JAMA, 1982 May 21, 247(19), 2680 - 2 Streptococcal wound infections caused by a vaginal carrier; Berkelman RL et al.; During a four-month period, ten cases of group A streptococcal (GAS) postoperative wound infection occurred among patients in a community hospital . Bacteremia developed in two patients, and one patient died . Group A streptococcal surgical wound infections were associated with exposure to a circulating nurse and duration of surgery . Prophylactic antibiotic reduced the risk of infection . Vaginal, perineal, and anal cultures from nurse A yielded GAS, serotype M-4, T-4, as did the blood of two infected patients . Penicillin eradicated GAS colonization of nurse A, and she returned to work . Five months later, two additional cases of GAS postoperative wound infections occurred and were associated with recolonization of the same nurse with GAS, serotype M-nontypeable, T-12 . She was relieved of patient-care duties, and no further cases have occurred. Zh Mikrobiol Epidemiol Immunobiol, 1982 May, (5), 79 - 83 {Effect of proteolysis inhibitors on the phagocytic activity and leukocyte cytoplasmic enzyme activity of white mice with streptococcal peritonitis}; Shpak SI et al.; The functional and metabolic properties of neutrophils in white mice were studied in the course of streptococcal peritonitis and after treatment by the intraperitoneal injection of normal rabbit serum, antitryptic and antikallikrein immune sera and inhitryl . Protease inhibitors were shown to activate the bactericidal and phagocytic activity of neutrophils, to normalize oxidation processes and to enhance the metabolism of glycogen. Arch Surg, 1982 May, 117(5), 561 - 7 The changing pattern of hemolytic streptococcal gangrene; Aitken DR et al.; We reviewed nine cases in which either limg-threatening or life-threatening complications developed due to streptococcal infection . Our findings indicate important changes in the pattern of this fulminating illness since its original description in 1924 . A higher mortality reflects increased longevity with a greater frequency of impaired host resistance and degenerative diseases involving vital organs . Initial symptoms and signs often mimic acute thrombophlebitis, acute arthritis, deep soft-tissue trauma, or acute vascular occlusion . The emergence of multiple organ failure and serious coagulation disorders are a challenge to current therapy . A diagnostic algorithm was developed to aid in the early diagnosis and management of this life-threatening infection. Clin Exp Immunol, 1982 May, 48(2), 458 - 68 The assessment of anti-idiopathic antibodies as effective immunoregulatory probes in vivo; Olson JC et al.; In order to increase our understanding of the potential to use anti-idiotypic antibodies as immune modulators in vivo, we extensively analysed influences induced by one such antibody (anti-Id-l) following its administration to animals of different ages, genetic backgrounds, and immunological histories . Id-l is an inter-strain idiotype associated with rat anti-Group A streptococcal carbohydrate antibodies . The intraperitoneal (i.p.) injection of anti-Id-l antibodies, prepared against Id-l+ antibodies from an HPR rat could effectively induce long-term idiotype suppression in all tested strains of rats, regardless of the age at the time of treatment, the RTl haplotype or IgG2c or k-chain allotype . Total anti-streptococcal antibodies were not suppressed by this treatment . Although long-term suppression could be induced at any age, the percentage of animals suppressed following neonatal injections was consistently less than that following adult injections of anti-idiotypic antibodies . In addition, neonatal injections of anti-Id-l or Id-l with anti-Id-l appeared to enhance Id-l production in a minority of the animals . Similar treatment of adult animals never increased Id-l synthesis, suggesting that cells associated with enhanced Id-l production in older animals are either refractory to activation-differentiation signals and/or are sequestered and no longer accessible by i.v . or i.p . routes of administration of the probe . Auto-anti-Id-l immunity induced by immunizing adult rats with heavy, light, F(ab')2 fragments or whole IgG molecules could also induce an Id-l suppressed state . We were not able to induce significant Id-l suppression if animals were immunized with antigen prior to the injection of anti-Id-l . There was evidence, however, that such treatment might lead in time to the development of some idiotype specific suppression. Immunology, 1982 May, 46(1), 83 - 8 Relationship of complement to experimental arthritis induced in rats with streptococcal cell walls; Schwab JH et al.; Experimental arthritis developed in rats injected intraperitoneally with aqueous suspensions of peptidoglycan-polysaccharide complexes (PG-APS) isolated from group A streptococcal cell walls . Reduction of serum complement by pretreatment with cobra venom factor (COV) reduced acute joint inflammation over the first 3 days following injection of PG-APs . Thereafter, the course of the disease was not different in the COV-treated rats . The serum levels of complement were depressed below detectable levels by 24 hr in rats injected only with cell walls, but rebounded to normal levels or above 3 days after injection . In rats injected with COV before cell walls, the complement levels also increased 3 days after injection of cell walls, in contrast to sustained depressed levels in rat injected only with COV . The correlation between severity of joint inflammation and serum complement levels at day 3 was positive in COV-treated rats . The quantity of cell wall per joint at day 3 correlated with the severity of joint disease . However, COV treatment did not alter the amount of cell wall localized in joint tissue . Therefore, although complement does appear to have a role in early joint inflammation, its effect is not upon the transport of cell wall into joint tissue. J Immunol, 1982 May, 128(5), 2032 - 5 Streptococcal group A carbohydrate has properties of both a thymus-independent (TI-2) and a thymus-dependent antigen; Briles DE et al.; Streptococcal group A carbohydrate, which elicits mouse antibody of primarily the IgM and IgG3 isotypes, is relatively nonimmunogenic in nu/nu or xid mice, and thus appears to be a type of TD-2 antigen . The TD-2 antigens described previously have been proteins that elicit IgG antibody primarily of the IgG1 and IgG2 isotypes . Our findings indicate that TD-2 properties may also be a characteristic of at least some carbohydrate antigens that can elicit IgG antibody predominantly of the IgG3 class. N Z Med J, 1982 Apr 28, 95(706), 262 - 4 A comparative study of the clinical patterns of acute glomerulonephritis from a high and a low incidence area of New Zealand; Dawson KP; Prompted by the marked regional differences in the incidence of acute nephritis in childhood, a comparative clinical study is reported . The features of the disease in a high incidence area, Tauranga, are contrasted with those in a low incidence area, Christchurch . The relative infrequency of the disease in Christchurch has been confirmed . The clinical features and the severity of the disease showed a similar pattern in the two centres . Serological evidence of recent streptococcal infection occurred in the majority of patients from both areas . Prior skin infection was more frequently reported from Tauranga and the significance of this is discussed. Eur J Clin Microbiol, 1982 Apr, 1(2), 102 - 6 Antimicrobial susceptibility of Gemella haemolysans isolated from patients with subacute endocarditis; Buu-Hoi A et al.; Gemella haemolysans, a member of the family Streptococcacae, was isolated from patients with subacute endocarditis . The minimal inhibitory concentrations of 21 antimicrobial agents for five strains of the organism were determined . All strains were highly sensitive to penicillin G and ampicillin . Cefotaxime was the most active cephalosporin tested . All strains were sensitive to vancomycin, chloramphenicol and rifampin . Four strains were sensitive to tetracycline and erythromycin . All strains demonstrated a low level of resistance to aminoglycosides and were highly resistant to sulfonamides and trimethoprim . Killing curves and checker-board titration demonstrated synergism between penicillin G and streptomycin or gentamicin, and also between vancomycin and streptomycin or gentamicin . The results suggest that penicillin G combined with an aminoglycoside can be recommended for the treatment of subacute endocarditis caused by Gemella haemolysans. Pediatrics, 1982 Apr, 69(4), 452 - 4 Serum penicillin concentrations after intramuscular administration of benzathine penicillin G in children; Ginsburg CM et al.; Concentrations of penicillin were measured in serum samples of 26 children who received benzathine penicillin G (BPG) alone or in combination with procaine penicillin (PBPG) . Both preparations were well absorbed; peak concentrations of penicillin after PBPG administration were 25-fold larger than those after BPG . One third and one half of serum samples from BPG and PBPG patients, respectively, contained no measurable penicillin activity at 18 days . At 30 days, there was no penicillin activity in any of the samples . These data raise questions regarding the use of BPG and PBPG for prophylaxis of group A streptococcal and pneumococcal infections. J Immunol, 1982 Apr, 128(4), 1631 - 6 Characterization of the human cellular immune response to purified group A streptococcal blastogen A1; Regelmann WE et al.; The human mononuclear cell response to purified extracellular streptococcal protein, blastogen A, was compared to the response of these cells to PHA and tetanus antigen . Blastogen A induced peak uptake of thymidine during day 6 of tissue culture whereas PHA induced peak uptake during day 5 and tetanus during day 8 . Like PHA, blastogen A transformed human umbilical cord lymphocytes and those of nonimmune animals . Also like PHA, blastogen A transformed primarily T lymphocytes . However, unlike PHA, the ability of T lymphocytes to respond to blastogen A was almost completely dependent on the presence of viable non-T lymphocytes . Monocytes were not as effective in facilitating the response to blastogen A as they were for PHA . Thus, blastogen A behaves most like a polyclonal T lymphocyte mitogen, although the degree of dependence of the transformation response on the presence of non-T lymphocytes is much greater than that of PHA. Mol Immunol, 1982 Mar, 19(3), 457 - 65 Properties of cold agglutinin and group carbohydrate-specific antibodies isolated from group C streptococcal antisera; Brown JC et al.; The relationship between erythrocyte autoreactive cold agglutinin (CA) antibodies and group carbohydrate-specific antibodies in hyperimmune rabbit Group C streptococcal antisera was investigated . The different antibody preparations examined were isolated from autologous erythrocyte, Group C carbohydrate, and alpha-GalNAc immunoabsorbents . Each population was subsequently tested for SRBC reactivity, RRBC autoreactivity, and carbohydrate and ligand reactivity, in hemagglutination assay, direct biphasic hemolytic and hemolytic inhibition assays, and radioimmunoassay . In absorption experiments, CA antibodies present in unfractionated serum and represented as purified IgG and IgM preparations, were reactive with Group C carbohydrate, but poorly reactive with alpha-GalNAc immunoabsorbent . In addition, CA antibody activity present in carbohydrate-eluted material, was absent in alpha-GalNAc-eluted material as determined by hemagglutination and direct hemolytic assay . By radioimmunoassay, carbohydrate-eluted and alpha-GalNAc-eluted streptococcal antibodies, and alpha-GalNAc-eluted BSA-alpha-GalNAc antibodies, exhibited similar reactivity with 125I-BSA-alpha-GalNAc antigen, and with GalNAc in radioimmunoassay inhibition experiments . In contrast to these results, both IgG and IgM CA antibodies exhibited a relatively low avidity toward 125I-BSA-alpha-GalNAc . Yet relative to the other antibody populations tested in radioimmunoassay inhibition experiments, CA antibodies did not exhibit a particularly significant difference in reactivity with GalNAc . However, recognition of other Gal-containing ligands, e.g . Mel and Lac, was restricted to the CA antibody preparations . These data suggest that CA antibodies present in Group C streptococcal antisera do not represent a higher affinity cross-reactive anticarbohydrate population, but instead perhaps represent cross-reactive carbohydrate-specific antibodies produced in response to nonimmunodominant Group C carbohydrate determinants. Zh Mikrobiol Epidemiol Immunobiol, 1982 Mar, (3), 30 - 2 {Fibroblast ultrastructural cytopathology in a streptococcal infection}; Korinteli VI et al.; The study of the dynamics of streptococcal infection in fibroblast cell culture by electron microscopic analysis has revealed the intracellular development of bacteria . The degree of ultrastructural cytopathology of homologous bacteriophages in the model system have been studied. Eur J Respir Dis, 1982 Mar, 63(2), 140 - 50 Viral respiratory infections in asthmatic children staying in a mountain resort; Roldaan AC et al.; In 32 mainly atopic children (aged 9-16 years) staying in a mountain resort the effects of viral infections on the course of asthma were studied . Daily surveillance was made of respiratory infection symptoms and clinical parameters for asthma, including forced expiratory volume in 1s (FEV1) . Serology for several respiratory viruses . Mycoplasma pneumoniae and Chlamydia psittaci was done . In 58 symptomatic respiratory infections (SRI) 39 asthmatic exacerbations occurred (67%) . Eighteen SRIs of viral origin caused 16 exacerbations (89%) . Twenty-one seroconversions with mild or absent symptoms of infection gave six exacerbations (29%) . Five flare-ups of asthma in eight episodes of seroconversion (63%) during which patients were not under observation were reported . Streptococcal pharyngitis did not cause asthmatic reactions . Thirteen SRIs due to influenza A all caused asthmatic exacerbations . The similarity of these data to those in children with "intrinsic" asthma suggests that the development of viral excerbations in asthmatics is not determined by whether the patient is allergic or not. J Clin Microbiol, 1982 Mar, 15(3), 481 - 3 Diagnosis of group A streptococcal infections directly from throat secretions; Edwards EA et al.; The diagnosis of group A streptococcal disease still relies on isolation of group A streptococcal strains on sheep blood agar followed by presumptive identification based on bacitracin sensitivity or the results of the more precise serogrouping methods such as the Lancefield precipitin test . A technique that would permit rapid identification of streptococcal infections directly from throat secretions would allow immediate appropriate antimicrobial therapy for the management of streptococcal infections to be started . We have been able to identify soluble group A antigen directly from throat secretions by using a latex agglutination test . In a clinical trial in which latex (Streptex group A) and conventional culturing techniques were used, 53 throat secretion cultures were tested: 26 were positive by both procedures, 5 were positive by culture only, 3 were positive by the latex agglutination test only, and 19 were negative by both tests. Jpn J Antibiot, 1982 Mar, 35(3), 754 - 60 {Clinical studies of 9, 3"-diacetylmidecamycin (author's transl)}; Sugaya N et al.; 1 . We had a chance to administer the "MOM dry syrup' (MOM fine granules) to 22 patients: 6 patients with streptococcal infections and 16 patients with other respiratory tract infections . The clinical efficacy was good in 16 cases and its rate was 80% . 