J Food Prot, 1998 Oct, 61(10), 1363 - 71 Shelf life of sliced raw potatoes of various cultivar varieties--substitution of bisulfites; Laurila EK et al.; The effects of potato variety (Van Gogh, Bintje and Fambo), washing with browning prevention chemicals in place of sodium bisulfite, percentages of CO2, O2, and N2 in the package headspace, and storage time (1, 4, and 7 days) on the sensory and microbiological quality of potato slices were examined . Citric acid and ascorbic acid (at 0.1% each and at 0.5% each) were used as browning prevention chemicals . In the packaging atmosphere the percentage of N2 was 75 or 80%, the percentage of O2 was 5 or 0%, and the percentage of CO2 was 20% at the beginning of storage . Packed potato slices were stored in the dark at 5 degrees C . Darkening was the most important factor limiting the sensory quality of raw potato slices . Darkening occurred quickly with Fambo slices; it seems that Fambo is not a suitable potato variety if slices are to be stored . Water-washed and cooked Van Gogh slices were still acceptable for retailing after a storage period of 7 days . After 7 days of storage the best sensory quality of both raw and cooked Bintje slices was obtained with washing solutions containing 0.1 to 0.5% citric and ascorbic acids and with the gas mixture containing 20% CO2 and 80% N2 . The number of microorganisms was higher in samples stored in the atmosphere containing 5% O2 than samples stored in the atmosphere containing 0% O2 . Washing of potato slices with browning prevention chemicals decreased the number of microorganisms compared to potato slices not washed or potato slices washed with water after 7 days of storage. J Food Prot, 1998 Oct, 61(10), 1347 - 51 Verification of the hygienic adequacy of beef carcass cooling processes by microbiological culture and the temperature-function integration technique; Jericho KW et al.; To enhance food safety and keeping quality, beef carcasses are cooled immediately after leaving the slaughter floor . Within hazard analysis and critical control point (HACCP) systems, this cooling process needs to be monitored by the industry and verified by regulatory agencies . This study assessed the usefulness of the temperature-function integration technique (TFIT) for the verification of the hygienic adequacy of two cooling processes for beef carcasses at one abattoir . The cooling process passes carcasses through a spray cooler for at least 17 h and a holding cooler for at least 7 h . The TFIT is faster and cheaper than culture methods . For spray cooler 1, the Escherichia coli generations predicted by TFIT for carcass surfaces (pelvic and shank sites) were compared to estimated E . coli counts from 120 surface excision samples (rump, brisket, and sacrum; 5 by 5 by 0.2 cm) before and after cooling . Counts of aerobic bacteria, coliforms, and E . coli were decreased after spray cooler 1 (P < or = 0.001) . The number of E . coli generations (with lag) at the pelvic site calculated by TFIT averaged 0.85 +/- 0.19 and 0.15 +/- 0.04 after emerging from spray coolers 1 and 2, respectively . The TFIT (with lag) was considered convenient and appropriate for the inspection service to verify HACCP systems for carcass cooling processes. Clin Infect Dis, 1998 Oct, 27(4), 851 - 64 Ventilator-associated sinusitis: a review; Westergren V et al.; A common foreign body of the nose in intensive care, the nasotracheal tube, has for 20 years been cited as a cause of bacterial infection of the paranasal sinus . High frequencies of bacterial culture positivity have occurred in several studies . However, the state of critically ill patients has to be evaluated before conclusions about cause of infection can be made . Nosocomial colonization with intensive care unit flora, in combination with use of antibiotics, precludes the use of procedures that are standard in office practice and microbiological diagnostics . New methods of sampling and quantitative culturing for the specific purpose of intensive care antral diagnostics, in combination with endoscopic inspection, have enlarged our knowledge of sinusitis . Among patients ventilator-treated for > or = 1 week, the occurrence of bacterial sinusitis is < 10% . For 80% of the examined antra there were similar inflammatory reactions without clinical signs of infection . Sporadically in these, cultures of antral specimens were positive for bacteria, which, by definition, would represent colonization. Clin Infect Dis, 1998 Oct, 27(4), 722 - 9 Randomized, double-blind study of ciprofloxacin and cefuroxime axetil for treatment of acute bacterial exacerbations of chronic bronchitis . The Bronchitis Study Group; Chodosh S et al.; In a prospective, multicenter, double-blind study, the interval to clinical relapse in patients with acute bacterial exacerbations of chronic bronchitis from whom a pretherapy pathogen was isolated was compared following treatment with ciprofloxacin or cefuroxime axetil . Clinical and microbiological responses at the end of therapy were secondary efficacy variables . Outpatients randomly received either ciprofloxacin or cefuroxime axetil (500 mg twice a day for 14 days) . Three hundred seven patients with acute exacerbations of chronic bronchitis were enrolled, of whom 208 had an exacerbation due to a bacterial pathogen . Clinical resolution at the end of ciprofloxacin and cefuroxime axetil therapy for patients for whom efficacy could be evaluated was 93% and 90%, respectively . Bacteriologic eradication rates were statistically higher for ciprofloxacin recipients (96% {89 of 93}) than for cefuroxime axetil recipients (82% {80 of 97}) (P < .01) . The median infection-free interval was 146 days for ciprofloxacin recipients vs . 178 days for cefuroxime axetil recipients (P = .37) . In conclusion, ciprofloxacin was associated with an infection-free interval and clinical response that were similar to those associated with cefuroxime axetil, but the bacteriologic eradication rate associated with ciprofloxacin was statistically significantly higher than that associated with cefuroxime axetil. Clin Infect Dis, 1998 Oct, 27(4), 695 - 9 Neutropenic enterocolitis: spectrum of the disease and comparison of definite and possible cases; Gomez L et al.; Twenty-nine cases of neutropenic enterocolitis (NEC) were identified from 1992 to June 1996, and their clinical, microbiological, and radiologic characteristics were reviewed . Eighteen of 29 episodes were considered to be definite NEC since abdominal computed tomographic or ultrasonographic findings (n = 14) and/or pathological findings (n = 7) were consistent with the diagnosis, whereas 11 were classified as possible NEC since these findings were normal or nondiagnostic . Abdominal pain, diarrhea, and fever occurred in nearly all cases in both groups, whereas bloody stools were more frequent and the duration of diarrhea was longer in definite cases . Other clinical, laboratory, and microbiological findings were of variable frequencies, with no apparent differences between groups . All 29 patients received medical/supportive treatment, and only five deaths were related to NEC . We conclude that NEC has a broad spectrum of clinical presentation, but patients whose imaging studies are positive appear to have a more serious form of the disease . Medical management appears appropriate in most cases, as the associated mortality rate is < 20%. Appl Environ Microbiol, 1998 Nov, 64(11), 4533 - 5 Inactivation of Escherichia coli O157:H7 in apple juice by irradiation; Buchanan RL et al.; Three strains (932, Ent-C9490, and SEA13B88) of Escherichia coli O157:H7 were used to determine the effectiveness of low-dose gamma irradiation for eliminating E . coli O157:H7 from apple juice or cider and to characterize the effect of inducing pH-dependent, stationary-phase acid resistance on radiation resistance . The strains were grown in tryptic soy broth with or without 1% dextrose for 18 h to produce cells that were or were not induced to pH-dependent stationary-phase acid resistance . The bacteria were then transferred to clarified apple juice and irradiated at 2 degrees C with a cesium-137 irradiator . Non-acid-adapted cells had radiation D values (radiation doses needed to decrease a microbial population by 90%) ranging from 0.12 to 0.21 kGy . D values increased to 0.22 to 0.31 kGy for acid-adapted cells . When acid-adapted SEA13B88 cells were tested in five apple juice brands having different levels of suspended solids (absorbances ranging from 0.04 to 2.01 at 550 nm), radiation resistance increased with increasing levels of suspended solids, with D values ranging from 0.26 to 0.35 kGy . Based on these results, a dose of 1.8 kGy should be sufficient to achieve the 5D inactivation of E . coli recommended by the National Advisory Committee for Microbiological Criteria for Foods. Eur J Clin Microbiol Infect Dis, 1998 Aug, 17(8), 561 - 5 Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990-1995; Hagelskjaer LH et al.; To establish the incidence and describe the clinical epidemiology of necrobacillosis and Lemierre's syndrome in Denmark, the clinical records of all laboratory-recorded cases of septicaemia due to Fusobacterium necrophorum biovar A, B, and C were reviewed retrospectively during a 6-year period . The incidence of necrobacillosis and Lemierre's syndrome was 1.5 and 0.8 per million persons per year, respectively, showing a tendency to increase during the period . Fusobacterium necrophorum was grown after three days' incubation, but the characteristic pleomorphic fusiform morphology was often disregarded as an important help in diagnosing necrobacillosis . The 24 patients with Lemierre's syndrome were all young and previously healthy, and none died, but pre-hospital delay was associated with a significantly higher morbidity and risk of metastatic infections . The remaining 25 patients with necrobacillosis had a high mortality, 24%, which was correlated with age and predisposing diseases, especially cancers . These findings stress the importance of a quicker clinical and microbiological diagnosis in cases of Lemierre's syndrome, and of screening for cancer in the remaining cases of necrobacillosis. Cancer Epidemiol Biomarkers Prev, 1998 Oct, 7(10), 901 - 6 Hypomethylation in cervical tissue: is there a correlation with folate status? Fowler BM, Giuliano AR, Piyathilake C, Nour M, Hatch K. We have shown previously that DNA hypomethylation is significantly associated with grade of cervical intraepithelial neoplasia (CIN; Y.I . Kim et al., Cancer, 74: 893-899, 1994) . The objective of this study was to further describe this relationship and to investigate the role of folate in the observed association of DNA hypomethylation and CIN . Eighty-three patients with abnormal PAP smear results were referred to the Cervical Dysplasia Clinic at the University of Arizona for colposcopic examination and biopsy . Patients completed a short questionnaire and provided a nonfasting serum sample . DNA hypomethylation was assessed by incubating DNA extracted from biopsy samples with {3H}methyl-S-adenosylmethionine and Sss 1 methylase . Cervical tissue and serum folate concentrations were assessed using a microbiological assay . All folate levels were log transformed prior to statistical analysis . The histological distribution of the samples was: 7 adjacent normal, 30 CIN I, 18 CIN II, 13 CIN III, and 11 carcinoma in situ (CIS) . The mean age of participants was 29.8 +/- 9.6 years . DNA hypomethylation was significantly different between select histological levels . Both cervical tissue folate and serum folate levels were significantly correlated to methylation level (P = 0.0211 and P = 0.0569, respectively) . Smoking, hormonal contraceptive use, parity, and human papillomavirus infection were not associated with DNA hypomethylation or folate status . The current use of vitamins was significantly associated with serum folate level but not with methylation or cervical folate levels . These data extend our earlier findings that DNA hypomethylation is an early event in cervical carcinogenesis . To conclude that the folate level is significantly related to DNA hypomethylation, further investigation of DNA hypomethylation of specific genes is required. Infection, 1998 Sep-Oct, 26(5), 329 - 34 Epidemiology and pathophysiology of intraabdominal infections (IAI); Farthmann EH et al.; Intraabdominal infection continues to be one of the major challenges in general surgery . Whilst the term "peritonitis" means an inflammation of the peritoneum regardless of its etiology, intraabdominal infections encompass all forms of bacterial peritonitis, of intraabdominal abscesses and of infections of intraabdominal organs . Several classification systems have been suggested for peritonitis and intraabdominal infections, respectively . However, neither phenomenological classifications nor classification systems with respect to the origin of bacterial contamination have a proven relevance for the clinical course of this disease . Moreover, most of the studies dealing with secondary peritonitis or intraabdominal infections are ill-comparable because of wide variations of inclusion criteria . Thus the true incidence of secondary bacterial peritonitis is difficult to assess . With respect to its etiology perforation of hollow viscus is the leading cause followed by postoperative peritonitis, ischemic damage of bowel wall, infection of intraabdominal organs and translocation in nonbacterial peritonitis . The anatomic origin of bacterial contamination and microbiological findings are no major predictors of outcome . However, the preoperative physiological derangement, the surgical clearance of the infectious focus and the response to treatment are established prognostic factors . The pathogenesis of intraabdominal infections is determined by bacterial factors which influence