Microbial

Ophthalmologe, 1993 Dec, 90(6), 716 - 9
{Reconstructive surgery of extremely severe chemical eye burn with perforation}; Kuckelkorn R et al.; A 23-year-old female received a very severe burn in the anterior eye segment of both eyes from hydrochloric acid . During medical treatment over a period of 4 weeks in an outpatient clinic, the left eye perforated because of corneal and scleral ulceration . In the first emergency operation the necrotic tissue was excised in both eyes . Scleral ulceration in the right eye was treated by a tenonplasty . In the left eye a tenonplasty was carried out in all quadrants . Because of the large amount of ulceration in the cornea, a keratoplasty with a scleral rim was performed . On this occasion a fibrinous membrane was pulled off the iris . The cataractous lens released spontaneously . Finally an anterior vitrectomy was carried out . Two weeks later endophthalmitis occurred . Therefore, a vitrectomy was performed . Microbiological examination yielded mold fungus . Seven days after this operation another infiltration of the vitreous could be detected sonographically . During the third operation 10 mm of the first 16-mm transplant was trephined for another keratoplasty . An open-air vitrectomy was carried out as well . Nevertheless, the bulbus became phthisic afterwards . Amazingly the tenonplasty led to complete regeneration of the conjunctiva and healing of the scleral ulceration . It was possible to take an autologous transplant of the conjunctiva from the eye and graft it on the right eye to relieve a nasal superior symblepharon . After successful keratoplasty visual acuity of the right eye is 0.5.

Aten Primaria, 1993 Dec, 12(10), 667 - 70
{Soft chancroid: 4 clinical cases}; Manget Velasco CS et al.; OBJECTIVE . The presentation of four clinical cases of chancroid confirmed by means of a culture for Haemophiullus Ducrey and the checking of its clinical and epidemiological characteristics . SETTING . Dermatology Clinic at the "V Centenario" Health Centre, San Sebastian de los Reyes, Madrid . PATIENTS AND OTHER PARTICIPANTS . Four clinical cases collected between 1988 and 1992 . They were characterised by the very painful ulcers on the penis which appeared from 10 to 15 days after possible infection . Two of them had been previously treated with penicillin but showed no improvement . MEASUREMENT AND MAIN RESULTS . Clinical records were consulted and the diagnosis was confirmed by means of microbiological culture . Analyses including VDRL and HIV serologies were performed . All the patients were male: the location was the balanopreputial furrow . In two cases the lesion and the secondary adenopathy were single . In the four the general analysis was normal and serology for syphilis negative . Two were HIV positive . All were cured with a single dose of Ceftriaxon . CONCLUSIONS . Even though the chancroid is not common in our field, it must be identifiable so that a proper differential diagnosis of all genital ulcers can be made, with confirmation by means of a culture in a specific medium . The present first line treatment should be in reach of the Public Health System's family doctors and be initiated at once, given that genital ulcers are a risk factor in HIV transmission . Additionally these patients' HIV antibodies should be studied.

Clin Infect Dis, 1993 Dec, 17(6), 1032 - 6
Extraosseous epidural tuberculoma: case report and review; Mantzoros CS et al.; Extraosseous epidural tuberculoma has been reported infrequently, in spite of the widespread availability in recent years of computerized axial tomography and magnetic resonance imaging that can detect bony involvement not apparent on roentgenography with plain films . Thirty-two cases of extraosseous epidural tuberculoma have been reported in the English-language literature; however, only seven of these were radiologically and microbiologically confirmed . The single case from North America was reported over 30 years ago . We describe a patient with a spinal epidural mass due to Mycobacterium tuberculosis that was not associated with bony involvement and review the epidemiology, pathophysiology, presentation, and outcome of the previously reported cases.

Southeast Asian J Trop Med Public Health, 1993 Dec, 24(4), 734 - 41
Helicobacter pylori prevalence in northeastern Thailand; Chinprasatsak S et al.; Helicobacter pylori is distributed worldwide and has been demonstrated in Thailand . However, no study has been conducted so far in northeastern Thailand . The objective of this study was to find the prevalence of H . pylori in patients undergoing upper gastrointestinal endoscopy in northeastern part of Thailand . One hundred and twenty-six patients undergoing surgery between November 1992 and January 1993 were studied . Biopsies were done at antrum, corpus, and other positive lesions . Diagnostic tests of H . pylori by using CLO test, microbiological tests (Gram stain and culture), and histological examination (hematoxylin and eosin) were carried out . The prevalence of H . pylori by CLO test, Gram stain, culture, and histology were 49.2%, 61.9%, 22.2%, and 45.2% respectively . The overall prevalence of H . pylori by all diagnostic tests was 73.8% (95% confidence interval = 66.1-81.5%) . This study revealed a high prevalence rate of H . pylori in patients which should alert clinicians who practice in this geographical area.

Zhonghua Yi Xue Za Zhi (Taipei), 1993 Nov, 52(5), 332 - 7
{Detection of Mycobacterium tuberculosis in sputum by polymerase chain reaction}; Huang PL et al.; A method based on DNA amplification (PCR) and hybridization for the detection of M . tuberculosis was used to test 86 sputum specimens from 52 patients in whom tuberculosis was suspected . M . tuberculosis was detected in 35 specimens, with 1 false positive . The finding was negative in 51 specimens, of which 4 were false negative . Thirty-two specimens were positive by standard microbiological criteria (acid-fast stain and culture), and 54 specimens were negative (including 6 false negative) . Of 38 specimens with definite diagnosis of tuberculosis, 89.5% (34/38) were positive by DNA amplification and 84.2% (32/38) by acid-fast stain and/or culture . The difference is not statistically significant (P > 0.05) . The specificity was 97.9% (47/48) and 100% (48/48) by DNA amplification and acid-fast stain and/or culture, specificity was 97.9% (47/48) and 100% (48/48) by DNA amplification and acid-fast stain and/or culture, individually, and difference is also not statistically significant (P > 0.05) . However, PCR combined with specific DNA probe is more sensitive than the acid-fast stain method and faster than the culture method . Therefore it is useful for early detection of pulmonary mycobacterial infection.

J Periodontol, 1993 Nov, 64(11), 1029 - 39
Impact of microbiological consultation on clinical decision making: a case-control study of clinical management of recurrent periodontitis; Levy D et al.; Data obtained from diagnostic tests may influence the clinician's perception of the patient's state and in some instances may alter subsequent choices of therapeutic interventions . To determine if microbiological consultation influences the clinical management of patients with recurrent periodontitis, an observational, case-control study was conducted to measure the amount and type of periodontal treatment provided by periodontists (n = 13) who had referred patients with recurrent periodontitis for microbiological consultation . The control group consisted of periodontists (n = 10) who had not referred recurrent periodontitis patients for testing . Patients (n = 31; 20 females, 11 males; mean age 49.8 +/- 10.0 years) treated by the case group of periodontists were matched for age and sex to patients (n = 48; 22 females, 26 males; mean age 49.9 +/- 8.5 years) treated by the control group of periodontists . Questionnaires were administered to quantitatively assess the amount and type of treatment before and after receiving the microbiological report . Specific analyses were performed as a function of the time of receipt of the microbiology report . Case-control differences prior to the receipt of the report indicated that the amount of surgery/year was 43% greater for controls (P < 0.04), in spite of control patients exhibiting fewer deep pockets than case patients (P < 0.05) . Case-control differences after the receipt of the report indicated that case patients were provided with 45% greater number of appointments/year (P < 0.005), 46% greater scaling/year (P < 0.02), and 79% greater antibiotics/year (P < 0.01) compared with controls . The report influenced 9 (69%) case periodontists to change treatment . Case patients who received a change in treatment (n = 21) exhibited greater number of deep pockets at the time of entry into the study (P < 0.05) as compared with case patients who did not receive a change in treatment . Paired t-tests of differences within groups before and after the report demonstrated that case patients had a significant increase in treatment after the report as shown by 22% greater number of visits/year (P < 0.05) and 54% greater number of antibiotic prescriptions/year (P < 0.01) . In contrast, controls demonstrated no significant change in treatment . Further, contrasts of change in treatment before and after the report again indicated that case patients exhibited a significantly higher number of visits/year (P < 0.04) and number of antibiotic prescriptions/year (P < 0.02) compared with control patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Z Gastroenterol, 1993 Nov, 31(11), 671 - 4
Brucellosis: differential diagnosis of acute abdominal pain; Goke M et al.; A 34-year-old Turkish woman presented with septic fever, sweats, arthralgia, and abdominal pain . Further examination revealed generalized lymphadenopathy, hepatosplenomegaly, pancytopenia, and multiple caseous granulomas . Microbiological diagnosis revealed Brucella melitensis type 3 as causative agent . This case report demonstrates that abdominal pain can be a symptom in brucellosis, and caseous granulomas may occur . In our mobile society Brucella infection should be considered as possible differential diagnosis in patients with fever, lymphadenopathy, hepatosplenomegaly, and pancytopenia, although human brucellosis is rare in Germany and other Western countries.

Rev Clin Esp, 1993 Nov, 193(7), 371 - 7
{Microbiological study via occluded telescopic catheter in patients under mechanical ventilation and suspected of pneumonia . Clinico-bacteriological follow up of the cases}; Sanchez Nieto JM et al.; Pneumonias related to mechanical ventilation pose a serious diagnostic challenge and are responsible for elevated mortality . Conventional diagnostic methods are of little help . The introduction of invasive techniques such as bronchial catling via an occluded telescopic catheter (OTC) has proven to be an important advance in diagnosis and therapy . We have compared the bacteriological results obtained using OTC with those using conventional diagnostic methods such as tracheobronchial pumps (TBP) and hemocultures, and we have undertaken a bacteriological, clinical follow-up of the cases . Seventy-four patients under mechanical ventilation and suspected of pneumonia were under study . The study consisted to two consecutive phases of collecting bacteriological samples throughout the patient's evolution . A total of 121 fibrobronchoscopies were performed . The sensitivity obtained with OTC was 76%, and the specificity was 100% . The two techniques, OTC and TBP, coincided in 38% of the cases . According to the bacteriological results obtained with OTC, the antibiotic treatment was modified in 44.5% of the patients . The sensitivity of the OTC was significantly less in those patients were the last doses of antibiotic was administered within two hours of performing the procedure . The procedure of gathering secretions from the inferior respiratory tract with OTC possesses greater sensitivity and diagnostic specificity in patients with mechanical ventilation and pulmonary infiltrates and improves the diagnosis performed by other conventional and routine techniques such as TBA and hemocultures.

