Zentralbl Chir, 1995, 120(6), 417 - 25 {Can selective decontamination of the digestive tract as a routine procedure on intensive care units be recommended?}; Spath G; After giving an overview on the epidemiological and microecological background, the applicable drugs, and the necessary microbiological surveillance for Selective Decontamination of the Digestive tract (SDD), the results of 2 new metaanalyses of 22 and 25 individual randomized studies are discussed . A 50%-reduction of the pneumonia incidence results in an only marginal reduction of the mortality rate in the subgroup of topically plus for the first few days systemically treated patients in mixed intensive care units . Facing the weak prognostic relevance of ventilator pneumonia, the reduction of microbial translocation from the lower GI tract as a major goal for SDD is discussed . The chance and the need to confirm a mortality benefit in multicentre trials enrolling large numbers of homogeneous surgical patients are explained . At the present time, SDD as a routine can not (yet) be recommended. Pneumonol Alergol Pol, 1995, 63(1-2), 8 - 13 {Diagnosis of Mycobacterium tuberculosis infections using PCR methods}; Rylski M et al.; This study is the first application of molecular-genetic methods for diagnosis of Mycobacterium tuberculosis in Poland . Polymerase chain reaction (PCR) with primers targeted to insertion sequence-like element 6110 (IS6110) was used in the examination of sputum from 60 patients (30 with tuberculosis and 30 with other respiratory tract diseases) . Results obtained by PCR were compared to microbiological methods (fast-acid staining, culture) and clinical examination . We found a 100% specificity of PCR. Mycoses, 1995, 38 Suppl 1, 51 - 4 {Mycotic complications in patients with chronic liver diseases and pancreatitis}; Knoke M et al.; We studied 15 patients with mostly alcoholic liver diseases and 25 patients with acute or chronic pancreatitis with regard to occurrence of yeasts in different microbiological samples and corresponding serological findings . In about a half of the patients with liver diseases yeast counts and serological titres were already raised in the first mycological investigation . Patients with pancreatitis, however, showed only little or negative cultural and serological results . This changed during the course of disease, where they developed significantly higher yeast counts and serotitres . Finally two case reports are presented: two patients with infected pancreatic pseudocysts (including a case of aspergillosis) . CONCLUSIONS: in patients with decompensated chronic liver diseases an early search for mycological complications is recommended . In pancreatic diseases these complications are rather seen later in the course of the disease, especially under intensive care conditions . Therefore, we encourage surveillance cultures and control of serotitres in these patients. J Med Assoc Thai, 1995 Jan, 78(1), 18 - 21 The treatment of chronic suppurative otitis media and otitis externa with 0.3 per cent ofloxacin otic solution: a clinico-microbiological study; Supiyaphun P et al.; .3 per cent ofloxacin solution has been studied widely and has been proved to be safe in both animal and human studies . Ototoxicity and hair cell damage were not found in animal experiments . Ototopical treatment in both pediatric and adult patients was proved to be safe in previous studies . P . aeruginosa and S . aureus play the major role in both CSOM and OE, and most causative pathogens are susceptible to ofloxacin . This study showed that the use of 0.3 per cent ofloxacin otic solution was safe in both children and adults and yielded excellent clinical results. Acta Microbiol Immunol Hung, 1995, 42(1), 39 - 44 Epifluorescent microscopy of earthworms' intestinal bacteria; Kristufek V et al.; Epifluorescent microscopy was employed to compare the bacterial live counts (BC) in the gut of two earthworm species Aporrectodea caliginosa and Lumbricus rubellus, representing different ecophysiological groups . The average number of BC was 10.9 x 10(9) g-1 dry weight in the gut of A . caliginosa, 5.9 x 10(9) in that of L . rubellus, 8.1 x 10(9) in earthworm casts and 6.0 x 10(9) in the soil . The number of BC showed a great seasonal variability in all the materials studied, exhibiting maxima in spring and autumn, and a minimum in summer . The BC increased in number during the passage of food material through the gut of both L . rubellus and A . caliginosa . The difference between BC in fore-gut and hind-gut were significantly higher in L . rubellus (4.2 x 10(9) vs . 8.8 x 10(9)) than that in A . caliginosa (10.3 x 10(9) vs . 13.4 x 10(9)) . Interspecific differences in the number of BC may result from the different chemical and microbiological composition of the material consumed by earthworms as related to different feeding habits of both species. Probl Tuberk, 1995, (3), 13 - 5 {Lung diseases among inhabitants of cities with microbiological and petrochemical industries discharging industrial waste}; Sizykh TP et al.; Outbreaks of diseases caused by toxic waste discharge took place in some cities where microbiological and petrochemical plants are located . The diseases manifested clinically with pulmonary edemas, irritative and intoxication syndromes and affected only subjects with chronic nonspecific lesions of the lungs . A hypophysis on bronchial asthma outbreaks secondary to paprin discharges in the atmosphere by microbiological plants was not confirmed. Minerva Chir, 1995 Jan-Feb, 50(1-2), 121 - 3 {Active monitoring of cefotetan use in surgery}; Maculotti L et al.; The authors studied efficacy and safety of cefotetan in 25 surgical patients, suffering from clinically and microbiologically tested infections . The average daily dose of the drug was 4 g in half of the cases and 6 g in the others . The average period of treatment was 8 days approximately . A clinically and microbiologically positive result was recorded in 88% of cases, while local and general safety was good in 92% of cases . Therefore, cefotetan confirmed to be an effective and reliable drug in general surgery. Adv Ren Replace Ther, 1995 Jan, 2(1), 70 - 9 Microbiological and endotoxin assays of hemodialysis fluids; Bland LA; The potential for exposure of dialysis patients to greater levels of microbial and endotoxin contamination has increased dramatically during the last decade with the increase in reuse of hemodialyzers, and the use of bicarbonate dialysate and high flux dialysis . To help prevent pyrogenic reactions and bacteremia in hemodialysis patients caused by microbial and endotoxin contamination of hemodialysis fluids, the Association for the Advancement of Medical Instrumentation (AAMI) has promulgated standards for maximum allowable concentrations of bacteria and endotoxin in these fluids . Each dialysis center should develop microbiological and endotoxin surveillance policies and procedures for the types of hemodialysis fluids to assay, frequency and manner of sample collection, assay techniques, and methods for recording and interpreting results to ensure compliance with the AAMI standards . These necessary components of a comprehensive surveillance program are discussed in depth in this article . A safer environment will be provided for each dialysis patient if appropriate microbiological assay procedures are followed and the results are consistently within the AAMI microbiological and endotoxin standards. Mol Gen Mikrobiol Virusol, 1995 Jan-Mar, (1), 36 - 9 {Identification of tuberculosis pathogens in clinical material using the polymerase chain reaction}; Grishina TD et al.; The authors examined the possibility of detecting M . tuberculosis cells in various types of diagnostic material (sputum, blood, bone marrow, bronchoalveolar lavage fluid) from tuberculosis patients using polymerase chain reaction (PCR) . The developed PCR-based test systems helped detect M . tuberculosis in 48 (90.6%) out of 53 tuberculosis patients, in contrast to much slower microbiological methods which permitted detection of Mycobacteria in only 21 (39.6%) patients . High specificity and virtually no false-positive results of PCR were demonstrated in testing diagnostic material from patients with chronic nonspecific pulmonary diseases and from children with lympholeukemia and anemia. J Clin Pediatr Dent, 1995 Winter, 19(2), 111 - 5 Microbiological assessment of dentin stained with a caries detector dye; Zacharia MA et al.; The purpose of this study was to assess microbiologically the efficacy of 1% acid red in propylene glycol dye to stain carious dentin . Thirty teeth with primary carious lesions involving dentin were chosen . Cavity preparation using the conventional visual and tactile criteria was done and the dye was applied to the prepared cavity . Dentin samples were collected, from carious dentin prior to cavity preparation, dye stained areas and unstained areas . The total colony forming units (CFU) in each sample were then assessed microbiologically . The results showed a highly significant difference in the total colony forming units in dye stained and dye unstained dentin samples . The 1% acid red dye in propylene glycol dye was found to be effective as an adjunctive aid in the diagnosis of carious dentin. Medicina (B Aires), 1995, 55(1), 48 - 50 {Malignant peritoneal mesothelioma . An infrequent cause of prolonged fever syndrome and leucocytosis in a young adult}; Melero M et al.; Peritoneal mesothelioma is a rare neoplasia usually associated with exposure to asbestos . The incidence in the population not in contact with asbestos is of one per million per year . The disease is most common in males over the age of 40, with signs and symptoms of neoplasic disease together with abdominal pain and ascitis with or without a palpable abdominal mass . We report the case of a young male without a history of exposure to asbestos who presented with prolonged fever, leukocytosis and a septated peritoneal exudate . With a presumptive diagnosis of peritoneal tuberculosis, the patient received empirical antituberculosis treatment . Because the clinical picture persisted and microbiological studies remained negative, a second exploratory laparotomy was performed which demonstrated the presence of a malignant epithelial peritoneal mesothelioma. J R Nav Med Serv, 1995 Winter, 80(3), 148 - 51 Is perianal sepsis adequately managed? The results of a five year audit at Royal Naval Hospital Haslar; Parker SJ et al.; A retrospective audit and postal questionnaire of 148 patients presenting with perianal sepsis confirms that the isolation of gut-related organisms remains a sensitive indicator of a perianal fistula . It did not confirm that the use of microbiological results affects the long term outcome for these patients . It suggests that early examination under anaesthetic and laying open of a fistula may not be necessary in all patients in which gut-related organisms are identified . There was no statistical difference in recurrence rates of perianal sepsis between those operated on by senior or junior surgeons, though there may have been selection bias in these patients. J Fr Ophtalmol, 1995, 18(6-7), 435 - 8 {Uveitis with hypopyon in patients with acquired immunodeficiency syndrome, treated with Rifabutin}; Frau E et al.; BACKGROUND: Iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex infections with systemic Rifabutin . We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association or not . METHODS: All patients were referred by an infection disease specialty service for complete ophthamological evaluation and ancillary laboratory . Six patients with AIDS, aged from 29 to 65 years, presented with acute unilateral hypopion . RESULTS: At the time of presentation, all six patients were receiving treatment for MAC infection with Rifabutin (dosage range, 300-600 mg/d) and four received Fluconazol . Results of microbiological investigations were negative . Hypopyon developed in the second eye of two patients . Hypopion resolved rapidly with intensive antibiotherapy without corticosteroids . CONCLUSION: Concomitant use of Rifabutin and Fluconazol may precipitate hypopyon uveitis . The cause of the uveitis is less certain, but the possible role of a microbiological agent cannot be ruled out. Schweiz Arch Tierheilkd, 1995, 137(11), 505 - 14 {Procedures for health monitoring in a breeding facility for specific pathogen free mice and rats}; Wyss-Spillmann SK et al.; Causes of variation in animal experiments include differences in the genotype of the animals as well as a number of environmental factors . Through standardisation of the physical, chemical and biological components of the environment the quality of the results of the experiments can be improved, which in turn leads to a reduction of the number of animals used . One of the means to achieve this goal is the use of specified pathogen free (SPF) animals . To assure the microbiological quality of these animals the population and its environment needs to be screened thoroughly on a routine basis . This publication describes the necessary quality assurance procedures . These include bacteriological, parasitological, virological and histological examinations of the animals themselves, as well as environmental screens such as microbiological examinations of feed, control of water quality or the testing of the efficacy of disinfectants. Biochem J, 1994 Dec 15, 304 ( Pt 3), 693 - 8 Identification of a human gastric mucin precursor: N-linked glycosylation and oligomerization; Klomp LW et al.; Gastric mucin plays an important role in the protection of the stomach wall from chemical, microbiological and mechanical damage . We have previously isolated human gastric mucus glycoproteins and raised a polyclonal antiserum against these macromolecules . This antiserum specifically reacted with gastric mucins in immunoblotting experiments and stained mucous granules at the apical side of gastric surface epithelial cells . A similar staining pattern was obtained after incubation with an antiserum against rat gastric mucin . Next we used the antiserum in pulse-chase experiments of human stomach tissue explants . After short labelling periods with {35S}methionine and {35S}cysteine, the antiserum reacted with a polypeptide with an apparent molecular mass of approx . 