the transition from contamination to infection . Intraabdominal adjuvants and the local host response are additionally important . Bacterial stimuli lead to an almost uniform activation response which is triggered by reaction of mesothelial cells and interspersed peritoneal macrophages and which also involves plasmatic systems, endothelial cells and extra- and intravascular leukocytes . The local consequences of this activation are the transmigration of granulocytes from peritoneal capillaries to the mesothelial surface and a dilatation of peritoneal blood vessels resulting in enhanced permeability, peritoneal edema and lastly the formation of protein-rich peritoneal exudate. Acta Gastroenterol Belg, 1998 Jul-Sep, 61(3), 321 - 6 Microbiological and serological diagnostic tests for Helicobacter pylori: an overview; Glupczynski Y; Different invasive and non-invasive diagnostic tests are available for the diagnosis of H . pylori in the individual patient . In practice, endoscopic tests are best for a primary diagnosis of H . pylori infection because endoscopy allows assessment of treatment indications . The new rapid urease tests may help the clinician in treatment decision-making . Culture is currently not recommended for routine evaluation, but it is becoming increasingly important in certain populations with higher prevalence of drug resistance, since it allows to test for susceptibility to antibiotics . Serological testing has been recommended for initial pre-endoscopy or pre-treatment screening in dyspeptic patients . However, several current "in-office" tests appear insufficiently accurate or would need further validation before being recommended for use in clinical management strategies at a primary care level . The urea breath tests are best suited to confirm eradication early after treatment while laboratory serology tests are of limited use since 6 months are required before a result can be obtained . The serological office tests cannot be used for post-treatment assessment of H . pylori status. Rev Esp Quimioter, 1998 Sep, 11(3), 229 - 37 {Clinical experience with meropenem in the treatment of severe infections in critically ill patients.}; Alverez Lerma F et al.; The use of meropenem, a new antibiotic from the carbapenemic family, was analyzed in the treatment of all types of serious infections in patients in critical condition . The global clinical response was satisfactory in 85.4% of the 178 assessable cases, with no significant differences being found in the form of treatment (monotherapy or combination therapy with aminoglycosides and/or glycopeptides) or in the type of infection treated, although the patients that received three or more antibiotics had more treatment failure . In the case of pneumonia, a better clinical response was observed with the use of monotherapy (38/40, 95% vs . 38/47, 80.8%, p = 0.049) . The microbiological response was satisfactory in 72.7% of the 110 assessable cases . Initial pathogens persisted in just 8.2% of the cases, with superinfection in 12.7% and colonization in 6.4% . Differences relating to the form of treatment or the area of infection were not detected . The severity of the patient's condition influenced the choice of the form of meropenem treatment (monotherapy or combined therapy) . Such factors as the patient's severity, the presence of hypotension or shock, and the need for mechanical ventilation were indicators for the use of two or more antibiotics . The severity also influenced the use of a larger average daily dose, as well as the length of treatment . Adverse reactions were detected in 6 of the 178 (3.37%) assessable patients, with 4 cases of nephrotoxicity, and 2 of hepatotoxicity . Global mortality was 14%, while infection-related mortality was 8.43%. Vestn Otorinolaringol, 1998, (5), 38 - 9 {Clinical-morphological assessment of the functional status of tonsils in clinical manifestations of chronic tonsillitis}; Khmel'nitskaia NM et al.; Correlations between lacunar content and morphofunctional condition of palatine tonsil immunocompetent tissue were studied histologically, histochemically, morphometrically, microbiologically and cytologically . The microbiological and cytological lacunar findings provide a life-time assessment of tonsillar functional activity . Clinical efficiency of the method makes it valuable for choice of treatment and evaluation of the response to conservative treatment of chronic tonsillitis. J Dent, 1998 Nov, 26(8), 657 - 64 A comparison of fluconazole and itraconazole in the management of denture stomatitis: a pilot study; Cross LJ et al.; OBJECTIVES: To compare fluconazole capsules (50 mg daily for 14 days) and itraconazole capsules (100 mg daily for 15 days) in the treatment of denture stomatitis, using objective clinical and mycological outcome measures . METHODS: Twenty complete denture wearers with denture stomatitis were enrolled . At baseline, palatal erythema was measured with an electro-optical instrument, a denture disc specimen was collected from the fitting surface of the denture for culture and an oral rinse and imprint cultures were collected for mycological culture . Ten patients received fluconazole capsules (50 mg daily for 14 days) and 10 received itraconazole capsules (100 mg daily for 15 days) . Palatal erythema was reassessed and the microbiological specimens re-collected on day 14 . RESULTS: The most common form of denture stomatitis seen in this group of patients was Newton's Type II . All patients responded to advice to leave their dentures out at night but there was a poor overall improvement in denture hygiene . There was an objective reduction in palatal erythema following treatment with both fluconazole and itraconazole . A wide range of yeasts were isolated from the mouths of all the denture stomatitis patients before treatment . C . albicans was the most common isolate . A mycological cure was achieved in only five of the 20 patients, one in the fluconazole group and four in the itraconazole group . A further eight patients in the fluconazole group and three in the itraconazole group had reduced yeast counts by the second visit . CONCLUSION: Fluconazole and itraconazole were of comparable efficacy in the treatment of denture stomatitis, on the basis of reduction in palatal erythema and mycological culture. Khirurgiia (Mosk), 1998, (9), 65 - 8 {Prophylaxis of postoperative wound complications}; Volenko AV; Etiological factors of postoperative wound complications were studied in experiment on the models of surgical wounds in 1185 white Wistar rats, 28 mongrel dogs, 48 corpses, as well as the role of sutures and suture materials in development of eventrations and postoperative hernias . Morphological and microbiological studies have shown that the key role in etiology of wound complication belongs to morphofunctional substratem of the wound comprises, besides the type of the wound, the degree of traumatization and ischemia of paravulnar tissues, presence of devitalized tissue in the wound, the features and quantity of suture material, pattern and intensity of microbial dissemination, characteristics of sutures, etc . Isolated presence of only one from the mentioned factors in majority of cases does not result in development of wound complication . Thus, wound infection even by critical doses of monocultures and their associations would not in alle cases cause the development of would infection . Thus, critical dose of microbes in fresh wounds could not be considered as an obligatory factor which results in suppuration. Scand J Infect Dis, 1998, 30(3), 237 - 43 Empiric monotherapy for febrile neutropenia--a randomized study comparing meropenem with ceftazidime; Lindblad R et al.; In this Swedish multicentre study we compared the efficacy of meropenem with ceftazidime for treatment of febrile neutropenia . 192 patients were randomized and the number of evaluable patients was 92 in the meropenem group and 95 in the ceftazidime group . 40 (43%) patients in the meropenem arm and 49 (52%) in the ceftazidime arm had acute leukaemia . 56 (61%) and 52 (55%) patients respectively had a neutrophil count of < 0.1 x 10(9)/l at randomization and the median duration of neutropenia was 6.5 and 8 d, respectively . Thirty-one (34%) and 28 (29%) patients had a microbiologically defined infection, 14 (15%) and 17 (18%) a clinically defined infection and the remaining 47 (51%) and 50 (53%) had unexplained fever . After 72 h of treatment, 46 (50%) patients in the meropenem arm and 53 (56%) patients in the ceftazidime arm were alive on unmodified monotherapy . 42 (46%) and 47 (49%) of these completed the study on monotherapy alone . Only 2 patients (2%) in each arm had to stop treatment owing to allergic reactions . None of the observed differences were statistically significant and we therefore conclude that meropenem was an effective and safe alternative to ceftazidime for empiric treatment of fever during neutropenia. Ugeskr Laeger, 1998 Oct 5, 160(41), 5931 - 4 {CT-guided spinal biopsy in spondylodiscitis}; Vinicoff PG et al.; Since February 1987 percutaneous CT-guided spine biopsy was performed in 18 patients with spondylodiscitis at the X-ray Department of Bispebjerg Hospital . Eleven cases were spontaneous and seven followed spinal surgery . The infection was located in five cases in the thoracic spine and in 13 cases in the lumbar spine . Only one biopsy was performed during general anaesthesia, the rest under local anaesthesia . No complications were observed . The bioptic material was cultivated immediately beside the patient and incubated for 14 days . The infective organism was isolated in 12 cases (67%) . Thus, material obtained through a fine needle was satisfactory for microbiological investigation . A biopsy is crucial for establishing a microbiological diagnosis and thereby enabling prompt adequate treatment. Sudhoffs Arch Z Wissenschaftsgesch, 1998, 82(1), 1 - 29 {Expedition, experiment and expertise reflected in Robert Koch's assets}; Munch R et al.; Basic techniques in bacteriology provided the foundation for the success of experimental medicine . The combination of laboratory experiments and field studies consolidated bacteriology as a paradigm for the development of preventive strategies . Robert Koch's (1843-1910) contribution to this development is crucial in that he integrated the technical facilities of his era into microbiological research . The present study introduces various sources of Koch's assets which, in addition to manuscripts and letters, include also bacteriological slides and photographs . These relicts allow to reconstruct an example of the scientific process as a whole, to investigate his style and purpose as a scientist, and to follow Koch's strategy of visualisation with contemporary technical equipment . The example chosen is Koch's last expedition when the German government sent him to investigate the spreading of sleeping-sickness in Eastern Africa and to test "Atoxyl" as a specific remedy . Most case-studies and laboratory-research took place on the Sese-Islands in Lake Victoria and illustrate the extreme conditions in tropical Africa . The experiments searching for the etiological agent of sleeping-sickness--a typical disease only for central Africa--involved bacteriological slides which were to be the basis for further experimental results and the expertise expected of him. J Nat Prod, 1998 Oct, 61(10), 1237 - 41 Microbiological transformation of manoyl oxide derivatives by Mucor plumbeus; Fraga BM et al.; Biotransformations of jhanol (18-hydroxymanoyl oxide) (2), jhanidiol (1beta,18-dihydroxymanoyl oxide) (3), and 1-oxo-jhanol (1-oxo-18-hydroxymanoyl oxide) (4) by the fungus Mucor plumbeus have been studied . In the incubation of 2 there exists a preference for hydroxylation at C-2(alpha) (8) and C-6(beta) (9-11) and, to a lesser degree, at C-1(alpha) (7), C-11(alpha) (6), and C-11(beta) (5 and 10) . In the second substrate (3), the presence of a 1beta-hydroxyl group inhibits 6beta- or 11-hydroxylation . Epoxidation of the vinyl group constitutes the main reaction, with the positions 2alpha (14) and 3beta (15) being hydroxylated . In the incubation of 4, there was a preference for 6beta-hydroxylation (21) or epoxidation of the vinyl group (22) . Other hydroxylations observed were at the 2alpha (19), 2beta (20), 3alpha (23), 3beta (24), and 11beta (18) positions. Respiration, 1998, 65(5), 381 - 5 Dirithromycin concentrations in bronchial mucosa and secretions; Leroyer C et al.; Since a high tissue penetration of dirithromycin (D) has been assessed in early studies, the aims of this study were to determine D concentrations in bronchial mucosa and secretions in patients suffering from an acute exacerbation of chronic bronchitis (AECB), to compare intra-individual bronchial mucosa and secretion concentrations and to relate bronchial concentrations of D and clinical efficacy . The main inclusion criteria were comprised of (1) AECB, defined by the presence of an increase in dyspnea, sputum production and change in sputum purulence, and (2) clinical indication of fiberoptic bronchoscopy allowing performance of bronchial biopsies . All patients were treated with a 500-mg once-daily D dose for 5 days . Patients were randomly divided into three groups, according to sampling times (24, 48 and 72 h after the last dose) . Tissue concentration analyses were performed by one blinded microbiologist (microbiological agar diffusion assay) . The results showed: (1) 37 out of the 46 patients (80.4%) had a favorable response to treatment at the time of fiberoptic bronchoscopy (14 cured, 23 improved); (2) bronchial mucosa concentrations were high in all groups, and (3) mean values at 24, 48 and 72 h after the last dose were respectively 6.51 +/- 1.44, 6 . 61 +/- 2.7, 5.67 +/- 1.02 mg.kg-1; no statistical difference was observed between the groups . In bronchial secretions collected simultaneously, concentrations were lower, i.e . 