Clin Infect Dis, 1993 Nov, 17(5), 864 - 70
Group II phospholipase A2 in sera of febrile patients with microbiologically or clinically documented infections; Rintala EM et al.; Group II phospholipase A2 (PLA2-II) is an inflammatory enzyme, which has been shown to be an acute-phase protein and to correlate with the severity of sepsis . In a prospective study, the concentration of PLA2-II in the sera of 46 patients with sepsis and nonseptic bacterial and viral infections was measured by a fluoroimmunoassay . The serum concentration of PLA2-II in patients with infections (median, 164.5 micrograms/L; range, 5.07-1,740 micrograms/L) was elevated 46-fold above normal concentrations (median, 3.61 micrograms/L; range, 1.32-25.25 micrograms/L) . The concentration of PLA2-II was higher in patients with sepsis (median, 284.5 micrograms/L; range, 12.95-1,574 micrograms/L) and nonseptic bacterial infections (median, 210.6 micrograms/L; range, 5.07-1,740 micrograms/L) than in those with viral infections (median, 46.78 micrograms/L; range 11.46-275.9 micrograms/L) (P = .0042) . The concentration of PLA2-II correlated well with the concentration of C-reactive protein (CRP) (r = .613, P = .0001) but not with the concentration of pancreatic PLA2 (r = .089, P = .365) . Measuring the serum concentration of PLA2-II is useful as an adjunct to the determination of CRP concentrations for differentiating bacterial from viral infection.

Antimicrob Agents Chemother, 1993 Nov, 37(11), 2407 - 11
Response to antifungal therapy by human immunodeficiency virus-infected patients with disseminated Penicillium marneffei infections and in vitro susceptibilities of isolates from clinical specimens; Supparatpinyo K et al.; Eighty-six patients with laboratory evidence of human immunodeficiency virus infection presented to Chiang Mai University Hospital in Chiang Mai, Thailand, between 1 June 1990 and 30 June 1992 with systemic infection caused by the dimorphic fungus Penicillium marneffei . Thirty isolates of P . marneffei from clinical specimens from these patients were tested for their in vitro susceptibilities to amphotericin B, 5-fluorocytosine, miconazole, ketoconazole, itraconazole, and fluconazole . P . marneffei was highly susceptible to miconazole, itraconazole, ketoconazole, and 5-fluorocytosine . Amphotericin B showed intermediate antifungal activity, while fluconazole was the least active; some strains of the fungus were resistant to fluconazole . The clinical and microbiological responses correlated with the overall patterns of in vitro susceptibility to the azoles, whereas results with amphotericin B were more difficult to assess . Antibiotic failures of initial therapy occurred in 8 of 35 (22.8%) patients treated with amphotericin B, 3 of 12 (25%) patients treated with itraconazole, and 7 of 11 (63.6%) patients treated with fluconazole . Itraconazole or ketoconazole should be considered to be the drug of first choice in the treatment of mild to moderately severe P . marneffei infection . Parenteral therapy with amphotericin B may be required for seriously ill patients . Since at least 12 patients who responded to initial therapy relapsed within 6 months regardless of initial antifungal therapy, maintenance oral therapy with itraconazole or ketoconazole may be necessary.

Nutr Hosp, 1993 Nov, 8(8), 479 - 88
{The stability of antibiotics administered in "and" with a parenteral nutrition mixture enriched with branched-chain amino acids . II . The cephalosporins}; de Juana P et al.; Part I of these stability studies commented on the benefits, in terms of care and therapy, of the Y administration of antibiotics and parenteral nutrition . The aim of this study is to determine the stability of the cephalosporins ceftazidime, ceftriaxone, ceftizosime and cefotaxime in vitro, at therapeutic concentrations, infused together with a parenteral nutrition mixture with polyols, enriched in branched chained amino acids, and without lipids . A microbiological stability analysis was carried out on the antibiotics in the parenteral nutrition, and an HPLC aminogram was done to determine the concentration of amino acids in the infusion together with the antibiotic . As well, pH, osmolarity and colour change were measured in the antibiotics, in the parenteral nutrition used and in the joint infusion mixtures . It is concluded that parenteral nutrition can be jointly infused with cefotaxime and ceftazidime, at the concentrations studied, given the stability results obtained both with HPLC (antibiotics and amino acids) and microbiologically (antibiotics) . At the same time, the microbiological analysis of ceftriaxone with the nutrition showed its stability in the study conditions . Its joint infusion with parenteral nutrition, studied by HPLC, confirmed the stability of the amino acids . The ceftizoxime analysed by HPLC remained stable during joint infusion with the parenteral nutrition.

Andrologia, 1993 Nov-Dec, 25(6), 377 - 83
Results of ofloxacin therapy in andrologic patients suffering from therapy-requiring asymptomatic infections; Andreessen R et al.; In 1990, microbiological ejaculate analyses were carried out on a routine basis on 125 andrological patients, in addition to the determination of the concentration, motility and morphology of the spermatozoa . Fourteen patients (11.2%) with therapy-requiring asymptomatic infections (TAI) > 10(4) CFU (colony-forming units) ml-1 were effectively treated with Ofloxacin (Tarivid) at 2 x 200 mg d-1 for a period of 20 d . Concentration, motility and morphology of the spermatozoa were determined before the Ofloxacin treatment and controlled 1, 3, and 6 months later and correlated to the values obtained before the treatment . Over the entire period of observation, the morphology did not change significantly, whilst initially 1 month after the treatment the concentration and the motility decreased significantly (P < 0.05) . Three months later they again reached the starting values . After 6 months, a significant improvement occurred with regard to the motility, as compared to the starting values (P < 0.01), whilst the concentration remained at the level of the starting values . By this, Ofloxacin has been proved to be an effective medication for the treatment of TAI . In the end, it still remains an open question whether the improvement in sperm motility is primarily related to the Ofloxacin therapy.

Equine Vet J, 1993 Nov, 25(6), 523 - 6
A review of cytological specimens from horses with and without clinical signs of respiratory disease; Freeman KP et al.; Thirty-six transtracheal washing (TTW) and 12 bronchoalveolar lavage (BAL) specimens collected in clinical practice from horses with and without respiratory disease were reviewed . Cytological features were considered in accordance with the presenting complaint, clinical signs, clinical diagnoses, microbiological, radiographic and/or endoscopic findings, therapy, and response to therapy . The trichrome-stained TTW and BAL specimens were useful in interpreting the results of concurrent microbiological cultures, and determining whether a condition was present based on occurrence of typical cytological features of patterns (e.g . probable allergy, chronic obstruction, uncomplicated exercise-induced pulmonary haemorrhage), determining pathological/anatomical diagnoses (e.g . bronchitis, bronchiolitis and/or alveolitis; presence of metaplasia or dysplasia) and possible aetiologies (e.g . allergy, bacterial infection) . Review of these cases confirmed the practicality of using cytological specimens to evaluate the equine respiratory tract; there were few unsatisfactory specimens and no reported complications . The importance of cytological evaluation of the equine respiratory system was emphasised by the identification of 13 cases in which clinical signs were not apparent at physical examination . Sequential collections of cytological specimens from foals, young horses before and during early training, and mature horses in training may provide more information about the response of the equine lung to stresses associated with training and/or common environmental exposures.

Int J Food Microbiol, 1993 Nov, 20(2), 109 - 16
Assessment of cleaning and disinfection in the food industry with the rapid ATP-bioluminescence technique combined with the tissue fluid contamination test and a conventional microbiological method; Poulis JA et al.; A quantitative ATP bioluminescence procedure has been used to determine the cleanliness of food processing factories and the results have been compared with those from conventional microbiological culture methods . ATP measurements were combined with the tissue or tissue fluid contamination (TTFC) assessment method to obtain an impression of the amount of inanimate contamination on the sampled surfaces . It was found that, in the sampled food factories, there was poor relation between the two assessment techniques: ATP bio-luminescence combined with TTFC and contact plating . However, either method in its own right is useful to check cleanliness of food industries . ATP measurements do have in addition the great advantage that it is a fast method and is easy to perform.

Clin Radiol, 1993 Nov, 48(5), 307 - 10
Radiological and pathological features of AIDS-related polypoid cholangitis; Collins CD et al.; A review of the radiographs obtained at ERCP from 31 patients with AIDS-related sclerosing cholangitis (ARSC) demonstrated intraluminal polypoidal defects within the common bile duct and larger intrahepatic ducts in eight cases (26%) . The radiological features from this subgroup are described and correlated with the microbiological and histological findings from biopsy specimens including two patients who underwent post-mortem examination . At microscopy the polypoid lesions were demonstrated to consist of granulation tissue . The presence of these polyps did not adversely affect the prognosis nor were they associated with any particular infective agent . We propose recognizing the existence of this entity by the term AIDS-related polypoid cholangitis (ARPC).

