Microbiological

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 poorly to medical therapy . Early surgical intervention is indicated in culture-proven scleritis due to Scedosporium prolificans.

AIDS Res Hum Retroviruses, 1994 Aug, 10(8), 913 - 6
Disseminated Mycobacterium avium complex disease in patients with AIDS; Benson C; Disseminated Mycobacterium avium complex (MAC) infection is a common complication of advanced HIV disease that is associated with significant morbidity . After diagnosis of MAC by recovery of organisms from blood or other normally sterile sites, specific treatment with multiple-drug regimens is appropriate and may reduce morbidity . Multiple-drug regimens with agents active against MAC should be employed to reduce the development of drug resistance . Unfortunately, as most clinical trials of anti-MAC agents have lasted 12 weeks or less and have not compared specific agents, the most effective multiple-drug regimen has not been established . The U.S . Public Health Service Task Force on Prophylaxis and Therapy of MAC recommends treatment of disseminated disease with at least two antimycobacterial agents, one of which should be clarithromycin or possibly azithromycin . Ethambutol, which may have an additive or synergistic effect in combination with other anti-MAC agents, is a reasonable second drug . Other agents with activity include rifampin or rifabutin, clofazimine, ciprofloxacin, or parenteral amikacin . A microbiological response may require up to 2 to 8 weeks . The clinical response generally parallels the microbiological response . Rifabutin, which is licensed for prophylaxis of MAC, reduces the incidence of and delays the time to MAC bacteremia . Individuals at highest risk of MAC bacteremia (i.e., CD4+ cell counts of < 75-100 cells/microliters) had the most benefit from rifabutin prophylaxis . Tuberculosis must be ruled out before rifabutin prophylaxis is initiated . Careful observation without prophylaxis is an acceptable alternative for those who are not able to take rifabutin or alternative agents.

Nihon Kyobu Shikkan Gakkai Zasshi, 1994 Aug, 32(8), 747 - 51
{Detection of Mycobacterium tuberculosis in transbronchial biopsy specimens by polymerase chain reaction}; Yamada M et al.; Polymerase chain reaction (PCR) for the rapid detection of Mycobacterium tuberculosis was used to test 30 clinical specimens (transbronchial biopsy specimens) from patients in whom tuberculosis was suspected on chest X-ray . In these patients, 15 cases were histologically diagnosed as tuberculosis . Among them, M . tuberculosis was detected in 8 specimens by PCR . Of 8 PCR positive specimens, 7 were also positive by smear and culture; the other was negative by smear and positive by culture . On the other hand, 15 cases were therapeutically diagnosed as the tuberculosis and these specimens showed negative results in neither PCR nor microbiological tests . We conclude that the PCR method is useful for rapid and direct detection of M . tuberculosis in transbronchial biopsy specimens.

Zentralbl Hyg Umweltmed, 1994 Aug, 196(2), 170 - 80
{Experiences with optimized methods for the detection of legionellae in drinking water}; Frahm E et al.; Entry of Legionellae into domestic water systems by passing through the drinking water distribution network has been assumed . To prove this question, samples were collected within a two years period at warm and cold water taps of households, the pipeline network and three water works of the city of Mainz, and examined for the presence of Legionellae . To detect even very small numbers of Legionellae, improvement of the conventional isolation procedure was necessary . Additionally, large volumes of cold water samples (50-250 L) were processed by using a pressure filter . For identification of Legionellae, an immunological rapid test (colony-blot-assay, own development) and a commercial gene-probe test (EnvironAmp Legionella Kits, Applied Biosystems) were enclosed in the programme . With the refined techniques the detection limit was improved while expenses of time and labour were reduced . Finally, the advantages and disadvantages of the single methods are discussed . For routine detection of Legionellae in the microbiological laboratory, a combination of effective methods is proposed which are easy to perform.

Trends Biotechnol, 1994 Aug, 12(8), 312 - 24
Neural-network contributions in biotechnology; Montague G et al.; In the mid-1980s, widespread interest in research into artificial neural networks re-emerged following a period of reduced research funding . The much wider availability and the increased power of computing systems, together with new areas of research, is expanding the range of potential application . The main reason for this is that the potential to describe the characteristics of extremely complex systems accurately has been attributed to this methodology . This article examines the contribution of various network methodologies to bioprocess modelling, control and pattern recognition . Industrial processes can benefit from the application of feedforward networks with sigmoidal activation functions, radial basis function networks and autoassociative networks . The contribution that neural networks can make to biochemical and microbiological scientific research is also reviewed briefly.

Commun Dis Rep CDR Rev, 1994 Jul 22, 4(8), R93 - 5
Surveillance of waterborne disease in England and Wales; Nazareth B et al.; A pilot scheme, designed to improve the information on waterborne disease available nationally, was set up in five health regions from October 1991 to March 1992 . Consultants in communicable disease control were asked to report each month on confirmed and suspected cases of waterborne disease, and microbiological and other contamination incidents . Twelve events were reported to the PHLS Communicable Disease Surveillance Centre (CDSC) in six months: five involved human illness and seven were contamination incidents . Six other events were reported to CDSC from regions that did not take part in the scheme . The total number of events reported was small and epidemiological evidence that linked disease with water consumption was often weak or absent . Nevertheless, the scheme provided valuable information on events associated with water and would prove useful if it were established nationally, linked with guidance on the investigation of incidents.

J Chromatogr B Biomed Appl, 1994 Jul 15, 657(2), 395 - 9
Identification and separation of five cephalosporins by micellar electrokinetic capillary chromatography; Sciacchitano CJ et al.; The cephalosporins are a group of structurally related, broad spectrum beta-lactam antibiotics isolated from the mold Cephalosporium . Methods of analysis of cephalosporin antibiotics include microbiological, titrimetric and chromatographic assays . Chromatographic techniques, including high-performance liquid chromatography, have been extensively utilized for specific and sensitive assays of beta-lactam antibiotics in a variety of matrices, i.e . clinical and pharmaceutical . Several of the drawbacks of HPLC in the analysis of cephalosporins in food and biological samples include matrix interferences and low resolution due to column adsorption . Recently, the applicability of capillary electrophoresis to the resolution of beta-lactam antibiotics has been demonstrated in the literature . In this paper we employed sodium borate and an anionic surfactant, sodium dodecyl sulfate (SDS), in a separation technique called micellar electrokinetic capillary chromatography with UV detection, to resolve a mixture of five cephalosporins--cefuroxime, cephalexin, cephapirin, cefamandole nafate and cephalothin . The presence of SDS in the running buffer above the critical micelle concentration, creates a pseudostationary phase enabling high-efficiency chromatographic separations . The effect of the ion-pairing reagent, pentanesulfonic acid sodium salt, on the resolution of the cephalosporin mixture in conjunction with SDS was also examined.

J Healthc Mater Manage, 1994 Aug, 12(8), 36 - 42
A novel test model for routine microbiological control of automated washer/disinfectors for flexible endoscopes; Geiss HK et al.; Concerns exist about effective methods for endoscope cleaning, disinfection and sterilization . The aim of this study was to establish a model for controlling the function of automatic washer/disinfectors for flexible endoscopes under routine conditions . The team developed a dummy endoscope channel system representing two complete gastroscopes and a colonoscope, with channels joined together and fitted with adaptors to allow the models to fit into different washer/disinfectors . The models were artificially contaminated with various combinations of four test organisms and coagulating blood and run through test cycles in different washer/disinfectors . A total of 24 test runs were performed . The reduction of a given microbial burden by at least five log steps is an established measure of efficacy of a decontamination procedure . When the two challenge tests (45 channels) and the six positive controls are excluded, only 13/309 channels (4.2%) failed the proof of efficacy . In contrast, the failure rate in the challenge test was 65.3% . The difference of the final bioburden is statistically significant . The data suggest this test model could be regarded as a first step in rational and reliable biological control of flexible endoscope reprocessing.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1994 Jul-Aug, 35(4), 253 - 60
Helicobacter pylori: a predominantly childhood infection--predominantly adult disease; Banatvala N; It is now 12 years since Helicobacter pylori was first cultured in an Australian laboratory . During these years significant understanding of the organism, its epidemiology and its disease associations have been made . Diagnostic methods and therapeutic regimens have appeared and been refined . In this article microbiological, epidemiological and clinical aspects of adult and childhood H . pylori are linked to present and future public health problems.

J AOAC Int, 1994 Jul-Aug, 77(4), 885 - 90
Determination of monensin in chicken tissues by liquid chromatography with postcolumn derivatization; Moran JW et al.; A method is described for the detection and quantitation of monensin in chicken tissues by liquid chromatography with postcolumn derivatization with vanillin . Monensin is extracted from the tissues by homogenization with methanol-water and is isolated and concentrated by liquid-liquid partition and sorbent extraction with silica gel . Monensin is mixed postcolumn with vanillin under acidic conditions and heated, and the resulting products are measured by a variable-wavelength detector operating at 520 nm . The method has a limit of quantitation of 0.025 microgram/g and is validated for use in the analyses of chicken muscle, liver, and skin (with adhering fat tissues) for monensin . Standard recoveries from the 3 tissue types tested at 3 levels ranged from 82 to 96% . The method represents an improvement in specificity, accuracy, and analysis time over existing methods, which use microbiological techniques.

Chemosphere, 1994 Jul, 29(1), 47 - 53
Volatile organic compounds from household waste; Wilkins K; Ninety volatile organic compounds were identified in the headspace of biodegradable and mixed household waste by GC/MS . Most of them could be attributed to biological waste, microbiological growth in biological waste or packaging materials . Although none of the compounds were present at concentrations exceeding their threshold limit values, it is possible that in closed garbage cans or containers organic sulfur compounds could contribute to the reported gastrointestinal problems of collection personnel.

J Infect Dis, 1994 Jul, 170(1), 242 - 6
A double-blind placebo-controlled trial of single-dose intravaginal versus single-dose oral metronidazole in the treatment of trichomonal vaginitis; Tidwell BH et al.; Since metronidazole is a mutagen in vitro, there is concern about the widespread systemic use of this drug in women with trichomoniasis, particularly those who are pregnant . A randomized, double-blind, placebo-controlled trial compared a single 2-g intravaginal dose of metronidazole cream with a single 2-g oral dose of metronidazole in patients with a culture positive for Trichomonas organisms . Of the 302 preenrollment cultures completed, 94 (31%) were positive . Sixty-one patients were enrolled in the study . Each received either oral placebo and intravaginal metronidazole or intravaginal placebo and oral metronidazole . Follow-up cultures were done on posttreatment day 3-5 . Of the 53 evaluatable patients, 14 (50%) of 28 in the intravaginal group and 22 (88%) of 25 in the oral group were microbiologically cured (P = .0037) . Single-dose intravaginal metronidazole is inferior to single-dose oral metronidazole and cannot be relied on as an alternative therapy.

New Microbiol, 1994 Jul, 17(3), 217 - 23
Rate of occurrence of Helicobacter pylori in patients with gastroduodenal pathology: pilot research; Nicosia R et al.; In an attempt to establish the etiologic role of Helicobacter pylori (H . pylori) in gastric and/or duodenal pathology, 169 patients were tested and compared with a control group of 25 healthy subjects, for a total of 194 subjects . Data on sex, age, familiarity, smoking, coffee and alcohol habits were collected and each patient underwent histological, microbiological and immunological tests . 80 (41.2%) subjects were found positive to H . pylori . This bacterium was detected in 53.3% of patients with gastric ulcer while IgG were found in 86.7%; in 50% of patients with chronic atrophic gastritis while IgG were detected in 80%; in 48.5% of patients with duodenal ulcer while IgG were found in 87.9%; in 41.8% of patients with superficial chronic gastritis while IgG were detected in 80.2% . In the control group of healthy patients H . pylori was found in 28% of patients while IgG were detected in 62.5% . The results do not confirm a direct clear-cut correlation between this microorganism and the pathologies studied.

J Pain Symptom Manage, 1994 Jul, 9(5), 308 - 11
The stability of mixtures of morphine hydrochloride, bupivacaine hydrochloride, and clonidine hydrochloride in portable pump reservoirs for the management of chronic pain syndromes; Wulf H et al.; The physical and chemical stability of a combination of drugs commonly administered into the epidural or intrathecal space for the treatment of chronic pain was investigated . The concentrations of bupivacaine hydrochloride, morphine hydrochloride, and clonidine hydrochloride were measured using high performance liquid chromatography . The solutions were stored in reservoir bags for up to 90 days . No macroscopic or microbiological signs of precipitation, change in color, or contamination were observed, and pH remained stable . None of the three drugs declined in concentration during the observation period . A small increase in concentration of all three drugs did occur over time, most probably due to evaporation processes . In conclusion, no problems in physical or chemical stability are to be expected when combining morphine, bupivacaine, and/or clonidine for long-term epidural or intrathecal administration . In the case of clinically apparent loss of analgesic efficacy, other mechanisms should be considered.

J Hosp Infect, 1994 Jul, 27(3), 219 - 35
How hospital linen and laundry services are provided; Barrie D; Hospitals provide clean linen for patients and staff . This article describes the laundering process, laundry equipment, how used hospital linen differs from that of other large organizations and the Department of Health guidance on handling and laundering hospital linen . It reviews how hospital linen contracts are awarded and the responsibilities of the team which evaluates them . Methods of microbiological testing of laundered linen and the interpretation of the results are considered . The properties of different fabrics available for use in operating theatres are summarized . Measures to prevent infection and injury to staff handling used linen are given.

Can J Vet Res, 1994 Jul, 58(3), 185 - 8
Microbiological evaluation of groups of beef carcasses: heifers and steers; Jericho KW et al.; Numbers of mesophilic bacteria were estimated on carcasses of 25 heifers and 25 steers of beef breeds in a modern, high-line-speed abattoir . One side of each carcass from each sex was sampled at the end of the kill-floor, before the carcass wash, on each of 25 visits . Two adjacent excision samples (5 x 5 x 0.5 cm) were taken from each of ten sites and processed for automatic enumeration of aerobic bacteria on hydrophobic grid membrane filters . The effects of sex and carcass weight on bacterial counts were examined . Groups of carcasses were examined to determine the sample size required for future assessments of kill-floor hygiene . The log10 of the most probable number of growth units (MPNGU)/cm2 did not differ significantly between heifers and steers (average over the ten sites of 2.2) and there was no effect of carcass weight on bacterial counts for nine of the ten sites . There were, however, highly significant (p < 0.001) differences in the counts between sites and the counts from the ten sites clustered into five homogenous groups . The between-carcass component of variation at a site was generally larger than the within-carcass component . We conclude that, to estimate the mean log10 MPNGU/cm2 at a site to within +/- 0.5 units, future group-carcass evaluations require about 200 samples from 10 (two adjacent samples/site) or 20 carcasses (one sample/site).

Arzneimittelforschung, 1994 Jul, 44(7), 850 - 5
Analytical-physical profile of the novel macrolide antibiotic flurithromycin ethylsuccinate; Colombo N et al.; Data are reported on the structural characterization of flurithromycin ethylsuccinate (FE, CAS 82730-23-2), a novel macrolide antibiotic . UV, IR, NMR and MS spectra confirmed the structure; in particular the presence of ketonic-hemiketalic equilibrium, already described for flurithromycin A, is supported by NMR and HPLC studies . Moreover physico-chemical properties and stability were studied; the product exhibits a good stability at solid state, whereas degradation products are present both in acidic and basic solution . Microbiological activity and principal pharmaceutical features were carried out.

Rozhl Chir, 1994 Jul, 73(5), 223 - 4
{Actinomycosis in surgery as a cause of non-healing abscesses}; Krikava K; The author describes the case-history of three subcutaneous abscesses resistant to healing with a very difficult microbiological diagnosis of the specific process . The actinomycotic origin was revealed only after repeated cultivation . Only after detection of the agent and aimed therapy with high PNC doses it proved possible to improve the patients' condition relatively quickly and substantially . Treatment is, however, of a prolonged character.

Poult Sci, 1994 Jul, 73(7), 1144 - 8
The effect of incubation temperature on recovery of mesophilic bacteria from broiler chicken carcasses subjected to temperature abuse; Russell SM et al.; The optimum temperature to recover mesophilic organisms from temperature-abused broiler chicken carcasses was determined . Twenty broiler carcasses were collected from a commercial processing plant in each of three trials . Ten carcasses were sampled immediately (Day 0 control); 8 carcasses were sampled after holding at 3 C for 3 d, temperature abusing at 25 C for 12 h, and holding them at 3 C for an additional 3 d (temperature abused); and the remaining 2 carcasses were sampled after holding at 3 C for 7 d (Day 7 control) . Whole carcass rinses were analyzed using total aerobic plate counts (TPC) and impedimetric detection times (DT) at incubation temperatures of 41, 42, 43, and 44 C . Total plate counts decreased (P < .05) and DT increased (P < .05), at all incubation temperatures tested, for carcasses held under refrigeration (Day 7 control) . This demonstrates that mesophilic bacteria, rather than psychrotrophic bacteria, are being enumerated, because psychrotrophs increase on chicken skin upon cold storage . Total plate count was greater (P < .05) and DT was significantly lower for temperature-abused vs Day 7 control birds (5.7 vs 3.6 log10 cfu/mL and 3.7 vs 6.5 h), respectively . These results indicate that temperature-abused carcasses can be microbiologically distinguished from nonabused controls at all incubation temperatures tested . Recovery of mesophiles was optimal at 41 and 42 C for TPC and 41, 42, and 43 C for DT . Because there were no differences between DT at 41, 42, and 43 C, and because 42 C has been successfully used in the past, either 42 C or 43 C can be used when determining DT.

Klin Monatsbl Augenheilkd, 1994 Jul, 205(1), 3 - 13
{Uveitis research 1963-1993 . 1993 Bruppach Lecture of the Zurich University}; Martenet AC; Considerations on the evolution of research on uveitis in the last thirty years . In the sixties, one was mainly looking for the etiology of the disease . Simultaneous serological investigations in serum and aqueous humor allowed in positive cases to conclude on a local antibody production, and thus certify the role of a given microbiological agent, for instance a virus . In the same time however, the importance of autantigens such as lens or uvea tissues was recognized . Even more important was the discovery of the s-antigen (soluble antigen) from the outer segments of the retinal photoreceptors, and with it the development of the model EAU (experimental autoimmune uveitis) . Since 1970, multiple pathogenetical, for instance genetic, processes of uveitis could be studied on molecular-biological level, among them the mechanisms of antigen presentation or the role of the various lymphocyte subpopulations during the immune response . There was also an evolution about therapy of uveitis during these 30 years . Main drugs were in the sixties steroids and classical cytostatics, later came cyclosporin-A and other immune modulatory drugs such as FK-506 . Finally, still only experimental, new methods of modulation of the disease are studied, such as changes in the presentation of the antigen or modulation of the immune response through monoclonal antibodies.

Bioorg Med Chem, 1994 Jul, 2(7), 609 - 16
Microbiological transformations--XXIX . Enantioselective hydrolysis of epoxides using microorganisms: a mechanistic study; Pedragosa-Moreau S et al.; The regio- and stereochemistry of the hydrolysis of styrene oxide 1 by two fungi: Aspergillus niger and Beauveria sulfurescens, were studied using H2(18)O labelling experiments . Also, the kinetic parameters of these hydrolyses were determined . We conclude that the epoxide hydrolases of these two fungi operate via different mechanisms.

Stomatologiia (Mosk), 1994 Jul-Sep, 73(3), 25 - 30
{The clinical picture, diagnosis and treatment of the stomatological manifestations of Sjögren's disease}; Pozharitskaia MM et al.; Eighty-three patients with Sjogren's disease, 23 with chronic parotitis and periodontitis, 325 controls were examined by general clinical, dental, X-ray, microbiological, immunological, and morphological methods . A clinico-pathogenetic analysis of dental manifestations of Sjogren's disease was carried out: atrophy and inflammatory process in the buccal mucosa, multiple caries . A pathogenetically based program of therapeutic and prophylactic measures making use of encad, bensilol, bensilol+trimecain is suggested for patients with Sjogren's disease.

Eur J Clin Microbiol Infect Dis, 1994 Jul, 13(7), 565 - 71
Analysis of Legionella pneumophila strains associated with nosocomial pneumonia in a neonatal intensive care unit; Luck PC et al.; A premature child received continuous mechanical ventilation in a neonatal intensive care unit . On day 10 of his life he developed pneumonia due to Legionella pneumophila serogroup 1, monoclonal subtype Bellingham . The strain was cultured from a tracheal secretion taken on day 10 and detected by immunofluorescence using monoclonal antibodies on days 10, 12 and 17 . Legionella pneumophila serogroups 1 and 6 (10(2)-4 x 10(4) cfu/l) were cultured from both central and peripheral hot water systems . Monoclonal antibody testing, macrorestriction analysis of the genomic DNA using pulse-field electrophoresis, and electrophoretic alloenzyme typing showed the isolate from the child to be identical to the serogroup 1 strains from the hot water system . Four unrelated Legionella strains of the same monoclonal subgroup Bellingham were studied for comparison . Legionellae were also isolated from two other incubators, but no clinical or microbiological indications of legionellosis were found in the neonates hospitalised there . Serogroup 1 strains isolated from the patient and from the hot water system and serogroup 6 isolates from the hot water supply were able to multiply in cultured Acanthamoeba castellanii cells and in guinea pigs . The serogroup 6 strain, although prevalent in the incubators, was not found in any of the clinical specimens by either culture of immunofluorescence.

Rev Med Chil, 1994 Jul, 122(7), 777 - 81
{Non ulcerative dyspepsia: relationship of symptomatology, gastritis and Helicobacter pylori}; Hoffenberg P et al.; BACKGROUND: histological alterations of gastric mucosa and its colonization by Helicobacter pylori are postuled to be implicated in the pathogenesis of non ulcer dyspepsia . AIM: to study the possible relationships between histological gastritis and Helicobacter pylori in non ulcer dyspepsia symptomatology . PATIENTS AND METHODS: fifty four patients (39 females) with non ulcer dyspepsia whose ages ranged from 17 to 68 years were subjected to an upper GI endoscopy with gastric mucosa biopsy samples for histological study and microbiological identification of Helicobacter pylori . Gastrointestinal complains were blindly quantified using a scored questionnaire . RESULTS: thirty one subjects (57.4%) had Helicobacter pylori in their gastric mucosa . There was acute inflammatory activity in 26 of the 31 patients with Helicobacter pylori (81%) and 15 of 23 without Helicobacter (65%) . The median score of symptoms was 7 (range 2-13) in patients with Helicobacter and 6 (range 2-10) in patients without Helicobacter . CONCLUSIONS: there were no significant differences in gastric mucosa acute inflammatory activity and non ulcer dyspepsia symptomatology between patients with or without Helicobacter pylori colonization of gastric mucosa.