1.26 +/- 0.3, 0.61 +/- 0.12, 0.84 +/- 0.12 . Significant associations were observed between bronchial mucosa and secretion concentrations (r = 0.71, p = 0.0001), and between clinical response and bronchial concentrations (p = 0.03, Kruskall-Wallis test) . In conclusion, these results may confirm the clinical significance of tissue concentrations measured in bronchial tissues of patients with AECB. Commun Dis Public Health, 1998 Sep, 1(3), 204 - 5 Scombrotoxic (histamine) fish poisoning in the United Kingdom: 1987 to 1996; Scoging A; Between 1987 and 1996 fresh tuna and canned tuna contaminated after processing became increasingly associated with incidents of scombrotoxic fish poisoning . Fish not commonly associated with this syndrome were implicated in several incidents . Awareness of bacterial contamination after processing has highlighted the need for submitted samples to be examined both microbiologically and toxicologically and for the potential role of other toxins in this syndrome to be considered . The overall rate of reported incidents of scombrotoxic fish poisoning remained stable. Commun Dis Public Health, 1998 Sep, 1(3), 146 - 51 Legionellosis associated with ships: 1977 to 1997; Rowbotham TJ; Over one hundred cases of legionnaires' disease have been linked to ships, and ten cases are known to have died . Most of the cases were associated with cruise ships, but a variety of other vessels were also linked to cases . Few vessels were investigated microbiologically, and the cases associated with ferries were exposed to other sources of infection . Cases appear to be less common among crew members than among passengers . To prevent further cases, ship owners, operators, and captains need to be diligent in maintaining the water and air conditioning systems of their vessels . Whirlpool spas need particular care . Ship-associated cases of non-pneumonic legionellosis appear to be rare. Compend Contin Educ Dent, 1998 Jul, 19(7), 686 - 9, 693-4, 696 passim Clinical and microbiological aspects of the Sargon immediate load implant; Nowzari H et al.; A maxillary lateral incisor with severe periodontal destruction was extracted after forced eruption and was replaced with a Sargon Immediate Load Implant . The clinical and microbiological results of the case are reported . The Sargon Immediate Load Implant is an apically expandable, quintapodal, root-form dental implant, designed to be loaded immediately with a provisional fixed restoration in normal occlusion. An Med Interna, 1998 Aug, 15(8), 415 - 20 {Tuberculosis and HIV infection . Clinical characteristics and diagnosis}; Lado Lado FL et al.; OBJECTIVE: To analyze the clinical characteristics and diagnose of tuberculosis in patients infected by human immunodeficiency virus in our setting . METHODS: We have revised the clinical, microbiological and histological characteristics of 92 cases diagnosed tuberculosis in seropositive patients, during a span time of 128 months . RESULTS: Of them, 71 were male and most of them (81.5%) were intravenous drugs users . The most (93.4%) were sintomatic when tuberculosis was diagnosed mainly fever and general and respiratory sintomatology . The most common signs were the presence of lymphadenopathies and hepatomegaly . The tuberculosis affected mainly pulmonary and ganglionary system . 34 cases had only pulmonary pathology, 24 extrapulmonary, 25 pulmonary and extrapulmonary and 9 miliary . The tuberculosis diagnose was based in microbiologic criteris . The most frequent source, as histologic critery, has been the ganglionary tissue . CONCLUSIONS: The only or associated pulmonary forms are more frequent . The most commonly extrapulmonary form is the ganglionary localization . The most of diagnose methods were obtained from respiratory tract and lymphadenopathy samples. Eye, 1998, 12 ( Pt 3a), 390 - 4 The effect of intracameral, per-operative antibiotics on microbial contamination of anterior chamber aspirates during phacoemulsification; Beigi B et al.; PURPOSE: To assess the effect of per-operative antibiotics on contamination of anterior chamber (AC) aspirates during phacoemulsification . METHODS: Two hundred and twenty patients undergoing phacoemulsification of cataract were randomly allocated to receive an irrigation infusion fluid containing either balanced salt solution (BSS) alone or BSS with vancomycin (20 mg/l) and gentamicin (8 mg/l) during surgery . Conjunctival swabs were obtained from all patients immediately before pre-operative preparation . At the end of surgery 20 ml of the AC aspirate was sent for direct and enrichment cultures . Qualitative and quantitative microbiological studies were undertaken . The chi-squared test was used to compare differences between the two groups . RESULTS: There was no significant difference between the positive culture rates of the conjunctival swabs (28 vs 27; p > 0.8) . In the group that received BSS alone there were 22 (20%) positive AC aspirate cultures, 18 of which were from enrichment cultures . There were 3 positive (2.7%) cultures from the group that received antibiotics added to the BSS (p < 0.0001) . CONCLUSION: The addition of gentamicin and vancomycin to the irrigation fluid during phacoemulsification results in a highly significant reduction in the microbial contamination of AC aspirates. Probl Tuberk, 1998, (4), 53 - 5 {Inhibitory effects of electric UHF field and magnetic infrared laser irradiation on Mycobacterium tuberculosis}; Lomachenkov VD et al.; Microbiological studies indicate that stimulating the multiplication of Mycobacteria tuberculosis, electric UHF fields at 40 and 70 W make them available for drug exposure despite drug resistance . Unlike the electric UHF fields, MILI has a direct inhibitory effect on Mycobacteria tuberculosis that are sensitive and resistant to antibiotic drugs, by potentiating their action . In the clinical setting, chemotherapy in combination with electric UHF fields and MILI therapy reduces the time of disappearance of clinical signs of the disease, infiltration resolution, bacterial isolation, and decay cavity closure. Med Pregl, 1998 Jul-Aug, 51(7-8), 346 - 9 {Premature rupture of the fetal membranes--an active or expectant approach in management of this obstetrical problem}; Milasinovic L et al.; INTRODUCTION: A prospective investigation and comparative analysis of clinical and microbiological results have been performed as to point to some facts of possible significance in solving the dilemmas concerning the problem of pregnant women with premature rupture of the membranes . MATERIAL AND METHODS: Intensive clinical monitoring of the course, methods and complications of the labor was undertaken in 75 pregnant women with premature rupture of the membranes and term delivery . Smears from the vagina, cervix, amnion and amniotic fluid were obtained from each pregnant woman, as well as nasal and throat smears from newborn infants in order to microbiological analysis . According to the method of labor treatment, the investigated patients (n = 75) were distributed into 2 groups . Early induction of labor was applied in 39 pregnant women (labor induction 6 h following rupture of the membranes) and expectatively treated 37 pregnant women (the control of pregnant women until initiation of the spontaneous contractions associated with antibiotic prophylaxis) . RESULTS AND DISCUSSION: Duration of labor (period from rupture of the membranes to the delivery and from the initiation of regular contractions to the delivery) was significantly shorter (p < 0.01) in the induced labor group . Cesarean section was performed in 18.4% od labors in the first and in 13.5% of labors in the second group . Chorioamnionitis occurred in 7.9% in the first and in 21.6% in the second group during the labor (p < 0.05) . The incidence of puerperal and neonatal infection was lower in the first investigated group (7.9% and 5.2%) than in the second group (18.9% and 16.2%) . Positive microbiological finding was recorded in 13.2% of pregnant women from the first group and in 27.0% from the second group (p < 0.05) . CONCLUSION: From the medical point of view it is reasonable to apply early induction of labor in pregnant women at more than 34 weeks' gestation . In pregnant women of less than 34 weeks' gestation, the expectant management of labor is recommended only in the next 48-72 hours. Med Pregl, 1998 Jul-Aug, 51(7-8), 333 - 42 Monitoring of serum concentrations of antibiotics by microbiological method: a one-year experience; Jankovic SM et al.; By monitoring serum concentrations of antibiotics one may have an opportunity to make optimal adjustment of dosing regime for each individual patient, resulting in therapeutic concentrations in tissues and avoiding their cumulation and thus side effects in the organism . Concentrations of gentamicin, amikacin, streptomycin, ceftriaxone, benzylpenicillin, clindamycin and lincomycin were measured in serum of 110 patients by microbiological agar cup method . The measurements were made only after establishment of steady-state . Current dosing regime of gentamicin gave systematically subtherapeutic serum concentrations, while usual doses of amikacin and streptomycin achieved serum concentrations slightly lower than minimal toxic concentrations . Three patients actually had toxic serum concentrations of amikacin . Current dosing regime of penicillin produces therapeutic serum concentrations . The results of our study recommend monitoring of serum concentrations of antibiotics by a microbiological method in patients not responding to antibiotic therapy or having insufficiency of excretory organs. Lijec Vjesn, 1998 Mar-Apr, 120(3-4), 62 - 4 {Nodular lymphoid hyperplasia of the colon and terminal ileum . Case report}; Persic M et al.; A patient admitted to our hospital because of diarrhea and hematochesia is presented . These complaints appeared eight months before, and were not accompanied by other disturbances . All hematological, biochemical and microbiological findings were normal, but endoscopic, x-ray and histologic examination of the gastrointestinal tract showed nodular lymphoid hyperplasia of the colon and terminal ileum . Since an immunological derangement was not verified, this seems to be a rare benign disorder as a response to repeated antigenic stimuli . In our patient these were recurrent parasitoses . The treatment is not needed, but due to the possibility of late onset hypogammaglobulinemia . Long-term patient follow up is required. Rev Cubana Med Trop, 1996, 48(2), 87 - 91 {Taxonomic study of species of the Mycobacterium genus isolated in Cuba}; Ferra Salazar C et al.; 40 strains of the Mycobacterium genus corresponding to 12 species, which were subjected to 62 microbiological and biochemical tests, were studied . Each one was considered as a character . As a result of the similitude coefficient and their grouping, 9 phenomes represented by: Phenome I (Mycobacterium fortuitum), Phenome II (MAI Complex), Phenome III (Mycobacterium phlei), Phenome IV (Mycobacterium triviale), Phenome V (Mycobacterium smegmatis), Phenome VI (Mycobacterium gordonae), Phenome VII (Mycobacterium szulgai), Phenome VIII (MAI Complex), and Phenome IX (Mycobacterium scrofulaceum), were obtained . The strain identification work was consistent with grouping from the phenotypic point of view. Rev Cubana Med Trop, 1992, 44(3), 215 - 9 {Evaluation of an ELISA for the detection of anti-Aspergillus fumigatus antibodies}; Hung Solano M et al.; An indirect MicroELISA system for the detection of anti-Aspergillus fumigatus antibodies using human anti-IgG conjugated to peroxidase was standardized . Serum samples of two patients having an aspergilloma diagnosed by clinical, microbiological, and serological criteria were used as positive controls . In addition, 119 serum samples of blood donors and 216 serum samples of patients having chronic pneumopathies were also studied . The standardized system may be used as a diagnostic complement for it is able to discriminate between antibody levels (IgG) in different clinical forms of aspergillosis and in those individuals having respiratory diseases which may favour the colonization by this pathogen. Presse Med, 1998 Feb 28, 27(8), 341 - 6 {Extrapulmonary tuberculosis in the central western region . Retrospective study of 217 cases (Gericco 1991-1993)}; Denis-Delpierre N et al.; OBJECTIVES: To analyze the epidemiological, clinical and diagnostic characteristics of extrapulmonary tuberculosis in western France observed from 1991 to 1993 in different patients populations (HIV+ infected patients, immunosuppressed non-HIV infected patients, non-immunosuppressed patients) and according to various localizations (lymph nodes, bone and joints, genital organs, nervous system and meninges, miliary disease) . METHODS: This retrospective study included 217 cases of extrapulmonary tuberculosis diagnosed from 1991 to 1993 in western France by GERICCO (Groupe d'Epidemiologie et de Recherche en Infectiologie Clinique du Centre-Ouest) . Demographic, clinical, biological, microbiological and radiographic characteristics as well as clinical course on specific therapy were assessed . RESULTS: Extrapulmonary tuberculosis generally occurred most often in immunosuppressed patients but 34% of cases were observed in people without any underlying disease or risk factors . Delay to diagnosis was especially long in the non-immunosuppressed patients (mean = 96 days) but shorter in the HIV-infected patients (mean = 59 days) . It was shorter in case of nervous system involvement (mean = 52 days) or military disease (mean = 80 days) than in bone and joints (mean = 120 days) and lymph nodes (mean = 102 days) . Microbiologically proven tuberculosis represented only 75% of cases despite numerous investigations . Overall prognosis