC light chain does not pair randomly with heavy chains of the IgG subclasses, but rather is associated preferentially with heavy chains of the IgG3 subclass whether or not it is associated with antibodies to GAC . These results suggest that the heavy chain pairing exhibited by this VK product may not be random.

Pediatr Infect Dis, 1983 Sep-Oct, 2(5), 356 - 8
Serum opsonic activity and peripheral neutrophil counts before and after exchange transfusion in infants with early onset group B streptococcal septicemia; Hall RT et al.; Serum opsonic antibody activity and peripheral neutrophil counts were measured in 41 infants who received an exchange transfusion of fresh whole blood for early onset group B streptococcal septicemia . Immature and mature neutrophils increased significantly in the peripheral blood post-exchange transfusion among survivors . Increases in opsonic antibody levels did not reach statistical significance following exchange transfusion . It is possible that exchange transfusion with fresh whole blood may enhance mobilization of neutrophils in infants with adequate bone marrow storage pools . A prospective controlled study is required to evaluate properly the role of exchange transfusion in infants with group B streptococcal sepsis.

J Clin Microbiol, 1983 Sep, 18(3), 622 - 7
Assay of antibody to group A streptococcal carbohydrate by enzyme-linked immunosorbent assay; Barrett DJ et al.; An indirect enzyme-linked immunosorbent assay system for determination of antibody levels to the group A streptococcal cell wall carbohydrate antigen is described . Optimal conditions for antigen preparation, purification, and conjugation to poly-L-lysine for adequate adsorption to the solid phase are presented . Antibody titers of unknown sera were determined by comparison to known reference standard pool sera . A highly significant correlation (p less than 0.0001) was found between enzyme-linked immunosorbent assay antibody titers and antigen-binding capacity in a previously described radioimmunoassay . Utilizing an isotype-specific anti-immunoglobulin reagent and immunoabsorbent-purified antibody to group A streptococcal cell wall carbohydrate antigen, we were able to detect nanogram quantities of antibody by the enzyme-linked immunosorbent assay technique . This system will provide for more generalized use of group A streptococcal cell wall carbohydrate antigen antibody determinations for the study of immune responses after streptococcal infections and their complications.

J R Soc Med, 1983 Sep, 76(9), 776 - 85
Mozart's illnesses and death; Davies PJ; Throughout his life Mozart suffered frequent attacks of tonsillitis . In 1784 he developed post-streptococcal Schonlein-Henoch syndrome which caused chronic glomerular nephritis and chronic renal failure . His fatal illness was due to Schonlein-Henoch purpura, with death from cerebral haemorrhage and bronchopneumonia . Venesection(s) may have contributed to his death.

Science, 1983 Aug 19, 221(4612), 758 - 60
Expression of streptococcal M protein in Escherichia coli; Scott JR et al.; The structural gene for group A streptococcal M protein, the fibrillar surface molecule enabling the organism to resist phagocytosis, has been cloned into Escherichia coli . The molecule produced by Escherichia coli is slightly larger than the M protein isolated by solubilization of the streptococcal cell wall, but is similar in size to that secreted by streptococcal protoplast and L forms . Immunologically, the molecule synthesized by Escherichia coli has the same type-specific determinants as the streptococcal M protein.

Can Med Assoc J, 1983 Aug 15, 129(4), 353 - 4
Mycoplasma hominis infection of the central nervous system in a neonate; McNaughton RD et al.; A newborn infant with group B streptococcal sepsis responded to the intravenous administration of antibiotics within 3 days, but then began to show signs of central nervous system infection . Routine cultures of cerebrospinal fluid samples were negative, but others done for Mycoplasma hominis yielded that organism . After 3 more days of antibiotic therapy, cultures for M . hominis were negative, and the child's recovery was uneventful.

Aust Fam Physician, 1983 Aug, 12(8), 585 - 7
The use of antibiotics in upper respiratory tract infection; Crome MA et al.; The current literature is surveyed for evidence on which to base policies for prescribing antibiotics in upper respiratory tract infections . Moderation is recommended in the prescribing of antibiotics for sore throat in adults . Antibiotic treatment of otitis media and sinusitis is appropriate only when severe infection is likely . It is concluded that there is a need for further controlled trials in Australian general practice to provide data on streptococcal disease in children, to determine carrier rates and when to treat.

J Thorac Cardiovasc Surg, 1983 Jul, 86(1), 112 - 4
Surgical management of prosthetic valve endocarditis; Raychaudhury T et al.; Operative mortality in patients with prosthetic valve endocarditis (PVE), who already have severe hemodynamic failure, is extremely high (35% to 84%) . Over a period of 10 years, between 1972 and 1981, fourteen consecutive urgent operations were performed for PVE in 12 patients . On thirteen occasions the patients were in severe hemodynamic failure (NYHA Functional Class IV), and five of them had early PVE (within 60 days of previous operation) . In all patients at least two of the other recognized risk factors, such as presence of non-streptococcal organisms, detachment of the prosthesis, and myocardial invasion, were present . All of the patients but one were operated upon within 48 hours of their hemodynamic deterioration, and there was one postoperative death (operative mortality 7%) . Our results indicate that an acceptable surgical mortality in patients with intractable heart failure due to early and late PVE can be achieved by prompt surgical intervention despite the presence of multiple risk factors.

Jpn J Antibiot, 1983 Jul, 36(7), 1888 - 94
{Clinical experience with an ampicillin suppository (KS-R1) in pediatrics}; Sakaguchi Z et al.; Ampicillin suppository (KS-R1) was given to 16 children with the following acute bacterial infection; 4 cases of acute pharyngitis, 2 cases of acute tonsillitis, 5 cases of acute bronchitis, 4 cases of bronchopneumonia, 1 case of group A beta-streptococcal infection . Out of 16 patients, good clinical responses were obtained in 16 patients, and bacteriological effectiveness was seen in all 3 cases . Side effects with KS-R1 were observed in 4 cases: 3 cases were perianal redness, and 4 cases were soft stool . From the above clinical results, KS-R1 is useful antibiotic suppository for treating the pediatric patients with various kinds of bacterial infections.

Hum Immunol, 1983 Jul, 7(3), 177 - 85
Family studies of the HLA system in acute post-streptococcal glomerulonephritis; Layrisse Z et al.; Eighteen families (67 siblings) of index cases with acute post-streptococcal glomerulonephritis (APSGN) were typed for HLA-A,B,C,DR antigens . Twenty cases of clinical nephritis and 10 cases of asymptomatic disease with detected among the sibships . In eight families with more than one affected individual comprising 18 sib pairs random segregation of paternal and maternal HLA haplotypes was found (0.5 less than p less than 0.06), but some antigens (CW1, DR3) showed deviation from the expected 1:1 ratio in affected and nonaffected siblings in backcross families . We had previously noticed the existence of Mendelian recessive ratios in APSGN but in the absence of clear evidence for a dominant or recessive mode of inheritance for a putative APSGN susceptibility gene(s), pedigree data were analyzed twice for linkage with HLA using the two genetic models . The data obtained, although not sufficient to reject the hypothesis of linkage, provide no support for it . Comparison of the frequency of 61 HLA antigens among 42 unrelated APSGN patients and 109 controls, showed that HLA-DRW4 is more frequent among the former (pc = 0.0500).

J Toxicol Environ Health, 1983 Jul, 12(1), 55 - 71
Effects of subchronic exposure to a mixture of O3, SO2, and (NH4)2SO4 on host defenses of mice; Aranyi C et al.; Mice exposed 5 h/d, 5 d/wk up to 103 d, to 0.2 mg O3/m3 or to a mixture of O3, 13.2 mg SO2/m3, and 1.04 mg (NH4)2SO4 aerosol/m3 showed significantly greater susceptibility to group C streptococcal aerosol infection relative to filtered air controls . Pulmonary bactericidal activity by alveolar macrophages was significantly enhanced in the lungs of mice exposed to the mixture relative to those inhaling filtered air or O3 alone . The total number and distribution of the free cells lavaged from the lungs, as well as cellular ATP levels, did not change due to the pollutant exposures . In vitro cytostasis in tumor target cells cocultured with peritoneal macrophages from the exposed mice was significantly enhanced in the O3-exposed and in the mixture-exposed treatment groups relative to controls and also in the mixture-exposed relative to the O3-exposed group when a target-to-effector-cell ratio of 1:10 was used; no such effects were observed when this ratio was 1:20 . Splenic T-lymphocyte function, as measured by blastogenesis to mitogens and alloantigens, was affected by exposure to O3 and/or the mixture, although the patterns of effects were qualitatively different . Splenic B-cell function and macrophage antigen processing, as measured by the generation of antibody plaque-forming cells, was unaffected by exposure.

Acta Paediatr Scand, 1983 Jul, 72(4), 597 - 602
Early onset group B streptococcal disease . Seven year experience and clinical scoring system; Lannering B et al.; Early onset group B streptococcal disease was reviewed for the seven year period between 1975 to 1981 at Vanderbilt University Medical Center . One hundred and twenty cases were identified . The disease varied from asymptomatic bacteremia to fatal cardiopulmonary collapse . Factors associated with a poor outcome were prematurity, low Apgar score at 5 min, the presence of shock, leukopenia, rupture of membranes for more than 12 hours, and a delay in treatment after the onset of symptoms . A scoring system for probability of death based on these 6 factors was then developed . Over the seven year period mortality decreased from 50% to 10% . The only factor identified with the decrease in mortality was a significant decrease in the number of hours between the onset of symptoms and the beginning of treatment . Early recognition and prompt treatment seem to be the major causes of the decreasing mortality over the seven years of this report.

J Clin Invest, 1983 Jul, 72(1), 260 - 9
Immunochemical analysis and immunogenicity of the type II group B streptococcal capsular polysaccharide; Kasper DL et al.; The relationship between group B streptococcal (GBS) type-specific antisera and the type II-specific polysaccharide is evaluated from a structural and immunologic viewpoint . Although all GBS type-specific polysaccharides are composed of the same monosaccharides, the type II antigen is more complex structurally and contains these sugars in a molar ratio different from the other antigens . Type II polysaccharide has two side chains . One contains only sialic acid and is less susceptible to acid cleavage than sialic acid residues found on types III, Ia, and Ib polysaccharides . The other side chain is composed of galactose as the only sugar . Immunochemical studies demonstrate that the type II polysaccharide has several immunodeterminants . One of these determinants is likely to be the side-chain galactose, while sialic acid appears to comprise part of another immunodeterminant, more complex than sialic acid alone . A series of cross-reactions is demonstrated between the type II native antigen and antisera to serotypes Ia, III, and Ib by a sensitive radioactive antigen-binding assay, which account for additional, complex immunodeterminants . The strongest of these cross-reactions is with type Ia antiserum and the weakest with Ib antiserum . Since Ia and Ib polysaccharides differ in only one linkage, these findings suggest that the trisaccharide beta D-N-acetyl-glucosamine-p(1 leads to 3) beta D-galactose-p(1 leads to 4) beta D-glucose-p {{beta D-GlcNAcp(1 leads to 3) beta D-Galp(1 leads to 4)beta D-Glcap}} is the likely common site responsible for the interaction of the type II native polysaccharide and type Ia antiserum . Another cross-reaction is observed between type III antiserum and type II native antigen . Inhibition studies indicate that the most likely cross-reactive determinant in this case is {beta D-Galp(1 leads to 4)beta D-GlcNAcp} . Type II polysaccharide has been utilized in a human vaccine trial to test safety and immunogenicity . The polysaccharide is highly immunogenic, inducing an antibody response in 95% of recipients, and nontoxic, with side-effects confined to minimal local reactions . Despite the cross-reactions observed between type-specific antigens and antibody prepared by immunization of rabbits with whole bacteria, which suggest shared immunodeterminants, similar cross-reactions were not detected in human sera after immunization with purified type II polysaccharide.

Biochem Biophys Res Commun, 1983 Jun 15, 113(2), 555 - 61
The pairing of light and heavy chains of isomeric anti-lactose antibodies; Pazur JH et al.; Sets of polyclonal isomeric anti-carbohydrate antibodies are present in sera of rabbits immunized with vaccines of non-viable streptococcal cells containing antigenic glycans . Anti-lactose antibodies have been purified by affinity chromatography and have been subjected to dissociation, electrophoretic and agar diffusion analyses . The anti-lactose antibody preparation was found to be composed of 16 isomeric proteins which yield 16 heavy chains and 16 light chains.

N Engl J Med, 1983 Jun 9, 308(23), 1383 - 9
Penicillin in infants weighing two kilograms or less with early-onset Group B streptococcal disease; Pyati SP et al.; We studied the effect of penicillin on early-onset Group B streptococcal disease over a 52-month period in neonates who were at high risk of infection . Shortly after birth, 1187 neonates weighing 2000 g or less had blood samples taken for cultures and were randomized into an early-treatment group (given intramuscular penicillin G within 60 minutes of birth) or a control group . The incidence of early-onset disease was 20 per 1000 live births (24 of 1187); the number of infants in the early-treatment group who had disease (10 of 589) was similar to that in the control group (14 of 598) . The fatality rates were similar in both groups (6 of 10 vs . 8 of 14) . Cultures from blood obtained with one hour of birth were positive in 21 of the 24 infants with disease; 22 of the 24 were symptomatic within four hours of birth . Thus, infection was well established before the first hour of postnatal life . At autopsy, gram-positive cocci were seen in lung sections of four infants in whom cultures of blood obtained after treatment had been sterile; this indicates that giving routine antibiotic therapy before culture samples are obtained can obscure bacteriologic diagnosis . We conclude that penicillin given at birth to neonates weighing 2000 g or less does not prevent early-onset streptococcal disease or reduce excess mortality associated with disease.