New Microbiol, 1994 Jul, 17(3), 255 - 8
Cat-scratch disease in Italy: a serological approach; Fumarola D et al.; The results of studies on the serologic responses to Afipia felis and Rochalimaea henselae in suspected patients for Cat Scratch Disease (CSD) are illustrated . This preliminary study performed using Indirect Immunofluorescence Assay, proved negative for A . felis and R . henselae in some patients and positive in others; in a few instances the test was positive for both organisms . Additional microbiological and serological studies are needed to clarify the exact role of these microorganisms in causing CSD.

Z Naturforsch {C}, 1994 Jul-Aug, 49(7-8), 489 - 500
Zn2Mg alkaline phosphatase in an early ptolemeic mummy; Kaup Y et al.; Bone samples of a ptolemeic mummy have been employed to study the mode of conservation on the intactness of Zn2Mg alkaline phosphatase in both structure and catalytic activity . A protein of M(r) = 190 +/- 10 kDa being identical to the 200 kDa enzyme of fresh human bones was successfully isolated . Regardless of age 200 kDa protein bands and a distinct subunit at 60 kDa were seen in SDS-PAGE electrophoresis . The 200 kDa band was also monitored by activity staining . The specific activity was 120 mU/mg and 65% of the respective activity obtained in the identical preparation using fresh human tibia or rib . The enzymic activity was inhibited in the presence of 1,10-phenanthroline and L-homoarginine . Radiocarbon dating supported the assignment of the mummy to the early ptolemeic period . Among the many bactericidal and fungicidal components employed for mummification were aromatic alcohols, mono- and sesquiterpenes . Pistachio resin was the major balm resin used . The microbiological sterility of the bone surface was ascertained by independent bacterial and fungal examinations.

Tidsskr Nor Laegeforen, 1994 Jun 30, 114(17), 1968 - 73
{Lyme borreliosis}; Jenum PA et al.; In Norway, physicians and patients alike are becoming increasingly aware of Lyme borreliosis . This fact has created a need for information on different aspects of this disease . This paper reviews the historical background for Lyme borreliosis and the epidemiological situation in Norway, based on data collected by the national system for notification of infectious diseases (MSIS) in 1993 . The role of the tick vector and the overall clinical picture is presented briefly . The authors discuss indications for and possibilities of different microbiological diagnostic methods, and finally list the recommendations for treatment and prophylaxis.

Pol Tyg Lek . 1994 Jun 6-13;49(23-24):535.
{Bacteriophage therapy in the treatment of recurrent subphrenic and subhepatic abscess with jejunal fistula after stomach resection}; Kwarcinski W et al.; The case of recurrent subphrenic abscess with the jejunal fistula after stomach resection in 41-years old male is presented . In microbiological examination E . coli antibiotic-resisted was discovered . The bacteriophages were prepared and administered to the patient . The operation was performed without any antibiotics . During the whole stay at hospital the patient had got bacteriophages . He left the hospital in 33rd day of stay without any abscesses.

Jpn J Antibiot, 1994 Jun, 47(6), 771 - 80
{Clinical efficacy of arbekacin in deep MRSA infection . Including follow-up study after the termination of chemotherapy}; Kuwabara M et al.; We analyzed the efficacy of arbekacin (ABK) using monotherapy or combined therapy on deep MRSA infection to find the most adequate usage of the drug . We also followed-up the isolation incidence of MRSA after the end of chemotherapy . The results are summarized as follows: 1 . Clinical efficacy of ABK on 29 pneumonia and 3 septicemia due to MRSA was 42.9% in ABK monotherapy (9 patients), 62.5% in combined therapy with ABK and minocycline (9 patients), 100% with ABK and imipenem/cilastatin (IPM/CS) (7 patients), and 100% with ABK and other drugs (7 patients) . 2 . As for microbiological efficacy, combined therapy with ABK and IPM/CS or other drug was superior to other methods . Among patients from whom two or more species of bacteria were isolated, causative bacteria persisted in many cases, and some replacements occurred . 3 . Kidney functions deteriorated in two patients that underwent monotherapy or combined therapy with ABK and IPM/CS, but they recovered when therapy was completed the completion . 4 . In the three month follow-up study after ABK therapy, we found four cases of renewed infections after disappearance of MRSA . When just decreases in the number of MRSA resulted upon the chemotherapy, the relapse occurred in all cases . 5 . Above results indicate that ABK is effective in MRSA infection, and combined therapy with beta-lactams is superior to other methods in serious MRSA infections . We also suggest that chemotherapy should be continued until the complete disappearance of MRSA is achieved.

Ryumachi, 1994 Jun, 34(3), 646 - 50
{A case of aseptic meningoencephalitis in a patient with secondary Sjögren syndrome with systemic lupus erythematosus}; Tsuji T et al.; A 26-year-old woman, who had been treated with prednisolone 30 mg/day for secondary Sjogren syndrome (SjS) with systemic lupus erythematosus (SLE), was complicated with aseptic meningoencephalitis (AME) . Cerebrospinal fluid (CSF) cell counts were 26/3, total protein 126 mg/dl, glucose 41 mg/dl . The CSF, blood, nasopharyngeal swab were cultured for bacteria, mycobacteria, viruses and fungi, but no evidence for an infectious etiology was obtained in this patient . The pair sera study for viruses titer were performed, but no significant titer elevation was observed . Head magnetic resonance imaging showed remarkable atrophy of bilateral occipital lobe and dilatation of posterior horn of bilateral ventricles . The high 2-5AS enzyme activity in the CSF suggested indirectly that the cause of this meningoencephalitis was virus infection . In this case microbiological studies were negative, so central nervous system SLE and/or central nervous system SjS were not completely neglected.

Genitourin Med, 1994 Jun, 70(3), 182 - 6
Immunohistochemical study of in vivo and in vitro IgA coating of candida species in vulvovaginal candidiasis; Bohler K et al.; OBJECTIVE--To evaluate whether quantitative or qualitative IgA deficiencies in cervicovaginal secretions can be identified in patients with recurrent vulvovaginal candidiasis . DESIGN--Prospective and controlled study . SETTING--Department of Dermatology, University of Vienna . SUBJECTS--30 patients with symptomatic and recurrent vulvovaginal candidiasis at the time of their presentation . 30 healthy women as a control group . INTERVENTION--Blood samples were drawn for measurement of serum IgA levels . Smears of the cervix and vagina were taken for direct microscopy and microbiological culture . Lavage of the vagina and ectocervix was performed with sterile saline solution for measurement of cervicovaginal IgA levels . MAIN OUTCOME MEASURES--IgA levels of serum and cervicovaginal secretion evaluated by Single Radial Immunodiffusion . IgA labelling was demonstrated on fungal elements in vaginal smears and subcultured blastospores after incubation with vaginal secretions by immunohistochemistry . RESULTS--We could not find any significant difference of IgA levels in serum and cervicovaginal secretions between the symptomatic group and healthy controls (p value for serum = 0.5796, p value for secretion = 0.2381) . In vaginal smears yeasts revealed IgA coating on their surfaces, whereas three of the 61 subcultures were negative . Negative subcultures were assigned to three patients with recurrent candidiasis . No correlation was found between IgA levels of cervicovaginal secretions and staining intensity of subcultured blastospores after incubation with vaginal secretions (r = -0.0578) . IgA levels of serum and vaginal secretion showed no correlation (r = -0.00012) . CONCLUSION--Recurrent vulvovaginal candidiasis cannot be attributed to IgA deficiency . In some cases an IgA coating defect of yeasts might be involved . In addition inactivation of the IgA molecule by candida proteases might be of pathogenetic importance.

Genitourin Med, 1994 Jun, 70(3), 155 - 61
Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya; Daly CC et al.; OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya . METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection . Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done . RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2% . Genital ulcers were found in 1.9% of women . Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors . The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous . The majority of women with microbiological evidence of infection had normal pelvic examinations . Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value . Nevertheless, a strong association between HIV seropositivity and STDs was observed . CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs . The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDsPIP: Between October 1989 and May 1991 in Kenya, clinicians interviewed and took cervical cultures from 4404 women attending 2 periurban family planning clinics in predominantly lower socioeconomic areas of Nairobi to determine risk factors for sexually transmitted diseases (STDs) among low-risk women . Most women were married and/or had only one sexual partner in the past year . The STD prevalence rates were 3.2% for gonorrhea, 1.9% for syphilis, 5.2% for trichomonas, and 4.9% for HIV infection . The crude analysis showed that unmarried status and at least 2 sexual partners in the last year were significantly correlated with each STD . When the researchers controlled for each disease and for other risk factors, however, neither unmarried status nor at least 2 sexual partners were associated with the STDs . The population attributable risks (PARs) for unmarried women were 9.7% for gonorrhea, 9.1% for syphilis, and 15.9% for trichomonas . The PARs for more than 1 sexual partner were 7.7%, 7.2%, and 7.4%, respectively . These PARs were relatively low due to the considerable proportion of married and monogamous women in the sample . HIV seropositivity was the most significant predictor of gonorrhea, syphilis, and trichomonas infections (odds ratio = 1.9-3.4) . The pelvic examinations of most women who had microbiological evidence of an STD were normal . The clinical diagnostic algorithms for STDs in the study used the most readily accessible and significant risk factors and physical examination findings . They had a relatively high specificity (76 - 99%) but low sensitivity ( 1 - 38%) . These findings showed that none of the risk factors or the physical examination could be sufficiently used to predict an STD diagnosis . They also indicate the need for inexpensive diagnostic tests to identify and treat women at a relatively low risk of STDs in family planning and other clinics .

Br J Radiol, 1994 Jun, 67(798), 535 - 9
Mediastinal computed tomography in a British Asian population; Leahy JF et al.; We describe a retrospective review of all the thoracic computed tomography (CT) scans performed on British Asian patients at New Cross Hospital, Wolverhampton between January 1989 and April 1992 . 39 patients were studied . Of 15 patients with active tuberculosis (TB), 14 showed mediastinal lymphadenopathy . In nine of these 15 patients this adenopathy was the only positive imaging finding, as neither lung parenchymal nor pleural abnormalities were detected on CT or plain chest radiograph (CXR) . The patterns of node distribution and enhancement following intravenous contrast are described . We conclude that thoracic CT is useful in Asian or other high risk patients in whom active TB is suspected, but who lack definitive microbiological or CXR proof of diagnosis.

Epidemiol Infect, 1994 Jun, 112(3), 561 - 7
An investigation of colonization of the conjunctival sac of sheep by bacteria and mycoplasmas; Dagnall GJ; The conjunctival sacs of 100 healthy adult ewes and 20 lambs and 76 adult ewes affected by ovine keratoconjunctivitis (OKC) were examined microbiologically . Branhamella ovis was the only organism regularly isolated from healthy ewes and lambs, Mycoplasma conjunctivae was isolated from the conjunctival sac of nine ewes but its occurrence was not associated with clinical signs of ovine keratoconjunctivitis . Mycoplasma conjunctivae and Branhamella ovis were isolated significantly more often from eyes affected by OKC than from unaffected eyes.

Epidemiol Infect, 1994 Jun, 112(3), 441 - 7
An outbreak of Escherichia coli O157 associated with a children's paddling pool; Brewster DH et al.; In May 1992, a small, circumscribed community outbreak of infection due to verotoxin-producing Escherichia coli O157 phage type 49 occurred in a semi-rural area of south-east Scotland . On the basis of stool cultures, six cases were identified, one of whom was asymptomatic . One child developed the haemolytic uraemic syndrome . Although the source of infection of the index case was not established nor could the extent of person-to-person spread be fully determined, the clinical, microbiological and epidemiological evidence available indicated that a children's paddling pool served as the focal point in the transmission of infection causing the outbreak.

J Chemother, 1994 Jun, 6(3), 163 - 6
Effect of the inoculum size on susceptibility tests performed on sessily growing bacteria; Selan L et al.; It has been clearly established that the inoculum size greatly affects the results of antibiotic susceptibility tests performed in both liquid and solid media in standard laboratory growth conditions (i.e . planktonic) . Recently methods were developed to perform antibiotic susceptibility tests on bacteria growing in sessile conditions . The present study investigates the effect of the inoculum size on results obtained by these methods . Results show that the inoculum size does not affect tests performed in sessile conditions . A simple and reliable method is proposed to be applied to routine microbiological laboratory procedures.

J Clin Pharm Ther, 1994 Jun, 19(3), 195 - 8
Chemical stability and adsorption of succinylcholine chloride injections in disposable plastic syringes; Pramar YV et al.; The purpose of these investigations was to determine the stability and adsorption behaviour of succinylcholine chloride (SCC) when stored in plastic syringes . Drug degradation was monitored using the USP high-pressure liquid chromatography method . Solutions containing 20 mg/ml of SCC in 5% dextrose, and in normal saline, were studied at 5, 25 and 40 degrees C . The hydrolysis of SCC in i.v . fluids followed apparent zero-order kinetics . The manufacturer's recommended expiry period was found to be too conservative . If protected from light, storage at room temperature for up to 3 months can be safely recommended, without significant loss of chemical stability . However, microbiological quality assurance will need to be implemented and an appropriate shelf-life assigned on the basis of both microbiological and chemical stability data.

P R Health Sci J, 1994 Jun, 13(2), 129 - 32
Identification of Mycobacterium avium and Mycobacterium intracellulare isolated in Puerto Rico from clinical samples by the use of a non-radioactive DNA probe; Garcia MT et al.; The Mycobacterium avium complex (MAC), especially M . avium, is an important opportunistic pathogen of AIDS patients in the United States . In Puerto Rico, the incidence of infections caused by MAC has not been determined . This is due, in part, to the difficulties associated to the microbiological identification of the microorganisms . In this work, a commercially available kit (AccuProbe, Gen-Probe, Inc., San Diego, CA) utilizing a DNA probe complementary to rRNA of M . avium and M . intracellulare was used to identify seventeen MAC strains and one unknown atypical mycobacterium recovered in culture in Puerto Rico from clinical samples . The results obtained revealed that M . avium was the predominant species recovered (83% of isolates tested) . Only two cultures were identified as M . intracellulare . The unknown culture, which did not react with either probe, turned out to be M . gordonae . The probe tests not only are simple to perform, but provide cultural identification results in as little as two hours . This study, the first one of its kind in Puerto Rico, demonstrates that the nucleic acid probes for the cultural identification of M . avium and M . intracellulare offer the potential of providing a prompt diagnosis and much needed data on the epidemiology of MAC infections in Puerto Rico.

Health Devices, 1994 Jun, 23(6), 212 - 53
Liquid disinfecting and sterilization reprocessors used for flexible endoscopes; Characteristics of virulence signs of enteroinvasive Escherichia coli (EIEC) isolated in CSFR and Bulgaria in 1988-1990; National Institute of Public Health, PragueDuring 1988-1990 a total of 345 virulent and avirulent strains of enteroinvasive E . coli (EIEC) were isolated from human faeces in microbiological laboratories in Prague and Sofia . This group of strains belonged to a total of 11 serotypes . The most frequently encountered serotypes in both laboratories were: 0124, 0164 and 028ac . From patients 205 strains were obtained and from healthy subjects 140 strains of EIEC . In all strains the following signs of virulence were investigated: biochemical properties, serotypes, Sereny's test, test on HeLa cells, sensitivity to colicine JS and the plasmid profile . The presence of high molecular plasmid 140 MDa correlated closely with positive results of the above mentioned tests . Plasmid 140 MDa was more frequently present in E . coli strains isolated from faeces of patients (in 76.09%) than in strains from healthy subjects (in 23%) . The strains circulating in the healthy population were in the majority avirulent.

Pediatrics, 1994 May, 93(5), 712 - 8
Association of pulmonary inflammation and increased microvascular permeability during the development of bronchopulmonary dysplasia: a sequential analysis of inflammatory mediators in respiratory fluids of high-risk preterm neonates; Groneck P et al.; OBJECTIVE . Bronchopulmonary dysplasia (BPD) of preterm neonates is associated with an increased recruitment of inflammatory cells into the airways . To evaluate further the role of inflammation in the pathogenesis of BPD, tracheobronchial aspirate fluid of neonates with birth weight < 1200 g (n = 59) was sequentially analyzed in a prospective study . METHODS . Tracheobronchial aspirate fluid was assessed for chemotactic activity, neutrophil cell count, concentrations of elastase-alpha 1-proteinase inhibitor and activity of free elastase, concentrations of chemoattractants (complement component C5-derived anaphylatoxin, leukotriene B4, interleukin-8), and albumin concentrations as well as alpha 1-proteinase inhibitor activity . The secretory component for immunoglobulin A was used as reference protein . Only specimens without evidence of microbiological colonization were studied . RESULTS . In neonates with prolonged respiratory disease (BPD-risk neonates, n = 24, fraction of inspired oxygen > or = 0.3 and/or peak inspiratory pressure > or = 16 cm H2O at day 10 postnatal age, birth weight 892 +/- 36 g, gestational age 27.2 +/- 0.3 weeks) chemotactic activity, cell count, concentrations of the chemoattractants complement component C5-derived anaphylatoxin, leukotriene B4, interleukin-8, as well as levels of elastase-alpha 1-proteinase inhibitor were significantly higher at day 10 and/or day 15 of postnatal age compared with neonates without chronic pulmonary disease (total n = 35; day 10, n = 11; day 15, n = 8) . There was no difference in free elastolytic activity . Concentrations of albumin as well as alpha 1-proteinase inhibitor activity were higher in BPD-risk patients on day 15, indicating an increased pulmonary leak . CONCLUSION . We conclude that preterm neonates at risk for the development of BPD show an enhanced inflammatory reaction in the lungs and an associated increase in pulmonary microvascular permeability . We speculate that inflammation may play an important role in the pathogenesis of BPD.

J Antimicrob Chemother, 1994 May, 33(5), 979 - 85
Accumulation of pefloxacin in the lower respiratory tract demonstrated by bronchoalveolar lavage; Panteix G et al.; The in-vivo pulmonary disposition of pefloxacin in alveolar macrophages alveolar macrophages and in the alveolar epithelial lining fluid recovered by bronchoalveolar lavage was studied in 10 healthy volunteers . Bronchoalveolar lavage was performed either 2 or 4 h after oral intake of 800 mg of the drug . The recovered fluid was immediately centrifuged and processed for the assays . Pefloxacin was assayed by High Pressure Liquid Chromatography (HPLC) and by a microbiological method . The mean concentrations of pefloxacin assayed by HPLC were 106 +/- 11.1 mg/L in alveolar macrophages and 88.2 +/- 10 mg/L in the epithelial lining fluid, whereas the mean serum concentration was 6.67 +/- 0.47 mg/L . Therefore, pefloxacin accumulated rapidly in human alveolar macrophages . The high epithelial lining fluid concentrations may be attributed to lipophilicity of the drug and to rapid diffusion from blood, pulmonary cells and interstitium during the bronchoalveolar lavage procedure . The substantial accumulation of pefloxacin in alveolar components (alveolar macrophages and epithelial lining fluid) endorses its use in the treatment of intracellular bacterial infections such as legionellosis; for these diseases, pefloxacin represents an alternative to the macrolide antibiotics.

Eur J Clin Microbiol Infect Dis, 1994 May, 13(5), 401 - 5
16S rRNA based polymerase chain reaction compared with culture and serological methods for diagnosis of Mycoplasma pneumoniae infection; van Kuppeveld FJ et al.; The use of a 16S rRNA based polymerase chain reaction (PCR) for the detection of Mycoplasma pneumoniae infection was investigated . Sputum samples from 34 patients with respiratory illness and evidence of pneumonia as judged by chest X-ray were analyzed by PCR and microbiological culture . Throat swabs from 14 healthy individuals were used as controls . For serology, an enzyme immunoassay for the detection of immunoglobulin M antibodies and a complement fixation assay were performed . Evidence of Mycoplasma pneumoniae infection was obtained in ten patients (29%), eight of whom were found positive by both PCR and serology . Two of the sputum samples from these eight patients were negative by culture . Of the remaining two patients positive for Mycoplasma pneumoniae, one was positive by PCR and culture but negative by serology, and one was found positive by serology but negative by PCR and culture . Thirteen of the 14 controls were negative by both PCR and serology . One control, however, was negative by serology but positive by PCR, which was probably due to asymptomatic carriage of Mycoplasma pneumoniae . The results of this study indicate the suitability of the PCR for the detection of Mycoplasma pneumoniae in clinical samples as well as its potential value as an additional tool for the diagnosis of infection.

Poult Sci, 1994 May, 73(5), 739 - 43
Effect of freezing on the recovery of mesophilic bacteria from temperature-abused broiler chicken carcasses; Russell SM et al.; The effects of freezing on the recovery of mesophilic bacteria from broiler chicken carcasses were determined . Fifty fresh broiler carcasses were used in each of three independent trials . Ten carcasses were sampled at time of collection (Treatment 1: Day 0 control) . The other 40 carcasses were sampled at Day 7 following one of four additional treatments with 10 carcasses each: held at 3 C (Treatment 2: 7-d control), frozen and then held at 3 C (Treatment 3: frozen control), temperature abused at 25 C for 12 h and held at 3 C (Treatment 4: temperature abused), and temperature abused at 25 C for 12 h, frozen, and held at 3 C (Treatment 5: temperature abused and frozen) . Carcasses were sampled by rinsing, and total plate counts (TPC) expressed as log10 colony-forming units per milliliter and impedance detection times (DT) in hours were determined using incubation temperatures of 42 and 43 C, respectively . Results for TPC for Treatments 1 to 5 were 3.89, 3.52, 2.86, 6.53, and 5.57 log10 cfu/mL, respectively . Results for DT for Treatments 1 to 5 were 5.41, 6.50, 7.10, 2.55, and 3.42 log10 cfu/mL, respectively . Freezing reduced the ability to detect temperature abuse because of a significant reduction in the number of mesophiles recovered using either microbiological technique . Freezing appears to decrease, but may not completely eliminate, the ability of selective incubation to detect temperature abuse.

Scand J Clin Lab Invest, 1994 May, 54(3), 235 - 40
Comparison of three commercial kits and a microbiological assay for the determination of vitamin B12 in serum; Arnaud J et al.; Different methods are available for cobalamin determination in serum . Microbiological and radio ligand binding assays are the most commonly used . Kits involving non-isotopic competitive-binding assay have been recently commercialized . In the present work, cobalamins were determined in 146 patient sera, using four methods: a microbiological method, two no boil radio ligand binding assay kits (Magic B12 FOL (NB) from Ciba-Corning and SimulTRAC SNB No Boil from Becton Dickinson) and a non-isotopic kit with acridinium ester labelled cobalamin (Magic Lite from Ciba-Corning) . Median (range) cobalamin concentrations in pmol l-1 were 317 (15-1291) using the microbiological method, 355 (25-3469) using the Magic Lite kit, 355 (35-2312) using the Magic B12 FOL (NB) kit and 380 (37-2021) using the SimulTRAC SNB No Boil kit . The ANOVA test indicated that differences between methods were statistically significant (p < 0.01) . Competitive-binding methods gave higher results than the microbiological method . Although correlation coefficients were not excellent (0.88 < r < 0.96), the results obtained with the different methods were generally similar and confirmed that competitive methods are useful for detecting low serum concentration of vitamin B12.