was good except in nervous system and meninges localizations . Failures were mainly due to death in immunosuppressed patients . CONCLUSION: Extrapulmonary tuberculosis remains frequent even in patients lacking risk factors . In 50% of cases, confirmation of diagnosis takes more than one month . In case of doubt, clinicians should not wait for laboratory results before implementing empirical specific therapy. Presse Med, 1998 Apr 11, 27(14), 653 - 7 {Pneumococcal infections in the adult population observed at the Poitiers University Hospital . Epidemiologic and clinical study}; Pasdeloup T et al.; OBJECTIVES: The aim of this study was to assess the prevalence of penicillin-nonsusceptible pneumococcus (PNSP) infections and their clinical and microbiological features among an adult population hospitalized at the Poitiers University Hospital . PATIENTS AND METHODS: A prospective study was conducted between November 1994 and October 1995 and included all pneumococcus infections . RESULTS: Fifty-three adults with one pneumococcal strain were included . The overall rate of PNSP strains was 28% . Infections with PNSP strains were more resistant than penicillin-susceptible pneumococcus to other antibiotics . The most frequent infection was pneumonia (36 infections, 28% PNSP) . DISCUSSION: The rate of PNSP in pneumococcal infections was the same in the Poitiers University Hospital as in national surveys in France . The high percentage of multiresistant strains (86.5%) limit the use of antibiotics other than beta-lactams . Surveys of pneumococcal resistance to antibiotics are needed to adapt antibiotic strategies to the local epidemiological situation. J Food Prot, 1998 Sep, 61(9), 1246 - 59 Hazard analysis and critical control point principles and application guidelines . Adopted August 14, 1997 . National Advisory Committee on Microbiological Criteria for Foods; A nondestructive leak detection method for flexible food packages using hydrogen as a tracer gas; VTT Biotechnology and Food Research, Finland . eero.hurme@vtt.fi A nondestructive leak detection method developed at Technical Research Centre of Finland (VTT) was tested for both gas-flushed and vacuum flexible packages . In the method, a gas package containing 0.5 to 5.0% (vol/vol) hydrogen in nitrogen was positioned in a test chamber, a controlled vacuum was pulled in the chamber through a pipe connected to a hydrogen sensor, and leaking packages were detected by the sensor as increased H2 concentration . The H2 tracer gas (0.5 to 5.0%) was introduced into leaking finished vacuum packages at 200 kPa pressure . Within 1 to 4 s the developed test method was able to detect leaks down to 10 to 15 microns and 20 to 30 microns in diameter in commercially manufactured gas-flushed packages filled with roasted meat balls and vacuum packages filled with ground coffee, respectively . Before leak testing, the vacuum packages were charged with H2 for 30 s . The sensitivity and leak detection time of the test method were improved when the H2 concentration in the package was increased and when the free space in the test chamber was decreased . The evaluated H2 concentrations did not affect the sensory or microbiological quality of the roasted meat balls . This study clearly demonstrated that the hydrogen tracer gas leak detection method has potential to be further developed as a fast, nondestructive, on-line leak testing apparatus for flexible packages with or without a headspace. J Food Prot, 1998 Sep, 61(9), 1161 - 4 Quality of commercial shelf-stable soymilk products; Bai Y et al.; Four brands of shelf-stable soymilks (three lots each) were evaluated for their quality . All samples were tested for trypsin inhibitor activity, microbial load (coliforms, aerobic mesophiles, and psychrotrophs), solids content, pH, color, and viscosity . Storage stability at 5 degrees C of the opened original containers was evaluated by microbiological analyses . Physical properties were consistent among three lots of the same brand, but varied among brands . Trypsin inhibitor activity ranged from 3.43 to 10.35 mg/g dried soymilk . The pH values of the soymilks varied between 6.41 and 7.34 . Viscosity was measured between 16.5 and 26.4 mPa . Solids content varied considerably among soymilks, from 6.88 to 12.37% (wt/vol) . Freshly opened commercial soymilk contained fewer than one microorganism per ml in all microbial counts . During storage at 5 degrees C, microbial counts increased sharply after 2 to 3 weeks . A single microorganism predominated in each stored sample . Shelf life (defined as the time during which aerobic mesophile counts remained below 10(6) CFU/ml) varied from 3 to 4 weeks . The appearance and pH of soymilks remained unchanged even after 4 weeks of storage . Five types of microorganisms were found in stored soymilk samples; none of them produced acid. Trans R Soc Trop Med Hyg, 1998 Mar-Apr, 92(2), 161 - 3 Prevalence of tuberculosis in TB suspects with short duration of cough; Banda HT et al.; The prevalence of pulmonary tuberculosis (PTB) in patients with short duration of cough was determined . Ninety-eight adult out-patients (60 men, 38 women; mean age 32 years) at Queen Elizabeth Central Hospital, Blantyre, Malawi, who had cough for 1-3 weeks which was unresponsive to a course of antibiotics, were successfully screened by microscopy and culture of 2 or 3 sputum specimens and chest radiography; 34 (35%) had PTB . Ten patients were sputum smear-positive and 24 were smear-negative and culture-positive . There was no difference in age, gender or clinical features of general illness, respiratory disease and HIV-related disease between patients with PTB and those with no evidence of PTB . Nine patients (26%) with microbiologically confirmed tuberculosis (TB) had chest radiograph abnormalities consistent with TB, compared with 5 (8%) of patients with no microbiological evidence of TB . Certain classes of patients with a short history of cough would benefit from PTB screening strategies with the emphasis on sputum examination rather than chest radiography, which is unreliable in such patients . The classes include (i) patients with other features of TB whose cough has not improved with antibiotic therapy, (ii) seriously ill patients, and (iii) patients in high risk institutions such as prisons and refugee camps. Tidsskr Nor Laegeforen, 1998 Aug 30, 118(20), 3148 - 51 {Air quality and microbiologic contamination in operating theatres}; Andersen BM et al.; The present study concerns the air quality and microbiological contamination in two newly built operating theatres; one with laminar air flow (LAF) equipment for cardio-thoracic operations, and one with conventional ventilation for urological operations . Both theatres had an identical number of air exchanges (17/h), identical microclimatic conditions and they employed the same cleaning procedures . In the LAF-ventilated operating theatre bacterial contamination of the air was effectively reduced to less than 10 colony-forming units (CFU)/m3 in all 125 samples (1 m3 per sample) tested . In most samples, 118/125, the bacterial count was less than 5 CFU/m3, despite the presence of ten persons . The conventionally ventilated theatre reached values up to 120 CFU/m3 during the most active period of the day when approximately seven persons were present . The LAF ventilation reduced both the content of particles in the air and contamination by bacteria on the floor . In both theatres cleaning procedures had only a low impact on CFU in the air and on the floor . The use of diathermia markedly increased the level of small particles in the air, and this may influence the air quality in the operating theatres. Otolaryngol Pol, 1998, 52(3), 271 - 5 {Therapeutic effectiveness of Cedax in the treatment of selected acute upper respiratory diseases}; Szmeja Z et al.; A group of 66 patients with acute inflammatory upper respiratory tract diseases were examined in the ENT Department of Poznan Medical Academy between November 1996 and November 1997 . Specimens for bacteriological cultures were collected from the ear, nose and throat . The subjects were treated with ceftibuten . Clinical improvement was reported in all cases . In 44 patients, ceftibuten treatment eliminated pathogenic bacteria (as evidenced by microbiological analysis). Bull Mem Acad R Med Belg, 1998, 153(2), 171 - 8; discussion 178-81 {Intestinal transplantation: a clinical reality in 1998}; Pirenne J; Each year, thousands of peoples die, suffering from an anatomical or functional loss of their intestine; these patients would benefit from bowel transplantation; the difficulties of bowel transplantation are as follows: 1 . the physiological characteristics of the small bowel, and the fact that denervation, lymphatics interruption and ischemia, independently from rejection, may disturb its function; 2 . secondly, the organ is septic; thus, its transplantation causes major infectious problems; 3 . at last, the immunological characteristics of the intestinal allograft . Bowel transplantation causes a two-way immunological conflict, not only a standard rejection response, but also a graft-versus-host disease, similar to that observed after bone marrow transplantation; this reaction is caused by the lymphoid tissue conveyed within the bowel graft . The introduction of a new immunosuppressive molecule, FK 506, in combination with profound antibiotic prophylactic regimens, decontamination protocols and vigorous anti-viral protection (against cytomegalovirus and Epstein-Barr), have significantly improved the results . Bowel transplantation has recently reached clinical application . The one-year survival rate of intestinal grafts reaches now 70% . Still, there is no doubt that, due to its microbiological and immunological characteristics, the small bowel will remain the most challenging abdominal organ to transplant. Pract Periodontics Aesthet Dent, 1998 Aug, 10(6), 687 - 98; quiz 700 An evaluation of differences and similarities observed in fixture failure of five distinct implant systems; Rosenberg ES et al.; While the long-term success of osseointegrated implants has been demonstrated in the dental literature, implant failure does occur as a result of various factors . The purpose of this investigation was to identify clinical and/or microbiological differences associated with failure in five implant systems . At the conclusion of this 7.5-year investigation, 67 of 958 implants were determined to have failed . An overall failure rate of 7.0% was evident in this study, which, depending on the particular system, ranged from 4.7% to 15.2%. Infect Control Hosp Epidemiol, 1998 Aug, 19(8), 593 - 6 Occult nosocomial infections; Petignat C et al.; Even with a good surveillance program, nosocomial infections may be not recognized because of several reasons: absence of symptoms or prolonged incubation period (eg, viral bloodborne infections, tuberculosis); problems with the microbiological diagnosis, because adequate specimens may be difficult to obtain or special methods should be used (eg, fungal infections, virus, new agents); shorter hospital stays (eg, surgical-site infections); difficulty in distinguishing between nosocomial and community-acquired infections (eg, influenza); and failure to detect clinically relevant colonization (eg, multiresistant microorganisms) . Because of the important potential consequences of occult nosocomial infections, specific surveillance programs should be designed to address these problems. Otolaryngol Pol, 1997, 51 Suppl 25, 353 - 5 {Clinical studies of Olbas oil tolerance and its effect on nasal mucosa in healthy volunteers}; Olszewska-Ziaber A et al.; The aim of the study was the clinical examinations of the tolerance and effect of Olbas oil on nasal mucosa in healthy volunteers during permanent 4 weeks administration . 23 healthy volunteers both sexes in the age between 20-50 were investigated . This investigations consisted of: history data, general and otorhinolaryngological examination, with particular evaluation of nasal mucosa, anterior rhinomanometry, olfactometry, saccharin translocation time, microbiological cultures, histamine nasal provocation test . Besides, each patient has follow up self evaluating chart of symptoms and adverse effect from the eyes, nose, pharynx and others . All the examined persons showed a very good tolerance of Olbas oil after 28 days of inhalation. Otolaryngol Pol, 1997, 51 Suppl 25, 312 - 4 {Clinical evaluation of Olbas oil effect on nasal mucosa in acute rhinitis patients during common cold}; Zalewski P et al.; The aim of the study was the clinical evaluation of the effect of Olbas oil on nasal mucosa in patients with acute rhinitis during common cold . 