500 kDa as determined by SDS/PAGE, which was converted after 90 min into a heterogeneous high-molecular-mass glycoprotein . This high-molecular-mass form, but not the 500 kDa polypeptide, was detectable in the culture medium after 2 h . This strongly suggests that the 500 kDa polypeptide is the precursor of the purified gastric mucin . Analysis of pulse-chase experiments by non-reducing SDS/PAGE revealed that the precursors form disulphide-linked oligomers early in biosynthesis, before the addition of O-linked sugars . After preincubation with the N-glycosylation inhibitor, tunicamycin, the apparent molecular mass of the precursor decreased marginally but consistently, indicating that N-linked glycan chains are present on the mucin precursor. Clin Intensive Care, 1995, 6(3), 121 - 6 Markers of ventilator-associated pneumonia; el-Ebiary M et al.; The diagnosis of ventilator-associated pneumonia (VAP) is difficult for several reasons . Firstly, clinical markers show a large percentage of false-positive and false-negative results . Secondly, microbiological diagnosis based on quantitative cultures of protected specimen brush (PSB), bronchoalveolar lavage (BAL), and endotracheal aspirates also present false-positive and false-negative results . Furthermore, definite results are delayed for 48-72 hours . For all these reasons it would be an advantage to have a biological marker of ventilator-associated pneumonia in clinical practice . Since clinical features of pneumonia in mechanically ventilated patients are neither specific nor sensitive, rapid markers of pneumonia might be of great assistance to the clinician in deciding whether to start an empiric antibiotic regimen . A marker of ventilator-associated pneumonia could be a rapid alternative diagnostic method which permits the definite diagnosis of pneumonia . Accordingly, specific markers of VAP, namely the presence of intracellular microorganisms, the detection of elastin fibres, the antibody-coated bacteria test, the level of endotoxin in bronchoalveolar lavage fluid, the local production of interleukin-8, the levels of lactate dehydrogenase, and decreased surfactant protein A, may be important as they can provide a rapid diagnosis of VAP . Among the markers alluded to above, the search for intracellular bacteria in polymorphonuclear leukocytes or macrophages is the most widely validated technique with an excellent specificity, provided that prior antibiotics are not given . However, this technique has its own limitations; it requires a considerable time effort for the microbiologist, and also compels the performance of BAL, a technique not always harmless to the patient. Schweiz Rundsch Med Prax, 1994 Dec 6, 83(49), 1374 - 7 {Pneumonia in clinical practice: diagnosis and therapy}; Zimmerli W; Outpatients with pneumonia are usually treated empirically . Therefore, the knowledge of the most important causative agents is a prerequisite for the 'educated guess' . With a broad microbiological evaluation, the etiology of a pneumonia can be detected in only half of the cases . In outpatients, 30% of the causative agents are viruses, 45% 'atypical bacteria' such as Mycoplasma sp . and Chlamydia pneumoniae, and 25% pneumococci and Hemophilus . In hospitalized patients, pneumococci and Hemophilus cause 60%, and 'atypical bacteria' only 25% of the community acquired pneumonias . The most relevant microbiological examination in outpatients is the Gram stain of the sputum . The sputum culture is seldom useful and sometimes even misleading, especially if the result is not interpreted in connection with the Gram stain . The most appropriate treatment of outpatients without underlying disease is a macrolide . In patients with chronic bronchitis, alcoholism or preceding influenza infection, amoxicillin/clavulanic acid or a new oral cephalosporin is the best choice . The detection of risk factors for fatal outcome is important for the decision to admit the patient to a hospital. Vet Rec, 1994 Dec 3, 135(23), 552 - 4 Bioavailability of different forms of amoxycillin administered orally to dogs; Kung K et al.; Amoxycillin was administered to six dogs intravenously (as the sodium salt at 20 mg/kg bodyweight) and orally (as the trihydrate at 20 mg/kg) . The oral treatments followed a Latin square pattern, each dog receiving amoxycillin as a 60 ml suspension by stomach tube, or as 3 ml of drops or in the form of tablets . The concentration of the drug in the plasma was measured microbiologically and its pharmacokinetic parameters were calculated by the use of statistical moments . After intravenous administration the mean +/- sd apparent volume of distribution was 0.312 +/- 0.102 litre/kg, the steady state rate of clearance was 3.4 +/- 1.1 ml/min/kg and the mean residence time was 1.6 +/- 0.4 hours . After oral administration the liquid forms of the drug tended to be more readily absorbed than the tablets, as indicated by their higher bioavailabilities (suspension 76.8 +/- 16.7 per cent, drops 68.2 +/- 25.8 per cent, tablets 64.2 +/- 17.9 per cent) . However, the differences between their pharmacokinetic parameters were not statistically significant . The respective values of Cmax for the tablets, drops and suspension were 18.6 +/- 5.3 micrograms/ml, 18.1 +/- 2.4 micrograms/ml and 20.7 +/- 2.2 micrograms/ml, of tmax 2.0 +/- 1.0 hours, 1.4 +/- 0.6 hours and 1.4 +/- 0.5 hours and of the AUC 69.5 +/- 22.5 micrograms/ml hours, 71.8 +/- 21.0 micrograms/ml hours and 80.6 +/- 21.8 micrograms/ml hours . The two useful drug products (drops and tablets) had similar pharmacokinetic profiles in the dogs and can therefore be regarded as equivalent in this species. Arch Latinoam Nutr, 1994 Dec, 44(4), 256 - 63 {Development and optimization of an isotonic sports drink}; Lopez L et al.; Within a research program on food products for athletes starting from natural apple concentrate, the design, manufacture and control of isotonic beverages, was undertaken . The dilution conditions for the apple concentrate were established studying several salts combinations which will supply those electrolytes that are eliminated through sweat and have to be replenished . They are sodium, potassium, chloride, magnesium and calcium in concentrations such as to supply an osmotic pressure similar to that observed in blood . The addition of a premix of vitamins (B1, B2, B6, B12, C, E, folic acid, niacin, pantothenic acid and biotin) in several levels of the Recommended Daily Allowance (RDA) (100, 75, 62.5, 60 and 30% of the RDA) was assayed . The obtained formula tasted salty and medicine-like, therefore the vitamin content had to be reduced, supplying 30% of the RDA in a premix constituted by those vitamins which are the most important for physical activity (B1, B2, B6 and C) . The quality of the formula was optimized considering variables such as flavor, color and maltodextrin levels by using methods of sensory evaluation . In the elaborated beverage controls such as pH, acidity, total solids (degree Bx), relative density and soluble solids/acidity ratio complying with the corresponding standards, were carried out . In addition, chemical composition, caloric value, microbiological and sensory quality, were controlled . The fruit juice was packed in a 250 ml self-supporting"Doy-Pack"-like bag . Both, microbiological and sensory quality were good, and the caloric value was 101.18 Kcal/250ml . Shelf life studies at two different temperature conditions 15-25 degrees C and 3-5 degrees C, were carried out . The limiting factor was flavor which defined a shelf life of at least 3 months, stored at refrigeration temperature (3-5 degrees C) . The formulated beverage supply the electrolyte concentrations which allows to be characterized as isotonic beverage, recommended for athletes. Am J Pathol, 1994 Dec, 145(6), 1537 - 46 Replicative Legionella pneumophila lung infection in intratracheally inoculated A/J mice . A murine model of human Legionnaires' disease; Brieland J et al.; The role of host immune responses in the pathogenesis of Legionnaires' disease is incompletely understood, due in part to the current lack of an animal model that is both susceptible to replicative Legionella pneumophila-induced lung infection and for which species-specific immunological reagents are available . We have developed a model of replicative L . pneumophila lung infection in intratracheally inoculated A/J mice . L . pneumophila was obtained in the exponential growth phase and inoculated into the trachea of 6- to 8-week-old female A/J mice . Microbiological and histopathological evidence of infection was demonstrated in mice inoculated with 10(6) colony-forming units . Development of an acute pneumonia that resembled human Legionnaires' disease coincided with exponential growth of the bacteria in the lung 24 to 48 hours after intratracheal inoculation of L . pneumophila . This was associated with increased plasma levels of interferon-gamma at 24 hours after inoculation . After 48 hours, the bacteria were gradually eliminated from the lung over the next 5 days, corresponding with resolution of the inflammatory response in the lung, thereby mimicking the outcome frequently seen in the immunocompetent human host . Treatment of animals with anti-interferon-gamma antibody enhanced bacterial replication and disease progression, indicating an important role of host immune response in resolution of the infection . Because of the availability of murine-specific reagents, this model of replicative L . pneumophila lung infection in A/J mice after intrapulmonary inoculation of L . pneumophila potentially provides an important tool for future studies investigating the role of host immune responses in the pathogenesis of Legionnaires' disease in the immunocompetent host. Gastroenterology, 1994 Dec, 107(6), 1726 - 35 Spontaneous, heritable colitis in a new substrain of C3H/HeJ mice; Sundberg JP et al.; BACKGROUND/AIMS: C3H/HeJ mice at the Jackson Laboratory have periodically been culled because of the occurrence of soft feces, perianal ulceration, and right-sided colitis . No pathogens have been isolated . The goal of the current study was to establish a substrain with a high incidence of this disease . METHODS: Affected male and female C3H/HeJ mice were bred . The clinical, pathological, microbiological, and genetic features of 216 mice of the resulting pedigree were characterized . RESULTS: A severely affected female crossed with a normal male resulted in a new substrain, denoted C3H/HeJBir, with a high incidence of right-sided colitis . Histologically, lesions occurred primarily in the cecum and proximal colon, characterized by acute and chronic inflammation, crypt abscesses, ulcerations, regenerative hyperplasia, and submucosal scarring . Such colitis peaked at 3-6 weeks; however, similar disease was found sporadically in animals more than 1 year of age . Small lesions at the anorectal junction were common throughout life . An extensive search for pathogens was negative . Genetic analysis of C3H/HeJBir mice suggested that the disease was inherited as a quantitative trait . CONCLUSIONS: C3H/HeJBir mice develop a spontaneous, heritable form of idiopathic inflammatory bowel disease and will be a valuable resource for genetic and immunologic studies of this disease. J Clin Pharm Ther, 1994 Dec, 19(6), 349 - 53 Stability of dantrolene oral suspension prepared from capsules; Fawcett JP et al.; The chemical stability of an extemporaneously compounded dantrolene oral suspension (5 mg/ml dantrolene sodium) in Syrup BP containing citric acid with and without methyl hydroxybenzoate preservative was studied on storage at 5, 25 and 40 degrees C for 150 days in high density polyethylene dispensing bottles . The amount of dantrolene free acid in suspension was monitored by a stability indicating HPLC assay . There was no significant decomposition of dantrolene under all storage conditions irrespective of the presence of preservative . The results show that the formulation of dantrolene oral suspension provides a convenient and stable dosage form for use in pediatric patients and in those unable to swallow capsules . It is recommended that the formulation be stored at room temperature and in the absence of microbiological testing a shelf-life of 30 days is proposed for the product prepared with preserved syrup. Can J Psychiatry, 1994 Dec, 39(10), 623 - 8 Parasitic diseases and psychiatric illness; Weiss MG; Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience . Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis . Emotional states may in turn affect the experience of medical illness . Psychiatrically significant features of medical illness are determined both by pathophysiology and by the personal and social context in which they occur . Many factors affect mental health in the tropics where the synergy of infection, emotional strengths, vulnerabilities, social supports and stressors is critical . This review discusses parasitic diseases of psychiatric interest by virtue of their effects on thinking, mood and behaviour; and it distinguishes issues that apply mainly to indigenous populations and visitors to endemic areas . In some paradoxical instances the psychiatric influence of parasitic diseases does not require infection; the review concludes by considering the prime example, delusions of parasitosis, which is a primary psychiatric disorder. Appl Environ Microbiol, 1994 Dec, 60(12), 4310 - 8 Optimization of an Escherichia coli formate dehydrogenase assay for selenium compounds; Tschursin E et al.; A microbiological assay to detect different chemical compounds of selenium for potential future use in the study of the distribution of these chemical forms in foods is being developed . This assay is based on the detection, by infrared analysis, of CO2 in a culture of Escherichia coli when the bacteria are grown in the presence of various selenium compounds . The CO2 production is the result of selenium-dependent formate dehydrogenase activity, which catalyzes oxidation of formic acid produced during glucose metabolism . Smooth response curves were generated over several orders of magnitude for selenocystine, selenite, and selenomethionine . The assay detects selenium concentrations (above background) as low as 1.5 nM for selenocystine and selenite and 4 nM for selenomethionine in minimal medium . Detection of selenomethionine was enhanced (to a sensitivity of 1.5 nM) by the addition of methionine to minimal medium and was enhanced even further (to a sensitivity of 0.8 nM) by the addition of a defined mixture of amino acids . Selenomethionine could be assayed in the presence of an amino acid concentration which is proportional to the amino acid/elemental selenium ratio found in a wheat gluten reference material (NIST SRM 8418) . This implies that the assay can detect selenium compounds in a variety of foods at low concentrations, avoiding the background CO2 production caused by high concentrations of non-selenium-containing amino acids . The observation that methionine enhanced selenomethionine availability for formate dehydrogenase synthesis supports studies in animals demonstrating that methionine controls selenomethionine incorporation into selenoenzymes.(ABSTRACT TRUNCATED AT 250 WORDS) Lett Appl Microbiol, 1994 Dec, 19(6), 401 - 5 Transfer of Nocardia amarae Lechevalier and Lechevalier 1974 to the genus Gordona as Gordona amarae comb . nov; Goodfellow M et al.; The taxonomic status of Nocardia amarae strains was examined using chemical, microbiological and nucleic acid sequencing methods . It was evident from the results of this and previous studies that Nocardia amarae has properties that are at variance with its classification in the genus Nocardia but consistent with its transfer to the genus Gordona . It is proposed that Nocardia amarae Lechevalier and Lechevalier 1974 be transferred to the genus Gordona as Gordona amarae comb . nov. Tuber Lung Dis, 1994 Dec, 75(6), 429 - 34 Tuberculous pericarditis in Tanzanian patients with and without HIV infection; Cegielski JP et al.; SETTING: Large academic medical center in Tanzania . OBJECTIVES: To determine the etiologies and outcomes of large pericardial effusions in HIV-infected and uninfected patients . DESIGN: Prospective cohort study of patients admitted with new large pericardial effusions, confirmed echocardiographically . Patients had pericardial biopsies and drainage with extensive analysis of tissue and fluid specimens, and were followed with clinical and echocardiographic examinations . RESULTS: Of 28 patients with large pericardial effusions, 19 were infected with HIV-1 . 22 had invasive diagnostic procedures: 14 of 14 HIV-infected patients, but only 4 of 8 non-HIV-infected patients, had tuberculous pericarditis (P = 0.01) . All but 1 of the HIV-infected patients had strongly positive tuberculin skin tests, and short-term outcomes were similar in the 2 groups . CONCLUSION: TB is the predominant cause of large pericardial effusion in HIV-infected patients in this setting; non-HIV-infected patients are more likely to have other etiologies . These patients were at an early stage of HIV infection and responded well to treatment . In settings where microbiological studies are not routinely available, HIV-infected patients with large pericardial effusions may be treated empirically for tuberculosis and monitored for improvement . If improvement does not follow within 2-4 weeks further studies are indicated . HIV-negative patients should undergo diagnostic evaluation initially. Comput Appl Biosci, 1994 Dec, 10(6), 657 - 60 Identifying correct bacteriological vocabulary: software to look up RKC codes and statements; Bryant TN; A program has been written to help identify the correct RKC codes (Rogosa, Krichevsky and Colwell, 1986) for describing microbiological attributes . Terms, which may be complete words, parts of words, or numbers, can be typed into the computer . A search is made of the set of about 13,800 RKC codes and statements that describe them . Statements that contain the search terms are displayed in a scrolling window so that the required statement(s) can be identified . A list of selected RKC statements can be built up in a second window for subsequent use by other software packages . The program called RKCLIST runs under the MS-DOS operating system . The software routines used to create RKCLIST have been written so that they can be incorporated into other software packages that make use of the RKC coding scheme. Int J Food Microbiol, 1994 Dec, 24(1-2), 41 - 52 Microbiological collaborative studies for quality control in food laboratories: reference material and evaluation of analyst's errors; Berg C et al.; Working groups of the Federal Health Office in Germany and of the International Dairy Federation (IDF) have developed a quality assurance system to assess the analyst performance for colony count methods . The experiment design consists of several dilution series produced from a homogeneous sample suspension . Each series contains a number of twofold dilution steps with parallel plates on each level . The structure of this design permits a detailed analysis of the total variance and identification of analysts' methodological errors as single effects . A computer-based interpretation aid may classify the laboratory as working in correspondence with good laboratory practice ('acceptable') or, otherwise, furnishing 'to good' or 'unacceptable' results . Some examples are given for deviation depending on individual faults . Both, internal quality assurance and collaborative studies demand suitable reference samples . The reference material used has to meet certain requirements concerning homogeneity, contamination level and microbiological stability during a period of storage and transport . A naturally contaminated sample material was prepared, which has been used successfully in microbiological collaborative studies. Int J Food Microbiol, 1994 Dec, 24(1-2), 33 - 9 Microbiological challenge testing for ensuring safety of food products; Notermans S et al.; Microbiological challenge testing (MCT), storage testing, and predictive modelling are tools to simulate or to test what can happen to a food product during processing, distribution and subsequent handling . MCT is carried out if the microorganism of interest is suspected to be present in low numbers or only incidentally, and should be applied if full knowledge about the characteristics of a potential hazardous microorganism does not exist . MCT involves: (a) an appropriate experimental design; (b) an inoculation procedure; (c) a test procedure; and (d) interpretation of results . If MCT is carried out properly, information is obtained on the types of microorganisms capable of growth in the product, so that risks of food poisoning can be assessed . Therefore, the information obtained can be the basis for setting safety criteria at the critical control points in a food processing operation . However, it remains necessary to verify the test results under field conditions. Int J Food Microbiol, 1994 Dec, 24(1-2), 1 - 9 Computer aided microbial safety design of food processes; Schellekens M et al.; To reduce the time required for product development, to avoid expensive experimental tests, and to quantify safety risks for fresh products and the consequence of processing there is a growing interest in computer aided food process design . This paper discusses the application of hybrid object-oriented and rule-based expert system technology to represent the data and knowledge of microbial experts and food engineers . Finite element models for heat transfer calculation routines, microbial growth and inactivation models and texture kinetics are combined with food composition data, thermophysical properties, process steps and expert knowledge on type and quantity of microbial contamination . A prototype system has been developed to evaluate changes in food composition, process steps and process parameters on microbiological safety and textual quality of foods. Aust Vet J, 1994 Dec, 71(12), 393 - 6 Food safety and residues in Australian agricultural produce; Nicholls TJ et al.; A brief history of food safety in Australia in the context of the development of scientific knowledge is presented . Australia's food and food commodity residue and contamination surveillance and monitoring programs are outlined . Although chemical residues are perceived as a major health risk by the general community, the risk of food causing illness or death because of chemical residues is low . The major threat to human health from food is microbiological contamination, in terms of deaths, sickness and economic loss . The emerging influences in food safety are scientific and technical developments, deregulation, social and demographic factors, and the media . The risk of disruption of domestic and export markets by food safety issues is considerable . The emergence of international standards for food production and processing will enable commercial contractual arrangements to minimise the frequency of disruptive food safety incidents. Clin Oral Implants Res, 1994 Dec, 5(4), 254 - 9 Experimentally induced peri-implant mucositis . A clinical study in humans; Pontoriero R et al.; The purpose of this study was to compare the clinical and microbiological (microscopic) parameters during the development of experimental gingivitis and experimental peri-implant mucositis . Twenty partially edentulous patients were treated for moderate to advanced periodontal disease . Following active periodontal therapy consisting of motivation, instruction in oral hygiene practices, scaling and root planing and periodontal surgery where indicated, IMZ oral implants were incorporated in posterior edentulous areas . After 3 months of healing, the prosthetic abutments were connected, and the patients were closely supervised for another 2 months of healing . At this time, baseline data were obtained . Re-examinations were scheduled at 3 and 6 months . Following this, the patients were asked to refrain from oral hygiene practices for 3 weeks . At all examinations including the end of the period of no oral hygiene, the following clinical parameters were obtained: Plaque Index, Gingival Index and Sulcus Bleeding Index, all modified by Mombelli et al . (1987), probing pocket depths and recession in mm . Furthermore, submucosal/subgingival plaque samples were obtained and analyzed using phase contrast microscopy . At the end of the 3-week period of plaque accumulation, optimal oral hygiene was reinstituted . There were no statistically significant differences between the mean values of all parameters at implant compared to tooth sites at any observation periods . The period of no oral hygiene demonstrated a similar cause-effect relationship between the accumulation of bacterial plaque and the development of peri-implant mucositis as established for the gingival units by the experimental gingivitis model. J Fla Med Assoc, 1994 Dec, 81(12), 835 - 7 Broad-range polymerase chain reaction for detection and identification of bacteria; Anderson B; Detection and identification of fastidious pathogenic bacteria have traditionally presented an obstacle to the clinical and laboratory microbiologist . The diagnosis of disease caused by these bacteria is often empiric relying on clinical observations or indirect laboratory tests . Recently, a technique called broad-range polymerase chain reaction (PCR) has been integrated into studies designed to detect and identify previously uncharacterized bacterial pathogens . By using regions of the bacterial 16S ribosomal RNA (rRNA) gene that are highly conserved to prime synthesis of the remainder of this gene, PCR amplification can be performed directly from clinical samples which may contain small numbers of bacteria . The resulting PCR-amplified DNA can be sequenced to identify variable regions of the 16S rRNA gene that are bacteria-specific . This technique has proven valuable in identifying new fastidious bacterial pathogens that have resisted detection and identification by traditional microbiological methods. Schweiz Rundsch Med Prax, 1994 Nov 22, 83(47), 1309 - 15 {Clinical aspects and diagnosis of infectious endocarditis}; Furrer H et al.; The first step in the diagnosis of infective endocarditis is a high level of clinical suspicion . Only rarely are all the classic signs of infective endocarditis, namely fever, a new cardiac murmur, splenomegaly, anemia and embolic phenomena, found . Every organ system can be involved by embolic or immunologic complications . We have to look specially for manifestations in skin and mucosa, CNS, kidney, locomotor system and lungs . The clinical spectrum has changed over the last decades . More elderly patients, patients with prosthetic heart valves and i.v . drug users are affected . The traditional classification into acute and subacute infective endocarditis has been replaced by a classification based on the microbiological etiology or on the involved valve (native, prosthetic, left- or right sided) . In particular, the clinical presentation of right-sided infective