2 . The causative organisms were isolated from 9 cases: 6 cases with S . pyogenes, 2 with S . pneumoniae and 1 case with B . pertussis . All of the clinical isolates were eradicated except for the S . pyogenes strains . 3 . Any remarked side effects were not observed but only eosinophilia in 2 cases . 4 . Because of no bitterness of the MOM dry syrup, all the children take it easily . 5 . MOM was effective in all the cases of pertussis and Mycoplasma pneumoniae pneumonia . As for streptococcal and pneumococcal infections, it is necessary to administer MOM under the control of bacterial sensitivity. Clin Pediatr (Phila), 1982 Feb, 21(2), 83 - 8 Treatment of Group A streptococcal pharyngitis in children . Results of a prospective, randomized study of four antimicrobial agents; Ginsburg CM et al.; Penicillin V, benzathine/procaine penicillin G, cefadroxil monohydrate, and erythromycin estolate were randomly assigned for therapy of group A streptococcal pharyngitis in 198 children . All patients improved with in 24 hours of initiating therapy . Reinfection with a new group A streptococcal serotype occurred in 13 patients, 12 developing 7 to 12 days after stopping therapy and 11 becoming symptomatic . Relapse with the same organism occurred in 16 patients, only 5 (31%) of whom were symptomatic . Antibody titer rises, antibiotic resistance of group A organisms, presence of penicillinase-producing staphylococci, and lack of compliance were not related to recurrent infections . There were no significant differences between the failure rates of the four test drugs: penicillin V, 12%; benzathine/procaine penicillin G, 12%; cefadroxil monohydrate, 5%; and erythromycin, 2%. Eur J Immunol, 1982 Feb, 12(2), 170 - 3 Allotypes in Basilea rabbits; Weiss S et al.; Basilea rabbits produce immunoglobulin molecules, practically all of which have lambda light chains rather than kappa chains . This variant strain was derived form a homozygous (b9/b9) male . Sensitive serological methods revealed that at least some homozygous bas/bas individuals possess traces (about 100 ng/ml) of b9 molecules . This level usually increases to almost 1 microgram/ml upon hyperimmunization with pneumococcal or streptococcal vaccines . One exceptional rabbit, with 50 micrograms/ml of b9 molecules, was found . In spite of the presence of b9 molecules in early pre-immune bleeds, homozygous bas/bas rabbits produce strong anti-b9 antibodies; i.e., they are capable of making autoantibodies . These anti-b9 allotypic antisera were not distinguishable by our methods from routinely produced anti-b9. Int Urol Nephrol, 1982, 14(1), 75 - 87 Humoral immunity to streptococcal antigen in acute and chronic glomerulonephritis; Krzymanski M et al.; A study was carried out to verify the clinical usefulness of the elaborated method for the measurement of antistreptococcal antibody in revealing the streptococcal etiology of glomerulonephritis . In 158 patients with glomerulonephritis antistreptococcal antibody (ASA), circulating immune complexes (CIC) and haemolytic activity of the complement were measured . On the basis of immune complex formation it has been concluded that streptococcal infection may cause glomerulonephritis . Serial determinations of ASA and CIC are helpful in establishing the streptococcal etiology of glomerulonephritis and in monitoring the course of the disease. Jpn J Surg, 1982, 12(2), 143 - 7 Survival time of tumor-bearing rats as related to operative stress and immunopotentiators; Hattori T et al.; To investigate the mechanism of tumor growth enhancement induced by operative stress in rats, laparo-thoracotomy was performed on day 2 after tumor cell inoculation associated with administrations of various kinds of immunopotentiators . OK-432 (Streptococcal preparation), PS-K (extract from mycelium of Coriolus Versicolor), Lentinan (extract from Lentinus Edodus) and C . parvum were administered intravenously or intraperitoneally in the fractionated form prior to or after inoculation . In general, administration of each immunopotentiator, except for Lentinan, resulted in a recovery from the reduction in survival days after laparo-thoracotomy . In particular, OK-432 administration prior to inoculation showed a significant improvement. Ann Acad Med Singapore, 1982 Jan, 11(1), 36 - 41 Prognosis of post-streptococcal glomerulonephritis: Chandigarh study; Singhal PC et al.; 144 patients (107 adults and 37 children) belonging to a homogenous North Indian population who were hospitalised for acute post-streptococcal glomerulonephritis have been followed up for a period of ten years . The majority of these belonged to the lower socio-economic group . Varying degrees of proteinuria was present in 88.2%, hypertension in 62.5%, renal insufficiency in 61% and hematuria in 51.4% of the patients at the onset of the disease . By the end of the two years, 25 patients were dead because of rapid progression to end stage renal failure and 6 patients had mild to moderate renal insufficiency . Of the 119 patients who were alive at the end of the two years, 32 patients (who had shown a clinical recovery) were not available for further regular follow up and were excluded from the long term study, 87 patients were followed up beyond 2 years . In addition to 6 patients who were already in renal insufficiency at two years, 6 more developed renal failure on further follow up . 3 out of these 12 patients progressed to end stage renal failure 5 to 10.5 years after the onset of the disease . Persistence of nephrotic state, hypertension and renal insufficiency following an acute attack, and the presence of glomerular crescents on renal histology were associated with a poor outcome . Whereas only 2 out of 37 children died of end-stage renal failure, the majority of the deaths were in the adults (26 out of 107) . Thus, 17% of the patients of acute post-streptococcal glomerulonephritis progressed to end stage renal failure within 2 weeks to 2 years, another 2% within 10 years and more than 6% will ultimately progress failure beyond 10 years. Biochem J, 1982 Jan 1, 201(1), 189 - 98 L-trans-Epoxysuccinyl-leucylamido(4-guanidino)butane (E-64) and its analogues as inhibitors of cysteine proteinases including cathepsins B, H and L; Barrett AJ et al.; 1 . L-trans-Epoxysuccinyl-leucylamido(4-guanidino)butane (E-64) at a concentration of 0.5 mM had no effect on the serine proteinases plasma kallikrein and leucocyte elastase or the metalloproteinases thermolysin and clostridial collagenase . In contrast, 10 muM-E-64 rapidly inactivated the cysteine proteinases cathepsins B, H and L and papain (t0.5 = 0.1-17.3s) . The streptococcal cysteine proteinase reacted much more slowly, and there was no irreversible inactivation of clostripain . The cysteine-dependent exopeptidase dipeptidyl peptidase I was very slowly inactivated by E-64 . 2 . the active-site-directed nature of the interaction of cathepsin B and papain with E-64 was established by protection of the enzyme in the presence of the reversible competitive inhibitor leupeptin and by the stereospecificity for inhibition by the L as opposed to the D compound . 3 . It was shown that the rapid stoichiometric reaction of the cysteine proteinases related to papain can be used to determine the operational molarity of solutions of the enzymes and thus to calibrate rate assays . 4 . The apparent second-order rate constants for the inactivation of human cathepsins B and H and rat cathepsin L by a series of structural analogues of E-64 are reported, and compared with those for some other active-site-directed inhibitors of cysteine proteinases . 5 . L-trans-Epoxysuccinyl-leucylamido(3-methyl)butane (Ep-475) was found to inhibit cathepsins B and L more rapidly than E-64 . 6 . Fumaryl-leucylamido(3-methyl)butane (Dc-11) was 100-fold less reactive than the corresponding epoxide, but was nevertheless about as effective as iodoacetate. Zh Mikrobiol Epidemiol Immunobiol, 1982 Jan, (1), 37 - 9 {Dynamics of lysosomal cationic proteins in experimental streptococcal infection in monkeys}; Voskanian NA et al.; The study of the time course of nonenzymatic lysosomal cation proteins in monkeys (rhesus macaques) revealed its correlation with the clinical manifestations of the developing disease . At the period of pronounced clinical manifestations of the disease the cation protein indices decreased . They returned to the initial level when the general state of the animals improved, the erythrocyte sedimentation rate decreased and the leukocyte formula became normal . The determination of the cation protein level can serve as an additional test for the evaluation of the natural resistance of the body. Int Arch Allergy Appl Immunol, 1982, 67(4), 322 - 8 In vitro augmentation of human natural killer (NK) cell activity by a streptococcal preparation OK-432 and its extracts, protein M and polysaccharides; Wakasugi H et al.; Effect of a streptococcal preparation OK-432 and its derivatives on the augmentation of human natural killer cell activity in vitro was examined . The strong augmentation was found by the OK-432 stimulation . Cell separation procedures revealed that cytotoxic activity augmented by the stimulant was considered to be mediated mainly by nonadherent, nonphagocytic, IgG-Fc receptor positive, non-T cells, i.e . NK cells . In addition, supernates cultured with OK-432 augmented NK activity, suggesting some kinds of soluble factors released in the supernates may be participating on the augmentation of human NK activity by OK-432. Arch Dis Child, 1982 Jan, 57(1), 75 - 6 Gallbladder distension in septic neonates; Peevy KJ et al.; Eight cases of neonatal gallbladder distension are described . Group B streptococcal sepsis (5 infants) of suspected sepsis (3 infants) was present and probably played an aetiological role in the development of a distended gallbladder . Two infants required surgery because of persistent gallbladder enlargement and rising levels of bilirubin . Five responded to vigorous medical management and one died from sepsis and pneumonia . The need for conservative early management is stressed. Infect Immun, 1982 Jan, 35(1), 377 - 80 In vivo changes in complement induced with peptidoglycan-polysaccharide polymers from streptococcal cell walls; Lambris JD et al.; In rats injected with an arthropathogenic dose of streptococcal cell wall fragments, serum hemolytic activity decreased over the first 24 h and was then elevated from days 2 through 6 after injection . Hemolytic activity was again elevated at days 16 and 40 . Levels of activity of alternative complement pathway, C3, and factor D were also altered. Infect Immun, 1982 Jan, 35(1), 20 - 4 Lactoperoxidase and thiocyanate protect bacteria from hydrogen peroxide; Adamson M et al.; Lactoperoxidase and thiocyanate were shown to protect Escherichia coli and three oral streptococcal species from the bactericidal effect of hydrogen peroxide under aerobic conditions . Lactoperoxidase in the absence of thiocyanate was also protective for two of the bacterial species in a dilution medium but potentiated hydrogen peroxide toxicity for the other two under the same conditions . The products of the reaction between hydrogen peroxide and thiocyanate in the presence of lactoperoxidase were not bactericidal except in the case of E . coli, and then only under special conditions . The results demonstrate the effectiveness of lactoperoxidase and thiocyanate in protecting living cells from hydrogen peroxide toxicity . Although the effect on human cells was not examined in this study, extrapolation of these results to the cells of the oral mucosa would suggest an important protective role of lactoperoxidase and thiocyanate against the toxic