15 patients with 2-3 days history of acute rhinitis during common cold, both sexes, in the age between 23-47 were investigated . All the examinations were done before using, after the first inhalation, and after 7 days of Olbas oil administration . The investigation before using Olbas oil was comprised of: history data, general and otorhinolaryngological examination with particular evaluation of nasal mucosa, anterior rhinomanometry, saccharin translocation time, olfactometry, microbiological cultures, histamine nasal provocation test . At the end, after 7 days of Olbas oil inhalation 3 times a day for 4 minutes 4 drops of Olbas oil applied into a handkerchief, all the test were done again, as at the beginning . The study showed a good of the effect of Olbas oil on nasal mucosa in patients with acute rhinitis during common cold. Otolaryngol Pol, 1997, 51 Suppl 25, 175 - 8 {Bacterial infections in otolaryngology on clinical material study}; Murlewska A et al.; Bacterial species causing the hospital of the upper respiratory tract and ear were analyzed in this study . Authors evaluated differences in the frequency of various microorganisms on the clinical material . A special attention is paid to the problems of anaerobial species . Microbiological analysis of the isolated bacterial species and the assessment of their drugfastness was conducted. Ann Biol Clin (Paris), 1998 Jan-Feb, 56(1), 21 - 8 {Biology of papillomavirus II infections . Their role in the carcinogenesis of the cervix}; Mougin C et al.; The association of human papillomaviruses (HPV), i.e., papillomavirus type 16, with cervical dysplasias and carcinomas is now well established . Additional agents such as sexual behaviour, immunity deficiency, sociodemographic factors, microbiological agents..., are however implicated in the multistage progression from viral infection to cancer . And inactivation of tumor suppressor gene products (p53, p105Rb), oncogene activation (c-myc, c-ras), aneuploidy, karyotypic abnormalities are key events in the tumor progression . Numerous aspects of the biology of human papillomavirus, i.e . natural history, epidemiology, nature and mechanisms of the immune response are under active investigation . Screening strategies of HPV infections (cytology, HPV DNA detection and HPV antibody detection) demonstrated their efficacy in many countries, while prophylaxy and treatment of these infections by vaccines are still under development. J Hosp Infect, 1998 Aug, 39(4), 315 - 21 Closed tracheal suctioning systems and infection control in the intensive care unit; Blackwood B et al.; Closed tracheal suction catheters offer a number of microbiological advantages over the conventional single-use suction catheters . Intensive care staff, however, have experienced difficulties such as pooling of the catheter irrigation saline within the connectors, and hand contamination from condensate which escapes via the irrigation port . Using a descriptive survey design we quantified how frequently these problems occurred . Over an eight-week period, staff completed 923 survey forms . Hand contamination from condensate was reported in 61% of responses . Rinsing the catheter after use was ineffective in 39% of responses, and 70% reported pooling of the saline in the swivel and ventilator connectors . Forty-five percent of responses reported ineffective secretion removal . The infection implications for clinical practice are discussed. Lakartidningen, 1998 Aug 26, 95(35), 3666 - 8 {New knowledge of heredity in inflammatory bowel disease . Specific gene mapping in a EU-project}; Almer S et al.; Chronic inflammatory bowel diseases, ulcerative colitis and Crohn's disease, are steadily increasing in prevalence, and one half to one per cent of the Swedish population are currently estimated to be affected . The aetiology remains unknown, but is probably multifactorial . Both dietary, microbiological and immunological causes have been discussed . Clinical studies, including several Swedish studies, have also shown genetic factors to be crucially involved . Findings in sophisticated molecular biological studies suggest certain specific genes to be involved, and a current EU project in which Sweden is participating has been launched to map the mode of inheritance in detail. Clin Radiol, 1998 Aug, 53(8), 587 - 92 The 'penumbra sign' on T1-weighted MR imaging in subacute osteomyelitis: frequency, cause and significance; Grey AC et al.; OBJECTIVE: We studied the frequency and cause of a feature exhibited on T1-weighted (T1-W) magnetic resonance (MR) imaging termed the 'penumbra sign' in a series of patients presenting with osteomyelitis and correlated it with the double-line sign described as a T2-weighted (T2-W) or short tau inversion recovery (STIR) feature of both the Brodie's abscess and avascular necrosis . MATERIALS AND METHODS: The clinical, radiographic, MR imaging, microbiological and histological findings in 32 patients referred to an orthopaedic oncology service, but subsequently proven to have osteomyelitis, were reviewed . The presence or absence of a rim of tissue lining an abscess cavity typified by minor signal hyperintensity relative to the main abscess contents on T1-W MR imaging (the 'penumbra sign') was identified . The sign was correlated with the radiographic and other findings . RESULTS: The penumbra sign was identified in 24 cases (75%) and appears to be a more sensitive sign than the corresponding double-line sign which was evident in only 29% of these on T2-W or fast STIR images . The lesions were unilocular in 11 cases (46%) and multilocular in 13 (54%) . The thickness of the penumbra ranged from 2 to 5mm . On histological examination the tissue comprising the penumbra sign was found to be highly vascularized granulation tissue containing thick walled arterioles . CONCLUSION: The penumbra sign is characteristically seen on T1-W MR images in subacute osteomyelitis and is due to a thick layer of highly vascularized granulation tissue which may not be visible as the double-line sign on T2-W or fast STIR sequences . This characteristic, but not pathognomonic, MR finding supports the diagnosis of bone infection and helps to exclude the presence of a tumour. Rev Argent Microbiol, 1998 Apr-Jun, 30(2), 96 - 9 {Sewage sludges: application of a technique for recovering Enterovirus}; Caillou S et al.; The aim of this work was to develop a technique to recover viruses from sewage sludges and to set a microbiological reliable index to control the efficiency of waste-water disinfection methods . Twelve samples were collected at San Felipe treatment plant, where the waste-water from Tucuman, Argentina, is received . To free virus from solids, sludges were shaken during 20 h at 4 degrees C and supernatants were obtained by centrifugation . Penicillin, streptomycin, neomycin and amphotericin B were added to avoid the development of contaminating flora . Samples were inoculated in Vero and HeLa cells and Enterovirus (Echo 7, Echo 11 and Echo 21) were isolated from five samples. Klin Lab Diagn, 1998 Jul, (7), 34 - 6 {The determination of the volume (weight) of an inoculate applied using the Semenikhina-designed replicator}; Pokhil SI et al.; The weight (volume) of inoculate applied with Semenikhina's replicator stamp with 1, 2, and 3-mm needles is determined . The method is sufficiently precise for microbiological screenings . The volume of inoculate depends on the diameter and geometrical shape of the needle and characteristics of inoculated substance and surface onto which it is applied. Ter Arkh, 1998, 70(7), 15 - 21 {The empirical antibiotic therapy of patients with acute leukemias: the results of a multicenter study}; Kliasova GA et al.; AIM: To evaluate efficacy of ampicilline/sulbactame and fluconasole in the regimen of empirical antibiotic therapy in patients with acute leukemia . MATERIALS AND METHODS: The trial covered 14 hematological departments of Russia and 1 of Ukraine . Acute myeloid leukemia patients were included . 92 cases of fever in 56 patients with analysis of efficacy in 66 cases were considered . At the first stage of empirical antibiotic therapy, cefoperason (4 g/day) and gentamycin (240 mg/day) were administered . If no response was reached, ampicilline/sulbactam (7.5 g/day) was added . This was the second stage . If no response occurred for 5 days the three drugs were joined by fluconasol (400 mg followed by 200 mg) . RESULTS: Fever of unclear genesis was cured in 82% (28 of 34), clinical infection--in 80% (20 of 25), microbiologically confirmed infection--in 4 of 7 cases . A complete response to the empirical antibiotic therapy was registered in 52 of 66 cases (79%) . 7(10.5%) patients died of infectious complications . 7(10.5%) received other antibiotics. Thorax, 1998 Apr, 53(4), 274 - 80 Clinical profiles of Chinese patients with diffuse panbronchiolitis; Tsang KW et al.; BACKGROUND: Diffuse panbronchiolitis (DPB), characterised by progressive sinobronchial sepsis, is well characterised in Japanese subjects but not in other ethnic groups . The experience with DPB in seven Chinese patients is described and the clinical profiles compared with those of Japanese subjects . METHODS: Seven Chinese patients (three women; mean (SD) age 48(18.6) years, all never smokers) who attended a teaching hospital centre and fulfilled the diagnostic criteria for DPB were assessed prospectively for clinical, radiological, lung function, microbiological, and other "characteristic" laboratory parameters . RESULTS: Lung function assessment showed a typical obstructive pattern (n = 5) and air trapping (n = 7) . Typical bronchiolar infiltration by lymphocytes and plasma cells and accumulation of foamy macrophages in the intraluminal tissue were detected in open lung biopsy specimens (n = 2) . Chest radiographs and high resolution computed tomographic scans revealed hyperinflation, diffuse nodules, bronchial thickening and dilatation, peripheral hypoattenuation, and bronchiolectasis . Radiological improvement, manifest as a reduction in nodular density and bronchial thickening, and persistence of other abnormalities such as air trapping were not accurately depicted by the classical Nakata or Akira classifications . The other "characteristic" features such as HLA-B54, IgG subclass deficiency, raised CD4/CD8 T lymphocyte ratio, cold haemagglutinaemia, raised IgA, IgG, and rheumatoid factor were not present . Treatment with erythromycin led to excellent responses in symptoms, lung function indices, and the radiological picture . A review of the non-Japanese cases in the literature reveals that this absence of typical "additional features" in DPB might also be applicable to non-Japanese patients . CONCLUSIONS: We report the only series of non-Japanese Mongoloid patients with well characterised DPB who had uncharacteristic investigation profiles . This experience should help other clinicians in the investigation and management of DPB in non-Japanese patients. Khirurgiia (Sofiia), 1997, 50(6), 19 - 22 {The treatment problems of soft-tissue infections}; Kovachev L; The treatment results is a series of twenty-six patients running a very serious course of soft-tissue infections are analyzed . Of the total number ten have diabetes mellitus . The sepsis severity score is 23 average according to the APACHE II rating system . Operative management is undertaken without any delay . It is preceded by comprehensive correction of the metabolic disorders present and antibiotic treatment, initially substantiated by presumable microbial causing agents . A total of 62 operations are done . In 36 per cent of cases being examined, the microbiological study contributes to a proper orientation of the antibiotic therapy performed . Bacteremia is documented in three instances . Total mortality rate amounts to 32 per cent (8 patients) . Infections running a serious clinical course may be caused by one or more microorganisms, but in either case the lethality is noteworthy . Active surgical management may prove effective provided it is initiated in the most opportune time . It is only part of the complex therapeutic approach to sepsis. J Clin Microbiol, 1998 Oct, 36(10), 2932 - 9 Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty . The OSIRIS Collaborative Study Group; Atkins BL et al.; A prospective study was performed to establish criteria for the microbiological diagnosis of prosthetic joint infection at elective revision arthroplasty . Patients were treated in a multidisciplinary unit dedicated to the management and study of musculoskeletal infection . Standard multiple samples of periprosthetic tissue were obtained at surgery, Gram stained, and cultured by direct and enrichment methods . With reference to histology as the criterion standard, sensitivities, specificities, and likelihood ratios (LRs) were calculated by using different cutoffs for the diagnosis of infection . We performed revisions on 334 patients over a 17-month period, of whom 297 were evaluable . The remaining 37 were excluded because histology results were unavailable or could not be interpreted due to underlying inflammatory joint disease . There were 41 infections, with only 65% of all samples sent from infected patients being culture positive, suggesting low numbers of bacteria in the samples taken . The isolation of an indistinguishable microorganism from three or more independent specimens was highly predictive of infection (sensitivity, 65%; specificity, 99.6%; LR, 168.6), while Gram staining was less useful (sensitivity, 12%; specificity, 98%; LR, 10) . A simple mathematical model was developed to predict the performance of the diagnostic test . We recommend that five or six specimens be sent, that the cutoff for a definite diagnosis of infection be three or more operative specimens that yield an indistinguishable organism, and that because of its low level of sensitivity, Gram staining should be abandoned as a diagnostic tool at elective revision arthroplasty. Lancet, 1998 Aug 29, 352(9129), 699 - 701 No evidence of pig DNA or retroviral infection in patients with short-term extracorporeal connection to pig kidneys; Patience C et al.; BACKGROUND: The xenotransplantation of organs and tissues, in particular those from pigs, is viewed as a means to alleviate the shortage of human donor organs and cells available for transplantation and also as a therapy for other diseases . The potential microbiological hazards of xenotransplantation have recently attracted much attention . One concern is over pig endogenous retroviruses (PERV) . Until the possible consequences of infection by PERV are better understood it is unlikely that a significant number of porcine xenotransplants will proceed . However, a small number of patients have already been treated with or exposed to living porcine cells or tissue, and investigation of these patients may provide valuable information . METHODS: We took serial blood samples from two renal dialysis patients whose circulation had been linked extracorporeally to