Rinsho Ketsueki, 1993 Nov, 34(11), 1438 - 44
{Cytomegalovirus antigenemia in the differential diagnosis of pulmonary infiltrates after allogeneic bone marrow transplantation}; Gondo H et al.; For the differential diagnosis of pulmonary infiltrates after bone marrow transplantation, cytomegalovirus (CMV) antigenemia was evaluated in 9 episodes of pneumonia which developed in 7 allogeneic marrow transplant patients between 9 and 495 days after transplant . The diagnosis of lung infiltration was made based on clinical findings including histological, cytological or microbiological examinations using bronchoalveolar lavage fluid specimens, sputum or lung tissue . The CMV antigen-positive leukocytes were detected with a direct immunoperoxidase technique using a peroxidase-labeled monoclonal antibody (HRP-C7) against CMV immediate early antigen . The episodes included 2 CMV pneumonias, 1 pneumocystis carinii pneumonia, 1 adenovirus pneumonia, 1 bacterial pneumonia, 1 bacterial and fungal pneumonia, 2 idiopathic pneumonias and 1 capillary leak syndrome associated with hyper acute GVHD . The CMV antigenemia became positive only in two patients with CMV pneumonia and the number of CMV antigen-positive leukocytes exceeded 10 per 50000 WBCs . The CMV antigenemia test required only 24 hours to obtain results . These observations suggest that the detection of CMV antigenemia is of great value in the differential diagnosis of pulmonary infiltrates in marrow transplant patients.

Crit Care Med, 1993 Nov, 21(11), 1758 - 64
Effects of hemorrhage, hypoxia, and intravascular coagulation on bacterial clearance and translocation; Koch T et al.; OBJECTIVE: This study was undertaken to discover if impaired blood clearance functions and killing capacity of the reticuloendothelial system contribute to the high occurrence rate of septic complications after shock, trauma, and thermal injury . DESIGN: Prospective, randomized, controlled trial . SETTING: Experimental laboratory in a university teaching hospital . SUBJECTS: Thirty-three standard-breed rabbits of either sex . INTERVENTIONS: Defined numbers of Escherichia coli (1.3 x 10(8)) colony-forming units were injected intravenously 60 min after induction of hypoxia, standardized by defined reduction of oxygen uptake (60% to 75% of baseline) induced by hypoventilation (n = 6) or hemorrhage (n = 6), after complete defibrination caused by the snake toxin, ancrod (n = 6), and after 60 mins without intervention (controls, n = 6) . At 180 mins after bacterial injection, the animals were killed and tissue samples of liver, kidney, spleen, and lung were collected for microbiological examinations . MEASUREMENTS AND MAIN RESULTS: Bacterial elimination from the blood and distribution pattern of viable bacteria in liver, spleen, kidney, and lung were investigated in hemorrhagic, hypoxic, and defibrinated rabbits . Compared with controls, there was a distinct alteration of the elimination kinetics of bacteria from the circulating blood in the experimental groups . First, the initial counts of viable E . coli were up to 300% (p < .05) higher in the defibrination, hemorrhage, and hypoxia groups than in controls . Second, greater numbers of E . coli were found in the blood for a significantly (p < .001) longer period, coupled with up to four times higher counts in organ homogenates in the hemorrhagic and defibrinated groups (p < .01) and more than 100 times higher counts than control values in the hypoxic animals (p < .001) . CONCLUSION: Hemorrhage, hypoxia, and intravascular coagulation induce impaired bacterial clearance from the blood that is associated with altered organ distribution patterns, thus reflecting dysfunction of the reticuloendothelial system.

Rofo, 1993 Nov, 159(5), 471 - 5
{The imaging diagnosis of acute cerebral tuberculosis}; Rutschle M et al.; 5 unusual cases of cerebral tuberculosis are reported . Three of the cases initially showed the typical history and aspect of herpes simplex encephalitis, and two of a cerebral tumour . Both CT and MRI, and also the clinical neurological symptoms, were confusing . Microbiological culture in three and histological preparation in two cases confirmed the diagnosis of cerebral tuberculosis . Three cases showed the development of tuberculomas under therapy . The study of the literature suggests that this is not rare, which is explained by pathogenetic reflexions concerning the allergic genesis of the tuberculomas.

Khirurgiia (Mosk), 1993 Nov, (11), 16 - 9
{The characteristics of suppurative wounds treated with xenogenic splenic homogenate}; Safarov SIu et al.; The authors discuss the results of treatment of 60 patients with persistent purulent wounds by applications of pig spleen homogenate (30 patients) and by the commonly accepted method (30 patients) . The cytologic and microbiological data studied during the course of the wound process in both groups are analysed . The terms of cleansing, regeneration, and epithelialization of the wound surface were analysed comparatively; they were found to be 1.5 times shorter in treatment with a homogenate of xenogeneic spleen . It was thus established that a pig spleen homogenate produces a good antiinflammatory and necrolytic effect and absorbs the detritus, microbes, and toxins.

Int Endod J, 1993 Nov, 26(6), 362 - 8
Pulpal disease and bursts of periodontal attachment loss; Hirsch RS et al.; Progression of periodontitis is currently thought to occur during bursts of activity, followed by periods of remission, when healing may occur . This concept contrasts with the older hypothesis that periodontitis was continuously, but slowly, progressive throughout life . At present, there is no proof of the conventional (microbiological) hypothesis which gives a major role to site-specific bacteria in the initiation of bursts of attachment loss . An alternative hypothesis is presented in this paper which accounts for periodontal attachment loss by pathways that are independent of plaque . Severe lesions of the periodontium caused by pulpal pathoses (apical and retrograde periodontitis) are known to form at any level of the periodontium, not only at the root apex . When these lesions cause destruction of the periodontal tissues at the alveolar crest, and when plaque, calculus and gingivitis are also present, an endodontic origin is rarely suspected . Three pathways are proposed to account for the development of localized periodontal attachment loss consequent to pulpal disease . This hypothesis accounts for the sudden deterioration of periodontal sites under regular review, the strict localization of alveolar defects with normal alveolar bone immediately adjacent, the presence of site-specific bacteria (secondary colonizers of deep pockets) which cannot cause disease when transferred to healthy sites, and the antibody responses directed against them.

Vet Rec, 1993 Oct 23, 133(17), 411 - 5
Efficacy of current EC meat inspection procedures and some proposed revisions with respect to microbiological safety: a critical review; Berends BR et al.; This paper presents an evaluation of the current EC meat inspection procedures, and some of their proposed revisions, in relation to their efficacy in assuring the microbiological safety and quality of meat, and the difficulties for health authorities and industry in providing such an assurance . It is concluded that neither the current nor the proposed revisions of ante and post mortem meat inspection procedures alone are sufficient, and that only integrated approaches, applied to each step of animal and meat production, will lead to better quality meat . Furthermore, for the design of a really effective and flexible long-term system of safety and quality assurance it is necessary to undertake a formal quantitative assessment of risk.

Chest, 1993 Oct, 104(4), 1149 - 55
The diagnostic accuracy of high-resolution computed tomography in diffuse infiltrative lung diseases; Nishimura K et al.; The purpose of this study was to evaluate the role of high-resolution computed tomography (HRCT) in the clinical diagnosis of diffuse infiltrative lung disease (DILD) . Diagnostic accuracy was compared using both chest radiography and HRCT . One hundred thirty-four cases of DILD, representing 21 different diseases, were selected for study, and the disease state was confirmed either histologically or microbiologically . The HRCT images and chest radiographs, available in all cases, were reviewed separately and in random order by 20 physicians who were provided only with information on each patient's age and sex . Overall, a correct first-choice diagnosis was made in 38 percent using radiographs and in 46 percent using HRCT images (p < 0.01) . The correct diagnosis was among the top three choices in 49 percent when chest radiographs were used, and in 59 percent when HRCT images were viewed (p < 0.01) . The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, sarcoidosis, alveolar proteinosis, bronchiolitis obliterans organizing pneumonia, hypersensitivity pneumonitis, and pulmonary lymphangiomyomatosis . High-resolution computed tomography was confirmed to be superior to conventional radiography in the accurate diagnosis of DILD in clinical practice.

Microb Pathog, 1993 Oct, 15(4), 243 - 53
Experimentally induced Mycoplasma pneumoniae pneumonia in chimpanzees; Barile MF et al.; Eight chimpanzees were examined . Two served as negative control and six inoculated with Mycoplasma pneumoniae became colonized . Colonization persisted for 28-68, 16-50 and 21 days with an average duration of 47, 32.5 and 21 days in the oropharyngeal, tracheal and lung tissues, respectively . Mycoplasma titers ranged from 10(8) to 10(1) color-changing units per specimen during the course of the infections . Seroconversion occurred within 12-15 days and peak antibody titers ranged from 1.256 to 1.1024 and developed between days 28 and 48 post-inoculation . Positive cold agglutinin titers were detected between 12 to 15 days and peak titers ranged from 1:80 to 1:640 . Significant increases in sIgA and IgG immunoglobulin antibody levels were detected in lung lavage fluids . Unlike the many other experimentally infected animals examined, chimpanzees infected with M . pneumoniae had positive X-ray findings, developed cold agglutinins and showed overt signs of disease . These signs include persistent cough, low grade fever, rhinitis, oropharyngitis, diarrhea, and loss of appetite . Peak severity of disease corresponded with peak lung colonization, and the detection of cold agglutinins and positive X-ray findings . The microbiological, serological and clinical aspects of pneumonia induced in chimpanzees was similar to naturally occurring primary atypical pneumonia in humans.

J Antimicrob Chemother, 1993 Oct, 32(4), 611 - 22
The optimal dosage of ceftazidime for severe lower respiratory tract infections; Cade JF et al.; The optimal dosage of antibiotics for the treatment of patients with severe lower respiratory tract infections (LRTI) has not been determined but may be lower than is commonly administered at present . We have compared the efficacy of a low dosage of ceftazidime (1 g tds) with the more usual dosage (2 g tds) in a prospective, randomized study of the treatment of LRTI in seriously ill patients . Fifty patients on an Intensive Care Unit received one or the other regimen for 5 days; the demographic characteristics of the two groups were comparable . There was no significant difference in terms of clinical and microbiological response rates between the two regimens . Overall, clinical resolution was documented for 86% of patients, there was no change in 8% and 6% deteriorated . Microbiological eradication was achieved in 52% of patients from whom a pathogen was isolated (46% of all patients) . We conclude that ceftazidime 1 g tds is effective treatment for severe LRTI in hospitalized patients.