endocarditis differs from the left-sided one . A diagnosis of infective endocarditis has to be considered in every patient with unexplained fever or a multisystem disease . A definite diagnosis of infective endocarditis rests on a multidisciplinary approach that involves the clinician and the echocardiography and microbiology laboratories. Med Klin (Munich), 1994 Nov 15, 89(11), 587 - 93 {Treatment of chronic constipation with physiologic Escherichia coli bacteria . Results of a clinical study of the effectiveness and tolerance of microbiological therapy with the E . coli Nissle 1917 strain (Mutaflor)}; Mollenbrink M et al.; AIM: A randomized, double-blind clinical trial including a change-over of medication was carried out for 9 weeks to investigate the efficacy of an E . coli preparation . The study's main objective was to prove that patients of the verum group had 1.5 stools/week more than placebo patients after a therapeutic period of just 4 weeks . Stool consistency as well as efficacy and compatibility of the medication as judged by doctor and patient were additional criteria . PATIENTS AND METHOD: For a 7-day run-in phase 134 patients were recruited who had suffered from constipation for 18.8 years in average . In this initial phase 64 patients evacuated more than 2 stools per week and were excluded from the study . The remaining 70 patients entered the therapeutic phase being randomly distributed amongst verum and placebo medication . After 4 weeks of therapy patients who delivered 2 or less stools/week obtained the alternative medication (change-over) . RESULTS: Within the 4th week of therapy the average number of stools per week from patients treated with the E . coli preparation (4.9) was already significantly higher than from placebo-treated patients (2.6; p < 0.001) . At the end of the 8th week of therapy the number of stools/week rose to 6.0 for verum-treated patients, whereas for the placebo-treated control group a decrease in stool frequency was observed (1.9 stools/week) . The results of change-over patients confirmed the data of the therapy weeks 1 to 4 . CONCLUSION: The E . coli preparation proved to be successful in the therapy of the idiopathic chronic constipation almost free of side effects. J Comput Assist Tomogr, 1994 Nov-Dec, 18(6), 862 - 6 High-resolution CT appearance of miliary tuberculosis; Oh YW et al.; OBJECTIVE: The purpose of this study was to define the range of abnormalities and to assess the contribution of high-resolution CT (HRCT) in the evaluation of miliary tuberculosis involving the lung parenchyma . MATERIALS AND METHODS: The authors retrospectively reviewed HRCT scans of 11 patients with microbiologically or clinically proved miliary tuberculosis . RESULTS: In 10 patients, the most characteristic HRCT finding of miliary tuberculosis was the presence of small nodules uniformly distributed throughout both lungs . The profusion of nodules was numerous in all 10 patients . High-resolution CT scans showed both sharply and poorly defined, small nodules varying in sizes from 1 to 2 mm (n = 6), 1 to 3 mm (n = 2), and 1 to 4 mm (n = 2) in diameter . These nodules had a diffuse random distribution in the secondary lobule in all 10 patients . In 1 of the 10 patients with small nodules on HRCT, chest radiography had shown no evidence of miliary nodules in the lung . In addition to nodules, HRCT showed diffuse or localized reticular opacities superimposed on nodules in five patients, especially in the lower lung zones . In 1 of all 11 patients, ground-glass attenuation was the predominant abnormality seen on HRCT . CONCLUSION: We believe that in the appropriate clinical situation, miliary tuberculosis may be suggested on HRCT . Moreover, in cases with no evidence of miliary nodules on the chest radiograph, HRCT scan may depict miliary nodules in the lung parenchyma. Acta Otorrinolaringol Esp, 1994 Nov-Dec, 45(6), 433 - 6 {Therapeutic possibilities in recurrent infantile tonsillitis}; de Miguel Martinez I et al.; The present study compares two therapy protocols in 40 children with recurrent tonsillitis . Twenty of them were randomly treated with penicillin, and the remaining 20 received penicillin + metronidazole . Clinical and microbiological assessment of the results was made . The association of penicillin and metronidazole was most efficient, probably due to its activity against Streptococus pyogenes and anaerobic betalactamase-producing bacterias . The high failure rate in the penicillin group states the necessity to change the therapy with this antibiotic in the treatment of childhood recurrent tonsillitis. Berl Munch Tierarztl Wochenschr, 1994 Nov, 107(11), 367 - 73 {Suitability of sampling methods for environmental studies in meat rendering and processing plants with European Community licenses}; Louwers J et al.; In EC-licensed meat rendering and processing plants microbiological test results obtained through contact slides and a highly precise swab method were compared . It was revealed that when using contact slides the absolute cfu can be determined only after prior verification with a reference method . The key provided by the manufacturer for data interpretation does not always match with results obtained by swab technique . Nevertheless, contact plates are suitable to determine the microbiological status . However, their technical deficiencies must be compensated . A simple swab method is well suited for use in meat rendering and processing plants . It is very economical due to low material costs and easy to apply by plant hygienists . The use of a seven step scale listing results up to 10(3) cfu/cm2 enables even non-experts to interpret their results reasonably. Support Care Cancer, 1994 Nov, 2(6), 347 - 54 Empirical therapy for bacterial infections in neutropenic patients; Klastersky J; Infection in neutropenic patients remains a continuing challenge as the modalities of cancer treatment evolve and new pathogens appear . Although the concept of empirical therapy remains valid, there is a need for adaptation of our therapeutic approaches to new clinical and microbiological evidence. J Periodontol, 1994 Nov, 65(11), 1058 - 66 Clinical and microbiological effects of controlled-release locally delivered minocycline in periodontitis; Jones AA et al.; The clinical efficacy of minocycline in a subgingival local delivery system was evaluated alone (M) or as an adjunct to scaling and root planing (M + SRP), in comparison to scaling and root planing (SRP) or to no subgingival treatment (NoTx) in adult periodontitis . Fifty-one adult patients with > or = 7 mm periodontal pockets demonstrating the presence by culture of Porphyromonas gingivalis (Pg), Prevotella intermedia (P(i)), or Actinobacillus actinomycetemcomitans (Aa) were randomized into one of the above 4 treatment groups . All sites > or = 5 mm in the most diseased quadrant in each patient received the therapy . Other quadrants were not treated . All patients received standardized oral hygiene instructions at the beginning of the study . At 0, 1, 3 and 6 months following therapy the 7 mm experimental sites were evaluated for selected periodontal pathogens by DNA probe analysis . At these same time points, the plaque index, gingival index, and bleeding on probing were evaluated as well as probing depth and relative clinical attachment level which were assessed by means of an automated probe . Probing depth reduction with M + SRP was significantly greater than all other groups at one month and significantly greater than NoTx and SRP at 3 months . There were no differences in probing depth reduction among groups at 6 months . At 6 months the gain in clinical attachment level was significantly greater for SRP than for either the NoTx or M groups . The prevalence of Pg decreased significantly in the M and M + SRP groups at one month.(ABSTRACT TRUNCATED AT 250 WORDS) J Hosp Infect, 1994 Nov, 28(3), 163 - 76 Guidelines for good practice in central venous catheterization . Hospital Infection Society and the Research Unit of the Royal College of Physicians; Elliott TS et al.; Central venous catheters (CVC) are commonly used in clinical practice and are associated with several complications, including early and late onset infection . In these guidelines, an outline of good practice for the use of CVC and the prevention of associated infections is presented . Definitions of both localized and systemic catheter-related sepsis are given . Subsequent good practice in relation to the insertion of CVC, including patient preparation, planned duration of catheterization, catheter materials and design of the CVC, are presented . Skin fixation and insertion site care, including the use of dressings and administration sets, as well as an approach to flow obstructions, are also reviewed . The clinical and microbiological diagnosis of catheter-related sepsis and its treatment is next presented . Finally, guidelines for CVC removal and replacement are given . The guidelines are designed to facilitate the development of good practice in the use of CVC, allowing appropriate protocols to be formulated and to reduce infection risk. J Clin Periodontol, 1994 Nov, 21(10), 720 - 7 Some microbiological, histopathological and immunohistochemical characteristics of progressive periodontal disease; Liljenberg B et al.; The aim of the present investigation was to study the local nature of human periodontal disease by assessing the microbiota and the composition of the tissue lesions at sites with progressive attachment loss in periodontitis susceptible subjects . 300 subjects with periodontal disease were monitored for 2 years without treatment . 8 subjects lost > 2 mm of attachment at > or = 3 sites during both the first and the second 12 month interval . These 8 subjects (progressive disease group; PD) were recalled for a microbiological and histopathological examination . A group of age- and sex-matched subjects were identified who during the 2 years of monitoring exhibited gingivitis and deep pockets, but no further attachment loss . This group of 11 subjects (non-progressive disease group; NPD) served as controls . From the 8 active disease subjects, > or = 1 interproximal site which had displayed disease activity (progressive disease active; PDA) and > or = 1 contralateral site without disease progression (progressive disease inactive; PDI) were sampled . From the 11 control subjects, 1 site/subject was sampled (NPD) . The total number of viable micro-organisms (TVC) in the subgingival microbiota was estimated and a series of bacterial species were identified and enumerated . The gingival tissue of the sampling site was excised and the soft tissue prepared for morphometrical and immunohistochemical analyses . No differences were observed in the subgingival microbiota of the sample sites in the subjects who exhibited disease progression (PD) when compared with the subjects with periodontally diseased but stable conditions (NPD).(ABSTRACT TRUNCATED AT 250 WORDS) J Okla State Med Assoc, 1994 Nov, 87(11), 504 - 5 Microbiological flora and nail polish: a brief report; Rayan GM et al.; Removing nail polish and prosthetic nails from operating room (OR) personnel prior to scrubbing and from patients prior to hand surgery is recommended but not practiced in many hospitals . There is concern that nail polish can act as a vehicle for the transfer of infectious agents . This study was designed to determine the incidence of microbiological flora of nail polish in a clinical setting. Enferm Infecc Microbiol Clin, 1994 Nov, 12(9), 443 - 8 {Clinicoepidemiologic study of tuberculosis in the Ferrol area (1990-1991)}; Sesma P et al.; BACKGROUND: To know about the main characteristics of tuberculous disease in our county . METHOD: A two-year period (1990-91), retrospective survey of the patients diagnosed of tuberculosis at a hospital from the north of La Coruna (Spain) was performed . A total of 322 cases were found, 165 diagnosed at the hospital and the remaining cases at the clinic . In the latter group, microbiological findings were the only diagnostic criteria considered . On the hospital-diagnosed cases three diagnostic categories were established: 1) definite; 2) probable, and 3) clinical diagnosis . RESULTS: The 1991 annual rate was 73.8 cases/100.000 inhabitants and the estimate rate was 80 cases/100.000 . On analysis of the hospital-based diagnosed subgroup (165 patients), there was a male predominance (112/165), mean age was 35 years and 75% of patients were 44-year-old or younger . The most common clinical presentation was pulmonary (94 cases), pleural (33 cases) and pleuro-pulmonary disease (18 cases) . Nine patients had concurrent infection with the human immunodeficiency virus . There was a culture-proven diagnosis of infection by Mycobacterium tuberculosis on 117/165 cases . A total of 115 cases (69.7%) received a three-drugs, 9 months therapy . The clinical outcome was fully satisfactory in 79/101 patients (78.2%) with a follow-up longer than 6 months . Only in one case there was a tuberculosis-related death . CONCLUSIONS: The high incidence rate, as well as age distribution and the frequency of pleural disease suggest a high tuberculous endemy at our region, over the rates from other parts of Spain. Mycoses, 1994 Nov-Dec, 37(11-12), 451 - 3 Successful treatment of griseofulvin-resistant tinea capitis in infants; Lukacs A et al.; We report on three siblings, children of a farmer, aged 3-8 years, suffering from tinea capitis due to Microsporum canis . Initially, the infection was treated systemically with griseofulvin as well as externally for 5 months without success . Therapy was changed to itraconazole 33 mg per day orally . Laboratory investigations followed every 4-6 weeks . Dependent on the dose per kg body weight the children were cured clinically after 2-5 