pig kidneys and tested them for pig DNA and PERV DNA by nested PCR . The patients' plasma was also tested for neutralising antibodies to two anthropotropic PERV strains . FINDINGS: Having established that the nested PCRs could detect single molecules of target sequence, we analysed DNA isolated from patients' peripheral blood mononuclear cells . We found no evidence of pig or PERV DNA in either patient, even in samples taken as early as 6 h after the perfusion . Furthermore, we found no evidence of seroconversion for PERV-specific antibodies . INTERPRETATION: The absence of porcine cells in the circulation of both patients, even in the samples taken soon after the perfusion experiment, suggests that any porcine cells dislodged from the kidney became rapidly sequestered from the circulation . Since cell-to-cell contact increases the efficiency of infection of PERV this removal of porcine cells may increase the risk of transmission of PERV to the xenograft recipient . We did not, however, detect indications of infection by PERV by PCR or neutralisation assay . The genetic and serological methods described here will be useful for detection of possible PERV infection in other patients. Int J Food Microbiol, 1998 Jul 21, 42(3), 175 - 84 Microbial contamination of meat during the skinning of beef carcass hindquarters at three slaughtering plants; Gill CO et al.; The microbiological effects on the product of the series of operations for skinning the hindquarters of beef carcasses at three packing plants were assessed . Samples were obtained at each plant from randomly selected carcasses, by swabbing specified sites related to opening cuts, rump skinning or flank skinning operations, randomly selected sites along the lines of the opening cuts, or randomly selected sites on the skinned hindquarters of carcasses . A set of 25 samples of each type was collected at each plant, with the collection of a single sample from each selected carcass . Aerobic counts, coliforms and Escherichia coli were enumerated in each sample, and a log mean value was estimated for each set of 25 counts on the assumption of a log normal distribution of the counts . The data indicated that the hindquarters skinning operations at plant A were hygienically inferior to those at the other two plants, with mean numbers of coliforms and E . coli being about two orders of magnitude greater, and aerobic counts being an order of magnitude greater on the skinned hindquarters of carcasses from plant A than on those from plants B or C . The data further indicated that the operation for cutting open the skin at plant C was hygienically superior to the equivalent operation at plant B, but that the operations for skinning the rump and flank at plant B were hygienically superior to the equivalent operations at plant C . The findings suggest that objective assessment of the microbiological effects on carcasses of beef carcass dressing processes will be required to ensure that Hazard Analysis: Critical Control Point and Quality Management Systems are operated to control the microbiological condition of carcasses. Spine, 1998 Aug 15, 23(16), 1793 - 5 Autologous bone grafting in staged scoliosis surgery . The patient as bone bank; Chugh S et al.; STUDY DESIGN: A prospective clinical study in which autologous rib graft, harvested during the thoracotomy in staged scoliosis correction, is stored within the patient for use during the second stage (posterior intrumentation and fusion) . OBJECTIVE: To determine whether the bone stored by this technique is biologically viable and microbiologically safe . SUMMARY OF BACKGROUND DATA: To the authors' knowledge, this method of storage of bone has never been described previously . METHODS: During the first operation, the excised rib was divided into 3-5 cm fragments and stored in a sub-muscular plane adjacent to the posterior elements of the spine before closure . The graft was then retrieved at the second stage . Samples were sent for histologic and microbiologic examination before implantation . RESULTS: On histologic examination, more than 50% of the osteocytes retained their basophilic staining, indicating that they were viable . In addition, osteoclastic activity was notably absent . There was no significant bacterial contamination of the samples . Clinically, all patients achieved satisfactory bone fusion . CONCLUSION: Homeostatic equilibrium in humans provides the ideal environment in which bone graft can be stored . There is no increased risk of infection, and the osteogenic potential of the graft is retained. Ann Periodontol, 1998 Jul, 3(1), 276 - 80 Helicobacter pylori: the mouth, stomach, and gut axis; Oshowo A et al.; The aim of this study was to identify the natural reservoir and route of transmission of Helicobacter pylori infection . Two hundred eight (208) dyspeptic patients (114 males, 94 females; peak age of cohort, 50-59.9) were recruited . Specimens were collected from saliva, supra- and subgingival dental plaque, tongue scrapings, and oropharyngeal swabs . At subsequent endoscopy, gastric antral biopsy was performed for the rapid urease test (RUT), microbiological culture, and, in some patients, histology . Gastric juice samples were aspirated, and in 50 patients duodenal aspirate was collected . Polymerase chain reaction (PCR) with primers targeted to the 16S rRNA sequence of H . pylori was also employed for each of the specimens . In those patients where H . pylori was detected from multiple sites (dental plaque, gastric juice, gastric biopsy, and duodenal aspirate), restriction endonuclease digestion with Hae III was performed to determine if they were epidemiologically linked . The results indicated that 15/208 patients (7%) tested positively for H . pylori by PCR in dental plaque; only 2 samples were positive by culture . In none of the other oral sites sampled was H . pylori detected by any test used in the study . Gastric juice and gastric biopsy specimens from 36/ 208 patients (17%) and 114/208 patients (55%), respectively, were positive by PCR . Duodenal aspirate from 6/50 patients (12%) also tested positively by PCR . All specimens tested by restriction endonuclease digestion with Hae III (15/15 patients) were positive in both antral biopsy and gastric juice specimens, as well as 5 specimens from the duodenal aspirate . Four of the dental plaque strains had restriction patterns similar to those of the stomach and duodenal sites, providing evidence that these sites were infected with the same strain of H . pylori . In conclusion, the results suggest that H . pylori selects the gastric mucosa as its preferred site . The detection in dental plaque could indicate that the oral cavity may act as a reservoir or sanctuary for the organism . Whether H . pylori is a resident or transient oral microorganism is still unclear, although it is more likely to be transient in nature. Eur J Clin Microbiol Infect Dis, 1998 May, 17(5), 344 - 8 Two cases of chronic arthritis of the forearm due to Mycobacterium tuberculosis; Hunfeld KP et al.; In the absence of coexisting active pulmonary disease, tuberculosis is frequently not considered in the differential diagnosis of chronic inflammation of the joints . The cases of two immigrant patients with tuberculous arthritis involving the forearm are reported . In both cases non-specific arthritis or trauma was suspected, resulting in a delay between the onset of symptoms and institution of specific therapy of 21 and 24 months, respectively . Diagnosis was achieved by histological and microbiological examination of synovial biopsy material . Polymerase chain reaction for Mycobacterium tuberculosis complex was positive in only one patient . Treatment consisted of antituberculosis chemotherapy, surgical synovectomy, and debridement of the affected joints . These cases serve as a reminder that, although rare, tuberculosis can cause chronic arthritis. Eur J Clin Microbiol Infect Dis, 1998 May, 17(5), 319 - 26 Brucellosis in patients infected with the human immunodeficiency virus; Moreno S et al.; Brucellosis has been described rarely in patients infected with HIV, despite the fact that eradication of intracellular brucellae is largely dependent on cell-mediated immunity . The characteristics of all patients with HIV infection and brucellosis seen in seven Spanish hospitals are reported . Since the beginning of the AIDS epidemic, 12 HIV-infected patients were diagnosed with brucellosis (8 with cultures positive for Brucella spp., 4 with high anti-Brucella antibody titers) . Most patients were male and intravenous drug users . Eleven patients had no symptoms of HIV infection when first diagnosed with brucellosis and had relatively preserved cellular immunity (median CD4 + cell count 588, range 136-1006) . There was a clear epidemiologic antecedent for acquisition of brucellosis in 11 patients . Clinical symptoms included fever, arthromyalgia, and sweating in all patients; four patients presented with focal disease . All patients had high agglutinin titers, and eight of nine had cultures positive for Brucella . Therapy with doxycycline and streptomycin was curative in all cases . Two patients experienced a recurrence of symptoms after initial treatment, although no microbiological relapses were documented after a median follow-up period of 18 months . HIV infection does not seem to increase the incidence of brucellosis . Since most cases occur in asymptomatic patients with relatively preserved immunity, the epidemiology, clinical presentation, diagnosis, response to therapy, and outcome are similar to those observed in non-HIV infected patients. Bone Marrow Transplant, 1998 Aug, 22(3), 285 - 8 Fatal herpesvirus 6 encephalitis after unrelated bone marrow transplant; Bosi A et al.; A complex pattern of neurological dysfunctions with generalized seizures and visual allucinations, but without focal signs, suddenly arose 20 days after an unrelated bone marrow transplant for chronic myelogenous leukemia (CML) in a 13-year-old girl, accompanied by signs of acute skin graft-versus-host disease (GVHD) . Magnetic resonance imaging (MRI) revealed multiple bilateral foci of signal abnormalities, which were exclusively localized in the grey matter, sparing the white . Extensive microbiological and virological assays of cerebrospinal fluid (CSF) allowed the identification of HHV-6, variant A, DNA . Further progression of both neurological alterations and of skin and gut GVHD led to a fatal outcome 2 weeks later . A retrospective analysis of both the recipient and donor mononuclear cell suspensions supported the hypothesis that HHV-6 had been acquired from the donor with the bone marrow graft . This report suggests a pathogenetic role of HHV-6 in viral encephalitis in immunocompromised bone marrow transplant (BMT) recipients, and its possible association with GVHD. Lancet, 1998 Aug 1, 352(9125), 353 - 8 Outbreak of epidemic typhus associated with trench fever in Burundi; Raoult D et al.; BACKGROUND: After a 12-year absence, epidemic typhus has re-emerged among the displaced population of Burundi . Following the outbreak of civil war in 1993, over 760000 people now inhabit refugee camps, under appalling conditions . A typhus outbreak occurred among prisoners in a jail in N'Gozi in 1995 . At the time, the disease was not recognised, and was referred to as sutama . Reports of sutama among the civilian population date back to late 1995 and, in association with body-louse infestation, the disease has subsequently swept across the higher and colder regions of the country . METHODS: During a field study in February, 1997, 102 refugees with sutama underwent clinical examination and interview . Serum samples were collected and infesting body lice removed . Microbiological analysis included antibody estimations and specific PCRs aimed at diagnosis of Rickettsia prowezekii, Bartonella quintana, and Borrelia recurrentis . Between January and September, 1997, nationwide epidemiological data on the prevalence and distribution of sutama was obtained through liaison with local health services . A second field study in March, 1997, entailed the collection of further serum samples from suspected cases of sutama in different regions of Burundi . FINDINGS: Most of the 102 patients with sutama during initial assessment presented with manifestations similar to those previously described for typhus in Africa, though skin eruptions occurred in only 25 (25%) cases . Microbiological testing revealed evidence of R prowazeki infection in 76 (75%) patients, confirming that most cases of clinically-diagnosed sutama were epidemic typhus, and supporting the reliability of clinical diagnosis as a basis for the nationwide surveillance of the disease . Up to September, 1997, 45558 typhus cases were clinically diagnosed, most of which occurred in regions at an altitude of over 1500 m . Serological testing of 232 individuals from different regions of Burundi provided microbiological evidence to support clinical diagnoses in seven provinces, confirming the widespread nature of the outbreak . Serum from 13 of the original 102 patients and 19 (8%) of the 232 suspected cases had raised antibody titres against B quintana . A fatality rate of 15% among jail inmates fell to 0.5% after administration of a single dose of 200 mg doxycycline to suspected cases . INTERPRETATION: A gigantic outbreak of R prowazekii-induced typhus and B quintana-induced trench fever is continuing in Burundi . Transmission of both diseases to such a large number of people has followed a widespread epidemic of body-louse infestation . Diagnosis of typhus could be reliably made by means of clinical criteria, and the disease could be efficiently and easily treated by antibiotics . This epidemic highlights the appalling conditions in central-African refugee camps and the failure of public-health programmes to serve their