Nurse Pract, 1983 Jun, 8(6), 19 - 22, 25-6
Holistic protocol: hereditary polymorphic light eruption; Power R; Hereditary polymorphic light eruption (HPLE) is a skin disorder of American Indians inherited as an autosomal dominant trait with reduced penetrance . Skin lesions which erupt on sun-exposed areas only are manifest clinically in many forms and are induced by ultraviolet radiation . The eruptions flare during the spring, summer and early fall and abate in late fall and winter . The course of the disorder over an individual's lifetime is erratic with unpredictable remissions and exacerbations . Treatment broadly includes protective measures, topical agents and systemic agents; all are long term and complex, demanding considerable life adjustment for the patient . Complications include streptococcal pyoderma and psychosocial trauma . Approaching and educating the patient holistically is an essential requirement for a practitioner participating in the care of a patient with HPLE.

Surg Neurol, 1983 Jun, 19(6), 524 - 7
Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess; Black PM et al.; Ventriculitis developed suddenly in a patient with an undiagnosed abscess and was accompanied by obtundation, fever, meningismus, and hemiplegia . Aspiration of a streptococcal thalamic abscess and high doses of intravenous penicillin produced marked improvement . Increasing dysphasia 5 weeks later was accompanied by ventricular dilatation, most marked on the left, with no evidence of recurrent abscess . The left foramen of Monro was demonstrably patent . Shunting relieved the symptoms of aphasia; they recurred with one episode of malfunction of the shunt . This case lends support to the belief that parenchymal characteristics are important in hydrocephalus and demonstrates how asymmetrical ventricular dilatation can produce focal symptoms.

Ann Trop Med Parasitol, 1983 Jun, 77(3), 279 - 85
Membranoproliferative glomerulonephritis in a tropical environment; Date A et al.; Electron microscopy of renal biopsy material from 50 patients with membranoproliferative glomerulonephritis treated in a southern Indian hospital, showed a low prevalence of type 2 (dense deposit) disease . Eosinophilia was seen in more than one-third of the 41 patients with type 1 disease . Associated diseases and possible sources of chronic antigenaemia found in some patients included: streptococcal infection, Bancroftian filariasis, tropical pulmonary eosinophilia, hepatitis B surface antigenaemia and lepromatous leprosy.

Int J Pediatr Nephrol, 1983 Jun, 4(2), 119 - 21
Reflux nephropathy complicated by acute post-streptococcal glomerulonephritis; Sheridan RJ et al.; A 7 years old male with severe bilateral vesicoureteral reflux developed acute renal failure without evidence of either infection or obstruction . The diagnosis of acute post-streptococcal glomerulonephritis was confirmed by clinical, serological and histological evaluation . The patient's creatinine clearance decreased from 25 ml/min/1.73 m2 to 10-13 ml/min/1.73 m2 following the acute nephritic episode and chronic dialysis therapy was required thereafter . This patient illustrates that a glomerular etiology should be suspected when acute renal failure occurs in a patient with reflux nephropathy and suggests that the prognosis of acute post-streptococcal glomerulonephritis may be worse in children with pre-existing renal disease.

Trop Geogr Med, 1983 Jun, 35(2), 145 - 50
Epidemiology of group B streptococcal carriage among pregnant women and their neonates: an African experience; Dawodu AH et al.; A prospective study of group B streptococcal vaginal carriage among 225 Nigerian pregnant women in labour at UCH, Ibadan during a 3 month period in 1980 revealed a vaginal carriage rate of 19.5%; 8.9% of the 224 infants of the 218 infant-mother pair studied were colonized at birth . A significant proportion of the colonized mothers were primigravidas but no significant association was found between vaginal colonization and premature onset of labour, prolonged rupture of membranes, prolonged labour, stillbirth rate or puerperal infection . None of the twenty colonized infants developed "early" or "late" group B streptococcal disease on 3 months follow up . These results suggest the incidence of group B streptococcal disease in the newborn in Nigeria may be low despite high vaginal carriage rate.

Presse Med, 1983 May 28, 12(23), 1467 - 71
{Study of critical levels of 3 antistreptococcal antibodies by data analysis}; Picard B et al.; Prinqual, a new statistical data-analysis method was used to determine the critical titers of antistreptolysin O (ASLO), anti-DNase B (ADB) and antistreptokinase (ASK) in the sera of 104 patients with suspected streptococcal infection and 121 blood-donors . The whole range from pathological to normal was thus covered, thereby avoiding bias concerning the proportion of normal titers in a control population . Another advantage of the method was that the titers of the 3 antibodies were considered simultaneously and the semi-quantitative results of serological tests were avoided . It appeared from this study that the upper limits of normal values were: ASLO, 100 U; ADB, 240 U and ASK, 40 U . The first probably pathological values were: ASLO, 150 U; ADB, 480 U and ASK, 320 U . These results are compared with those available in the literature.

Nurse Pract, 1983 May, 8(5), 17 - 9
Acute rheumatic fever; Macek L; The classic dramatic clinical presentation of acute rheumatic fever (ARF), with high fever, severe carditis and acute polyarthritis, is changing to an asymptomatic, milder form . The cardiac damage potential of the disease remains high . It is the responsibility of the primary care nurse practitioner to 1) provide primary prevention of ARF through appropriate treatment of streptococcal pharyngitis; 2) be cognizant of the manifestations of the disease; and 3) provide secondary prevention of subsequent attacks through prophylaxis.

Infect Immun, 1983 May, 40(2), 832 - 5
Do lymphocytes from Chagasic patients respond to heart antigens?
Todd CW, Todd NR, Guimaraes AC.
Lymphocyte transformation studies of nonadherent lymphocytes from chronic Chagasic and uninfected persons demonstrated that responses of all individuals to a mouse heart homogenate showed a correlation with responses to streptococcal antigens . Considering the known cross-reactions between streptococcal and cardiac antigens and the high reactivity of Chagasic patients to streptococcal antigens, it is possible that positive lymphocyte transformation to unfractionated heart antigen preparations may not represent specific reactivity to heart antigens.

Eur J Immunol, 1983 May, 13(5), 370 - 8
Antigen-binding human T suppressor cells and their association with the HLA-DR locus; Lehner T; The ability of human lymphocytes to bind antigen was studied by direct binding of 125I-labeled streptococcal protein antigen, followed by autoradiography . T-enriched lymphocytes depleted of adherent cells and B cells showed specific binding of 125I-labeled streptococcal antigen (SA) at 4 degrees C and in the presence of sodium azide . Further depletions of the T-enriched population by the monoclonal T4 or T8 antiserum and complement revealed that the antigen-binding T cell is T4-, T8+ . This was confirmed by positive selection of T8 cells, by rosetting with ox red blood cells and by the binding of SA by in vitro induced suppressor but not helper cells . Antigen specificity of binding to the suppressor cells was established by complete inhibition with the SA but no inhibition with keyhole limpet hemocyanin . A characteristic dose-response of binding 1 or 10 ng SA to HLA-DRw6 lymphocytes and 1000 ng SA to DR4,1,2,3 or 5 lymphocytes was found . A comparison of the dose-responses of antigen-binding T8+ suppressor cells with those of helper and suppressor functions showed that the dose of SA which binds to suppressor cells is similar to the dose required to induce helper but not suppressor function . A plausible interpretation of these observations is that the T8+ antigen-binding suppressor cells might function as "contrasuppressor cells" which compete successfully for the membrane receptors of helper cells, thereby preventing suppression by the major subset of suppressor cells.

Clin Immunol Immunopathol, 1983 May, 27(2), 261 - 71
Polyclonal activation of immunoglobulin secretion without prior DNA synthesis in human B lymphocytes induced by Klebsiella pneumoniae; Gross WL et al.; The capacity of various cell preparations of Klebsiella pneumoniae K43 (Klebs) to induce {3H}thymidine uptake and immunoglobulin (Ig) secretion by human mononuclear blood cells (MNC) and their lymphocyte subpopulations was investigated . All Klebs preparations were virtually devoid of mitogenic properties, in contrast to control preparations of pokeweed mitogen (PWM) and group A streptococcal cell membranes (A-ScM) . Klebs induced differentiation of B cells into Ig-secreting cells . B-cell populations that were sufficiently depleted of T cells to be unresponsive to A-ScM ("highly purified B cells") showed a marked response to Klebs . Similarly, the number of plaque-forming cells (PFC) in Klebs-driven cultures did not change after restitution of T cells, whereas the presence of restituted T cells augmented the B-cell response to PWM and A-ScM . Radical removal of adherent MNC ("monocytes"), however, completely abrogated the PFC response and {3H}thymidine uptake of both MNC activated by Klebs and MNC activated by PWM or A-ScM.

S Afr Med J, 1983 Apr 23, 63(17), 647 - 8
Should young adults with sore throat be treated with antibiotics?
van Wyk M, van Rensburg AJ, Schoeman HS.
The diagnosis of streptococcal sore throat on clinical grounds remains a problem . In this study the clinical prediction in a group of young adults corresponded with laboratory findings indicative of a streptococcal (group A or non-A) infection in 23% of cases . The culture of throat swabs was of little value, as the only group A culture-positive patient did not show an antibody response, indicating a carrier state . In 5 cases a streptococcal infection was diagnosed on rising antibody titres only, as culture remained negative . The value of rising antibody titres as a diagnostic tool is also questioned, since they occurred more frequently in the healthy controls than in the sore-throat group . Antibiotic treatment for sore throat was rarely supported by laboratory findings in the young adult population studied.

Ann Clin Res, 1983 Apr, 15(2), 92 - 4
Acute rheumatic fever with extracapillary glomerulonephritis and the nephrotic syndrome; Mustonen J et al.; A 34 year old woman is described in whom carditis, arthritis, fever, leukocytosis and a high sedimentation rate developed two weeks after a streptococcal infection . The patient also had the nephrotic syndrome and rapidly progressive renal insufficiency . The renal biopsy specimen showed acute extracapillary (crescentic) glomerulonephritis . The initial response to corticosteroid therapy was good, but later a slowly progressive renal function impairment was seen.

J Immunol, 1983 Apr, 130(4), 1674 - 7
Capping of complement receptors on human neutrophils induced by group A streptococcal cell walls; Pryzwansky KB et al.; Peptidoglycan-polysaccharide polymers derived from group A streptococcal cell walls (PG-PS) were opsonized with either purified C3 or normal human serum and were used as a probe to investigate the mobility of CR1 and CR3, the C3b and iC3b receptors, respectively, on human neutrophils . Incubation of monolayers or cell suspensions of neutrophils with PG-PS opsonized with C3b or serum resulted in capping of PG-PS, as detected by fluorescein-labeled antibody to PS . No binding of PG-PS to neutrophils was observed with heat-inactivated serum . By 30 min the cell walls were internalized and observed in one to three vacuoles . Capping was totally inhibited when PG-PS opsonized with C3b or serum was preincubated with Fab'-anti-C3b . Similar inhibition was observed when C3b-opsonized PG-PS was incubated with neutrophils that were preincubated with anti-CR1 or fluid-phase C3b; only partial inhibition of neutrophil capping was observed by using serum-opsonized PG-PS . Because anti-CR1 blocks only the C3b receptor, the cap formation observed with serum-opsonized PG-PS is probably due to CR3 . These results suggest that both CR1 and CR3 on neutrophils cap after stimulation by group A streptococcal cell wall fragments.

Pediatrics, 1983 Apr, 71(4), 554 - 8
Incidence of postextraction bacteremia under penicillin cover in children with cardiac disease; Hess J et al.; To assess the efficacy of penicillin prophylaxis as recommended by the American Heart Association to prevent the onset of bacterial endocarditis, the incidence of postextraction bacteremia was determined in 82 children with cardiac disease who were receiving prophylactic penicillin . Aerobic and anaerobic blood cultures were taken five minutes after dental extraction, as was a blood sample to assay the serum penicillin concentration . The incidence of postextraction bacteremia was 21% . Streptococcal species accounted for half of the number of aerobes isolated . Of the isolated microorganisms, 16% were strict anaerobes . Susceptibility testing of the isolates showed that 24 penicillin-sensitive and eight penicillin-resistant microorganisms caused the bacteremia . There was neither a significant difference between the serum penicillin concentrations of children with and without bacteremia, nor between the serum penicillin concentrations of children with bacteremia due to penicillin-sensitive microorganisms and children with bacteremia due to penicillin-resistant microorganisms . It is concluded that the occurrence of postextraction bacteremia is not prevented by penicillin prophylaxis and that the serum penicillin concentration at extraction is not the discriminating factor in preventing this bacteremia . None of the children developed bacterial endocarditis . It is speculated that mechanisms not thoroughly studied are involved in the prevention of bacterial endocarditis after dental extraction.

Biochem J, 1983 Apr 1, 211(1), 173 - 80
A new isotype sequence (V kappa 27) of the variable region of kappa-light chains from a mouse hybridoma-derived anti-(streptococcal group A polysaccharide) antibody containing an additional cysteine residue . Application of the dimethylaminoazobenzene isothiocyanate technique for the isolation of peptides; Chang JY et al.; The first complete sequence of the variable region of a kappa-light chain (V kappa) from a mouse anti-(streptococcal group A polysaccharide) antibody (immunoglobulin 7S34.1) is reported . Immunoglobulin 7S34.1 was isolated from the ascitic fluid of hybridoma 7S34.1 previously cloned in vitro . A newly developed technique for the isolation of peptides by using pre-column formation of peptide derivatives with dimethylaminoazobenzene isothiocyanate also served to complete the sequence . The sequence of the variable region of the kappa-light chain of immunoglobulin 7S34.1 defines a new mouse V kappa isotype (V kappa 27) and is the first mouse immunoglobulin light-chain variable region to be shown to have an extra cysteine residue at position 48.