Cornea, 1994 May, 13(3), 274 - 6
Nocardial necrotizing scleritis after trauma . Successful outcome using cefazolin; Basti S et al.; Nocardial necrotizing scleritis is uncommon, but potentially sight threatening . We report the occurrence of necrotizing scleritis in a 58-year-old farm worker after he sustained trauma with vegetable matter . Microbiological studies isolated Nocardia asteroides, sensitive only to cefazolin . Clinically the patient responded well to this drug, attaining a final visual acuity of 20/40, with complete resolution of the scleritis . Early isolation and testing for antibiotic sensitivity were responsible for the successful management of this patient.

Arch Bronconeumol, 1994 May, 30(5), 240 - 4
{Cholesterol in pleural fluid . Its usefulness in differentiating between exudates and transudates}; Sanchez Hernandez I et al.; To analyze the usefulness of cholesterol levels in the differentiation of exudates and transudates . A 3.5-year prospective study of 170 patients with pleural discharge . Clinical microbiological and cyto-histological criteria were used for diagnosis . Exudates were classified by Light's criteria, by cholesterol > or = 45 mg/dl in pleural liquid, by a cholesterol in pleural liquid/cholesterol in serum quotient > or = 0.3 and by a finding of both LDH and cholesterol in pleural fluid . These criteria were compared with the final etiological diagnosis . Only pleural discharges with confirmed etiological diagnoses were analyzed . In the 130 pleural discharges for which certain etiological diagnoses were obtained, 33 were transudates and 97 were exudates . Light's criteria allowed accurate classification of 92 (95%) of the 97 exudates and 30 (91%) of the 33 transudates . The cholesterol in pleural liquid/cholesterol in serum quotient was the most productive and useful parameter (96% sensitivity, 97% specificity), better than pleural fluid cholesterol and the Light's criteria . The association of LDH and pleural fluid cholesterol classified 100% of the exudates, with efficacy similar to that of Light's criteria . The cholesterol in pleural fluid/serum quotient was the most useful biochemical variable . Cholesterol levels were about as useful as Light's criteria . The association of LDH and cholesterol allows us to bypass blood analyses for the diagnosis of exudates.

Arch Bronconeumol, 1994 May, 30(5), 236 - 9
{The efficacy of bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis}; Caminero Luna JA et al.; In order to analyze the usefulness of bronchoalveolar lavage (BAL) for conventional microbiological diagnosis of tuberculosis (TB) and other mycobacteria, and to assess the need to use it or not as a routine diagnostic technique in these diseases, we studied 30 patients with mycobacteria (26 TB and 4 Mycobacterium avium-intracellulare infections) by bronchoscopy, with BAL and bronchoaspirate (BAS) bacteriological analyses also available . The results were compared with those obtained for sputum taken before and after bronchoscopy when these specimens were available . The overall yield for BAL and BAS cultures was 90%, with BAL (83.3%) specimens being more productive than BAS (73.3%) specimens . Both performed far better than the 53.8% recorded for cultures of pre-bronchoscopy sputum and 60% for post-bronchoscopy sputum . BAL was the only diagnostic specimen from 7 patients, while BAS the only one from 4 . Sensitivity was similar for the two mycobacteria studied . The results for direct bacilloscopy, however, at 30% for the two specimens, rose to 36.6% when they were analyzed together with BAS and BAL . We conclude that bronchoscopy should be performed on all patients suspected of mycobacterial infection when sputum bacilloscopy is negative and patients have no expectoration . Performance of BAL should be routine since this simple and usually uncomplicated technique produces the most productive specimens.

Rinsho Byori, 1994 May, 42(5), 511 - 3
{Clinical microbiology}; Okada J; The basic purpose of postgraduate education programs in clinical microbiology for the Board of Clinical Laboratory Physicians are mainly to bring up a specialist who can give microbiological laboratory diagnosis . The most important duties of clinical laboratory physicians are to determine causative agents and to select appropriate therapeutic drugs . The guideline for educational curriculum (tentative GIOs) was demonstrated, and the evaluation of education program was discussed.

Radiol Med (Torino), 1994 May, 87(5), 683 - 7
{Scintigraphy with gallium-67 citrate in patients with AIDS: pathologic extrapulmonary uptake}; Brunetti A et al.; 67Gallium citrate can accumulate in different inflammatory and neoplastic lesions . The mechanisms of 67Gallium uptake in abnormal tissue are still partially unknown and the tracer is considered a nonspecific indicator of disease . In AIDS patients, 67Gallium citrate is used in the diagnosis and characterization of opportunistic pulmonary infections and especially of Pneumocystis carinii pneumonia . From June 1989 through December 1992 in our Department 140 67Gallium scans were performed on 103 AIDS patients, referred for evaluation of pulmonary symptoms . All studies were carried out 72 hours after i.v . administration of 185 MBq 67Gallium citrate, with anterior and posterior views of head, chest and abdomen . The images were evaluated with conventional diagnostic criteria and site, number and intensity of abnormal foci of extrapulmonary uptake were recorded . Abnormal extrapulmonary uptake was found in 17 patients (12%): gastric (3, two of which also exhibited abnormal intestinal uptake), esophageal (1) hepatic (1), intestinal (2) renal (4), nodal (3), ocular (1), cutaneous (1), sinusal (1) localizations . In all cases clinical, endoscopic, bioptic or microbiological demonstration of the possible cause of 67Gallium uptake was obtained . An intriguing finding in our series was the lower incidence of gastric uptake (two patients with miliary tuberculosis and one patient with gastric candidiasis) than in the literature . This finding could be explained by clinical and epidemiologic differences between different patient populations . However, the scan interval after tracer administration should be also taken into account, since in our study scans were always performed at 72 hours, while in other series the interval ranged 24-48 hours . The relatively high incidence of abnormal extrapulmonary uptake confirms the opportunity of whole body exploration after 67Gallium administration in the patients with such multisystemic disease as AIDS, even when the patients are referred mainly for respiratory problems.

AIDS, 1994 May, 8(5), 661 - 5
Serum carotene deficiency in HIV-infected patients . Berlin Diarrhoea/Wasting Syndrome Study Group; Ullrich R et al.; OBJECTIVE: To assess total serum carotene concentration in HIV-infected patients as an indicator of fat malabsorption in correlation with diarrhoea, secondary enteric infections, and blood lymphocyte subsets . DESIGN: Prospective study . SETTING: Two referral-based tertiary care centres in Berlin, Germany . PATIENTS: A total of 33 controls and 116 HIV-infected patients who had complete microbiological evaluation of stools and biopsies obtained at upper endoscopy because of diarrhoea (n = 54), or other symptoms (n = 62), were studied . MAIN OUTCOME MEASURES: Total serum carotene concentration was determined spectrophotometrically . RESULTS: Total serum carotene concentration was abnormal (< 0.88 mumol/l) in 77% of HIV-infected patients and significantly decreased compared with controls {0.47 mumol/l (range, 0.06-1.69 mumol/l) versus 1.37 mumol/l (range, 0.88-2.92 mumol/l); P < 0.0001} . Total serum carotene concentration did not differ between AIDS patients and patients at earlier disease stages, between patients with or without secondary enteric infections, or between patients with or without fever . In patients at earlier disease stages, but not in AIDS patients, total serum carotene concentration was lower for patients with than without diarrhoea . The percentage of CD4 lymphocytes (r = 0.364; P < 0.001), CD4 count (r = 0.28; P = 0.0013), and CD4/CD8 ratio (r = 0.38; P < 0.001) in the peripheral blood correlated with total serum carotene levels in HIV-infected patients . CONCLUSION: HIV-infected patients frequently have abnormal total serum carotene concentrations indicating fat malabsorption which may contribute to diarrhoea . Furthermore, total serum carotene concentrations correlate with immunologic abnormalities in HIV infection.

Zentralbl Veterinarmed B, 1994 May, 41(3), 176 - 228
Hygienic aspects of the production and agricultural use of animal wastes; Strauch D et al.; Regarding the hygienic aspects of the production and use of animal wastes, further research on the following aspects is essential: pathogenic agents present in residues of animal production in the context of transmissible multifactorial diseases and the epidemiology of pathogens under different ecological conditions; recycling of toxic agents, e.g., copper, selenium and iodine, in animal wastes in the context of the food chain from soil to humans; hygienic effects of animal wastes on water as regards the standards required by medical authorities; effects of agents used to increase animal production, or used for medicinal purposes, which are present as residues in animal excreta and may be hazardous to public health; effects of animal excreta on microbiological processes in the soil; effects of dust and airborne microbial emissions from animal production, and finally, processes of self-disinfection of manure and livestock slurry during storage as a means of reducing the amounts of chemical disinfectants used, of reducing environmental pollution, and of studying the application of biotechnological methods to disinfect manure and livestock slurry, this study being of particular importance.

Dtsch Med Wochenschr, 1994 Apr 29, 119(17), 624 - 7
{Acute pancreatitis due to the rupture of an echinococcal cyst into the bile duct system}; Parthe S et al.; A 47-year-old woman with stones in the gall-bladder suddenly developed severe upper abdominal pain . Cholesterol concentration was elevated, as were amylase (555 U/l) and lipase (408 U/l) concentrations, suggesting biliary pancreatitis . Endoscopic retrograde cholangiography demonstrated a cyst, about 10 cm in diameter, in the left lobe of the liver, connected to the biliary tract system . Ultrasonography and computed tomography additionally showed a smaller cyst in the right lobe . Infection with Echinococcus granulosus was proven microbiologically on bile (demonstration of hooklets and protoscolices) as well as serologically . Transpapillary cholangioscopy demonstrated daughter cysts within the echinococcal cyst . The main cyst was rinsed with 20% NaCl for 10 days via a nasocystic catheter . In addition, mebendazole (three times daily 1000 mg) was administered for 13 months . The signs if inflammation receded and the cyst shrank to a small residual volume . Surgical intervention became unnecessary.

JAMA, 1994 Apr 6, 271(13), 1014 - 6
The relationship between the thrombotic and infectious complications of central venous catheters; Raad II et al.; OBJECTIVES--To assess the frequency of thrombotic and infectious complications of long-term use of vascular catheters in cancer patients and to determine whether the two types of complication are related . DESIGN--Case series . SETTING--A 500-bed tertiary cancer center . PATIENTS--Seventy-two cancer patients . INTERVENTIONS--During a 16-month period, postmortem examinations of catheterized veins and contralateral uncatheterized veins were done on all patients with indwelling central venous catheters who met study criteria . MAIN OUTCOME MEASURES--Catheter-related septicemia determined by clinical and microbiological data as well as postmortem pathology; venous pathological changes such as mural hemorrhage, thrombosis, calcification, ulceration, and inflammation . RESULTS--Premortem clinical and microbiological data were obtained retrospectively on all patients . Pathological changes were noted in 35 catheterized veins (49%) compared with five contralateral control veins (9.2%) (P < .001) . Mural thrombi were noted in 27 catheterized veins (38%) compared with only one contralateral control vein (1.4%) (P < .001) . Other pathological changes consisted of four central venous catheter-related mural thrombi (5.6%) in the right atrium and four instances (5.6%) of nonbacterial thrombotic endocarditis, three involving the tricuspid and one the mitral valves . Seven patients had catheter-related septicemia . Of the 31 patients with mural thrombosis of the catheterized vein or right atrium, seven developed catheter-related septicemia, whereas none of the 41 patients with normal catheterized veins and atria developed catheter-related septicemia (P < .01) . CONCLUSIONS--Thrombotic complications are common in catheterized veins and are often associated with catheter sepsis.

Infect Control Hosp Epidemiol, 1994 Apr, 15(4 Pt 1), 239 - 42
Impact of an educational program for the prevention of colonization of intravascular catheters; Parras F et al.; OBJECTIVE: To evaluate the efficacy of an educational program for the prevention of catheter colonization . DESIGN: Two cross-sectional studies were carried out in a 500-bed randomly selected area of the hospital, separated by an educational program on the care of intravenous lines based on the Centers for Disease Control and Prevention (CDC) recommendations for the control of catheter-related infections . SETTING: A 2,100-bed urban general hospital affiliated with the University of Madrid (Spain) . METHODS: Characteristics of patients and catheters and appropriateness of catheter care were evaluated . Cultures were taken from the point of insertion of the vascular catheter, the hubs, and infusion fluids . When catheter-associated infection was suspected, the distal end of the catheter was sent for culture and two blood cultures were taken . We compared the clinical and microbiological data before and after carrying out an educational program based on CDC recommendations for the control of catheter-related infections . RESULTS: Characteristics of patients and catheters did not differ between the two cross-sectional studies . Compared with baseline data, after the educational program we observed a reduction of inappropriate catheter care, from 83% to 38% (45% difference, 95% confidence interval {CI95}, 55% to 35%, P < 0.0000), and a reduction in the rate of skin colonization, from 34% to 18% (16% difference, CI95, 26% to 5%, P < 0.001) . The frequency of phlebitis (15% versus 14%), hub colonizations (12% versus 11%), catheter colonizations (2% versus 1%), and catheter-related bacteremias (0% versus 0%) remained unchanged between the two cross-sectional studies . CONCLUSIONS: Our educational program improved catheter care and reduced significantly the proportion of skin colonization around the insertion point . However, the educational program did not modify the proportion of hub colonization; because hub colonization has been demonstrated to be a source of line sepsis, our data suggest the need for a specific program directed to the maintenance of catheter hubs.

Genitourin Med, 1994 Apr, 70(2), 124 - 6
The value of prophylactic (monthly) clotrimazole versus empiric self-treatment in recurrent vaginal candidiasis; Fong IW; OBJECTIVE--To determine the comparative efficacy and cost benefit of prophylactic monthly (perimenstrual) clotrimazole, versus empiric self-treatment with the same agent at the onset of symptoms in recurrent vulvovaginal candidiasis . DESIGN--Prospective, randomised, open cross-over study of women with proven recurrent vulvovaginal candidiasis . Clinical and microbiological assessments were done every two months for 12 months . SETTING--Women's Clinic of a University Teaching Hospital . SUBJECTS--Twenty-three otherwise healthy, non-pregnant women with greater than four proven episodes of candida vaginitis in the last year were enrolled into the study . INTERVENTION--Patients were randomised to receive: (1) a single dose of prophylactic clotrimazole 500 mg ovule just before or on the last day of the menses each month for 6 months; (2) or a single dose of clotrimazole 500 mg ovule empirically at the onset of symptoms for 6 months . After the first 6 months patients were crossed-over to the opposite regimen . MAIN OUTCOME MEASURES--Symptoms of recurrent vulvovaginitis during each period, and number of clotrimazole ovules used for each 6 month period . The personal preference of the patients for the two different regimens were assessed at the end of study . RESULTS--During the prophylactic 6 months period of the study, 23 patients had 50 episodes of symptomatic vaginitis (mean 2.2 episodes per patient), versus 86 episodes (mean 3.7 episodes/patient) during the empiric self-treatment 6 months period (P = 0.05) . However, during the prophylactic period a total of 168 clotrimazole ovules were used (mean 7.3 per patient), versus 84 ovules (mean 3.6 per patient) during the empiric self-treatment period, p < 0.001 . The personal preference of the patients for the type of regimen employed were 17 (73.9%) in favour of the empirical treatment, versus 4 (17.4%) in favour of the prophylactic treatment and 2 (8.7%) no personal preference, p < 0.01 . CONCLUSION--Empiric self-treatment is more cost-effective and preferable to patients than cyclical monthly prophylactic use of 500 mg clotrimazole vaginal ovules.

Br J Rheumatol, 1994 Apr, 33(4), 361 - 9
The microbiology of chronic inflammatory arthritis: an historical review; Hughes RA; Tissues from patients with RA have always been subject to close microbiological scrutiny in attempts to determine the pathogenesis of joint inflammation . This paper presents an historical review of micro-organisms isolated from patients with chronic RA dating from the early days of microbiology in the late 19th century until the present day . The relevance of these findings is discussed in the light of current hypotheses concerning the role of infection in the aetiology of RA.

Am J Respir Crit Care Med, 1994 Apr, 149(4 Pt 1), 989 - 93
Evidence for a Th1-like bronchoalveolar T-cell subset and predominance of interferon-gamma gene activation in pulmonary tuberculosis; Robinson DS et al.; Mycobacterium-specific human helper T-cell clones produce a Th1 pattern of cytokines in vitro: interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), but little or no IL-4 or IL-5 . To test the hypothesis that a similar Th1-like pattern of cytokine gene expression occurs in vivo in pulmonary tuberculosis we used in situ hybridization to detect cytokine mRNA expression by bronchoalveolar lavage cells from nine patients with microbiologically confirmed tuberculosis and nine control subjects . Because IFN-gamma may also originate from alveolar macrophages, simultaneous immunocytochemistry and in situ hybridization was applied to determine whether cytokine mRNA was localized to bronchoalveolar macrophages in addition to T-lymphocytes . When samples from patients with tuberculosis and control subjects were compared, there was a significant increase in numbers of IFN-gamma mRNA-positive BAL cells per 1,000 among patients with tuberculosis (p < 0.01) . Differences between the two groups in the proportions of cells expressing IL-2, IL-4, or IL-5 mRNA were not significant . Expression of IFN-gamma mRNA by macrophages was detected (median, 14.3% of IFN-gamma mRNA-positive BAL cells) . However, the majority of IFN-gamma mRNA expressing BAL cells were T-lymphocytes (median, 80.7%) . Activation of Th1-like bronchoalveolar T-lymphocytes, together with production of IFN-gamma by alveolar macrophages, may contribute to the local cellular immune response in pulmonary tuberculosis.

Eur J Clin Microbiol Infect Dis, 1994 Apr, 13(4), 351 - 4
Fluconazole treatment of neonates and infants with severe fungal infections not treatable with conventional agents; Fasano C et al.; Fluconazole was evaluated prospectively in 40 neonates and infants between the ages of 2 days and 3 months in whom conventional antifungal therapy was ineffective or contraindicated . The patients received therapy on an individual compassionate request basis for microbiologically documented or presumed fungal infection . The mean fluconazole dosage was 5.3 mg/kg/day (range 1-16 mg/kg/day) and the mean duration of therapy was 26 days (range 2-80 days) . Efficacy was evaluated in neonates with proven fungal infection as documented by the presence of a pathogen at baseline . A positive clinical response was achieved in 97% (31/32) of the clinically evaluable patients; eradication of the fungal organism was achieved in 97% (30/31) of evaluable patients . Adverse events occurred in two patients (5%); therapy was not discontinued in either patient . These favorable safety and efficacy data are similar to results obtained with fluconazole in older children and adults.

An Med Interna, 1994 Apr, 11(4), 167 - 72
{Intestinal tuberculosis in patients with and without HIV infection}; Martinez Vazquez C et al.; GOAL . To Study the main characteristics of intestinal tuberculosis (ITB), comparing patients with and without infection by HIV (HIV and non-HIV, respectively) . PATIENTS AND METHODS . The clinical records of patients diagnosed of this disease in the past five years in our center, were retrospectively reviewed . We used as inclusion criteria the histological and/or microbiological corroboration of the intestinal anatomical piece or the bacteriological and/or histological corroboration of tuberculosis at any other location with clinical and radiological signs compatible with intestinal affection . Two groups were established according to the serological results for HIV: HIV and non-HIV . RESULTS . We studied seven cases, three of them infected by the HIV . The mean age of HIV patients was 23 years, whereas the mean age of non-HIV patients was 49 years . Three non-HIV patients referred pulmonary tuberculosis when they were young . The interval between the onset of symptoms and the diagnosis in HIV patients was 45 days, ranging in the non-HIV patients between one month and four years . All the patients had abdominal pain . Six patients, including three HIV, had fever and constitutional syndrome . Thoracal radiography showed tuberculosis activity, bacteriologically demonstrated, in a HIV patient and in a non-HIV patient . Except one HIV-patient, the remainder were laparotomized . In all the HIV patients, intestinal tuberculosis was suspected upon admission, but this was not the case in the four non-HIV patients . CAT was the most useful of all the supplementary explorations conducted . Retrospectively, only four laparotomies were justified, although before this procedure, four patients were incorrectly oriented, one of them infected by the HIV . All the patients showed a good response to an specific treatment . CONCLUSIONS . Laparotomy is still a frequent diagnostic method . The characteristics of the HIV patients are similar to the ones of the non-HIV patients . The main differences are: younger ages and shorter time of evolution until diagnosis in the HIV group, and evidence of former or current pulmonary tuberculosis in the non-HIV group.

Clin Infect Dis, 1994 Apr, 18(4), 525 - 32
Risk factors for fungal infection in patients with malignant hematologic disorders: implications for empirical therapy and prophylaxis; Guiot HF et al.; To determine which patients are at high risk for disseminated fungal infection and should be given systemic prophylaxis, we studied the charts of 341 patients with malignant hematologic disorders who were admitted to our institution during 10 consecutive years . These patients represented 636 admissions; during these admissions, 60 invasive fungal infections occurred, with deaths in 44 cases . All patients who died of these infections either had persisting granulocytopenia and a poor prognosis for the underlying disease or suffered from chronic graft-vs.-host disease . Two of 58 patients who had no or low-level candidal colonization developed this infection (P < .001) . Nine of the 10 patients with candidal infection had microbiologically proven bacteremia within the week preceding the candidal infection . After bone marrow transplantation, 8 of 10 patients with chronic graft-vs.-host disease vs . 2 of 36 without this disease (P < .001) developed fatal infection with Aspergillus species . The results of our study reveal that patients with high-level candidal colonization who were treated for microbiologically proven bacteremia and patients with chronic graft-vs.-host disease might benefit from systemic antifungal prophylaxis.

Med Vet Entomol, 1994 Apr, 8(2), 165 - 71
Use of partially engorged female ticks as laboratory animals in microbiological research; Rehacek J et al.; Partially engorged female ticks were used as laboratory animals in microbiological research . The ticks, which were inoculated intracoelomally, became a convenient substrate for the detection of viruses, rickettsiae and protozoal parasites . This research concerned the isolation of newly recovered micro-organisms, the study of development, structure and distribution of microbial agents in ticks, and the study of their interaction with other pathogens or symbionts during mixed infection in a tick body . The isolation and maintenance of Rickettsiella phytoseiuli, the organism not of tick-borne origin, was achieved . For use in Central Europe the tick Dermacentor reticulatus is recommended for the above investigations.