effects of hydrogen peroxide in the oral cavity. Transplantation, 1982 Jan, 33(1), 80 - 6 Acquisition of graft-versus-host reactivity by immature thymocytes in the coexistence of activated macrophages; Yamashita A et al.; The collaborative role of macrophages in the acquisition of the rat graft-versus-host (GVH) reactivity by parental thymocytes was investigated by the popliteal lymph node enlargement assay . The addition of peritoneal macrophages activated by streptococcal bacteria injection resulted in significantly increased GVH reactivity of parental thymocytes, when assayed both in normal F1 hybrid hosts and in those depleted of effective macrophages and lymphocytes . The thymocytes that acquire that alloantigen reactivity in the presence of activated macrophages were shown to be cortisone sensitive and of high density . Hence, the cortisone-resistant and less dense population of thymocytes did not exhibit further reactivity even in the presence of macrophages; however, this subpopulation showed an enriched activity on its own . Moreover, the simultaneous injection of activated macrophages induced a further augmenting effect on the graft-versus-host reaction (GVHR) of freshly peripheralized thymocytes, but did not affect the reactivity of lymph lymphocytes from parental rats thymectomized 15 months previously . These data suggest that activated macrophages play an essential role in the acquisition of alloantigen reactivity by immature thymocytes, and also that the macrophage-dependent thymocytes in the reaction may reside among the subpopulation that is cortisone sensitive, highly dense, short-lived, and freshly peripheralized . The possible nature of immunological maturation of immature thymocytes in the periphery is discussed in relation to cellular interactions with activated macrophages. Scand J Infect Dis Suppl, 1982, 31, 68 - 77 Gram-positive microorganisms in sepsis; Holm SE; The significance of various microorganisms as pathogens in septicemia has been changing over the years . This has been amply demonstrated by several authors especially in the interesting survey from Boston by Maxwell Finland covering a 30 years' period from 1935-1965 . Dramatic changes were noted among the Gram-positives and this seemed to coincide with the introduction of antibiotics . However, since that time a continuous variation of microflora isolated from patients with bacteremia has been reported, which indicates the significance of a through analysis of isolated pathogens presently and in the future . The difference in etiology in various age groups has been strengthened and microorganisms, which were seldom found ten years ago, are now of major clinical importance in septicemia . There is no simple explanation to this phenomenon but rather reflects a summary of influences including changes of the host-microorganism interaction induced by different treatment procedures, survival of patients with diseases with a negative effect on the infectious response, new and better microbiological diagnostic procedures, etc . The possibility that the increased frequency of e.g . group B streptococcal infections reflects a change in 'Status epidemicus' must also be born in mind . The clinical significance of changes in the etiology of septicemia is obvious since the microorganisms have different virulence factors, influencing in various ways upon the host . These microorganisms may also have a different or changing antibiotic sensitivity pattern . It should be added, however, that the changes in antibiotic sensitivity pattern is a multifacetted problem involving factors like types of patients in a hospital, treatment regime, antibiotic use. Dev Comp Immunol, 1982 Spring, 6(2), 263 - 9 Phylogeny of immunoglobulin structure and function . XIV . Peptide map and amino acid composition studies of shark antibody light chains; Clem LW et al.; Light chains from antibodies to the streptococcal A-variant carbohydrate from individual nurse sharks were compared by peptide maps of tryptic digests and amino acid compositions . Although the amino acid compositions of the different chains were quite similar, considerable differences as well as similarities were demonstrable on peptide maps . The peptide maps were interpreted as indicating that shark L chains likely have constant and variable regions as seen in the immunoglobulins of higher animals . Furthermore the unique peptides characteristic of different L chains support the hypothesis that nurse sharks, as a species, possess a relatively large number of different L chain amino acid sequences which are compatible with antibody binding sites to the streptococcal antigen . Hence the repetoire of nurse shark antibody combining sites to this antigen appears to be quite extensive. Med Decis Making, 1982 Winter, 2(4), 463 - 9 Treating sore throats in the emergency room . The importance of follow-up in decision making; Centor RM et al.; Evaluation and treatment of emergency room patients complaining of sore throats are complicated by an unknown probability of follow-up . Tompkins' analysis of cost-effective sore throat management strategies was modified by adding an expression for variable follow-up rate . The original analysis specified a culture range when the probability of streptococcal infection was between 0.05 and 0.20, while the expanded analysis demonstrates that this range decreases with decreasing follow-up . For follow-up rates of 0.70 or less, all patients would be in either the treatment or no treatment group . This analysis demonstrates the importance of follow-up in out-patient decision making, and illustrates the methodology for including follow-up (and similar factors) in our analyses. J Perinat Med, 1982, 10(6), 279 - 85 The influence of group B streptococcal-carriership on pregnancy outcome; Gerards LJ et al.; 762 women were screened for GBS-carriership in the first trimester of pregnancy . The mean age of carriers was 27.2 years . Follow-up was performed in 64 initially positive and 97 negative cases . Persistent carriership was the most important determinant for neonatal GBS-acquisition . Race, birth-weight, gestational-age, interval between rupture of the membranes and birth could not be associated with GBS-carriership or neonatal acquisition . The number of neonates with fetal distress was significantly higher amongst those born to all GBS-carriers; the number of S.G.A.-infants was significantly elevated amongst those born to permanently positive women . Vertical transmission was found in 86% of the mother-infant pairs . GBS serotype III and Ib were predominant . Serotype III was significantly more isolated from non-caucasian women . The transmission frequency of all types was equal (46%), except for type IIc (22%) . None of the serotypes was especially associated with fetal distress or smallness for gestational age. Int Arch Allergy Appl Immunol, 1982, 67(3), 245 - 53 Dissociation of immune complexes in tissue sections by excess of antigen; Penner E et al.; Immune complexes (IC) present in the glomeruli of rabbits with chronic serum sickness (CSS) and in patients with systemic lupus erythematosus (SLE), idiopathic membranous nephropathy (IMN), and acute poststreptococcal glomerulonephritis (PSGN) were analyzed by incubation with antigenic preparations . The efficacy of these preparations to dissolve IC was assayed by comparison of results of direct immunofluorescence tests performed with the kidney tissues before and after incubation with antigenic preparations . The FITC-conjugated antisera used in these tests were specific for IgG, C3, and-in the case of CSS-for the eliciting antigen, bovine serum albumin (BSA) . During the acute proteinuric phase of CSS in rabbits, incubation of tissue sections with BSA alone led to complete dissolution of IC . In many rabbits with late phase proteinuria, however, tissues had to be incubated with both BSA and aggregated fraction II of rabbit serum . In all biopsy specimens from patients with IMN, and in some specimens from patients with PSGN and SLE, aggregated fraction II of human serum resulted in complete or incomplete dissolution of IC . On the other hand, incubation of tissues with excess DNA in SLE or with streptococcal antigens PSGN did not lead to dissolution of IC . These studies suggest significant participation of antibodies to aggregated immunoglobulins (i.e., rheumatoid factors or rheumatoid-like factors) in IC found in the above-mentioned diseases . Other antigen -antibody systems, however, may also contribute to the deposits in the glomerulonephritides studied. Trans R Soc Trop Med Hyg, 1982, 76(3), 304 - 6 Circulating factor from a kala-azar patient suppresses in vitro antileishmanial T cell proliferation; Wyler DJ; In vitro lymphocyte blastogenesis stimulated by phytohaemagglutinin (PHA), streptococcal antigens (SKSD) and leishmanial antigens were used to assess T cell responsiveness in one patient with kala-azar before and after therapy . During the illness, responses to PHA and SKSD but not to leishmanial antigens could be detected . After treatment lymphocytes responded to all three stimuli when cells were cultured in convalescent plasma, but failed to respond to leishmanial antigens when cultured in plasma obtained before treatment . These observations suggest the presence of a circulating inhibitor of anti-leishmanial T cell responsiveness in kala-azar, and warrant further investigation. Microbiol Immunol, 1982, 26(1), 59 - 66 Changes in prostaglandin levels in cultures of SV40 -transformed macrophage cell lines in relation to their phenotypic expression; Tanigawa T et al.; A radioimmunoassay was performed to determine the total amounts of the A, B, and E series prostaglandins (prostaglandins) in culture fluids of simian virus 40 (SV40)-transformed mouse clonal macrophages, line 28-12, and its subline, 28-12 (Ara) . When the proportion of phagocytic cells in confluent 28-12 cell cultures increased, the prostaglandin levels in the culture fluids decreased . On the other hand, stably phagocytic 28-12 (Ara) cells, which were derived from 28-12 cells and which had a reduced growth rate, did not release prostaglandins under the usual culture conditions; however, when they were treated with lipopolysaccharide or streptococcal preparation OK-432, large amounts of prostaglandins were released . In contrast, nonphagocytic cell populations in the cultures of 28-12 cells were not responsive to the drug treatment . These results suggest that there is a correlation between the phenotypic change from the nonphagocytic to the phagocytic state and a decrease in prostaglandin levels in culture fluids, and indicate that phagocytic cells are responsive to prostaglandin inducers, whereas nonphagocytic cells are not. Dev Comp Immunol, 1982 Summer, 6(3), 463 - 72 Phylogeny of immunoglobulin structure and function XV . Idiotypic analysis of shark antibodies; Clem LW et al.; Nurse shark antibodies to the streptococcal A-variant carbohydrate were specifically purified from the sera of four individual animals and used as immunogens in guinea pigs . The resultant guinea pig antisera contained antibodies with apparent idiotypic specificities for the homologous shark proteins . The shark idiotypic sites were located on the Fab fragments and appeared to require the participation of H and L chains for full expression . Tests for cross reactivity employing the four guinea pig anti-idiotypic sera and antibodies from 13 immunized sharks were positive in only two cases (heterologous inhibition) . These findings indicate that the idiotypic library (and by inference the antibody combining site repertoire) of nurse sharks to the streptococcal A-variant antigen is probably quite extensive. Acta Derm Venereol, 1982, 62(3), 265 - 6 Suppression of erythema nodosum by indomethacin; Ubogy Z et al.; Erythema nodosum (EN) can be a debilitating illness . Many treatment modalities have been suggested but none is universally effective . We describe three patients with severe EN secondary to streptococcal pharyngitis who were unresponsive to large doses of aspirin . Following the administration of indomethacin in doses of 100 to 150 mg per day, all three showed a dramatic response, with prompt resolution both of systemic symptoms and of local signs of inflammation . The lesions of EN involve the lower cutis, with inflammation of septae and fat lobules . It is likely, therefore, that the local liberation of fatty acids leads to increased prostaglandin synthesis which, in turn, is responsible for the intense inflammation . The impressive suppression of EN by indomethacin could be related to the inhibition of prostaglandin synthetase in the subcutaneous fatty tissues. Clin Exp Immunol, 1981 Dec, 46(3), 557 - 64 Complement-mediated solubilization in patients with systemic lupus erythematosus, nephritis or vasculitis; Schifferli JA et al.; Solubilization of an immune precipitate by serum is a complement function mediated by the alternative pathway and enhanced by the classical pathway--it therefore provides the basis of a simple quantitative assessment of the integrity of complement function . Using a preformed radiolabelled precipitate of BSA-alpha BSA Ab, the solubilization capacity of serial sera from 75 patients with various immune complex diseases or diseases associated with hypocomplementaemia was investigated to correlate this assay of complement function prospectively with disease activity and with measurements of circulating immune complexes (CIC) . Reduction in solubilization, defined by more than 25% of values in a given patient being below the normal range, was found in 11 of 12 patients with active SLE, two of 19 patients with active systemic vasculitis, three of three patients with post-streptococcal glomerulonephritis