Biochem J, 1983 Apr 1, 211(1), 163 - 71
A new method for the selective isolation of cysteine-containing peptides . Specific labelling of the thiol group with a hydrophobic chromophore; Chang JY et al.; A new method for the selective isolation of cysteine-containing peptides was designed . The method is based on the specific labelling of thiol groups with a hydrophobic chromophore followed by enzymic fragmentation of the labelled protein and reversed-phase high-pressure liquid-chromatographic separation of the peptide mixture . This new method has several distinct advantages: (1) the hydrophobic-chromophore-labelled cysteine-containing peptides are easily separated from non-cysteine-containing peptides by reversed-phase high-pressure liquid chromatography; (2) only cysteine-containing peptides are detected in the visible region with sensitivity at the low picomole level; this high sensitivity allows isolation of nanogram amounts of pure cysteine-containing peptide; (3) during sequence determination of the chromophore-labelled cysteine-containing peptides, the cysteine residues are released as coloured anilinothiazolinone derivatives and can be detected directly in the picomole range; (4) with proteins bearing several disulphide groups, each disulphide group may undergo a different degree of reduction, and therefore the recovery of individual cysteine-containing peptides may be used to deduce the disulphide linkages present in the native protein . Two thiol-specific reagents, 4-dimethylaminoazobenzene-4'-iodoacetamide and 4-dimethylaminoazobenzene-4'-N-maleimide, were synthesized and characterized . The method was successfully used to isolate five cysteine-containing peptides from a completely reduced monoclonal-antibody kappa-light chain raised against the azobenzenearsonate determinant and six cysteine-containing peptides from a kappa-light chain raised against streptococcal group A polysaccharide . The principle of this method is applicable to the isolation of any peptide containing amino acid residues that can be specifically labelled with a hydrophobic chromophore.

Postgrad Med J, 1983 Apr, 59(690), 269 - 71
Reversible diminished insulin requirement during acute renal failure; Naschitz JE et al.; Very little is known concerning insulin requirements in diabetic patients who develop acute renal failure, although decrease in daily insulin requirement in patients with chronic renal failure is recognized . A 46-year-old diabetic patient is described, whose daily insulin requirement decreased from 56 to 8 units per day during an episode of acute post-streptococcal glomerulonephritis causing acute reversible renal failure . The insulin requirement returned to its previous level after the patient recovered.

Eur J Immunol, 1983 Apr, 13(4), 273 - 8
A cross-reacting human idiotype (B17) associated with antibodies to N-acetyl-D-glucosamine . Specificity, immunoglobulin class association, and distribution in the population; Emmrich F et al.; This report describes the study of the expression of an idiotype in the human population which is associated with antibodies to N-acetyl-D-glucosamine (GlcNAc) present in most human sera presumably due to streptococcal infections . The idiotype is identified with antisera and monoclonal antibodies prepared against the IgM (kappa) antibody secreted by the Epstein-Barr virus-transformed human B cell line B17 . At least 90% of 207 individuals tested had immunoglobulin with B17 idiotypic determinants in their sera, as demonstrated with conventional and one monoclonal anti-idiotypic antibody . Another monoclonal anti-idiotypic antibody reacted with antibodies in only a few of the sera . No correlation was found between the level of expression of different idiotopes in individual human sera, suggesting molecular heterogeneity of the B17-positive antibody population . B17-positive immunoglobulins are to a large extent specific for GlcNAc but represent only a minor population of all GlcNAc-specific antibodies in human sera . B17 determinants are on IgM (kappa) in all human sera and on IgG and IgA in some . In addition, some lambda-bearing Ig was found to react with anti-B17 antisera, suggesting the detection of VH-associated idiotypic determinants in this experimental system.

Biochim Biophys Acta, 1983 Mar 23, 729(1), 115 - 22
Approximate dimensions of membrane lesions produced by streptolysin S and streptolysin O; Buckingham L et al.; Membrane lesions produced by the streptococcal membranolysins streptolysin S and streptolysin O were investigated . Escape of labeled marker molecules of various sizes from resealed sheep erythrocyte ghosts treated with the toxins for 30 min allowed estimation of the sizes of the primary channels formed . Streptolysin S formed lesions ranging in size up to 45 A in diameter, and even high toxin concentrations did not result in larger channels . The lesions produced by streptolysin O exceeded 128 A in diameter . Kinetics experiments demonstrated that the primary streptolysin O lesions were formed rapidly (1-2 min), but release of marker molecules from streptolysin S-treated vesicles began only after a 5-15-min lag period . Label release from large unilamellar liposomes treated with streptolysin S suggested that membrane fluidity does not affect the size of the streptolysin S lesions.

J Immunol Methods, 1983 Mar 11, 58(1-2), 133 - 42
An amplification system using BSA-antibody conjugate for sensitive enzyme immunoassay; Guesdon JL et al.; A procedure is described for sensitive titration of antibodies, macromolecular antigens and haptens by enzyme immunoassay . It involves using first antigen or antibody labelled with bovine serum albumin (BSA) and then an anti-BSA antibody conjugated with an enzyme . The performance characteristics of this assay are indicated and compared with those for conventional enzyme immunoassay . The present procedure allowed fast sensitive titration of human IgE, rabbit type III anti-streptococcal antibody and cAMP.

Nature, 1983 Mar 3, 302(5903), 67 - 9
Suppressor T cells control the HLA-linked low responsiveness to streptococcal antigen in man; Nishimura Y et al.; We have previously reported that low immune responsiveness to the streptococcal cell wall (SCW) antigen is controlled by an HLA-linked dominant gene which we designated as an immune suppression gene to the SCW antigen (Is-SCW) without knowing its function . We have extended the study of the genetic control of the immune response to the SCW antigen and confirmed both the bimodal distribution of immune responsiveness and HLA-linked dominant inheritance of low responsiveness . Here we report an analysis of the function and expression of Is-SCW at the cellular level and demonstrate that the Is-SCW controls the generation of antigen-specific suppressor T cell in low responders.

Gan To Kagaku Ryoho, 1983 Mar, 10(3), 768 - 74
{Coenzyme Q10 in cancer chemotherapy--experimental studies on augmentation of the effects of masked compounds, especially in the combined chemotherapy with immunopotentiators}; Kokawa T et al.; Immunopotentiators may mitigate the depression of immunological function caused by the cancer itself or by chemotherapeutics . However, it has been found that these immunopotentiators reduce the metabolic activity of the host against drugs, including "masked" chemotherapeutics, which might be activated by metabolization in the body . Reported here is the result of serial experiments carried out on the activation of cyclophosphamide (CPM) in tumor-bearing animals, pretreated with phenobarbital, a drug-metabolizing enzyme inducer, and coenzyme Q10, a physiological activator of the electron transfer system in mitochondrias, in combination with immunopotentiators . Female Donryu rats (120 g body weight) implanted with Yoshida Sarcoma cells (YS) (2.5 X 10(6) i.p.) were treated with CPM (160 mg/kg X 1 i.p.), 84 hrs after implantation; the levels of the normustard-like substances (active metabolites of CPM) were serially measured . Some of the animals were also treated with PSK (125 mg/kg X 5 i.p.), a proteinpolysaccharide immunopotentiator obtained from mycelia of the Coriolus vesicolor, or with OK-432 (10 KE/kg X 5 i.m.), a streptococcal immunopotentiator . The results obtained were as follows: The blood levels of the normustard-like substances were lowered, i.e . the CPM activation was depressed in the YS-bearing rats and the depression was markedly intensified by PSK or OK-432 administration . Phenobarbital (40 mg/kg X 3 i.p.) or coenzyme Q10 (5 mg/rat X 5 i.p.) administration could mitigate the depression of the blood levels caused by the immunopotentiators, and the combination of phenobarbital with coenzyme Q10 could recover the blood levels up to those of the YS-bearing control rats, or even higher . YS-implanted (i.p.) rats treated with CPM+ immunopotentiators+coenzyme Q10 survived longer than those treated with CPM+immunopotentiators . These findings suggest the usefulness of coenzyme Q10 for the enhancement of cancer immunochemotherapy using masked compounds combined with immunopotentiators; all the more so, because coenzyme Q10 has also an immuno-stimulating effect, moreover, it presents almost no side effects in clinical application.

An Esp Pediatr, 1983 Mar, 18(3), 181 - 8
{Hemolytic-uremic syndrome in children . Review of nine cases}; Gimenez Llort A et al.; Nine cases of hemolytic uraemic syndrome diagnosed in a single institution during the last eight years are reviewed . In two cases the prodromic phase was rather dramatic and, the disease itself was apparently triggered by streptococcal infections (S . haemolyticus of group C in one case and S . "Agalactiae" in another one) . Interestingly enough, one patient with familiar haemolytic uraemic syndrome showed hypocomplementaemia . Complement levels were also low in another patient . In seven out of nine cases, a histopathologic study of the kidney was carried out showing micro angiopathy predominantly glomerular (five cases), microangiopathy predominantly arterial (one case) and cortical necrosis (one case) . A fairly good correlation between the histopathological changes and the clinical outcome has been observed in the only case with long-term sequelae who has predominantly vascular microangiopathy . With respect to the therapy, efficacy of the inhibitor of the angiotensin converting enzyme in a case in which severe arterial hypertension appeared, is emphasized.

Rev Infect Dis, 1983 Mar-Apr, 5(2), 196 - 204
Group G streptococcal bacteremia: clinical study and review of the literature; Auckenthaler R et al.; Patients with group G streptococcal bactermia represented 10.8% of those with beta-hemolytic streptococcal bacteremia and 0.3% of all those with bacteremia between 1970 and 1980 at Mayo Clinic-affiliated hospitals . The most frequent portal of entry was the skin, usually in cases with preexisting edema due to previous surgical removal, irradiation, or tumor infiltration of lymph nodes, or to chronic venous insufficiency . The majority of these patients had underlying hematologic malignancies or solid tumors . Clinical response to therapy with beta-lactam antibiotics was rapid.

Surgery, 1983 Mar, 93(3), 365 - 73
New approach to management of malignant ascites with a streptococcal preparation, OK-432 . II . Intraperitoneal inflammatory cell-mediated tumor cell destruction; Katano M et al.; Twelve patients with malignant ascites caused by gastric cancer were treated with intraperitoneal injections of a streptococcal preparation, OK-432 . All had resolution of the ascites after OK-432 treatment . Neutrophils, macrophages, and lymphocytes increased in number in ascitic fluid samples . Some of the OK-432-induced inflammatory cells were attached to tumor cells . The absolute number of tumor cells decreased as the number of infiltrating inflammatory cells increased . Infiltrating lymphocytes were mainly E rosette-forming cells . Infiltrating macrophages were in an activated state . The infiltrating neutrophils, lymphocytes, and macrophages could inhibit DNA synthesis of the patient's own tumor cells in the ascitic fluid after OK-432 injection, but not before the injection . These results indicate that OK-432-induced neutrophils, lymphocytes, probably T cells, and activated macrophages may play an important role in tumor cell destruction in ascites . Moreover, as the number of tumor cells decreased, the ascitic fluid protein levels decreased . Decrease of the ascitic fluid protein level may suppress further accumulation of ascitic fluid, and the low protein level in ascitic fluid is likely to facilitate the reabsorption of the fluid into the bloodstream.

Ann Immunol (Paris), 1983 Mar-Apr, 134C(2), 275 - 80
{Characterization of the antigen in circulating immune complexes and application to the detection of streptococcal antigens in human infectious endocarditis}; Grangeot-Keros L et al.; Immune complexes from patients with subacute endocarditis were used to develop a methodology for characterization of the antigen involved in human circulating immune complexes . This model was chosen because it permits isolation of the causative agent of the streptococcal infection thought to contain the antigen present in the immune complex . A comparison was made between two methods for characterization of bacterial antigen bound to antibody . In the first, animals were immunized with purified immune complexes and the production of antistreptococcal antibodies was investigated . In the second method, a sandwich ELISA was developed, implying the double specificity of the immune complex (human immunoglobulin and streptococcal antigen) . The latter method gave the best results, detecting antigen in the immune complexes of 8 out of 10 patients' sera . The application of this method to other immunopathological situations is discussed.

Am J Kidney Dis, 1983 Mar, 2(5), 512 - 20
Henoch-Schönlein nephritis: prognostic features and the challenge of therapy; Austin HA 3rd et al.; Henoch-Schonlein purpura is an intriguing entity of uncertain etiology associated with circulating IaA immune complexes, enhanced spontaneous immunoglobulin production, and an apparent imbalance in T cell regulatory functions . The associated glomerulonephritis is highly variable in nature and may profoundly influence clinical outcome . Prognostic features are reviewed in an effort to identify high-risk patients . Age, non-renal manifestations, non-selectivity of proteinuria, and evidence of preceding streptococcal infection are relatively weak predictors of end-stage renal disease . The presenting clinical and histologic expressions of nephritis are more useful prognosticators, but neither are completely reliable . Patients with greater than 50% crescents, and those with nephrotic syndrome complicated by various combinations of hypertension, azotemia, oliguria, and/or hypoproteinemia, are at increased risk of renal failure and might benefit from therapeutic interventions . Experience with various modalities is reviewed . Faced with uncontrolled clinical data, it is unclear whether immunosuppressive agents or plasmapheresis offer a therapeutic advantage over oral corticosteroids alone.

Cell Immunol, 1983 Feb 15, 76(1), 200 - 6
Polyclonal antibody-forming cell activation and immunomodulation of the in vitro immune response induced by streptococcal extracellular products; Cavaillon JM et al.; The capacity of three different extracellular streptococcal products to induce polyclonal activation of precursors of plaque-forming cells (PFC) was investigated . The gamma fraction (pI = 4.2), previously shown to be only weakly mitogenic, was the most potent activator of rabbit and mouse immunoglobulin-secreting cells . The polyclonal stimulation induced by the two other fractions (kappa: pI = 4.8 and epsilon: pI = 10.3), shown to be mitogenic in both systems, was only observed in the rabbit system . Using these fractions, the in vitro immunomodulation of the anti-sheep red blood cell immune response was also investigated . Both gamma and epsilon fractions were shown to possess adjuvant properties, whereas the kappa fraction was a suppressor of the specific immune response . It appears, therefore, that the diversified immunological activities observed with extracellular streptococcal products can be dissociated and belong to different entities.