months and microbiologically after 5-8 months . Thus, itraconazole seems to be superior to conventional treatment with Microsporum canis-induced tinea capitis. An Med Interna, 1994 Nov, 11(11), 537 - 40 {Disseminated candidiasis in parenteral drug addicts . Report of 15 cases}; Laguna del Estal P et al.; Fungic infections related to parenteral use of drugs increased significantly from 1980 on with the description of the disseminated candidiasis syndrome . Associated to the administration of brown heroin, this syndrome is characterized by the development of cutaneous, ocular and osteoarticular infections, isolated or combined, by Candidas albicans . We present 15 patients with disseminated candidiasis: 12 developed ocular affection (10 endophthalmitis and 2 chorioretinitis): 9, cutaneous lesions and 3 osteoarticular affection (3 costochondritis and one hip arthritis); 8 presented simultaneous infections in several locations . The biopsy and culture of the cutaneous lesions was the most profitable test in order to establish the microbiological diagnosis . We comment on the main etiopathogenetic, clinical, diagnostic and therapeutic aspects of the disseminated candidiasis syndrome. Trans R Soc Trop Med Hyg, 1994 Nov-Dec, 88(6), 672 - 6 A clinico-pathological study of cutaneous leishmaniasis in British troops from Belize; Biddlestone LR et al.; Thirty-four cases of cutaneous leishmaniasis contracted by British soldiers in Belize were studied . Pre- and post-treatment biopsies were taken from all patients . The range of histological appearances is described and the value of histological examination (including Giemsa staining and immunohistochemistry), cytological preparations and microbiological culture in diagnosis and clinical management assessed . Histology and culture were found to be complementary techniques in reaching a positive diagnosis, whilst cytological preparations were of no additional value . Histological examination of post-treatment biopsies merely confirmed the clinical impression of healing or non-healing whilst culture identified viable organisms in apparently healed lesions, which were subsequently re-treated. Clin Orthop, 1994 Nov, (308), 183 - 6 Melioidosis . Another etiology of granulomatous osteomyelitis . Report of 2 cases; Sirikulchayanonta V et al.; Two cases of granulomatous osteomyelitis caused by melioidosis are reported . Histologically, the granulomatous lesions were indistinguishable from tuberculosis and required confirmation with microbiological culture . It is important that melioidosis be considered in the differential diagnosis of granulomatous osteomyelitis since the treatment is quite different from tuberculosis. Genitourin Med, 1994 Oct, 70(5), 345 - 6 Mild balanoposthitis; Fornasa CV et al.; AIM--To identify and study cases of mild balanoposthitis (MBP) with penile pathology among patients observed at a dermatology clinic over an 18-month period . MATERIALS--The study included 321 patients with penile pathology . The term MBP was used to describe balanoposthitis of a localised, inflammatory nature with few, non-specific symptoms and a tendency to become chronic or recur . Two hundred and seventy had diseases clearly identifiable by clinical examination or laboratory tests; 51 cases were diagnosed as MBP and these patients had blood tests (to evaluate immune status) and microbiological examination; when these proved negative, a series of patch tests was also used . RESULTS--Of the 51 patients diagnosed as having MBP, the cause was ascertained in 34 cases (infection, mechanical trauma, contact irritation, contact allergy, etc.), whereas no specific aetiological factor was detected to explain the symptoms in the remaining 17 cases. FEMS Microbiol Rev, 1994 Oct, 15(2-3), 175 - 83 Microbes in food processing technology; Hofstra H et al.; There is an increasing understanding that the microbial quality of a certain food is the result of a chain of events . It is clear that the microbial safety of food can only be guaranteed when the overall processing, including the production of raw materials, distribution and handling by the consumer are taken into consideration . Therefore, the microbiological quality assurance of foods is not only a matter of control, but also of a careful design of the total process chain . Food industry has now generally adapted quality assurance systems and is implementing the Hazard Analysis Critical Control Point (HACCP) concept . Rapid microbiological monitoring systems should be used in these cases . There is a need for rapid and simple microbiological tests which can be adapted to the technology and logistics of specific production processes . Traditional microbiological methods generally do not meet these high requirements . This paper discusses the tests, based on molecular biological principles, to detect and identify microbes in food-processing chains . Tests based on DNA technology are discussed, including in vitro DNA amplification like the polymerase chain reaction (PCR) method and identifications based on RFLP, RAPD and DNA fingerprinting analysis . PCR-based methodology can be used for the rapid detection of microbes in food manufacturing environments . In addition, DNA fingerprinting methods are suitable for investigating sources and routes of microbial contamination in the food cycle. Immunol Lett, 1994 Oct, 42(3), 179 - 83 Lymphocytes from the site of disease are functionally different from peripheral blood lymphocytes and may demonstrate etiologically related antigen specificity; Ford DK et al.; Over a 12-year period, in vitro synovial lymphocyte responses to microbiological antigen stimulation were measured by the {3H}thymidine uptake method in referred patients with all types of non-crystal, non-septic, inflammatory arthritis . From this large study group comparisons of synovial with peripheral blood lymphocyte (PBL) responses were available in 9 patients with enteric reactive arthritis (ERA), 12 patients with sexually acquired reactive arthritis (SARA) and 18 patients with recurrent or persistent oligoarthritis or with polyarticular 'rheumatoid' arthritis . Employing 2-tailed t tests, analysis of variance (ANOVA) or meta-analysis, as appropriate to the obtained data, significant differences were found between synovial and peripheral blood responses . In only 2 of 9 patients with bacteriologically defined ERA, in only 4 of 12 patients with SARA and in only 2 of 18 patients with oligoarthritis or 'rheumatoid' arthritis did the PBLs show statistically significant responses to the antigen that elicited a significant response from synovial lymphocytes . It is concluded that lymphocytes from the site of disease are often functionally different from PBLs and may demonstrate etiologically related antigen specificity; thus they may be a preferred source of lymphocytes for the investigation of immunologically mediated disease, the etiology of which is not understood . This viewpoint is supported by a recent paper on the specificity of hepatic lymphocytes for a protein of hepatitis C in patients with chronic hepatitis C, and also by the use of tumour-infiltrating lymphocytes for anti-melanoma therapy. J Vet Pharmacol Ther, 1994 Oct, 17(5), 359 - 64 Comparative pharmacokinetics of ampicillin-sulbactam combination in calves and sheep; Montesissa C et al.; The pharmacokinetics of ampicillin and sulbactam administered in combination were studied in calves and sheep . The animals were administered an aqueous solution of ampicillin/sulbactam (2:1, w/w) intravenously and intramuscularly at doses of 13.2 and 6.6 mg.kg-1, respectively . A microbiological method was used to detect ampicillin, and HPLC was used to detect sulbactam in serum . Following intravenous (i.v.) administration, the distribution phases were rapid and similar (about 15 min) for both drugs in both species, whereas sulbactam in calves and ampicillin in sheep showed a faster elimination rate . After intramuscular (i.m.) administration both drugs showed peak concentrations higher in calves than in sheep; the peak time of sulbactam was shorter in calves than in sheep . No other significant differences in the pharmacokinetics of the combination were observed between the species after i.m . injection . The mean residence and absorption times, calculated by non-compartmental analysis, for both calves and sheep suggested that the differences in ampicillin and sulbactam pharmacokinetics could be attributable to the different molecular structures. Lab Anim, 1994 Oct, 28(4), 347 - 54 Efficiency of air filter sets for the prevention of airborne infections in laboratory animal houses; Mrozek M et al.; Air filter sets (classes EU6 and EU9, or EU6 and S) were tested for their efficiency in protecting laboratory animals against potential airborne infections . Flexible-film isolators were used as a smaller scale model . In the first experiment, lasting 7 months, it was tested whether minute virus of mice (MVM) was able to penetrate the air filters between one isolator containing experimentally infected mice and another with MVM negative mice . In the second experiment we tested whether microorganisms in the incoming air were able to penetrate air filter sets . To assess this gnotobiotic mice in an isolator were monitored for 9 months for changes of their microbial flora . In both experiments a combination of EU6 and EU9 air filters proved to be sufficient to maintain the microbiological status of the animals . The same combination of medium efficiency filters (EU6 and EU9) is used on the air supply to 4 SPF-barrier units in which infections with MVM occurred repeatedly soon after the initial stocking . After a thorough disinfection no reinfection has been detected to date . This demonstrates that the relatively low efficiency of the air filters was not the cause of the repeated infection . The procedure for disinfection is described. Klin Monatsbl Augenheilkd, 1994 Oct, 205(4), 210 - 7 {The COMOD system . A preservative-free multidose container for eyedrops}; Teping C et al.; BACKGROUND: The newly developed COMOD -system is a multi-dose-container for eye drops which makes the addition of preservatives unnecessary . In this study we investigated the microbiological safety of the COMOD -system which was used in action for the first time . METHODS: After cataract surgery 97 patients only used unpreserved, dexamethason-containing eye drops in COMOD -bottles for two days in hospital and for five more days at home . The used bottle were examined microbiologically afterwards . RESULTS: No COMOD -bottle showed a microbiologically serious contamination; no patient showed an unusual healing process which would have been typical for any infection . Concerning the handling it turned out during use in hospital that the hand-made prototypes have to be improves . The vast majority of patients managed the handling at home well, independent of sex or age . CONCLUSION: The COMOD -system is a suitable microbiologically safe container for unpreserved eye drops. Fogorv Sz, 1994 Oct, 87(10), 299 - 303 {Microbiological study of the correlation between pontics and their mucosal and bone bases}; Hermann P et al.; Authors investigated the possible relationship between different types of ponties and the development of dental plaque . Microbiological examinations revealed, that keeping to the strictest hygiene rules, even the least proposed saddle ponties should be omitted . Attention is called to the utmost importance of motivation and instruction in case of patients wearing bridges. J Clin Periodontol, 1994 Oct, 21(9), 583 - 8 The prevalence of A . actinomycetemcomitans, P . gingivalis and P . intermedia in selected subjects with periodontitis; Van der Weijden GA et al.; The present study was carried out in a private periodontal practice . 