and in three of six patients with nephrotic syndrome due to other types of nephritis . In serial studies, solubilization correlated with disease activity in patients with SLE (P less than 0.005), systemic vasculitis (P less than 0.05) and post-streptococcal glomerulonephritis (P less than 0.05) . CIC were found more frequently than abnormalities in solubilization; however, the solubilization assay identified a population of patients with CIC more likely to have active disease . This simple assay of complement function provides data on an aspect of immune complex disease not readily apparent from standard estimations of circulating immune complexes, and appears to be a better measure of their potential phlogistic effects. Jpn Circ J, 1981 Dec, 45(12), 1382 - 3 Diagnosis of streptococcal infection: previous or recent; Fujikawa S et al.; For the determination of streptococcal infection, it is necessary to test 3 antibodies, i.e., ASO, ASK and ADN-B at a time, and if 2 of the 3 titers are positive one can make diagnosis of fairly recent streptococcal infection, but if only one of the 3 titers are positive, previous or non-specific causes should be considered. Jpn Circ J, 1981 Dec, 45(12), 1374 - 8 Clinical appraisal of the antideoxyribonuclease-B (ADNB) by means of streptonase-B test (Wampole); Oda T et al.; Titers of antideoxyribonuclease-B (ADNB, by Streptonase-B test), antistreptolysin-O (ASO, by Rantz-Randall's micromethod) and Kinase test (antivaridase agglutination test) were performed on 118 sera of patients with suspected streptococcal infection and compared . Between ASO and ADNB, a fairly significant correlation was seen (r = 0.69), but many cases in which ADNB exceeded ASO were observed . Between Kinase and ADNB, no significant correlation was seen (r = 0.49) . Successive determination of antibody titers were made in 14 consecutive patients with acute glomerulonephritis, anaphylactoid purpura nephritis, rheumatic fever and chronic rheumatic heart disease . In general, ADNB titer was significantly higher than ASO with few exceptions . The duration of high titer of ADNB was much longer than ASO Kinase titers were sometimes unstable . Throughout this study it has been noted that the result of ADNB was very easily to read and was highly reproducible . There were no nonspecific or pseudopositive reactions . Therefore, ADNB is useful for the diagnosis of streptococcal infection and its complication especially when other antibody titers give negative or doubtful results. Rev Rhum Mal Osteoartic, 1981 Dec, 48(12), 781 - 6 {Experimental study of the inducing action of streptococcal pathogenic factors on immunity and cellular autoimmunity}; Voicoulesco C et al.; Rabbits issued from a closed colony which was genetically homogenous were used to investigate the capacity of streptolysin O and streptococcal M-protein to induce both cellular immune and autoimmune responses with respect to autologous cardiac tissue . The presence of immune response was indicated by positive responses of two tests of cellular immunity: blastogenesis of splenic T lymphocytes and inhibition of splenic macrophage migration . By thing into account that a nonspecific direct effect is produced by certain components of the streptococcal cell wall (lipoteichoic acid) but not by streptolysin O or M-protein on splenic lymphocytes, and according to the data on the modifications of lymphocyte populations during the autoimmune processes, it was possible to presume that anti-cardiac autoimmunity was as much due to a modification of cardiac tissue towards "non-self" status caused by experimental inductive factors as to he presence of a functional imbalance of the immunomodulatory lymphocyte system due to a predominance of auxiliary T lymphocytes. J Clin Microbiol, 1981 Dec, 14(6), 678 - 80 Quantitative evaluation of variation in composition of the streptozyme agglutination reagent for detection of antibodies to group A streptococcal extracellular antigens; Kaplan EL et al.; The antibody titers of 90 acute- and convalescent-phase sera from 30 patients (mean age, 15.0 years) were studied with five different lots of Streptozyme reagent to determine whether variation exists among lots of reagent and whether this can affect clinical interpretation of antibody titers . Each serum was tested simultaneously with each of the five lots of reagent . Lot-to-lot variation in the reagent resulted in a significant difference (greater than 2 dilution increments) in antibody titer for 61 (68%) of the 90 sera tested . In addition, differences among the five lots also resulted in variation in determining whether a significant rise in titer occurred from the acute-phase to the convalescent serum for a given patient . These data indicate a need for precise identification and quantitation of the streptococcal antigens coated onto erythrocytes used for the Streptozyme test reagent. Am J Clin Pathol, 1981 Dec, 76(6), 823 - 6 Fatal group B streptococcal pneumonia in neonates . Effects of antibiotics; Hamoudi AC et al.; Prophylactic penicillin has been suggested to prevent neonatal group B streptococcal infections (GBS) . However, there is a concern that the antibiotics may conceal significant bacteremia if post-treatment blood cultures were used to recover the etiologic agent . To clarify this point, the autopsy records of 111 cases of fatal neonatal pneumonias is infants less than one week of age for the period 1974-1978 were reviewed . Nineteen documented cases of group B streptococcal infections were uncovered . Review of antibiotic therapy in these infants indicate that such therapy can indeed conceal the etiologic agent of pneumonia if one uses post treatment blood (or other normally sterile body fluids) cultures as the basis of diagnosis . On the other hand, review of 41 cases with morphologic evidence of pneumonia and no identifiable etiologic agent reveal that the majority of these were referral cases from outlying hospitals who received antibiotics prior to any diagnostic work-up. Ann Trop Paediatr, 1981 Dec, 1(4), 229 - 35 Pneumococcal bacteraemia--a study of 75 black children; Berkowitz FE; Seventy-five black children from 0 to ten years old with pneumococcal bacteraemia, who were hospitalized during a one-year period, were studied retrospectively from case records . Half the children were under one year and 68% under two years of age . Sixty-seven per cent were malnourished, 34% severely so . The overall case-fatality-rate was 26.7% being highest in children presenting in autumn (52.4%) and in those with meningitis (54.5%), severe protein-calorie malnutrition (42.8%) or associated infections (61.5%) . Host defences against the pneumococcus are discussed, especially in relation to their deficiencies in malnourished and young children . Special mention is made of early-onset neonatal sepsis due to the pneumococcus and of the association between pneumococcal bacteraemia and acute post-streptococcal glomerulonephritis . This study indicates that pneumococcal bacteraemia is a serious infection in children, especially in those with malnutrition and other infections . In view of the emergence of penicillin-resistant strains, its treatment may become more difficult in the future. Infect Immun, 1981 Dec, 34(3), 828 - 34 Reactivity with rabbit immunoglobulin G of cold agglutinins isolated from group C streptococcal antisera; Colling RG et al.; Cold agglutinin antibodies were isolated from group C streptococcal antisera by thermal elution from rabbit erythrocytes . These antibodies reacted with bovine submaxillary mucin, fetuin, immunoglobulin G, and the Fc fragment of immunoglobulin G in hemolytic inhibition assays . Further, in radioimmunoassay these antibodies reacted with the major glycopeptide fragment of rabbit immunoglobulin G . Affinity-purified group carbohydrate-specific antibodies reacted weakly with glycopeptide . These data suggest that certain populations of antibody in group C streptococcal antisera may participate in tissue reactivity via interaction with cell surface glycoproteins, including immunoglobulin G. S Afr Med J, 1981 Nov 21, 60(21), 829 - 32 Rapidly progressive glomerulonephritis in black children . A report of 4 cases; Dilima MG et al.; Rapidly progressive glomerulonephritis in children in rare, and we have therefore described 4 cases in Black children . All had evidence of a preceding streptococcal infection and there were crescents in more than 80% of the glomeruli seen on histological examination . The dominant clinical features were oliguria or anuria in a setting of nephritis or nephrotic syndrome, with a relentless progression to chronic renal failure and death . Quadruple therapy with cyclophosphamide, steroids, heparin and dipyridamole in 3 of the patients was of no lasting benefit and was attended by severe complications . Guidelines to the monitoring of children with post-streptococcal glomerulonephritis for the early detection of this uncommon complication are given. Clin Exp Immunol, 1981 Nov, 46(2), 397 - 405 Lymphocyte cell subpopulations during acute post-streptococcal glomerulonephritis: cell surface antigens and binding of streptococcal membrane antigens and C-reactive protein; Williams RC Jr et al.; T lymphocyte surface markers were examined in 23 patients with acute post-streptococcal glomerulonephritis (AGN) in parallel with normal controls and individuals without nephritis who showed evidence of pharyngeal or skin-sore beta-haemolytic streptococcal infection . Numbers of T gamma cells were similar in AGN and normal controls but were significantly lower (P less than 0.05) than those in skin-sore culture-positive streptococcal infection controls . Numbers of T mu cells were similar in AGN and normal controls but were lower (P less than 0.05) than those observed in streptococcal controls . Percentages of T mu cells were similar in AGN and normal controls but were lower (P less than 0.05) than those recorded in streptococcal infection control groups . Proportions of T cells were reduced during AGN (P less than 0.05) . Lymphocytes capable of binding type 12 group A streptococcal membranes were increased (30.4%) in patients with AGN as compared to normal controls (4.1%) . Subjects with streptococcal infection alone showed elevated but intermediate relative numbers (10.5%) of lymphocytes binding group A membranes . Increased relative numbers of both B and T lymphocytes binding group A streptococcal membranes were present in both AGN and non-nephritogenic streptococcal infection controls. J Clin Lab Immunol, 1981 Nov, 6(3), 233 - 6 Lymphocytotoxic activity in primary glomerulonephritis: evidence for immune complex-mediated cytotoxicity; Charlesworth JA et al.; Sera from 84 patients with primary glomerulonephritis (GN) were tested for lymphocytotoxic activity (LCA) against panels of (a) normal peripheral lymphocytes and (b) B-lymphocytes obtained from patients with chronic lymphatic leukaemia (CLL) . Significant LCA was found particularly in minimal change GN, acute post-streptococcal GN (AGN-PS) and mesangiocapillary GN (MCGN) where 62%, 75% and 45% respectively of samples were positive . No correlation was observed between LCA and levels of C3 or immune complexes . All but three positive sera showed reactivity against T and B cells; these three showed only T cell cytotoxicity . Fractionation of 6 sera (2 minimal change GN; 2 AGN-PS; 2 MCGN) on Sephadex G200 showed cell killing to reside in the exclusion peak . When samples were separated under dissociating conditions at pH 3.0, there was significant reduction in LCA (P less than 0.001) compared to that of fractions collected at pH 7.2 . The same protocol did not affect the lymphocytotoxicity of anti-human lymphocyte globulin . The data suggest that lymphocyte killing in GN is mediated at least in part by antigen/antibody complex activity . The reaction is immunochemically similar to that seen in systemic lupus erythematosus and may have comparable implications for antibody regulation in GN. Scand J Immunol, 1981 Oct, 14(4), 335 - 42 The four subclasses of IgG can be isolated from mouse serum by using Protein A-Sepharose; Seppala I et al.; We confirmed the findings of Ey and colleagues that mouse IgG is absorbed by protein A-Sepharose at pH 8.0 . Also confirmed was their finding that IgG1 mainly elutes from such a column by means of a buffer with pH 6.0 and that the corresponding pH values for IgG2a and IgG2b were 4.5 and 3.5 . We made the new finding that the bulk of IgG2a bearing allotypes a or j eluted already at pH 5, in contrast to IgG2a bearing allotype b . Another new finding was that IgG3 was mainly eluted at pH 4.5 regardless of the allotype . All four subclasses of IgG could thus be physically separated if the allotype was a or j (the only known exception is allotype b) . Separation of IgG2a and IgG3 was achieved even when the allotype was b by using a pH gradient for elution . IgG2a came out at a slightly higher pH than IgG3 . Mouse IgG antibodies against group A streptococcal polysaccharide belonged mostly to IgG3 and, to a lesser extent, to IgG2a and IgG2b. Am Fam Physician, 1981 Sep, 24(3), 181 - 5 The common cold; Ellenbogen C; The clinical distinction between a patient who has a common cold with pharyngitis and a patient at risk for streptococcal pharyngitis is based on the symptoms that are present and those that are absent . Many other diagnostic distinctions in patients with a common cold or similar acute respiratory illnesses can be made, using readily available information . Management can be cost-effective and of low toxicity when the relative merits and risks of each preparation and its constituents are understood. N Z Med J, 1981 Aug 26, 94(690), 139 - 40 With what was rheumatic fever confused? Stanhope