Sem Hop, 1983 Feb 3, 59(5), 327 - 8
{Association of streptococcal spondylitis and endocarditis . 2 new cases}; Philippe P et al.; Two new cases of spondylitis associated with endocarditis are reported . Approximately 30 cases have already been published in the medical literature . Although this association is infrequent, the possibility of its occurrence calls for repeated auscultation in patients with spondylitis and focal roentgenograms in patient with bacterial endocarditis who develop vertebral pain.

Gan To Kagaku Ryoho, 1983 Feb, 10(2 Pt), 194 - 7
{Management of rectal and ureteral obstruction following gastrointestinal cancer}; Niimoto M et al.; During the period from June 1973 to August 1982, thirteen patients with gastric cancer and seven patients with colorectal cancer received surgical treatment due to the obstruction of the rectum or ureter . Of thirteen gastric cancer patients, 11 underwent the formation of the artificial anus for rectal obstruction . Nephrostomy was performed in 4 gastric cancer patients with ureteral obstruction . Seven patients with colorectal cancer underwent the formation of the artificial anus for rectal obstruction . In the recurrent cancer of the gastrointestinal tract, obstruction of the rectum or ureter mainly occurred due to peritoneal invasion or tumor formation . During laparotomy, OK-432, a Streptococcal preparation, was administered with a large dose of 100 K . E . to the patients with advanced or recurrent cancer foci . The prognosis for those patients was poor, and the main reason for poor survival was the advancement of disease in the cases of rectal or ureteral obstruction.

Clin Exp Immunol, 1983 Feb, 51(2), 207 - 14
Immunosuppression in Kenyan visceral leishmaniasis; Ho M et al.; Cell-mediated immune responses were evaluated in 15 patients with active visceral leishmaniasis from Masinga location in eastern Kenya where the disease is endemic . Age and sex matched controls were selected from a village school in the same area . In vivo studies were carried out by skin testing with leishmanin, tuberculin, streptococcal and candida antigens . Lymphocyte blastogenic transformation to the mitogens phytohaemagglutinin (PHA) and concanavalin A (Con A) and the antigens purified protein derivative (PPD), streptokinase-streptodornase (SKSD) and leishmanial antigen (LA) was studied in vitro . The results showed that immunosuppression in visceral leishmaniasis in Kenya was both specific and non-specific . In the majority of patients there was complete anergy to all antigens in vivo and in vitro . The suppression of responses to mitogens was less marked . Recovery of non-specific responses preceded the development of specific immunity . In a small number of patients (23%) immune unresponsiveness to leishmanial antigens persisted 1 year after parasitological cure.

J Clin Microbiol, 1983 Feb, 17(2), 187 - 91
Selective recovery of oral Capnocytophaga spp . with sheep blood agar containing bacitracin and polymyxin B; Mashimo PA et al.; On the basis of in vitro susceptibility testing of antibiotics, dyes, and other antimicrobial agents, we developed and evaluated a medium, TBBP, for the selective isolation of oral Capnocytophaga spp . TBBP medium consists of 4% Trypticase soy agar (BBL Microbiology Systems, Cockeysville, Md.), 5% sheep blood, 0.1% yeast extract, 50 micrograms of bacitracin per ml, and 100 micrograms of polymyxin B per ml . A total of 34 Capnocytophaga stock cultures grew well on TBBP medium . Except for some streptococcal strains, TBBP medium inhibited growth of all test stock culture isolates of common oral gram-positive and gram-negative species . In a clinical study of 15 deep periodontal pockets, TBBP medium demonstrated Capnocytophaga recoverability that was similar to or higher than that shown by a nonselective blood agar medium . Typical Capnocytophaga colonial morphology enabled us to readily distinguish this organism from the few other bacteria which could grow on TBBP medium.

Arch Dis Child, 1983 Feb, 58(2), 106 - 9
Prevalence and pattern of renal disease in eastern Libya; Elzouki AY et al.; A prospective study was conducted to identify the pattern and aetiology of kidney disease in children living in eastern Libya . A total of 343 patients was studied, representing 3% of annual admissions to the children's hospital . The major renal diseases were post-streptococcal glomerulonephritis (in 116), acute renal failure (in 93), and idiopathic nephrotic syndrome (in 65) . Less common diseases were tubular transport defect (in 3) and end-stage renal disease (in 3) . The mortality rate (excluding neonates) was below 1% . The pattern of kidney disease referred to this hospital in Libya was different from that reported in other parts of Africa.

J Am Acad Dermatol, 1983 Feb, 8(2), 177 - 81
Treatment of staphylococcal skin infections: a comparison of cephalexin and dicloxacillin; Dillon HC Jr; Cephalexin, given twice daily, and dicloxacillin, given four times daily, were compared in a randomly controlled study for the treatment of staphylococcal skin and skin structure infections . Among 70 evaluable patients, 57 had staphylococcal bullous impetigo . The remaining 13 patients had bullous impetigo with streptococcal or mixed streptococcal-staphylococcal cultures (6 patients), abscess (4 patients), or cellulitis with pyoderma (3 patients) . Staphylococci were recovered from lesions of 64 of the 70 evaluable patients; all strains were sensitive to both cephalexin and dicloxacillin, but only 2 of the 64 strains were susceptible to penicillin G . Cephalexin and dicloxacillin proved equally effective . Treatment failures were uncommon (1 patient in each group), and recurrences (3 patients in each group) were limited to patients with bullous impetigo . In general, patients with staphylococcal bullous impetigo responded promptly, with clearing of lesions evident within the first week, but delayed healing with persistence of staphylococci in lesions was more common in the group receiving dicloxacillin . Twice-daily dosing with oral antibiotics is obviously convenient and may enhance compliance . Twice-daily therapy with cephalexin for staphylococcal skin and skin structure infections can be recommended with confidence.

J Bacteriol, 1983 Feb, 153(2), 627 - 34
Transfer of resistance plasmids from Staphylococcus epidermidis to Staphylococcus aureus: evidence for conjugative exchange of resistance; Forbes BA et al.; The ability of Staphylococcus epidermidis to transfer antimicrobial resistance to Staphylococcus aureus was tested by mixed culture on filter membranes . Two of six clinical isolates examined were able to transfer resistance to S . aureus strains 879R4RF, RN450RF, and UM1385RF . Subsequent S.aureus transconjugants resulting from matings with S . epidermidis donors were able to serve as donors to other S . aureus strains at similar frequencies . Cell-free and mitomycin C-induced filtrates of donors and transconjugants showed no plaque-forming ability . Addition of DNase I, citrate, EDTA, calcium chloride, and human sera to mating mixes and agar showed no effect on transfer . Nonviable donor cells were unable to transfer resistance and transfer did not occur at 4 degrees C . Cell-to-cell contact was required since transfer did not occur in broth or when filters of donor and recipient, respectively, were placed back-to-back so cells were not in direct contact . Analysis of DNA from S . epidermidis isolate UM899, its subsequent S . aureus transconjugants, and cured derivatives demonstrated that all resistance markers which transferred resided on plasmids . Mating experiments suggested a central role for the gentamicin plasmid pAM899-1 in the transfer process . It is concluded that our results are consistent with a conjugative transfer of resistance from S . epidermidis to S . aureus analogous to plasmid transfer demonstrated in streptococcal species for plasmids such as pAM beta 1 . This represents a novel mechanism for gene exchange among staphylococci.

J Immunol, 1983 Feb, 130(2), 722 - 6
Serologic aspects of IgG4 antibodies . I . Prolonged immunization results in an IgG4-restricted response; Aalberse RC et al.; Labeled antigen-binding tests were used to determine quantitatively the contribution of IgG4 antibodies to the total IgG antibody response in humans . In agreement with literature, we found no IgG4-restricted antibody responses with tetanus toxoid or streptococcal carbohydrate . In the serum of individuals immunized for several years with phospholipase (PLA) from honey bee venom, grass pollen allergen, or house dust mite allergen, we often found that more than 50% of the total antigen-binding capacity was due to IgG4 antibodies . In the case of beekeepers, it could clearly be shown that during prolonged immunization a shift in the IgG4:IgG1 antibody ratio occurs that finally results in an IgG4-dominated antibody response . Evidence is provided that antigen-binding assays may even underestimate the contribution of IgG4 antibodies, because in contrast to IgG1 antibodies, IgG4 antibodies act as monovalent antibodies in being unable to cross-link immunosorbent-bound antigen and radiolabeled antigen.

Mayo Clin Proc, 1983 Feb, 58(2), 79 - 87
Cephalosporin antibiotics; Thompson RL et al.; Cephalosporin antibiotics are bactericidal against most gram-positive cocci and gram-negative bacilli of clinical importance . They are relatively nontoxic but like the penicillins may cause hypersensitivity reactions . Agents with clinically advantageous pharmacokinetics include cefazolin, moxalactam, and cefadroxil . First-generation cephalosporins are indicated for surgical prophylaxis and for treatment of most staphylococcal and streptococcal infections in patients who are allergic to penicillins . Activity against gram-negative bacilli increases from first- to third-generation drugs, but sensitive isolates should be treated with first-generation agents to prevent resistance to newer cephalosporins and to minimize the expense for the patient . Treatment of Bacteroides fragilis and Pseudomonas aeruginosa infections is not entirely satisfactory with currently available agents . No cephalosporin is active against the enterococci, and superinfection with these organisms has occurred during treatment with moxalactam . Some experimental cephalosporins have improved activity against P . aeruginosa and gram-negative bacilli that are resistant to multiple drugs . A few of these agents have a very long half-life . It is likely that cephalosporin antibiotics will continue to proliferate.

Klin Wochenschr, 1983 Feb 1, 61(3), 151 - 5
{Postpartum streptococcal gangrene}; Niebel J et al.; A case of acute hemolytic streptococcal gangrene is presented . Typical signs of this disease are local pain, erythema, edema, formation of blisters, and gangrene . Malaise and fever are more unspecific . The special clinical feature of this postpartum case is discussed and compared with the literature . The therapy comprised extended incision of the vulva, application of antimicrobial agents, and exchange transfusion.

Infect Immun, 1983 Feb, 39(2), 580 - 5
Enhanced susceptibility of mice with streptozotocin-induced diabetes to type II group B streptococcal infection; Edwards MS et al.; Since diabetes mellitus predisposes adults to group B streptococcal (GBS) bacteremia, a murine model of streptozotocin-induced diabetes and type II GBS bacteremia was developed to assess certain immune factors which might influence susceptibility to infection . In diabetic mice, the 50% lethal dose for two strains of type II GBS was significantly lower (greater than 1 log10 decrease in CFU per milliliter) than in control animals . This enhanced virulence of GBS for diabetic animals was associated with prolonged bacteremia, persistent sequestration of organisms in the splanchnic reticuloendothelial system, and a shift from splenic to hepatic clearance . Although immunization of control and diabetic animals resulted in high concentrations of type-specific serum antibody, it had no effect on late reticuloendothelial system sequestration in diabetics . In contrast, depletion of complement by treatment of mice with cobra venom factor blocked reticuloendothelial system clearance and resulted in fatal infection in both diabetic and control mice . These results indicate that neither type-specific antibody nor an intact complement system is adequate for effective clearance of type II GBS bacteremia in mice with experimentally induced diabetes . This clearance deficit could be the result of a defect in hepatocyte membrane receptors necessary for removal of this encapsulated microorganism.

J Antimicrob Chemother, 1983 Feb, 11(2), 125 - 33
Effectiveness of treatment with mezlocillin, ampicillin and latamoxef (moxalactam) of experimental group B beta-haemolytic streptococcal meningitis in rabbits; Khurana CM et al.; This study compared the effectiveness of treatment with various antibiotics in rabbits with experimental group B beta-haemolytic streptococcal meningitis . Groups of nine infected rabbits each received the following treatments intramuscularly, three times per day: (1) control--no treatment; (2) mezlocillin--400 mg/kg/day; (3) mezlocillin--400 mg/kg/day + gentamicin--15 mg/kg/day; (4) ampicillin--400 mg/kg/day; (5) ampicillin--400 mg/kg/day + gentamicin 15 mg/kg/day; (6) latamoxef (moxalactam)--100 mg/kg/day . Bacterial counts in the cerebrospinal fluid (CSF) and drug levels in the serum and CSF were measured each hour for 7 h and at 24, 48 and 72 h after start of therapy . Percent penetration values (CSF concentration/serum concentration X 100) for the drugs were calculated and effectiveness of bacterial clearing from the CSF was determined . Over the 72 h period, the most effective therapy was mezlocillin + gentamicin, followed by ampicillin + gentamicin, mezlocillin, ampicillin and latamoxef in order of effectiveness in clearing bacteria from the CSF.

Med J Aust, 1983 Jan 22, 1(2), 64 - 6
Epidemic of acute poststreptococcal glomerulonephritis in aboriginal communities; Gogna NK et al.; During 1980, an epidemic of acute glomerulonephritis occurred in a number of Aboriginal communities in the Northern Territory, affecting several hundred people . Clinical and laboratory studies of children admitted to the paediatric wards of Darwin Hospital, and of a larger number of individuals in the communities, have established that the nephritis was preceded by a streptococcal infection, and a recognised nephritogenic streptococcal strain was isolated from a number of children . The clinical course of the disease was mild in the majority of those affected and none had had serious complications . Serological results indicate the importance of measuring antideoxyribonuclease B levels as well as antistreptolysin O titres when seeking evidence of antecedent streptococcal infection.

Trans R Soc Trop Med Hyg, 1983, 77(2), 189 - 91
Streptococcal antibodies and complement components in tropical post-streptococcal glomerulonephritis; Koshi G et al.; Anti-deoxyribonuclease "B' was elevated in 94.9% of 59 cases of post-streptococcal glomerulonephritis studied, whereas ASO was elevated only in 54.4% of cases showing that the ADNB titre is a more sensitive indicator of antecedent streptococcal infection than ASO, in tropical countries with a high prevalence of pyoderma . Serum C3c (beta 1A) levels were significantly decreased, especially in the early phase of the illness and returned to normal with remission . C4 levels were decreased only in the early phase of the illness, suggesting involvement of the alternate pathway subsequent to classical pathway activation.

