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