inhabitants . Louse-associated disease remains a major health threat in this and other war-torn regions of the world. J Appl Microbiol, 1998 Jun, 84(6), 1050 - 8 Evaluation of the hygienic performances of the processes for beef carcass dressing at 10 packing plants; Gill CO et al.; The hygienic performances of the carcass dressing processes at 10 beef packing plants were assessed from small sets of microbiological data . For each process, a single sample was obtained from a randomly selected site on each of 25 randomly selected beef sides leaving the process . In addition, during a period of about a year, a further nine such sets of samples were obtained from each of two of those processes . The aerobic bacteria, coliforms and Escherichia coli recovered from each sample were enumerated . For each set of 25 counts, values for the mean log and standard deviation were calculated on the assumption that the log values were normally distributed, and the log of the arithmetic mean was estimated for each set from the mean log and the standard deviation . The processes were ranked with respect to the log mean numbers of E . coli, coliforms and total counts estimated for the products . Log mean numbers of E . coli, coliforms and total counts ranged from about 2 to < 100 cm-2, from about 3 to < 100 cm-2, and from about 5 to about 2 cm-2, respectively . For one of the processes, 8, 7, and 8 of the log mean values for the replicated sets of aerobic, coliform and E . coli counts, respectively, differed by < 1 log unit . For the other process 5, 7, and 9 of the log mean values for the replicated sets of aerobic, coliform and E . coli counts, respectively, differed by < 1 log unit . These results indicate that the first process was generally consistent in the contamination of carcasses with aerobes, coliforms and E . coli . The contamination of carcasses in the second process with coliforms and E . coli was also generally consistent, but contamination of those carcasses with aerobes was inconsistent . The findings suggest that beef carcass dressing processes can be operated consistently with respect to the bacterial contamination of carcasses, and that log mean numbers of 1 +/- 0.5 to 100 cm-2, 1 +/- 0.5 to 100 cm-2 and 3 +/- 0.5 cm-2 for E . coli, coliform and total counts, respectively, may be appropriate, commercially attainable acceptance criteria for the hygienic performance of beef carcass dressing processes. Behav Res Ther, 1998 Oct, 36(10), 959 - 70 Danger ideation reduction therapy (DIRT) for obsessive-compulsive washers . A controlled trial; Jones MK et al.; Twenty-one OCD sufferers with washing/contamination concerns took part in a controlled treatment trial at the Anxiety Disorders Clinic, University of Sydney . Eleven of the subjects received danger ideation reduction therapy (DIRT) over eight, 1 h weekly group sessions conducted by the second author . Ten subjects were placed on a wait list and did not receive DIRT or any other treatment . DIRT procedures were solely directed at decreasing danger-related expectancies concerning contamination and did not include exposure, response prevention or behavioral experiments . Components of DIRT include attentional focusing, filmed interviews, corrective information, cognitive restructuring, expert testimony, microbiological experiments and a probability of catastrophe assessment task . All subjects were assessed at pre-treatment, post-treatment and three-month follow-up using the Maudsley Obsessional-Compulsive Inventory, Leyton Obsessionality Inventory, Beck Depression Inventory and a Self Rating of Severity Scale . Changes from pre-treatment to after treatment (post-treatment and follow-up scores averaged) were significantly greater in the DIRT condition than in the control condition for all measures . No significant differences were obtained between groups on post-treatment to follow-up change on any measure . The implications of these findings for theoretical models of OCD and its management are discussed. Int J Artif Organs, 1998 Jun, 21(6), 335 - 40 Monocyte activation and humoral immune response to endotoxins in patients receiving on-line hemodiafiltration therapy; Weber C et al.; With the on-line preparation of substitution fluid, an easy-to-operate and cost-effective alternative to conventional hemodiafiltration (HDF) has been realized . The continuous filtration of dialysis fluid, furthermore, allows high volumes of exchange . Microbial contamination and subsequently endotoxins, however, may be present in dialysis fluid, and thus the microbiological safety has become a pivotal issue . In this clinical study we evaluated the safety of the Fresenius Medical Care on-line HDF system which is based on a two-stage filtration of dialysis fluid with upstream DIASAFE and downstream on-line HDF filter . During the three-month study period we failed to detect germs or endotoxins in the substitution fluid . Augmented plasma interleukin-1beta (IL-1beta) and tumor necrosis factor alpha (TNFalpha) concentrations were found neither during the intradialytic period nor when pre-session values at study begin and study end were compared . In addition, changes in the anti-endotoxin core antibody levels and soluble CD14 (sCD14) concentration, or pyrogenic episodes were not observed . On-line HDF with DIASAFE and on-line HDF filter thus represents a safe treatment modality by effectively depleting dialysis fluid of cytokine-inducing substances. Rev Sci Tech, 1998 Aug, 17(2), 426 - 43 An overview of the roles and structure of international high-security veterinary laboratories for infectious animal diseases; Murray PK; The unique structure, role and operations of government high-security (HS) laboratories which work on animal diseases are described, with particular reference to the laboratories of nine countries . High-security laboratories provide cost-effective insurance against catastrophic losses which could occur following exotic disease outbreaks . The importance of these laboratories is reflected in the fact that several new laboratories have recently been constructed at considerable expense and older facilities have undergone major renovations . Biosecurity is fundamental to the operation of high-security laboratories, so good facility design and microbiological security practices are very important . High-security laboratories conduct exotic disease diagnosis, certification and surveillance, and also perform research into virology, disease pathogenesis and improvements to diagnostic tests and vaccines . The mandate of these laboratories includes the training of veterinarians in the recognition of exotic diseases . One extremely important role is the provision of expert advice on exotic diseases and participation (both nationally and internationally) in policy decisions regarding animal disease issues. J Food Prot, 1998 Aug, 61(8), 1075 - 86 Potential application of risk assessment techniques to microbiological issues related to international trade in food and food products . International Commission on Microbiological Specifications for Foods (ICMSF) Working Group on Microbial Risk Assessment; Principles of risk assessment for illness caused by foodborne biological agents . National Advisory Committee on Microbiological Criteria for Foods; The Risk Assessment Subcommittee of the National Advisory Committee on Microbiological Criteria in Foods has prepared a generic document on the principles of risk assessment as applied to biological agents that can cause human foodborne disease . Typical biological agents include bacteria, viruses, fungi, helminths, protozoa, algae, parasites, and the toxic products that these agents may produce . Basic principles elaborated to characterize food pathogen risks include the four broadly accepted components of risk assessment . The role of surveillance and investigational activities to link biological agents and their food sources to consumer illness is described as is the role of predictive modeling for food pathogens. Eur J Cancer, 1998 Mar, 34(4), 580 - 3 Clinical efficacy of ultrasound guided percutaneous drainage of abscesses in patients with leukaemia and lymphoma; Civardi G et al.; Ultrasound guided percutaneous drainage (US-PD), a minimally invasive technique, has been reported as highly effective for the treatment of deeply located abscesses, particularly in immunocompromised patients . Therefore, we retrospectively studied its therapeutic efficacy and safety in a series of 14 patients with leukaemia and lymphoma . We collected the clinical and sonographic data of 14 patients with various types of leukaemia and lymphoma . These patients were consecutively observed in four clinical centres with long-term experience with ultrasound guided therapeutic techniques . The cases were analysed according to underlying disease, clinical features, location of the abscess, drainage technique, microbiological data and both short- and long-term outcome . In our series, 11 patients were treated with repeated ultrasound guided needle aspirations (US-NA) and 3 underwent catheter drainage (US-PCD) . In 12/14 cases the procedure was successful (86%): the mortality rate was 14% . 5 patients died during the follow-up period because of the underlying disease, without abscess recurrence . No complications were reported . Our data suggest that ultrasound guided percutaneous drainage should be considered the first choice, minimally invasive procedure for the treatment of deeply located abscesses in patients with leukaemia and lymphoma. Tierarztl Prax Ausg G Grosstiere Nutztiere, 1998 Jul, 26(4), 218 - 24 {Fundamentals of hygiene to be used for stallions in an instrumental artificial insemination}; Klug E et al.; Equine artificial insemination (AI) meanwhile has been widely established in the warm blood horse industry . Because of its importance consistent hygienic aspects and their significance for the use of stallions as semen donors in AI-programs are presented and clarified . Incidence as well as importance of equine venereal infectious diseases are considered . Data of physiological bacterial genital flora and treatment principles of therapeutic control of venereal infectious bacterial agents as well as a model of control of Equine Viral Arteritis are given . A prophylactic hygiene program for donor stallions in routine AI including special microbiological monitoring is presented. Cytopathology, 1998 Aug, 9(4), 230 - 9 Diagnostic utility of fine needle aspiration (FNA) cytology in HIV-infected patients with lymphadenopathy; Reid AJ et al.; Sixty-five FNA cytology procedures were performed on lymph nodes in 52 HIV+ patients . Cervical lymph nodes were the commonest site of FNA cytology investigation (54%) . The diagnoses were persistent generalized lymphadenopathy (38%), infection (17%), and malignancy (11%) . Diagnosis could not be rendered in 25% of FNA cytology due to inadequate sampling . Of those with infection, mycobacterial disease was the commonest cause (91%), the diagnosis of which was enhanced by concurrent microbiological examination . Non-Hodgkin's lymphoma was the commonest malignancy . Sixteen lymph node FNA cytologies had subsequent tissue biopsy . There were two false-positive and four false-negative FNA cytologies . FNA cytology in HIV+ patients is most useful in the diagnosis of infection, obviating the need for tissue biopsy and allowing prompt initiation of treatment. Clin Infect Dis, 1998 Aug, 27(2), 283 - 6 Oropharyngeal candidiasis as a marker for esophageal candidiasis in patients with cancer; Samonis G et al.; The present study was designed to determine the frequency of candidal esophagitis in cancer patients with oral thrush . Patients with clinically and microbiologically diagnosed oral candidiasis were evaluated by endoscopy for concurrent esophageal candidiasis . Esophageal involvement was documented by mucosal lesions, microbiological findings of candidal infection in smears of brushing material, positive cultures of brushing material, and histological evidence of mucosal invasion by the yeast . For 21 of the 22 patients studied, there were endoscopic and microbiological findings of candidal esophagitis . Cultures of the brushing material from all 22 patients were positive, while histological evidence was found for 14 patients . Only 10 of the patients had mild esophageal symptoms . It is concluded that oral thrush represents a reliable marker for esophageal candidiasis in patients with cancer . Routine endoscopy is not necessary to confirm the diagnosis; this procedure should be reserved for patients with persistent thrush and symptoms despite antifungal therapy. J Food Prot, 1998 Jun, 61(6), 762 - 75 Hazard analysis and critical control point principles and application guidelines . National Advisory Committee on Microbiological Criteria for Foods; Some remarks on the design of three-class sampling plans; Institut fur Biometrie und Informationsverarbeitung, Freie Universitat Berlin, GermanyAmong the variety of sampling plans for the evaluation of bacterial counts the attributive three-class sampling plan has widely gained acceptance because of its simple application and its robust functionality . However, the performance characteristics of three-class sampling plans depend on lot heterogeneity and the distance between the microbiological limits m and M, which are the maximum level of target organisms under conditions of good manufacturing practice (GMP) and the level of target organisms that is considered as unacceptable or defective . The probability of lot rejection due to a single sample result above M increases with increasing lot heterogeneity and/or with decreasing distance between these limits . Especially for investigations on nonpathogenic microorganisms it is questionable whether a lot still meeting GMP conditions should be rejected solely because a single sample result lies above