JM, Chilvers CD, Aitchison WR. Follow-up of 427 cases initially diagnosed in Wairoa county during 1962-76 as rheumatic fever and/or rheumatic heart disease showed that 40 had neither condition and 51 had chronic rheumatic heart disease only . Sources of misdiagnosis were cardiac (e.g . congenital heart disease, onset of atrial fibrillation), joint (e.g . rheumatoid arthritis, gout), streptococcal infections not proceeding to rheumatic activity and febrile conditions of childhood . Awareness of the problems, some strengthening of the diagnostic criteria, and the evolution of the illness with time would serve to correct misdiagnosis. N Z Med J, 1981 Aug 26, 94(690), 134 - 7 Acute glomerulonephritis in childhood: a prospective study of hospital admissions; Wallace MR; Eighty-four children with acute post-infectious glomerulonephritis were admitted to the Waikato Hospital in 1976-1980 . The rate of admission, sex difference, and seasonal variation in admission numbers were similar to the pattern of the previous ten years . Only 11 children (13 percent) showed evidence of antecedent streptococcal infection, but there was evidence for a variety of other infections before admission . Clinical abnormalities had disappeared in the majority of 31 children reviewed at 48 months, although 20 percent had proteinuria . The long-term prognosis is yet to be determined for these children. An Esp Pediatr, 1981 Aug, 15(2), 139 - 50 {Streptococcal infection and rheumatic fever (author's transl)}; Hernandez Rodriguez M; Author reviews relations between streptococcal infections and rheumatic fever, particularly biological characteristics of streptococo, genetic and pathogenic factors . Special emphasis is placed on diagnostic criteria to avoid overdiagnosis . Finally, the basis for a program directed to eradicate the disease: screening of susceptible, individuals selection of rheumatogenic serotypes and vaccine preparation against this antigenic strains are reviewed. Clin Exp Immunol, 1981 Aug, 45(2), 253 - 60 Infective endocarditis-associated glomerulonephritis in rabbits: evidence of a pathogenetic role for antiglobulins; Sindrey M et al.; Serial studies of circulating immune complexes, serum complement, proteinuria and renal histology and immunofluorescence have been undertaken in infective endocarditis glomerulonephritis in rabbits . Eighteen of 24 rabbits developed evidence of glomerulonephritis and 13 of 18 had circulating immune complexes . Gel filtration studies showed the immune complexes to have a size range of ca 4.10(6)--3.10(5) daltons . Direct immunofluorescence staining of glomeruli showed that IgM was the predominant immunoglobulin present and that antiglobulin activity was associated with IgM deposition . Intraglomerular localization of antiglobulin was closely associated with evidence of glomerulonephritis . Streptococcal antigen(s) were not demonstrable in glomeruli, even after acid elution of sections. Postgrad Med, 1981 Aug, 70(2), 193 - 200 Allergic vasculitis: most common of the necrotizing vasculitides; Sams WM Jr; Allergic vasculitis presents with purpuric lesions that are distinguishable by their palpability and by their distribution primarily on the lower extremities . The disease can affect any organ system but most often involves the kidneys, joints, gastrointestinal tract, lungs, or nervous system . Histopathologic examination shows characteristic destruction of the vessel wall by polymorphonuclear leukocytes . Numerous etiologic agents have been implicated, but streptococcal infection and drug ingestion are the most common . Presumptive evidence suggests that the disease is due to immune complexes . The workup is aimed at establishing the cause and extent of systemic involvement, and treatment is tailored accordingly. Cancer Res, 1981 Jul, 41(7), 2954 - 8 Effect of a streptococcal preparation, OK-432, on hematopoietic spleen colony formation in irradiated mice; Hiraoka A et al.; In vivo effect of an immunostimulant, OK-432, on hematopoietic spleen colonies (CFU-S) was investigated in irradiated JCL/ICR mice . Administration of OK-432 i.p . at various times before and/or after irradiation resulted in a significant increase in endogenous CFU-S . This increase was further characterized microscopically by an increase in the number of megakaryocytic colonies . Transplantable exogenous CFU-S also increased when normal bone marrow cells were transplanted into irradiated recipient mice previously given OK-432 i.p . Treatment with OK-432 gave rise to an earlier recovery of granulocyte and, particularly, platelet counts in the peripheral blood after irradiation . All these findings indicate that an increase in CFU-S is associated with activated hematopoietic microenvironment by OK-432. J Clin Immunol, 1981 Jul, 1(3), 154 - 62 Augmentation of natural killer (NK) cell activity by a streptococcal preparation, OK-432, in patients with malignant tumors; Wakasugi H et al.; Recently, a streptococcal preparation, OK-432 has been used successfully as an immunopotentiator for immunotherapy in patients with malignant tumors in Japan . In this paper, we report that the administration of OK-432 augments the cytotoxic activity of peripheral blood lymphoid cells against a natural killer (NK) cell-sensitive erythroleukemic cell line, K562, in tumor patients . In patients before or after surgery, sufficient amounts of OK-432 strongly augmented the cytotoxic activity within 3 days after the initial administration of OK-432 . Thereafter the levels of cytotoxicity declined rapidly . The administration of a lower dose of OK-432 gave a lower increase in cytotoxicity . Enhanced cytotoxicity occurred with the reintroduction of OK-432 but remained at lower levels of activity . Characterization and fractionation of OK-432-induced effector cells revealed that the augmented cytotoxicity seemed to be carried mainly by NK cells . A low titer of interferon was detected in 3 of 10 patients within 72 hr after the first inoculation of the agent . Furthermore, we discuss the potency of OK-432 for the induction of interferon in detail. Minerva Med, 1981 Jun 30, 72(26), 1703 - 6 {The value of the basophil degranulation test on the study of hypersensitivity reactions to iodinated contrast media}; Stratta P et al.; The ability of basophils and tissue mastocytes activated by sensitised IgE antibodies to release mediators in the presence of the specific antigen underlies immediate hypersensitivity reactions . This phenomenon can be explored by the in vitro basophil degranulation test adopted not only in experimental pathology, but in human allergological pathology and in the study of post-streptococcal and lupus glomerulonephritis . The test has been carried out to analyse sensitisation to iodate contrast media in 71 patients already submitted to contrastography, 37 of whom had given evidence of allergic reactions . All patients with a previous history of sensitisation presented, in vitro, a positive reaction (56 + 15.3% degranulation) in the presence of the contrast medium . Against this, none of the patients with negative test presented an allergic reaction during contrastography . Stress is laid on the practical importance of the test prior to performance of contrastography so as to predict possible sensitisation and select the most suitable medium. Med Clin (Barc), 1981 Jun 10, 77(1), 33 - 6 {Rapidly progressive glomerular disease treated with plasmapheresis (author's transl)}; Praga M et al.; A case of rapidly progressive glomerular disease with 100% of epithelial crescents completely enveloping each glomerulus, prolonged anuria and renal failure requiring dialysis . There were no indications of either streptococcal etiology or systemic disease . Improvement in renal function in response to plasmapheresis and immunosuppressants was spectacular . During two subsequent episodes of renal failure with diminished diuresis response to plasmapheresis was again striking . Assay for circulating immune-complex was always negative . No anti-basement membrane antibodies were found . Due to the lack of an adequate vascular access plasmapheresis was discontinued and the patient died 7 months after onset . Tendency to interstitial glomerular sclerosis was established with three renal biopsy specimens taken during progression of the disease . Intense metabolic acidosis suggestive of tubular acidosis, disproportionate to renal insufficiency presented during the last months . Pathologic and prognostic aspects as well as possible access for plasmapheresis are discussed. Int Dent J, 1981 Jun, 31(2), 145 - 51 Diagnosis and antibiotic treatment of alveolar infections in dentistry; Woods R; A scheme for differential diagnosis of dental alveolar infections has been presented . It depends on relating clinical symptoms with bacteria causing these infections and then coupling this information with established antibiotic sensitivity patterns of these bacteria . Approaching this problem by first assessing the likely pathogen then relating it to its antibiotic sensitivity would seem to be a sound therapeutic principle . This is because antibiotic sensitivity patterns change from time to time; there are also regional and geographic differences . By first establishing whether or not the infection is streptococcal, the predominant cause of alveolar infections, the opportunity for correct use of the penicillin, in particular amoxycillin, can be introduced . It is fortunate that erythromycin has such a wide application to the pathogens of alveolar infections as where there is doubt regarding diagnosis it can in most cases be utilized effectively . It should be recognized by all practitioners treating acute infections that antibiotics can be of great benefit . They augment, but they cannot replace, sound treatment of infection using established therapeutic principles. Proc Natl Acad Sci U S A, 1981 Jun, 78(6), 3824 - 8 Prediction of protein antigenic determinants from amino acid sequences; Hopp TP et al.; A method is presented for locating protein antigenic determinants by analyzing amino acid sequences in order to find the point of greatest local hydrophilicity . This is accomplished by assigning each amino acid a numerical value (hydrophilicity value) and then repetitively averaging these values along the peptide chain . The point of highest local average hydrophilicity is invariably located in, or immediately adjacent to, an antigenic determinant . It was found that the prediction success rate depended on averaging group length, with hexapeptide averages yielding optimal results . The method was developed using 12 proteins for which extensive immunochemical analysis has been carried out and subsequently was used to predict antigenic determinants for the following proteins: hepatitis B surface antigen, influenza hemagglutinins, fowl plague virus hemagglutinin, human histocompatibility antigen HLA-B7, human interferons, Escherichia coli and cholera enterotoxins, ragweed allergens Ra3 and Ra5, and streptococcal M protein . The hepatitis B surface antigen sequence was synthesized by chemical means and was shown to have antigenic activity by radioimmunoassay. JAMA, 1981 May 22-29, 245(20), 2044 - 6 Increased risk of group B streptococcal disease in twins; Edwards MS et al.; Infants who are the product of multiple births comprise a newly defined group of patients at increased risk for the development of invasive, group B streptococcal infection . This report summarizes the clinical and bacteriological features of 11 sets of twins and one set of triplets in which one (nine sets) or more (three sets) infants had proved early- or late-onset group B streptococcal infection . Reasons for the enhanced susceptability of index patients and their siblings are discussed . On the basis of these observations, an emperical approach is proposed for the treatment of the apparently noninvolved sibling of a twin with invasive group B streptococcal infection. Dig Dis Sci, 1981 May, 26(5), 470 - 3 Severe penicillin-induced cholestasis in a 91-year-old woman; Williams CN et al.; An elderly woman was admitted for treatment of severe stasis ulceration, associated with varicose veins . One course of cloxacillin was given orally followed by a second course of penicillin-G to eradicate persistant hemolytic streptococcal skin infection . Deep progressive jaundice subsequently developed due to intrahepatic cholestasis and persisted for several weeks before resolution . Having excluded a progressive extrahepatic malignant lesion by appropriate investigations, the diagnosis was substantiated by classical changes present in a percutaneous liver biopsy. Radiology, 1981 May, 139(2), 385 - 9 Delayed appearance of right diaphragmatic hernia associated with group B streptococcal infection in newborns; McCarten KM et al.; Right diaphragmatic hernia should be considered when an infant with Group B streptococcal infection shows deterioration . Although the diaphragm appears normal at first, increased density is seen in the right lower lobe shortly thereafter, indicating pneumonia and/or irregular aeration . Pleural effusion may develop over the next few days . Characteristically, the bowel gas on the right and the liver shadow gradually become elevated and the heart and mediastinal structures shift into the left hemithorax; loops of bowel may be seen in the right hemithorax as well . Static plain views should confirm hernia or eventration, necessitating immediate surgery. Ann Otol Rhinol Laryngol Suppl, 1981 May-Jun, 90(3 Pt 3), 75 - 8 Etiology, diagnosis, and antimicrobial treatment of pharyngitis and pharyngotonsillitis; Paradise JL; This review focuses on clinically important aspects of the etiology, diagnosis, and antimicrobial treatment of pharyngitis and pharyngotonsillitis . Most episodes of throat infection are of viral etiology, and accordingly are not susceptible to antimicrobial drugs currently available . By contrast, streptococcal and other varieties of bacterial pharyngitis do call for appropriate antimicrobial treatment . The review encompasses a discussion of clinical, bacteriological, and serological diagnosis; an algorithm for decision-making about antimicrobial treatment that is based on both clinical findings and culture results; and a summary of treatment regimens, emphasizing the management of streptococcal throat infection. Blood, 1981 May, 57(5), 888 - 93 Hereditary myeloperoxidase deficiency; Kitahara M et al.; Subjects with neutrophil myeloperoxidase (MPO) deficiency have been rarely reported . In part this may be due to the lack of a simple screening technique that would detect them . With the routine use of a cytochemical leukocyte differential counter that employs MPO stains, over a 40-mo a period 8 unrelated probands with partial MPO-deficiency and one with complete deficiency were identified . Family studies have identified 23 additional, partially deficient subjects . The largest pedigrees demonstrate that the carrier state or partial MPO deficiency is inherited in an autosomal dominant pattern . Leukocytes from a subject with complete MPO deficiency and from some subjects with partial deficiency have impaired bactericidal activity against S . aureus . Superoxide generation was increased and chemiluminescence decreased in MPO-deficient leukocytes . Eleven subjects were prospectively followed for 18-30 mo . Only two partially deficient subjects have had serious infections consisting of recurrent streptococcal cellulitis and aseptic meningitis . These data suggest that leukocyte MPO deficiency is a common inherited defect that results in minimal clinical problems, supporting the concept of multiple leukocyte bacterial killing systems. Res Commun Chem Pathol Pharmacol, 1981 Apr, 32(1), 155 - 66 Antistreptococcal cell membrane antisera and the antigenicity of glomerular basement membrane; Lange CF et al.; Antigenic cross-reactivity between mouse or human glomerular basement membrane (GBM) and group A type 12 beta-hemolytic streptococcal cell membranes (SCM) was evaluated by immunofluorescent techniques . Neonatal tissue proved to be more reactive than adult tissue with anti-SCM and anti-GBM antisera whose specificity was toward protein epitopes . Removal of carbohydrate moieties by enzymes (CHOase), converted adult tissue antigenicity to that of the neonate . Partial removal of some CHO, especially sialic acid, gave a partial enhancement of antigenicity . Contrariwise, antisera directed toward CHO epitopes while showing some reactivity in adult tissue gave variable results in the neonatal or young tissue . Anti-CHO sera of SCM were negative while anti-CHO sera of GBM immunogens did react slightly . None of the antisera used in these studies gave positive reactivity to heart, lung or liver tissue from any mice. J Periodontol, 1981 Apr, 52(4), 197 - 205 Penetration of dental plaque components into gingiva: sequential topical treatments with hyaluronidase and streptococcal polysaccharide in rats; Gaffar A et al.; EIGHTY-FIVE Sprague-Dawley rats were used in two experiments to determine the conditions necessary to permit transepithelial penetration by deleterious macromolecules in murine oral mucosa . In experiment one, Group I was a water and diet control; Group II mucosa was treated with hyaluronidase; Group III with streptococcal polysaccharide; and Group IV with hyaluronidase, followed by treatment with the polysaccharide . In the second experiment, the histological effects of the streptococcal polysaccharide were quantified by administering a series of concentrations, from 10 mg/ml to 100 microgram/ml . The results suggest that tissue-damaging plaque components, such as hyaluronidase and polysaccharide, act in combination to pass through the epithelial structures into the subjacent connective tissues to cause destructive changes in rat gingiva . Such changes may possibly be related to those seen in the periodontium when it is adjacent to dental plaque. Med Trop (Mars), 1981 Mar-Apr, 41(2), 201 - 5 {Child scabies in Nouvelle-Calédonie: its complications in general, and renal in particular (author's transl)}; Thevenieau D; Child scabies in Nouvelle-Caledonie, is: -- frequent nowadays; -- sometimes difficult to diagnose because of secondary infection or eczematisation; -- most often of favorable evolution with a one-day treatment applied to both children and their close relatives; -- sometimes complicated by surinfection, either of staphylococcic origin with various but osseous foci or streptococcic with severe glomerulonephritis. Acta Paediatr Scand, 1981 Mar, 70(2), 207 - 10 Increasing incidence of neonatal septicemia: causative organism and predisposing risk factors; Bennet R et al.; The incidence of neonatal septicemia in the referral area of St . Goran's Children's Hospital in Stockholm has been studied during a ten-year period (1969-1978) . An increase was noticed during the period 1974-1978 in comparison with the preceding five-year period . The incidence per 1 000 live births was 1.4 and 3.1, respectively . The incidence of osteoarthritis increased from 0.21 to 0.41 per 1 000 . Mortality rate from neonatal septicemia remained unchanged . Gram-negative organisms as an etiologic factor seemed to be decreasing while staphylococcal infections have increased . Group B streptococcal infection occurred with the same frequency during the whole period . The low incidence of enteric organisms might be related to the common practice of feeding the babies with milk from their own mothers . Perinatal risk factors were equally common in both five-year periods . The observed increase of the prevalence of neonatal septicemia caused by Staphylococcus aureus may be explained by a higher rate of survival of highly susceptible low-birthweight infants and other sick neonates treated in the neonatal intensive care unit. Jpn Heart J, 1981 Mar, 22(2), 167 - 72 Rheumatic fever in children . A follow-up study with emphasis on cardiac sequelae; Chen SC et al.; Eighty-nine children with rheumatic fever between 1964 and 1978 were reviewed . There were 40 males and 49 females . The first attack occurred mostly between 6 and 12 years . Arthritis was present in 62.9%; carditis, 55.1%; chorea, 19.1% . Children were followed from 20 months to 15 years (mean 61 months) . Seventeen developed current attacks (19.1%) . On final examination, 40 had no heart disease, 30 had mild heart disease, 6 required valve surgery, 4 had died, and 9 had moderate heart disease but not operated . Chorea was present in 20 children . Six of them also had mitral insufficiency, 3 had recurrence after episode of chorea . Prompt diagnosis and treatment of streptococcal infection and penicillin prophylaxis need to be stressed . Service carditis on initial attack and recurrence predispose to the development of severe heart disease. J Pediatr, 1981 Mar, 98(3), 403 - 10 Poststreptococcal crescenteric glomerulonephritis in children: comparison of quintuple therapy versus supportive care; Roy S 3rd et al.; Crescenteric glomerulonephritis preceded by a streptococcal infection with creatinine clearance CCr of less than 30 ml/minute/1.73 m2 was treated by supportive care plus three months of quintuple therapy (prednisone, azathioprine, cyclophosphamide, dipyridamole, and heparin followed by warfarin) in five children (Group A) or by supportive care alone in five others (Group B) . Of the glomeruli examined, 69.8 +/- 11.7% (mean +/- SE) in Group A and 64.4 +/- 10.6% in Group B had crescents which involved 54.0 +/- 10.8% and 60.0 +/- 10.5% of glomerular circumference, respectively . Clinical and histologic findings supported a recent streptococcal infection in every patient . Two patients from Group A had mild proteinuria and normal CCr at 12 months; one died abruptly of pulmonary hemorrhage after maintaining a normal CCr for 25 months . Following a second episode of poststreptococcal acute glomerulonephritis seven months after the first, one patient from Group B had persistent mild proteinuria for 41 months and hypertension through 56 months of follow-up . Nine surviving patients have maintained normal CCr for eight to 60 months (mean 29.5 months) . The findings of this study suggest that this quintuple therapy offers no advantage over supportive care in the clinical management and outcome of children with severe crescenteric glomerulonephritis when an antecedent streptococcal infection is confirmed by serologic and histopathologic criteria. Pediatrics, 1981 Mar, 67(3), 376 - 7 Facial cellulitis: an early indicator of group B streptococcal bacteremia; Hauger SB; Epithelial manifestations as indicators of group B streptococcal (GBS) bacteremia have been infrequently reported in the literature . This report describes three infants, ranging in age from 2 1/2 weeks to 7 weeks, who were seen with facial cellulitis as the only sign of GBS bacteremia . Only one of these infants had fever on presentation; otherwise, there were no signs of systemic illness . "Spontaneous cellulitis" should be viewed as an indicator of underlying bacteremia; in an infant less than 3 months of age, GBS should be considered a prime etiologic agent. Vopr Pitan, 1981 Mar-Apr, (2), 47 - 50 {Specific and nonspecific cytolysis reactions in rheumatic patients with a low degree of activity in the process of combined treatment by a high-protein diet and drug preparations}; Samsonov MA et al.; Effect of therapy including high-protein diet and hormones on specific and nonspecific cytolysis was studied in patients with torpid and latent-running recurrent rheumatic carditis . The number of HeLa cells on which specific antigens (cardiac tissue extract, collagen, group C streptococcal nucleoproteid) were adsorbed significantly decreased on addition to the test target sensitized lymphocytes from the patients examined . As a result of therapy most patients showed the reduced activity of supernatants obtained from peripheral blood lymphocyte cultures that were incubated with specific antigens. Infect Immun, 1981 Feb, 31(2), 732 - 6 Staphylococcal scarlet fever: role of pyrogenic exotoxins; Schlievert PM; Staphylococcal pyrogenic exotoxin (PE) types A and B were tested for their role in production of a scarlatiniform rash . The PEs elicited minimal skin reactions after intracutaneous injection into animals not presensitized to the toxins . In contrast, erythematous injection into animals not presensitized to the toxins . In contrast, erythematous and edematous rashes were produced after administration of either PE to animals presensitized to homologous toxin . After 3 to 4 days, the erythematous areas showed membranous desquamation . Staphylococcal PEs also enhanced delayed and Arthus hypersensitivity skin reactions developed against unrelated proteins; the reactions subsequently desquamated . In addition, animals previously sensitized to either staphylococcal PE type developed scarlatiniform rashes after challenged with heterologous staphylococcal or any group A streptococcal PE . The data suggest that staphylococcal PEs produce scarlet fever-like rashes comparable to group A streptococcal PEs and that all PE types contain a common core moiety against which delayed hypersensitivity may be developed. J Clin Periodontol, 1981 Feb, 8(1), 45 - 56 The predominant cultivable dental plaque flora of beagle dogs with periodontitis; Syed SA et al.; The predominant cultivable dental plaque flora was studied in 10 adult female beagle dogs with advanced periodontitis . Supragingival and subgingival plaque from a maxillary third premolar (P3) was removed and cultured anaerobically on various growth media and all colonies were subcultured and partially characterized . Histopathological specimens of the plaque sampling sites showed significant loss of connective tissue attachment . Spirochetes were found in all samples . Anaerobic gram-negative organisms were predominant in both types of plaque accounting for about 55% of the cultivable organisms in the supragingival plaque and almost 75% in the subgingival plaque . Bacteroides asaccharolyticus was the most predominant organism in the supragingival plaque, whereas Fusobacterium nucleatum predominated in the subgingival flora . Streptococcal and actinomycotic species were common in the supragingival plaque, but their proportions, especially those of the actinomycetes, were decreased in the subgingival flora . In many respects the bacterial profile associated with disease resembled that reported in human periodontal disease. Arch Dermatol, 1981 Jan, 117(1), 47 - 9 Facial erysipelas in the immunocompromised host . Report of two cases; Cupps TR et al.; Two cases of facial erysipelas in immunologically altered hosts are reported herein . The unusual presentation with absence of erythema in the skin lesion is emphasized . Atypical fever patterns were also noted . In one patient, the facial lesion followed the onset of fever by 48 hours, and, in the other, the facial swelling preceded the fever . Various aspects of the patient's altered host status are discussed in light of the atypical clinical presentation . Recognition of facial erysipelas as a potential source of group A beta-hemolytic streptococcemia in immune-altered hosts is important to ensure rapid and appropriate therapeutic intervention. J Exp Med, 1981 Jan 1, 153(1), 196 - 206 Role of immune recognition in latent allotype induction and clearance . Evidence for an allotypic network; Yarmush ML et al.; The role of allotype recognition in the regulation of the expression of latent allotypes has been investigated in two series of