Sex Transm Dis, 1979 Apr-Jun, 6(2), 64 - 8 Orogenital contact and the isolation of Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum from the pharynx; Sackel SG et al.; Men and women who came to clinics in Boston underwent pharyngeal examinations, and pharyngeal specimens were obtained for cultures for Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum . Fifty-one (4.9%) of 1,037 participants had gonococcal pharyngeal infection . M . hominis and U . urealyticum were recovered from the pharynges of 149 (14.3%) and 154 (14.8%) of 1,044 participants, respectively . The history of ever having performed fellatio was associated with pharyngeal infection with N . gonorrhoeae (P less than 0.02), M . hominis (P less than 0.05), and U . urealyticum (P less than 0.006) . A history of fellatio was also associated with a history of a recent sore throat . There was, however, no association between pharyngeal infection with N . gonorrhoeae, M . hominis, or U . urealyticum and a recent sore throat . Cunnilingus was not associated with symptoms or signs or pharyngitis or with the isolation of gonococci or genital mycoplasmas from the pharynx . The pharyngitis associated with fellatio remains a microbiologic enigma. Can J Microbiol, 1979 Apr, 25(4), 512 - 21 Auxanographic grouping and typing of Neisseria gonorrhoeae; Hendry AT et al.; Nearly 96% of 1297 Neisseria gonorrhoeae isolates in Hamilton were assigned to six major auxanographic groups (non-requiring or NR, Pro-, Orn-, Pro-Cit-Ura-, Orn-Ura-Hyx-, Cit-Ura-Hyx-) as established by requirements for none, or any one or more of proline, uracil, hypoxanthine, citrulline (Cit-), or citrulline replaceable by ornithine (Orn-) on chemically defined medium modified from Catlin (1973) . Seven other groups, and strains not growing, accounted for 4.2% . The most common groups were Orn-Ura-Hyx- (25.6%) and Pro-Cit-Ura (31.8%) . This latter group has not been previously described . These "Pro Cit/Orn Ura Hyx" criteria were among the most unequivocal to interpret; with rare exceptions for proline, a requirement was shown by absence of growth at any time in the zones of inoculation from a replicator . For some strains, some of the possible additional requirements (leucine, valine, isoleucine, glutamine, threonine, serine, histidine, etc.) could be less readily ascertained, because an occasional manifestation was to reduce the amount of growth, or to slow down the rate of growth, compared to complete medium . The first four of the six groups were the least fastidious, in that few strains had any additional requirements . About 2% of strains were inhibited by 0.25 mM phenylalanine. Infect Immun, 1979 Apr, 24(1), 51 - 8 Strain differentiation of Neisseria gonorrhoeae by reverse passive hemagglutination; Armstrong AS et al.; A reverse passive hemagglutination test that utilizes human erythrocytes coated with antibody to gonococci was developed to distinguish differences among 11 strains of Neisseria gonorrhoeae . Different rabbits were immunized with each strain of gonococcus . Antibody was purified by passing antiserum over an immunoadsorbent column containing homologous cell walls trapped in a cross-linked polyacrylamide gel . Antibody, after absorption with N . meningitidis, was used for coating 11 individual suspensions of erythrocytes, each with antibody to one gonococcal strain . The panel of coated erythrocytes was added to microtiter trays containing dilutions of homologous bacterial lysate and lysates from 10 heterologous strains . Agglutination titers were highest with homologous lysates, although cross-reactions occurred among some heterologous lysates . Lysates of nongonococcal Neisseria species and of other genera did not agglutinate coated erythrocytes . The reverse passive hemagglutination test can be a useful procedure to distinguish differences among strains of N . gonorrhoeae. Br J Vener Dis, 1979 Apr, 55(2), 90 - 3 Preservation of Neisseria gonorrhoeae by the gelatin-disc method; Yamai S et al.; Studies of Neisseria gonorrhoeae are difficult to perform because of the organism's poor survival in vitro . To solve this problem we tried to preserve the organism by a gelatin-disc method . The rate of survival and changes of variations in some biochemical properties of eight strains of N . gonorrhoeae were followed for three years . These studies proved that preservation was satisfactory with only a 1/10 reduction of the living cells . Another trial showed that the organism survived for over six months after being frozen at -20 degrees C . The colonial types, agglutination against red cells from rabbit and guinea pig, and antibiotic susceptibility to penicillin, chloramphenicol, tetracycline, kanamycin, and streptomycin did not change after three years' preservation. Br J Vener Dis, 1979 Apr, 55(2), 80 - 2 Sensitivity of Neisseria gonorrhoeae to penicillin in West Germany; Petzoldt D et al.; The sensitivity of gonococci to penicillin in Germany has largely decreased in the last 22 years . No significant decrease has occurred, however, in the last three years, but the results show that a slight tendency to decrease may be persisting. Acta Pathol Microbiol Scand {B}, 1979 Apr, 87B(2), 109 - 15 Electron microscopical study of Neisseria meningitidis releasing various amounts of free endotoxin; Andersen BM et al.; A study has been made of the ultrastructure of four strains of Neisseria meningitidis which liberate varying amounts of free endotoxin in a chemically-defined, protein-free medium . The two strains which did not release detectable or only sparse amounts of free, filtrable endotoxin were rather uniform in cell size . Their cells appeared to be intact and showed a low tendency to aggregate, In addition cells of these strains showed only sporadic loose, trilaminar membranes and blebs, and free membranous structures were sparse in the medium . The endotoxin releasing strains liberated a high yield of free structures from the outer cell wall into the medium . These structures may represent the lipopolysaccharide (LPS). Br J Vener Dis, 1979 Apr, 55(2), 83 - 9 Effect of different preparation procedures on the ultrastructure of gonococci; Gebhart W et al.; Culture samples of Neisseria gonorrhoeae and Escherichia coli were studied by transmission and electron microscopy to evaluate the effect of different preparation procedures on the pilation of these organisms . Unfixed as well as fixed bacteria showed only few, long, filamentous appendages when investigated in ultrathin sections, negatively stained specimens, or critical-point dried preparations . Snap-frozen specimens of E . coli showed many short and thin pili after being shadowed with carbon and platinum whereas those of N . gonorrhoeae showed only some type-C-like pili . Thus, the number and morphological appearance of pili appear to be greatly influenced by the preparation techniques used for study by electronmicroscopy . Conclusions as to the type and the infectivity of a bacterial strain can, therefore, not be based on purely morphological criteria. South Med J, 1979 Mar, 72(3), 375 - 6 Hepatitis B presenting with tenosynovitis; Greenberg RN et al.; A 31-year-old nurse's aide developed fever, malaise, migratory arthralgias, arthritis, and severe tenosynovitis six weeks after pricking her finger with a needle contaminated by blood from a patient having type B viral hepatitis . Although disseminated Neisseria gonorrhoeae infection was the initial diagnosis, her symptoms worsened on treatment with ampicillin . While the patient was on aspirin therapy, her symptoms improved dramatically and eventually resolved as she showed evidence, through laboratory findings, of an anicteric hepatitis B infection . Evidently tenosynovitis can be part of the hepatitis B prodrome. Asian J Infect Dis, 1979 Mar, 3(1), 45 - 6 Recognition of an asymptomatic male carrier of Neisseria gonorrhoeae in Singapore - a case report; Tan RJ et al.; Neisseria gonorrhoeae was isolated from centrifuged urine deposit of an asymptomatic male . The case history and significance of this asymptomatic infection are described. Asian J Infect Dis, 1979 Mar, 3(1), 37 - 9 Kanamycin in the treatment of penicillinase-producing gonococcai infections; Rajan VS et al.; A retrospective study of 356 cases of bacteriologically proven penicillinase-producing gonococcal infections treated with a single dose of 2 g of kanamycin intramuscularly was carried out . It was found that 14 patients failed to complete followup examinations . Of the remaining 342 who were examined bacteriologically following treatment, 335 were found to be cured of the infection . The cure rate was 96% . No adverse reactions were noted after administration of the drug . Compared to the other drugs used, kanamycin was relatively cheaper . The authors conclude that kanamycin is safe, economical and very effective in the treatment of gonorrhoea caused by the strains of penicillinase-producing Neisseria gonorrhoeae in South East Asia. Ann Dermatol Venereol, 1979 Mar, 106(3), 267 - 72 {Auxotypes and sensitivity to 6 antibiotics of strains of Neisseria gonorrhoeae isolated at Strasbourg in 1977-1978 (author's transl)}; Le Faou A et al.; We have studied 386 strains of Neisseria gonorrhoeae isolated in our laboratory from July 1977 to October 1978, with the Catlin's auxotyping method . The distribution of the four main auxotypes, i . e . (+), (PRO-), (ARG-), (ARG-, HYX-, URA-), is different from those reported by others (in U . S . A . and Sweden) . In Strasbourg, the auxotype (+) is prevalent . We have noticed some differences among classes of population . For example (ARG-) and (ARG-, HYX-, URA-) are scarcely isolated from prostitutes and we have found less (ARG-) strains in women than in men . The determination of the minimum inhibitory concentration of 6 antibiotics has shown there was no differences between the auxotypes except for the (ARG-, HYX-, URA-) strains which are more susceptible to all the antibiotics, but spectinomycin . Since August 1978, we have also noticed an increasing of the resistance which is mainly due to (PRO-) strains. Am J Dis Child, 1979 Mar, 133(3), 260 - 2 Raised intracranial pressure: its management in Neisseria meningitidis meningoencephalitis; Nugent SK et al.; Further reduction in morbidity and mortality from bacterial meningitis is unlikely to stem from innovations in antibiotic management . Emphasis must therefore be directed toward prevention, more rapid diagnosis, and improved therapy for maintaining the integrity of the CNS . Raised intracranial pressure is frequently associated with bacterial meningitis . In selected patients with bacterial meningitis and clinical evidence of elevated intracranial pressure, monitoring and aggressive treatment of this pressure could be crucial to survival. Infect Immun, 1979 Mar, 23(3), 717 - 22 Immunological and serological diversity of Neisseria gonorrhoeae: identification of new immunotypes and highly protective strains; Wong KH et al.; Gonococci, irrespective of serotype or immunotype, varied significantly in their capacity to induce immunity in animal models, and in vitro serological relatedness did not always insure in vivo cross-protection . By using a serum bactericidal assay followed by in vivo cross-protection studies, new immunotypic strains which were highly protective were identified from cultures isolated in different geographical areas and from patients with various clinical manifestations . Beta-lactamase production and gonococcal immunotype did not appear as related characteristics in that certain penicillin-sensitive strains were highly effective in immunizing animals against infection with beta-lactamase producers . The findings of this study emphasize the importance of using appropriate biological tests and strains for the investigation of gonococcal immunity and vaccine development . Immunization with a combination of a few major gonococcal immunotypic immunogens may provide substantial protection against the majority of penicillin-sensitive and beta-lactamase-producing gonococci . Investigation of isolated immunotypic immunogens is in progress. Can Med Assoc J . 