M . Taking the often used three-class sampling plan (n = 5; cm = 2, cm = 0) as an example, it is demonstrated how insight into the relationship between sample variability and an appropriate distance between m and M can be gained . These calculations are based on the assumptions that logarithmically transformed bacterial counts follow a normal distribution and that an indifference lot with a contamination level at m is to be evaluated . For this kind of lot the probability of acceptance or rejection is equally 0.5 according to the two-class sampling plan . Introducing a limit for the additional risk of rejection of an indifference lot with acceptable heterogeneity when the three-class sampling plan is applied, a criterion for choosing the distance between m and M is developed. J Food Prot, 1998 Jun, 61(6), 735 - 7 Microbiological and chemical changes in high-pressure-treated milk during refrigerated storage; Garcia-Risco MR et al.; The microbiological and biochemical changes during storage of high-pressure-treated (400 MPa at 25 degrees C, for 30 min) whole (3.5% fat) and skim (0.3% fat) milk at refrigeration temperatures (7 degrees C) were studied . From a microbiological point of view, high-pressure treatment of milk led to an increase in the shelf life because, after 45 days of refrigerated storage, the psychotrophic and pseudomonad counts of the pressurized milk were lower than those of the unpressurized milk after 15 days . Capillary electrophoresis of the case in fraction showed that proteolysis by bacterial proteinases was not relevant in high-pressure-treated milk, as evidenced by a negligible degradation of kappa-casein . However, since the pressure conditions assayed did not lead to plasmin inactivation, considerable beta-, alpha-s1-casein hydrolysis took place during refrigerated storage, which can be responsible for flavor defects . No significant differences were found between skim and whole high-pressure-treated-milks. J Food Prot, 1998 Apr, 61(4), 495 - 8 Role of organic acids during processing to improve quality of channel catfish fillets; Fernandes CF et al.; A microbial preparation derived from aquacultured channel catfish fillets (Ictalurus punctatus) was acidified with 0, 1, 2 and 4% (vol/vol) weak organic and held in an ice bath at 0 degree C to simulate the chilling process . Additionally, catfish fillets were sprayed under varying pressures at 15 degrees C with organic acids to evaluate the efficacy of concentrations of organic acids and spray pressures to ameliorate the microbiological quality . To determine plate counts, the dilution fluid was neutralized to pH 7.2 with 1.0 M NaOH . The aerobic plates counts of microorganisms in the chilling water were monitored over a 20-min interval . Aerobic plate counts were found on the channel catfish fillets before and after spray washing with organic acids . Plates were incubated at 35 degrees C for 48 h . The addition of organic acids tot he microbial preparation used in simulating the chilling process significantly (P < 0.05) reduced the number of bacterial surviving . The number of surviving bacteria in the chilled water decreased with increasing concentration and time of exposure to organic acids . Propionic acid had the most detrimental effect on organisms present in the microfloral preparation followed by acetic and lactic acids . Spray washing of catfish fillets with water did not significantly (P < 0.05) affect the microbial quality of fillets . However, catfish fillets sprayed with organic (lactic and propionic) acids significantly (P < 0.05) reduced the microbial counts by 10-fold . Lactic and propionic acids were not significantly (P > 0.05) different in influencing the aerobic counts of the catfish fillets. J Food Prot, 1998 Apr, 61(4), 402 - 8 Repeatability of the Petrifilm HEC test and agreement with a hydrophobic grid membrane filtration method for the enumeration of Escherichia coli O157:H7 on beef carcasses; Power CA et al.; The Petrifilm HEC test (3M Canada Inc., London, Ontario), a quantitative microbiological test for Escherichia coli O157:H7, was evaluated for its performance as a beef-carcass monitoring test . Test repeatability and agreement and agreement with an E . coli O157:H7 detection method using a hydrophobic grid membrane filter (HGMF) overlaid onto cefixime-tellurite-sorbitol MacConkey agar (CT-SMAC) followed by a latex agglutination test for the O157 antigen were determined by using pure cultures of E . coli O157:H7, beef samples experimentally contaminated with bovine feces containing E . coli O157:H7, and naturally contaminated beef carcasses of unknown E . coli O157:H7 status from a local abattoir . The Petrifilm HEC test showed excellent repeatability and excellent agreement with the HGMF-CT-SMAC method when test samples were obtained from pure cultures and experimentally contaminated meat . All 125 naturally contaminated beef carcasses surveyed were negative for E . coli O157:H7 with both microbial methods . The Petrifilm HEC test, however, demonstrated a significantly lower proportion of cross-reactive organisms (false-positive reactions) than the HGMF-CT-SMAC method . Given the performance of this test coupled with its ease of use and compact size, it shows considerable promise for carcass testing where abattoir laboratory facilities are limited and as a substitute for more complex laboratory testing methods used in established laboratories. J Food Prot, 1998 Mar, 61(3), 334 - 8 Analysis of bottled water for Escherichia coli and total coliforms; Grant MA; U.S . Food and Drug Administration regulations governing bottled water include microbiological quality guidelines based on coliform counts . Recently, a new MF medium for simultaneous detection of total coliforms and Escherichia coli was developed . This medium, m-ColiBlue24 (m-CB) was compared to m-Endo medium and an International Organization for Standardization standard coliform medium, lactose agar with Tergitol 7 . Coliform analysis was conducted on 104 brands of bottled water from 10 countries . Some samples were additionally analyzed for heterotrophic plate count on Pseudomonas sp . populations, including P . aeruginosa . Presumptive coliform colonies were found in 5.8% of the samples with m-CB, 1.9% with m-Endo and 11.5% with lactose agar with Tergitol 7 . None of the presumptive coliforms from any of the three media were verified as true coliforms in subsequent analysis . Consequently, the presumptive recovery rates actually represented false-positive error (FPE) rates . The FPE for m-CB and m-Endo were not statistically different (P < 0.05) but the FPE for lactose agar with Tergitol 7 was significantly larger. J Food Prot, 1998 Feb, 61(2), 217 - 20 Changes in microbiological and physicochemical properties of bee pollen by application of gamma irradiation and ozone treatment; Yook HS et al.; The effects of gamma irradiation and ozone treatment on microbiological and physicochemical properties of bee pollen were investigated . Gamma irradiation at 7.5 kGy reduced the total microbial loads below detection levels (>10(2) CFU g(-1)), but after ozone treatment of up to 18 ppm for 8 h the total aerobic bacteria were found in concentrations of more than 10(3) CFU g(-1) . Physicochemical properties such as amino acid and fatty acid composition, thiobarbituric acid value, mineral content, and pigment were not significantly changed by gamma irradiation, whereas ozone treatment caused significant changes in fatty acid composition, thiobarbituric acid value, and pigment by lipid oxidation and decoloration (P < 0.05). J Periodontol, 1998 Jul, 69(7), 819 - 27 Effects of topical metronidazole and tetracycline in treatment of adult periodontitis; Lie T et al.; The present study was performed to assess and compare the clinical healing and the microbiological findings following local application of metronidazole or tetracycline to augment subgingival scaling in previously untreated adult periodontitis sites . Eighteen patients with moderate to severe adult periodontitis at single-rooted teeth were selected . In each patient, 3 interproximal sites having comparable root anatomy, probing depth > or =5 mm and bleeding on probing were randomly assigned to 1 of 3 treatment groups: 1) two sessions of subgingival scaling and root planing; 2) similar to 1, with each treatment supplemented with a 25% metronidazole sustained release gel; 3) similar to 1 with each treatment supplemented with a 3% tetracycline ointment . The treatments were performed by 1 operator and the clinical variables probing depth, attachment level, and bleeding on probing were evaluated at baseline, 3 months and 6 months by a second blinded examiner . The microbiological findings were evaluated using a commercial test kit . The average probing depth reduction for the 3 groups at 6 months was 1.5 mm and the average gain of clinical attachment was 0.8 mm . There were no significant differences between the effects following topical application of the metronidazole gel or the tetracycline ointment . Scaling and root planing alone appeared as effective as the drug augmented regimens, although there was a weak but non-significant tendency for better results in sites treated with the antibiotic drugs . Actinobacillus actinomycetemcomitans was generally not detected; Prevotella intermedia was not significantly reduced, while Porphyromonas gingivalis was significantly reduced in all treatment groups . It was concluded that the augmentative effect of the metronidazole gel and the tetracycline ointment was comparable but small compared to scaling and root planing alone . The clinical importance of such small augmentation effects should be further evaluated. Chronobiol Int, 1998 Jul, 15(4), 309 - 21 Chronokinetics of active biliary ampicillin secretion in rats; Mesnard-Ricci B et al.; The existence of temporal variation in biliary excretion has been demonstrated for dibromosulfophthalein and ampicillin (AMP) . This study was performed to investigate if the 24 h rhythm of active AMP biliary secretion could be attributed to circadian rhythms in the capacity and/or binding affinity of the active secretion mechanism . In this study, 12 Sprague-Dawley rats, housed under a 12 h light/12 h dark environment, were used . Each rat received four 1 h infusions of incremental doses of AMP during either the active (24:00 group) or rest phase (12:00 group) under pentobarbital anesthesia . High doses of AMP were administered to saturate the biliary secretion of AMP via the anion carrier system . Bile and plasma were collected at steady state for each infusion and analyzed by a microbiological assay . The systemic clearance of AMP was increased approximately twofold during the active phase (24:00 group) compared to the resting phase (12:00 group) . Plots of bile excretion rate versus plasma concentration indicated saturation of the anion carrier system . Analysis of the data using the Michaelis-Menten model revealed no significant difference in the binding affinity (1/Km) of the biliary anion carrier system between the 12:00 and 24:00 groups . However, the maximum AMP excretion rate attained in the bile (maximum transport or Vmax) showed a 50% increase during the active phase, thus implicating a day-night variation in transport capacity of the anionic pathway . Therefore, temporal variation in the capacity of the secretory mechanisms is a determinant contributor to the proposed circadian rhythm observed in the biliary elimination of AMP. Vox Sang, 1998, 74 Suppl 2, 275 - 84 Molecular genetic methods: principles and feasibility in transfusion medicine; Avent ND; The scale of the application of molecular biological techniques to modern medicine and research in the biological sciences is vast, and in many instances has captured widespread public appeal . The intention of this review is to summarise the impact of molecular techniques on Transfusion Medicine ranging from diagnostic testing (platelet, granulocyte and red cell genotyping; microbiological testing), stable gene integration into haematopoeitic stem cells (gene therapy), production of blood products in transgenic animals and cell lines, and the inhibition of gene expression using synthetic antisense oligodeoxynucleotides . All of these techniques involve the manipulation of genes, be it from the relatively simple examination of different alleles to the technically demanding ability to express mammalian genes in culture and other animals. Ann N Y Acad Sci, 1997 Dec 15, 832, 358 - 62 Phagocytic activity of bronchoalveolar lavage neutrophils in intensive care unit patients on mechanical ventilation; Piva E et al.; In ventilator-dependent patients the management of clinically suspected nosocomial pneumonia is often difficult . A diagnosis of pneumonia is based upon findings including pulmonary infiltrate, fever, leukocytosis, or purulent secretions . By using bronchoscopic techniques, we can obtain bronchoalveolar lavage specimens (BAL) from the affected area of the lung . Neutrophils (PMN), which are important for lung defense, are found in increased numbers in BAL of these patients . We therefore ascertained the phagocytic activity of PMN against bacteria and fungi by microscopic examination . BAL specimens from ten mechanically ventilated patients were evaluated to assess the cellular counts using a Burker hemocytometer, the differential cell counts by cytospin preparations (MGG stain), and the phagocytic activity of PMN and macrophages using the intracellular bacteria index (ICB) values . Microscopical examination of BAL cells and evaluation of ICB values (cut-off > 5%) were higher in four out of twelve patients and the quantitative assessment of bacteria in PMN cytoplasm on cytospin preparations was found to be useful for the diagnosis of pneumonia . In these patients, pneumonia was suspected (in one patient fungal pneumonia) on the ba