Mikrobiyol Bul, 1993 Oct, 27(4), 277 - 83
{Ultrastructure and properties of Actinobacillus actinomycetemcomitans}; Akincibay H et al.; In this study, plaque samples taken from periodontal pockets were cultured on Tryptic-soy-serum-bacitracin-vancomycin agar and identified according to colony morphology, Gram stain, catalase reaction and nitrate reduction tests after an incubation of 48 hours in candle jar . Cells identified as Actinobacillus actinomycetemcomitans were evaluated under the transmission electron microscope for fine structure . Outer membrane was observed as an irregular structure containing microcapsules . Unlike previous studies, periplasmic space was observed separately from other layers . Cytoplasmic membrane was observed surrounded by an electron-opaque cytoplasm . Besides, extracellular vesicles were seen extending to the outer environment around cytoplasmic membrane . Pathogenic properties of organelles were discussed . As a result, it was concluded that, in the future studies, products released and structural alterations occurring during growth of the organism, their pathologic effects and ways to suppress them need to be investigated microbiologically, ultrastructurally and biochemically.

J Laryngol Otol, 1993 Oct, 107(10), 898 - 901
What causes acute otitis externa?
Russell JD, Donnelly M, McShane DP, Alun-Jones T, Walsh M.
External otitis is an extremely common condition and can affect between five to twenty per cent of the patients attending ENT clinics (Hawke et al., 1984) . Its precise pathogenesis remains unclear, despite several aetiological classifications in the literature . The aim of this study was to investigate the relationship between infection, water exposure and trauma and the development of acute otitis externa . The study comprised 100 patients with their first attack of otitis externa and 150 age and sex matched controls . In only 40 per cent of cases could a primary microbiological cause be found . There was no significant statistical difference found between the two groups regarding the use of agents capable of traumatizing the external canal . Regular swimming, showering and hair washing were significantly more common in patients with acute otitis externa . Allergic disorders were nearly three times more common in the external otitis group suggesting a possible immunological aetiology.

Rev Clin Esp, 1993 Oct, 193(5), 221 - 4
{Elevated negative predictive value of angiotensin converting enzyme in the diagnosis of active sarcoidosis}; Munoz J et al.; OBJECTIVE . To evaluate the usefulness of angiotensin converting enzyme (ACE) in the differential diagnosis of active sarcoidosis in action with other interstitial and granulomatous processes . METHODS . The study involved 30 patients with a histological diagnosis of sarcoidosis, 38 subjects with anatomopathologically and/or microbiologically confirmed pleuropulmonary tuberculosis, and 12 subjects with idiopathic pulmonary fibrosis confirmed by histological studies . Following the technique developed by Rohatgi and Ryan, a radioenzymatic system was used to determine the activity of serum ACE . In patients with sarcoidosis, levels of ACE were measured in active cases as well as those in remission . Our laboratory reference values for those over 20 years of age are 39.84 +/- 9.19 mumol/min/l . RESULTS . Levels of ACE were significantly higher (p < 0.001) in active sarcoidosis (67.71 +/- 17.73 mumol/min/l) than during inactivity (41.18 +/- 16.00 mumol/min/l), tuberculosis (46.99 +/- 13.65 mumol/min/l), or fibrosis (35.87 +/- 11.36 mumol/mol/l) . A cut-off point of 59 mumol/min/l shows a significant association with the diagnosis of active sarcoidosis (p < 0.001) and reaches a negative predictive value of 90.90% . CONCLUSION . The usefulness of serum ACE in the differential diagnosis of sarcoidosis should be reconsidered.

Q J Med, 1993 Oct, 86(10), 669 - 75
A study of acute community-acquired pneumonia, including details of cardiac changes; Seedat MA et al.; We prospectively studied 102 patients, aged 15-50 years, with acute community-acquired lobar pneumonia without underlying cardiorespiratory illness, admitted to Baragwanath Hospital May 1990-April 1991 . Demographic, clinical, microbiological and laboratory data and negative prognostic features of these patients are described . In particular, we documented electrocardiographic changes and studied their possible relevance in patients with pneumonia . Electrocardiographic changes occurred in 32 patients (31%) . The commonest changes were clockwise rotation (16%), followed by P . pulmonale (9.8%) and S1 Q3 T3 pattern (7.8%) Other changes included right axis deviation (n = 6), right bundle branch block (n = 3), ventricular extrasystoles (n = 2), atrial fibrillation (n = 1) and nodal rhythm (n = 1) . These changes returned to normal in survivors after a mean of 2 days . The S1 Q3 T3 pattern was associated with cardiac enzyme leak (CK-MB fraction), hypoxia and a high Simplified Acute Physiology Score (SAPS) . In addition, P . pulmonale, right axis deviation and clockwise rotation correlated with hypoxia and a high SAPS score . Clockwise rotation also correlated with serum (including cardiac fraction) enzymes leak (LDH and CK-MB fraction), and pulmonary artery pressure . The overall mortality rate was 10.8%, with no association between electrocardiographic changes and mortality . The negative prognostic factors documented were hypoxia (p < 0.0001), multilobar pulmonary consolidation (p < 0.0001), tachycardia (p = 0.0001), tachypnoea (p = 0.0002), renal dysfunction function (p = 0.0009), hypotension (systolic p < 0.02, diastolic p < 0.003), bacteraemia (p = 0.003), and serum (including cardiac fraction) enzymes leak: LDH (p < 0.02), CK (p < 0.002) and CK-MB fraction (p = 0.0002) . These factors, with the exception of renal dysfunction, also correlated with the need for intensive care unit admission . Acute and reversible electrocardiographic changes are common in acute community-acquired lobar pneumonia . Electrocardiographic changes, especially those compatible with acute cor pulmonale and accompanied by cardiac enzyme (CK-MB fraction) leak, correlated with severity of illness but not with mortality.

J Clin Microbiol, 1993 Oct, 31(10), 2621 - 4
Comparison of commercial diagnostic tests for Helicobacter pylori antibodies; Schembri MA et al.; A number of serological tests measuring the presence of Helicobacter pylori-specific serum immunoglobulin G (IgG) are now commercially available . The aim of this study was to evaluate the clinical accuracy of five commercial H . pylori antibody tests: GAP-IgG (Biomerica), HELpTEST (AMRAD, Kew, Victoria, Australia), HELICO-G (Porton Cambridge), Pyloriset (Orion Diagnostica), and ROCHE (Roche Diagnostics) . A total of 162 subjects presenting for routine upper endoscopy were studied . H . pylori was diagnosed if culture, histology, or both were positive . Ten milliliters of venous blood was collected at the time of endoscopy for serological assessment . The sensitivity and specificity of each test (GAP-IgG, HELpTEST, HELICO-G, Pyloriset, and ROCHE) were as follows: 83 and 79%, 92 and 77%, 86 and 65%, 89 and 56%, and 98 and 69%, respectively . Positive and negative predictive values were 97 and 83%, 90 and 91%, 76 and 83%, 68 and 84%, and 86 and 97%, respectively . The specificity of most tests increased by approximately 10% when sera from subjects less than 45 years old were examined . The number of sera falling into the grey zone for each test (an indeterminate result with respect to H . pylori status) varied between 2.5 and 19% . This study highlights the need for all serological kits to be independently evaluated on the population to be studied by testing against a microbiologically defined panel of H . pylori-positive and -negative sera.

Anal Biochem, 1993 Oct, 214(1), 313 - 7
Testing potential gyrase inhibitors of bacterial DNA gyrase: a comparison of the supercoiling inhibition assay and "cleavable complex" assay; Barrett JF et al.; Inhibitory activity of test compounds against Escherichia coli DNA gyrase in a "cleavable complex" assay, readily observed in vitro at the enzyme level by the artificial addition of a denaturing agent, is found to be an excellent indicator of 4-quinolone inhibition of DNA gyrase, and as accurate a predictor of target enzyme inhibitory activity as the measurement of the inhibition of DNA gyrase supercoiling . This study was designed to examine the specificity of DNA gyrase inhibitors of various chemical classes in these two DNA gyrase assays, and define the use of these two assays in understanding the nature of inhibition by experimental compounds . Supercoiling inhibition was detected by determination of the 50% inhibition level, and cleavable complex inhibition measured by the determination of the drug concentration at which 50% of the maximal (of control) formation of linear, cleaved DNA was obtained . Results indicate that these two assays can serve several different functions in microbiological research, among them: (1) quantitation of enzyme inhibitory activity at the target level; and (2) distinguishing between nonspecific inhibition or artifactual inhibition of DNA gyrase and true, mechanism-based inhibition of the catalytic activity of DNA gyrase.

Am J Ind Med, 1993 Oct, 24(4), 387 - 400
An environmental and respiratory health survey of workers in a grain mill in the Johannesburg area, South Africa; Fonn S et al.; A respiratory health survey was conducted in a grain mill and the relationship of health indicators to quantitative measures of airborne dust, fungal, and bacterial contamination was examined . Respiratory symptoms were more prevalent in the high dust exposure categories; lung function levels were also higher in the high dust exposure categories, consistent with a "healthy" worker effect . Workers in the three higher dust exposure categories showed either no change or a decrease in lung function over the working week, while workers in the low exposure category demonstrated an improvement in lung function over the working week . Total dust and microbiological (fungal and bacterial) load were found to be significantly related to each other, and the relationship of microbiological load to lung function level and changes over the working week were similar to those found for total dust.