1979 Feb 17;120(4):408. Occurrence of gonococcal perihepatitis after therapeutic abortion; Portnoy D et al.; PIP: A case history of an 18-year-old woman admitted 2 days after undergoing a therapeutic abortion with acute abdominal pain is reported . The patient denied nausea or vomiting, but she appeared very ill with a temperature of 38.3 degrees centigrade . Pelvic examination was normal . The possibility of gonococcal perihepatitis was considered . When endocervical secretions were Gram-stained, gram-negative intracellular diplococci and neisseria gonorrhoeae were cultured . The patient had only 1 sexual partner, but that partner had had intercourse with at least 2 other women during the same period he was intimate with the patient . The patient responded to intravenous penicillin and was discharged after 5 days of treatment . It was suspected that dissemination of the gonococci was during the therapeutic abortion via the fallopian tubes . Neither the patient nor her partner, it was emphasized, showed genital symptoms, therefore the need to screen potential abortion patients is acute with gonorrhea at the epidemic stage . Am J Obstet Gynecol, 1979 Feb 15, 133(4), 362 - 5 Bacteriology of acute pelvic inflammatory disease . Suboptimal survival of Neisseria gonorrhoeae in a nonbuffered transport system; Chow AW et al.; In our earlier study, Neisseria gonorrhoeae was infrequently isolated while Bacteroides fragilis was totally absent from cul-de-sac aspirates of patients with acute pelvic inflammatory disease (PID) . Twenty additional women were studied to further elucidate the bacteriology of this disease . Recovery rate of N . gonorrhoeae from cul-de-sac aspirates collected in selective transport medium (Transgrow) was 25 per cent among patients with gonococcal PID, compared to only 8 per cent when specimens were collected in a nonselective transport system (Anaport) . In vitro studies confirmed a detrimental effect of the Anaport for survival of N . gonorrhoeae during transport . This suboptimal survival was primarily related to low pH of the transport system under prereduced conditions, and could be corrected when pH of the transport vial was preadjusted and maintained between 6 and 7 . B . fragilis was again absent from the cul-de-sac in all patients, while streptococci, peptococci, and peptostreptococci remained the most predominant isolates . These data may explain the empiric observations that penicillin and tetracycline are effective in most cases of acute PID. Br J Vener Dis, 1979 Feb, 55(1), 5 - 9 Serum immunoglobulin response in uncomplicated gonorrhoea; McMillan A et al.; Sera from 225 men and 140 women were examined by an indirect immunofluorescent antibody technique for antibody reactive with Neisseria gonorrhoeae . Antigonococcal IgM was demonstrated at a titre of greater than or equal to 16 in about 45% of infected, but in only 3% of non-infected, patients . Most of this antibody occurred in sera of patients who had been infected for less than 14 days . Antibody of the IgA class was found at a titre of greater than or equal to 16 in over half the infected, but in none of the non-infected, patients . IgG antibody reactive with the gonococcus was found in each infected patient at a titre of greater than or equal to 16 but in only 8% of controls . The mean log titre of this antibody was significantly higher in patients who had been infected for more than seven days than in those whose infection was of shorter duration. Aust N Z J Obstet Gynaecol, 1979 Feb, 19(1), 61 - 2 A large cyst of Skene's duct -- a rare cause of superficial dyspareunia; James ST; A case is reported which illustrates a rare cause of external dyspareunia, probably of Neisserial origin, and satisfactorily resolved by surgical extirpation . The morphological and embryological significance of the Skene's duct and related cysts are discussed. Can J Microbiol, 1979 Feb, 25(2), 235 - 7 Cyclic adenosine 3', 5'-monophosphate in Neisseria gonorrhoeae; Morriss DM et al.; Intracellular cyclic adenosine 3', 5'-monophosphate (cAMP) was measured in two laboratory strains of Neisseria gonorrhoeae . Decreasing the glucose content of a defined media from 33 mM to 5.5 mM glucose resulted in an 11-to 25-fold increase of intracellular cAMP. Can J Microbiol, 1979 Feb, 25(2), 138 - 45 Induction of reaginic (IgE) gonococcal antibodies in the rat by a common antigen of Neisseria gonorrhoeae; Ashton FE et al.; An antigen (ZAB) common to Neisseria gonorrhoeae was prepared by stepwise elution of a crude gonococcal antigen (ZA) from columns of diethylaminoethyl cellulose employing 0.02 M phosphate buffers, pH 7.6, containing increasing concentrations of sodium chloride . Rats immunized with ZAB produced reaginic (IgE) antibody which cross-reacted with ZA prepared from eight gonococcal strains by the passive cutaneous anaphylaxis (PCA) test . Heating of the sera at 56 degrees C for 4 h destroyed the PCA activity . The PCA activity of the anti-ZAB rat serum was removed after absorption with ZAB antigen or with rabbit anti-rat IgE but not after absorption with gonococcal lipopolysaccharide or with heat-killed or formalinized gonococci . Treatment of ZAB with trypsin or heating at 100 degrees C for 30 min destroyed or reduced the antigenic activity respectively . Further purification of ZAB by filtration through Sephadex G-100 gave a preparation (ZAB2) which contained the common antigen as shown by the cross-reactivity of anti-ZAB2 rat serum with seven stains of N . gonorrhoeae . Fraction ZAB2 contained material which had a molecular weight less than 13,700 and was associated with the presence of material absorbing at 260 nm . The results of this study indicate that a low molecular weight antigen, which appears to be protein in nature and associated with nuclei acid, is common to the gonococcus and is the main antigenic component inducing reaginic (IgE) antibody in the rat. Can J Microbiol, 1979 Feb, 25(2), 119 - 23 Transport of Neisseria meningitidis cultures: growth-supporting media and freezing as an alternative; White LA et al.; The abilities of Transgrow (TG), Thayer-Martin (TM), and New York City (NYC) solid media to maintain the viability of 12 strains of Neisseria meningitidis under various controlled conditions were assessed . The effects of charcoal impregnation of swabs, temperature, and an enriched CO2 atmosphere were examined with holding for up to 21 days . Recovery from samples held at 35 degrees C was, in almost all instances, greater than at 22 or 4 degrees C . A strong requirement for added CO2 was demonstrated, especially at lower temperatures . No positive effect could be attributed to the use of charcoal-impregnated swabs . NYC and TM media were the best overall, with the former permitting recovery from more than 75% of all samples held on slants for 20 days at 4 degrees C in an atmosphere of 5% CO2 in air . Freezing, with holding on dry ice, was a useful alternative to the use of growth-supporting media . This latter method eliminated the requirement for an enriched CO2 atmosphere. Appl Environ Microbiol, 1979 Feb, 37(2), 293 - 7 Stability and viability of Neisseria gonorrhoeae in various solutions and buffers; Norrod P et al.; The stability and viability of Neisseria gonorrhoeae WP (T4) was tested in a variety of buffers and solutions, many of which are commonly used in gonococcal research . Each solution was tested at room temperature for its ability to maintain stability and viability of gonococci in concentrated suspensions and to maintain viability of gonococci in dilute suspensions . The 14 buffers and solutions tested could be divided into four groups based upon these criteria . Only a few solutions satisfied all three criteria . Of those tested, Gey salt solution and bovine serum albumin (0.01%) and proteose peptone (1%) in saline were the only two in which the gonococci retained viability in dilute suspensions for 25 min . Most of the solutions were not able to maintain viability of gonococci in dilute suspensions, even when the same solution was capable of maintaining stability and viability in concentrated suspensions. Br J Vener Dis, 1979 Feb, 55(1), 20 - 3 Inhibition of Neisseria gonorrhoeae by normal human saliva; Mellersh A et al.; Saliva was found to be a powerful and specific inhibitor of Neisseria gonorrhoeae . Although 28 other species of bacteria were tested, including Neisseria meningitidis, Neisseria pharyngis var flava, Neisseria lactamica, and Neisseria catarrhalis, we failed to find any others sensitive to saliva under similar conditions . The physical properties of the inhibitory substance indicated that it might be salivary alpha-amylase . To test this hypothesis alpha-amylase was extracted from saliva and was shown to have a high antigonococcal activity . Hog pancreas alpha-amylase also showed strong antigonococcal activity, thus the observations indicate that for the strains we tested alpha-amylase is inhibitory to gonococci . This observation indicates that either the gonococcal outer cell wall contains some unique lipopolysaccharides or that the gonococcus is unusually dependent on the integrity of these moieties . Whichever speculation proves to be true it indicates a need for a careful study of the gonococcal cell wall. Acta Pathol Microbiol Scand {B}, 1979 Feb, 87B(1), 55 - 64 Serology of Neisseria gonorrhoeae . Demonstration of strain-specific antigens by immunoelectrophoresis, immunofluorescence and co-agglutination techniques; Danielsson D et al.; Among a group of four selected strains of Neisseria gonorrhaeae, common and strain-specific antigens were demonstrated by immunoelectrophoresis, indirect immunofluorescence (IFL) and co-agglutination (COA) . In preparations of ultrasonically-disrupted organisms, the strain-specific antigens appeared in crossed-line immunoelectrophoresis (C-LIE) with antigen containing intermediate agar gel as a two-peak precipitin line, one peak close to the antigen well, the other towards the anode . A similar pattern was found for each of the four strains studied . These strain-specific precipitin lines were also identified in rocket-line immunoelectrophoresis (R-LIE) tests, which were found useful for comparative studies . Using whole cells, strain-specific antigens were also demonstrated by COA and IFL tests with the use of cross-absorbed antibodies . The results corresponded to those obtained with C-LIE and R-LIE . Immunosorption experiments indicated identity between the strain-specific antigens shown by COA tests and those demonstrated by C-LIE and R-LIE tests. Infect Immun, 1979 Feb, 23(2), 353 - 9 Cell envelope of Neisseria gonorrhoeae CS7: peptidoglycan protein complex; Hebeler BH et al.; Treatment of cells grown to exponential phase with 4% sodium dodecyl sulfate for 3 h at 100 degrees C resulted in solubilization of all cellular components except for peptidoglycan . In most strains, cells cultured in liquid gonococcal broth at pH 7.2 yielded a peptidoglycan composed primarily of N-acetylmuramic acid N-acetylglucosamine, alanine, glutamic acid, and diaminopimelic acid in a molar ratio of 1:1:2:1:1 . The peptidoglycan in these cells accounted for 1 to 2% (dry weight) of the cells . However, in cells cultured at pH 6.0, the dry weight of peptidoglycan increased to 4 to 13% . Preliminary investigations indicated that the apparent increase in weight is strain dependent and is due in part to associated protein(s) . Neisseria gonorrhoeae strain CS7 had elevated amounts of protein associated with the peptidoglycan regardless of growth pH . The peptidoglycan-protein complex could not be dissociated by additional extraction with sodium dodecyl sulfate, 10 M LiCl2, or ethylenediaminetetraacetate or by 7.5% polyacrylamide gel electrophoresis . The complex could be degraded by lysozyme, trypsin, chymotrypsin, Pronase B, and Chalaropsis sp . muramidase. JAMA, 1979 Jan 5, 241(1), 52 - 3 Purulent rectal discharge associated with a nontreponemal spirochete; Kaplan LR et al.; A nontreponemal spirochete was isolated from the rectum of a homosexual man with a chronic purulent discharge . Known infectious causes of the disease were excluded . Although the pathogenicity of the organism was not proved, the patient's symptoms rapidly resolved following penicillin G benzathine therapy . When culture of a nonhemorrhagic, purulent rectal discharge fails to verify Neisseria gonorrhoeae, health care personnel are encouraged to carefully examine a Gram's-stained smear of the discharge for spiral-shaped organisms. Ann Biol Clin (Paris), 1979, 37(6), 351 - 4 {Use of electrosyneresis in the diagnosis of bacterial meningitis (author's transl)}; Barege H et al.; The authors present the interest of electrosyneresis for diagnosis of purulent meningitis . Test material is a study about 120 cerebrospinal fluids . Electrosyneresis sometimes permits to identify the germ when microscopic examination and culture are negative or when microscopy is positive and the culture negative . Application of electrosyneresis is still limited in France by the small immunogenicity of the specific polysaccharide of Neisseria meningitidis serotype B . principal etiologic agent of purulent meningitis, that do not allow, at present, to obtain suitable serums. Rev Infect Dis, 1979 Jan-Feb, 1(1), 183 - 8 Treatment of uncomplicated gonococcal urethritis with cefoxitin: comparison with penicillin; Siegel MS et al.; Cefoxitin is a semisynthetic cephamycin with good in vitro activity against Neisseria gonorrhoeae . In a controlled clinical trial, 143 men with uncomplicated gonococcal urethritis received either cefoxitin (2.0 g intramuscularly {im} with 1.0 g of oral probenecid) or aqueous procaine penicillin G (4.8 x 10(6) units im with 1.0 g of oral probenecid) . Of the 117 patients who returned for follow-up on days 3-13 after treatment, only 1.8% in the group given cefoxitin and 3.6% in the group given penicillin were not cured . The incidence of pain at the site of injection and rates of adverse reactions were similar for both groups . No hematologic, renal, or hepatic toxicity could be ascribed to either treatment regimen . Although none of the infections were due to beta-lactamase-producing gonococci, the results provide a basis for additional studies of the efficacy of cefoxitin in treatment of infections due to penicillinase-producing N . gonorrhoeae. Acta Chir Scand, 1979, 145(7), 483 - 5 Acute perihepatitis; Husebo OS et al.; Fourteen young females with acute pains in the right hypochondrium were admitted to the Surgical Department . The history and clinical findings were typical of acute perihepatitis (Fitz-Hugh-Curtis syndrome), and the diagnosis was confirmed by laparoscopy . The gynecological symptoms and signs were negligible, and Neisseria gonorrhoeae were cultured from the endocervix in two of the patients . Pathogenes in the suprahepatic space were not demonstrated . Eight patients used intrauterine contraceptive device (IUD) of the Copper-T-type . Acute perihepatitis is an important differential diagnosis in young females presenting with acute pains in the right hypochondrium. Postgrad Med J, 1979, 55 Suppl 4, 85 - 7 Cefaclor in the treatment of uncomplicated gonococcal urethritis; Harrison WO; Cefaclor is a cephalosporin antibiotic whose chemical structure