Oncology, 1983, 40(2), 115 - 9
Combination therapy of radiation and immunomodulators in the treatment of MM46 tumor transplanted in C3H/He mice; Miyaji C et al.; Female C3H/He mice aged 10 weeks with transplanted MM46 tumor were used in an investigation of the timing of administration of immunomodulators, such as PSK (a protein-bound polysaccharide prepared from Coriolus versicolor), OK-432 (streptococcal preparation), bestatin (inhibitor of aminopeptidase B) combined with two fractionated local irradiation with the total dose of 3,000 rad . The daily dose of 250 mg/kg of PSK, 1.0 KE/mouse of OK-432, or 300 micrograms/mouse of bestatin were injected intraperitoneally for 4 consecutive days before or after irradiation . The antitumor effect was evaluated by the changes of tumor volume and survival curves . When PSK or OK-432 was administered after irradiation, tumor growth was decreased and 60-day survival rate and survival curve were significantly elongated compared with the control group and the group to which PSK or OK-432 were administered before irradiation (p less than 0.025, p less than 0.05, respectively) . As for bestatin, no remarkable difference was observed irrespective of the timing of administration . These results suggested that some immunomodulators show different antitumor activity depending on the combined timing relative to radiotherapy.

J Clin Microbiol, 1983 Jan, 17(1), 170 - 1
Micronitrous acid extraction-coagglutination test for rapid diagnosis of streptococcal pharyngitis; Gerber MA; A micronitrous acid extraction-coagglutination test for the rapid diagnosis of streptococcal pharyngitis was examined in a busy pediatric clinic and found to be a simple, rapid, and inexpensive procedure with a sensitivity of 78% and a specificity of 98% when compared with blood agar culturing.

Int Arch Allergy Appl Immunol, 1983, 70(2), 151 - 6
HLA-related lymphocyte responsiveness in psoriasis; Gross WL et al.; In order to find associations among the genetic, immunological and environmental factors that might be important in the pathogenesis of psoriasis, the relationship between streptococcal antigen- or mitogen-induced lymphocyte responses in vitro and HLA phenotypes was studied in 23 patients with psoriasis . Patients showed an elevated lymphocyte response to somatic A-streptococcal antigens when compared with healthy controls . In contrast, the response to mitogens (PHA, Con A, PWM) was impaired in patients with psoriasis . The impaired mitogen-induced lymphocyte transformation was found mostly in psoriatics with HLA-B13/B17 . The elevated cellular immune response to somatic A-streptococcal antigens, on the other hand, was observed mainly in psoriatics without HLA-B13/B17 . The results indicate that gene products of the HLA region known to be associated with psoriasis are involved in the cellular immune response, as expected from clinical trials . These findings also provide further evidence of at least two different subtypes of psoriasis, characterized by genetically and immunologically defined markers.

Ann Med Interne (Paris), 1983, 134(7), 656 - 8
{Erysipelothrix rhusiopathiae endocarditis . A case report and review of the literature}; Bricaire F et al.; A case of acute aortic valve Erysipelothrix rhusiopathiae endocarditis is reported in a 48 year old fisherman with no history of initial erysipelar and requiring emergency aortic valve replacement 48 hours after starting antibiotic therapy with Ampicillin and Gentamicin . The outcome was favourable . In the light of 32 of the 40 previously published cases, the authors discuss the difficulty in identifying the causal organism, the main epidemiological features, the occupational association of these infections, the incidence of primary infections, the involvement of the aortic valve and the more serious nature of the disease compared to non-D streptococcal endocarditis, despite high sensitivity to Penicillin G.

Clin Exp Rheumatol, 1983 Jan-Mar, 1(1), 49 - 52
Musculoskeletal manifestations of bacterial endocarditis; Levo Y et al.; The musculoskeletal (MS) involvement of 91 patients with bacterial endocarditis (BE) is reported . Twenty-three patients (25.2%) exhibited MS symptoms; 74% had arthralgias often associated with arthritis and low back pain (LBP), 48% had myalgias, and 43.4% had LBP . The articular symptoms usually were polyarticular and symmetric, affecting both the large and small joints . Two of 12 patients had a positive test for rheumatoid factor activity, and 2 of 5 had a positive FANA test . Patients with MS symptoms did not differ from those with no such symptoms by their mean age, by their underlying heart disease, or by the nature of their cardiac lesions . They were characterized by female preponderance and increased prevalence of streptococcal infections . In view of our data and the relevant literature, it seems that MS symptoms are common in patients with BE . They often antedate the diagnosis of BE by several weeks and can mimic other rheumatic diseases . Therefore, unexplained rheumatic symptoms should always alert the physician to the possibility of bacterial endocarditis.

Arch Immunol Ther Exp (Warsz), 1983, 31(5), 649 - 54
Studies on the therapeutic effect of Wratizolin in selected dermatoses; Michalowski R et al.; Clinical investigations of ITCL drug ("Polfa") were carried out on 50 patients (15 women, 16 men, 19 children, at the age of 4-80) . ITCL has been successful in non-specific inflammations accompanying some virus dermatoses (zoster, herpes simplex), in streptococcal pyoderma (impetigo, ecthyma), and in some allergic dermatoses (disseminated eczema and atopic dermatitis) . Encouraging results were obtained with ITCL in the treatment of psoriasis . It seems that the further attempts with this should be continued in psoriasis . The capillaroscopic examinations in 6 patients revealed ITCL to have vasoconstrictive effect on the nail wall cutis capillaries 6 h after its application . This may be associated with the anti-inflammatory effect of the drug.

Z Allg Mikrobiol, 1983, 23(9), 539 - 47
Double or triple sets of replication functions as inverted and direct repeats on in vitro reconstructed streptococcal MLS resistance plasmids; Behnke D et al.; In vitro rearrangement of plasmid pDB102 together with comparative studies of other streptococcal plasmids allowed the localization of replication and copy control functions on sequences which were present on pDB102 and its naturally occurring ancestor pSM19035 as duplicates in inverted orientation . Evidence is presented that neither the presence of duplicate replication regions nor their arrangement in inverted orientation was essential for plasmid survival . Among the in vitro reconstructed plasmids were several that stably carried two or three sets of replication and copy control functions either as inverted or direct repeats or both . A copy control mutation is described which led to a tenfold increase of copy number over that of the naturally occurring plasmid pSM19035.

Q J Med, 1983 Autumn, 52(208), 471 - 87
Late onset systemic lupus erythematosus and lupus-like disease in patients with apparent idiopathic glomerulonephritis; Adu D et al.; We report 17 patients who presented with either apparent idiopathic glomerulonephritis (16 patients) or post-streptococcal glomerulonephritis (one patient) . Doubts arose about the nature of these patients' disease, either because their initial renal histology was suggestive of systemic lupus erythematosus (SLE) in the absence of its clinical or serological features, or because they developed with time the clinical or serological features of SLE . Three patients had a positive antinuclear antibody (ANA) test at the onset of their illness, but normal levels of serum binding of double-stranded DNA (dsDNAB) . In another four patients the dsDNAB was slightly raised but with a negative ANA . On renal biopsy the predominant appearance was membranous glomerulonephritis (GN) in 10, subendothelial mesangiocapillary GN (MCGN) in three, and focal segmental glomerulosclerosis in two; one patient each had a focal proliferative GN and a diffuse endocapillary GN . On 1 micron renal sections stained with toluidine blue, 10 patients had immune deposits at multiple sites within the glomeruli . Over a period of one to 14 years, six patients developed extrarenal features suggestive of SLE, nine a positive ANA, and 12 increased serum levels of dsDNAB . Five patients became hypocomplementaemic . Cryoglobulins were isolated from the sera of 10 out of 12 patients; seven contained DNA . Separated cryoglobulin IgG from eight patients showed antibody activity directed against both ss and dsDNA in four, and against dsDNA only in three . On the basis of the clinical, histological and serological observation during follow-up five patients were reclassified as definite SLE, four as probable SLE and two as possible SLE . Rarely, SLE may present with nephritis as the sole disease manifestation, antedating other clinical features and even immunological markers of the disease by years . In addition, some patients with a glomerulonephritis may show clinical and immunological, or histological features of SLE, but do not fit accepted definitions of the disease.

Adv Myocardiol, 1983, 4, 215 - 26
Pathogenesis of immune-mediated carditis in monkeys; Anand IS et al.; An experimental model of carditis has been produced in the rhesus monkey by giving 12 weekly injections of streptococcal membrane antigen . Carditis was produced in as short a period as 14 weeks . There was evidence of myocarditis, endocarditis, and, in two animals, myocardial granuloma formation . No valvular lesions were seen . Measurement of immune responses showed that heart cross-reactive antibodies started appearing in the circulation after the second injection . By the sixth injection, there was evidence of complement consumption and appearance of circulating immune complexes . Antibody-dependent cell cytotoxicity started operating after the second injection, and by the sixth injection, peripheral lymphocytes had acquired hypersensitivity to membrane antigen . It is concluded that some of these immunologic responses might have played a role in the genesis of carditis.

Scand J Infect Dis Suppl, 1983, 39, 68 - 72
Some non-bacteriological determinants and implications of antibiotic use in upper respiratory tract illness; Howie JG; Antibiotics are widely but inconsistently used by general practitioners in the UK for treatment of respiratory infections . Although it might be expected that antibiotic use would be governed by biomedical factors this is often not the case . Four non-bacteriological determinants of antibiotic use are identified and discussed; these are (i) the doctor's anxiety about his workload, (ii) the response of doctors to social pressures, (iii) misinterpretation of underlying reasons for a consultation and (iv) fear of the possible development of sequels to streptococcal illness . The implications of the variable response of doctors to these influences are discussed . These apply, not only to doctors and patients, but also to relationships between them . In addition there are important implications for the credibility of general practice as a critical and academically respectable discipline.

Scand J Infect Dis Suppl, 1983, 39, 73 - 8
Bacterial interference in streptococcal tonsillitis; Holm SE et al.; On the basis of the presented results and those published by other investigators it can be stated that in the throat (i) bacterial interference is a multifaceted phenomenon; (ii) bacterial interference not only varies individually but also fluctuates in the individual by time and the epidemiological situation; (iii) bacterial interference among the microbes in the normal flora apparently helps the individual to combat the invading microorganisms; (iv) bacteriocins, if present, in the invading bacteria represent an important virulence factor; (v) bacterial interference as a factor of the host resistance to infection can be influenced negatively by antibiotic therapy; (vi) bacterial interference can act synergistically with antibiotics given in optimal doses saving the normal flora.

Diagn Immunol, 1983, 1(2), 75 - 9
A sensitive assay to evaluate antistreptococcal antibodies using an in vitro-produced monoclonal human rheumatoid factor; Avital A et al.; A human monoclonal rheumatoid factor (RF) produced in vitro by an Epstein-Barr virus (EBV) immortalized cell line is used in an assay to detect and quantitate antibodies directed against streptococcal antigens in human sera . The assay, based on the binding of the rheumatoid factor to IgG-immune complexes, applies this monoclonal antibody in its iodinated form . The assay can easily quantitate IgG-antistreptococcal antibodies and enables the quantitation of these specific antibodies in sera that contain even very low titers.

Diagn Immunol, 1983, 1(2), 64 - 7
Enzyme-linked immunosorbent assay (ELISA) for streptokinase antibodies; Leonardi MS et al.; A micro plate Enzyme-linked immunosorbent assay (ELISA), developed for detection of antibodies to Streptokinase, was used to analyze 80 human sera . The aim was to provide a simple method for antibody screening that required neither sophisticated equipment nor a high degree of technological skill . Preliminary results show that ELISA is specific, reproducible and sensitive . Comparative evaluation of the ELISA and the coagulum lysis test for antibodies against streptokinase show excellent correlation . We also evaluated the anti-Streptolysin O titer either by conventional method or ELISA . The sensitivity of ELISA for detecting anti-Streptolysin O antibodies was 3-4-fold higher than that of the hemolytic test . The sensitivity of ELISA for detecting anti-streptokinase antibodies was 10-20-fold higher than that of the coagulum lysis . The Enzyme-linked immunosorbent assay seems to offer some advantages over the more commonly used coagulum lysis test as far as sensitivity is concerned and potentially it is suggested that this method could be usefully employed clinically in human streptococcal infections.

Postgrad Med J, 1983, 59 Suppl 5, 43 - 6
The role of cephalexin in the treatment of skin and soft-tissue infections; Derrick CW Jr et al.; Cephalexin remains an effective and highly useful antibiotic for the treatment of streptococcal and staphylococcal skin infections . Twelve years of experience have not diminished its efficacy, and cure rates of 90% or higher continue to be achieved . Its resistance to degradation by gastric acid and its uniform absorption ensure its bioavailability, and its efficacy in twice-daily dosages enhances medication compliance . The suspension formulation is well accepted by young children, and side effects have generally been mild and infrequent . Cephalexin is comparable to erythromycin, clindamycin, dicloxacillin, cloxacillin, and other cephalosporins in the treatment of streptococcal and staphylococcal infections . Because many of these antibiotics are similar in their efficacy, palatability, and adverse reactions, cost factors may play an important role in choosing one over the other . Penicillin remains the drug of choice for streptococcal skin infections . If the cure rates of the mixed streptococcal-staphylococcal lesions continue to decrease with penicillin, cephalexin and the other alternative antibiotics may assume a more important role in the primary treatment of these infections in the future.