J Craniomaxillofac Surg, 1994 Apr, 22(2), 120 - 5
Computed tomography (CT) in the diagnosis of sinus aspergillosis; Krennmair G et al.; 19 patients with radiodense sinus concretions found on standard radiography underwent a preoperative computed tomographic examination of the sinus maxillaris and the sinus concretions . 13 patients (68.4%) with the occurrence of radiodense concretions presented postoperative histologically and microbiologically diagnosed sinus aspergillosis infection . In 13 patients, the sinus concretions had a density higher than 2000 HU (Hounsfield unit) and 6 patients had concretions with a density lower than 2000 HU . 12 (92.3%) of 13 patients with concretions having a density greater than 2000 HU had a postoperatively diagnosed sinus aspergillosis infection . The incidence of diagnosed sinus aspergillosis increased from 68.4% by standard radiography to 92.3% by computed tomographic examination on the supposition that the concretions have a density higher than 2000 HU . The computer tomography (CT)-density of sinus concretions in patients with diagnosed sinus aspergillosis was 2826.7 +/- 362.8 HU . The concretions of patients without sinus aspergillosis had a lower density (788.1 +/- 916.8 HU; p < 0.001) . CT-density of root filling material presented nearly the same number in patients with aspergillosis infection (2789.3 +/- 287.5 HU) and in patients without sinus aspergillosis infection (2635.0 +/- 367.8 HU) . In patients with diagnosed sinus aspergillosis, a significant correlation between the density of sinus concretions and the density of adjoined dental root filling material was found . Our study demonstrates that an additional preoperative paranasal sinus CT inclusive densitometry of the sinus concretions present is more sensitive than standard radiography for predicting the diagnosis of sinus aspergillosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aust Dent J, 1994 Apr, 39(2), 73 - 6
HIV infection and the dentist . 2 . The diagnosis and management of gingivitis and periodontitis; Yeung S et al.; In HIV infected patients, a distinct form of gingivitis and periodontitis was reported recently . This paper reviews the clinical and microbiological features of these lesions and makes recommendations regarding their clinical management . The need for early treatment and control of periodontitis in HIV seropositive patients is emphasized.

J Spinal Disord, 1994 Apr, 7(2), 173 - 80
Pyogenic vertebral osteomyelitis: treatment by anterior spinal debridement and fusion; Fang D et al.; Forty-three patients with pathologically proven vertebral osteomyelitis were studied between 1957 and 1990 . Thirty-nine underwent anterior debridement and fusion, and four underwent anterior debridement only . The indications for surgery were uncertain diagnosis, persistent pain, failed conservative treatment with uncontrolled sepsis, and neurological involvement . Thirty patients were followed-up for an average period of 5 years, with a minimum of 2 years and the longest for 15 years . All their symptoms improved after surgery; only one patient subsequently deteriorated due to multiple level recurrence . All patients with neurological deficit improved . Bony fusion occurred in 93% of cases (average time to fusion, 6.8 months), and 90% of the patients were able to return to their original work 4-20 months after surgery . We feel that anterior debridement and spinal fusion allow for reliable microbiological and histological diagnosis, and rapid relief of symptoms and return to work . Primary bone grafting is successful despite the presence of infection.

Immun Infekt, 1994 Apr, 22(2), 41 - 4
{Microbiological diagnosis of malaria and amoebiasis}; Knobloch J; All stages of malaria and amebiasis may be sensitively and specifically diagnosed by means of microbiological methods . Microscopical parasitology holds a key position when supplemented by immunodiagnostic assays . Molecular biology techniques are currently still inferior to the above procedure . Tests for the differentiation between pathogenic and nonpathogenic Entamoeba histolytica (Entamoeba dispar) require further simplification before generally applicable.

J Assoc Physicians India, 1994 Apr, 42(4), 300 - 1
Eighth nerve involvement in meningo-encephalitis; Talukdar CK et al.; Seventy-two patients suffering from meningo-encephalitis were studied, clinically, biochemically, microbiologically and virologically . Evidence of rising titre in serum and CSF of antibodies to Japanese encephalitis were present in 50% of cases, and recent past infection in 20% of cases . Cranial nerve involvement particularly the "8th" was present in 70% of cases though there was a 2.5% involvement of the 2nd, 3rd and 6th nerves . All the patients belonged to plain Tribal population and all had a history of eating pork 7-10 days prior to development of the infection.

Rev Prat, 1994 Apr 1, 44(7), 865 - 9
{A new bacterium: Rochalimaea}; Maurin M et al.; Originally limited to trench fever, infections due to Rochalimaea now comprise manifestations particular to patients with human immunodeficiency virus (bacillary angiomatosis and hepatic peliosis), but also manifestations as diverse as isolated fever, septicaemia, endocarditis, lymphocytic meningitis, or central neurological disorders, in immunodepressed or immunocompetent subjects . The involvement of Rochalimaea in cat-scratch fever remains debated . Microbiological analysis used for diagnosis has been modified to allow isolation of these new bacteria, whose culture is slow and difficult, in the course of the above-cited clinical manifestations, which should further extend the range of Rochalimaea infections.

Sci Total Environ, 1994 Mar 31, 143(1), 75 - 92
Safe food manufacturing; Shapiro A et al.; Food safety is a growing preoccupation of the health authorities and the major food companies in any European country . All the aspects of food manufacturing, from the raw materials until the product is consumed have to insure they are innoxious to human health, eliminate any harmful effects related either to food handling or consumption in domestic or common eating places, as well as protect, as much as possible, our environment . Thus, the food manufacturer has to examine step-by-step the security of the agro-cultures, their composition, but also the possible residues of pollutants and contaminants, or chemicals used to protect them against various pests and determine the possible loss or retention of these substances during technological processes . Animal raw materials should not contain veterinary drug residues or an abnormal amount of some components that result from inadequate feeding . Care should be taken to ensure the security of foods manufactured by biotechnology processes . The organisms and the whole processes used in food biotechnologies should eliminate any impurities . Any minor food ingredients, such as food additives, are under a permanent revision from the point of view of their safety . The industry reacts immediately if any justification requires that a particular food additive should not be used . In other words all the raw materials must conform to their specifications . Technological processes must create a food with an adequate microbiological quality, e.g . free of pathogens and their toxic metabolites . Any danger of microbiological contamination or accidental pollution, such as mechanical particles, chemical substances, etc . should be eliminated . The particular role of food packaging is crucial, since this is a barrier to protect the food against further parasites or microbial contamination and preserve the food from alterations due to enzymatic reactions that require particular oxygen and water activity conditions . The packaging should also protect against possible criminal damage . In addition, the material of packaging should not allow micro-migration to the food . It should be inert against its food content . Another aspect of food packaging that has to be taken into account is its recovery and recyclability . Finally, the food manufacturer has to ensure that the nutritional value of the product does not diminish through its shelf-life . The consumer should be advised about the effects of culinary practices since some of them, such as deep frying or grilling under certain circumstances, may create undesirable substances potentially harmful to human health . The food manufacturing in the context of the environment protection requires a separate issue.(ABSTRACT TRUNCATED AT 400 WORDS)

Lancet, 1994 Mar 19, 343(8899), 696 - 700
Placebo-controlled phase III trial of lenograstim in bone-marrow transplantation; Gisselbrecht C et al.; Haemopoietic growth factors are accepted as accelerating haemopoietic recovery after bone-marrow grafting, yet no large randomised trials have been published that convincingly show benefit . Lenograstim (glycosylated recombinant human granulocyte colony-stimulating factor) was given to 315 patients after bone-marrow transplantation in a prospective randomised placebo-controlled multicentre trial . 1 day after bone-marrow infusion, 163 patients received lenograstim 5 micrograms/kg per day by 30-min infusion, and 152 patients received placebo daily for 28 days or until neutrophil recovery . 137 patients had lymphoma, 35 myeloma, 85 acute lymphoblastic leukaemia, and 58 a solid tumour . Patients were stratified by age and by type of bone-marrow transplantation (BMT) . Neutrophil recovery to above 10(9)/L for 3 consecutive days was seen earlier in lenograstim-treated patients (16 vs 27 days, p < 0.001) . Time to neutrophil recovery above 0.5 x 10(9)/L was reduced (14 vs 20 days, p < 0.001) . The difference was significant both in autograft (20 vs 14 days, p < 0.001) and allograft (20 vs 14 days, p < 0.01) patients, in children (20 vs 13 days, p < 0.001), and adults . Lenograstim-treated patients had fewer days of infection, and of antibiotic administration, and also spent less time in hospital . However, clinical and microbiological sepsis was similar in both groups . There was no significant toxicity ascribed to lenograstim . Survival was the same at days 100 and 365 . In patients undergoing autologous or allogeneic BMT for neoplastic disease, lenograstim significantly reduced duration of neutropenia and led to earlier hospital discharge.

Int J Oral Maxillofac Implants, 1994 Mar-Apr, 9(2), 156 - 62
Effects of subgingival irrigation with chlorhexidine on the periodontal status of patients with HA-coated integral dental implants; Lavigne SE et al.; The purpose of this study was to examine the effect of chlorhexidine irrigation on the periodontal status of patients with HA-coated dental implants as measured by clinical, microbiological, and immunological measures . Thirty non-adjacent implants were randomly assigned to receive a one-time irrigation with either 0.12% chlorhexidine or sterile saline, or no irrigation . All parameters were measured at baseline, 2, 5, and 8 weeks . Results showed no significant differences between any treatment modalities at any time interval . A statistically significant decrease in probing depth (P < .05) occurred within the chlorhexidine and no-treatment groups at all time intervals compared to baseline.

Antimicrob Agents Chemother, 1994 Mar, 38(3), 518 - 22
Dose-dependent antifungal activity and nephrotoxicity of amphotericin B colloidal dispersion in experimental pulmonary aspergillosis; Allende MC et al.; We investigated the safety and efficacy of amphotericin B colloidal dispersion (ABCD) for the treatment of invasive pulmonary aspergillosis in persistently granulocytopenic rabbits . Treatment groups included ABCD in dosages of 1, 5, and 10 mg/kg/day intravenously or conventional desoxycholate amphotericin B (DAmB) at 1 mg/kg/day intravenously . Antifungal activity was directly related to increasing dosage of ABCD as determined by the concentration of Aspergillus fumigatus organisms in lungs and the frequency of hemorrhagic pulmonary lesions . At 5 and 10 mg/kg/day, there was a significant reduction in the tissue burden of A . fumigatus as measured by percent culture-positive lobes and CFU per gram of tissue (P < or = 0.001), whereas at 1 mg/kg/day measured by percent culture-positive lobes and CFU per gram of tissue (P < or = 0.001), whereas at 1 mg/kg/day the tissue burden of A . fumigatus was not significantly different from that in untreated controls . Microbiological clearance was significantly greater at 1 mg of DAmB per kg per day than at 1 mg of ABCD per kg per day (P < or = 0.001) . There was no difference in microbiological clearance of bronchoalveolar lavage fluid among the treatment groups as measured by CFU per milliliter . As determined by survival, ABCD at 5.0 mg/kg/day was more effective than DAmB at 1.0 mg/kg/day and ABCD at 10 mg/kg/day . ABCD at 10 mg/kg/day was more nephrotoxic than the lower dosages of ABCD and resulted in higher mortality . Impairment of glomerular filtration developed as a direct function increasing the ABCD dosage (r = 0.77; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Marrow Transplant, 1994 Mar, 13(3), 265 - 9
Successful bone marrow transplantation in patients with previous invasive fungal infections: report of four cases; Martino R et al.; Patients with previous invasive fungal infections (IFI) are at high risk of reactivation of the infection during BMT, even after an apparently curative antifungal treatment . We report four patients who suffered an IFI after intensive chemotherapy for acute leukemia and were later submitted for BMT . One patient had developed a chronic systemic candidiasis during consolidation chemotherapy and received prophylactic oral or iv fluconazole (200 mg daily) throughout BMT . Two patients developed an invasive pulmonary aspergillosis after intensive chemotherapy, one of them after salvage therapy for post-allogeneic BMT relapse and the other after consolidation therapy . The former patient underwent partial lobectomy after treatment with amphotericin B before a second allogeneic BMT was performed . Both patients received prophylactic itraconazole (400 mg daily by mouth) throughout the BMT procedure . The fourth patient had pneumonia caused by Scedosporium apiospermum (the anamorph form of the fungus Pseudallescheria boydii) during consolidation chemotherapy which was successfully treated with itraconazole . During BMT he also received oral itraconazole (400 mg daily) as prophylaxis against reactivation of the infection . All four patients had successful BMT and none had clinical, radiological or microbiological evidence of reactivation of IFI during BMT.

Analyst, 1994 Mar, 119(3), 427 - 30
Competitive enzyme-linked immunosorbent assay for the determination of zinc bacitracin in animal feedingstuffs; Williams C et al.; Traditionally, bioassay has been the chosen technique for the determination of bacitracin compounds in animal feedingstuffs . However, detection and determination of this antibiotic have given problems when it is present at low levels . A competitive enzyme-linked immunosorbent assay (ELISA) by which it is possible to detect both bacitracin and zinc bacitracin at levels as low as 1 mg kg-1 in animal feeds is described . The ELISA technique has been used in this laboratory to monitor samples from a drug stability storage trial for the presence of zinc bacitracin . In addition, individual polypeptide components of zinc bacitracin have been separated by high-performance liquid chromatography . Fractions were collected and tested by the ELISA technique to assess the response between individual components and the primary antibody . The response was compared with known microbiological activity.

Vnitr Lek, 1994 Mar, 40(3), 179 - 83
{Use of bronchoalveolar lavage in the diagnosis of pulmonary complications in immunocompromised patients}; Mayer J et al.; The authors examined, using bronchoalveolar lavage, 70 immunocompromised patients with pulmonary complications . The bronchoalveolar fluid was subjected to cytological and microbiological examination . The examination was not associated with any serious undesirable side effects, not even in patients who were in a serious general condition . Based on the examination the treatment was changed in 83% of the patients and the correctness of treatment was confirmed in 7% of the patients . In 76% of the patients the condition improved . It was possible for instance to diagnose pneumonia caused by Pneumocystic carinii, the Herpes simplex virus and fungi even in patients who did not expectorate sputum . The authors hold the view that this examination should be indicated early.

Minerva Stomatol, 1994 Mar, 43(3), 103 - 14
{The role of antibiotics in periodontology . A review of the literature}; Maggiore E et al.; This review deals with antibiotic treatment of periodontitis . Antibiotic therapy aims at eradicating or controlling specific pathogens in patients with recently diagnosed active periodontitis or a history of recurrent disease, who fail to stabilize after mechanical/surgical therapy . A variety of microbes may cause periodontitis, and the choice of the antibiotic should be guided by accurate microbiological and sensitivity testings . Review of recent literature shows that appropriate systemic antibiotic therapy may increase the chance of healing in patients with recent or high risk of periodontal breakdown . Topical administration of antibiotic should be reserved to selected cases, such as Actinobacillus actinomycetemcomitans infections, in whom it is to be used in conjunction with mechanical treatment.

Clin Lab Med, 1994 Mar, 14(1), 99 - 105
Laboratory detection of mycobacteremia; Reimer LG; Mycobacteremia, rarely seen or recognized before the AIDS epidemic, has now become common in patients with advanced HIV infection . With the introduction of new media and techniques for preparing specimens for media inoculation that lyse and concentrate organisms, our ability to detect mycobacteremia has improved such that we also occasionally detect these organisms in the blood of individuals with other underlying conditions . A precise understanding of the clinical and epidemiologic manifestations of mycobacteremia is not yet available, however, and additional advancements in blood culture techniques and alternative approaches to diagnosis will continue to be important in clinical microbiological research.

Br J Surg, 1994 Mar, 81(3), 368 - 9
Surgical assessment of acute anorectal sepsis is a better predictor of fistula than microbiological analysis; Lunniss PJ et al.; Twenty-two patients with acute anorectal sepsis were examined prospectively to compare surgical assessment with microbiological analysis as predictors of the aetiology of the sepsis . Culture of gut organisms was a sensitive method of detecting an underlying fistula but was not particularly specific (80 per cent) . Demonstration of sepsis in the intersphincteric space in association with an anorectal abscess was 100 per cent sensitive and 100 per cent specific for detection of an underlying fistula . The demonstration was facilitated by a radially placed incision.

J Periodontol, 1994 Mar, 65(3), 274 - 9
Maintenance therapy in young adults with severe generalized periodontitis; Gunsolley JC et al.; The purpose of this study was to evaluate one year of maintenance therapy in young adults with severe periodontitis (SP) who had previously received periodontal therapy consisting of root planing and scaling followed by open flap debridement . Subjects were evaluated with clinical and microbiological measurements at 3, 6, 9, and 12 months following the completion of active therapy . Subjects were included in the study if they completed a minimum of two evaluation appointments . Monitoring of these subjects during the maintenance phase was analyzed by three methods . First, changes in mean attachment level and mean probing depth were calculated at 3-month intervals to determine if the subjects continued to lose or gain attachment and/or had periodontal pockets of increasing or decreasing depth . Second, the frequency of periodontal breakdown was determined and compared to breakdown rates of subjects in other patient populations . Third, future changes in attachment level were related to the presence or absence of two putative periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque . Mean attachment level remained constant in 13 subjects who completed one year of maintenance therapy . However, mean probing depth increased at a yearly rate of 0.19 mm and in periodontally-involved sites pocket depth increased at a yearly rate of 0.65 mm both of which were statistically significantly different from 0 (P < .05) . The frequency of periodontal breakdown in this study was higher than reported in other similar studies of different periodontitis patient populations . The remainder of the data in the study was from 21 subjects who had completed at least two recall appointments.(ABSTRACT TRUNCATED AT 250 WORDS)

J Periodontol, 1994 Mar, 65(3), 268 - 73
Periodontal therapy in young adults with severe generalized periodontitis; Gunsolley JC et al.; This study evaluated the effect of periodontal therapy on clinical and microbiological parameters in 23 subjects with severe generalized early onset periodontitis . Therapy consisted of oral hygiene instruction and root planing and scaling, followed 3 months later by open flap debridement . Subjects were monitored for both clinical measures and levels of Actinobacillus actinomycetemcomitans and Porphyromas gingivalis as identified by indirect immunofluoresence . Clinical and microbiological evaluations were done at the start of the study, 3 months after the completion of root planing and scaling and 3 months after open flap debridement . Mean probing depth was reduced by both root planing and scaling and open flap debridement and the level of reduction demonstrated by both phases of therapy was similar to reductions found in studies that utilized subjects with chronic adult periodontitis . In contrast, reductions in attachment level due to the two phases of therapy, demonstrated in previous studies of subjects with adult periodontitis were not found in the young adult subjects with severe periodontal disease utilized in this study . Levels of A . actinomycetemcomitans were not significantly affected by root planing and scaling, but were reduced by open flap debridement . P . gingivalis was virtually eliminated by root planing and scaling, demonstrating that the two bacterial types respond differently to periodontal therapy . These changes in microbiological parameters were similar to those found in studies of localized juvenile periodontitis subjects, where surgery or antibiotics have been shown to be necessary to reduce levels of A . actinomycetemcomitans.

Gut, 1994 Mar, 35(3), 313 - 6
High prevalence of Helicobacter pylori infection in cohabiting children . Epidemiology of a cluster, with special emphasis on molecular typing; Vincent P et al.; Intrafamilial cases of infection with the same strain of Helicobacter pylori (H pylori) have been reported but these clusters were too small to distinguish between person to person spread or coinfection from a common environmental source . To gain more information on the mode of transmission of H pylori, an epidemiological survey with bacterial strain differentiation by restriction endonuclease analysis of chromosomal DNA was carried out in an institution of 117 children with encephalopathy (aged 3.5 to 19 years) . All children with antibodies against H pylori had gastroscopy to obtain gastric biopsy specimens . The prevalence of infection (confirmed histologically or microbiologically, or both) was 38% (45/117), and rose to 67% in one of the five sections of the institution . H pylori was isolated in 34/45 cases, and 22 different strains were found of which five strains were present in more than one child . Up to seven children were infected by the same strain, five of them were living in the same section . Analysis of the characteristics of infected children showed the predominant role of living conditions and the period of time cohabiting in this unexpectedly high prevalence of H pylori infection in children living in good sanitary conditions.

Infection, 1994 Mar-Apr, 22(2), 81 - 5
Amphotericin B versus amphotericin B plus 5-flucytosine: poor results in the treatment of proven systemic mycoses in neutropenic patients; Verweij PE et al.; Twenty-eight neutropenic (< 500 granulocytes/microliters) adults with microbiologically or histologically proven systemic mycosis were randomly assigned to receive either amphotericin B alone (0.5 mg/kg/day; n = 14) or amphotericin B (0.5 mg/kg/day) plus 5-flucytosine (150 mg/kg/day; n = 14) intravenously . Therapy was given for an average duration of 10 days in both groups, amounting to a total dose of amphotericin B of 338 mg and 308 mg, respectively . The mean duration of granulocytopenia was 18 days in the amphotericin B group and 20 days in the combination group . Only two patients treated with amphotericin B alone and three given the combination survived . Adverse events were similar in both groups with an elevation of the serum creatinine in six cases during the administration of amphotericin B alone and in seven cases treated with the combination . No other serious adverse events were encountered . Treatment with both regimens was disappointing partly because mycosis was too far advanced by the time therapy was begun and neutrophils were recovered in only half the patients.

J Pharm Sci Technol, 1994 Mar-Apr, 48(2), 76 - 85
Transport considerations for microbiological control in piping; Noble PT; Microbiological control in clean piping systems is limited by transport processes that distribute the disinfecting medium . The critical locations where transport resistance can be expected are the piping dead legs . Transport in dead legs was analyzed theoretically for two common disinfection methods: thermal; and ozone treatment . Established guidelines for clean piping design should not be universally applied . Specific guidelines for these different technologies are proposed . By differentiating between permanent and temporary dead legs, ozonated systems can be designed to be at least as reliable as thermal systems . Scale-up of thermal systems should include increasing the circulating velocity of the loop.

Enferm Infecc Microbiol Clin, 1994 Mar, 12(3), 154 - 7
{Clindamycin-primaquine in the treatment of Pneumocystis carinii pneumonia}; Garces JL et al.; BACKGROUND: The efficacy of clindamycin-primaquine as treatment of Pneumocystis carinii pneumonia (PCP) is similar to that of trimethoprim-sulfamethoxazol and endovenous pentamidine . The untoward effects of this combination are scarce and of mild degree . METHODS: Patients presenting with microbiologically confirmed PCP (bronchoalveolar lavage or induced sputum) were treated with clindamycin-primaquine . Patients presenting PO2 of less than 60 mmHg were excluded, being therefore treated with conventional therapy . RESULTS: Sixteen patients received treatment with clindamycin-primaquine . All demonstrated clinical improvement after the fifth day of treatment . Treatment was discontinued in three patients due to cutaneous adverse reactions . One patient voluntarily discontinued treatment, being readmitted with acute respiratory failure, and died . Clinical cure was achieved in 13 patients who completed the treatment with clindamycin-primaquine . CONCLUSIONS: The combination of clindamycin-primaquine was effective as the treatment of Pneumocystis carinii pneumonia in the patients here reported . The percentage of patients who presented secondary effects was not greater than expected with other therapeutic options . The severity of the adverse events was mild and easy to control.