is similar to that of cephalexin . The substitution of a chloro group for the methyl group of cephalexin has produced a compound with markedly improved antibacterial activity, while retaining the property of gastrointestinal absorption . Cefaclor has shown good in vitro activity against Neisseria gonorrhoeae . In a controlled clinical trial, 40 men with uncomplicated gonococcal urethritis received cefaclor given as a one gram loading dose, followed by 500 mg 4 times daily for 3 days, for a total dose of 7 g . All patients were re-evaluated at 3 to 7 days following completion of therapy . Two patients did not complete the entire course of therapy and were eventually treated with another regimen . Of 38 men who took the full course of therapy, 35 were clinically and bacteriologically cured . Two men were clinically infected but had negative pretreatment cultures . Of 19 men with beta-lactamase-positive gonococcal urethritis, 18 were cured, whereas among 17 men with penicillin-sensitive strains, all were cured . There were no adverse reactions to the drug, and all patients expressed a preference for the oral regimen . The success of cefaclor in this pilot study suggests that additional clinical trials should be performed. Med Microbiol Immunol (Berl), 1979, 167(4), 231 - 8 Variations in attachment of Neisseria gonorrhoeae to vaginal epithelial cells during the menstrual cycle and early pregnancy; Forslin L et al.; An in vitro system was used to study the ability of virulent gonococci to adhere to vaginal epithelial cells obtained from healthy donors during the pre- and postmenstrual phases, and from those in early pregnancy . It was found that more gonococci adhered to the cells from donors in the postmenstrual phase than to cells from those in the premenstrual one . This difference was statistically highly significant . The attachment rate of gonococci to vaginal epithelial cells was similar in early pregnancy and in the premenstrual phase. Microbios, 1979, 24(96), 123 - 31 Biological activity of an antibiotic produced by Myxococcus coralloides; Arias JM et al.; A strain of Myxococcus coralloides was isolated which produced an antibiotic active against Gram-positive bacteria and also against Neisseria sp at high levels of antibiotic . The antibiotic was bactericidal on sensitive growing bacteria . It was inactive on non-growing cells and also on cells whose growth has been stopped by addition of chloramphenicol . Strains of S . aureus resistant to several antibiotics, including penicillin and ampicillin, were also sensitive to this antibiotic. Arzneimittelforschung, 1979, 29(2a), 392 - 3 Investigations on antibacterial activity of cefazedone against Neisseria gonorrhoeae; Grunder K et al.; The sensitivity of 67 strains of Neisseria gonorrhoeae isolated from 1977 to 1978 were tested against the new cephalosporin derivative (6R,7R)-7-(2-{3,5-dichloro-4-oxo-1(4H)-pyridyl}-acetamido)-3-({(5-methyl-1,3,4-thiadiazol-2-yl)-thio}methyl)-8-oxo-5-thia-1-azabicyclo{4,2,0}oct-2-ene-2-carboxylic acid (cefazedone, Refosporen) . All strains including three penicillin-resistant beta-lactamase producing Neisseria were sensitive at a range of 0.0078 to 2.0 micrograms/ml cefazedone. J Infect Dis, 1979 Jan, 139(1), 89 - 92 Studies on gonococcus infection . XVII . IgA1-cleaving protease in vaginal washings from women with gonorrhea; Blake M et al.; Vaginal washings from women attending a veneral disease clinic were examined for the presence of protease that cleaved IgA subclass 1 (IgA1) . In a crude assay, vaginal washings cleaved {125I}IgA1 in 19 of 25 specimens from individuals from whom Neisseria gonorrhoeae were cultivated . Forty-six specimens from 104 women whose cultures were negative for N . gonorrhoeae also cleaved {125I}IgA1 . Vaginal washings from six of six women with culture-proven gonorrhea cleaved {125I}IgA1 into low-molecular-weight components identical to those produced by partially purified IgA1-specific protease from gonococci . The hydrolysis of {125I}IgA1 by vaginal washings from women whose cultures were negative for N . gonorrhoeae yielded cleavage products that resembled those of trypsin or alpha-chymotrypsin . These findings indicate that gonococci residing in the female genital tract produce IgA1-specific protease that can be detected in the vaginal washings of infected women. J Infect Dis, 1979 Jan, 139(1), 52 - 9 Comparative immunogenicity of vaccines prepared from capsular polysaccharides of group C Neisseria meningitidis O-acetyl-positive and O-acetyl-negative variants and Escherichia coli K92 in adult volunteers; Glode MP et al.; Three structurally and antigenically similar capsular polysaccharides, two derived from group C Neisseria meningitidis (O-acetyl-positive and O-acetyl-negative variants) and one from Escherichia coli K92, which cross-reacts with polysaccharide from group C N . meningitidis, were compared for their ability to induce anticapsular and bactericidal antibodies to group C N . meningitidis in adult volunteers . All three vaccines elicited group C-specific serum antibodies . The vaccine derived from the O-acetyl-negative variant was the most immunogenic of the three vaccines . With use of radiolabeled O-acetyl-positive group C N . meningitidis polysaccharide antigen, the geometric mean titers of antibody in serum were 41.7 microgram/ml to the O-acetyl-negative variant, 22.8 microgram/ml to the O-acetyl-positive variant, and 7.1 microgram/ml to E . coli K92 . Antibodies induced by all three vaccines were bactericidal for both of the group C N . meningitidis polysaccharide variants . An inverse relation between the comparative immunogenicity of the O-acetyl-negative polysaccharide and the virulence of group C N . meningitidis was found. J Clin Microbiol, 1979 Jan, 9(1), 97 - 102 Electron capture gas-liquid chromatographic-mass spectral identification of acids produced by Neisseria meningitidis in a defined medium; Alley CC et al.; The acid metabolites and the cellular fatty acids of three strains of Neisseria meningitidis grown in a chemically defined liquid medium were determined with computerized frequency-pulsed electron capture gas-liquid chromatography . Five acids not previously reported were subsequently identified: isobutyric, octanoic, decenoic (C10:1), dodecenoic (C12:1), and tetradecenoic (C14:1) . These acids were produced during active metabolism and were not detected as cellular constituents . The frequency-pulsed electron capture gas-liquid chromatography methods which we used provide a rapid, reliable, sensitive means of detecting both these and other metabolic and cellular acids in spent culture medium. Scand J Infect Dis, 1979, 11(4), 291 - 301 Relative opsonic and protective activities of antibodies against K1, O and lipid A antigens of Escherichia coli; Welch WD et al.; The K1 Escherichia coli capsular antigen has been implicated as a virulence factor because of the frequency of isolation of K1 containing strains from certain invasive human infections . In the study of the interaction between K1 strains, normal human polymorphonuclear cells (PMNs) and fresh human serum, we have found varying susceptibility to phagocytosis and killing; thus, the in vitro opsonophagocytic and in vivo protective role of K1, somatic O and core glycolipid antibodies remain unclear . We have therefore examined strains of E . coli with defined susceptibility to phagocytosis by normal PMNs and sera and compared the effect of K1, somatic O and lipid A antibodies in opsonophagocytic tests and mouse protection experiments . K1 E . coli strains demonstrating relative resistance to phagocytosis and killing were effectively opsonized only with specific K1 capsular antisera . Similarly, K1 capsular antisera, but not anti-O or lipid A antisera, also provided protection in mice challenged with a LD100 of K1 E . coli that were "resistant" to phagocytosis . The ability of purified capsular antigens from Neisseria meningitidis group B and K1 "resistant" E . coli to inhibit the phagocytosis of a "sensitive" non-K1 and a K1 E . coli strain of "intermediate" susceptibility to opsonophagocytosis was also investigated . Purified K1 and group B capsular antigens were able to block specific capsular-antibody mediated opsonophagocytosis, yet these capsular antigens failed to inhibit the phagocytosis of non-K1 "sensitive" or K1 "intermediate" E . coli . These studies suggest that K1 antibodies are obligatory for the in vitro and in vivo opsonophagocytosis of "resistant" K1 E . coli and that the K1 antigen must remain in situ on the bacterial surface to exert an anti-phagocytic effect. Dermatol Monatsschr, 1979 Jan, 165(1), 18 - 27 {Electron microscopic representation of the pili structure of Neisseria gonorrhoeae (author's transl)}; Muller G et al.; The technique of negative staining and ultra-thin section has been used for investigations of 30 Neisseria gonorrhoeae strains in order to represent the structure of pili (fimbriae) electron microscopically . The staining of the gonococci was effected by phosphotungstic acid (0,5%) . The pili ascertained were 30 to 60 A thick . In course of in vitro passages up to 10 . subculture morphological changes of the pili have been observed . The application of trisbuffer or solution of Hylase (hyaluronidase) showed not any improved results in comparison with buffered NaCl-solution as suspension medium . The investigation of ultra-thin sections showed that the structure of the pili could be exhibited not clearly . Therefore, these technique seems to be not suitable for qualitative representative of the pili. Br J Vener Dis, 1978 Dec, 54(6), 398 - 9 Inactivation of gonococci by procaine penicillin in vivo . A pilot study; Rajan VS et al.; A pilot study was carried out of 25 male volunteers with gonococcal urethritis . After intramuscular administration of 3 megaunits procaine penicillin and 1 g oral probenecid the urethral culture results for Neisseria gonorrhoeae remained positive up to five hours and thereafter became negative . These results may be useful in providing guidelines for advice on the duration of sexual abstinence following treatment . It is suggested that similar studies should be carried out in women. J Clin Microbiol, 1978 Dec, 8(6), 729 - 32 Neisseria sicca endocarditis: report of a case and review of the literature; Gay RM et al.; A rare case of bacterial endocarditis caused by Neisseria sicca is reported . Review of the literature revealed only five other cases where sufficient data existed to confirm this particular organism as the etiological agent of bacterial endocarditis. J Clin Microbiol, 1978 Dec, 8(6), 643 - 7 Rapid micro-carbohydrate test for confirmation of Neisseria gonorrhoeae; Yong DC et al.; A rapid carbohydrate utilization procedure for the confirmation of Neisseria gonorrhoeae and identification of other Neisseria species has been developed . This method utilizes both preformed enzymes, introduced in a heavy inoculum, and enzymes formed by the microorganisms as a result of growth in a small volume of super-enriched medium . Expected carbohydrate reactions were produced by 383 clinical isolates of neisseriae and were clearly visible within 4 h of incubation . The combined use of disposable glass tubes (6 by 50 mm) and microamounts of media (0.05 ml) make this method not only rapid, but also low in cost. J Infect Dis, 1978 Dec, 138(6), 731 - 5 Antibody responses of human infants to three doses of group A Neisseria meningitidis polysaccharide vaccine administered at two, four, and six months of age; Gold R et al.; Infants were immunized with group A Neisseria meningitidis polysaccharide vaccine at two, four, and six months of age . Two lots of group A vaccine that differed in molecular weight were used; lot no . 1980A was of significantly larger molecular size than lot no . A-7 . No significant adverse reactions occurred . The geometric mean concentration of serum antibody to group A N . meningitidis one month after the third dose of lot no . 