Proc Eur Dial Transplant Assoc, 1983, 19, 686 - 91
Glomerular deposits of rheumatoid factor in glomerulonephritis; Bartolomeo F et al.; One hundred and forty-four kidney biopsy specimens with various forms of glomerulonephritis were studied to assess the presence of Rheumatoid Factor (RF) deposits . RF deposits were found in 21 specimens: six with acute post-streptococcal glomerulonephritis, two with crescentic glomerulonephritis, four with lupus nephritis, eight with essential mixed cryoglobulinaemia glomerulonephritis, and one with end-stage kidney disease . Blocking and elution studies carried out on specimens with essential mixed cryoglobulinaemia provided evidence that the RF deposits derive from circulating monoclonal RF . This data suggests that RF participates in the formation of glomerular immune deposits in several forms of immune complex mediated glomerulonephritis.

Clin Ther, 1983, 5(3), 299 - 304
Multicenter comparison of cyclacillin and amoxicillin in the treatment of acute streptococcal pharyngitis; McLinn SE et al.; A double-blind study of 134 pediatric outpatients with acute streptococcal pharyngitis demonstrated that cyclacillin, administered three times a day for ten days, is as effective as a similar regimen of amoxicillin . Clinical success was achieved in 95% of the children treated with either drug . A bacteriological cure was seen in 82% of the children evaluated in the cyclacillin group and 90% of those evaluated in the amoxicillin group . The mean time required for remission of signs and symptoms in the respective treatment groups was 3.1 and 3.0 days . Only two patients (3%) in each treatment group experienced an adverse effect of the prescribed drug.

Am J Nephrol, 1983 Jan-Feb, 3(1), 23 - 9
Circulating immune complexes in patients with uncomplicated group A streptococcal pharyngitis and patients with acute poststreptococcal glomerulonephritis; Yoshizawa N et al.; To investigate the role of circulating immune complexes (CIC) in the pathogenesis of acute poststreptococcal glomerulonephritis (AGN), sera were obtained serially from 13 patients with biopsy-proven AGN, 16 patients with group A streptococcal infection, and 20 age- and sex-matched controls . Samples were analysed for Clq-binding activity (Clq-BA), levels of IgG, IgA, IgM, C3 and C4, and antibody titres to streptococcal enzymes . Significant elevation of Clq-BA was observed in 11 patients (84.5%) with AGN and 7 patients (44%) with streptococcal infection alone . The data suggest that CIC do not necessarily cause glomerular damage, but rather represent a systemic inflammatory response in patients with group A streptococcal infection.

Infect Immun, 1983 Jan, 39(1), 311 - 4
Effects of carrier ampholyte contamination on the biological and biochemical properties of streptococcal pyrogenic exotoxin type C; Bloomster TG et al.; Three streptococcal pyrogenic exotoxins (SPEs), designated as SPE A, B, and C, have been purified and characterized . Routine purification of the SPEs includes the technique of isoelectric focusing . An earlier study showed that the removal of commercial carrier ampholytes (Ampholines) from SPE was difficult . The physiochemical properties of SPE C were previously reported; however, the SPE C preparation used in those experiments was contaminated with Ampholines . As an alternative to Ampholines, we used simple buffers to generate the isoelectric focusing pH gradient and used this SPE C in a comparative study to evaluate the effects of Ampholine contamination on the biological and biochemical properties of this toxin . We found that Ampholine contamination overestimates protein concentration; consequently, the biological activity of SPE C was actually greater than reported . The most serious effect of Ampholines in SPE C was on amino acid analysis . The presence of Ampholines causes an apparent increase in neutral amino acids and a decrease in basic amino acids.

Am J Med, 1983 Jan, 74(1), 90 - 6
Tissue distribution of lymphocytes in rheumatic heart valves as defined by monoclonal anti-T cell antibodies; Raizada V et al.; Fresh cardiac valvular tissues and atrial appendages removed from 106 Indian patients with rheumatic heart disease at the time of corrective cardiac surgery were examined to determine the characteristics of valvular interstitial lymphocytic infiltrates using conventional histologic staining along with indirect immunofluorescent techniques . Precise identification of the phenotypic profiles of inflammatory mononuclear cells was attempted using anti-IgG, anti-Ia, and monoclonal mouse hybridoma reagents identifying T cells (OKT3) as well as T cell subsets (OKT4 helper/inducer and OKT8 suppressor/cytotoxic cells) . A similar group of 21 patients undergoing cardiac valvular resection in Albuquerque was studied . The mean age of Indian patients providing valve tissues was 27.7, whereas in those in Albuquerque, it was 52 years . Twenty-five percent of rheumatic heart valves in Indian patients showed significant interstitial lymphoid infiltrates, and one third of the rheumatic valves from patients in Albuquerque showed similar mononuclear cell collections . Lymphoid infiltrates contained a predominance of T cells (70 to 80 percent) and only occasional B cells . Most of the T cells were OKT4-positive, with only a minor representation of suppressor/cytotoxic OKT8-positive T cells . In many instances, OKT4-positive helper T cell collections were closely juxtaposed to fibroblasts and collagen fibrils . These findings suggest that the chronic rheumatic scarring process may involve helper/inducer T cells as an ancillary factor in the indolent contracture and fibrosis of deformed cardiac valvular structures . Attempts to demonstrate residual streptococcal antigens by indirect immunofluorescence using a wide panel of heterologous rabbit F(ab')2 reagents with specificity for group A streptococcal membranes, cell wall mucopeptide, or group A carbohydrate gave negative results.

Mol Gen Genet, 1983, 189(2), 251 - 5
A physical map of the group A streptococcal pyrogenic exotoxin bacteriophage T12 genome; Johnson LP et al.; A physical map of group A streptococcal bacteriophage T12 was constructed with restriction endonucleases Sal/I, PstI, and EcoRI . The map is circularly permuted with a total length of 36.0 kb . Sub-molar quantities of certain restriction fragments, some of very precise MW and some of heterogeneous MW, were observed . This observation, together with mapping data, suggests that DNA packaging is initiated at a precise site on a concatemeric precursor and proceeds for a limited number of rounds.

Z Naturforsch {C}, 1983 Jan-Feb, 38(1-2), 107 - 11
Effect of streptococcal extracellular nuclease on the carrier activity of RNA for streptolysin S; Taketo A et al.; Upon digestion with a streptococcal extracellular nuclease, yeast RNA yielded acid-insoluble core having increased carrier activity for streptolysin S . The carrier activity was found in minor fractions of the core which were eluted from a DEAE-cellulose column at higher salt concentrations . Upon gel filtration through a Sephadex G-75 column, the effective component (Fr . I) was eluted earlier than bulk oligonucleotides (Fr . II) . Nucleotide composition (in mol %) of Fr . I was AMP: 21.8; GMP: 55.1; CMP: 8.2; UMP: 14.9, whereas that of Fr . II was AMP: 38.0; GMP: 33.1; CMP: 8.0; UMP: 20.9 . Chromatographic patterns of SLS complex induced by Fr . I were similar to those of the toxin formed in the presence of active fraction prepared from RNase I core . Hemolytic activity of the latter complex was, like the former, unaffected by streptococcal nuclease treatment . The carrier activity of DNA digested with the nuclease was also investigated.

Arch Oral Biol, 1983, 28(3), 253 - 8
An improved method for measuring aggregation of certain streptococcal bacteria found in dental plaque; Ochiai K et al.; Various cells were incubated with either dextran or sucrose and the reaction was terminated by the addition of a 20 per cent solution of formaldehyde . A reaction mixture consisting of cells and aggregated cells was applied to a step-gradient glycerol column (0-60 per cent) and 0.5 ml fractions were collected from the bottom of the column . Non-aggregated cells remained in the top layer of the column . Aggregated cells settled in the 30 per cent glycerol layer as determined by either spectrophotometric or radioactive methods . The amount of aggregated cells demonstrated in this layer increased with either incubation time or concentration of sucrose, dextran or cells . Cells of Strep, mutans strains 6715, AHT, 10449, OMZ-176, OMZ-175 and two mutants of Strep . mutans strain 6715 (designated C4 and C307) aggregated strongly . Cells of Strep . mutans strain LM7 aggregated weakly, whereas cells of Strep . mutans 6715 mutant UAB165, a mutant defective in aggregation . Strep . mutans strain BHT, Strep . salivarius and Strep . sanguis did not aggregate in the presence of either sucrose or dextran . Experiments testing co-aggregation between two different types of cells were done by using 3H-labelled and 14C-labelled cells . Strep . mutans strain 6715 co-aggregated with Strep . sanguis in the presence of sucrose or dextran, whereas Strep . mutans strain 6715 did not aggregate with Strep . salivarius . The method separates aggregated from non-aggregated cells and enables quantitation of sucrose- or dextran-induced aggregation and co-aggregation.

Nord Vet Med, 1982 Dec, 34(12), 435 - 40
{Results of the intracisternal treatment of subacute and chronic mastitis in lactating cows}; Pyorala S; In a field trial 92 lactating cows and 138 quarters affected with subacute or chronic mastitis were treated with intramammary preparations . Antibiotics were chosen in every case regarding to the antibiotic sensitivity test . The names of the preparations, their compositions and the dosages are stated in table I . Post-treatment samples were collected about 4 weeks after the treatment and a clinical investigation and CMT were made at the same time . The bacteriological cure rate was 57% and the rate of completely cured quarters (negative CMT and clinical findings) was 35% for all infections . The cure rate was 43% and 18%, respectively, in 40 cases of infections when S . aureus was the cause . For the streptococcal mastitis, a total of 57 quarters, the cure rate was 65% and 53%, respectively . The cure rates for different infection agents are seen in table II and for different antibiotics in table III.

J Clin Microbiol, 1982 Dec, 16(6), 1057 - 60
Group G streptococcal epizootic in a closed cat colony; Tillman PC et al.; An epizootic of beta-hemolytic Lancefield group G streptococcal infections occurred in a specific-pathogen-free colony of laboratory cats . A total of 19 out of 68 animals in a single building were affected over a 10-day period . Clinical signs included fever, depression, lymphadenopathy, pharyngitis, and submandibular edema . The organism was recovered from the pharynx in two of five clinically normal cats from the affected building . Cultures from 12 animals in the same colony but housed in unaffected buildings were negative . Two doses of long-acting penicillin G 72 h apart stopped the outbreak and resulted in negative cultures for previously affected animals . Three months later, two new cases occurred in the same building . The disease was finally eradicated from the colony by depopulating the affected building.

J Clin Microbiol, 1982 Dec, 16(6), 1091 - 5
Automated identification of gram-positive bacteria; Ruoff KL et al.; A total of 451 strains of gram-positive bacteria were identified with a prototype of the Gram-Positive Identification card used in conjunction with the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) . Of the species that the Gram-Positive Identification card is capable of identifying, 85% of staphylococcal, 50% of beta-hemolytic group A, B, C, F, and G streptococcal, 91% of group D streptococcal, 100% of pneumococcal, 63% of viridans streptococcal, and 100% of Listeria monocytogenes strains tested displayed Gram-Positive Identification card identifications that were in agreement with identifications obtained by conventional methods.

J Reticuloendothel Soc, 1982 Dec, 32(6), 433 - 42
Activation and augmentation of guinea pig macrophages with streptococcal preparation OK-432 and stimulated spleen cell products; Onozaki K et al.; A mechanism of macrophage activation by a streptococcal preparation (OK-432) was studied . Peritoneal exudate macrophages from normal guinea pigs treated in vitro with OK-432 were activated, manifesting increased glucose consumption, increased spreading, and morphological alterations under scanning electron microscopy . Macrophages showed extensive spreading within 1 hr after OK-432 treatment; they then became rounded with characteristic ruffles in their surfaces after 6 hr of treatment . Highly purified macrophages were activated as effectively as a crude macrophage preparation, suggesting that the macrophage activation resulted from a direct interaction between macrophages and OK-432 . However, when spleen cells were treated with OK-432, a factor(s) capable of activating macrophages was produced in the culture supernatant . Spleen macrophage-rich preparation was found to release the factor(s) upon stimulation with OK-432, but this did not occur with the lymphocyte-or granulocyte-rich preparations . These results indicate that OK-432 not only activates macrophages by direct interaction without lymphokine participation, but also augments the activation by affecting spleen cells, probably macrophages, in such a way as to produce monokines.

Clin Nephrol, 1982 Dec, 18(6), 280 - 5
Immunopathology, extent and course of glomerulonephritis with crescent formation; Bhuyan UN et al.; Ten out of 66 cases of glomerulonephritis (GN) with variable crescent formation appeared to be of post-streptococcal origin . Immunofluorescent studies of biopsies from 42 of the patients showed findings suggestive of immune complex glomerular injury in 86% whilst there was no evidence of immunologic or nonimmunologic injury in the remainder . Anti-GBM GN was not demonstrable, although it can not be certain that there were no cases amongst the patients whose biopsies were not examined by immunofluorescence . Conservative measures were adequate for the treatment of cases with less than 50% crescents . In the others, with greater than or equal to 50% crescents, appreciable improvement was observed with anticoagulation, immunosuppression and dialysis . The mortality was 30% in cases with 50-80% and 65% in cases with greater than 80% crescents . No appreciable difference in survival was observed between post-streptococcal and idiopathic cases . The single most important factor in prognosis, regardless of etiology, appeared to be the extent of crescent formation . Tubulo-interstitial damage was contributory . Necrotizing angiitis, present in 4 cases, affected the course adversely.