Aust J Adv Nurs, 1994 Mar-May, 11(3), 34 - 40
A comparative study of neonates' umbilical cord management ; Barclay L et al.; The aim of this study was to establish the effect of treating neonates' umbilical cords with chlorhexidine 0.5% in alcohol 70% on cord separation time and to observe the clinical and microbiological consequences of not treating the cords of healthy neonates . The treated group contained 466 babies whose cords were treated with chlorhexidine, 424 babies were not treated . Microbiological colonisation patterns of the cords of babies in both groups were monitored both for purposes of this investigation and to ensure that no untoward consequences resulted from non-treatment . The research showed that treatment prolonged separation time by 1.7 days, which was significant at the level of p = 0.000, and that normal colonisation was delayed in the treated group.

Semin Respir Infect, 1994 Mar, 9(1), 31 - 40
Bronchiectasis; Nicotra MB; Bronchiectasis, a condition characterized by abnormal and permanent dilatation of pulmonary airways, is an old disease, well recognized in the era before widespread immunization for childhood diseases and the development of antibiotics . After that time, interest in this disease waned . The recognition of bronchiectasis in association with congenital diseases awakened interest in the disease . Review of literature relating to the etiologies of bronchiectasis does not substantiate a congenital origin in most; it appears that the majority of cases of bronchiectasis result from prior infections of the lungs, either viral or bacterial, including mycobacterial . The initial insult triggers an inflammatory change in the bronchial wall that persists even after the episode ends . Over time, the bronchial wall is damaged, making it subject to permanent dilatation . Clinical findings of bronchiectasis include chronic cough with sputum production, often purulent, sometimes hemoptoic . Recurrent pleurisy and fever occur . Spirometry in most patients shows airway obstruction, even if the patient has never smoked . Chest radiographs are usually abnormal, with chronic increased markings caused by infiltrates or scarring, atelectasis, and pleural thickening . Microbiological studies may show a variety of organisms, some commensals, others pathogenic . Diagnosis is made based on the clinical picture with a compatible chest radiograph and confirmed with a high-resolution computed tomography (CT) scan . Therapy of bronchiectasis is directed at airway obstruction, including chest physiotherapy and bronchodilators, and at the infections . Few controlled studies to evaluate any therapy have been performed.

Microbiologia, 1994 Mar-Jun, 10(1-2), 187 - 94
Culture media and Chaos theory--predicting the unpredictable; Bridson EY; Undefined culture media have played a major role in diagnostic microbiology for 100 years . Chaos theory explains why increased knowledge of microbial systems has failed to predict defined nutritional requirements for the isolation of organisms . A brief description of Chaos theory is given and three microbiological areas of unpredictability are discussed: uncertain identity of isolates, unknown stress damage, unexplored variation of individual colony populations . Probably all living biological systems are non-linear, complex interactions and operate within Chaos theory.

Int J Paediatr Dent, 1994 Mar, 4(1), 47 - 53
Localized prepubertal periodontitis in a 5-year-old child: investigations and clinical observations over a 3-year period; Linden G et al.; A 5-year-old boy presented with persistent generalized gingival inflammation . Clinical and radiographic examination supplemented by immunological and microbiological investigation led to a diagnosis of localized prepubertal periodontitis . The child was subsequently monitored for 3 years and despite treatment there was continued bone loss related to his primary teeth . This case highlights the need for liaison between specialists in paediatric dentistry, periodontology, immunology and microbiology in order to diagnose prepubertal periodontitis and to establish a rational basis for treatment to prevent progression to juvenile periodontitis.

Pract Periodontics Aesthet Dent . 1994 Mar;6(2):60, 62, 65.
Ha coatings in implant dentistry: hype, hysteria, or clinical reality?
Zablotsky M.
Hydroxylapatite (HA) coatings have shown promise due to the enhanced integration of osseous tissues to coated implant surfaces, particularly in sites where bone quality or quantity is compromised . This promise has resulted in a dramatic increase in clinical utilization of HA-coated implants . In spite of encouraging clinical findings, the long-term stability of the hydroxylapatite/bone interface has been challenged . Microbiologically, the HA-coated implant surface may be more susceptible to the formation of bacterial plaque . Additionally, critical variations exist between implant coatings that may affect long-term survival . Despite such concerns, after eight years of clinical utilization, the hydroxylapatite-coated implant surface has not been shown to be predisposed to increased long-term failure.

Pharm World Sci, 1994 Feb 18, 16(1), 18 - 21
The preservation of some oral liquid preparations . The replacement of chloroform by other preservatives; van Doorne H et al.; Chloroform should be considered as an obsolete preservative for pharmaceutical preparations, because of its toxicological implications and its physical instability . The effectiveness of possible alternatives for chloroform in three oral liquid pharmaceutical preparations was investigated, using a microbiological challenge test . Magnesium trisilicate mixture (British Pharmacopoeia) can be adequately preserved with methylparaben (2 g/l) . Only insignificant amounts of methylparaben were absorbed by the solids present in the magnesium trisilicate mixture . Ferrous sulfate mixture (British Pharmacopoeia) can be preserved with a mixture of methylparaben (1.8 g/l) and propylparaben (0.2 g/l) . Sorbic acid (1 g/l) is a suitable preservative for promethazine hydrochloride syrup.

Health Care Superv, 1994 Mar, 12(3), 20 - 7
Understanding microbiological concepts and computerized surveillance: enhancing professional practice; Rundio A Jr; This article describes a research study that explored whether registered professional nurses, when exposed to an experimental educational intervention that consisted of a simulated patient environment with staged microbiological concepts relating to reservoirs of infection and BOSS surveillance data reports, retain the concepts of microbiology and can apply these concepts in clinical practice . The design of this research project was quasi-experimental with triangulation of a qualitative dimension as all experimental group participants were interviewed at the completion of this study . Implications concerning nursing curricula and inservice education programs in health care facilities are discussed.

Genitourin Med, 1994 Feb, 70(1), 7 - 11
Genital ulcer disease: accuracy of clinical diagnosis and strategies to improve control in Durban, South Africa; O'Farrell N et al.; OBJECTIVE--To investigate the accuracy of clinical diagnosis in genital ulcer disease (GUD); to devise management strategies for improving the control of GUD and thereby limit the spread of HIV-1 infection . DESIGN--Clinical and microbiological assessment of GUD in men and women . The index of suspicion, diagnostic accuracy, diagnostic efficiency and positive and negative predictive values of a clinical diagnosis were investigated . SETTING--City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa . PARTICIPANTS--100 men and 100 women with genital ulcers . RESULTS--The accuracy of a clinical diagnosis was, in men: lymphogranuloma venereum (LGV) 66%, donovanosis 63%, chancroid 42%, genital herpes 39%, primary syphilis 32%, mixed infections 8%, and in women; secondary syphilis 94%, donovanosis 83%, genital herpes 60%, primary syphilis 58%, chancroid 57%, LGV 40%, mixed infections 14% . Overall, diagnostic efficiency was greater in women than in men . When compared with other causes of GUD, donovanosis ulcers bled to the touch and were larger and not usually associated with inguinal lymphadenopathy . In women, extensive vulval condylomata lata were readily differentiated from all other causes of GUD . CONCLUSION--A clinical diagnosis in genital ulceration was less accurate in men than in women . The diagnostic accuracies for donovanosis and secondary syphilis were relatively high but for most other conditions were low . Differences between clinical and laboratory diagnostic accuracies may reflect similarities between the clinical appearances of the various causes of GUD, the presence of mixed infections, atypical ulceration due to longstanding disease, and insensitive laboratory tests . In this community all large ulcers should be treated empirically for syphilis and donovanosis . Uncircumcised men with GUD are an important HIV core or "superspreader" group locally, and prevention strategies should include counselling and health education in the light of the inaccuracy of clinical diagnosis found in this study . The development of rapid accurate tests for GUD is urgently requiredPIP: Clinical and microbiological assessments of genital ulcer disease (GUD) were taken in 100 men and 100 women with genital ulcers at the City Health Sexually Transmitted Diseases Clinic of King Edward VIII Hospital in Durban, South Africa . The study was conducted to investigate the accuracy of clinical diagnosis in GUD and to devise strategies for improving the control of GUD and the spread of HIV-1 infection . The authors found clinical diagnosis in genital ulceration to generally be less accurate in men than in women . Diagnostic accuracies for donovanosis and secondary syphilis were relatively high, but low for most other conditions . The observed differences between clinical and laboratory diagnostic accuracies may reflect similarities between the clinical appearances of the various causes of GUD, the presence of mixed infections, atypical ulceration due to longstanding disease, and insensitive laboratory tests . It is recommended that all large ulcers in this community be treated empirically for syphilis and donovanosis . Rapid accurate tests for GUD urgently need to be developed . The authors also stress that uncircumcised men with GUD are an important HIV core group locally and that prevention strategies should include counseling and health education given the inaccuracy of clinical diagnosis found in the study .

Genitourin Med, 1994 Feb, 70(1), 15 - 21
Surveillance of sexually transmitted diseases in France: recent trends and incidence; Meyer L et al.; OBJECTIVE--To present recent trends in sexually transmitted diseases (STDs) in France and to estimate the gonorrhoea incidence in 1990 . METHODS--Trends were analysed from data of three surveillance systems: (1) STD clinics: number of diagnoses, (2) a sentinel voluntary General Practitioner (GP) network: mean number of acute male urethritis/week/GP, characteristics of the notified urethritis (age, presence of discharge, sexual orientation), (3) a sentinel voluntary laboratory network: mean number of gonorrhoea isolates/month/laboratory, characteristics of patients with positive isolates (sex, age, site of sampling) and of strains (PPNG and TRNG rates) . To estimate the gonorrhoea incidence in France in 1990, results of a study held among a national sample of laboratories were used, combined with data from surveillance systems and specific studies . RESULTS--Decreasing trends in gonorrhoea in STD clinics and in the laboratory network as well as in acute male urethritis in the GP network have been observed since implementation of the networks in 1985 . The rate of PPNG strains has regularly increased in the laboratory network to reach 14% in 1991 . Data suggest that the incidence in some acute non recurrent STDs could have increased among homo/bisexual men since 1988 . Chlamydia trachomatis is now the most frequent diagnosis in STD clinics . Estimation of male gonorrhoea incidence rate in France in 1990 of 74/100,000 inhabitants (15-59 years) is consistent with figures observed in England and Wales, where the age distribution is very similar . On the other hand, the estimated female gonorrhoea incidence rate of 14/100,000, which concerns only microbiologically ascertained cases, is one third in France than that observed in England and Wales . CONCLUSION--The consistency of the decreasing trends in gonorrhoea and acute male urethritis observed from the different networks reduces the possibility of a bias due to any change in notification or in prescription . Trends in Chlamydia trachomatis will be better appraised in the near future with the recent implementation of new systems . The French STD surveillance appears quite satisfactory for male infections and has been able to show a marked decrease in the incidence of some STDs in the last years . Surveillance of female STDs is to be improved, in terms of monitored diagnoses and selected health care facilities . Differences between the female gonorrhoea incidence rate observed in England and Wales and the one computed for France could be attributed to differences in contact tracing policies between the two countries or to differences in sexual lifestyles.

Monaldi Arch Chest Dis, 1994 Feb, 49(1), 52 - 6
Critical review of microbiological data and methods in diagnosis of lower respiratory tract infections; Davies BI; A review is presented of the microbiological data, and the methods for obtaining these data, which are relevant for the diagnosis of lower respiratory tract infection . The necessity for adequate information exchange between the microbiology laboratory and the clinic is stressed . Once the specimen (usually sputum) has reached the laboratory, it is screened macroscopically and microscopically for adequacy, and cultures are set up . Many patients with acute community-acquired pneumonia (CAP) have no sputum, and some produce purulent sputum containing no obvious infecting micro-organisms . Despite modern microbiological techniques, only 110 out of 250 acute CAP patients had positive bacteriological cultures and 41 more yielded only positive serological results, so that an aetiological diagnosis was reached in 60% . Invasive methods of specimen collection (bronchoscopy, BAL, protected brush, etc) have also been studied, together with quantitative bacterial counting, but the results have not yielded so much useful information that these procedures can be unreservedly recommended . Molecular biological methods (DNA probes, PCR, etc) are only now becoming available . The bacteriological findings in patients with acute CAP have been compared with those in acute exacerbations of chronic bronchitis (CB), and several differences have emerged in the order of frequency of occurence . H . influenzae is in first place with exacerbations of CB, but is second to S . pneumoniae in acute CAP . The latter occupies third position in CB, with Moraxella catarrhalis second . The role of Chlamydia pneumoniae in acute CAP is not yet clear, but the serological results suggest an association in 42 out of 147 patients tested (29%), 15 of whom also had positive bacteriological cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur Respir J, 1994 Feb, 7(2), 235 - 9
Bacterial pneumonia in HIV-infected patients: a prospective study of 68 episodes; Falco V et al.; We collected clinical and microbiological observations, as well as follow-up on human immunodeficiency virus (HIV)-infected patients with bacterial pneumonia, and compared pneumococcal pneumonia in patients with and without HIV infection . Fifty five HIV-infected patients, who had had 68 episodes of bacterial pneumonia, were studied prospectively . Twenty one HIV-infected patients with pneumococcal pneumonia were compared to 69 non-HIV-infected patients with pneumococcal pneumonia . Aetiological diagnosis was established in 48 cases (71%) . The most common causative agents were S . pneumoniae and H . influenzae . Sixty percent of episodes took place in asymptomatic carriers of HIV infection and 37% in acquired immune deficiency syndrome (AIDS) patients . Overall mortality was 10% . Fifty five percent of patients with follow-up had recurrent episodes . Bacteraemic pneumococcal pneumonia was more frequent in HIV- than in non-HIV-infected patients, and the mortality of pneumococcal pneumonia was also higher in HIV- (19%) than in non-HIV-infected (4.3%) patients . We conclude that bacterial pneumonia is a frequent problem in HIV-infected patients and that recurrent episodes are common . The clinical presentation of pneumococcal pneumonia is generally indistinguishable from that occurring in normal hosts, but bacteraemia is more common and the mortality is higher in HIV-infected patients.

J Periodontol, 1994 Feb, 65(2), 154 - 61
Clinical, microbiological, and histological factors which influence the success of regenerative periodontal therapy; Machtei EE et al.; The primary objectives of this double-blind, controlled clinical trial were to assess factor(s) which affect the success of guided tissue regeneration (GTR) procedures in mandibular Class II buccal furcation defects . Thirty subjects, with mandibular Class II furcation defects, were randomly assigned to one of two treatment groups; patients in Group A received oral hygiene instructions with scaling and root planing, while subjects in Group B received similar treatment but without subgingival scaling and root planing at the affected site . After initial oral hygiene instructions and scaling and root planing, GTR surgery was performed using ePTFE barrier membranes . Membranes were retrieved at 6 weeks and subjected to histological examination . Twelve months after regenerative therapy, clinical measurements and re-entry surgical measurements were repeated . Probing reduction (2.61 mm), horizontal probing attachment gain (2.59 mm), and vertical probing attachment gain (0.95 mm) were all significantly better compared to baseline . Likewise, significant improvements in furcation volume (8.0 microliters) and in bone measurements were observed at re-entry . There was no discernible difference between subjects for whom complete anti-infective therapy was deferred to the time of the surgery (Group B) compared to subjects in whom complete anti-infective therapy was performed as part of the hygienic phase of therapy (Group A) . Pre-operative pocket depth was directly correlated with the magnitude of attachment gain as well as the amount of new bone formation in the furcation area . Subjects who maintained good oral hygiene and who had minimal gingival inflammation throughout the study demonstrated consistently better regenerative response.(ABSTRACT TRUNCATED AT 250 WORDS)

J Am Coll Nutr, 1994 Feb, 13(1), 87 - 94
Assessment of vitamin B6 status of strength and speedpower athletes; Rokitzki L et al.; OBJECTIVE: The investigation was designed to obtain information concerning the vitamin B6 status in high-performance athletes . SUBJECTS: Fifty-seven strength and speedpower athletes were available for examination . METHODS: Vitamin B6 status was determined by a 7-day weighed food record, enzyme activity (alpha-EGOT) measurement, whole blood concentrations (Saccharomyces carlsbergenisis and 4-pyridoxinic acid (4-PA) excretion (high-pressure liquid chromatography) . RESULTS: The absolute vitamin B6 intake in > 30% of the athletes was below the German recommended dietary allowance (GRDA) and, in relation to the protein intake (GRDA 0.20 mg vitamin B6/g protein), > 60% of the athletes had values below the GRDA . More than 90% of the athletes did not attain the reference value (0.88 nmol/mL) for untrained individuals in vitamin B6 whole blood concentration, and only a few athletes (< 5%) had alpha-EGOT values above the reference value of alpha-EGOT > 1.50) . The 4-PA excretion was below the reference value of > 2.73 mumol/g creatinine in 18% of all athletes examined . CONCLUSIONS: Vitamin B6 status can be quantified using the weighed food record, microbiological whole blood determination, and 4-PA excretion; however, limits of the individual methods must be taken into account . Vitamin B6 supply of the athletes still cannot be definitively assessed because there are no generally valid reference values.

Plant Foods Hum Nutr, 1994 Feb, 45(2), 183 - 9
Microbiological evaluation of tofu and tempeh during processing and storage; Ashenafi M; Tofu samples consisting of 'Fresh Tofu', 'Herb Tofu', 'Tofu Paste', 'Fried Tofu', 'Tofu Burger', 'Smoked Tofu' and different types of herbs used for making 'Herb Tofu' were analysed for their microbiological load . Tempeh samples consisted of cook water, inoculated beans and fresh tempeh . 'Fresh Tofu' and 'Herb Tofu' had high bacterial counts (> or = 10(5) cfu/g) . 'Tofu Burger' and 'Smoked Tofu' had counts around 10(4) cfu/g . 'Tofu Paste' and 'Fried Tofu' had low counts (< 10(2) cfu/g) . Cutting board, knife and frequent hand contact with product were the major sources of contamination for tofu . Herbs used for making 'Herb Tofu' were highly contaminated (> 10(5) cfu/g) . Cook water and cooked beans for tempeh production had lower counts (< or = 10(4) cfu/g) . Initial count of fresh tempeh was high (about 10(8) cfu/g) . Most products had counts of > 10(6) cfu/g after 7 days of cold storage . The microbiological quality of the product may improve if producers avoid unnecessary contamination during processing.

J Clin Periodontol, 1994 Feb, 21(2), 98 - 106
Microbial identification and antibiotic sensitivity testing, an aid for patients refractory to periodontal therapy . A report of 3 cases; Fine DH; The importance of microbial surveillance is illustrated in 3 clinical cases . Each case demonstrated a continued lack of response to conventional periodontal treatment . Repeated bouts of periodontal abscess formation and bone loss occurred over a 3- to 4-year period, despite numerous surgeries supplemented with antibiotics . As a result, patients were termed refractory to treatment and extensive microbiological analysis and sensitivity testing was performed . Following institution of the appropriate antibiotic and conservative therapy consisting of several sessions of scaling and root planning, each of these cases demonstrated a dramatic remission of disease progression . No further breakdown has been seen for a minimum of 2 1/2 years . While anecdotal in nature, these cases support the usefulness of microbial identification coupled with antibiotic sensitivity as an adjunct to conventional conservative periodontal therapy.

J Clin Periodontol, 1994 Feb, 21(2), 65 - 75
Subgingival distribution of A . actinomycetemcomitans in periodontitis; Ebersole JL et al.; This investigation developed an experimental design that (1) detailed the distribution of A . actinomycetemcomitans in subgingival plaque related to the level of serum antibody to this pathogen; (2) used broad based subgingival plaque sampling to allow a definition of the distribution of A . actinomycetemcomitans infection in periodontitis patients; (3) described the distribution of A . actinomycetemcomitans serotypes in patients and within sites; and, (4) assessed how this infection impacted upon local clinical symptoms of disease . We noted a significant positive relationship between the level of IgG anti-A . actinomycetemcomitans antibody and the frequency of teeth infected until nearly 13 teeth demonstrated an infection . Furthermore, the results showed a generally negative relationship between the antibody level and the burden of A . actinomycetemcomitans in the infected sites . Interproximal sites associated with first molar teeth were the predominant sites for subgingival colonization; incisors were also frequently infected in this population . The first molar teeth also exhibited the greatest level of A . actinomycetemcomitans, while the incisors demonstrated a high level of A . actinomycetemcomitans in individual sites . The results clearly indicated the majority of the sites sampled were colonized by a single serotype of A . actinomycetemcomitans . We detected A . actinomycetemcomitans nearly 2 x times more frequently and a significant increase in the proportion of A . actinomycetemcomitans was found in samples obtained from teeth with bleeding on probing . The results also showed a significant trend for both pocket depth and attachment levels to be related to the presence and proportion of A . actinomycetemcomitans in the subgingival plaque . These findings detail the microbiological, immunological and clinical characteristics of a unique subset of periodontitis patients that appear to exhibit disease associated (caused?) with A . actinomycetemcomitans infection irrespective of clinical categorization . The results support a unique distribution of this microorganism in the subgingival ecology that is related to active host immune responses and clinical presentation of the tooth.

J Clin Periodontol, 1994 Feb, 21(2), 107 - 12
Microbiological and clinical effects of metronidazole and amoxicillin in Actinobacillus actinomycetemcomitans-associated periodontitis . A 2-year evaluation; Pavicic MJ et al.; In this study, we evaluated the microbiological and clinical effects of mechanical debridement in combination with metronidazole and amoxicillin therapy in 48 patients with Actinobacillus actinomycetemcomitans-associated periodontitis, 3 months and at least 24 months after active treatment . The results of this study showed that 47 out of 48 patients were still negative for A . actinomycetemcomitans subgingivally, at the mucous membranes, the tonsillar area and in the saliva, 2 years after therapy . The clinical results showed that a reduction of probing pocket depth, probing attachment level, bleeding index and plaque index was not only seen in the time between baseline and 3 months after therapy, but further clinical improvement was observed between 3 and 24 months after active treatment . We conclude that combined mechanical debridement and metronidazole plus amoxicillin therapy is very effective in suppressing A . actinomycetemcomitans below cultivable levels over a long period of time, suggesting elimination of this organism, and that recolonization of A . actinomycetemcomitans seems to be a rare event . The elimination of A . actinomycetemcomitans is paralleled by a further improvement of the periodontal status of the patients, even up to 24 months after active treatment.

J Epidemiol Community Health, 1994 Feb, 48(1), 41 - 5
An outbreak of illness among schoolchildren in London: toxic poisoning not mass hysteria; Aldous JC et al.; STUDY OBJECTIVE--To determine the cause of an outbreak of acute gastrointestinal illness that occurred shortly after lunch in children attending a school in London, UK . DESIGN--A questionnaire survey of children at the affected school was carried out on the day after the incident . Microbiological, environmental, and toxicological investigations were also undertaken . SETTING--A school in London, UK . PARTICIPANTS--Altogether 374/468 (80%) of the children who had eaten lunch at the school on the day of the incident completed a questionnaire . MAIN RESULTS--There was a significant association between illness and the consumption of raw cucumber (relative risk = 6.1; 95% confidence interval 2.2, 16) . Microbiological investigation of the foods served at lunch did not show any pathogens and toxicological investigations suggested that the cucumbers were contaminated by a pesticide . CONCLUSIONS--Although the outbreak displayed several typical features of mass psychogenic illness, the most probable cause was a toxic chemical present in cucumber served at lunch . Those responsible for investigating outbreaks of illness should be aware of the possible toxicological causes and the appropriate modes of investigation . They should be wary of too readily attributing a psychogenic cause to unusual outbreaks of acute illness in schoolchildren.