Z Lebensm Unters Forsch, 1993 Oct, 197(4), 321 - 31
{Identification of irradiated pasteurized egg products: a combined method for use in routine control}; Helle N et al.; Pasteurized egg products (whole egg, egg yolk and egg white) were tested for irradiation treatment in the German food control laboratories in Oldenburg/Niedersachsen and Kassel/Hessen as well as in the food irradiation laboratory of the German federal health office . Gas chromatographic/mass spectrometric measurements on the fat components of egg-products showed clearly whether the product had been irradiated or not . While in unirradiated samples no traces of special hydrocarbons (according to the fatty acid composition of egg) and no traces of the irradiation-specific compound 2-Dodecyl-cyclobutanone were found, irradiated control samples as well as products of two Belgian suppliers contained these substances . Additionally, regarding the rather high time consumption of gas chromatography, electron spin resonance (ESR)-measurements were carried out on the packaging material of egg products . Irradiated packaging material (cellulose) could be easily detected by the appearance of a signal pair in the ESR spectrum (cellulose radical) . ESR measurements are very fast and easy to perform so that this method can be used for screening . Microbiological investigations showed remarkably reduced total numbers of microorganisms for some irradiated samples, but the microbiological status is influenced by other factors like storage-time and -temperature, so that microbiological tests can not be used successfully for screening on irradiation treatment.

Genitourin Med, 1993 Oct, 69(5), 352 - 6
HIV and other sexually transmitted diseases at a rural hospital in Zimbabwe; Le Bacq F et al.; OBJECTIVE--To define the epidemiological characteristics of STD patients attending an outpatient clinic in rural Zimbabwe, to examine the aetiologic agents causing infection and to determine their relationship with HIV infection . SUBJECTS--319 men and 146 women, making a sample of about 7% all patients attending an STD clinic during the 3 month study period . Microbiological data were collected from 104 men and 72 women selected randomly from these . Pregnant women were excluded and patients who had received antibiotics within the previous 14 days were excluded from the microbiology sub-sample . SETTING--An outpatient STD clinic at a District Hospital on a major truck route about 300 km north of the capital, Harare . METHODS--All new patients attending the clinic during a 3 month period were enrolled for clinical and epidemiological investigations using a standard procedure . Specimens for microbiological investigation were taken from every second patient seen on the first three days of each week . RESULTS--The typical patient was male (m:f ratio 2.2) aged 20-29 years (68% patients), not married (56% men) and in paid employment (66% men vs . 27% for the district) . In men the most common presenting feature was genital ulceration, while in women, discharges were more common . Genital warts were noted frequently in both sexes . In the sub-sample examined microbiologically, H ducreyi was isolated from 46% ulcers clinically diagnosed as chancroid, and motile spirochaetes were detected in 25% painless ulcers . Neither of these were detected in ulcers in women, but HSV antigen was found as frequently in ulcers from men (19%) as from women (17%) . In patients with genital discharges, gonococcal infection occurred in 64% men and 17% women, while T vaginalis was isolated from 39% women and only 8% men . Over 60% gonococcal isolates were PPNG, and 18% showed in vitro resistance to tetracycline . Yeasts, mainly C albicans were isolated from 42% women with a discharge and 25% women with ulcers . In men the presence of yeasts was associated with superficial ulceration and itchiness of the glans . Positive HIV-1 serology was found in 64% patients . There was no statistical association with current genital ulcers, though there was an association with previous STD episodes and particularly with serological evidence of syphilis . Apart from yeasts, there was no association between positive HIV-1 serology and the presence of pathogens in the genital tract . CONCLUSIONS--The high prevalence of HIV-1 antibodies in STD patients in Karoi suggests integration of STD and AIDS control programmes to be a necessity . Since paid employment was a common feature of both STD clinic attendance and HIV-1 seropositivity, these programmes may be effectively directed through the work place.

Spine, 1993 Oct 1, 18(13), 1890 - 4
Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis . Clinical and biologic study; Oga M et al.; The risk of persistence and recurrence of infection in posterior spinal instrumentation surgery for spinal tuberculosis was studied clinically and microbiologically . Eleven patients with thoracic, thoracolumbar, and lumbar spinal tuberculosis treated by debridement, anterior fusion, and combined posterior instrumentation surgery were analyzed . Seven patients had tuberculosis in both anterior and posterior spinal elements . There were no cases of persistence or recurrence of infection after surgery, and instrumentation provided immediate stability and protected against development of kyphotic deformity . The adherence properties of Mycobacterium tuberculosis to stainless steel (SUS 316) was evaluated experimentally . The results showed that posterior instrumentation surgery was not a hazard to spinal tuberculosis infection when combined with radical debridement and intensive anti-tuberculosis chemotherapy.

Infect Control Hosp Epidemiol, 1993 Oct, 14(10), 571 - 5
Prevention of Legionella infections in a bone marrow transplant unit: multifaceted approach to decontamination of a water system; Matulonis U et al.; OBJECTIVE: To evaluate measures intended to reduce Legionella infections in patients undergoing bone marrow transplantation (BMT) . DESIGN: Ongoing clinical and microbiological surveillance for Legionella colonization or infection was undertaken . All neutropenic patients with pulmonary infiltrates and fever unresponsive to broad-spectrum antibiotics were tested for Legionella organisms . SETTING: A 505-bed medical-surgical hospital with a designated BMT unit . PATIENTS: Two hundred twenty-five patients underwent BMT; 201 were treated on a new BMT unit . The incidence of Legionella infections was compared to that seen in an estimated 150 neutropenic patients treated on other units . INTERVENTION: A combined approach to decontamination of a hospital water supply was assessed . This included heating, particulate filtration, ultraviolet sterilization, and monthly pulse hyperchlorination of water supplied to the BMT unit . The incidence of Legionella infections was assessed on the BMT unit and compared with the frequency elsewhere in the hospital . RESULTS: There were only three cases of Legionella pneumonia among 201 patients undergoing transplantation on a new BMT unit . In contrast, 33 cases of Legionella infections were detected from approximately 150 patients treated on general medical floors . CONCLUSION: A multifaceted approach to decontamination of a hospital water system led to a marked reduction in Legionella infections.

J Clin Periodontol, 1993 Oct, 20(9), 683 - 90
The effect of sibling relationship on the periodontal condition; van der Velden U et al.; The purpose of this investigation was to study clinically as well as microbiologically the effect of sibling relationship on the periodontal condition in a young population with a relatively high prevalence of periodontal disease and deprived from regular dental care . In this study, 23 family units consisting of 3 more siblings were evaluated . In all, 78 subjects aged 15 to 25 years were included in the study . The mean interproximal amount of loss of attachment in this population was 0.29 mm . The individual mean ranged from 0 to 1.27 mm . In 33% of the subjects, > or = 1 sites with a probing depth of 5 mm or more in conjunction with 2 mm of attachment loss were present . The results show a significant sibship effect for: plaque, calculus, loss of attachment, spirochetes on the tongue and in the pocket, Porphyromonas gingivalis on the gingiva and in the saliva and Prevotella intermedia in the saliva . These results support the hypothesis that periodontitis aggregates in families.

J Clin Periodontol, 1993 Oct, 20(9), 641 - 50
Epidemiology and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans among children and their family members . A report of 4 surveys; Petit MD et al.; The distribution and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in 4 families were studied . The families were included, based on the isolation of P . gingivalis from a young child or adolescent . The probands of these 4 families were: a 5-year old periodontally healthy boy; a 17-year old girl with severe generalized juvenile periodontitis; an 11-year old girl with prepubertal periodontitis; 2 sisters, 5 and 17-years old, with untreated severe periodontitis as a component of the Papillon-Lefevre syndrome . All members of the 4 families were examined clinically and microbiologically for the presence of P . gingivalis and A . actinomycetemcomitans . Most of the parents appeared to be adult periodontitis patients; the parents of one proband were edentulous . Results showed that in all cases at least one of the parents was positive for P . gingivalis . On the basis of indistinguishable restriction endonuclease patterns (REPs) of P . gingivalis and A . actinomycetemcomitans isolates from parents and their children, and distinct REPs from unrelated individuals, the present study indicates that P . gingivalis and A . actinomycetemcomitans were transmitted between parents and their children.

Arch Pathol Lab Med, 1993 Oct, 117(10), 1022 - 6
Spontaneous abortions during the second trimester of gestation; Gaillard DA et al.; To determine the factors causing spontaneous abortions, 422 consecutive second-trimester abortions and the corresponding clinical data were studied prospectively . All of the fetuses and placentas were referred to a single pathologist and microbiological cultures were carried out in 205 of these cases . One hundred twenty-one medically included abortions were used as controls for the interpretation of the investigations relating to infection . According to the degree of maceration, two groups could be isolated and seemed to represent different diseases and mechanisms of spontaneous abortions . In the largest group (78.6%) without long intrauterine retention, one explanation could be given for 85% of these cases . Ascending infections occurred through unruptured membranes, whether or not they were associated with obstetric complications . The second group (21.4%) included severely macerated fetuses where a cause of death could only be determined in 44% of the cases that had a predominance of fetal abnormalities and maternal factors.

Gig Sanit, 1993 Oct, (10), 9 - 11
{Morbidity in children in the regions of microbiologic synthesis industry}; Nemyria VI et al.; Data on children's morbidity in the regions with microbiological synthesis enterprises are presented . Significant difference between general and allergic morbidity were found.