8 clinical criteria were chosen to select patients for microbiological examination . These criteria characterize prominent features of disease which at the start, during, or in the maintenance phase of treatment suggest difficulties in the progress of the periodontal therapy . Based on these clinical characteristics, an inventory was made of the prevalence of the 3 putative periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia . Out of 320 referred patients 91 patients did meet > or = 1 of the clinical criteria and consequently were selected for microbiological examination . Results showed that young patients (19-30 years) with periodontitis demonstrated the presence of A . actinomycetemcomitans more often (69%: p < 0.005) compared to older age cohorts . A . actinomycetemcomitans was found more often when localized breakdown (in particular in the 1st molar and incisor region) was observed and in patient who responded poorly to scaling and rootplaning . P . gingivalis and P . intermedia were most frequently recovered in patients showing primarily a bone loss pattern of angular defects of > or = 5 mm . Retrospectively, these patients were further categorized, based on full mouth radiographs, in (1) patients with primarily horizontal bone loss and (2) patients with primarily angular bony defects . Results showed that A . actinomycetemcomitans occurred less frequently in patients showing horizontal bone loss (p < 0.05). Appl Microbiol Biotechnol, 1994 Oct, 42(1), 173 - 8 Microbial cometabolism of sucralose, a chlorinated disaccharide, in environmental samples; Labare MP et al.; During the rapid mineralization in soil of sucralose (4-chloro-4-deoxy-alpha, D-Galactopyranosyl-1,6-dichloro-1,6-dideoxy-beta, D-fructofuranoside), a metabolic product was formed that appears to be the corresponding unsaturated aldehyde . During the slow and incomplete mineralization of sucralose in lake water, which was not increased by the addition of nitrogen and phosphorus, the same compound was produced . That product was further metabolized by microorganisms in lake water and soil . Mineralization was also slow in sewage under aerobic conditions, but organic products were not detected . Little or no CO2 was formed from the disaccharide in flooded soil or anaerobic sewage . Bacteria in culture did not use sucralose as a carbon source but did convert it to the presumed unsaturated aldehyde, 1,6-dichloro-1,6-dideoxy-D-fructose and possibly the uronic acid of sucralose . Sucralose carbon was not incorporated into cells of two sucralose-metabolizing bacteria or the microbial biomass of sewage or lake water . The chlorinated disaccharide was slowly metabolized by a galactose oxidase preparation . It is concluded that the chlorinated sugar is acted on microbiologically by cometabolism. Phytochemistry, 1994 Oct, 37(3), 741 - 7 Chemical-microbiological synthesis of ent-13-epi-manoyl oxides with biological activities; Garcia-Grandos A et al.; The biotransformation of ent-13-epi-3-keto manoyl oxide, which possesses antileishmania activity, with Curvularia lunata produced ent-6 beta-hydroxy, ent-1 alpha-hydroxy, ent-11 beta-hydroxy and delta 1-derivatives, as well as a reduction product a C-3 (S-alcohol) with another hydroxyl group at C-6 (ent-6 beta) or C-11 (ent-11 beta) . The ent-6 beta-hydroxy and delta 1-derivatives inhibited growth of the pathogenic protozoa, Leishmania donovani . The biotransformation of ent-12 alpha-acetoxy-3 beta-hydroxy-13-epi-manoyl oxide and ent-3 beta-acetoxy-12 beta-dihydroxy-13-epi-manoyl oxide gave ent-3 eta,12 beta-dihydroxy-13-epi-manoyl oxide and ent-3 beta,6 beta,12 beta-trihydroxy-13-epi-manoyl oxide (trimanoyl) . Both products increased the activity of adenylatecyclase. Phytochemistry, 1994 Oct, 37(3), 717 - 21 The microbiological transformation of two ent-16 beta,17-epoxykaurane derivatives by Gibberella fujikuroi; Fraga BM et al.; The biotransformation of ent-16beta-17-epoxy-7 alpha-hydroxykaurane by Gibberella fujikuroi affords ent-7 alpha,11 alpha,16 beta,17-tetrahydroxykaurane and ent-7 alpha, 9 alpha, 16 beta, 17-tetrahydroxykaurane . These results indicated that the presence of the 16 alpha, 17-diol group, into which the 16 alpha, 17-epoxy is transformed in the medium, inhibits oxidation at C-19 and favours hydroxylation at C-11(beta) . Incubation of ent-16 beta, 17-epoxykauran-19-oic acid, via the 16 alpha, 17-diol, gave the 7-aldehyde of 16 alpha, 17-dihydroxy-GA12. Arch Ophthalmol, 1994 Sep, 112(9), 1159 - 65 Hypopyon uveitis in patients with acquired immunodeficiency syndrome treated for systemic Mycobacterium avium complex infection with rifabutin; Saran BR et al.; OBJECTIVE: Iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome (AIDS) who are treated for Mycobacterium avium complex (MAC) infection with systemic rifabutin . We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association . DESIGN: Retrospective case series . SETTING: Outpatient clinic and inpatient hospital-based ophthalmology referral practice and infectious disease specialty service . PATIENTS: Seven patients with AIDS, aged 10 to 40 years, presenting with acute unilateral hypopyon mimicking infectious endophthalmitis . MAIN OUTCOME MEASURES: Findings from complete ophthalmological evaluation and ancillary laboratory testing . RESULTS: At the time of presentation, all seven patients were receiving treatment for MAC infection with rifabutin (dosage range, 300 to 600 mg/d) and clarithromycin . Results of microbiological investigations in five patients were negative . Iridocyclitis became bilateral in all seven patients, and hypopyon developed in the contralateral eye in five of seven patients . Hypopyon resolved rapidly with intensive topical corticosteroid therapy . Residual inflammation responded to topical corticosteroids with or without reduction of the rifabutin dosage . CONCLUSIONS: Concomitant use of rifabutin, clarithromycin, and fluconazole may precipitate hypopyon uveitis in patients with AIDS being treated for MAC infection. Crit Care Med, 1994 Sep, 22(9), 1424 - 30 Value of routine pressure monitoring system changes after 72 hours of continuous use; O'Malley MK et al.; OBJECTIVE: To assess the infection potential of not routinely changing invasive monitoring kits and associated plasticware . DESIGN: A prospective, observational study of microbiological contamination of a cohort of pressure monitoring infusion systems . SETTING: Adult intensive care units in a university tertiary care center . PATIENTS: Patients who had invasively monitored arterial, central venous, or pulmonary artery catheters in place for > or = 96 hrs without a change to the system were entered into the study . INTERVENTIONS: Fluid samples were obtained from the proximal stopcock of the monitoring kits every 24 hrs, beginning with a sample at 72 hrs and continuing until either the plasticware or catheter was changed or discontinued . Fluid samples were placed in tryptic soy broth and spread on blood agar plates within 24 hrs . MEASUREMENTS AND MAIN RESULTS: Of 451 intervals in which the system remained unviolated for > or = 96 hrs except for sampling, no positive cultures were found . Of the 333 monitoring kits/lines in the study, four cultures became positive within 48 hrs of a violation of the system (flush bag change) . Positive cultures were obtained from two different patients, one patient having positive fluid cultures from arterial, central venous, and pulmonary arterial kits . This bacterial growth would not have been eliminated with routine system changes as it occurred within a 48-hr timeframe . CONCLUSIONS: Invasive hemodynamic pressure monitoring systems including tubing and plasticware need not be changed routinely as these changes may cause a higher incidence of contamination due to increased violations of the systems. Intern Med, 1994 Sep, 33(9), 536 - 9 Pulmonary infection due to Mycobacterium xenopi; Terashima T et al.; We describe two cases of pulmonary infection due to Mycobacterium xenopi (M . xenopi) . Both cases were men, ages 61 and 54 yr . In the first patient, lung infection due to M . xenopi occurred after gastrectomy . The second patient had an inactive M . tuberculosis infection . Both had pulmonary symptoms including cough, sputum and fever . Each chest X-ray showed an infiltrative shadow with a cavity in a unilateral, upper lobe . Isolates from both patients were studied not only by microbiological characteristics but also by DNA-DNA hybridization . All isolates were susceptible to streptomycin and kanamycin . In the first case, the patient had initially received rifampicin, isoniazid and ethambutol despite in vitro susceptibility patterns, however, there was no response and a new infiltrative shadow appeared in the contralateral lobe . With a multiple drug regimen based on in vitro susceptibility, clinical and roentgenographic improvements were achieved . The second patient showed a favorable response to the initial chemotherapy . Pulmonary infection due to M . xenopi can generally be successfully treated with drugs to which the organisms show in vitro sensitivity . We also reviewed the other two cases reported in Japan. J Periodontol, 1994 Sep, 65(9), 840 - 7 Effects of tetracycline-containing gel and a mixture of tetracycline and citric acid-containing gel on non-surgical periodontal therapy; Jeong SN et al.; The purpose of this study was to assess the clinical and microbiological effects of a newly developed root conditioning gel system containing tetracycline or a mixture of tetracycline and citric acid on non-surgical periodontal therapy . Sixty-four (64) single-rooted teeth with a probing depth of 4 to 6 mm were randomly subjected to one of the following four treatments; 1) root planing alone (RP group); 2) tetracycline-containing gel alone (TCG group); 3) root planing plus tetracycline-containing gel (RP + TCG group); or 4) root planing plus a mixture of tetracycline and citric acid-containing gel (RP + TC-CAG group) . Probing depth, attachment level, and tooth mobility were measured and the presence of dental plaque and gingival inflammation was recorded at baseline and after 2, 4, 8, and 12 weeks . Subgingival plaque samples from each site were collected at the same visits and examined with phase contrast microscopy for proportions of motile rods and spirochetes . Plaque index, gingival sulcus bleeding index (SBI), probing depth, and attachment level decreased significantly in all groups compared to the baseline values (P < 0.05) . A significant decrease in probing pocket depth was noted after 12 weeks in RP + TC-CAG group compared to the other groups (P < 0.05) . Significantly more gain in attachment was detected in the RP + TC-CAG group compared to the TCG group (P < 0.05) . Tooth mobility scores also decreased later in the study . A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group.(ABSTRACT TRUNCATED AT 250 WORDS) J Periodontol, 1994 Sep, 65(9), 835 - 9 Locally delivered minocycline and guided tissue regeneration to treat post-juvenile periodontitis . A case report; Saito A et al.; A case of post-juvenile periodontitis in a 28-year-old female patient is described along with new periodontal treatment modalities . Administration of minocycline-HCl with local drug delivery system was introduced as a part of initial periodontal therapy following microbiological and immunological examinations . The lesions were subsequently treated by guided tissue regeneration, which resulted in considerable gain of attachment with minimal recession of marginal gingiva . This observation suggests that the local delivery of antibiotics and regenerative therapy may prove to be effective alternative modalities in treatment of post-juvenile periodontitis. J Periodontol, 1994 Sep, 65(9), 827 - 34 Actinobacillus actinomycetemcomitans in adult periodontitis . II . Characterization of isolated strains and effect of mechanical periodontal treatment; Mombelli A et al.; Ten systemically healthy subjects (ages 28 to 60 years) with untreated moderate to severe periodontal disease and evidence of presence of A . actinomycetemcomitans underwent standard mechanical periodontal treatment consisting of oral hygiene instruction and systematic deep scaling and root planing . Before, and 4 to 5 weeks after treatment, clinical measurements and separate subgingival microbiological samples were taken from the mesial and distal aspect of every tooth, with the exception of the third molars . A . actinomycetemcomitans could still be detected in all patients after treatment . In 9 of the 10 patients, all tested isolates from both examinations were of a single type . Two patients carried serotype a; 2 serotype b; 2 serotype c; and 1 serotype e . Two individuals showed only non-typeable isolates lacking serotype a, b, c, d, or e specific antigens . Another subject was colonized by serotype c and, in addition, yielded a non-typeable isolate . Persistence of A . actinomycetemcomitans after treatment was significantly correlated with the frequency of A . actinomycetemcomitans before treatment (P < 0.001) and the mean probing depth before treatment (P < 0.05) . No serotype-specific patterns of treatment outcome could be recognized . The analysis of the site specific effect of treatment showed a significant relationship between post treatment levels of A . actinomycetemcomitans and both probing depth reduction as well as attachment gain . Individuals showing evidence of A . actinomycetemcomitans in a multitude of sites appeared to be more difficult to treat than patients with few positive sites only . Within such individuals, the deeper pockets showed the greater resistance to eradication of A . actinomycetemcomitans. Leuk Res, 1994 Sep, 18(9), 665 - 70 The differential diagnostic capacity of serum amyloid A protein between infectious and non-infectious febrile episodes of neutropenic patients with acute leukemia; Casl MT et al.; We studied the behavior of four major acute phase proteins (SAA, CRP, ACT and AGP) in pyrexial occurrences of 16 neutropenic patients with acute leukemia . Altogether 37 febrile episodes were recorded; 27 were infectious in origin (microbiologically documented infection and clinically documented infection, MDI/CDI group) and 10 were pyrexias of unknown origin (PUO group) . In the MDI/CDI group the mean value for the highest individual SAA concentration was 282 +/- 161 mg/l and in the PUO group 95 +/- 79 mg/l . The corresponding mean values were 4.0 mg/l (range 0.2-5.5 mg/l) in 10 control patients with 1 year remission and 0.8 mg/l (range < 0.1-1.2 mg/l) in 30 healthy adults . The peak value of SAA rose above 100 mg/l in 85% of our MDI/CDI pyrexias and in 40% of PUO . More reliable results were obtained when the difference between the value on the day when pyrexia occurred and the previous day was calculated . In that case, the difference was above 75 mg/l in 23 of 27 (85%) MDI/CDI pyrexias and in none of 10 (0%) PUO . In the MDI/CDI group the mean difference was 204 +/- 137 mg/l while it was only 26 +/- 19 mg/l in the PUO group . The statistical significance was very high (p < 0.0001) . The CRP monitoring was very inferior to SAA while ACT and AGP monitorings were unsatisfactory. Eur J Haematol, 1994 Sep, 53(3), 168 - 74 Revisited indications for bone marrow examinations in HIV-infected patients; Ciaudo M et al.; We reviewed the indications for and the results of bone marrow examination (BME) from HIV-infected patients as an attempt to improve its diagnostic yield . One-hundred-and-eight bone marrow specimens from 90 patients during a 3-year period were examined . A cytological, histological and microbiological study was carried out on the specimens . Forty-three evaluable examinations (40% of total) performed for cytopenia showed normo- or hypercellularity in 33 (77%) . Fifty bone marrow specimens were cultured for mycobacteria with a yield of 42% when the indication was persistent fever . Positive cultures yielded Mycobacterium avium complex in 8 out of 12 patients . Twenty-seven patients had both culture and biopsy; granulomas were associated with all the positive (10/10) and with 1 out of 17 negative cultures (chi-square test: p < 0.001) . A bone marrow involvement with lymphoma was found in 2 out of 6 patients with previously diagnosed lymphoma, and biopsy revealed a lymphoma in 2 patients . Morphological bone marrow examination should be associated with other techniques in order to appreciate bone marrow production . Bone marrow biopsy is useful for the investigation of persistent fever since granulomas suggestive of disseminated mycobacteria are frequent and allow a treatment to be initiated before microbiological confirmation and antibiotic susceptibility test. An Med Interna, 1994 Sep, 11(9), 422 - 6 {A pleuropulmonary tuberculosis study in a pneumology service}; Florez Martin S et al.; We reviewed the records of 125 patients admitted in our Service of Pneumology from January 1985 to December 1992, which were diagnosed of pleural or pulmonary tuberculosis . Several characteristics are described, with the following findings: 1) Higher incidence among men . 