experiments . The first experiments were designed to investigate the apparent instability of latent allotypes in circulation . In these experiments, clearance rates of IgG preparations bearing allotypes matched and unmatched to the recipient were examined . In all cases, iodinated IgG matched in allotype to the recipient was cleared at a normal rate from the serum . However, in several cases, iodinated IgG of an unmatched allotype was cleared at a rate and in a manner suggesting prior sensitization of the recipient to IgG of that allotype . Such apparent sensitization correlated with the presence of the foreign allotypes as a latent allotype in several bleedings taken both before and after the clearance experiment . In the second series of experiments, designed to test the ability of antiallotype antibodies to affect the expression of latent allotypes, five rabbits were immunized first with purified antiallotype antibodies and then after 3-4 mo, with streptococcal vaccine . Examination of the antistreptococcal antibodies for latent allotype revealed, in all cases, that the allotype against which the antiallotype antibodies were directed was present in levels 8- to 20-fold greater than were observed before the antiallotype injections . These results indicate that recognition of allotypic determinants is an important element in the control of latent allotype expression and suggest the existence of a regulatory network involving antiallotype antibodies. Helv Paediatr Acta, 1981, 36(6), 567 - 72 Mycoplasma pneumoniae infection presenting as acute rheumatic fever; Berant M et al.; We describe five children in whom symptoms and signs fully consistent with a diagnosis of acute rheumatic fever arose in association with infection by Mycoplasma pneumoniae . With the decline of streptococcal disease as a causative agent of acute rheumatic fever, other etiologic possibilities capable of reproducing the clinical syndrome - especially Mycoplasma pneumoniae - should be considered, as this may have therapeutic and prognostic implications. Cor Vasa, 1981, 23(1), 4 - 7 Pediatric cardiology in Asia; Vongprateep C; The problems of pediatric cardiology in Asia can be summarized as follows . In the countries like India, Indonesia, Malaysia, Pakistan and some other countries especially with government support like Thailand, the priority is primary health care . Except in Japan, cardiac care for children is not well supported financially . Training in pediatric cardiology is not readily available . Consequently small numbers of pediatric cardiologists, pediatric cardiac surgeons and active centres are available even in Japan . It is importannt to reduce the incidence of rheumatic fever and rheumatic heart disease by prevention of streptococcal infections and to increase the standard of living and environment . Transportation and referral system diagnosis, and treatment and follow-up is a special problem in neonatal care in relation to heart disease . Concentration of physicians, medical schools and cardiac centers in urban areas, old customs and poor understanding of people about the treatability and preventability of heart diseases in children complicate the improvement in the management of children with heart diseases. Arch Exp Veterinarmed, 1981, 35(1), 1 - 18 {Origin and behavior of macrophages in the milk of cows with healthy and pathological udders}; Mielke H et al.; Macrophages of cow milk are part of the mononucleic phagocyte system . Most of them are histiocytes which are transferred from udder tissue into milk at various stages of activity . They are variable in shape, size, and number and have certain defence and purification functions in the milk . Transformation in milk of lymphocytes to macrophages are considered possible . No hard evidence has been produced, as yet, to the repeatedly produced by means of optical light microscopy to close conglomeration of macrophages and lymphocytes in milk, which is interpreted as macrophage-lymphocyte interaction, as in immunoreactive processes . Cows with clinically intact udders were found to have in their milk between 17 and 20 per cent of macrophages, 37 or 38 per cent of polymorphonucleic leucocytes, between 13 and 20 per cent of lymphocytes as well as between 26 and 32 per cent of non-differentiable cells and cell fragments . The repair phase of acute mastitis was found to be associated with drastic decrease of milk cell counts, along with percentual rise in macrophages, caused mainly by reduction in polymorphonucleic leucocytes in the milk . With subclinical and chronic mastitis, the percentage of macrophages was found to be increased, particularly due to streptococcal infection. Perspect Pediatr Pathol, 1981, 6, 139 - 51 Group B beta hemolytic streptococcal sepsis in the newborn; Craig JM; Group B Beta Hemolytic streptococcal infection among newborn infants has recently grown in importance . The pathological changes in the early onset cases appear to be confined to the lung . In our patients, hyaline membranes with peripheral atelectasis was unusual, although fibrin deposited in areas without accompanying atelectasis may lead to confusion with hyaline membrane disease . The clinical features and pathologic changes caused by GBS had some differences from those due to other organisms giving rise to fatal pneumonia in the newborn . The lungs of GBS-infected babies in our autopsy series were not as heavy, had more alveolar fibrin deposition, but not more hyaline membrane disease than in nonstreptococcal cases . Alveolar inflammation was more marked in nonstreptococcal cases, but the GBS cases had more interstitial inflammation . Massive alveolar bacterial growth was more common in the GBS cases . Chronic thymic involution was less marked in the GBS cases, while acute splenitis was more common . Meningitis was present in four of our nonstreptococcal cases, but in none of the GBS cases . The clinical courses of GBS and nonstreptococcal fatal pneumonias differed . The mothers of infants with GBS infection were less febrile and ahd an increased frequency of prolonged rupture of the membranes, while the infants had a decreased duration of life, compared to those with nonstreptococcal sepsis. Ann Acad Med Singapore, 1981 Jan, 10(1), 79 - 83 A prospective study of group B streptococcal colonization in parturient mothers and their infants; Chow KK et al.; The objective of this study was to investigate the rates of group B streptococcal colonization among parturients within the 24 hours prior to delivery and colonization of their newborns . It was also to identify high risk factors . 204 parturients were randomly selected in the Alexandra Hospital, Singapore . Swabs for culture were taken from the maternal vagina and throat and the neonate's ears, throat and umbilicus . In this study it was found that vaginal colonization in the mother is significantly associated with neonatal colonization . Among the various ethnic groups, Malays and Indians/Pakistanis are at a higher risk of having vaginal colonization . All other factors studied, however, failed to show any influence on neonatal colonization and thus appear to have had no forewarning value. Ann Immunol (Paris), 1981 Jan-Feb, 132C(1), 87 - 100 Antistreptococcal group A antibodies: production after in vitro activation and hybridization of mouse spleen cells; Herbst H et al.; Streptococcal group A polysaccharide-specific antibodies were raised by the method of somatic cell hybridization . Spleen cells of experimentally unprimed BALB/c and C57BL/6 mice were activated in vitro by the streptococcal vaccine and fused with the Sp2/0-Ag14 line at times o, 35, 70, and 105 h thereafter . Hybridomas were obtained at all times independent of the addition of thymocyte-conditioned medium . Occurrence of specific hybridomas for the T cell-dependent A-CHO, however, required activation for greater than 35 h . Low responder C57BL/6 splenocytes fused at considerably higher fusion efficiency to yield specific hybridomas than high responder spleen cells 105 h after activation by antigen . The isotypes of A-CHO-specific antibodies comprised predominantly mu and kappa polypeptides; however, gamma 3, alpha, and gamma polypeptide chains were also identified . All specific antibodies were agglutinating the group A streptococcal cells; this agglutination was fully inhibited by the addition of 1% N-acetyl-D-glucosamine, the immune determinant sugar of the A-CHO . Three hybridomas obtained by fusion of BALB/c splenocytes 105 h after activation were cloned and grown as tumours in the peritoneal cavity of BALB/c mice . The monoclonal antibodies in the ascites did not precipitate the A-CHO but continued to agglutinate group A streptococcal cells in a hapten inhibitable fashion with different specificity profiles . Antibody from clone 21S36.1 was coprecipitable upon addition of A-CHO with a gamma G3 monoclonal hybridoma-derived antibody in a ratio of 1/7 while the other two monoclonal gamma M antibodies and the S117 myeloma protein were not . The result suggests that antibody 21S36.1 recognizes one chain terminal determinant of the A-CHO. Padiatr Padol, 1981, 16(1), 35 - 46 {Local manifestations of neonatal group B streptococcal disease (author's transl)}; Mravlag G et al.; In the case of neonatal group B streptococcal disease, two distinct types of illness have been described in the past few years . The early onset type occurs in the first hours of days of life and emerges as septicemia . The late onset type occurs after the first week and emerges as meningitis . Other frequent local manifestations are pneumonia and pleural effusions, but there are few reports on localized inflammation of other organs . This paper gives a brief survey of the local manifestations of the disease . In addition, a case of a 1120 g premature of 29 gestational week is reported . After ten uneventful weeks, the patient developed acute fulminating group B streptococcal septicemia . The initial signs of apnea, respiratory insufficiency and shock were followed by meningitis, cellulitis of the tongue and skin and severe coagulopathy . After seven days the baby died of an intracranial hemorrhage. Vopr Pitan, 1981 Jan-Feb, (1), 8 - 11 {Evaluation of the effect of a high-protein diet in combination with hormone and drug preparations on immunological homeostasis indices in rheumatism patients with a low degree of activity of the disease process}; Samsonov MA et al.; High protein diet coupled with drugs was used for the treatment of patients with protracted and latent recurrent rheumocarditis . The mean daily doses of the drugs administered were as follows: 2 g of aspirin and 15 mg of prednisolone . With clinical improvement most patients showed a decrease in the amount of blast transformed lymphocytes in stained smears of the cultures of peripheral leukocytes incubated in the presence of cardial antigen, collagen and group C streptococcal nucleoprotein . They also manifested the diminished ability on in vitro sensitized lymphocytes to produce the leukocyte migration inhibition factor. Acta Med Scand, 1981, 209(1-2), 103 - 10 Glomerulonephritis in infections with Yersinia enterocolitica O-serotype 3 . II . The incidence and immunological features of Yersinia infection in a consecutive glomerulonephritis population; Friedberg M et al.; In a consecutive series of 38 patients with acute glomerulonephritis (GN), 17 showed serological or immunological signs of current or previous yersiniosis . None of these 17 patients had raised antistreptolysin-o titres . Only half of these patients had had clinical symptoms of Yersinia infection . Light microscopic examination revealed that 12 of the 17 patients had proliferative and 4 epimembranous GN . In 8 out of 14 biopsy specimens, Yersinia antigen could be demonstrated by immunoglobulins and complement . Immunofluorescence microscopy examination of all biopsy specimens containing sufficient tissue for a valid analysis showed deposits of complement and immunoglobulin G, most specimens also immunoglobulins A and M . It is considered highly likely that Y . ent . O:3 may be, and frequently is, an etiological factor for development of acute GN . It would be advisable not only to investigate all patients with acute GN for streptococcal infections, but also to carry out serological and bacteriological tests for Y . eng . O:3 infection and to institute an active therapeutic approach to acute infections caused by this bacterium. J Bacteriol, 1981 Jan, 145(1), 129 - 37 Naturally occurring macrolide-lincosamide-streptogramin B resistance in Bacillus licheniformis; Docherty A et al.; Resistance to the macrolide-lincosamide-streptogramin B (MLS) group of antibiotics is widespread and of clinical importance . B . Weisblum and his coworkers have demonstrated that this resistance is associated with methylation of the 23S ribosomal ribonucleic acid of the large ribosomal subunit which results in a diminished affinity of this organelle for these antibiotics (Lai et al, J . Mol . Biol . 