1980A was 0.89 microgram/ml, nearly twice the concentration induced by lot no . A-7 (0.48 microgram/ml) . When the infants were 12 months of age, concentrations of antibody in both groups had declined to similar levels, which were still greater than the mean concentration of antibody in unimmunized children . By 18 months of age, the antibody levels of immunized and unimmunized infants were the same . The three-dose schedule resulted in significantly lower concentrations of antibody than previously studied schedules of two doses given three to four months apart. Br J Vener Dis, 1978 Dec, 54(6), 409 - 13 Isolation of Chlamydia trachomatis from Bartholin's ducts; Davies JA et al.; Exudate from Bartholin's ducts from 30 selected patients was investigated for Chlamydia trachomatis and Neisseria gonorrhoeae . N . gonorrhoeae was isolated from the duct exudate in 24 patients and C . trachomatis in nine . Concurrent infection of the ducts was present in seven (29.2%); the remaining two patients were sexual contacts of men with non-specific urethritis . The duct exudate was mucopus in seven patients, cloudy mucus in one, and clear mucus in the other . Although contamination of the vulva by C . trachomatis derived from cervical or urethral infection cannot be excluded, three cases are described which suggest that a true infection of the duct occurs and may persist after gonococcal infection has been cured. Br J Vener Dis, 1978 Dec, 54(6), 394 - 7 Bulk growth of Neisseria gonorrhoeae type 1 in a biphasic system; Ison C et al.; A biphasic system for the bulk growth of Neisseria gonorrhoeae is described . It appears to combine the convenience of liquid media with the growth qualities of solid media . By using the agar in dialysis tubes rather than as slabs the surface-to-volume ratio was improved and harvesting made easier . The system is also useful in isolating gonococci from blood and joint fluids in patients with disseminated infection. Br J Vener Dis, 1978 Dec, 54(6), 386 - 93 Method for studying the role of indigenous cervical flora in colonisation by Neisseria gonorrhoeae; McBride ME et al.; A method for quantitating cervical flora has been evaluated statistically and used to study the bacterial flora of the cervix in 14 women sexually exposed to men with gonococcal urethritis . A comparison was made between those women who subsequently became colonised with Neisseria gonorrhoeae and those who did not to determine whether either total microbial populations or the different species present could be related to colonisation by N . gonorrhoeae . Two control groups of healthy women, one of patients from a public clinic and the other of patients from a private practice, were studied in the same way . Normal flora isolates were tested in vitro for antagonism or synergism toward N . gonorrhoeae or both . Cervical flora was characterised in all patient groups by wide variations between individuals, both in type and numbers of organisms . No significant differences were found in total bacterial populations or in the number of species isolated from the cervix between patient groups . Populations of N . gonorrhoeae ranged from less than 10 bacteria to log104.36 . Only one normal flora isolate, a strain of Streptococcus viridans isolated from a woman exposed to but not infected by N . gonorrhoeae, demonstrated inhibition of growth towards N . gonorrhoeae. Obstet Gynecol, 1978 Dec, 52(6), 698 - 702 Chlamydia trachomatis cervicitis in gynecologic outpatients; Ripa KT et al.; Symptoms suggestive of a lower genital tract infection (LGTI) are common complaints in women who consult gynecologists . Sexually transmitted microorganisms, such as Chlamydia trachomatis . Neisseria gonorrhoeae, and Trichomonas vaginalis, are responsible for a substantial proportion of LGTI . This study was performed to establish the frequency of LGTI caused by C trachomatis in women attending a gynecologic outpatient clinic . Of 170 women with LGTI, 32.9% harbored one or more of these organisms: C trachomatis was found in 19.3%, N gonorrhoeae in 4.7%, and T vaginalis in 25.9% . The results of the isolation studies were correlated with clinical signs and symptoms . In women under 25 years of age, chlamydial cervicitis was found significantly more often in users of oral contraceptives than in nonusers . In women not taking such drugs, cervical erosion was found more often in Chlamydia-positive than Chlamydia-negative women . Since clinical examination failed to reveal any characteristic signs in cases of chlamydial infection, it was not possible to distinguish a chlamydial from a gonococcal infection . This study also reports the successful treatment of 15 women affected by chlamydial cervicitis with doxycycline or trimethoprim sulphamethoxazole. Acta Pathol Microbiol Scand {B}, 1978 Dec, 86B(6), 327 - 34 Laboratory identification of pathogenic Neisseria with special regard to atypical strains: an evaluation of sugar degradation, immunofluorescence and co-agglutination tests; Olcen P et al.; Sugar degradation tests (SDT) were compared with immunofluorescence (IFL) and co-agglutination (COA) tests for the diagnosis of Neisseria gonorrhoeae (GC) and Neisseria meningitidis (MC) . Somewhat more than 5% of the GC strains and 8% of the MC strains were misinterpreted by SDT . On most occasions the disagreement between SDT and serological tests was due to the inability of the MC strains (less so for GC strains) to degrade sugars correctly . Because of this, three out of 15 strains (20%) from pharyngeal specimens were primarily considered to be GC by SDT but were identified as MC by COA tests . Deficiencies in sugar degradations were also found in a group of clinical problem strains . Many of them were unable or had a decreased ability to degrade glucose or maltose but were diagnosed distinctly as MC by the COA test . There were no false positives with the IFL or COA tests, but 2% of the GC strains and 26% of the MC carrier strains (non-groupable) were not identified by COA . Both IFL and COA tests are good adjuncts to SDT for the diagnosis of GC and clinically significant MC, since the results are reliable and the tests rapid and simple to perform. J Bacteriol, 1978 Dec, 136(3), 1127 - 34 Heat-modifiable outer membrane proteins of Neisseria meningitidis and their organization within the membrane; Frasch CE et al.; Neisseria meningitidis group B serotype 2 strain M986 contains two predominant outer membrane proteins, with apparent molecular weights of 41,000 (protein b) and 28,000 (protein e) . Heating of outer membrane vesicles at 56 degrees C for 20 min caused much of b** to disaggregate and denature into b (41,000 daltons) . In contrast, protein e could be rapidly solubilized by SDS at room temperature into its monomeric state (e*), but it was not converted to its final higher apparent molecular weight of 28,000 (e) unless heated at 100 degrees C for 2 min . We propose that protein b exists in the membrane as trimers or tetramers in a transmembrane configuration and that protein e exists as subunits on the exterior surface of the outer membrane and has a highly ordered tertiary structure. Infect Immun, 1978 Dec, 22(3), 698 - 708 Binding of cholesterol by Neisseria gonorrhoeae; Miller RD et al.; The binding of {1,2-3H}cholesterol to Neisseria gonorrhoeae CS-7, Pseudomonas aeruginosa, and Salmonella typhimurium (smooth and rough strains) was investigated . The kinetics of cholesterol binding to N . gonorrhoeae CS-7 demonstrated that binding occurred slowly with maximum binding by 10 h . Under optimum conditions, a large percentage (65%) of the added cholesterol was associated with the cells . Chemical fractionation revealed that ca . 98% of the labeled cholesterol was associated with the cell membrane(s) . The bound cholesterol was not esterified and was associated primarily with the cytoplasmic membrane . Intact gonococci bound 4 to 30 times more cholesterol than the deep rough mutant S . typhimurium TA1535, the wild-type S . typhimurium DB-21, and P . aeruginosa . In contrast, isolated cell membranes from all organisms rapidly bound cholesterol to the same extent . Therefore, the outer membrane can function as a permeability barrier to cholesterol . Cholesterol binding to both whole cells and isolated cell membranes was influenced by the incubation temperature . The rate of cholesterol binding by whole cells of N . gonorrhoeae decreased markedly at lower temperatures, with almost complete cessation of binding at 0 degrees C . A similar temperature effect on the binding of cholesterol to isolated membranes was not observed . Thus, the effect of temperature on the binding of cholesterol to whole cells was an effect not on the actual binding process but rather on the ability of the cholesterol molecule to penetrate the lipid domain of the gonococcal outer membrane. JAMA, 1978 Nov 17, 240(21), 2267 - 70 Therapy of gonorrhea . Comparison of trimethoprim-sulfamethoxazole and ampicillin; Sattler FR et al.; Eighty-nine men with gonococcal urethritis were randomly treated with trimethoprim-sulfamethoxazole, four tablets (trimethoprin, 320 mg, and sulfamethoxazole, 1,600 mg) twice daily for two days, or ampicillin, 3.5 g, plus probenecid, 1 g, in a single dose . Forty-one (95.3%) of 43 patients who received trimethoprin-sulfamethosazole and 41 (97.6%) of 42 given ampicillin were cured . Neither drug caused major side effects . All isolates of Neisseria gonorrhoeae were susceptible in vitro to trimethoprim-sulfame-thoxazole, and all but one were inhibited by ampicillin . The ampicillin-resistant strain (minimum inhibitory concentration, 4 micrograms/ml) produced penicillinase and was reovered from a patient who responded to treatment with trimethoprim-sulfamethoxazole . There was no significant correlation between the minimum inhibitory concentrations of trimethoprim-sulfamethoxazole and ampicillin . It is concluded that trimethoprim-sulfamethoxazole is as efficacious and safe as ampicillin in the therapy of gonococcal urethritis. Can J Microbiol, 1978 Nov, 24(11), 1419 - 22 Structure of the D-glucans produced by Neisseria perflava; MacKenzie CR et al.; A chemical and enzymic study of the cellular glucan of Neisseria perflava and of the glucan produced from sucrose by a cell-free extract of N . perflava showed from optical rotation, 13C nuclear magnetic resonance, methylation analysis, and alpha- and beta-amylase hydrolysis studies that the glucans had glycogen-like structures . These structures were composed of chains of 1-4-alpha-D-glucopyranosyl units with branch points of 4-O- and 6-O-disubstituted D-glucopyranose units . While the backbone structures of the two glucans were similar, the release of maltose by the action of beta-amylase indicated that the 1-4 linked nonreducing side chains of the cell-free enzymically synthesized glucan were longer (approximately seven units) than those present in the cellular glucan (approximately two to three units), a result in agreement with methylation analyses. J Clin Microbiol, 1978 Nov, 8(5), 525 - 8 Neisseria confirmation by an enriched, bicarbonate-containing carbohydrate medium; Graves JO et al.; A sugar fermentation medium for the confirmation of Neisseria and related species was developed . The medium contained a commercial supplement and a hemoglobin source prepared from lysed sheep erythrocytes . Bicarbonate in the medium substituted for a CO2-supplemented atmosphere . The medium was dispensed into screw-capped tubes . This medium was compared to cystine-Trypticase agar and the modified rapid fermentation test in the confirmation of Neisseria species . Performance of the new medium was equivalent to that of the modified rapid fermentation test, but cystine-Trypticase agar failed to confirm a significant number of clinical isolates of Neisseria gonorrhoeae. Biomed Mass Spectrom, 1978 Nov, 5(11), 627 - 33 Identification of amino sugars from bacterial lipopolysaccharides by gas chromatography electron impact and chemical ionization mass spectrometry; Bowser DV et al.; Amino sugars isolated from lipopolysaccharides of Brucella suis, Brucella abortus and Neisseria gonorrhoeae colony types 1 and 4 were identified using gas chromatography electron impact and chemical ionization mass spectrometry . Lipopolysaccharides were obtained by aqueous ether or aqueous phenol extraction . Isolated lipopolysaccharides were hydrolyzed in 1% acetic acid followed by hydrolysis of the polysaccharide moiety in 2 NHCl for 6 h at 100 degrees C . Amino sugars were first isolated by elution from Dowex 50 H+ and then N-acetylated, followed by trimethylsilylation . Trimethylsilyl ethers of 2-acetamido-2-deoxysugars; N-acetylglucosamine, N-acetylmannosamine, N-acetylgalactosamine, and a 2-acetamido-2.6-dideoxysugar, N-acetylquinovosamine, were identified by their fragmentation patterns . In the electron impact mode, N-acetylglucosamine and N-acetyl-galactosamine were distinguished from one another by comparing peak intensities at m/e 233 and 305 . However, N-acetylglucosamine and N-acetylmannosamine could not be differentiated by electron impact mass spectrometry . In the chemical ionization mode, N-acetylglucosamine and N-acetylmannosamine both with base peaks at m/e 494, could be distinguished from N-acetylgalactosamine and N-acetylquinovosamine by their base peaks at m/e 420 and 332, respectively . N-Acetylglucosamine and N-acetylmannosamine were differentiated from one another by comparing peak intensities at m/e 330, 404, 420, and 510 {MH}+ . This is the first report of chemical ionization mass spectrometry applied to the identification of amino sugars in bacterial lipopolysaccharides and shows that some 2-amino-2-deoxysugars can be differentiated by both electron impact and chemical ionization mass spectrometry. Can J Microbiol, 1978 Nov, 24(11), 1300 - 5 Enzyme-linked immunosorbent assays for the detection of Neisseria gonorrhoeae specific antibodies; Brodeur BR et al.; An indirect enzyme-linked immunosorbent assay (ELISA) using rigid polystyrene microtiter plates was adapted to detect specific gonococcal antibodies against outer membrane-complex antigens extracted from Neisseria gonorrhoeae . The concentration of antigen to obtain maximum coating of the well was 10 micrograms protein per millilitre . The optimal binding of the primary antibody and enzyme-conjugated antimmunoglobulin was achieved after 1 h at 37 degrees C . Under these conditions using gonococcal antisera, no cross-reactivity was observed with outer membrane antigens extracted from Neisseria meningitidis serogroups B, C, X, Y, and W135 . Neisseria meningitidis serogroup A demonstrated low levels of cross-reactivity . All the non-pathogenic Neisseria spp . tested were negative (absorbance value at 400 nm/30 min less than 0.15) . The reaction of immune serum against outer membrane complex absorbed to the microwells was completely inhibited with soluble-specific antigen but not with purified N . gonorrhoeae lipopolysaccharide . Quantitative inhibition permitted the measurement of low levels of antigen (0.5 microgram/ml) . The detection of N . gonorrhoeae antibody with ELISA is specific and highly sensitive. Infect Immun, 1978 Nov, 22(2), 350 - 8 Studies on gonococcus infection . XVI . Purification of Neisseria gonorrhoeae immunoglobulin A1 protease; Blake MS et al.; A protease which cleaves human immunoglobulin A1 (IgA1) has been purified from broth cultures of Neisseria gonorrhoeae . This IgA1 protease is produced by pilated and nonpilated gonococci throughout their growth cycles . A combination of ammonium sulfate precipitation, column chromatography, and either isoelectric focusing or affinity chromatography was utilized to obtain an enzyme preparation that showed approximately 3,800-fold purification and exhibited two bands (65,000 and 70,000 daltons) by analytical polyacrylamide electrophoresis in the presence of sodium dodecyl sulfate and reducing conditions . IgA1 protease activity is dependent on divalent cations and is heat labile . Detection and quantitation of IgA protease activity utilized an assay in which {125I}IgA1 is incubated with protease preparations and the cleavage products are analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Infect Immun, 1978 Nov, 22(2), 403 - 10 Comparison of antigenic heterogeneity of Neisseria gonorrhoeae strains by micro-immunofluorescence and serum bactericidal tests; Mark JA et al.; The antigenic heterogeneity of Neisseria gonorrhoeae strains was assessed by the micro-immunofluorescence (micro-IF) and the serum bactericidal tests . The micro-IF test verified the antigenic heterogeneity of nine strains received from the Center for Disease Control and placed them into immunotypes A and B . The serum bactericidal system also detected different antigenic determinants among the strains . Although the micro-IF and bactericidal assays did not correspond in each instance, the overall pattern of similarities and differences among these gonococcal strains was similar . The micro-IF pattern obtained with mouse antisera was identical to the pattern revealed with guinea pig antisera . Different colony type organisms showed similar sensitivity in the bactericidal test . The micro-IF test is a rapid technique for the immunotyping of N . gonorrhoeae and has the additional advantages of reproducibility and simplicity. Med Microbiol Immunol (Berl), 1978 Oct 20, 165(3), 163 - 8 {Serological confirmation of the two subspecies of Neisseria mucosa Véron et al . 