Eur J Epidemiol, 1994 Feb, 10(1), 17 - 22
Clinical and mycological evaluation of fluconazole in the secondary prophylaxis of esophageal candidiasis in AIDS patients . An open, multicenter study; Agresti MG et al.; A prospective, multicenter, open study of fluconazole prophylaxis was performed in AIDS patients to evaluate the efficacy and toxicity of the drug in preventing relapses of esophageal candidiasis . To this aim, 99 AIDS patients who presented a first episode of clinically and microbiologically confirmed esophageal candidiasis were enrolled in eleven clinical centers scattered throughout the Italian territory . After resolution of this initial esophagitis, all subjects were given fluconazole, 100 mg/die, and followed up for a 6 month period . Only 7 out of the 99 patients enrolled had a relapse of Candida esophagitis, during a mean follow-up period of 138.5 days . All relapsing patients had CD4+ cell number < 100/microliters at baseline . Mild side effects were reported in only eight patients . However, 14 of the 27 subjects from whom serial serum samples were available became (12) or remained (2) antigenemic during fluconazole prophylaxis, independently from relapse, suggesting the persistence of tissue-invasive, proliferating Candida cells . Overall, the data of this study suggest a beneficial effect of prophylactic maintenance therapy with fluconazole against Candida esophagitis, particularly in the population with > 100 CD4+/microliters . However, the data on Candida antigenemia in these patients invite the consideration of a relative inefficiency of the drug to eradicate the microrganism from the esophageal tissue.

Fundam Appl Toxicol, 1994 Feb, 22(2), 161 - 71
Space exploration and toxicology: a new frontier; Oberdorster G et al.; Results of the microbial and immunological studies discussed above clearly illustrate an in-flight or post-flight blunting of the cellular immune mechanism in humans and test animals, coincident with a relative increase in pathogenic microorganisms . This situation predicts an increased incidence of in-flight infectious disease events . To prevent this from occurring, most observers agree that a robust program of preflight and in-flight immunological and microbiological monitoring, combined with an effective countermeasures program, are required for optimally successful long-duration spaceflight.

Tuber Lung Dis, 1994 Feb, 75(1), 75 - 9
Association between the histological diagnosis of tuberculosis and microbiological findings; Cutler RR et al.; The aim of this study was to determine the association between the histological diagnosis of tuberculosis and the microbiological findings and to indicate how these results affect treatment . Histopathology and microbiology records were examined retrospectively . 89 cases were identified between 1984 and 1988 . 67% were diagnosed as tuberculosis (TB) by both methods, 97% were diagnosed as TB or 'compatible with TB' by histology . For 7% of these the final diagnosis was found to be other than TB . 48% of patients diagnosed as TB on the basis of histology alone were treated for TB . 70% were diagnosed as TB by microbiology and treated . When matched and appropriate specimens were sent to both departments there was a high level of agreement between histopathologists and microbiologists . There was a problem with inappropriate specimens sent to microbiology.

J Clin Epidemiol, 1994 Jan, 47(1), 23 - 33
The etiology of the anemia of chronic disease and infection; Kent S et al.; Anemia of infection and chronic disease has traditionally been considered a disorder associated with infections/inflammation . We instead propose that the anemia of infection and chronic disease confers protection from pathogen or neoplastic invasion . There is substantial microbiological and medical research that indicates that the anemia of infection and chronic disease may be a non-specific immunological defense . We suggest it is analogous to fever, which was also originally considered to be a disorder in need of treatment but which is now seen as a positive response of the host to microbial invasion . We suggest that these two non-specific defenses against microorganism proliferation may have evolved together as complementary strategies the body employs to ward off disease.

Scand J Infect Dis, 1994, 26(1), 77 - 84
Incidence and clinical significance of positive blood cultures in febrile episodes of patients with hematological malignancies; Rintala E; The characteristics of 554 febrile episodes in 126 patients with a hematological malignancy over a 6-year period (1985-90) were reviewed in order to study the current incidence and clinical significance of blood culture positivity . An infection was documented microbiologically in 28% and clinically in 30% of the episodes . Blood cultures were positive in 19% of the febrile episodes . The rate of blood culture positivity was unrelated to the type of hematological malignancy, to neutropenia and to the presence of infection foci . 21% (26/126) of the patients died of sepsis-related causes . Sepsis-related death occurred in 23% of the blood culture positive febrile episodes, with a median survival time of 2 days . Infection prophylaxis did not reduce either the rate of blood culture positivity or the rate of sepsis-related deaths . Thus, the small proportion of febrile episodes whose fever etiology could be established by blood culture represented 'the tip of the iceberg', i.e . rapidly lethal septic infections with a high mortality rate . This fatality could neither be predicted by a search for infection foci nor prevented by infection prophylaxis.

Infection, 1994 Jan-Feb, 22(1), 62 - 4
A randomized study comparing low dose ciprofloxacin and ofloxacin in the treatment of lower respiratory tract infections; Polubiec A et al.; An open, randomized study was carried out to compare the efficacy of ciprofloxacin, 250 mg twice daily, and ofloxacin, 200 mg twice daily, in hospitalized patients with lower respiratory tract infections such as bacterial exacerbation of chronic bronchitis or community-acquired pneumonia . Fifty patients were treated in each group . The duration of treatment was 10 to 12 days . Microbiological examinations were carried out on sputum samples taken before, during and after treatment . In both groups, the clinical results were considered to be excellent, with clinical cure in 98% of the patients treated with ciprofloxacin and in 90% of patients treated with ofloxacin . Eradication of the initial sputum isolate was achieved in 98% of the patients of the ciprofloxacin group and in 82% of the patients of the ofloxacin group.

Nord Med, 1994, 109(4), 111 - 6
{Myocarditis . Epidemiology, etiology and clinical aspects}; Friman G et al.; The term myocarditis covers a diversity of pathological conditions . Aetiologically, the best documented is acute infective myocarditis, predominantly caused by enteroviruses, particularly Coxsackie B . However, there are many possible sources of infection, and the management of immunosuppressed patients requires careful deliberation . Research into the pathogenesis of viral myocarditis has made formidable advances and provided detailed knowledge of the mechanisms responsible for myocardial damage . Microbiological techniques have yielded evidence of the involvement of Coxsackie viruses in the development of dilated cardiomyopathy . Nowadays, the term myocarditis has a strictly histopathological definition which is clinically applicable only in the few cases where endomyocardial biopsy is performed . The diagnosis, acute infective myocarditis, can usually be made with reasonable certainty on the basis of ECG findings and the serum concentrations of biochemical markers . Physical diagnostic procedures, particularly echocardiography, can provide useful supporting evidence . Prognosis is generally good in cases of acute infective myocarditis, whereas that in other forms of myocarditis varies from case to case . To date, antiviral agents have no established place in the treatment of viral myocarditis . Where diagnosis is based upon endomyocardial biopsy (e.g., in lymphocytic myocarditis), immunosuppressive therapy generally has no significant effect.

Pathology, 1994 Jan, 26(1), 48 - 51
Microbiological aspects of an outbreak of Legionnaires' disease in south western Sydney; Munro R et al.; In April 1992 an outbreak of Legionnaires' disease occurred in south western Sydney . Twenty four patients were diagnosed as having Legionnaires' disease either on the basis of a positive culture of Legionella pneumophila serogroup I from a respiratory specimen (14 patients) or a four-fold or greater rise in antibody titre or isolated convalescent titre > 1024 with IgM antibodies present (10 patients) . This is the largest outbreak in New South Wales since 44 cases of Legionnaires' disease were reported in Wollongong in 1987 . Culture and direct immunofluorescent staining (DFA) were performed for early laboratory diagnosis . The DFA test and a set of defined clinical criteria were then used to classify patients as probable cases of Legionnaires' disease for subsequent Public Health investigations . The DFA test had a predictive value for a positive culture of 45.8% and for a negative culture of 97.1% . Its positive predictive value for a definite diagnosis of Legionnaires' disease (either positive culture or seroconversion), however, was 78.3% with a negative predictive valve of 95.1% . During a 27 day period DFA and culture for Legionella species were performed on 198 specimens from 127 patients . Cultures became positive after a mean of 5 days incubation (range 1-11 days) . The use of both selective and non-selective media is recommended for optimal recovery of L . pneumophila since some isolates were obtained on only one culture plate . After an initial evaluation of heat decontamination of specimens this process was abandoned, since in 8/63 specimens so treated, L . pneumophila was recovered prior to but not following heat decontamination and was not grown only in heated specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Mol Gen Mikrobiol Virusol, 1994 Jan-Feb, (1), 10 - 5
{Use of the polymerase chain reaction to identify Helicobacter pylori in clinical material}; Markova GA et al.; A new system for the detection of Helicobacter pylori DNA, based on the method of directed amplification, has been developed . Primers for specific detection of H . pylori were selected from a nucleotide sequence of 16 S-p RNA . The sequences of the primers had a few nucleotide substitutions as compared with the sequences of closely related microorganisms . An essential condition for the attainment of reaction specificity was the rise of annealing step temperature to 66 degrees C . Sensitivity of the system was in the range of 3 to 30 fg of DNA, or 20 to 100 bacterial cells . Using the proposed system for the detection of H . pylori DNA clinical specimens (stomach biopsy sample, gastric juice and wash-offs of oral cavity), obtained from 49 patients with antral gastritis, were analyzed . The method of H . pylori detection in clinical specimens using polymerase chain reaction (PCR) turned out to be more sensitive compared with microbiological tests . By application of PCR H . pylori DNA was detected in subgingival pockets.

J Periodontol, 1994 Jan, 65(1), 68 - 78
Modeling the relationship between clinical, microbiologic, and immunologic parameters and alveolar bone levels in an elderly population; Wheeler TT et al.; A cross-sectional periodontal study of 74 subjects aged 65 to 75 years was performed . Clinical data were collected and related to microbiological and immunological data . A statistical model (step-wise multiple regression) of factors related to bone loss was created initially using clinical data only; then by adding either the microbiologic or immunologic data; and then by using clinical, microbiologic, and immunologic data together . When only clinical data were considered, three factors were found to have significant positive correlations with bone loss . Tooth mobility accounted for 17% of the variability in the alveolar bone level measurements, probing depth for 12%(r2), and plaque index for 3%, for a total of 32% of the variability explained by these clinical factors . Tooth mobility and probing depth were clinical factors which remained significant in the model when the microbiological data were also considered . As percentages of the total cultivable microbiota, E . corrodens (r2 = 14%) and black-pigmenting Prevotella intermedia (r2 = 4%) correlated positively with alveolar bone loss . The addition of the microbiologic data only increased the r2 to 33% . When immunological data were considered with the clinical data, pocket depth and tooth mobility were the clinical parameters which remained in the model . IgG antibody levels to P . gingivalis W83 and/or 381 (r2 = 24%) A . actinomycetemcomitans 627 (r2 = 2%) were the significant immunologic measures having a positive correlation with bone loss . Anti-F . nucleatum levels had a significant negative correlation . A total of 50% of the variability in alveolar bone level was accounted for in the model by the addition of specific serum antibody levels to subgingival plaque microorganisms . When clinical, microbiological, and immunological measurements were all considered together, antibody to P . gingivalis W83 and/or 381 (r2 = 42%), percentage of B-lymphocytes (r2 = 3%), probing depth (r2 = 4%), anti-E . corrodens levels (r2 = 2%), and anti-P . gingivalis 33277 levels (r2 = 4%) all had significant positive correlation with loss of alveolar bone . The number of enteric bacteria, anti-F . nucleatum levels, and anti-P . intermedia levels each had a significant negative correlation with alveolar bone heights . The r2 for this model was 75% . These results indicated that antibody levels to subgingival plaque microorganisms and tooth mobility were the best predictors of bone loss in the elderly patients tested in this study.

J Clin Periodontol, 1994 Jan, 21(1), 48 - 50
Repeated subgingival oxygen irrigations in untreated periodontal patients; Schlagenhauf U et al.; The aim of this study was to assess the effect of repeated subgingival oxygen irrigations in previously untreated deep periodontal pockets . 112 pockets > or = 4 mm were selected in 14 subjects . Probing attachment level and bleeding on probing were recorded, as well as the presence of disease-associated micro-organisms within the pocket . Subsequently, the pockets were irrigated with gaseous oxygen 1 x a week during a continuous 8-week period . Irrigations with nitrogen served as control . The re-evaluation of all clinical and microbiological parameters at the end of study revealed that repeated oxygen insufflations resulted in a significant clinical improvement of the periodontal baseline conditions superior to the one found in the control.

J Clin Microbiol, 1994 Jan, 32(1), 46 - 50
Evaluation of a new immunodiagnostic assay for Helicobacter pylori antibody detection: correlation with histopathological and microbiological results; Pronovost AD et al.; Infection with Helicobacter pylori has been associated with the pathogenesis of chronic active gastritis and gastric and duodenal ulcer disease . Detection of immunoglobulin G antibodies to H . pylori offers a simple alternative to direct detection of the organism in biopsied tissue by culture or histopathological methods . A rapid flow-through membrane-based enzyme immunoassay for the detection of human immunoglobulin G antibodies to H . pylori has been developed and evaluated . Clinical evaluations were performed with 256 patient serum samples obtained from four clinical sites . Biopsy samples were obtained by endoscopic procedures at the same time as the serum samples, and were histopathologically and microbiologically categorized for the presence or absence of H . pylori . Sensitivity and specificity for this rapid enzyme immunoassay were 92 and 88%, respectively, compared directly with endoscopy results . After discordant results were resolved by a quantitative microwell enzyme-linked immunosorbent assay, the resulting sensitivity and specificity were 94 and > 99%, respectively . These results indicate that this rapid enzyme immunoassay is a useful technique to determine H . pylori infection status and is a viable alternative to invasive endoscopic procedures.

J Clin Microbiol, 1994 Jan, 32(1), 224 - 7
Osteomyelitis and intervertebral discitis caused by Blastoschizomyces capitatus in a patient with acute leukemia; D'Antonio D et al.; We describe the first known case of vertebral osteomyelitis and discitis caused by Blastoschizomyces capitatus in a leukemic patient and the results of therapy . We also reconfirm the microbiological characteristics which differentiate this species from other yeastlike pathogens.

Pharm Acta Helv, 1994 Jan, 68(3), 169 - 71
Microbiological conversions of solamargine; Regerat F et al.; A strain of Aspergillus ochraceus, a microorganism classically used for bioconversions of the steroid nucleus, was tested on solasodine glucosides . It induced specific modifications to the oside chain of the solamargine molecule, without modifying the genin nucleus . These modifications depended on the composition of the culture medium and the aeration, and led under certain conditions to a single isomer of the secondary glucoside beta 2-solamargine or Khasianine: o-alpha-L-rhamnopyranosyl-(1-->4 glu)-O-(3)-beta-D-glucopyranosyl solasodine.

J Clin Gastroenterol, 1994 Jan, 18(1), 23 - 6
Spectrum of ulcerative colitis in north India; Duphare H et al.; We analyzed retrospectively the characteristics of 87 patients with ulcerative colitis seen in a tertiary care center in north India . Ulcerative colitis was diagnosed on the basis of clinical features, sigmoidoscopy, rectal biopsy, and exclusion of microbiological causes of colitis . Severe clinical disease was seen in 53 (60%) patients that correlated with extensive colonic involvement (p < 0.001), severe changes on sigmoidoscopy (p < 0.001) and histology (p < 0.001), erythrocyte sedimentation rate (ESR) of > 30 mm for the first hour, and serum albumin of < 3 g/dl (p < 0.001) . Remission of the disease was maintained on sulfasalazine in 18 (20.7%) patients, whereas 47 (54%) required steroids . Proctocolectomy with ileoanal anastomosis was done in 22 (25.3%) patients in whom there was poor response to medical treatment . Postoperative complications were seen in seven (31.8%) patients, and death occurred in four (18.1%) patients . Ulcerative colitis thus commonly presents as severe disease, with the majority of patients requiring surgery due to poor response to medical therapy . This pattern of disease as seen in an academic referral hospital in north India is virtually indistinguishable from that seen in similar centers in the West . However, in our setting, proctocolectomy and ileoanal anastomosis is cost-effective in patients unresponsive to, or unable to afford, drug treatment.

Ann Dermatol Venereol, 1994, 121(1), 25 - 9
{Microscopic diagnosis of onychomycoses}; Pierard GE et al.; INTRODUCTION . The microbiological identification of onychomycosis may be uncertain as some fungi growing in culture from this material are not necessarily pathogen and invasive . Conversely, the negativity of a culture is not rare even when fungi are seen by microscopy . MATERIALS AND METHODS . We compared the information brought by standard histological examination, immunohistochemistry and in vivo confocal microscopy . RESULTS . The histological examination of nails is of importance in this pathology . We present a laboratory technique that proves to be easy and rapid . We report diagnostic criteria allowing the distinction between dermatophytes, yeasts and non-dermatophyte molds . The standard microscopic examination may further be improved by immunohistochemistry using some antibodies to fungi . In vivo confocal microscopy is a technique for the future . The dermatologist will be able to see fungi in the nail at the clinical examination, without any sampling or peculiar preparation . CONCLUSION . The histological examination is a routine technique useful for defining the nature and localization of fungi in the nail plate . Immunohistochemistry applied to onychomycosis is an experimental approach bringing prominent informations about the identification of fungi . In vivo confocal microscopy is a door opened to the future.

Res Microbiol, 1994 Jan, 145(1), 5 - 8
Follow-up of tuberculosis patients undergoing standard anti-tuberculosis chemotherapy by using a polymerase chain reaction; Levee G et al.; We have analysed the clearance of Mycobacterium tuberculosis in sputum specimens from pulmonary tuberculosis patients undergoing 6-month chemotherapy, using the polymerase chain reaction (PCR) and standard microbiological methods . In a group of 19 patients, 11 (58%) were smear- or culture-positive and 13 (74%) were PCR-positive before treatment . Of the 16 patients followed from 2 months after the start of treatment and thereafter, all became smear-negative and culture-negative, whereas, with PCR, 4 (27%), 2 (13%) and 1 (7%) of these patients remained positive after 2, 3 and 6 months, respectively . These results suggest the possible usefulness of PCR in monitoring the efficacy of treatment when bacteriological tests are negative, so as to identify patients with a high risk of relapse.

J Fr Ophtalmol, 1994, 17(5), 314 - 20
{Microbiological safety and endothelial quality control during preservation of corneal grafts at +31 degree C}; Laroche L et al.; Over a 10-month-period, 59 corneas were organ-cultured at + 31 degrees C and 7 were preserved at + 4 degrees C . Among the 59 organ-cultured corneas, 41% (24) were grafted and 25% (15) developed an infection during preservation . At the time of surgery, preservation medium and scleral rim were tested for microbiology . Infection during preservation was bacterial (80%, 12/15) and fungal (20%, 3/12) . Scleral rims were sterile in 96% (24/25) of the grafted corneas preserved at + 31 degrees C but 34% (2/6) at + 4 degrees C (p < 0.01) . Preservation media were sterile in 100% (24/24) of organ-cultures at + 31 degrees C but in 83% cases (5/6) of preservations at + 4 degrees C (NS) . The percentage of endothelial dead cells increased with postmortem enucleation delay (r = 0.43; p = 0.03) . The average endothelial cell loss during organ-culture was 11.2% (+/- 10.4) . It correlated with endothelial density (r = 0.42; p = 0.04) and with percentage of endothelial dead cells (r = 0.43; p = 0.04) after enucleation . Organ-cultured at + 31 degrees C was able to assess graft sterility in almost 100% of the cases but corneas are lost due to infection . Graft sterility is not usually possible with preservation at + 4 degrees C.

Nephrol Dial Transplant, 1994, 9 Suppl 2, 46 - 56
Phagocytic cell function as an index of biocompatibility; Ward RA; This review describes the physiology and biochemistry of phagocytic cells and examines the rationale for using their function to assess biocompatibility . Haemodialysis modulates phagocyte adhesion receptors to a degree dependent on the level of complement activation by the membrane, and this modulation leads to a proportional change in the number of circulating phagocytes because of pulmonary sequestration of activated cells . However, it is not clear that other acute changes in phagocyte function are directly attributable to the nature of the membrane; they may merely reflect changes in the population of circulating cells resulting from pulmonary sequestration . While haemodialysis is associated with stimulation of monocyte cytokine production, the relative contributions to this phenomenon of the membrane material, its mass transfer properties, and the microbiological quality of the dialysate are incompletely understood . A lack of well-designed studies and difficulty in separating the effects of uraemia from those of dialysis make it impossible to know if chronic changes in phagocyte function are a consequence of the choice of dialysis membrane . Thus, while changes in the number of circulating phagocytes and their expression of adhesion receptors are useful indices of biocompatibility, a clear association has yet to be shown between membrane properties and changes in other measures of phagocytes function.

Minerva Cardioangiol, 1994 Jan-Feb, 42(1-2), 43 - 50
{The trophic venous ulcer . The physiopathological, microbiological and pharmacological aspects}; Trabucchi E et al.; The ulcus cruris is an ulcerative lesions caused by chronic venous stasis and chronic venous hypertension . Every pathologic obstacle to venous return can cause ulcus cruris . Ulcus could be brought back to 3 situations: postphlebitic syndrome, chronic venous insufficiency and primitive varicosities . The common denominator is always the increase in venous pressure, the appearance of reflux and venous stasis . Venous ulcers are possibly characterized by tissue degeneration and by bacterial superinfection . A particular bacterial flora is found in these injuries, it is qualitatively different from that of healthy skin . The therapy of ulcus cruris cannot leave out by its etiopathogenesis: the first treatment always consists in the stasis suppression to arrive quickly to a complete cicatricial would repair . In it three moments are recognizable: ulcus abstersion, disinfection and cicatrization . The venous ulcer is not cured when it is closed, but when it has no recurrency: the cicatrization is obtainable treating the principal causes, eliminating the venous stasis and anticipating the relapses.

J Pharm Sci Technol, 1994 Jan-Feb, 48(1), 41 - 4
The biotest RCS air samplers in unidirectional flow; Ljungqvist B et al.; When monitoring the microbiological quality of air in unidirectional air flow units the Biotest air sampler Reuter Centrifugal Sampler (RCS) is often used . In this unidirectional air flow the dispersion region of contaminants (disturbance region caused by turbulence) around the RCS sampler is much larger than that of undisturbed parallel air flow . The recently developed air sampler from Biotest, the RCS+, has a smaller and a different type of dispersion region (disturbance region) than that of the common RCS sampler . The differences must be taken into consideration when the two types of RCS air sampler are used within unidirectional air flow units, especially during aseptic operations in pharmaceutical production.