Gan To Kagaku Ryoho, 1982 Nov, 9(11), 1961 - 8
{Antitumor effect of intraperitoneal administration of a streptococcal preparation, OK-432, in carcinomatous peritonitis . I . Experimental study in the rat}; Saji S et al.; The effect of intraperitoneal (ip) OK-432 administration and its mechanism were investigated with experimental tumor of rats . Animals: 4 week-old female SD rats (Slc/SD, closed colony) . Tumor: An ascitic tumor, produced by intraperitoneal inoculation of strain cells . These have been established from MRMT-1, which originally was induced by 3-methyl cholanthrene administration . Experimental study: On day 4 or 6 of ip inoculation of 1 x 10(6) tumor cells, 50 KE/kg of OK-432 was administered intraperitoneally and cells were daily examined microscopically . Morphological changes around tumor cells were investigated with Papanicolaou-stained preparations . Following results were obtained: A marked increase in neutrophils was noted in ascitis at 24 hours after ip administration of OK-432; macrophages and lymphocytes appearing later than neutrophils . A subsequent decrease in neutrophils was accompanied by gradual increase in tumor cells . When OK-432 was administered intraperitoneally on day 4 of ip inoculation of tumor cells, aggregation of neutrophils around tumor cells was observed on day 6, and rosette formations around tumor cells with 76 to 10 neutrophils were noted on days 7 and 8 . Subsequently tumor cells forming centers of rosettes were found to be destroyed and disappeared . On days 10 to 12, regrowth of tumor cells within incomplete rosette formation was found in ascites . The above reactions were not remarkable, when OK-432 was administered intraperitoneally on day 6 of ip inoculation of tumor cells, and were never observed in untreated cases . These results indicated that cytotoxic effects of ip administration of OK-432 were displayed mainly by rosette formation with neutrophilic cells.

Rheumatol Rehabil, 1982 Nov, 21(4), 195 - 200
Clinical features of first attack of rheumatic fever in adults; Al-Rawi ZS et al.; The clinical features of the first attack acute rheumatic fever in 32 adults are described in a prospective study . Classical migratory polyarthritis occurred in 11 patients whilst the arthritis in the remaining 21 was additive in type, rapidly becoming symmetrical . The lower limb joints were involved more frequently than those of the upper limb . Mild transient carditis was present in only one patient . All patients showed evidence of antecedent streptococcal infection but none had chorea, subcutaneous nodules or erythema marginatum . The disease ran a benign course so that the sensitivity of the modified Jones criteria for adult rheumatic fever needs re-evaluation . Rheumatic fever is still a significant health problem in Iraq and should always be considered in the differential diagnosis of acute polyarthritis in adults.

Pediatrics, 1982 Nov, 70(5), 722 - 4
Multiple microaerophilic streptococcal lung abscesses after orthodontic treatment; Stern RC et al.; An immunocompetent 12-year-old boy developed multiple microaerophilic streptococcal lung abscesses after application of orthodontic bands ("braces") . The dental work was done in the supine position . The data suggest that the patient aspirated the organisms and, possibly, flecks of dental cement, during orthodontic treatment . "Rubber dams" should be used to help prevent aspiration in children who receive dental work in the supine position . When a rubber dam cannot be used, as with orthodontic treatment, physicians should advise patients who are at risk for developing pulmonary infection (eg, patients with neuromuscular diseases which compromise cough and/or gag, cystic fibrosis, sickle cell anemia, primary immunodeficiency, etc) to have this dental work, including orthodontic treatment, performed in the erect position.

Phlebologie, 1982 Oct-Dec, 35(4), 825 - 32
{Microbial diffusion and antibiotherapy}; Vilain R; Cleaning leg ulcers depends on tissular and microbial enzymes, the production of which depends on good vascularization . When an aetiological treatment is started, the microbes ensure sufficient cleaning, leading to granulation and epidermization . Antibiotherapy is pointless . Sometimes it can be detrimental, replacing a natural growth with alien strains which cause diffusion . Very exceptionally, a short course of antibiotherapy may be necessary to cope with signs of diffusion, usually signifying a Group A streptococcal infection, with seasonal recrudescence . The Blue Pus Microbe has no special pathological significance . It merely indicates that the case has become chronic.

Clin Exp Immunol, 1982 Oct, 50(1), 139 - 47
Characterization of the mitogenic and antigenic stimulatory properties of a purified streptolysin O preparation; Lea T et al.; In vitro transformation of human peripheral blood lymphocytes was induced by a purified group A streptococcal extract rich in streptolysin O (SLO) . The stimulation was shown to be largely a general mitogenic effect rather than antigen-selective as a large panel of normal blood donors responded strongly . Further support for a non-specific stimulation was obtained by experiments with cord blood lymphocytes . An antigen-specific response could also be detected as culture supernatants from the stimulation experiments contained immunoglobulins with SLO neutralizing properties . In addition, the total response could partly be inhibited by rabbit heteroantisera against HLA-DR-like antigens supporting the above contention . The stimulatory properties were found to reside in the SLO molecule although results may indicate that the determinants provoking the lymphocyte transformation differ from the determinants possessing the haemolytic properties . Peak response was found on days 4-5 . Cell fractionation experiments indicated that only T lymphocytes were stimulated although co-operating B cells and/or monocytes were necessary.

Laryngol Rhinol Otol (Stuttg), 1982 Oct, 61(10), 583 - 90
{Lymphocyte transformation test of peripheral and tonsillar lymphocytes in chronic tonsillitis}; Enzmann H et al.; Transformation tests of tonsillar and blood lymphocytes with many streptococcal extracellular antigens and streptococcal membrane antigen in patients suffering from chronic tonsillitis were performed . The in-vitro cellular immunoresponse depends on the antigen, the age of the patient, and the origin of the lymphocytes: blood or tonsil . There is good evidence that there is a selective unresponsiveness of the blood lymphocytes in adult patients, stimulated with streptococcal membrane antigen.

Infect Immun, 1982 Oct, 38(1), 127 - 35
Measurement of bacterial cell wall in tissues by solid-phase radioimmunoassay: correlation of distribution and persistence with experimental arthritis in rats; Eisenberg R et al.; We have developed sensitive and specific solid-phase radioimmunoassays to quantitate the distribution and persistence of bacterial antigen in rats developing arthritis in response to a single injection of streptococcal cell wall material . Three separate assays were specific for either the A polysaccharide (N-acetyl-D-glucosamine), A-variant polysaccharide (polyrhamnose), or peptidoglycan (D-ala-D-ala) moieties of the streptococcal cell wall . Antigen was detected in all tissues surveyed, although the greatest amount was in the liver and spleen . By using three fractions of cell wall separated by size, we have shown that the development of arthritis correlates with the degree of cell wall deposited and persisting in the joints . Further statistical analyses suggested differences in metabolism by different tissues and differential metabolism of different antigenic epitopes in some cases.

Immunobiology, 1982 Oct, 163(1), 95 - 109
Clonal analysis of a human lymphoblastoid cell line (B17) secreting antibody to N-acetyl-D-glucosamine; Polke C et al.; In this paper we analyse the clonal composition of a human lymphoblastoid B-cell line secreting IgM/k antibody to N-acetyl-D-glucosamine, the immunodominant sugar of Group-A-streptococcal carbohydrate . Besides non-antibody secreting cells, the line consists of two clonotypes of antibody-secreting cells: B17 cells producing over 90% and F6 cells producing less than 10% of the antibody in the supernatant . The proportions of B17 and F6 cells in the cell line seem to be similar to the proportion of antibodies in the supernatant . F6 cells can be isolated by cloning and maintained as stable lines, whereas this is more difficult with B17 cells . The results suggest that upon establishment of the line, at least two N-acetyl-D-glucosamine-specific B cells were immortalized and coexist together as independent clonotypes . Although F6 cells seem to have a slight tissue culture advantage, they represent the minor clonotype in the B17 cell line.

J Natl Cancer Inst, 1982 Oct, 69(4), 807 - 12
In vitro potentiation of human natural killer cell activity by a streptococcal preparation, OK-432: interferon and interleukin-2 participation in the stimulation with OK-432; Wakasugi H et al.; Inasmuch as human natural killer (NK) cell activity was markedly augmented by a streptococcal immunopotentiator, OK-432, both in vivo and in vitro, the mechanism in which OK-432 augmented human NK cell activity was analyzed . Culture supernatants of nonadherent lymphocytes stimulated with OK-432 significantly augmented NK cell activity . Significant activity of both interferon (IFN) (both alpha- and gamma-types) and interleukin-2 (IL-2) was detected in the culture supernatants from nonadherent lymphocytes . Concomitant treatment of supernatants with anti-IFN-alpha antiserum and pH-2 glycine-HCI buffer or the absorption of supernatants with an IL-2-dependent cell line completely abrogated the NK-augmenting activity, whereas the treatment with either one of these resulted in only partial elimination of the activity . These results indicate that OK-432 stimulates human nonadherent lymphocytes to produce IFN and IL-2 and that both factors are primarily responsible for the NK augmentation by OK-432.

J Immunol, 1982 Oct, 129(4), 1513 - 8
Monoclonal antibodies to streptococcal group A carbohydrate . I . A dominant idiotypic determinant is located on Vk; Nahm MH et al.; In an effort to better define the antibody repertoire to streptococcal group A carbohydrate (GAC), somatic cell hybrids were prepared from A/J mice immunized with streptococcal vaccine . Most antibodies were IgG3K and IgMK, while 2 of 26 antibodies were lambda type . Each of the IgG3 antibodies had a distinct isoelectric point consistent with previous estimates of clonal repertoires of approximately 200 . IEF analysis of the L chains, however, showed that about half of the antibodies produce a common L chain, called VK1GAC, previously identified in A/J anti-GAC serum antibodies . Additional support for the structural similarity of these L chains was gained by developing an idiotype antiserum to VK1GAC . All proteins with the common L chain spectrotype react strongly with anti-VK1GAC . Thus, it appears that anti-GAC antibodies are composed of H chains bearing a few VH regions pairing with a few L chains.

Hoppe Seylers Z Physiol Chem, 1982 Sep, 363(9), 1069 - 76
Murine VK25 isotype sequence: monoclonal antibody 2S1.3 specific for the group A streptococcal polysaccharide; Herbst H et al.; Antibodies 2S1.3 and 2S1.1 are hybridoma derived gamma 3K murine immunoglobulins with specificity for N-acetylglucosamine beta 1 leads to 3-linked to L-rhamnose, the immunodeterminant of the streptococcal group A polysaccharide . The VL 2S1.3 amino acid sequence is the second complete one reported with this specificity, and it is the first fully determined VK25 structure . The VK regions of this and the previously described monoclonal anti-A-CHO antibody 7S34.1 are compared with 17 selected partial and complete murine VK regions, preferentially from anti-polysaccharide antibodies . Both VK 2S1.3 and 7S34.1 increase the variability of existing murine VK regions; however, they are, as anti-A-CHO antibodies, most homologous to each other sharing the so far unique residue argine 74 . The amino acid sequence of the constant region of 2S1.3 light chain was also determined . It was found to be identical with that of MOPC21, but different from MOPC41 and MOPC70 in residue positions 127, 129, 163 and 166.

Arthritis Rheum, 1982 Sep, 25(9), 1064 - 72
Strain and sex variation in the susceptibility to streptococcal cell wall-induced polyarthritis in the rat; Wilder RL et al.; Sixteen inbred rat strains were examined for susceptibility and resistance to group A streptococcal cell wall-induced polyarthritis . The findings indicated that 2 or more genetic loci, as well as sex-related factors, played a major role in determining susceptibility to arthritis in this model . Breeding studies demonstrated that susceptibility was a dominant or codominant trait . A positive association between the severity of arthritis and the development of chronic inflammation in multiple tissues was also observed . In strains that were relatively resistant to arthritis, chronic inflammation was generally limited to the spleen . Since translocation of the poorly degradable and phlogogenic streptococcal cell walls to the synovium and other tissues appears to initiate inflammation, these studies suggested that susceptibility might be the result of a defect in host mechanisms limiting cell wall dissemination.

Am J Kidney Dis, 1982 Sep, 2(2), 281 - 6
Nasal and cutaneous flora among hemodialysis patients and personnel: quantitative and qualitative characterization and patterns of Staphylococcal carriage; Goldblum SE et al.; Staphylococcal sepsis is a leading cause of morbidity and mortality among chronic hemodialysis (HD) patients . We studied nasal and cutaneous flora of HD patients and personnel and their patterns of staphylococcal carriage . HD patients had significantly increased cutaneous total bacterial colony counts (p less than 0.01) as well as both nasal (p less than 0.0001) and cutaneous (p less than 0.0001) carriage of Staphylococcus aureus compared to personnel . Cutaneous staphylococcal carriage could be significantly correlated with nasal carriage (p less than 0.01) . Cutaneous streptococcal species and gram-negative bacilli were not different between patients and personnel . Staphylococcal phage typing of nasal isolates from staphylococcal carriers revealed a mean of 90% of isolates from each subject belonging to a predominant phage type . Predominant nasal staphylococcal phage types corresponded with respective predominant cutaneous phage types in 93% of HD patients carriers . These studies substantiate autoinoculation of S . aureus from the nasal vestibule to the skin overlying the vascular access site.

Public Health Rep, 1982 Sep-Oct, 97(5), 460 - 4
Factors affecting streptococcal colonization among children in selected areas of Alaska; Brant LJ et al.; The epidemiology of streptococcal disease affecting 706 Alaskan Eskimo children was investigated by analysis of data on throat cultures obtained during a long-term surveillance program begun in 1971 . A binary variable multiple-regression model was used to study the association between streptococcal colonization of these children and six potential risk factors: age, sex, number of children in household, region, health-aide rating, and colonization rate for each child the previous year . Factors found to be significantly associated with streptococcal colonization included age, past colonization, competence of local health-aide in providing care, and health-care region . Age varied most in the standardized colonization ratio (percentage of corresponding adjusted rate to overall crude colonization rate), ranging from 122 percent for children 3--6 years old to 67 percent for children 13--18 years old . The number of children in over-crowded homes and a child's sex were not apparently important . The method of analysis can be used to provide health-care planners with a simple means of identifying potentially important areas of concern for planning effective and economical health-care strategy.