1959 (author's transl)}; Berger U; The two subspecies of N . mucosa (subsp . mucosa, subsp . heidelbergensis) can be separated not only on the basis of pigment production, type of growth and enzymatic activities, but also by their antigenic composition . This could be demonstrated by the immunodiffusion with absorbed antisera. S Afr Med J, 1978 Oct 7, 54(15), 601 - 3 Antibiotic susceptibility of Neisseria gonorrhoeae isolated in Johannesburg; Robins-Browne RM et al.; The susceptibility of 175 clinical isolates of Neisseria gonorrhoeae to penicillin G, ampicillin, erythromycin, tetracycline and spectinomycin was determined . Almost one-fifth of strains were relatively resistant to penicillin G . Relative resistance to penicillin G was significantly correlated with resistance to ampicillin, tetracycline and erythromycin, but not with resistance to spectinomycin . No penicillinase-producing or spectinomycin-resistant strains were encountered in this study . The relevance of the findings to the management of gonococcal urethritis is discussed. Health Lab Sci, 1978 Oct, 15(4), 192 - 6 Gonorrhea card test: an agglutination test for uncomplicated gonorrhea; Kamei K et al.; An antigen extracted and purified from Neisseria gonorrhoeae B370, type 4, was employed to sensitize charcoal particles for use in an agglutination assay of human sera for antibodies that indicate active gonorrheal infection . The screening card test is more sensitive than the fluorescent gonorrheal test-heated (FGT-H), especially in men . A simple one-step absorption improved the specificity without reducing the sensitivity of the test. Br J Vener Dis, 1978 Oct, 54(5), 324 - 5 Unsuspected gonococcal infection in female patients; Jha PK et al.; Four hundred and ten female patients attending obstetric and gynaecological outpatient departments were investigated for possible gonococcal infection . All were in their reproductive phase . Forty-two (10.2%) of them harboured Neisseria gonorrhoeae . Of the infected patients, 40.5% had no symptoms at all . Investigation was carried out using a single, endocervical specimen cultured in Chacko-Nair egg-enriched media. Br J Vener Dis, 1978 Oct, 54(5), 341 - 3 Genital herpesvirus infection in women attending a venereal diseases clinic; Willmott FE et al.; Routine cervical viral cultures (and cultures from lesions if present) were performed on 2630 female patients attending a venereal diseases clinic over a period of four years . Of these patients 96 (3.7%) had genital herpetic infection; of these 23 (24%) were asymptomatic . The association of herpesvirus with other genital infections is considered, but no increase in the incidence of Neisseria gonorrhoeae, Trichomonas vaginalis, and genital warts was found; there was an increased incidence of Candida albicans . A significantly higher percentage of the patients with herpesvirus took oral contraceptives . The findings are discussed and compared with previous reports. Sex Transm Dis, 1978 Oct-Dec, 5(4), 158 - 9 Spectinomycin in the treatment of anal gonorrhea: a retrospective study; Felman YM et al.; The authors conducted a retrospective study of 125 male patients treated for anal gonorrhea with 4 g of spectinomycin in a social hygiene clinic . Of those treated, nine (7.2%) still had cultures positive for Neisseria gonorrhoeae when tested again five to 14 days after treatment. Health Lab Sci, 1978 Oct, 15(4), 206 - 9 Preservation and storage of pathogenic Neisseria; Cody RM; Pathogenic species of Neisseria, especially N . gonorrhoeae are notoriously difficult to maintain in a viable state for long storage periods . Frequent transfer of cultures on artificial media and storage at 4 to 8 C quickly leads to loss of viability and virulence and to changes in antigenicity . Freeze-drying has been reported as a convenient method for long-term storage of these organisms; however, many laboratories are not properly equipped to use this method . A simple, inexpensive, and efficient procedure is described for storage of N . gonorrhoeae or N . meningitidis for 12 and 18 months, respectively . Results of this work may provide the basis for an efficient method of transporting these organisms over long distances via mail. Sex Transm Dis, 1978 Oct-Dec, 5(4), 146 - 50 Gonorrhea in the homosexual man: frequency of infection by culture site; McMillan A et al.; The aims of this study were determine the frequencies of infection with Neisseria gonorrhoeae at various sites in homosexual men who were attending clinics for treatment of sexually transmitted diseases in central Scotland and to appraise the diagnostic tests used . Specimens for culture were taken from the urethra, pharynx, and anorectum of every homosexual man in the study . When the first cultures of pharyngeal and rectal specimens were negative, these cultures were repeated twice at weekly intervals . The urethra was infected in 169 (60.8%), the anorectum in 114 (41.0%), and the pharynx in 23 (8.3%) of 278 patients who had gonorrhea . By reliance on only one set of tests, eight (7.0%) of 114 patients who had rectal gonorrhoea and six (26.1%) of 23 patients with pharyngeal infection would have been missed . The results indicate the importance of obtaining specimens for culture from all sites that might possibly be infected, regardless of the symptoms. Sex Transm Dis, 1978 Oct-Dec, 5(4), 127 - 31 Auxotypes and antibiotic susceptibility patterns of Neisseria gonorrhoeae from disseminated and local infections; Thompson SE et al.; The arginine-hypoxanthine-uracil auxotype has been linked with the propensity of gonococci to cause disseminated infections . Gonococci recovered from 25 patients with disseminated gonococcal infections were compared with gonococci recovered from matched controls, patients with uncomplicated gonorrhea selected during the same month . Minimal inhibitory concentrations of penicillin, tetracycline, erythromycin, and ampicillin, and the nutritional requirements (auxotypes) for proline alone, arginine alone, arginine, hypoxanthine and uracil together, serine alone and cysteine-cystine (wild type) were analyzed by discriminant analysis . Significant susceptibility to penicillin characterized strains causing disseminated infection, and a proline requirement was the most common auxotype (48%) among strains isolated in Atlanta . Together the minimal inhibitory concentration of penicillin and the proline auxotype best separated the strains causing gonorrhea . The arginine-hypoxanthine-uracil auxotype was was found in only 24% of strains causing disseminated infections . A trait other than auxotype must determine the capacity of the organisms to disseminate. J Gen Microbiol, 1978 Oct, 108(2), 213 - 9 The surface properties of Neisseria gonorrhoeae: topographical distribution of the outer membrane protein antigens; Heckels JE; Gonococci were labelled with 125I using the lactoperoxidase system . The amount of label incorporated was similar with all strains including those which appeared capsulated . Electrophoresis on sodium dodecyl sulphate-polyacrylamide gels revealed that the major proteins labelled were those found in outer membrane preparations . Comparison of variants of one strain showed that the major outer membrane protein (protein I) was always present and heavily labelled . The second major protein (protein II) was present in variable amounts but labelling was proportional to the amount present . A third protein (III) was only present in outer membranes from a freshly isolated variant but was present in whole cells of each strain . Protein III was not labelled in whole cells but was labelled in outer membrane preparations suggesting that many membranes have their inner surface exposed . The labelling of a strain adapted to growth in guinea-pig chambers failed to reveal any new major surface proteins . The results demonstrate the variation in surface topography possible with variants of one strain of gonococcus but show that one major protein antigen is always expressed on the surface. J Gen Microbiol, 1978 Oct, 108(2), 205 - 12 The surface properties of Neisseria gonorrhoeae: determinants of susceptibility to antibody complement killing; Ward ME et al.; Monovalent rabbit antisera were prepared to highly purified gonococcal lipopolysaccharide (LPS), to pili and to two major purified outer envelope proteins . All these antisera were free from significant specific IgM antibody and were standardized to 4 microgram specific IgG antibody per test, permitting accurate comparisons between the different gonococcal surface antigens as triggers of the complement-dependent bactericidal reaction . LPS was the most effective antigen at inducing a bactericidal response to homologous and heterologous gonococci, followed by the two individual outer envelope proteins . Pili were relatively ineffective . Strain P9 gonococci grown in vivo or which possessed a 'capsule' in vitro were more resistant to serum killing than the non-capsulated parent strain . One highly susceptible strain, F62, which was killed by complement in the absence of any LPS antibody, was able to directly activate complement by the alternative pathway. Am J Med Technol, 1978 Oct, 44(10), 937 - 40 Evaluation of the Microcult-GC kit as a screening method for the detection of Neisseria gonorrhoeae; Sachs G et al.; The Microcult-GC Kit was compared to the standard modified Thayer-Martin plate method for the isolation and presumptive identification of Neisseria gonorrhoeae . Two hundred and thirty specimens representing urethral, endocervical, rectal, and pharyngeal sites were inoculated to both media . If only genital and rectal cultures were compared, the overall agreement was 98 percent, with a false positive rate of 1/145 (0.7 percent) and a false negative rate of 2/145 (1.4 percent) . However, in the pharyngeal cultures, 16 of 32 gave false positives, thus emphasizing the manufacturer's instructions to limit the kit's use to genital and rectal cultures . The kit system gives rapid presumptive results, has a long shelf life at room temperature, and needs little laboratory equipment for proper use. J Bacteriol, 1978 Oct, 136(1), 391 - 401 Cell envelope alterations in antibiotic-sensitive and-resistant strains of Neisseria gonorrhoeae; Guymon LF et al.; The cell envelopes of antibiotic-resistant and -sensitive isogenic strains of Neisseria gonorrhoeae were analyzed to determine whether acquisition of genetic loci for altered antibiotic sensitivity was accompanied by alterations in cell envelope composition . No differences in the composition of phospholipids and lipopolysaccharides were noted . Acquisition of mtr-2, which results in low-level, nonspecific increased resistance to multiple antibiotics, dyes, and detergents, was accompanied by a sevenfold increase in the amount of a minor, 52,000-molecular-weight outer membrane protein and a 32% increase in the extent of peptidoglycan cross-linking . Subsequent addition of the nonspecific hypersensitivity loci env-1 or env-2 to a strain carrying mtr-2 resulted in reversal of the phenotypic resistance determined by mtr-2 and marked reduction in both the amount of the 52,000-molecular-weight outer membrane protein and the extent of peptidoglycan cross-linking . Introduction of penB2, which results in a fourfold increase in resistance to penicillin and tetracycline, was accompanied by the disappearance of the principal outer membrane protein of the wild-type strain (molecular weight, 36,900) and the appearance of a new species of the principal outer membrane protein (molecular weight, 39,400) in the transformant. J Bacteriol, 1978 Oct, 136(1), 131 - 5 Arginine biosynthesis in Neisseria gonorrhoeae: enzymes catalyzing the formation of ornithine and citrulline; Shinners EN et al.; Many of the Neisseria gonorrhoeae strains isolated from patients require arginine for growth in a defined medium . As a basis for genetic studies of these Arg- strains, we examined two biosynthetic enzymes of Arg+ (nonrequiring) gonococci . Cell-free extracts contained (i) glutamate acetyltransferase, which catalyzes the formation of L-ornithine from alpha-N-acetyl-L-ornithine, and (ii) ornithine transcaramylase, which catalyzes the reaction between L-ornithine and carbamyl phosphate, yielding L-citrulline . Arg- strains were unable to utilze alpha-N-acetyl-L-ornithine for growth lacked significant activity of glutamate acetyltransferase, and activity was gained by Arg+ clones derived by DNA-mediated transformation . Some of the Arg- patient isolates were unable to use either alpha-N-acetyl-L-ornithine or L-ornithine in place of arginine, and two separate steps of genetic transformation were required to yield Arg+ cells . Extracts of these doubly auxotrophic cells lacked glutamate acetyltransferase activity, but, unexpectedly, they displayed normal ornithine transcarbamylase activity . This finding illustrates the importance of identifying the products specified by arg loci during genetic studies of arginine auxotrophy. Br J Vener Dis, 1978 Oct, 54(5), 316 - 21 In-vitro antimicrobial susceptibility of Neisseria gonorrhoeae in New Zealand; Green MJ; Four hundred and forty-two isolates of Neisseria gonorrhoeae were tested by an agar dilution method for their susceptibility to penicillin, ampicillin, tetracycline, cephaloridine, and spectinomycin . Of these isolates, 295 were tested for their susceptibility to sulphamethoxazole and to trimethoprim by the same method, using Oxoid diagnostic sensitivity test agar plus 7.5% laked horse blood instead of Proteose No . 