J Med Vet Mycol, 1994, 32(4), 235 - 56
Mycotic keratitis--an underestimated mycosis; Thomas PA; Mycotic keratitis, an important ophthalmologic problem, especially in outdoor workers in the tropics, is frequently caused by filamentous fungi such as species of Fusarium, Aspergillus and Curvularia, and by yeast-like fungi such as Candida . A rapid, presumptive diagnosis can be made by recognition of certain typical clinical features and by direct microscopic detection of fungi in corneal scrapings stained by various methods . The diagnosis is confirmed by culture . In difficult cases, microbiological studies on corneal biopsies or histopathological studies on tissue sections may need to be performed . The use of fluorescein-conjugated lectins and similar diagnostic tools is aimed at providing rapid, species-specific detection of fungi in corneal tissue . Antifungal therapy must be instituted as soon as the diagnosis is made . While keratitis due to Aspergillus, Candida and dematiaceous fungi can be successfully treated by many of the currently available polyenes and azoles, the treatment of Fusarium keratitis still frequently requires the use of pimaricin or econazole . Treatment by the oral and parenteral routes may prove useful in severe mycotic keratitis . Surgery may need to be performed on cases unresponsive to medical therapy or where serious complications are likely to occur . The pathogenesis of mycotic keratitis appears to involve agent factors, such as invasiveness and toxigenicity, and host factors, such as trauma and intrinsic defects in resistance . Areas for future research include the development of rapid, species-specific diagnostic aids, of broad-spectrum antifungal compounds active by various routes, and of therapeutic modalities which act on the fungus and on molecules involved in the pathogenesis of the condition.

Med Dosw Mikrobiol, 1994, 46(1-2), 63 - 6
{Importance of microbiological examinations for control of hospital infections}; Krzeminska-Jaskowiak E; Investigations aimed at analysis of causes of appearance of hospital infections were performed in selected Intensive Care Unit according to following scheme: 1 . Analysis of hospital infection registration cards . 2 . Bacteriological investigation of samples from patients . 3 . Control of efficiency of disinfection and sterilization processes . 4 . Bacteriological investigation of the hospital personnel . 5 . Bacteriological investigation of drainage basins . Results of this study permitted for determination of etiological factors which most frequently cause infections, as well as of other causes increasing the hospital infection risk.

Perit Dial Int, 1994, 14(3), 231 - 5
Usefulness of dialysate fibrin degradation products and lactic dehydrogenase isoenzyme patterns in assessing the clinical course of peritonitis; Suzuki K et al.; OBJECTIVE: To establish the usefulness of fibrin degradation products (FDP) and lactic dehydrogenase isoenzyme patterns (LDH isoenzyme) in assessing the clinical course of peritonitis . DESIGN: A retrospective study of patients with peritonitis who were divided into three groups according to their clinical course . SETTING: Single dialysis unit of a general hospital . INTERVENTIONS: Patients were treated by intraperitoneal and oral antibiotics . PATIENTS: Twenty-six patients with 34 episodes of peritonitis were studied . Group 1 consisted of 21 patients with 26 recoveries from peritonitis; Group 2 consisted of 5 patients with 5 relapsing episodes of peritonitis, and Group 3 consisted of 3 patients with 3 persistent episodes of peritonitis . MAIN OUTCOME MEASURES: Concentrations of WBCs, FDP, LDH isoenzyme and microbiological culture of the dialysate were determined . RESULTS: In most of Group 1, WBCs, FDP, and LDH isoenzyme returned to normal within 2 weeks . In 4 patients of Group 1, who had complications (diverticulitis, cholecystitis, cystitis, and tunnel infection), WBCs, FDP, and LDH isoenzyme returned to normal gradually within 3 weeks . In Group 2, WBCs returned to normal, but FDP remained relatively high and LDH isoenzyme did not normalize . In Group 3, WBCs, FDP and LDH isoenzyme did not normalize . CONCLUSIONS: Failure of normalization of FDP and LDH isoenzyme suggests an incomplete recovery from peritonitis . FDP and LDH isoenzyme are useful in assessing the course of peritonitis.

Acta Neurochir (Wien), 1994, 127(1-2), 85 - 90
Factors that enhance the likelihood of successful stereotactic treatment of brain abscesses; Kondziolka D et al.; Successful clinical outcomes are not achieved in all patients who undergo image-guided stereotactic surgery as the initial procedure in the management of brain abscess . We sought to define those factors related to management failure, so that the initial surgical approach could be selected using preoperative clinical or imaging criteria . We reviewed our twelve-year experience in 29 consecutive patients . Twenty-two (76%) patients had drainage of abscesses with purulent centers . Seven (24%) underwent lesion biopsy for diagnosis . Twelve patients (with abscesses > 3 cm in average diameter) underwent stereotactic insertion of drainage catheters . Ten patients (34%) had adverse risk factors including immunologic suppression after prior organ transplantation, chronic steroid therapy, prior antineoplastic chemotherapy, or retained foreign body . Microbiological identification of the causative organism was obtained in 22 patients; 6 patients had positive Gram stains without growth in culture (bacteriological diagnosis = 97%) . Long-term clinical evaluation (up to 8.5 years, median 3 years) confirmed disease resolution after initial single-procedure stereotactic management in 21 patients (72%) . Eventual abscess resolution occurred in an additional 6 patients (21%), all of whom required multiple procedures . Five patients died of complications of their systemic disease during the follow-up period . Fifteen of the 18 (83%) surviving patients who had no associated risk factors returned to their premorbid functional capacity . Factors associated with initial treatment failure included inadequate aspiration, lack of catheter drainage of larger abscesses, chronic immunosuppression, and insufficient antibiotic therapy.

Acta Neurochir (Wien), 1994, 127(1-2), 73 - 8
Abdominal CSF pseudocysts in patients with ventriculo-peritoneal shunts . Report of fourteen cases and review of the literature; Rainov N et al.; The abdominal intraperitoneal cerebrospinal fluid pseudocyst is an infrequent but important complication in patients with ventriculoperitoneal shunts . Since 1954, 115 cases of paediatric pseudocysts have been reported in the literature . One additional report deals with an adult patient . We report on 14 cases of sonographically diagnosed abdominal pseudocysts . Their aetiology, diagnosis, clinical signs and symptoms and surgical management are investigated . In our hydrocephalus series we have an incidence of pseudocyst formation of 4.5% . The most common presentation of the paediatric patients is with symptoms of elevated intracranial pressure and abdominal pain, whereas the adults have predominantly local abdominal signs . Diagnosis is readily made with ultrasonography . Predisposing factors for pseudocyst formation are multiple shunt revisions and infection . Microscopically, the pseudocysts consist of fibrous tissue without epithelial lining . The treatment involves surgical removal of the catheter with or without excision of the pseudocyst wall and placement of a new catheter intraperitoneally in a different quadrant or an intra-atrial shunt . Recurrences are rare, especially under appropriate medical treatment of infection . In our series, microbiologically proven infection was present in 30% of the cases.

Wien Med Wochenschr, 1994, 144(8-9), 156 - 62
{Microbiological diagnosis of tuberculosis}; Allerberger F et al.; The increased incidence of tuberculosis as well as the availability of new diagnostic testing methods clearly have various implications for the routine microbiology laboratory: samples must be sent to the microbiology lab for testing immediately after being taken and microscopically investigated the same day . In other countries, difficult to treat, multi-resistant Mycobacterium tuberculosis strains have occurred . Thus decisive hygienic measures must be taken early on in cases of highly infectious patients (i.e . patients with microscopically positive sputum) . Liquid media (MB Check Roche, Bactec) as well as Lowenstein Jensen media must be inoculated in the lab . Liquid media allow both faster detection of certain atypical mycobacteria and increased accuracy . Classification of culturally established agents through commercial genetic probes (AccuProbe Mycobacterien) or with high pressure liquid chromatography is possible within hours when acid-fast rods are present . Time consuming identification by determination of biochemical and culture morphological characteristics should be reserved for reference labs . Today, rapid tests like analysis of tuberculostearic acid or polymerase chain reaction are already useful for special questions like ruling out tuberculous meningitis . In most cases, however, these rapid tests cannot replace identification of microbes with culture techniques.

Optom Clin, 1994, 3(4), 1 - 22
An introduction to ocular immunology; Weissman BA et al.; The interdigitated mechanisms by which an organism protects itself from microbiological infection have been collectively termed the immune system . We have been given the impression that the eye is "immunologically privileged" because the cornea accepts allografts . Despite the common success of corneal grafts, however, the ocular surface must perpetually combat infection with an array of immunological machinery . This includes mechanical protection as well as elements of humoral, cellular, adaptive, and innate immunity in the tears, conjunctiva, and even the cornea . Optometrists who fit contact lenses strive to help patients achieve safe contact lens wear by minimizing the risk of corneal infection and overaction (hypersensitivity) of the immune system in response to contact lenses and related care products . An understanding of immunology in general and the ocular response(s) in particular enables the clinician to provide a broader scope of care.

Khirurgiia (Sofiia), 1994, 47(2), 5 - 7
{Peritonitis of large-bowel origin--complicated colorectal carcinoma}; Stoianov Kh et al.; A total of 803 patients presenting colorectal carcinoma are operated on over a 14-year period (1979 through 1992) . In 272 cases (33.8 per cent) the disease runs a complicated clinical course . Perforative peritonitis is recorded in 29 cases-10.6 per cent of the total number of patients with complicated course, and 3.6 per cent of the total number subjected to operation . Ileus peritonitis free of perforation is discovered in twenty-seven cases-9.5 per cent of 272, and 3.23 per cent of the total number-803 . The microbiological study of abdominal cavity exudate from the patients with ileus peritonitis points to predomination of anaerobic micro-organisms, having an essential practical bearing on performing adequate perioperative and postoperative antibiotic treatment, and peritoneal cavity lavage during the operation . Radical two-staged operations with removal of the perforated neoplastic process in the first stage and preternatural anus formation are the method of choice . Palliative operations leaving the perforated carcinoma within the abdominal cavity account for 100 per cent lethality . A radical one-staged operation is indicated only in the event of localized peritonitis, young patients, preserved good general condition, usually following right hemicolectomy.

Khirurgiia (Sofiia), 1994, 47(2), 11 - 4
{Histopathological, electron microscopic and microbiological studies in patients with obstructive large-bowel ileus of tumor origin}; Stoianov Kh et al.; We have studied the Liver and colon of 23 patients histologically, and 15-electron microscopically . In the course of light microscopic observation of the colon wall above the obstruction we found: degeneration and desquamation of epithelial lining, decrease of goblet cells, increase of acid glycoproteins, hypertrophy of myofibrils in the muscle layer and fibrogenesis in the interstitial tissue in between . In liver: there was slight to moderate fibrosis in portal tracts and somewhere in the sinusoids, and moderate inflammatory infiltrate in them . Electron microscopic observations showed: a . in colon above the carcinomatous obstruction we found hypertrophy of muscle cells and in between collagenoblasts I-II type; b . in liver without metastases the space of Disse was distended, with bundles of collagen somewhere . Ito cells showed signs of fibroblast transformation . Our hypothesis is that these chronic changes are a reaction to the protracted obstruction and to colon carcinoma.

Int J Vitam Nutr Res, 1994, 64(4), 288 - 93
FLAIR intercomparisons on serum and red cell folate; van den Berg H et al.; Interlaboratory variation in the results for serum and red cell folate was assessed as part of the EC FLAIR Concerted Action No 10 with 11 participating laboratories from 7 European countries . In the first intercomparison freeze dried quality control serum samples at two different levels were analysed using different assay methodologies (microbiological, radioassay, HPLC and chemilumiscence) . Considerable variability was observed both between different methods ("over-all" coefficient of variation (CV) 18-41%), as well as between laboratories using a similar assay kit/protocol . In the second intercomparison recovery studies were performed with sera spiked with calibrated standard preparations of pteroylmonoglutamic acid (PGA) or 5-methyltetrahydrofolic acid (5-MTHF) . With radioassays average PGA recoveries ranged between 86-140% (mean 110%), for 5-MTHF between 99-144% (mean: 130%) . In the third intercomparison with commercial whole blood control samples variabilities (CV's) between 36 and 63% were found . These results indicate that especially radioassays tend to overestimate serum folate content due to improper standard calibration . Also small differences in assay pH as well as matrix effects may contribute to the variability . These data stress the importance of improved standardization of (commercial) diagnostic kits and the provision of suitable reference materials with assigned folate levels spanning its physiological concentration range.

Acta Microbiol Immunol Hung, 1994, 41(4), 391 - 401
Functions of symbiotic fungus gardens in higher termites of the genus Macrotermes: evidence against the acquired enzyme hypothesis; Bignell DE et al.; Behavioural, microbiological and biochemical studies on Macrotermes subhyalinus and M . michaelseni by collaborating laboratories in the U.K., Switzerland and Australia are described . Younger workers consume both primary forage and the conidia of a symbiotically associated fungus of the genus Termitomyces, but all workers produce a fully competent cellulase complex (endoglucanase + glucosidase) in the midgut which is clearly distinguishable from analogous enzymes in fungal tissues . Workers have a RQ of 1.0; although a bacterial flora is present, assessments of CH4/H2 efflux and intestinal VFAs suggest that respiration is sustained by aerobic carbohydrate dissimilation . Calculations based on estimates of food ingestion by workers and measurements of cellulase activity show that endogenous production of reducing sugars from polysaccharide is sufficient to sustain the observed metabolic rate . Conidia contain both cellulase and glucose at much higher concentrations than other fungal tissues, but the role and fate of these substances on entering the young worker guts is unknown . Older workers consume fully composted forage in which cellulose, hemicellulose, pectin and lignin are all significantly degraded, with a corresponding increase in nitrogen content.

Med Pr, 1994, 45(6), 495 - 500
{Contamination of archives by filamentous fungi and their evaluation for potential pathogenicity}; Krysinska-Traczyk E; The results of microbiological examinations of dust samples collected from mortgage registers in the court archives are presented . In the samples examined filamentous fungi of Penicillium genus were observed as well as Cladosporium herbarum, Geotrichum candidum, Cephalosporium glutineum, Mucor racemosus, Trichoderma viride and Aspergillus niger . Filamentous fungi of Penicillium genus occurred in the highest concentration accounting for 350,000 CFU/g . The levels of the remaining fungi were lower--they ranged from 500 CFU/g to 100,000 CFU/g . The concentration of filamentous fungi observed in archives can create health risk for workers.

Wien Med Wochenschr, 1994, 144(17), 419 - 24
{Work and life style of homeopathic physicians in Austria . A descriptive study}; Rasky E et al.; This study is based on a survey involving 117 physicians in Austria, working in private practice and under the National Health Plan on a homeopathic basis . The questionnaire covered such topics as socio-demographic data, individual methods of working, office organization, application of alternative therapies, health awareness, and perception of the general acceptance of homeopathy . The results showed that considerably more time is taken for treating patients homeopathically than for patients treated traditionally under the National Health Plan . More than half the physicians use homeopathic remedies exclusively, whereas homeopathic combination remedies were rarely administered . Neural therapy, microbiological therapy (bacterial immunostimulation) and phytotherapy are those alternative therapies most frequently used in addition . A spiritual approach seems to be a significant component of the working methods of these doctors . Their working method is generally traditional: exact medical history and physical examination are ranked high, whereas biochemical data are regarded to be less important for diagnosis.

Annu Rev Microbiol, 1994, 48, 773 - 800
Microbial biocatalysis in the generation of flavor and fragrance chemicals; Hagedorn S et al.; Microbial biocatalysis is used in the commercial production of many flavor and fragrance chemicals . Bulk flavoring chemicals such as citric acid, high fructose corn syrup, and glutamic acid are produced in millions of pounds annually using microbial processes . In the past few years, biocatalysis has also begun to play an increasingly important role in the production of many flavor and fragrance aroma chemicals . Microbial processes have traditionally played an integral role in the development of complex mixtures of flavor and aroma chemicals since the discovery of beer, wine, cheese, and soy sauce thousands of years ago . Today, contemporary microbiological techniques are being increasingly applied to enhance the efficiency of many microbial biocatalysts for the production of specific flavor and fragrance chemicals . However, to ensure commercial implementation of these new microbial processes, much more needs to be learned about the basic biochemistry and genetics of these novel biocatalysts.

Annu Rev Microbiol, 1994, 48, 559 - 84
Strategies for the discovery of secondary metabolites from marine bacteria: ecological perspectives; Jensen PR et al.; Marine microorganisms have become an important point of study in the search for novel microbial products . Today, both academic and industrial interest in marine microorganisms is on the rise, in part because of the growing number of unique, biologically active secondary metabolites reported from marine bacteria . Our ability to assess the biosynthetic potential of marine bacteria, however, is inevitably coupled to our basic understanding of their biology . This review summarizes the chemical discoveries and biological activities reported from marine bacteria and focuses upon several microbiological topics as they relate to natural product discovery, including the distributions, diversity, and culturability of marine bacteria, as well as the role of symbiotic bacteria in the production of substances previously ascribed to other sources.

J Perinat Med, 1994, 22(3), 227 - 34
Relationship between amniotic fluid and maternal blood nutrient levels; Tamura T et al.; To study the relationships between amniotic fluid and maternal blood nutrient concentrations, we obtained amniotic fluid and blood samples simultaneously from 76 pregnant women at around 17 weeks gestation . Folate and vitamin B-12 levels were measured by microbiological assay and radioassay, respectively, and zinc, copper and iron levels by atomic absorption spectrophotometry . Mean concentrations of plasma and red blood cell (RBC) folate and plasma copper of the pregnant women were 38 (+/- 1, SD), 1,501 (+/- 374) nmol/L, and 32.7 (+/- 4.8) mumol/L, respectively, all of which were higher than those of healthy non-pregnant controls (p < 0.001) . Mean concentrations of plasma vitamin B-12, zinc and iron levels and RBC zinc were 320 (+/- 130) pmol/L, 12.2 (+/- 2.3), 21.7 (+/- 6.1) and 177 (+/- 30) mumol/L and these were similar to those of non-pregnant controls . Amniotic fluid folate, zinc, copper and iron concentrations were 21 (+/- 13) nmol/L, 1.4 (+/- 0.6), 1.7 (+/- 0.6) and 6.8 (+/- 2.1) mumol/L, respectively, which were significantly lower than plasma levels (p < 0.001) . However, this relationship was reversed for vitamin B-12 (650 +/- 420 pmol/L) . Significant correlations were found between amniotic fluid and maternal plasma and RBC for folate, and between amniotic fluid and maternal plasma for vitamin B-12 (p < 0.001) . No such correlations were observed for zinc, copper and iron . There was no correlation between amniotic fluid and/or blood nutrient concentrations and pregnancy outcome including birth weight of infants.

Virchows Arch, 1994, 425(4), 339 - 47
Helicobacter pylori: the new bug on the (paraffin) block; Genta RM et al.; A nameless spirillar organism in search of a disease only a few years ago, Helicobacter pylori has seen its fortunes suddenly reversed . After a rapid succession of name changes and some acrimonious disputes across continents, in less than a decade H . pylori has been catapulted to the centre stage of gastroenterological and microbiological research and has topped the most-wanted list of the pharmaceutical industry . The discovery of H . pylori has provided the momentum for the formation of the group that eventually created the Sydney System . Today, H . pylori is increasingly recognized as one of the most prevalent human pathogens worldwide . Its causal association with chronic active gastritis is undisputed and its role in the pathogenesis of peptide ulcer disease, although still poorly understood, is universally accepted . Furthermore, possible connections between chronic H . pylori infection and gastric carcinoma and primary gastric lymphoma are now being explored with increasing alacrity . With a few notable exceptions, pathologists have remained passive spectators of these exciting discoveries and have allowed gastroenterologists and microbiologists to set the pace in the quest for the determinants of gastritis, peptic ulcer and gastric cancer . This article is intended to outline some of the accepted facts on the development, progression, and pathology of H . pylori gastritis and to pose questions about this elusive infection . The authors hope that it might also contribute to stimulate further research, particularly on those aspects that are eminently suited to be addressed by pathologists.

Rev Belge Med Dent, 1994, 49(3), 9 - 13
{Is dental caries contagious?}; Buttner M; Results from microbiological studies and saliva analyses have now become valuable diagnostic aids which we could no longer imagine being without . They give us additional, objective information on the clinical and radiological examination of caries . These tests have also proved to be valuable pedagogical aids for motivating patients in individual prophylaxis . The question asked at the beginning, "Are caries infectious?" can be answered as follows: Yes, the possibility of transmitting caries exists mainly during the first three years of an infant's life and when the molars erupt in the sixth and twelfth years . Transmission is avoidable when one knows the various ways in which it is transmitted . Information on this and knowledge among the general public is still, however, in its infancy.

Rev Belge Med Dent, 1994, 49(2), 26 - 43
{"Chairside" microbiological tests in periodontics}; Quirynen M et al.; Based on the specific plaque theory in periodontology, several chairside tests have been introduced for the microbiological examination of periodontal patients . For the majority of these patients, however, a standard therapy (root planing in combination with good oral hygiene) results in a favorable outcome . Therefore, only for a small minority of periodontal patients a microbiological analysis could possibly contribute to better treatment . For such patients, a choice can be made between a culture technique (which is labour intensive and has a long waiting time before an answer is available) and one of the chairside tests . The culture technique has the advantage to examine most of the flora . The chairside tests have the advantage of giving immediate results, but are limited to a small number of species or morphotypes . As long as the outcome of a microbiological examination in general cannot be translated into a more specific treatment strategy, the frequent use of microbial analyses should not be advocated . Since the validity of the chairside tests have yet to be fully examined through clinical trials, culturing should be the method of choice, because their antibiogram could lead to a more specific antibiotic therapy for the few patients in need.

Rev Belge Med Dent, 1994, 49(2), 18 - 25
{Microbiological tests in the diagnosis of periodontal disease}; Sauvetre E; Today our knowledges concerning microbial aetiology and periodontal pathogeny allow us to use some tests in our private practice, that are different from those of yesterday . This article will attempt to review them.

Probl Tuberk, 1994, (6), 26 - 9
{Clinical course and diagnosis of female genital tuberculosis}; Kolachevskaia EN et al.; The incidence of genital tuberculosis has increased for the last decade 2-fold reaching 11.9% of all the extrapulmonary cases . Three clinical forms of tuberculosis of the uterine appendages are distinguished: latent or minor inflammation, marked inflammation with tubuloovarian lesions, tuberculomas . The diagnosis of the disease, especially of latent forms, is not easy and requires studying the disease history, the results of subcutaneous 50 TU tuberculin test, histerosalpingography, endoscopic (surgical laparoscopy, histeroscopy, colposcopy), histological and microbiological findings.