In Vitro Cell Dev Biol Anim, 1993 Oct, 29A(10), 819 - 21
Mycoplasma detection by PCR analysis; Hopert A et al.; The polymerase chain reaction (PCR) method was used to detect mycoplasma contamination in a panel of 42 continuous cell lines . According to the microbiological cultivation assay on agar, 29 cell lines were chronically infected and 13 cell lines were negative . Sets of outer and inner primers (nested double-step PCR) were applied which anneal to DNA sequences coding for conserved regions of the 16S rRNA . These oligonucleotides allow for the amplification of DNA regions found in at least 25 mycoplasma species (including the ones most commonly found in cell cultures), but do not cross-hybridize with DNA from eukaryotic cells . Mycoplasma-positive cell lines showed distinctive bands in ethidium bromide-stained gels, both after the first round of amplification as well as after the second PCR; all agar-negative cell lines were also unambiguously negative in the PCR assay . Thus, neither false-positive nor false-negative results occurred . Provided that the proper PCR working conditions are scrupulously observed, the PCR amplification has several outstanding advantages: high sensitivity, specificity, reliability, objectivity, speed, and simplicity.

Res Microbiol, 1993 Oct, 144(8), 647 - 51
Identification of some clinically significant actinomycetes; Goodfellow M et al.; Early recognition of infections caused by actinomycetes tend to be highly dependent on at least a tentative diagnosis derived from microbiological tests, since the clinical symptoms can be difficult to interpret . Reliable identification of clinically significant actinomycetes depends upon the application of taxonomic techniques that are not yet widely used in clinical laboratories . The value of rapid enzyme, chemical and molecular fingerprinting techniques is exemplified by their application to the identification of representatives of clinically significant actinomycete taxa.

Arch Latinoam Nutr, 1993 Sep, 43(3), 241 - 7
{Development of soy-based protein candy bars for athletes}; Wittig de Penna E et al.; Two varieties of soy-based candy bars were developed for sportsmen who need a higher protein intake . The two varieties, almond and nut, were covered with chocolate . The ingredients used were isolated soy protein, texturized soy flour, milk solids, cocoa powder, toasted oat, nuts, almonds, authorized flavors, preservants and antioxidants . Controls were carried out in the optimized products, and the results indicate a very good sensory and microbiological quality . The average nutritional composition of both varieties is: 12,4% proteins, 9% lipids and 58,7% carbohydrates, and the caloric value is 375,2 kcal/100 g . A shelf-life study was performed at room temperature with the candy bars packed in an aluminium foil . Determining that the quality remains without significant changes during 30 days for the nut candy, and at least for 60 days for the almond candy bar.

Naturwissenschaften, 1993 Sep, 80(9), 410 - 6
{Patent protection of biotechnological developments}; Fitzner U; Patents can be granted with respect to microbiological processes and products therefrom . In principle it is necessary to deposit a culture of the microorganisms at a recognized depository institution . The deposited culture is available upon request to any person from the date of publication of the patent application . Consequently, there is a great risk that the applicant's product is used by other people.

Pediatrics, 1993 Sep, 92(3), 415 - 9
Effects of repeated application of emollient cream to premature neonates' skin; Lane AT et al.; OBJECTIVE . Emollient cream moisturizers are often used on premature newborns in neonatal intensive care units without accurate knowledge of the risks or benefits to the neonate . DESIGN . We prospectively compared premature neonates treated with a water-in-oil emollient cream for up to 16 days to untreated premature neonates . SETTING . The study was completed in a neonatal intensive care unit on neonates admitted for respiratory distress and/or possible sepsis . PATIENTS . Thirty-four neonates, between 29 and 36 weeks estimated gestational age, entered the study . INTERVENTIONS . One-half of the neonates were treated twice a day with an water-in-oil emollient cream, and the other half served as controls . OUTCOME MEASURES . The skin condition of the neonates' hands, feet, and abdomen was evaluated on entering the study and twice a week . Fungal cultures and quantitative bacterial cultures were obtained from the axilla and abdomen on entering the study and twice a week . RESULTS . The mean gestational age of the treated neonates was 32.3 weeks, whereas the mean gestational age of the control neonates was 32.5 weeks . The neonates treated with emollient cream demonstrated statistically less dermatitis of their hands (day 2 through day 11), their feet (day 2 through day 16), and their abdomen (day 7 through day 11) . Fungal cultures and quantitative bacterial cultures of the abdomen and axilla were equivalent in both groups . CONCLUSIONS . These studies document that emollient cream moisturizer therapy of premature neonates decreases dermatitis without changing the microbiological flora.

Clin Oral Implants Res, 1993 Sep, 4(3), 113 - 20
A longitudinal microbiological study on osseointegrated titanium implants in partially edentulous patients; Leonhardt A et al.; The aim was to longitudinally follow the colonization of putative periodontal pathogens on titanium implants in partially edentulous patients . Nineteen individuals, who were partially edentulous and were on the waiting-list to be treated with titanium fixtures, were included in the study . They were treated for periodontal disease with oral hygiene instructions and supra- and subgingival debridement and were left for maintenance . Full-mouth recordings of each patient were performed at baseline, including attachment level and probing pocket depth . Bleeding was provoked and visible plaque were registered . Subgingival samples were taken for examination of Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans . Bridge connection was completed 1 month after abutment connection . The bone level was registered on radiographs . The patients were followed with clinical registrations and subgingival samples at 6, 12, 24 and 36 months . No significant changes in pocket depth, attachment level, bleeding on probing or plaque score occurred during the experimental period . The number of individuals positive at teeth and abutments for the various bacterial species reached approximately similar levels at 6 months . No significant changes over time were seen . Comparison between bone height, seen on radiographs, at abutments after 2, 12 and 36 months gave only 3 sites with bone loss of > 0.5 mm . All these sites were found in one patient and were accompanied by P . intermedia.

Zentralbl Bakteriol, 1993 Sep, 280(1-2), 155 - 65
Immunisation against gastric infection with Helicobacter species: first step in the prophylaxis of gastric cancer?
Chen M, Lee A, Hazell S, Hu P, Li Y.
The discovery of the gastric bacterium, Helicobacter pylori and the demonstration of its role in the pathogenesis of gastroduodenal disease, has been one of the major microbiological advances in the last decade . Recent demonstration of long term infection with this bacterium as a risk factor in gastric carcinoma suggests that intervention in a disease of major morbidity and mortality is possible . Using a model of Helicobacter infection in mice it has been shown that oral immunisation with a sonicate of Helicobacter felis plus the adjuvant cholera toxin results in protection against an oral challenge with large numbers of viable bacteria . The success of the immunising regimen has been shown to correlate with the development of local immunity . Formulation of equivalent safe vaccines of H . pylori will make possible the immunisation of children in countries such as China, Japan and Columbia and so prevent the establishment of long term inflammation and thus significantly reduce the incidence of gastric cancer in those societies . This animal model is proposed as a major tool in the development of effective oral immunisation.

Community Dent Health, 1993 Sep, 10 Suppl 2, 19 - 28
The changing face of periodontal epidemiology; Clerehugh V; From the time of the earliest civilisations, there has been documentation of diseases affecting the periodontal tissues . Yet it is only in the last 40 years or so that indices of the periodontal diseases were developed and the bacterial aetiology of gingivitis demonstrated . Epidemiological studies conducted in the 1950's and 1960's gave us valuable data on the prevalence and incidence of the periodontal diseases and factors associated with their aetiology and progression . However, with the introduction of new periodontal indices and refinement of criteria amidst increasing periodontal research, our perspectives of periodontal epidemiology have changed . Advanced destructive periodontal disease is less prevalent than previously thought, so there has been a shift towards risk assessment and determination of disease susceptibility . The future is promising, and possible advances in clinical and microbiological epidemiological research are considered, along with study of the host response to bacterial challenge.

Theor Med, 1993 Sep, 14(3), 249 - 56
Definition and classification of cancer: monothetic or polythetic?
Vineis P.
Since the microbiological revolution, most infectious diseases have been defined and classified according to an etiologic criterion, i.e . the identification of single, external "necessary" causes (for example, Mycobacterium for tuberculosis) . This is not the case with cancer . Not only external "necessary" causes of cancer have not been identified, but also the morphological classification cannot be based on univocal criteria . Although "neoplasia" and "anaplasia" appear to be universal attributes of cancer, these events are only quantitative . Neoplastic growth can be fast or slow (development may take weeks or years), and tissue pathologies are difficult to detect from normal tissue in some cancers but are obvious in others . Common special properties of anaplasia appear to be concealed in the wide range of morphologies . In the absence of a coherent morphological definition, and of external necessary causes (such as bacteria for infectious diseases), a mechanistic definition could be adopted . However, unless molecular biology discovers specific mechanistic steps in carcinogenesis, which indicate the existence of "necessary" events in carcinogenesis, we cannot adopt a univocal (monothetic) definition of cancer . The alternative is to use a polythetic definition, according to Wittgenstein's model of a "long rope twisted together out of many shorter fibres."

Mod Pathol, 1993 Sep, 6(5), 513 - 5
Gastritis associated with Gastrospirillum hominis in children . Comparison with Helicobacter pylori and review of the literature; Oliva MM et al.; Interest in possible microbiological causes of gastritis has significantly increased since the discovery of Helicobacter pylori . Recently a spiral bacterium named Gastrospirillum hominis was described in association with chronic gastritis in adult patients . Here, we present the finding of Gastrospirillum hominis in the gastric biopsies of two children who underwent upper endoscopy for gastrointestinal symptoms . The frequency of Gastrospirillum hominis (0.3%) in our pediatric population was similar to that reported in adults . We observed a chronic gastritis associated with the spiral bacteria which was milder than the gastritis noted in our pediatric patients with Helicobacter pylori infection . Further comparisons between these two organisms, as well as the literature on Gastrospirillum hominis, are also reviewed.