3 agar plus 1% IsoVitaleX and 1% haemoglobin . One hundred (22.6%) of the isolates were found to be relatively resistant to penicillin (minimum inhibitory concentration (MIC) less than 0.1 iu/ml), but only 1.1% had a MIC of 1 iu/ml or higher . Ampicillin was slightly more active than penicillin in that all isolates were inhibited by 0.5 microgram/ml or less . For 3.7% of isolates the MIC of tetracycline was 2 microgram/ml or higher . All isolates were sensitive to spectinomycin . By calculating the Spearman rank correlation coefficient (rs), a high correlation (rs greater than 0.5) was found between susceptibility to penicillin and susceptibility to ampicillin, tetracycline, and cephaloridine . Low correlation (rs less than 0.2) was found between susceptibility to penicillin and susceptibility to spectinomycin, sulphamethoxazole, and trimethoprim. Br J Vener Dis, 1978 Oct, 54(5), 309 - 15 In-vitro activity of antimicrobial agents against Neisseria gonorrhoeae in Brussels; Vanhoof R et al.; The minimum inhibitory concentrations (MICs) of 18 antimicrobial agents against 104 strains of Neisseria gonorrhoeae isolated in the Brussels area between January and October 1976 have been measured . The MICs for penicillin G, ampicillin, amoxycillin, carbenicillin, and cephalexin showed a bimodal distribution . The second modus strains of cephalexin (MIC = 6.25 microgram/ml) were relatively resistant to penicillin G (MIC greater than or equal to 0.08 microgram/ml) . About 51% of all strains were relatively resistant to penicillin G, 40.5% to ampicillin (MIC greater than or equal to 0.16 microgram/ml), 46% to amoxycillin, and 47.5% to carbenicillin . For cephalexin and cephaloridine, 25% and 8.5% respectively of all strains were relatively resistant (MIC greater than 3.12 microgram/ml) . For cefazolin all MICs fell into a range of 0.097--3.12 microgram/ml . Resistance to tetracycline, doxycycline, minocycline, erythromycin, and spiramycin (MIC greater than or equal to 1 microgram/ml) was found in 9.5%, 7%, 6%, 36.5%, and 71% respectively of all isolates . No strains were resistant to rifampicin . For chloramphenicol and thiamphenicol the MICs ranged from 0.39 to 12.5 microgram/ml and from 0.195 to 3.12 microgram/ml respectively . The results for sulphamethoxazole, trimethoprim, and the combination of sulphamethoxazole and trimethoprim in a 20:1 ratio are given and discussed . The fractional inhibitory concentration (FIC) indices have also been calculated . No beta-lactamase-producing strains were found, and a contingency coefficient C has been determined for all the pairs of antibiotics investigated. JAMA, 1978 Sep 22, 240(13), 1360 - 1 Gonorrhea detection in posthysterectomy patients; Klaus BD et al.; A retrospective study of women examined at the Venereal Disease Clinic after hysterectomy was made to determine which culture site was most likely to show anogenital Neisseria gonorrhoeae infection when the cervix was absent . Seventeen of 104 such patients were culture positive for N gonorrhoeae . Rates of positivity for our culture sites were as follows: urethral, 17/17 (100%); vaginal, 7/17 (41%); and rectal, 2/17 (12%). Niger Med J, 1978 Sep, 8(5), 452 - 6 Aetiology of infertility in the Came Roune; Nasah BT; PIP: Involuntary infertility is a public health problem for couples in Africa where a suspected belt of low infertility stretches across Gabon, Cameroon, Peoples Republic of Congo, Central African Empire, Zaire, Uganda and Southern Sudan . No single factor has been isolated as the cause, however, secondary infertility is highly correlated with induced or spontaneous abortion . 388 patients were seen over a 2 year period in Cameroon . 149 were primary and 238 were secondary cases of infertility . Ages of patients ranged from 16-40 years . The majority of secondary cases had delivered their babies in private or public health facilities . It was hypothesized that an infection was contracted in the hospital . Puerperal infection was studied at the Central Maternity in Younde . Neisseria gonorrhoea was found to be 25% incidence, high enough to be considered an epidemic . Improved facilities for diagnosis and neonatology, particularly the prevention of prematurity, are needed . Women in Cameroon are more afraid of infertility than of cancer . Bull Tokyo Med Dent Univ, 1978 Sep, 25(3), 181 - 7 Neisseria in early stage of dental plaque; Horikawa T et al.; Neisseria in the early stage of dental plaque was studied . Two hundred seventeen strains of Neisseria were isolated from the 12-hour plaque of 9 subjects by using lactose-agar . The isolated strains were divided into 6 major groups with biological characteristics . One hundred twenty-one strains (56%) produced glycogen-like polysaccharide from sucrose . They were divided into 3 groups . Groups 1 and 2 were identified as N . mucosa and N . sicca, respectively . There were 106 strains of N . sica, being the most predominant of the species . The number of strains not producing polysaccharide was 96 (44%) . Groups 4 and 5 were Branhamella and N . subflava . The absorption spectra of the ethanol extracts of the pigment in each group were similar and this result supported propriety of the classification by biological characteristics . The adhesiveness of Neisseria to the glass plate was examined . Approximately one-half of N . sica showed an adhesion capacity. Infect Immun, 1978 Sep, 21(3), 879 - 85 Glycoproteins of natural origin with an affinity for hepatitis B surface antigen; Millman I et al.; Sera from certain animal species contain a substance(s) which binds hepatitis B surface antigen . The hepatitis B binding substance found in animals is not antibody, but appears to be a glycoprotein which reacted with antigen-coated beads and produced a "false positive" test for antibody . This glycoprotein could be selectively and quantitatively removed by reaction with purified hepatitis B surface antigen and centrifugation . Pili fractions isolated from Neisseria gonorrhoeae and Escherichia coli bound to hepatitis B surface antigen and produced false positive anti-hepatitis B surface antigen reactions . Mouse anti-bovine hepatitis B binding substance and rabbit anti-E . coli pili were capable of neutralizing bovine hepatitis B binding substance. Ann Sclavo, 1978 Sep-Oct, 20(5), 671 - 4 {Sensitivity to antibiotics of the "Neisseria meningitidis" strains isolated among healthy subjects (author's transl)}; Cuccia I et al.; In 1977, from March through April, 16 strains of N . meningitidis were isolated among 400 healthy subjects: 334 school-children 6-11 years of age and 66 adults, with a carrier rate of 3.85% and 4.5% respectively . The serological identification carried out by slide agglutination showed: 1 strain belonging to serogroup A; 4 strains to serogroup B; 1 strain to serogroup C; 1 strain to serogroup Y; 3 strains were autoagglutinable and 5 nonagglutinable . Minimum inhibiting concentrations of sulfamethoxypyrazine and some antibiotics (penicillin, streptomycin, rifampicin, chloramphenicol, chlortetracyclin) were determined for 12 strains . All the isolates were inhibited by a concentration of rifampicin of 0.2 microgram/ml, whereas 2 strains were resistant, respectively, to 0.8 UI/ml of penicillin (M.I.C . greater than 0.8 less than or equal to 1 UI/ml) and to 4 UI/ml (M.I.C . greater than 4 less than or equal to 6 UI/ml) . Various levels of resistance to sulfamethoxypyrazine and other antibiotics were also noted. Infect Immun, 1978 Sep, 21(3), 918 - 24 Effects of iron and culture filtrates on killing of Neisseria gonorrhoeae by normal human serum; Norrod P et al.; Neisseria gonorrhoeae GC9, both colony types T2 and T4, were killed by normal human serum, although populations of colony type T4 were more susceptible . Ferric ammonium citrate prevented the killing of populations of both T2 and T4 colony types . Other iron compounds tested showed no protective effect, nor did ammonium citrate or the divalent cations magnesium or calcium . A filtrate from cultures of an N . gonorrhoeae strain grown in a liquid defined medium showed a similar protective effect in the serum assay . The filtrate appeared to chelate iron, as measured by decreased ability of iron-free transferin to bind iron in the presence of the filtrate . However, the two effects did not appear to be related . Neither ferric ammonium citrate nor the culture filtrate sufficiently inactivated complement to account for protection. Am J Clin Pathol, 1978 Sep, 70(3), 333 - 6 A comparison of genital infections caused by chlamydia trachomatis and by neisseria gonorrhoeae; Smith TF et al.; Patients with culture-proven infections with Neisseria gonorrhoeae or Chlamydia trachomatis, or both, seen at the Olmsted County Health Department Sexually Transmitted Disease Clinic were evaluated for the presence of dysuria and exudate . Eighty-four patients (21%) had neither symptom . N . gonorrhoeae infection alone was most frequent (47%), but C . trachomatis predominated in men . Dysuria was most often detected in men infected with C . trachomatis, but exudate was most frequently found in men infected with N . gonorrhoeae alone or in mixed infections with C . trachomatis . The presence of both symptoms was more common in men than in women infected with N . gonorrhoeae or C . trachomatis . However, as the occurrence of dysuria and exudate was generally similar within the male and female groups, regardless of the organisms recovered, the type of infection cannot be accurately determined on the basis of symptomatology alone . The authors therefore believe that the diagnosis of genital infection by C . trachomatis or N . gonorrhoeae, or both, by culture technics is essential because effective treatment with antimicrobial therapy often requires this information. J Infect Dis, 1978 Sep, 138(3), 333 - 9 Studies on the relationships between serum bactericidal activity and uncomplicated genital infections due to Neisseria gonorrhoeae; Brooks GF et al.; This report concerns the relationships between patients' uncomplicated genital infections due to Neisseria gonorrhoeae and the bactericidal activity of their sera against their infecting organisms . Forty isolates of N . gonorrhoeae and 91 serum samples were obtained from 23 patients with their first or repeated gonococcal infections . Of 32 sera obtained at the time of infection, 14 (44%) were bactericidal for the infecting strains . Of convalescent-phase sera from 27 infections, 12 (44%) were bactericidal; 22%-33% of convalescent-phase sera had increased bactericidal activity when compared with acute-phase sera or sera obtained before infection . Eleven patients developed 17 new infections after sera and negative cultures were obtained; in six (35%) the previously obtained sera were bactericidal but did not prevent infection. J Infect Dis, 1978 Sep, 138(3), 319 - 5 Antigen-specific serotyping of Neisseria gonorrhoeae . I . Use of an enzyme-linked immunosorbent assay to quantitate pilus antigens on gonococci; Buchanan TM; Purified pili from Neisseria gonorrhoeae were used in an enzyme-linked immunosorbent assay (ELISA) to quantitate human or rabbit antibodies to pili; amounts of pilus antigen on different gonococci were quantitated, and yields of pili during purification were determined in ELISA by the degree of inhibition of optical density . The amount of pilus antigen expressed on the surface of colony type 1 or 2 gonococci of three different strains varied from 450 to 9,000 ng/600 microliter of a 200-Klett unit suspension . The quantity of pilus antigen was correlated directly with the extent of piliation as determined by electron microscopy . No pilus antigen was found by ELISA in colony type 4 organisms (devoid of pili) of three different strains . No more than 10% shared antigenicity was observed for antigenically different pili . Present