2) Relevant incidence among young people . 3) Frequent association with risk factors or concomitant diseases, mainly tobacco and alcohol consumption . 4) Delay in the diagnosis, probably due to the unspecific symptoms observed; fever, cough, constitutional syndrome . 5) The must frequent radiological findings were pleural leakage and cavitated infiltrations affecting the upper lobes . 6) Sputum microbiological exam still has a high diagnostic profitability. Clin Oral Implants Res, 1994 Sep, 5(3), 164 - 72 ITI implants in combination with bone grafts: design and biomechanical aspects; Sutter F et al.; In this article we describe the implantation of ITI implants in combination with bone grafts . Two different cases were considered: the augmentation of an atrophic maxilla or mandible where the transplant was fixed by means of ITI implants and the implantation into free transplants fixed by means of the THORP reconstruction plate system . These indications require 2-stage procedures with submerged implants and transplants during the healing period . For this new applications, standard ITI implants were combined with specially developed new transgingival units of high manufacturing precision . The new design resulted in a maximum tightening moment of 4.0 N.m versus 1.25 N.m achievable with a conventional 2-mm screw . Dynamic testing showed that, for the range of tightening moments of 0.25 N.m up to 1.0 N.m, the loosening moment after 2,000,000 cycles remained approximately 10% above the tightening moment . For the clinical application a tightening moment of 0.35-0.5 N.m is recommended . The special design and the high precision of the extension parts results in a tight adaptation between the primary implant and the extension parts, which may be important for microbiological reasons. Fogorv Sz, 1994 Sep, 87(9), 263 - 72 {Treatment of xerostomia with lactoperoxidase-containing mouthwashes and toothpaste}; Sari K et al.; The aim of the study was to determine the effect of a lactoperoxidase--hypothiocyanate enzyme system on the subjective complaints and symptoms of patients suffering from "dry mouth syndrome" with diseases of the oral mucosa . The objective changes in the oral microbiological flora and cytological pattern were also assessed . The lactoperoxidase-enzyme system-containing products--like Oralbalance gel (in combination with Biotene toothpaste)--seems to be a useful tool of choice for symptomatic therapy in patients, complaining of "dry mouth syndrome". Ceylon Med J, 1994 Sep, 39(3), 132 - 4 Econazole and clotrimazole in the treatment of vaginal candidiasis: a double blind comparative study; Perera J et al.; OBJECTIVES: To compare the efficacy of treatment with econazole and clotrimazole in patients with vaginal candidiasis . DESIGN: A double blind study . Patients with vaginal candidiasis were randomly treated with vaginal depot preparations of econazole and clotrimazole . Efficacy after treatment by reduction of symptoms, a gynaecological examination and microbiological analysis of vaginal fluid . Adverse reactions were noted . SETTING: University gynaecological clinic at the de Soysa Hospital for Women, Colombo . PATIENTS: 102 patients microbiologically confirmed as having vaginal candidiasis . RESULTS: Two weeks after econazole treatment 19% still complained of a discharge and 7.5% had pruritus . The respective values for clotrimazole were 18% and 12% . The finding on gynaecological examination generally supported the reduction of symptoms . Microbiological assessment showed that 90.5% in the econazole group and 96% in the clotrimazole group became culture negative at two weeks after treatment . Adverse effects were similar in incidence and number for both treatment groups . Econazole was less acceptable to patients than clotrimazole . CONCLUSIONS: Econazole and clotrimazole are of equal efficacy for treatment of vaginal candidiasis . Econazole was less acceptable to patients. Clin Infect Dis, 1994 Sep, 19(3), 423 - 30 Invasive zygomycosis due to Conidiobolus incongruus; Walsh TJ et al.; During the past decade, an increasing spectrum of pathogenic Zygomycetes fungi have caused infections in humans . The preponderance of these deeply invasive infections have been caused by members of the order Mucorales . However, deeply invasive zygomycoses due to genera of the order Entomophthorales (Conidiobolus species and Basidiobolus species) have seldom been reported . We describe a granulocytopenic patient with pulmonary and pericardial zygomycosis due to Conidiobolus incongruus, describe this organism's susceptibility to antifungal agents, characterize its diagnostic microbiological characteristics, and review previously reported cases of deeply invasive zygomycosis due to Conidiobolus species . In immunocompromised patients, C . incongruus is an uncommon but highly invasive fungal pathogen that may be resistant to amphotericin B and can be distinguished from other Zygomycetes fungi by characteristic mycological features. Antimicrob Agents Chemother, 1994 Sep, 38(9), 2210 - 2 Penetration of cefprozil into middle ear fluid of patients with otitis media; Shyu WC et al.; Penetration of cefprozil into the middle ear fluid was investigated in patients with chronic otitis media . A total of 89 patients ranging from 7 months to 11 years old participated in the study . The middle ear fluid was removed by ventilation tubes inserted through the tympanic membrane at times ranging from 0.38 to 5.97 h after oral administration of a single dose of 15 or 20 mg/kg of body weight . A blood sample was also collected as soon as the middle ear fluid was removed . Plasma samples were analyzed for the concentration of cefprozil by a high-performance liquid chromatographic assay . Middle ear fluid samples were analyzed for the concentration of cefprozil by a microbiological assay . The concentrations of cefprozil in plasma ranged from 0.38 to 15.97 micrograms/ml at the 15-mg/kg dose level and from 1.28 to 21.47 micrograms/ml at the 20-mg/kg dose level . The corresponding middle ear fluid concentrations of cefprozil ranged from 0.06 to 4.44 micrograms/ml and from 0.17 to 8.67 micrograms/ml, respectively . Cefprozil penetrates well into middle ear fluid in patients with chronic otitis media. Antimicrob Agents Chemother, 1994 Sep, 38(9), 2111 - 5 Pharmacokinetics of fluconazole in cerebrospinal fluid and serum of rabbits: validation of an animal model used to measure drug concentrations in cerebrospinal fluid; Madu A et al.; Complete concentration-time data describing the pharmacokinetics of fluconazole in the cerebrospinal fluid (CSF) following a single dose are not available for humans or animals . We studied the pharmacokinetics of fluconazole with an indwelling intracisternal needle as described by R.G . Dacey and M.A . Sande (Antimicrob . Agents Chemother . 6:437-441, 1974) . To determine whether the presence of an intracisternal needle alters pharmacokinetics in the CSF, we validated this model with uninfected rabbits by measuring pharmacokinetic constants following direct intracisternal and intravenous administration of fluconazole . Following direct injection, there was no alteration of elimination rates in the CSF with increasing sample number or time . Following intravenous administration, the penetration and kinetic constants were the same in individual animals from which multiple CSF samples were obtained as in a composite subject constructed by pooling virgin samples from different animals . The presence of the intracisternal needle did not alter CSF chemistry or leukocyte counts, and erythrocyte contamination was < 0.001% . While drug concentrations were measured by a microbiological assay, we also compared the sensitivity and reproducibility of a high-performance liquid chromatography (HPLC) assay with those of the microbiological assay . Following a single intravenous dose, the maximum concentration of the drug in serum, the time to maximum concentration of the drug in serum, the terminal elimination half-life in the CSF, and the percent penetration by fluconazole were 6.12 micrograms/ml, 1 h, 9.0 h, and 84.3%, respectively . We conclude that the sampling of CSF via an indwelling needle does not alter fluconazole pharmacokinetics, cause inflammation, or alter chemical parameters; that the microbiological assay is at least equivalent in sensitivity and reproducibility to the HPLC assay; and that robust parameters describing the pharmacokinetics of fluconazole are possible with this model. Pediatr Pathol, 1994 Sep-Oct, 14(5), 817 - 22 How useful is postmortem examination in sudden infant death syndrome? Byard RW, Carmichael E, Beal S. There exists great variability in the literature as to the percentage of cases of sudden and unexpected infant death in which definable causes can be identified . Review was undertaken of the clinical and family histories, death scene features including parental interviews, and pathological and microbiological features of 361 consecutive cases presenting as sudden and unexpected infant death with minimal preceding symptoms and signs to the Adelaide Children's Hospital over a 10-year period from 1983 to 1992 . Three hundred and twenty-nine cases of SIDS were identified . Nine cases (2.5%) were attributed to accidental asphyxia based partly on death scene examination . This left only 23 cases (6.4%), which were due to a variety of other diverse entities including sepsis, volvulus with sepsis, congenital cardiac disease, probable metabolic disorders, heat stroke, and unclassifiable disorders . This relatively low figure lends support to definitions of SIDS that emphasize the importance of death scene investigation and clinical history review prior to postmortem examination. Pol Arch Med Wewn, 1994 Sep, 92(3), 251 - 9 {Tuberculosis--an increasing risk for patients treated with long-term hemodialysis}; Sulima-Gillow A et al.; In the recent years an increase in the incidence of tuberculosis (TB) has been observed world-wide, including Poland . In the Department of Nephrology of Gdansk School of Medicine, an increase in the incidence of TB has been observed among patients undergoing maintenance hemodialysis (HD) . The aim of this work was to analyse the natural history of TB infection in this group of patients . Over the last seven years TB was diagnosed in 9 patients (5 female, 4 male) out of 171 patients on HD (5.2%) . Seven of those were diagnosed in the last three years . The average age of patients with TB was 47.2 years . In three patients the clinical symptoms of TB has appeared during the first year of hemodialysis treatment (average 5.6 months), in the rest the mean period of dialysis before the TB diagnosis was 60 months . The TB was extrapulmonary (lymph nodes, pericardium and bones) in 5 patients . In most cases the clinical symptoms of TB were present, however, one patient was asymptomatic . Four cases were confirmed microbiologically and/or histopathologically . All patients treated with antituberculous drugs showed clinical recovery or cure, however in six patients the anti TB treatment was complicated by adverse drug reactions . One patient died and TB was diagnosed post mortem . In two patients who had had lymph nodal TB 2 and 6 years earlier, we now observed pulmonary TB . There were no cases of TB among hemodialysis unit staff . Conclusions: There is a increasing incidence of TB in population of HD patients.