Eur J Cancer, 1994, 30A Suppl 3, S40 - 3
Evaluation of haematopoietic growth factors: defining relevant clinical endpoints in growth factor trials; Linch DC; Initial evaluation of the therapeutic efficacy of haemopoietic growth factors involves assessment of their effects on the blood count, in various clinical situations . However, hard clinical data are also needed . Microbiologically documented infection is the ideal parameter but is difficult to measure . Consequently, the surrogate parameters of duration of fever and antibiotic usage are used instead . Febrile neutropenia is not a clinical endpoint, but merely a useful indicator to begin antibiotic therapy . To date, cost evaluations of growth factor use have relied on retrospective analyses of relevant clinical data including antibiotic usage, parenteral nutrition requirements, and duration of hospitalisation . Growth factors can reduce all these parameters in selected situations . Clinical data also suggest that growth factors facilitate chemotherapy dose optimisation and intensification, although the degree of intensification appears limited (20-40%) . Currently, it is unclear whether such therapy confers benefit in terms of remission rates and survival.

Acta Vet Scand, 1994, 35(4), 383 - 8
Microbiological contamination of reindeer carcass during slaughter; Vaarala A et al.; Microbiological counts for 10 different sampling sites of 28 reindeer carcasses were studied in 3 reindeer slaughterhouses in Finland . On each carcass the hindshank, round, abdomen, flank, brisket, foreleg, shoulder, neck, foreback and back were sampled immediately after slaughter, using a non-destructive swabbing method . The overall mean bacterial count for 10 sampling sites of reindeer carcasses was 1.51 +/- 0.51 log10 cfu/cm . Statistically significant differences were detected between sampling sites . The back part of the reindeer carcass, i.e . hindshank, round, back and foreback, seemed to be relatively clean . The most contaminated parts were the foreleg, brisket and abdomen (2.05-2.95 log10 cfu/cm2); these could be used for monitoring the hygiene of the reindeer carcass after slaughter . Differences between the 3 slaughterhouses were detected for some sampling sites, which may be due to differences in slaughter techniques and hygiene.

Med Dosw Mikrobiol, 1994, 46(4), 293 - 300
{Use of 4 microbiological methods to detect Helicobacter pylori}; Gospodarek E et al.; The presence of Helicobacter pylori (HPY) was confirmed in 90% of a group of 76 patients with gastric disorders . The methods included the direct urease test, a preparation directly stained by the Gram method, culture and serological study using Cobas Core Anti-H . pylori EIA . High levels of IgG HPY antibodies were found in the serum of patients with gastritis chronica and ulcus duodeni . Urease activity can be observed even after 48 hours . Nevertheless such interpretation of test results requires confirmation by other microbiological methods applied simultaneously . HPY was obtained in 50% of culture . Already one hour after the test started, it was possible to confirm this species on the basis of Rapidec pylori . The presented procedure can be used and performed in a laboratory cooperating effectively with a gastroenterologist.

Clin Exp Neurol, 1994, 31, 79 - 84
Primary cerebral abscess due to Nocardia asteroides presenting as stroke; Cheung RT et al.; Nocardial cerebral abscess, an uncommon condition, is usually secondary to a septic focus elsewhere in the body . We report a 44-year-old Chinese male patient who had primary nocardial cerebral abscesses due to Nocardia asteroides which presented with stroke-like episodes . He improved spontaneously between these episodes . The diagnosis was reached only after a contrast CT brain study and microbiological examination of specimens obtained during craniotomy . An early contrast CT study is important in avoiding any delay in diagnosis and treatment of this serious condition.

Arch Inst Pasteur Madagascar, 1994, 61(2), 105 - 7
{Study of 3985 female genital smears from the Clinical Biology Center of the Pasteur Institute in Madagascar}; Faibis F et al.; A microbiological study of 3985 cervico-vaginal swabs has been carried out on patients from Pasteur Institute of Madagascar, most of them suffering from leucorrhea . This puts forward the predominance of non-specific vaginitis as well as cervicitis caused by mycoplasmas.

Drugs, 1994, 47 Suppl 3, 10 - 9; discussion 19-20
Comparative pharmacokinetics of the new oral cephalosporins; Lode H et al.; The comparative pharmacokinetics of the new oral cephalosporins (ester and nonester types), together with that of the first generation carbacephem, loracarbef, are considered in healthy volunteers . Also in this review, pharmacokinetic and microbiological data are combined in order to predict the possible clinical efficacy of this group of agents . Despite apparent similarities in the structure of these agents, single dose studies have revealed marked differences in the pharmacokinetics of the oral cephalosporins . Multiple dose studies showed no evidence of accumulation with these agents . In the elderly, only minor changes in the pharmacokinetics of the oral agents were observed, and were insufficient to warrant dosage adjustment . Unlike that of the nonester compounds, the bioavailability of the ester cephalosporins is increased when they are administered after food . Variable effects are observed when the ester agents are coadministered with antacids or H2-antagonists; while the absorption of cefetamet pivoxil was unaffected by coadministered antacids or H2-antagonists, the absorption of cefpodoxime proxetil was reduced.

Appl Environ Microbiol, 1994 Jan, 60(1), 149 - 52
Detection of mycoplasma contamination in cell cultures by a mycoplasma group-specific PCR; van Kuppeveld FJ et al.; The suitability of a 16S rRNA-based mycoplasma group-specific PCR for the detection of mycoplasma contamination in cell cultures was investigated . A total of 104 cell cultures were tested by using microbiological culture, DNA fluorochrome staining, DNA-rRNA hybridization, and PCR techniques . A comparison of the results obtained with these techniques revealed agreement for 95 cell cultures . Discrepant results, which were interpreted as false negative or false positive on the basis of a comparison with the results obtained with other methods, were observed with nine cell cultures . The microbiological culture technique produced false-negative results for four cell cultures . The hybridization technique produced false-negative results for two cell cultures, and for one of these cell cultures the DNA staining technique also produced a false-negative result . The PCR may have produced false-positive results for one cell culture . Ambiguous results were obtained with the remaining two cell cultures . Furthermore, the presence of contaminating bacteria interfered with the interpretation of the DNA staining results for 16 cell cultures . For the same reason the hybridization signals of nine cell cultures could not be interpreted . Our results demonstrate the drawbacks of each of the detection methods and the suitability of the PCR for the detection of mycoplasmas in cell cultures.

Gene, 1993 Dec 15, 135(1-2), 299 - 302
Lawyers' delights and geneticists' nightmares: at forty, the double helix shows some wrinkles; Sgaramella V; The National Institutes of Health (NIH) request to patent the base sequences of incomplete and uncharacterized fragments of DNA copied on messenger RNAs (cDNAs) extracted from human tissues, the refusal by the patent office, and the appeal placed by NIH, have incited a violent controversy, fueled by rational, as well as emotional elements . In a compromising mode between liberalism and protectionism, I propose that legal protection be considered only for those RNA/DNA sequences, either natural or artificial, which can generate practical applications per se, and not through their expression products . Another controversy is developing around a popular tool for genomic research: the fidelity of yeast artificial chromosome (YAC) libraries being distributed worldwide for physical mapping is being questioned . Some of these libraries have been shown to be affected by surprisingly high levels of co-cloning, in addition to more common gene reshuffling instances . Also in this case, scientific as well as non-scientific components have to be considered . Possible remedies for the underlying problems may be found in the proper use of kinetic, enzymatic and microbiological variables in the production of YACs . Here too, a sharper distinction between the secular and scientific gratifications of research could help.

Rev Sci Tech, 1993 Dec, 12(4), 1265 - 90
Risk analysis and meat hygiene; Hathaway SC; Meat hygiene consists of three major activities: post-mortem inspection; monitoring and surveillance for chemical hazards; and maintenance of good hygienic practice throughout all stages between slaughter and consumption of meat . Risk analysis is an applied science of increasing importance to these activities in the following areas: facilitating the distribution of pre-harvest, harvest and post-harvest inspection resources, proportional to the likelihood of public health and animal health hazards; establishing internationally-harmonized standards and specifications which are consistent and science-based; and improving the safety and wholesomeness of meat and meat products in local and international trade . Risk analysis, in one form or another, is well developed with respect to establishing standards and specifications for chemical hazards; methods for risk analysis of post-mortem meat inspection programmes are beginning to emerge . However, risk analysis of microbiological hazards in meat and meat products presents particular difficulties . All areas of application currently suffer from a lack of international agreement on risk assessment and risk management methodology.

Nippon Rinsho, 1993 Dec, 51(12), 3242 - 7
{Helicobacter pylori and gastric cancer in view of relation to atrophy of background gastric mucosa}; Sakaki N; To make clinical assessment regarding the role of Helicobacter pylori (H . pylori) in the occurrence of gastric cancer, we examined serological and microbiological positive rate of H . pylori and histological and endoscopic findings of atrophic gastritis of background mucosa in 149 gastric cancer patients, 136 gastric ulcer patients, 82 chronic gastritis cases and 46 normal control . Serological H . pylori positive rate examined using GAP-IgG in 43 gastric cancer patients was 95%, which was significantly higher than normal control (4%) but the same level as in chronic gastritis cases (87%) and gastric ulcer patients (93%) . While, Microbiological H . pylori positive rate by culture was 62% in 149 gastric cancer, 7% in normal control, 74% in chronic gastritis and 80% in gastric ulcer . H . pylori infection and the degree of lymphocyte infiltration were significantly correlated and H . pylori was frequently detected in the cases with mild and moderate atrophic gastritis in all groups . No difference was observed in H . pylori positive rate between the well and poorly differentiated cancer cases; 96% and 94% by GAP-IgG, 57% and 66% by culture, respectively . As a conclusion, it was suspected that the relation between H . pylori infection and gastric cancer was indirect and associated with atrophic process of background mucosa.

J Histochem Cytochem, 1993 Dec, 41(12), 1761 - 6
Detection of messenger RNA and low-abundance heteronuclear RNA with single-stranded DNA probes produced by amplified primer extension labeling; Brooks PJ et al.; We describe a procedure for detection of low-abundance cellular RNAs by in situ hybridization histochemistry, using single-stranded DNA probes produced by amplified primer extension labeling with Taq polymerase . We have used this approach to detect a number of high- and low-abundance RNA species and have found it to be a simple and reproducible method of obtaining sensitive probes for in situ hybridization studies . For example, DNA probes generated by amplified primer extension labeling can detect low-abundance heteronuclear RNAs in individual neurons . Since this procedure does not involve recombinant DNA technology or microbiological facilities, it should prove useful to a wide variety of investigators studying the regulation of gene expression at the cellular level.

J Chemother, 1993 Dec, 5(6), 548 - 50
Efficacy and tolerability of brodimoprim in pharyngotonsillitis in children; Galetti G et al.; 160 children with an average age of 9 years (range 6-15) affected by acute bacterial tonsillitis, were selected and assigned, following an open, parallel group design to: a) brodimoprim at the dose of 10 mg/kg on the first day, in single administration, and of 5 mg/kg on the following days; b) cotrimoxazole suspension, at the dosage of 6 mg of trimethoprim/kg/day, in two daily administrations; c) amoxicillin with clavulanic acid suspension (amoxi-clavulanate) 50 mg/kg every 12 hours . Quantity of pharynx and tonsillar exudate, pharynx pain, dysphonia and dysphagia were checked at the basal time, 3rd, 7th and at the last day of therapy . These symptoms were evaluated using a four-step rating scale . The evolution of body temperature was measured at two different times (1 and 5 o'clock p.m.), until the end of treatment, foreseen five days after disappearance of fever . Microbiological evaluation through a pharynx swab was performed at the beginning and at the end of therapy . Side-effects were registered during all the observation period . Lab-tests were carried out at the enrollment and at the end of treatment . The frequency and intensity of symptoms decreased significantly in all treatment groups . In comparison with amoxi-clavulanate, the brodimoprim group showed an earlier improvement (3rd day) of the clinical situation and a significantly better regression of pharynx exudate (p < 0.01), pharynx pain (p < 0.05) and dysphonia (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

J Chemother, 1993 Dec, 5(6), 529 - 31
Efficacy and tolerability of brodimoprim in otitis; De Campora E et al.; Eighty adult patients affected by acute bacterial otitis media were selected and randomized into two balanced groups of treatment: 1) brodimoprim 200 mg tablets at the dosage of 2 tablets in single dose on the first day and one tablet on the following days; 2) josamycin 500 mg tablets at the dosage of 3 tablets/day . The average duration of treatment was 8 days: all patients completed the trial . The symptoms were evaluated by score method (on the 3rd, 7th and on the last day of therapy) and a thermometric curve was made daily . Microbiological examination of the exudate was performed in the patients with auricular discharge (28), at the beginning of the treatment and 7 days after the end of therapy . The tolerability was assessed through registration of side effects . Brodimoprim resulted more effective in the reduction of hypoacusis and tinnitus; other symptoms demonstrated higher percentage reductions in the group under brodimoprim therapy . Bacteriological exams were negative at the second checkup, except in 6 patients (3 per group) . Side effects were reported in 5 patients (12.5%) treated with brodimoprim and in 9 (22.5%) treated with josamycin . Abnormal values in laboratory tests were not observed.

J Chemother, 1993 Dec, 5(6), 494 - 8
Pharmacokinetics and blister fluid penetration of brodimoprim in adults; Novelli A et al.; We investigated the pharmacokinetic properties of brodimoprim (B), a new diaminopyrimidine, including its penetration into suction blister fluid (SBF) after a single or multiple oral dose in 15 patients with a mean age of 61.5 +/- 9.3 yrs, suffering from respiratory tract infections with normal renal and hepatic function . Patients were divided into 3 groups of 5 cases each, according to treatment plan: Group I = B 400 mg single dose day 1; Group II = B 400 mg qD day 1 and 200 mg qD days 2 to 4; Group III = B 200 mg BID day 1 and 200 mg qD days 2 to 4 . Concentrations were determined microbiologically using B . subtilis ATCC 6633 as the test organism with a lower limit of sensitivity of 0.37 mg/l . With a single oral dose of 400 mg (Group I) a computed serum Cmax of 2.9 +/- 0.6 mg/l was observed 5.6h after administration, with a elimination half-life (t1/2 beta) of 32.3 +/- 4.1 h . In SBF a mean peak of 1.9 +/- 0.6 mg/l was reached after 6h with a t1/2 beta of 34.7 +/- 5.4 h and a penetration index (Pl), obtained by the AUCSBF/AUCs percent ratio of 61% . With multiple doses serum peak concentrations increased significantly, while the time to reach the peak (Tmax) was shorter (3.7-4.2 h) than after a single dose . Main kinetic parameters, such as t1/2 beta, mean residence time (MRT), elimination rate constant (Kel) and AUC, were significantly higher in Group II and III patients than in Group I cases . Similar differences were observed among the main SBF kinetic parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Clin Microbiol Infect Dis, 1993 Dec, 12(12), 897 - 906
Strategy for antibiotic therapy in febrile neutropenic patients on selective antibiotic decontamination; de Marie S et al.; In a non-randomized prospective study the need for broad-spectrum antibiotic therapy was evaluated in selectively decontaminated neutropenic patients with fever . Fifty-two adult patients with a neutrophil count < 0.5 x 10(9)/l suffered 77 febrile episodes while receiving oral antibiotics for selective decontamination . Antibiotic treatment was only initiated if additional clinical signs or the microbiological culture results pointed to the likelihood of an infection . Treatment was either empirically based (broad-spectrum) or specific (narrow-spectrum) . If a causative agent was identified, therapy was adjusted accordingly . If evidence of infection was lacking after 72-96 hours, the antibiotics were discontinued, and these patients were reexamined meticulously and repeatedly . For the 40 episodes without confirmed infection, the median duration of therapy was three days (range 0-13 days) and the survival rate 100%; for the 37 episodes with confirmed infection, the median duration of therapy was 12 days (range 1-49 days, p < 0.0001) and the survival rate 85% . After adjustment of therapy the final regimen was broad-spectrum in only 18% of treated episodes . None of the six deaths could be attributed to the withholding or stopping of broad-spectrum therapy . It is concluded that in febrile neutropenic patients on selective decontamination a standard therapy regimen with prolonged administration of broad-spectrum antibiotics is not necessary . After initial intervention antibiotic therapy can safely be tailored to the needs of the individual patient.

Scand J Work Environ Health, 1993 Dec, 19(6), 421 - 5
Microbial growth on respirator filters from improper storage; Pasanen AL et al.; Microbiological contamination and particle penetration were studied in two respirator filters with high efficiency . Microbial growth in filter materials during storage under conditions and the passing of microorganisms through the filters were particularly examined . Filters with different fiberglass and cellulose proportions were loaded in environments containing high microbial levels and incubated at a relative humidity of 98% . Particle penetration through loaded and incubated filters and carbon, nitrogen and microbial content were measured . After incubation, considerable particle penetration and the passing of fungal spores were observed for filters composed mainly of cellulose, probably because of humid conditions, which stimulated fungi to grow and extend mycelia and spores through the filter . Microbial activity, microorganism concentrations, and the chemical properties of the filter materials also supported this hypothesis . Storing used respirators in humid environments may result in heavy microbial contamination of the filters, especially if the filter material is biodegradable by microorganisms.

Pol Arch Med Wewn, 1993 Dec, 90(6), 450 - 4
{Actinomycosis as a complication of blood diseases}; Usnarska-Zubkiewicz L et al.; Two cases of actinomycosis in chronic myelogenous leukaemia (CML) and Hodgkin's disease (HD) are presented . The first patient with blastic crisis in CML had painful infiltration above and beneath the clavicular region, affecting the right humeral joint, what required differentiation from neoplastic infiltration . Specific infiltration, formation of fistuli and good response to antibiotic therapy suggested actinomycosis . Finally actinomycosis was diagnosed by microbiological and histopathological examination . The infection with actinomycosis in the other patient interfered with early diagnosis of coexistant Hodgkin's disease . The histopathologic examination of right cervical lymph nodes indicated the chronic inflammatory process . The subsequent histo pathologic examination of the axillary lymph node showed Hodgkin's disease, type LD . Culture from the exudating wound after lymph node excision was positive for actinomyces . Simultaneous treatment with cytostatics and antibiotics resulted in complete recovery of patient . In the above reported patients, actinomycosis complicated the course of CML and HD . The immune deficiency of the organism in both patients facilitated the development of the actinomycosis.

Bone Marrow Transplant, 1993 Dec, 12(6), 635 - 41
Monitoring cytokine production in peripheral blood during acute graft-versus-host disease following allogeneic bone marrow transplantation; Rowbottom AW et al.; Plasma concentrations and peripheral blood cells containing cytoplasmic cytokines were monitored during the post-transplant period in 10 patients who had received allogeneic bone marrow transplants (BMT) for the correction of inherited genetic disorders . The presence of CD14-positive cells containing cytoplasmic interleukin-1 alpha and beta in the peripheral blood was indicative of acute graft-versus-host disease (GVHD) . Plasma concentrations of IL-1 alpha, IL-1 beta and TNF-alpha were significantly raised in the GVHD group when compared with the uneventful days . There was, however, poor temporal correlation between the plasma concentrations and clinical manifestations of acute GVHD . Cells containing cytoplasmic IL-6 were present in the peripheral blood when patients had clinically suspected and/or microbiologically confirmed infection . The results from this study demonstrate that analysis of peripheral blood cells for cytoplasmic IL-1 alpha and IL-1 beta are better markers of acute GVHD than is monitoring plasma concentrations of these cytokines.

Arch Fam Med, 1993 Dec, 2(12), 1239 - 48
Factors associated with human papillomavirus infection in women encountered in community-based offices; Reed BD et al.; OBJECTIVE: To assess risk factors for cervical human papillomavirus (HPV) infection in women presenting to community-based offices because of vaginal symptoms or for preventive screening . DESIGN: Cross-sectional analysis of history, physical examination, and microbiological infection variables . SETTING: Two community-based family practice offices in southeastern Michigan . PATIENTS: Two hundred seventy-three women, 18 to 50 years of age, presenting to the study sites because of vaginal symptoms or for a pelvic examination for preventive screening . MAIN OUTCOME MEASURE: Human papillomavirus infection of the uterine cervix as determined by polymerase chain reaction testing . RESULTS: Human papillomavirus infection was detected in 21.2% of the women (24.9% and 13.1% of women with and without vaginal symptoms, respectively); 34% of these infections were HPV types 16 or 18 . Fifty-four percent of the women with HPV infection who underwent colposcopy had condyloma or cervical intraepithelial neoplasia verified on biopsy . Independent associations were found between HPV infection and the following female risk factors: the presence of vaginal itching, odor, or swelling; knowing the current sexual partner less than 24 months; age less than 40 years; household income of $14,000 or less; and ever having had six or more sexual partners . CONCLUSIONS: In addition to three previously described risk factors for genital HPV infection, two previously unrecognized risk factors were identified in this lower-risk population . These risk factors included the presence of vaginal symptoms of itching, odor, or swelling and having known the current sexual partner less than 24 months . Nevertheless, using risk factors alone, two thirds of the women infected with HPV in this population were not identified as being at high risk of infection . No subset of sexually active women was identified who were at no risk of HPV infection.

Z Ernahrungswiss, 1993 Dec, 32(4), 282 - 8
{Pantothenic acid levels in blood of athletes at rest and after aerobic exercise}; Rokitzki L et al.; Ninety-six high-performance athletes of various disciplines were available for this investigation . All athletes had many years of training and competition experience . The pantothenic acid contents in the blood were determined by means of microbiological measurements . In addition to the pantothenic acid level at rest, measurements were made resp . physical exertion in 14 marathon runners and nine body builders . Blood was collected for determination of pantothenic acid before (a), after (b) and 2 h after exercise . Compared to the reference values for untrained persons (1.34 +/- 0.13 nmol/mL), the marathon runners with 0.76 (0.31-0.94) nmol/mL and soccer players with 1.19 (0.37-2.64) nmol/mL were below the reference values . According to relative frequencies, more than 30% of all athletes were below the lower limit (< 1.20 nmol/mL) . The values in body builders/racing cyclists differed significantly from those in marathon racers (p < 0.001), which is presumably due to unallowed supplementation . During exercise, there was a significant increase in the pantothenic acid level in marathon runners (p < 0.01).

HNO, 1993 Dec, 41(12), 591 - 4
{Tuberculosis in the otorhinolaryngologic area . A still current differential diagnosis}; Schneider W et al.; Between 1986 and 1992 18 cases of tuberculosis of the cervical lymph nodes, the larynx, the middle ear, or the paranasal sinuses were diagnosed at the ENT clinic of the University of Erlangen-Nuremberg . A rare case of tuberculous infection of both the maxillary and ethmoidal sinuses and the pharyngeal tonsil is presented . All patients with involvement of the upper respiratory tract had concomitant productive pulmonary tuberculosis, whereas in tuberculous cervical lymphadenitis and otitis media the disease was regularly limited to the neck and the ear respectively . Preoperative microbiological testing pointed to a tuberculous origin in only 3 of the 18 patients, so that histological and microbiological examination of excision biopsy specimens was the most reliable test . As there was no apparent decrease in incidence over the 7 years, we conclude that tuberculosis remains an important differential diagnosis in ENT.

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