Eur J Clin Microbiol Infect Dis, 1993 Sep, 12(9), 696 - 9
Incidence of community-acquired pneumonia caused by Chlamydia pneumoniae in Italian patients; Blasi F et al.; The incidence of Chlamydia pneumoniae as a cause of community-acquired pneumonia was evaluated in a one-year prospective study in 108 patients with community-acquired pneumonia . The bacteriological diagnosis was based on culture of sputum or bronchial aspirate and examination of acute and convalescent phase sera for Mycoplasma pneumoniae, Legionella pneumophila and Chlamydia pneumoniae . A definitive microbiological diagnosis was obtained in 58 (54%) patients . Chlamydia pneumoniae was the causative agent in 14 patients (13%) on the basis of positive serological tests; in 10 of the 14 patients Chlamydia pneumoniae was also detected by means of an indirect immunofluorescence test using pharyngeal swab specimens . In conclusion, Chlamydia pneumoniae seems to be a common etiological agent of community-acquired pneumonia, as increasingly reported in the last six to seven years.

Ann Clin Lab Sci, 1993 Sep-Oct, 23(5), 377 - 84
Malassezia furfur folliculitis in cancer patients . The need for interaction of microbiologist, surgical pathologist, and clinician in facilitating identification by the clinical microbiology laboratory; Sandin RL et al.; Malassezia furfur (MF) is a lipophilic yeast which can be found as a member of the indigenous microbiota of human skin . In immunocompromised transplant patients, MF can cause a distinctive folliculitis which is a clinical look-alike to Candida folliculitis, the latter of more potentially devastating significance . Recovery of MF in culture is dependent upon the addition to culture media of an exogenous source of fatty acids, such as olive oil . The addition of an extra Sabourauds plate with an olive oil overlay to the routine set of media used to inoculate all skin biopsy specimens in order to detect MF is labor-intensive and not cost-effective . Thus, MF may not be isolated in cases of MF folliculitis unless the clinical microbiology laboratory is put on alert by the clinical suspicions of the attending physician, or by histopathologic findings suggestive of folliculitis revealed by review of surgical pathology slides . The clinical, pathological, and microbiological findings of two cases of MF folliculitis are presented where an interactive approach featuring communication between the microbiologist, the surgical pathologist, and the clinician guided the microbiology laboratory to the isolation and identification of isolates of MF that were clinically-relevant . These cases underscore how a combined approach which features communication between the laboratory and the clinical services always provides superior guidance in the diagnosis and therapy of infectious diseases.

Z Lebensm Unters Forsch, 1993 Sep, 197(3), 217 - 26
{International cooperation on the detection of irradiated food}; Delincee H; A survey over recent international developments to detect the irradiation treatment of foods is given, in particular the programmes of "ADMIT" (FAO/IAEA) and of BCR (European Community) . The need to detect radiation treatment by analysing the food itself is desirable to check compliance with existing regulations, such as the enforcement of labelling and control of prohibition, to enhance consumer confidence in the correct application of radiation processing, and to protect consumers' freedom of choice between irradiated or unirradiated food products . Some larger collaborative studies on an international scale have already taken place, e.g . ESR measurements of bones from chicken, pork, beef, frog legs and fish, thermoluminescence of insoluble minerals isolated from herbs and spices, gas chromatographic analysis of hydrocarbons and alkylcyclobutanones derived from the lipid fraction of chicken and the microbiological DEFT/APC procedure for spices . These methods could soon be implemented in international standard protocols.

Prikl Biokhim Mikrobiol, 1993 Sep-Oct, 29(5), 675 - 83
{Microbiological synthesis of sterols}; Sinitskaia NA et al.; The data on preparation and application of microbial sterols are reviewed . The ways of optimization of ergosterol production are discussed . The microbiological techniques for obtaining other sterols are proposed based on using specific inhibitors and mutants . The data concerning chemical and biological transformation of yeast sterols to androstane hormones and D vitamins are presented.

Nucl Med Commun, 1993 Sep, 14(9), 766 - 74
Detection of lung and bone infection with anti-granulocyte monoclonal antibody BW 250/183 radiolabelled with 99Tcm; Peltier P et al.; Twenty-four patients with suspected infection (eight bone, 16 lung) were studied using monoclonal antibody BW250/183 which recognizes epitopes present on the surface of granulocytes . Bronchofibroscopic samples (microbiological studies and alveolar cell counts) were obtained from 14/16 patients with lung disease . Bronchofibroscopy isolated a micro-organism nine times . In two other cases, the diagnosis of infection was based on clinical course data . Infection was confirmed by surgical biopsy in the eight patients with bone pathology . Scans were performed 2 and 24 h after injection of 1 mg BW 250/183 labelled with 99Tcm . For lung disease, immunoscintigraphy was positive six times (five true positive, one false positive) and negative 10 times (six false negative, four true negative) . Immunoscintigraphy was false negative when the lung infection was not systematized or no granulocytes were mobilized in the infectious site . Immunoscintigraphy was falsely positive when noninfectious lung disease mobilized granulocytes . It was positive in all patients with bone infection . Images recorded at 24 h had better sensitivity (five false negative) than those at 2 h (eight false negative).

J Dermatol, 1993 Sep, 20(9), 566 - 71
A case of lupus meningitis treated successfully with methylprednisolone pulse therapy; Kanekura T et al.; A 46-year-old female had suffered from systemic lupus erythematosus (SLE) for 8 years . Headache, vomiting and stiff neck appeared in the active phase of SLE . Findings in the cerebrospinal fluid were consistent with those of lupus meningitis . No pathogenic microbes were detected by microbiological or immunological examinations . She was diagnosed as having lupus meningitis . The method discussed herein which elucidates the cause of fever in SLE using white blood cell count (WBC) and alpha-2 globulin appeared to be useful for examining this case of meningitis . Lupus meningitis seems to preferentially occur in SLE patients with positive anti-ribonucleoprotein (RNP) antibody . Pulse therapy with methylprednisolone appeared to work well in this lupus meningitis patient who had had a long course of corticosteroid therapy.

Rev Sci Tech, 1993 Sep, 12(3), 757 - 805
Health surveillance of the transfer of bovine embryos fertilised in vitro; Thibier M; The production of embryos fertilised in vitro is part of the third generation of biotechnologies applied to reproduction and is now undergoing development and application in the field . International exchanges of these embryos have already commenced . However, there are certain associated health risks . In decreasing order of importance, these involve dangers inherent in the initial biological material from which gametes and various somatic cells vital to such production (follicular and tubal cells, etc.) are derived, then possible external contamination during the production process, and finally storage and transport . Although the research which has been conducted on the interaction between these embryos and pathogens is still rather limited, as the technique has been under development for only a short time, it is clear that the media in which the oocytes undergo maturation, the spermatozoa undergo capacitation or the embryos are cultured constitute excellent indicators of the potential microbiological or viral environment . This can be utilised in health surveillance of the manipulations . Recently, specific recommendations for making such exchanges safe have been inserted into the Office International des Epizooties International Animal Health Code . These recommendations are based on the concept of official approval of specific embryo transfer teams and examination of animals from which gametes are obtained.

Clin Infect Dis, 1993 Sep, 17(3), 313 - 20; quiz 321-2
Infective endocarditis; Bayer AS; As compared to the characterization of IE in the 1970s and early 1980s, it appears that IE in the 1990s is more likely to present acutely and in association with fewer classic stigmata and is more likely to be caused by S . aureus . Whether this represents a true clinical and microbiological shift in disease spectrum or is the result of reporting bias is unclear at this time . The ability to clinically designate a case definitely as IE has been improved with utilization of new diagnostic criteria that incorporate findings from two-dimensional echocardiography in the classification schema . These new criteria have been validated in selected patient populations but remain to be validated in other patient groups at risk for IE (e.g., prosthetic-valve recipients) . Two-dimensional echocardiography is the noninvasive technique of choice for defining vegetative IE . TEE is significantly more sensitive in identifying valvular vegetations than is TTE, and TEE also is the method of choice for delineating periannular complications of IE . The role of Doppler flow assessment of valvular regurgitation in IE remains to be clarified . Short-course (2-week) regimens of beta-lactam agents plus aminoglycosides appear to be highly effective for the treatment of right-sided IE due to S . aureus . The use of vancomycin for treatment of S . aureus IE remains problematic because of reports of slow response and suboptimal treatment outcomes.

Berl Munch Tierarztl Wochenschr, 1993 Sep, 106(9), 300 - 2
{Experiences with a mobile laboratory during Operation "Kurdenhilfe" in Iran in 1991}; Langfeldt N et al.; During the operation "Kurdenhilfe" from 9th of May to 14th of June in 1991 the German army managed a field-hospital in the province Bakhtaran of Iran . Part of this field-hospital was a mobile field-laboratory in which microbiological/serological and parasitological examinations could be done . It is reported about equipment, methods and results.

Dent Mater, 1993 Sep, 9(5), 312 - 6
Microbial accumulation and vitality on different restorative materials; Hahn R et al.; A new technique using standardized test facings was designed to evaluate interdental plaque accumulation on different restoration materials . In 10 volunteers, a total of 40 samples, including enamel, two different ceramics and a bonding composite, were inserted one by one into a precision attachment in an experimental inlay bordering on either the lower second premolar or the lower first molar . Bacterial accumulation on each approximal specimen was allowed to mature for 3 d . Following microbiological processing of the plaque samples, total bacterial counts, colony forming units and the bacterial vitality were determined . The results revealed different accumulation rate patterns . Both ceramics accumulated less plaque with a reduced vitality compared to enamel, while the bonding composite showed no significant differences compared to the natural tooth substance . No significant differences were detected when comparing the two examined ceramics.