Arch Intern Med, 1982 Sep, 142(9), 1642 - 5
Group b Streptococcal pneumonia in the elderly; Verghese A et al.; Group B streptococcal infections, although well studied in neonates, have only recently been appreciated as important infectious agents in adults . Seven cases of Group B streptococcal pneumonia were verified by transtracheal aspiration, blood and sputum cultures, or multiple stab cultures at autopsy . The infections were largely nosocomial and, ultimately, fatal in all seven patients . Our patients were older (average age, 73 years) and much more debilitated than the 13 cases reported in the literature . Diabetes was less common than previously reported . Previous antibiotic therapy was common . Concomitant isolation of another organism (especially Staphylococcus aureus) occurred in five patients . The morphologic findings at autopsy, in one patient, were characterized by a severely necrotizing destructive process . In our experience, Group B streptococcal pneumonia is more common, more devastating, and occurs in an older population than previously reported.

Pediatrics, 1982 Sep, 70(3), 343 - 7
Improved survival in the suckling rat model of group B streptococcal sepsis after treatment with nonsteroidal anti-inflammatory drugs; Short BL et al.; The nonsteroidal anti-inflammatory drugs, indomethacin and ibuprofen, have been shown to increase survival in various animal models of Gram-negative or endotoxin shock . To evaluate the use of these drugs in group B streptococcal sepsis, a clinically similar disease state, a newborn suckling rat model (4 to 5 days old) designed to simulate early-onset group B streptococcal sepsis was used . Sepsis was induced by a subcutaneous injection of group B streptococcal organisms (type III) . A mortality ranging from 30% to 90% was used for the study . Indomethacin (3 mg/kg) or ibuprofen (4 mg/kg) treatment was administered by an intraperitoneal injection either at the time of the bacterial injection or after bacteremia (four hours) had occurred . Indomethacin clearly improved survival rates, even when given after bacteremia . Ibuprofen also clearly increased survival when given at the same time as the bacterial injection . Ibuprofen was more effective than indomethacin in the high mortality model (lethal dose for 90% survival of group) . These drugs alter mechanisms that may be important in the irreversibility of sepsis and they may become useful adjuvants to our present treatment of early onset group B streptococcal sepsis.

Clin Exp Immunol, 1982 Aug, 49(2), 457 - 66
Preferential rheumatoid factor reactivity with disulphide bond altered IgG in radioimmunoassay; Brown CS et al.; Rheumatoid factor (RF) antibody populations were purified by immunoabsorption from rheumatoid arthritis patients' sera and from rabbit hyperimmune anti-streptococcal sera . On the basis of the particular affinity matrix from which the RF were eluted, the antibody populations were classified as being preferentially reactive with either mildly reduced and alkylated (MRA) or native, intact, homologous (with regard to species) IgG . Immune complexes formed between these RF preparations and IgG were characterized by their susceptibility to polyethylene glycol (PEG) precipitation . The two RF specificity populations were incubated in the presence of 125I-labelled MRA and intact homologous IgG preparations . The resultant complexes were subsequently precipitated in the presence of 0-20% (w/v) PEG . From the data generated by incubation of a constant amount of RF in the presence of either intact or MRA IgG, the amount of complex precipitated over the range of PEG concentrations examined was greatest when the form of IgG used for immunoadsorption was also used as the radiolabelled antigen . When a constant concentration of PEG was used and the concentration of the IgG antigen and RF were separately varied, precipitable complexes were formed at lower concentrations of each variable when radiolabelled antigen homology, with respect to the affinity matrix, was maintained . Therefore, although cross-reactive, the two RF specificities were clearly selective with regard to their affinity for a given form of IgG.

Am J Dis Child, 1982 Aug, 136(8), 725 - 7
beta-hemolytic streptococcal infection appearing as persistent fetal circulation; Shankaran S et al.; Sixty neonates who were transferred to a neonatal intensive care unit during a four-year period had diagnoses of persistent fetal circulation (PFC) . Six of these 60 neonates had beta-hemolytic streptococcal infection . The clinical appearance of these six neonates included respiratory distress, cyanosis, and/or apnea . The chest roentgenograms showed mild to moderate lung disease . All six neonates had progressive acidosis with hypoxemia . The diagnosis of PFC was made by cardiac catheterization or contrast echoangiography . The neonates were treated with mechanical ventilation, antibodies, and supportive therapy, including tolazoline hydrochloride . Mortality was high; only one of the six neonates survived . Streptococcal infection should be added to the growing list of conditions associated with PFC.

Postgrad Med, 1982 Aug, 72(2), 179 - 85
Acute urticaria in children: causes and an aggressive diagnostic approach; Schuller DE; Infection, not allergy, appears to be the most common cause of acute urticaria in children . In a review of 76 cases, an association with infection was documented or suspected in 60% of cases-half of these viral . An aggressive diagnostic approach may prevent unwarranted lifelong dietary and drug restrictions or reveal a potentially serious disease, such as streptococcal pharyngitis.

Clin Pediatr (Phila), 1982 Aug, 21(8), 468 - 71
Streptococcal pharyngitis: evaluation of diagnosis by gram stain in a pediatric acute care clinic; Funamura JL et al.; Clinical prediction of streptococcal pharyngitis at the initial visit is often difficult . The applicability of the gram stain in the initial assessment of streptococcal pharyngitis was evaluated by comparing gram stain with ultimate culture results . Positive gram stains showed polymorphonuclear cells and typical gram-positive cocci . Thirty-one physicians rotating through the Acute Care Clinic of a county teaching hospital participated in the evaluation . The sensitivity, specificity, and predictive value of a positive test (PVP) were 62 per cent, 70 per cent, and 47 per cent, respectively . These results were compared to a clinical algorithm and to the results of a group with more expertise in the technique . It is concluded that the gram-stained smear of pharyngeal secretions does not appear to be a practical tool for the diagnosis of streptococcal pharyngitis in a busy pediatric emergency unit of a teaching hospital.

Clin Exp Immunol, 1982 Aug, 49(2), 488 - 92
Functional alterations in non-T cells in rheumatic heart disease; Gray ED et al.; The mediation of the T cell lymphoproliferative response to streptococcal blastogen A by non-T mononuclear cells was studied in patients with rheumatic heart disease (RHD) and control subjects . Non-T cells are essential for T cell response to blastogen A . Non-T cells from RHD patients were less effective in enabling the T lymphocyte response to blastogen A than control non-T cells though no consistent difference was observed in the response to phytohaemagglutinin . The results suggest that a functional alteration is present in the non-T cells from RHD patients which might be related to the pathogenesis of the disease.

J Clin Microbiol, 1982 Aug, 16(2), 350 - 4
Immunospecificity and quantitation of an enzyme-linked immunosorbent assay for group B streptococcal antibody; Anthony BF et al.; Type-specific antigen was purified from the supernatant of type III group B streptococcal cultures, tyrosylated, and bound to microtiter wells for an enzyme-linked immunosorbent assay . The immunological specificity of the antigen and the assay was shown by (i) reaction only with homologous unabsorbed rabbit sera and (ii) inhibition after incubation of human serum with homologous but not heterologous purified antigen . The assay was quantitated by relating optical density readings to absolute amounts of human immunoglobulin G bound to the microtiter wells.

Drug Intell Clin Pharm, 1982 Jul-Aug, 16(7-8), 587 - 91
The impact of the docent clinical pharmacist on treatment of streptococcal pneumonia; Covinsky JO et al.; This two-phase retrospective study was designed to evaluate the impact of the clinical pharmacist on prescribing practice of physicians in an internal medicine service . Streptococcal (pneumococcal) pneumonia was chosen as the model disease state . The drug of choice was used more frequently and there was a statistically significant difference in raw cost of antibiotic, total cost for antibiotic administration, daily raw cost for antibiotics; total raw cost for antibiotic administration, and patient charges when physicians were exposed to the clinical pharmacists' influence.

Prog Cardiovasc Dis, 1982 Jul-Aug, 25(1), 43 - 54
Evaluation and management of prosthetic valve endocarditis; Mayer KH et al.; Despite improved operative technique and sophistication in managing patients undergoing cardiac valve replacement, prosthetic valve endocarditis (PVE) remains a source of major morbidity (overall recent incidence approximately 2.1%), and these patients have a high case-fatality rate (58% overall) . Early PVE (less than 60 days postoperative) has a worse prognosis (78% case-fatality rate) and is usually caused by staphylococcal species, gram-negative rods, and fungi; whereas the case-fatality rate in late PVE is 46%, owing to the lower fatality of streptococcal species infections that tend to occur late . Risk factors that portend a poor clinical response to medical therapy alone include the presence of congestive heart failure, paravalvular leakage, systemic embolic, early PVE, nonstreptococcal etiology, aortic location in a nonheterograft valve, as well as persistent fever (greater than 10 days) . Given the frequently dismal outcomes in the medical management of these patients, the case is made for early surgical intervention in most cases of PVE (except for late streptococcal disease), especially if any of the aforementioned risk factors are present.

Am J Dis Child, 1982 Jul, 136(7), 631 - 3
Group B streptococcal cellulitis-adenitis in infants; Baker CJ; Seven infants with group B streptococcal (GBS) cellulitis-adenitis were compared with nine previously described patients . The clinical features of infection included a mean age at onset of five weeks, a male predominance (75%), a history of poor feeding or irritability (94%), and a rapid resolution with appropriate antimicrobial therapy . Bacteremia occurred in 94% of the patients . Type III GBS were associated with 75% of these infections; no antibody response to the capsular antigen of these organisms was detected in convalescent sera . Two of our cases had previously unreported sites of involvement, inguinal lymph nodes and a thyroglossal duct cyst . Four infants (80%) with typical facial or submandibular GBS cellulitis had ipsilateral otitis media at the time of admission . Otitis media with subsequent lymphatic spread to facial or submandibular areas, rather than primary bacteremia, may explain the pathogenesis of these unusual infections.

Lancet, 1982 Jun 26, 1(8287), 1426 - 30
Single-dose penicillin prophylaxis of neonatal group-B-streptococcal disease; Siegel JD et al.; The efficacy of a single dose of aqueous penicillin G in preventing neonatal group-B streptococcal infections was demonstrated in a randomised study conducted over 41 months . 16 082 infant received a single dose of penicillin within one hour of delivery, and 15 976 infants who received tetracycline ophthalmic ointment served as the control group . Group-B streptococcal systemic infections were significantly less common in the penicillin-treated infants (0.6 vs 1.7 cases per 100 live birth, p = 0.004) . The incidence of infection caused by penicillin-resistant pathogen was insignificantly increased in the penicillin group (2.2 vs 1.6 cases per thousand live birth, p = 0.32) . this difference was accounted for almost completely by the events of the first 12 months of the study period when, for unexplained reasons, there was a considerable increase in the number of penicillin-resistant infections in the penicillin group (3.6 vs 1.4 cases per 1000 live births, p = 0.09) . The mortality associated with penicillin-susceptible pathogens was higher in the control group (0.1 vs 0.4 per 1000 live births, p = 0.18) . However, the mortality associated with penicillin-resistant pathogens was increased in the penicillin (0.4 vs 1.0 per 1000 live births, p = 0.06) . The combined mortality rates for all pathogens were not significantly different (1.1 vs 0.7 per 1000 liver births, p = 0.27, for the penicillin and control groups, respectively) and were nearly equivalent when the excess number of deaths associated with penicillin-resistant infections in the penicillin group during the first study year was excluded from analysis . The incidence of gonococcal ophthalmia and conjunctivitis was unaffected by the use of intramuscular penicillin at birth.

N Z Med J, 1982 Jun 9, 95(709), 373 - 6
Streptococcal involvement in childhood acute glomerulonephritis: a review of 20 cases at admission; Dawson KP et al.; Twenty children sequentially admitted to the paediatric ward, Tauranga Hospital, with a diagnosis of acute glomerulonephritis, are reviewed for evidence of recent streptococcal infection as at admission . Sixteen children (80 percent) were shown to have at least one streptococcal antibody titre (ASO and anti-DNase B) elevated above the upper limit of normal for the population . Two children had negligible antibody levels detected . Case histories and/or cultural results provided additional supportive evidence for recent streptococcal infection . Serotypes of recognised nephritogenic potential were isolated from five patients.

J Exp Med, 1982 Jun 1, 155(6), 1702 - 18
Streptococcal cell walls and synovial cell activation . Stimulation of synovial fibroblast plasminogen activator activity by monocytes treated with group A streptococcal cell wall sonicates and muramyl dipeptide; Hamilton JA et al.; Group A streptococcal peptidoglycan has previously been shown to be arthritogenic in rats and has been implicated as a structure present in a class of possible etiologic agents for rheumatoid arthritis . The present study reports that conditioned medium from human monocytes, after interaction with cell wall sonicates of four group A streptococcal strains, stimulates the plasminogen activator (PA) activity of nonrheumatoid synovial fibroblasts . Low concentrations of N-acetylmuramyl-L-alanyl-D isoglutamine (muramyl dipeptide) can also generate this synovial activator (SA) activity from human monocytes . Preliminary biochemical data suggest that the SA activity is distinct from interferon-gamma, interleukin 1, and interleukin 2 . These results indicate that agents that are arthritogenic in rats can modulate human synovial fibroblast functions via monocytes . The findings are proposed to have possible significance for an understanding of the cellular interactions involved in the formation and function of the rheumatoid pannus, because PA has been invoked as possibly being generally important for the processes of cell migration, tissue remodeling, and inflammation.

What Is Staphylococcus Aureus?, What Is Growth Medium?, What Is Fermentation?, What Is Yeast?, What Is Genetic Engineering?, r, Microorganism, s, Microorganisms, n, Bacterium, s, Microbe, a, Bacteriology, c, Salmonella typhimurium, i, Streptococcal, n, Saccharomyces yeast, a, Bacillus, n, Bacillus, e, Biofilms, a, Pathogenic bacterium, c, Phage, s, S. cerevisiae, i, Antibiotics, c, Bacteroides, e, S. cerevisiae, c, Wastewater, o, Escherichia coli, o, Microorganisms, e, Schizosaccharomyces, c, Prokaryotes, a, Bacteria, o, Microbiological, i, Eubacterium, r, Streptococcal

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005