(ABSTRACT TRUNCATED AT 250 WORDS) Mycopathologia, 1994 Sep, 127(3), 183 - 8 Mycoflora of the toxic feeds associated with equine leukoencephalomalacia (ELEM) outbreaks in Brazil; Meireles MC et al.; The mycoflora of 39 feed samples associated with 29 Equine Leukoencephalomalacia (ELEM) outbreaks was studied from 1988 to 1990, in Brazil . Microbiological examination indicated Fusarium spp . as the most frequent mold which occurred in 97.4% of samples followed by Penicillium spp . in 61.5% and Aspergillus spp . in 35.9% . The moisture content of feed implicated in death of horses was above 15% which can favor the development of Fusarium spp . From the genus, F . moniliforme was the predominant species with an occurrence of 82.0% . Two additional species, not commonly associated with animal toxicosis, were isolated in low frequency, F . proliferatum (12.8%) and F . subglutinans (2.6%) . It is important to emphasize that the isolation of F . proliferatum and F . subglutinans from feed obtained from the epizootic areas has not been documented previously in Brazil. Southeast Asian J Trop Med Public Health, 1994 Sep, 25(3), 457 - 8 The increasing importance of vitamin B12 deficiency as a contributing factor to anemia in Malaysia; Ishak R et al.; A comparative study was done to determine the profile of vitamin B12 and folate status in Malaysians during two different periods . For the period of 1987/88, we analysed a total of 9,162 cases (inpatients) referred for vitamin B12 estimation and 10,290 cases for folate estimation . We found that 2.6% were vitamin B12 deficient and 31.2% were folate deficient . For the period of 1992/93, of the 9,962 cases assayed, 8.2% were found to be vitamin B12 deficient whereas 7.6% of the 10,355 cases referred were folate deficient . Vitamin B12 and folate were assayed either using microbiological or radioassays . These findings indicate that there appears to be a change in the status of both vitamin B12 and folate over the five year interval. Eur J Biochem, 1994 Aug 15, 224(1), 97 - 101 Synthesis and characterization of Desulfovibrio gigas rubredoxin and rubredoxin fragments; Christensen HE et al.; The 52-residue Desulfovibrio gigas rubredoxin peptide chain has been synthesized and a procedure for chain folding around iron(II) developed . The folded, stable synthetic rubredoxin can be subjected to purification, and reversibly oxidized and reduced . Ultraviolet/visible absorption and CD spectra of both forms show all the same features as native D . gigas rubredoxin, and the symmetric and asymmetric Fe-S stretching bands in the resonance Raman spectrum can be identified . In addition, the matrix-assisted laser desorption mass spectrum of a peptide sample exposed to trace amounts of iron is dominated by a peak at 5735Da very close to the value for the calculated molecular mass . Details in the ultraviolet/visible bandshape and mass spectrum, however, indicate remaining impurities . In comparison, a previously synthesized 25-residue rubredoxin fragment with the non-conserved positions 13-35 and 51-52 omitted and Val5-Glu50 anchored via glycine folds gives the correct molecular mass and ultraviolet/visible spectrum, but is much more labile than the 52-residue protein . This shows that non-conserved residues are crucial in protein folding and that chemical metalloprotein synthesis offers alternative prospects to microbiological protein engineering. J Clin Pharm Ther, 1994 Aug, 19(4), 249 - 56 Enhancement of microbiological safety levels of aseptically admixed total parenteral nutrition solutions through low-dose gamma irradiation; Koornhof HJ et al.; This study was undertaken to determine the effect of low-dose gamma irradiation on aseptically admixed total parenteral nutrition (TPN) solutions to which large inocula of three test bacterial species were added . Microbiological safety levels were quantified in terms of sterility assurance levels (SALs), indicating the probability of contamination occurring expressed as 10-n . The radiation sensitivity (D10 values) of test bacteria in TPN solutions inoculated with a series of bacteria recognized as common contaminants of these products, was determined . Attainable SALs of TPN solutions containing test bacteria were subsequently calculated from the D10 values . Results showed that a minimum absorbed radiation dose as low as 1.5 kGy improved the SAL of aseptically prepared TPN solutions from a probability value of 10(-3) to a value of less than 10(-8) for the microorganisms investigated . At an absorbed dose as high as 8.3 kGy, no measurable changes in amino acid, electrolyte, glucose and lipid components of the solutions were detected . These findings have important implications for the enhancement of microbiological safety levels of aseptically prepared intravenous fluids in general. Clin Infect Dis, 1994 Aug, 19(2), 339 - 41 Successful treatment of systemic and local infections due to Exophiala species; Gold WL et al.; We report the successful treatment of three cases of infection due to Exophiala species . These organisms belong to the heterogeneous group of dematiaceous (darkly pigmented) fungi . Two cases of infection occurred in organ transplant recipients who were receiving immunosuppressive medications . Both of these infections remained localized to the subcutaneous tissues and were successfully treated with surgical excision of the lesions . We also describe what is to our knowledge the first reported case of prosthetic valve endocarditis due to Exophiala castellanii that was managed with a combination of medical and surgical therapies . Exophiala species remain an uncommon cause of infection . However, as the population of immunocompromised patients continues to grow and further improvements in the microbiological techniques for identification of these fungi occur, these organisms will be recognized with increasing frequency as a cause of human disease. J Pharm Sci, 1994 Aug, 83(8), 1147 - 9 A rapid HPLC method for the quantification of tyrothricin, menthol, and benzocaine in pharmaceutical formulations; Caraballo I et al.; A rapid, sensitive, and accurate reversed-phase HPLC method has been developed for the analysis and quantification of pharmaceutical formulations containing tyrothricin (1), an antibiotic used in antiseptic buccal compressed tablets for local application . The assay has been carried out under isocratic conditions, using a stationary phase of alumina particles coated with polybutadiene and an alkaline mobile phase (pH = 8.2) . No HPLC method was reported for the analysis of 1 . So, this new technique is an alternative to the slow and tedious microbiological methods . On the other hand, it allows the simultaneous quantification of 1, benzocaine (2), and menthol (3), an aromatic compound not currently analyzed by liquid chromatography. J Periodontol, 1994 Aug, 65(8), 766 - 70 Clinical and microbiological status of osseointegrated implants; George K et al.; Peri-implantitis, an inflammatory response around implants, has a poorly defined etiology and pathogenesis . To better understand the role of specific microorganisms in this disease process, clinical and microbiological parameters were examined in 24 patients with 98 osseointegrated implants . Sites were evaluated for probing depth (PD), plaque/calculus index (PI), gingival bleeding index (GBI), mobility, and crevicular fluid flow rate (CFFR) . Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in subgingival plaque were identified by latex agglutination assays . Clinically, a statistically significant correlation (P < 0.001) was observed between probing depth and the length of time an implant was present . Mobility was also significantly greater (P < 0.001) in the maxillary than in the mandibular implants . Subgingival sites harboring one of the three microorganisms had significantly greater PD, GBI, and CFFR than non-colonized sites . Implants in partially edentulous patients more frequently were colonized with P . gingivalis/P . intermedia than edentulous patients . The incidence of these microorganisms also correlated with fixture longevity . Implants present for 3 to 4 years had a significantly greater frequency of test microorganisms than implants present for 1 to 2 years . These findings suggest that microbial pathogens associated with periodontitis occur more commonly around implants exhibiting gingival inflammation (GBI) and may contribute to peri-implantitis. Rev Esp Enferm Dig, 1994 Aug, 86(2), 569 - 76 {Prevalence of Helicobacter pylori infection in symptomatic adults}; Boixeda D et al.; AIM: To study the prevalence of Helicobacter pylori infection in different gastroduodenal entities in a wide group of symptomatic patients of our area . MATERIALS AND METHODS: 796 (493 females) patients referred to our Hospital for upper gastrointestinal endoscopy were studied . Mean age was 51.1 +/- 16.6 yrs . In all patients biopsies samples were taken from the gastric antrum for histological and microbiological (urease test) studies . A patient was considered Helicobacter pylori negative when its presence was not proved by microbiological and histological methods . RESULTS: 70.9% (73.8% males and 64.7% females) were Helicobacter pylori positive . The great majority of patients belong to 4 . and 5 . decade . Endoscopic diagnosis were: normal endoscopy 47.4%; antral gastritis 79.9%; pangastritis 68%; gastric ulcer 75.9%; duodenal ulcer 98.2%; pyloric ulcer 94.7%; endoscopic duodenitis 95.7%; gastric cancer 31.9%; operated stomachs 45.6%; and esophagitis 33.3% . CONCLUSIONS: The urease test had a high specificity (100%) and sensitivity (90%) . Global results of H . pylori infection and its distribution among different gastroduodenal entities was similar to those described in other publications in our setting, although the prevalence was lower when compared with those countries with a lower socioeconomic status . H . pylori infection age-distribution suggests that this infection is acquired throughout life. Zh Mikrobiol Epidemiol Immunobiol, 1994 Aug-Sep, Suppl 1, 64 - 8 {Is sarcoidosis a chronic persistent infection?}; Khomenko AG et al.; The study carried out with the use of microbiological diagnostic methods has revealed that in 67% of cases specimens obtained from sarcoidosis patients for analysis contain different forms of mycobacteria (typical Mycobacterium tuberculosis and granular forms of mycobacteria) . The content of typical and granular forms of mycobacteria detected in diagnostic specimens has been shown to differ, depending on the clinical form of sarcoidosis: as a rule, in cases of the sluggish course of sarcoidosis granular forms of mycobacteria are detected, while during the exacerbation of the disease and in cases of the acute course of newly diagnosed sarcoidosis the proportion of typical M.tuberculosis increases . To verify M.tuberculosis with greater certainty, two highly sensitive and specific amplification test systems have been developed on the basis of polymerase chain reaction . In this article the goals of microbiological and molecular genetic investigations which may jointly give direct proofs of the etiological importance of mycobacteria in sarcoidosis are considered and discussed; sarcoidosis may probably be regarded as chronic persistence infection. J Chemother, 1994 Aug, 6(4), 257 - 64 Pefloxacin in the treatment of severe infections in gynecological cancer patients; Scalambrino S et al.; Infections often complicate the medical or surgical treatment of hospitalized cancer patients . In these cases, a broad-spectrum antibiotic treatment is necessary before the microbiological results are available . The aim of the present study is to verify the efficacy of pefloxacin as empirical antibiotic therapy in controlling infectious complications induced by surgery, chemotherapy or radiotherapy in female patients with gynecological cancer . To this purpose, 58 hospitalized patients with gynecologic malignancy and severe infectious complications were treated with intravenous pefloxacin at the dosage regimen of 400 mg every 12 hours . In all, 49 (or 91%) of the 54 evaluable patients were cured . The mean duration of successful treatment was 5.9 +/- 2.1 days (ranging 4-13 days) . No side effects or clinical laboratory abnormalities requiring reduction or discontinuation of therapy were observed . We conclude that pefloxacin may be considered a first choice, broad-spectrum, single antibiotic for use in the empirical therapy of infections in gynecological cancer patients. J Chemother, 1994 Aug, 6(4), 243 - 5 Stability of cefodizime in solution and compatibility with other injectable drugs; Merighi M et al.; The stability of cefodizime in five intravenous infusion fluids (0.9% sodium chloride, 5% dextrose in water, 10% dextrose in water, 5% amino acid injection, 3% polygeline) was studied at room temperature and at 4 degrees C . The compatibility of cefodizime with commonly used injectable drugs (ranitidine, metoclopramide, folinic acid, furosemide, aminophilline, methylprednisolone, betamethasone, hydrocortisone, dexamethasone, ketoprofen, noramidopyrine, acetylcysteine, digoxin, diazepam, acetylsalicylic acid, chlorpromazine, clonidine, clomipramine) was studied in 0.9% sodium chloride and 5% dextrose at room temperature . At intervals during the storage periods (up to 24 hrs at room temperature; up to 6 days at 4 degrees C) color, clarity and solution pH were examined; cefodizime content was determined by a microbiological method . Cefodizime concentrations remained greater than 90% of the initial concentrations in all infusion fluids for at least 24 hrs at room temperature and 6 days at 4 degrees C . No visual changes or appreciable changes in pH were observed for any of the solutions . Immediate clouding was observed when chlorpromazine was combined with the solution of cefodizime . A color change was observed when acetylcysteine was mixed with cefodizime . An increase in pH was noted when aminophilline was added to the solution of cefodizime . However, cefodizime concentrations remained greater than 90% of the initial concentrations of the solutions after mixture with all the tested drugs for at least 24 hrs at room temperature.(ABSTRACT TRUNCATED AT 250 WORDS) Aust N Z J Ophthalmol, 1994 Aug, 22(3), 207 - 9 Scedosporium prolificans sclerokeratitis; Sullivan LJ et al.; BACKGROUND: The fungus Scedosporium prolificans was first described as a human pathogen in 1984, and has been associated with metastatic endophthalmitis and one previously reported case of sclerokeratitis . METHODS: We report a case of S . prolificans sclerokeratitis in the setting of late scleral necrosis complicating pterygium surgery with adjunctive beta-irradiation . RESULTS: A poor clinical response to topical natamycin and amphotericin B, and systemic itraconazole and ketoconazole was encountered . Enucleation was required, with subsequent microbiological cure . Pathological correlation is described . CONCLUSIONS: S . prolificans infections often respond