74:67-72, 1973) . We report that 10 of 15 natural isolates of Bacillus licheniformis, a common soil organism, are resistant to the MLS antibiotics . The properties of this resistance (high level of tolerance for erythromycin, broad cross-resistance spectrum, and inducibility) suggest that resistance is conferred as described above . The resistance determinant from one of these strains was cloned onto a B . subtilis plasmid vector, and the resulting hybrid plasmid (pBD90) was used to prepare radioactive probe deoxyribonucleic acid for hybridization studies . All of the resistance B . licheniformis strains studied exhibited homology with the pBD90 insert . Plasmid pBD90 showed no homology to the following staphylococcal and streptococcal MLS-resistance plasmids: pE194, pE5, pAM77, pI258 . Plasmids pE194 and pE5, on the other hand, carry homologous MLS genes but showed no detectable homology to one another in their replication genes . pBD90 specified a 35,000-dalton erythromycin-inducible protein, detectable in minicells, which therefore appears different from the 29,000-dalton inducible resistance protein specified by pE194 . We conclude that there are at least three distinct MLS resistance determinants to be found among gram-positive bacteria. Rev Chir Orthop Reparatrice Appar Mot, 1981, 67(7), 639 - 45 {Streptococcal gangrene . A report on 9 cases (author's transl)}; Lortat-Jacob A et al.; The authors have treated 9 cases of streptococcal gangrene of the limbs . They describe the clinical features:local oedema, erythema, and cyanotic spots . In 7 of the cases the infected general condition was very severe . At operation, the subcutaneous soft tissues were grey-green without pus . The authors have reviewed the literature and consider that treatment should be based on early excision of the skin and subcutaneous tissues . Antibiotics are of great help but are not sufficient by themselves . Nine patients reached a stable state but sequelae have been severe with one disarticulation of the shoulder, one ankylosis of the wrist, one ankylosis of the knee and one generalised stiffness of the hand . Only five patients have been completely cured. Am Fam Physician, 1981 Jan, 23(1), 121 - 5 Topical antibiotics and minor skin trauma; Leyden JJ et al.; Recent double-blind controlled studies show that the application of a neomycin-bacitracin-polymyxin preparation reduces the incidence of staphylococcal and streptococcal infection of minor skin trauma . Allergic sensitization to neomycin is rare . Systemic side effects occur only with improper massive exposure . Resistant strains have appeared only in "closed populations." It is concluded that topical antibiotic combinations are safe and effective. Int J Immunopharmacol, 1981, 3(4), 365 - 75 In vitro augmentation of natural killing activity by OK-432; Uchida A et al.; OK-432, a streptococcal preparation, augmented the natural killing (NK) activity of peripheral blood lymphocytes of normal donors and cancer patients against both NK sensitive and resistant human target cells in vitro . The enhancement of NK activity was evident after 4 h pretreatment and maximum by 16-24 h . The manifestation of OK-432 induced augmentation required active cell metabolism, RNA and protein synthesis but no DNA synthesis of lymphocytes . The supernatants produced by OK-432 stimulated lymphocyte cultures had no enhancing substance nor interferon . Anti-interferon antibodies did not inhibit boosting activity of OK-432 . Large granular lymphocytes were involved in both spontaneous and OK-432 induced cytotoxic activity . The proportion of lymphocytes conjugating to target cells was not changed by OK-432 . These results suggest that OK-432 augments cytotoxic activity of large granular lymphocytes having ability to recognize target cells independent of interferon induction. Microbiol Immunol, 1981, 25(7), 683 - 92 Production of interferon by an SV40-transformed macrophage line, BB-W-531-2; Takayama H et al.; A simian virus 40-transformed mouse macrophage line, BB-W-531-2, was examined for its ability to produce interferon . BB-W-531-2 cells showed a phenotypic change between the macrophage and the nonmacrophage states . A viral inhibitor (interferon) was produced by the cells during the phenotypic change from the nonmacrophage to the macrophage state . Cells having macrophage properties were well capable of producing interferon when they were stimulated with ultraviolet-inactivated vaccinia virus, lipopolysaccharide, a streptococcal preparation (OK-432) or polyinosinate . polycytidylate . In contrast, cells that had lost their macrophage properties did not produce interferon even when they were given the same treatments as the cells having macrophage properties . The results suggest that the ability of BB-W-531-2 cells to produce interferon is associated with the expression of several macrophage properties. Crit Rev Clin Lab Sci, 1981, 14(2), 75 - 108 Whipple's disease: a review emphasizing immunology and microbiology; Keren DF; Whipple's disease is an important and fascinating problem of local immunity in the gastrointestinal tract . Does the disease occur when an organism that is rare in nature infects an individual or do patients with Whipple's disease have a definable defect in their immune response that permits infection by a more common agent? Data in recent years indicate that there is only one type of microorganism that causes Whipple's disease . It is rod-shaped by electron microscopy and has a definable antigenic pattern by immunofluorescence . Paradoxically (considering its geometry), it reacts most strongly with antisera directed to streptococcal antigens . Patients with Whipple's disease do not have a disorder of immunoglobulin synthesis and do not have immune complexes present in their gut walls . Further, although earlier studies indicated that a defective response of T-lymphocytes to PHA is consistently present in these patients even years after therapy, more recent studies have found no consistent defect in mitogenic responses to PHA, CON A, or PWM . Also, recent studies indicate that mononuclear cells from patients with Whipple's disease usually mediate antibody-dependent cell-mediated cytotoxicity as well as controls, although spontaneous cell-mediated killing may be decreased . All these studies suggest that the defect is not primarily of lymphocytes, rather it is more likely that a defect exists in monocytes and macrophages . Future studies on Whipple's disease should add to existing knowledge of how the immune processes intracellular microorganisms. Clin Exp Immunol, 1980 Dec, 42(3), 450 - 7 Antibody response to streptococcal cell wall antigens associated with experimental arthritis in rats; Greenblatt JJ et al.; The antibody response to group A streptococcal cell wall components was measured in rats during the development of chronic, remittent experimental arthritis . The arthritis was induced by a single intraperitoneal injection of an aqueous suspension of group A streptococcal cell wall fragments and antibodies were measured by a radioactive antigen-binding assay . Antibodies in serum against both peptidoglycan and A polysaccharide reached maximum levels at 1 or 2 weeks and declined to preimmunization levels by day 63 . The kinetics and magnitude of the antibody responses were similar in neonatally thymectomized and non-thymectomized rats . A relationship between chronic joint lesions and anti-peptidoglycan concentration in serum was indicated, since all rats which produced high levels of antibody developed severe chronic arthritis . However, 46% of the rats which produced very low levels of antibody also developed moderate to severe arthritis . There was no correlation between anti-A polysaccharide antibodies and joint disease, although the concentration of this antibody was 10- to 100-fold greater than the anti-peptidoglycan . We conclude that antibody can be a component in the pathogenesis of this experimental model of arthritis, but its role requires further elucidation. J Natl Cancer Inst, 1980 Dec, 65(6), 1265 - 9 Augmentation of mouse natural killer cell activity by a streptococcal preparation, OK-432; Oshimi K et al.; Streptococcal immunopotentiator OK-432 (NSC-B116209) augmented the natural killer (NK) cell activity of peritoneal exudate cells (PEC) in inbred C57BL/6 mice given ip injections of 0.1 mg OK-432 per mouse . The cytotoxic activity of PEC increased as early as 1 day after inoculation, reached its peak on day 3, and gradually declined thereafter, YAC-1, K562, and MOLT-4 target cells were more sensitive to PEC than were EL 4 and P815 target cells . The elimination of adherent cells by a nylon wool column enriched the proportion of cytotoxic cells among PEC . Nylon wool column-passed PEC were resistant to treatment with anti-Thy 1.2 antibody plus complement and sensitive to anti-asialo GM1 serum plus complement . Because 1:40-diluted rabbit antiserum against glycosphingolipid asialo GM1 is capable of eliminating mouse NK cell activity and is not cytotoxic to killer T-cells, the above results strongly suggest that OK-432 augments the NK cell activity in mice. Antimicrob Agents Chemother, 1980 Dec, 18(6), 969 - 75 Morphological expressions of antibiotic synergism against Pseudomonas aeruginosa as observed by scanning electron microscopy; Waisbren SJ et al.; Antibiotic-induced changes in Pseudomonas aeruginosa were observed by means of a scanning electron microscope . Seven frequent and five less frequent morphological changes were noted . The frequent changes were: (i) elongation; (ii) chain formation; (iii) nub formation; (iv) spheroplasts; (v) surface holes or pits; (vi) super-elongation; and (vii) increased filamentation . The less frequent changes were: (i) rounded ends; (ii) streptococcal forms; (ii) stalked nubs; (iv) surface bulges; and (v) convoluted surfaces . A morphological equivalent of antibiotic synergism was found in which changes were noted due to synergistic combinations of antibiotics that were not observed when the antibiotics were used alone or when a nonsynergistic combination of antibiotics was used. Acta Med Okayama, 1980 Dec, 34(6), 401 - 8 Effect of streptococcal preparation (picibanil) on the postoperative rise in serum alanine aminotransferase activity in patients with urogenital cancer; Taketa K et al.; The effect of Picibanil, a streptococcal agent, on the development of liver injury after operations for urogenital cancer was studied retrospectively in the light of serum alanine aminotransferase (ALT) activity . The series comprised 32 cases receiving Picibanil and 33 controls with otherwise comparable clinical backgrounds . Picibanil reduced the incidence of postoperative ALT rise over 50 U/l within 6 weeks but increased it thereafter . The increase in ALT activity after 6 weeks was relatively small and was seen more often in patients given blood transfusions . It was interpreted as retardation and suppression of ALT rise and as being related to the induction of interferon or to immunopotentiation . Other antihepatotoxic effects of Picibanil, due to its antioxidant activity, for example, may also account for the prevention of the early postoperative rise in ALT activity. Vet Rec, 1980 Nov 15, 107(20), 467 - 9 Streptococcal meningitis in pigs: results of a five-year survey; Lamont MH et al.; Information about new outbreaks of streptococcal meningitis in pigs has been collected since the disease was first recognised in the United Kingdom in late 1973 . The apparent spread of the disease across the country is illustrated . Factors affecting the age distribution of the disease and the dissemination of the infection are also discussed. Bol Med Hosp Infant Mex, 1980 Nov-Dec, 37(6), 1123 - 34 {Glomerulonephritis with mesangial IgA deposit (IgA mesangiopathy?)}; Mota F et al.; Clinical correlations and evolution were studied in 34 biopsies from patients with the following diagnosis: Henoch-Schonlein purpura in 17, monosymptomatic hematuria in 11, idiopathic nephrotic syndrome in 3, and Fanconi Syndrome, Systemic lupus erythematosus and tubulointerstitial nephritis, one for each diagnosis respectively . All these biopsies showed anti-IgA mesangial deposits, by immunofluorescence techniques with variable morphology by light microscopy . Endo and extracapillary proliferation was the most frequent lesions . Twenty cases had follow-up observation for over 2 years: 7 cases were in remission, hematuria and/or proteinuria persisted in 10 and 3 cases progressed to chronic renal failure . In conclusion, mesangial IgA deposits are not an infrequent finding in renal biopsies performed in the Hospital Infantil de Mexico . Although the predominant clinical diagnosis was either Henoch-Schonlein purpura or monosymptomatic hematuria, other diagnosis were also found . Some cases with this mesangiopathy presented as idiopathic nephrotic syndrome or post-streptococcal glomerulonephritis, but with serum complement within normal levels . Long-term prognosis was related to glomerular morphology as in other glomerulopathies. Acta Pathol Jpn, 1980 Nov, 30(6), 995 - 1007 The significance of in vitro activation of guinea pig complement in glomeruli of human renal biopsy materials from varied subtypes of glomerulonephritis; Masugi Y et al.; To measure the potential ability of complement activation by glomerular-bound immune complex or C3 convertase, the in vitro fixation of guinea pig complement (GPC) components to glomeruli was examined by immunofluorescence on the frozen sections of human renal biopsy materials, from the varied subtypes of glomerulonephritis (GN) . Study for the pathway of complement activation in each subtype was also done . The extent of GPC activation fairly well paralleled with those of the autologous immunoreactants depositions and further with the morphological alterations of glomeruli in the cases of proliferative GN, advanced membranoproliferative GN (MPGN), lupus nephritis, purpura nephritis of non-IgA nephritis type and advanced focal segmental glomerular sclerosis . The ability of GPC activation was present but generally weak in the cases of post-streptococcal acute GN (post-str . AGN) and subsiding MPGN . The rate of positivity was further reduced in the cases of membranous nephropathy (MN), IgA nephritis and related purpura nephritis . The dominant alternative pathway of GPC activation was found in MPGN, post-str . AGN, IgA nephritis, and related purpura nephritis, the only classical pathway was noted in MN. J Lab Clin Med, 1980 Nov, 96(5),