purification procedures for gonococcal pili provide a yield of approximately 15% . ELISA may allow better evaluation and quantitation of the potential roles of antibody to pili in the killing or opsonization of gonococci or in the inhibition of gonococcal attachment to human cells. Can Med Assoc J, 1978 Aug 12, 119(3), 223 - 8 Cross-Canada survey of susceptibility of Neisseria gonorrhoeae isolates to six antimicrobial agents; Dillon JR et al.; The minimum inhibitory concentrations (MIC's) of penicillin, ampicillin, tetracycline, erythromycin, spectinomycin and sulfadiazine were determined for 732 isolates of Neisseria gonorrhoeae collected in 1973-74 . Comparison of the results of this survey with data from other Canadian studies showed that the percentage of isolates resistant to tetracycline had not changed since 1966, but that the percentage of erythromycin-resistant isolates had decreased . After an initial increase in 1966 the percentage of penicillin-resistant isolates stabilized . Spectinomycin-resistant isolates were not found . Positive correlations were observed between the MICs of the antibiotics tested; the highest positive correlations were between penicillin and ampicillin and between penicillin and tetracycline . A positive correlation was also noted between penicillin resistance and increasing spectinomycin MICs . Finally, a significant seasonal variation in MICs was found, the trend being towards increasing MICs during the summer. Br J Vener Dis, 1978 Aug, 54(4), 243 - 6 Talampicillin and probenecid compared with ampicillin and probenecid for the treatment of gonococcal urethritis in men; Al-Egaily S et al.; Two hundred and ten men suffering from uncomplicated gonococcal urethritis were treated with one of two treatment schedules . Of 109 patients treated with 3 g ampicillin and 2 g probenecid (group A) there were two recurrences in the first week after treatment and none in the second week . Of 101 patients treated with 1.5 g talampicillin and 2 g probenecid (group B), there were three recurrences in the first week and none in the second week . Both antibiotics were well tolerated, but one patient vomited two hours after taking talampicillin . The sensitivity pattern of Neisseria gonorrhoeae to penicillin at The London Hospital has shown an increase in the proportion of more sensitive strains during the last three years . Talampicillin given in a single dose with probenecid is satisfactory in the treatment of acute gonococcal urethritis but, apart from the smaller dosage, it does not offer any advantage over ampicillin with probenecid. Br J Vener Dis, 1978 Aug, 54(4), 229 - 34 Lymphocyte reactivity in patients with gonococcal urethritis; Rosenthal L et al.; Lymphocyte reactivity to virulent gonococcal antigen T2 and the non-pathogenic Neisseria pharyngis (NPN) has been studied by using the 14C-thymidine uptake in cell cultures from 42 patients with gonococcal urethritis and from 18 controls . The DNA synthesis in cell cultures with T2 antigen was higher in 21 female patients than in the 18 controls . No differences in DNA synthesis were observed in antigen-stimulated cell cultures from patients with single or multiple infections, from patients with urogenital complication, or from controls . Gonococcal antibodies in the serum were detected by the gonococcal complement-fixation test (GCFT) . A study of the possible correlation between the outcome of the serological test and the cellular response to gonococcal antigen showed that 14C-thymidine uptake in lymphocyte cultures from male patients with negative GCFT, stimulated with T2 antigen, was much lower than the thymidine uptake in stimulated cell cultures from all the other male and female patients (P less than 0.001) . The DNA synthesis was higher in cell cultures from seronegative women than from seronegative men (P less than 0.01) . A significant difference (P less than 0.01) was also noted in the lymphocyte reactivity to gonococcal antigen between controls and all patients, except in those men who gave negative results to the serological tests . There were no differences between these two groups with respect to the thymidine uptake in NPN-stimulated cell cultures. Infect Immun, 1978 Aug, 21(2), 575 - 84 Studies on gonococcus infection . XV . Identification of surface proteins of Neisseria gonorrhoeae correlated with leukocyte association; King GJ et al.; Neisseria gonorrhoeae which exhibit high levels of leukocyte association have a surface protein which is considerably diminished in isogenic gonococci which exhibit low levels of leukocyte association (LA) . The LA protein exhibits strain variation in molecular weight and immunogenicity . Membranes derived from LA+ and LA- organisms show quantitative differences in their adsorption to leukocytes; these differences are analogous to those found for the intact organisms regarding their association with leukocytes. J Clin Microbiol, 1978 Aug, 8(2), 260 - 1 Identification of Neisseria gonorrhoeae from primary cultures by a slide agglutination test; Malysheff C et al.; Hen antigonococcal lipopolysaccharide hen serum was used in a simple slide agglutination test for the identification of Neisseria gonorrhoeae from primary isolates. Obstet Gynecol, 1978 Aug, 52(2), 161 - 4 The bacterial pathogenesis of acute pelvic inflammatory disease; Cunningham FG et al.; To study the bacterial pathogenesis of acute pelvic inflammatory disease, peritoneal fluid was obtained by culdocentesis in 133 of 344 women with this disease . In 104 of the specimens bacteria were identified both in the gram-stained smear and culture . Neisseria gonorrhoeae was isolated from the lower genital tract in over half of these women, and there were 3 patterns of bacterial recovery from peritoneal fluid: N gonorrhoeae alone (22%), N gonorrhoeae and other organisms (32%), and nongonococcal organisms alone (46%) . In women without cervical gonorrhea only nongonococcal organisms were identified from peritoneal fluid . In both groups of women a similar number of nongonococcal organisms were isolated . The results of this study supported those reported prior to availability of antimicrobials and suggest that N gonorrhoeae initiates most cases of pelvic inflammatory disease . A significant number of these women have superinfection with nongonococcal organisms which may preclude recovery of gonococci. J Lab Clin Med, 1978 Aug, 92(2), 211 - 20 Serum bactericidal action and activation of the classic and alternate complement pathways by Neisseria gonorrhoeae; Ingwer I et al.; In order to more fully understand the host defense mechanisms against gonococcal infections, we decided to define the role of the classic and alternate complement pathways in gonococcal BA . Sera and infecting isolates were collected from several patients with genital and disseminated gonococcal infections . Sera from two never-infected subjects and a hypogammaglobulinemic patient were also collected . Sera from patients with genital gonorrhea and never-infected controls demonstrated marked BA for gonococci after 30 min incubation . Chelation of these sera with MgEGTA delayed the expression of BA . Consumption of C3, but not C4, was observed in chelated samples . BA could not be demonstrated in any of the sera from DGI patients or the patient with hypogammaglobulinemia . Aliquots of fresh and chelated hypogammaglobulinemic serum to which IgM or IgG antigonococcal antibodies were added showed marked BA by 30 and 60 min, respectively . Absorption of chelated serum with a serum-sensitive isolate eliminated the previously observed delayed BA . The findings suggest that gonococcal serum BA is primarily associated with activation of the classic complement pathway . Activation of the alternate pathway also occurs; however, its expression is delayed and appears to be antibody-dependent. J Infect Dis, 1978 Aug, 138(2), 160 - 5 Phenotypic and epidemiologic correlates of auxotype in Neisseria gonorrhoeae; Knapp JS et al.; Previous studies from Seattle, Wash., suggested that strains of Neisseria gonorrhoeae which require arginine, hypoxanthine, and uracil (Arg-Hyx-Ura- auxotype) are unifomly highly susceptible to penicillin G, are relatively resistant to complement-dependent killing by heated, pooled human serum, and are associated with disseminated gonococcal infection . For further study of the epidemiology of these strains and for analysis of the susceptibility to penicillin, serum sensitivity, and the nutritional requirements of gonococcal isolates from other cities, a survey was made of urethral and cervical strains isolated in 1972--1974 from 50 randomly selected pateit-s with uncomplicated gonorrhea from each of nine cities . Arg-Hyx-Ura-strains represented greater than 50% of isolates from Seattle and Des Moines, Iowa, 22% of isolates from Denver, Colo., and Dayton, Ohio, and less than or equal to 12% of the isolates from Boston, Mass., Newark, N.J., Norfork, Va., Miami, Fla., and Oakland, Calif . Arg-Hyx-Ura- strains were recovered from 42% of white and 9% of black patients (P less than 0.001), and clincis with the highest incidences of these strains had the highest proportion of white patients among those with gonorrhea . Arg-Hyx-Ura- strains were all susceptible to less than or equal to 0.125 microgram of penicillin G/ml and were more resistant than strains with other auxotypes to killing by heat-inactivated human serum plus complement (P less than 0.001). Br J Vener Dis, 1978 Aug, 54(4), 239 - 42 Effects of various divalent cations on the survival of Neisseria gonorrhoeae in liquid media; Odugbemi T et al.; The effect of various concentrations of divalent cations on survival of gonococci in liquid medium was studied . The growth of Neisseria gonorrhoeae was inhibited by manganous chloride in concentrations above 1 X 10(-5)mol/l while the growth of control organisms such as Neisseria meningitidis and Escherichia coli was not inhibited by the same salt even at 1 X 10(-2)mol/l . Copper sulphate, cobaltous nitrate, nickel chloride, and zinc sulphate also had deleterious effects on gonococci . Magnesium chloride at 1.5 X 10(-1)mol/l permitted the growth of gonococci . The toxicity of manganous chloride and copper sulphate in the liquid media was in some measure reduced by adding charcoal but not by adding starch . The significance of these findings is discussed in relation to the efficiency of primary isolation and transport media for gonococci. Br J Vener Dis, 1978 Aug, 54(4), 235 - 8 Genital inoculation of male Macaca fascicularis with Neisseria gonorrhoeae and Ureaplasma urealyticum; Bowie WR et al.; Inoculation of the urethra, conjunctiva, pharynx, and anal canal of six male crab-eating macaques (Macaca fascicularis) with urethral exudate from male patients with urethral gonorrhoea or with laboratory gonococcal strains was unsuccessful in establishing infection or producing increased polymorphonuclear leucocytes on Gram stain . Intraurethral inoculation with laboratory strains of Ureaplasma urealyticum resulted in transiently positive urethral cultures for U . urealyticum and was associated in some cases with increased numbers of polymorphonuclear leucocytes on Gram stain of urethral material . The findings suggest that the crab-eating macaque may be useful for studying the pathogenesis of urethral infection with U . urealyticum. Infect Immun, 1978 Jul, 21(1), 292 - 302 Studies on gonococcus infection . XIV . Cell wall protein differences among color/opacity colony variants of Neisseria gonorrhoeae; Swanson J; Gonococci from colonies exhibiting optical opacity and dark coloration have surface proteins that are not visualized in isogenic transparent, light-colored colony forms . These "colony opacity-associated proteins" have apparent molecular weights varying from 24,000 to 30,000 by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate; their apparent molecular weights are independent of that for their major outer membrane protein . The opacity-associated proteins are more susceptible to hydrolysis by trypsin than is the major outer membrane protein, but gonococci possessing the opacity-associated protein(s) also show enhanced susceptibility of their major outer membrane proteins to the action of trypsin . These conclusions were reached by comparing the electrophoretic patterns of whole-cell lysates from both "laboratory strains" and several recent clinical isolates of Neisseria gonorrhoeae. J Bacteriol, 1978 Jul, 135(1), 283 - 5 Prevention of autolysis in suspensions of Neisseria gonorrhoeae by mercuric ions; Peetz RH et al.; Mercuric ions were the only metal ions which prevented autolysis of Neisseria gonorrhoeae, as measured both by stabilization of optical density and by prevention of release of {3H}diaminopimelic acid. Infect Immun, 1978 Jul, 21(1), 87 - 95 Effect of pH on the growth and glucose metabolism of Neisseria gonorrhoeae; Morse SA et al.; This study examined the effect of pH on the metabolism of glucose by Neisseria gonorrhoeae . Radiorespirometric studies revealed that cells growing at pH 7.2 or 8.0 metabolized glucose primarily (ca . 80%) via the Entner-Doudoroff pathway . The remainder of the glucose was metabolized via the pentose phosphate pathway (ca . 20%) . The tricarboxylic acid cycle was not active during glucose catabolism at either pH 7.2 or 8.0, and acetate accumulated in the medium . Cells growing at pH 6.0 had markedly increased pentose phosphate pathway activity (ca . 50%) and a functioning tricarboxylic acid cycle . The alteration in pathways was not due to differences in growth rate, but to the pH of the medium . Chemical fractionation of labeled cells and total hexose analyses revealed that growth pH markedly affected the composition of the gonococcus. Br J Vener Dis, 1978 Jun, 54(3), 160 - 4 Studies on Neisseria gonorrhoeae cultured in liquid medium; Eaves JA; Experiments were carried out to determine the minimum amount of inoculum of gonococci that is needed to produce growth in ANM liquid medium . This was found to be less than had previously been thought . Minimum inocula were used to study penicillin sensitivity in liquid medium . This work showed that growth occurred at higher concentrations of penicillin with larger inocula . Evidence was also obtained which suggested that in some circumstances penicillin acts bacteriostatically rather than bacteriocidally . It was also shown that growth of gonococci can be inhibited in liquid medium by the presence of hyperimmune serum, the inhibition being more marked in the presence of fresh complement . This work is continuing in the hope that it may provide a basis for a much-needed serological test for gonorrhoea . This would be especially valuable in chronic assymptomatic infections. Zentralbl Bakteriol {Orig A}, 1978 Jun, 240(4), 480 - 8 {Fluorescent antibody technique in identification of Neisseria gonorrhoeae-microcolonies grown on membrane filters (author's transl)}; Blenk H et al.; Filter membranes (Nucleopore, No . N060, CPR 01300, pore size 0.6 mu) are inoculated with a pure suspension of N . gonorrhoeae or a Urethral smear from patients suffering from gonococcal urethritis . The membranes are placed on chocolate agar and incubated for three hours . After fixation in formaldehyd, grown microcolonies of N . gonorrhoea are detected microscopically after incubation of the membranes with a fluorescein-isothiocyanate labeled gonococcal antiserum (Difco, charge no . 605907) (Fig . 3--5) . The high specificity of the antiserum was shown by lack of reaction with various other neisseriae (except for N . meningitidis, which showed a weak positive reaction) or other bacteria, respectively (table 1) . To investigate the reliability of the new method urethral smears of 23 patients suffering from acute or chronic gonorrhoea were examined by culturing for gonococci in the conventional way and by means of the new technique . In all cases gonocococci were detected with both methods . This suggests that the fluorescent antibody technique has at least the same sensibility as the conventional one, and has the advantage that the result is obtained within one day. Infect Immun, 1978 Jun, 20(3), 732 - 8 Quantitative measurement of phagocytosis of Neisseria gonorrhoeae by mouse peritoneal macrophages; Jones RB et al.; The simultaneous labeling of gonococci with {6-3H}uracil and of mouse peritoneal macrophages with L-{U-14C}leucine permits a quantitative assessment of the association of gonococci with macrophages under various experimental conditions . Colony-type T1 (piliated) gonococci associated more than T4 (nonpiliated) organisms at 4 degrees C, but at 37 degrees C the association of T4 gonococci with macrophages exceeded that for the T1 organisms . The association of T1 gonococci with macrophages could be enhanced as much as 70-fold by homologous rabbit antisera prepared against whole, formaldehyde-treated organisms . This immune enhancement represented primarily increased phagocytosis rather than surface attachment, as shown by its inhibition at 4 degrees C or with 2-deoxyglucose . The data further suggested that this enhanced phagocytosis was mediated via the Fc receptor for immunoglobulin G. J Bacteriol, 1978 Jun, 134(3), 1179 - 80 N-Terminal amino acid sequence of pilin isolated from Pseudomonas aeruginosa; Paranchych W et al.; The amino-terminal amino acid sequence of the pili protein from Pseudomonas aeruginosa K pili is presented . The sequence is compared with those reported by others for pilin obtained from Neisseria gonorrhoeae and Moraxella nonlique-faciens . All three sequences are highly homologous, contain only two hydrophilic residues in the first 22 positions, and contain an unusual amino acid, N-monomethylphenylalanine, at the amino terminus. Med Trop (Mars), 1978 May-Jun, 38(3), 331 - 49 {Present evaluation of hansenian treatment by association of chemotherapy and immunostimulation (author's transl)}; Saint-Andre P et al.; I.--Treatment with BCG and DDS in lepromatous or borderline patients . II.--Value of BCG added to a prior and long-continued treatment with DDS or rifamipicine . III.--Value of various immunostimulants given previously to a treatment with BCG and chemotherapy . IV.--Value of lysate of Neisseria perflava as an immunostimulant associated with DDS in an initial treatment of lepromatous and borderline patients . V.--Results of a seventeen months treatment of lepromatous and borderline patients with a lysate of Neisseria perflava associated with DDS . The various therapeutic trials reported in these 5 papers demonstrate that hansenian nevritis conventionnally treated may show improvement when an immunostimulant (BCG or bacterial lysate or levamisole) is given either previously or in association with DDS or rifampicine or after such a treatment . It has still been observed that two immunostimulants given simultaneously have no good effect and that this association must be discarded. Can J Microbiol, 1978 May, 24(5), 579 - 85 Characterization of the mitogenic activity elicited by Neisseria gonorrhoeae ribosomal fractions; Brodeur BR; Ribosomal preparations from Neisseria gonorrhoeae types 1 and 4 were examined for their in vitro stimulation of mouse splenocytes to determine the ribosomal moiety or contaminant responsible for the immunoproliferative activity . In immunodiffusion tests with homologous rabbit antiserum, crude 70S ribosomes formed four precipitin bands while the purified 30S and 50S subunits showed one major line . The same antiserum reacted with lysed N . gonorrhoeae and Neisseria meningitidis A cells but no precipitation occurred with Escherichia coli cells purified N . gonorrhoeae lipopolysaccharide (LPS) . No membrane or LPS contaminant was detected in the purified 30S and 50S preparations . All the ribosomal preparations from virulent and non-virulent N . gonorrhoeae consistently stimulated the murine splenocytes . The mitogenic activity of the 30S and 50S ribosomal preparation was destroyed by treatment with trypsin but only slightly decreased by ribonuclease . It is suggested that the lymphoproliferative response elicited by gonococcal ribosomes is triggered by the protein moiety of the 30S or 50S subunits. J Gen Microbiol, 1978 May, 106(1), 129 - 36 The effect of specific antiserum on the resistance of Neisseria gonorrhoeae to intracellular killing by phagocytes of human blood; Veale DR et al.; The high natural resistance of gonococci showing a characteristic 'double highlight' (DH) colonial morphology (Penn, Veale & Smith, 1977b) to intracellular killing by human phagocytes was markedly reduced by addition of rabbit antiserum to the phagocytosis medium or by preincubation of organisms with antiserum . Antisera raised to three different DH gonococcal strains showed a complex pattern of specificity in phagocytosis tests with the homologous organisms and three other DH strains . The effect of antiserum could be neutralized by adsorption with intact organisms or with extracts, prepared ultrasonically, of the homologous strain . Antiserum also promoted the intracellular killing of a strain which had a 'single highlight' colonial morphology (Penn et al., 1977b) and a low natural resistance to phagocytic killing, but adsorption with this strain neutralized the antiserum less consistently than the DH strain . The neutralization of antiserum-mediated promotion of intracellular killing by extracts of organisms naturally resistant to such killing may provide an assay for the aggressins responsible for this resistance. J Infect Dis, 1978 May, 137(5), 568 - 72 Microflora of the cervix during normal labor and the puerperium; Thadepalli H et al.; The normal flora of the cervix was studied in 50 healthy women in labor and on the third day postpartum . Aerobic bacteria were the exclusvie isolates in 25% of these women, and 75% had anaerobic bacteria in addition to aerobes . Anaerobes were always found in association with aerobes . The most frequent isolate of Bacteroides was Bacteroides melaninogenicus, found in 20% of the women during labor and 14% during the puerperium . Bacteroides fragilis was distinctly absent during labor but was found in 6.8% of the women during the puerperium . Clostridia were found in 1% but histotoxic clostridia were not found . None had gram-negative diplococci (Neisseria or Veillonella) . Gram-negative diplococci and spore-bearing bacilli visible by gram strain and B . fragilis demonstrated by culture, if present in the cervical specimens obtaineduring labor, should be considered abnormal. JACEP, 1978 May, 7(5), 186 - 91 Management and microbiology of cutaneous abscesses; Meislin HW et al.; Cutaneous abscesses in the perineal region contain primarily anaerobes commonly found in stool . Non-perineal abscesses contain mixed microflora indigenous to the skin . Bacteroides fragilis, the only anaerobe resistant to penicillin, is found predominantly in the perineal area . Staphylococcus aureus, although the most common aerobe found, is seen less frequently than expected and is almost always resistant to penicillin . Escherichia coli and Neisseria gonorrhoeae are rarely found . Incision and drainage is the primary mode of treatment . Fever is rare, though tachycardia is common in patients with normal host defenses . Patients with altered host defenses may require initial culture and Gram-stained smear to determine appropriate antibiotic therapy . The Gram-stained smear reliably indicates sterile and mixed abscesses, as well as those containing pure S aureus . Incision and drainage alone is the only therapy required in the usual patient . Since in these patients antibiotics are not required, initial culture and Gram-stained smear are unnecessary. J Bacteriol, 1978 May, 134(2), 537 - 45 Effects of selected inhibitors on electron transport in Neisseria gonorrhoeae; Kenimer EA et al.; The electron transport system of Neisseria gonorrhoeae was partially characterized by using spectrophotometric, spectroscopic, and oxygen consumption measurements . The effects of selected electron transport inhibitors (amytal, rotenone, 2-heptyl-4-hydroxyquinoline, antimycin A1, and potassium cyanide {KCN}) on electron transfer in whole-cell and sonically treated whole-cell preparations of N . gonorrhoeae were examined . The oxidation of reduced nicotinamide adenine dinucleotide, measured as a decrease in absorbance at 340 nm, was inhibited by each of the compounds tested . Oxygen consumption stimulated by reduced nicotinamide adenine dinucleotide was also inhibited, whereas oxygen uptake stimulated by succinate and malate was inhibited by KCN alone, suggesting the presence of a KCN-sensitive terminal oxidase . Room temperature optical difference spectra indicate an operational electron bypass around the amytal-rotenone-binding site . Difference spectra in the presence of 2-heptyl-4-hydroxyquinoline suggest a possible site of interaction of this compound at the substrate side of cytochrome b . Reduced-minus-oxidized spectra of ascorbate-tetramethyl-p-phenylenediamine suggest the participation of b-, a-, and d-type cytochromes in terminal oxidase activity . Hence, N . gonorrhoeae appears to have an electron transport chain containing cytochrome c, two b-type cytochromes (one of which has an oxidase function), and possibly a- and d-type cytochromes . An abbreviated chain exists through which succinate and malate can be oxidized directly by a KCN-sensitive component. Infect Immun, 1978 May, 20(2), 573 - 4 Role of iron in disseminated gonococcal infections; Payne SM et al.; Strains of Neisseria gonorrhoeae isolated from disseminated gonococcal infections have enhanced ability to acquire iron in an experimental host when compared with urogenital gonococcal isolates from patients with uncomplicated infections. J Clin Microbiol, 1978 May, 7(5), 470 - 3 Identification and grouping of Neisseria meningitidis directly on agar plates by coagglutination with specific antibody-coated protein A-containing staphylococci; Zimmerman SE et al.; It has been shown that Neisseria meningitidis can be grouped by coagglutination directly upon growth on sheep blood or chocolate agar plates . All positive reactions were group specific, and only a single colony was required for a positive reaction . There was variation seen in the effectiveness of commercial antisera in preparing sensitive reagents . Certain throat and sputum isolates of group Z organisms failed to react by coagglutination, although they would react directly with antiserum in whole-cell agglutination . This problem remains unresolved but may not be greatly significant in laboratory use of this method since group Z is rarely associated with disease. J Clin Microbiol, 1978 May, 7(5), 415 - 8 Identification of some basic extractable compounds produced by Neisseria gonorrhoeae and Neisseria meningitidis in a defined medium; Brooks JB et al.; Electron capture gas-liquid chromatography and mass spectrometry have been used to identify some of the basic extractable heptafluorobutyric anhydride reactive compounds found in a defined medium after 20 h of growth by Neisseria gonorrhoeae and N . meningitidis . Acetoin, 2,3-butanediol, pyrroline, and 1,3-diaminopropane were identified by both gas chromatography and mass spectrometry; 2-hydroxy-pyrrolidine and 3-aminomethyl-pyrrolidine were tentatively identified by mass spectrometry . A possible origin of the amines is through enzymatic oxidation of polyamines. Infect Immun, 1978 May, 20(2), 418 -