J Immunol Methods, 1993 Aug 26, 164(1), 91 - 100
Specificity and sensitivity of polymerase chain reaction (PCR) in comparison with other methods for the detection of mycoplasma contamination in cell lines; Hopert A et al.; The polymerase chain reaction (PCR) amplification was used for the detection of mycoplasma contamination in 42 continuous cell lines . Using the microbiological cultivation on agar as the reference method, 29 cell lines were regarded as positive and 13 cell lines as negative . The double-step PCR analysis employed nested primers that anneal to gene sequences coding for the evolutionarily conserved 16 S rRNA of some 25 different mycoplasma species (including the ones most commonly found in cell cultures) . In terms of the positivity or negativity of mycoplasma infection the results were identical for the agar assay and PCR amplification . All positive cell lines displayed distinct, unequivocal, objectively discernible bands on agarose gels while the non-infected specimens showed no DNA amplification . A simultaneously performed comparison with four other commonly used detection methods (DNA-RNA hybridization in solution, DAPI DNA fluorescence staining, immunostaining with a monoclonal antibody and an ELISA) showed that PCR produced significantly less false-negative or false-positive results than all the other methods . Furthermore, in dilution experiments, PCR correctly detected the infecting mycoplasmas at the lowest level of 1/10(4) whereas the other assays were less sensitive . It is concluded that double-step PCR employing nested primers is superior to other mycoplasma detection methods in many respects: simplicity and speed, high specificity and extreme sensitivity, objectivity and accuracy.

Arch Intern Med, 1993 Aug 9, 153(15), 1791 - 6
Low infection rate and long durability of nontunneled silastic catheters . A safe and cost-effective alternative for long-term venous access; Raad I et al.; BACKGROUND: Tunneled central venous catheters (CVCs) and infusion ports have often been considered as the only safe alternative for long-term venous access . The objective of this study was to assess the durability, cost, and infection rate of nontunneled, noncuffed Silastic CVCs . METHODS: We studied a representative cohort of 340 consecutive cancer patients with 359 nontunneled Silastic CVCs inserted and followed up at our center . All patients were evaluated clinically and microbiologically at the time of CVC removal . RESULTS: The mean in-place duration of the catheter for the 359 nontunneled CVCs studied was 109 days (total, 39,147 days of catheter use), and the infection rate was 0.13 per 100 catheter days . When compared with the tunneled Hickman catheter, the insertion cost saving was at least $2322 per CVC . At our institution, the use of nontunneled Silastic catheters with the support of an expert infusion team has resulted in an annual cost saving of at least $7,692,000 . Long peripheral CVCs (in the basilic/cephalic vein) had a 26% rate of inflammation at the insertion site compared with only 2.6% for the short subclavian CVCs (P < .01) . Most of the exit-site inflammations were sterile, with negative skin and catheter cultures . Neutropenia, bone marrow transplantation, high-dose steroids, and use of vesicant chemotherapeutic agents through the CVC did not predispose the patients to catheter infection . By univariate analysis, acute leukemia was the only risk factor for catheter infection . CONCLUSIONS: Given the low infection rate and long durability of nontunneled silicone CVCs, these catheters could offer a cost-effective and safe alternative to surgically implantable tunneled catheters.

Med J Aust, 1993 Aug 2, 159(3), 153 - 8
Brucellosis: re-emergence and changing epidemiology in Queensland; Robson JM et al.; OBJECTIVE: To define the epidemiological and clinical characteristics of human brucellosis, which is being detected in increasing numbers of patients in Queensland . DESIGN AND SETTING: Thirty-four cases of brucellosis diagnosed according to standard clinical and microbiological criteria were studied either retrospectively or prospectively over a two-year period from October 1989 to October 1991 . RESULTS: Cases were assessed by means of standard laboratory investigations and a questionnaire documenting clinical symptoms, occupation and recreational activities, treatment and response, relapse rate and complications . Blood cultures taken from 11 patients were positive for Brucella suis; in three others, Brucella suis was cultured from other sites . In the 12 months before diagnosis, all affected individuals were involved in the killing and slaughter of feral pigs . Most infections occurred in rural Queensland but six were contracted in metropolitan Brisbane from feral pig abattoirs . All patients responded to appropriate antibiotic therapy; the relapse rate was 66% in those treated for less than four weeks . Complications (multiple splenic abscesses, epididymitis, cervical lymphadenitis and septic arthritis) occurred in four patients, who were ill for more than one month before diagnosis . CONCLUSIONS: Brucellosis due to Brucella abortus is a disappearing disease in Australia as a result of effective eradication programs in cattle . However, the disease is re-emerging in Queensland because of recreational and occupational exposure to feral pigs infected with Brucella suis . The population at risk is increasing as the lucrative export industry based on field-shot feral pigs expands.

Comput Biomed Res, 1993 Aug, 26(4), 383 - 92
Comparative study of human expertise and an expert system: application to the diagnosis of child's meningitis; Francois P et al.; We present a general method of statistical evaluation for expert systems, applied to a system for the diagnosis of child's meningitis . Fifty difficult clinical cases of child's meningitis were submitted to the system, to seven senior specialists and to seven young physicians . Multidimensional analysis of the diagnosis of the infection category reveals that the two groups of physicians separate naturally and that the system is located among the group of experts . The study of the agreement of the microbiological diagnosis and therapeutic advice shows that the advice of the two groups of physicians is significantly different and that the advice of the system is significantly closer to that of the experts . This result is confirmed by the study of therapeutic errors . This type of study allows one to classify the performance of the system among physicians having different levels of expertise without referring to an objective solution.

Clin Infect Dis, 1993 Aug, 17(2), 204 - 9
Multifocal osteoarticular tuberculosis: report of four cases and review of management; Muradali D et al.; We report the clinical, microbiological, and radiological features of four cases of multifocal osteoarticular tuberculosis, and we review the management of this condition . In each case the initial clinical diagnosis was one of malignant disease, and the possibility of tuberculous bone infection was overlooked . There was neither clinical nor radiological evidence of pulmonary involvement in any case . Antituberculous chemotherapy was initiated in two instances on the basis of histopathologic findings compatible with tuberculous osteomyelitis; such treatment was delayed in the other two cases until the diagnosis was confirmed by culture . Antituberculous chemotherapy alone was successful in three cases, while the fourth case required emergency anterior spinal decompression as well . Two patients developed additional skeletal lesions after the initiation of appropriate antituberculous chemotherapy . Multifocal osteoarticular tuberculosis must be considered in the differential diagnosis of multiple destructive skeletal lesions in all patients from areas where tuberculosis is endemic . This condition may mimic malignant disease both clinically and radiologically.

Clin Infect Dis, 1993 Aug, 17(2), 178 - 84
Clindamycin/primaquine versus trimethoprim-sulfamethoxazole as primary therapy for Pneumocystis carinii pneumonia in AIDS: a randomized, double-blind pilot trial; Toma E et al.; The aim of this double-blind pilot trial was to compare clindamycin/primaquine with trimethoprim-sulfamethoxazole (TMP-SMZ) as primary treatment for AIDS-related Pneumocystis carinii pneumonia (PCP) . The focus was on toxicity and tolerability since comparisons of efficacy were limited by the small sample size . Sixty-five individuals with a first episode of possible PCP were randomly assigned to receive clindamycin/primaquine (34 patients) or TMP-SMZ (31 patients) . PCP was subsequently proven microbiologically in 27 and 22 of the patients in these respective groups . Half of the participants had an arterial partial oxygen pressure at enrollment of < or = torr . The incidence and severity of adverse reactions were lower--but not significantly lower (P = .07 and .08, respectively)--with clindamycin/primaquine . The markers of severity improved in a similar manner regardless of which regimen was administered . No significant differences were documented in outcome, duration of survival, length of the PCP-free interval, or rate of relapse . The results of this pilot study show a trend toward less toxicity with clindamycin/primaquine than with TMP-SMZ . This result must be confirmed by larger-scale clinical trials, which are also needed to better compare the efficacy of the two regimens.

Br J Obstet Gynaecol, 1993 Aug, 100(8), 765 - 7
The coelomic cavity: an important site of materno-fetal nutrient exchange in the first trimester of pregnancy; Campbell J et al.; OBJECTIVE: To measure levels of folate and vitamin B12 in matched samples of amniotic fluid and extra-embryonic coelomic fluid from 9 to 12 weeks' gestation . DESIGN: Prospective observational study . SETTING: Homerton Hospital, London . SUBJECTS: Twenty-two women with ultrasonographically normal pregnancies before surgical termination . METHODS: Transvaginal ultrasound-guided needle aspiration of amniotic fluid and extra-embryonic coelomic fluid was performed . Pure samples of amniotic fluid and extra-embryonic coelomic fluid were obtained from each pregnancy, and folate and vitamin B12 were measured using microbiological assays . RESULTS: Levels of folate and vitamin B12 were higher in extra-embryonic coelomic fluid than in amniotic fluid and maternal serum . Amniotic fluid folate levels were lower than in maternal serum whereas vitamin B12 levels in amniotic fluid were higher than in maternal serum . All differences in concentration were significant (P < 0.0005; paired t-test) . Positive correlations were found between the concentrations of folate and vitamin B12 in each fluid . There was a linear correlation between gestational age and amniotic fluid folate levels (r = 0.648; P = 0.001) . CONCLUSIONS: High concentrations of folate and vitamin B12 in coelomic fluid suggest that the coelomic cavity plays an important role in the materno-fetal exchange of these nutrients.

Poult Sci, 1993 Aug, 72(8), 1584 - 91
The analysis of egg wash water for the rapid assessment of microbiological quality; Bartlett FM et al.; A total of 101 egg wash water samples from five different egg grading stations in eastern Ontario were analyzed for a variety of physical and chemical variables in an attempt to find a correlation with total bacterial counts . Temperature, pH, total chlorine, and percentage transmission at 600 nm (%T) were found to be significant variables, and a multiple regression equation was derived that accounted for 65% of the total variation . The equation was used to classify wash water samples as acceptable (< or = 10(5) cfu/mL) or unacceptable and correctly classified 77.2% of the samples . Classification of a second (validation) data set from 58 wash water samples was correctly predicted in 72% of the cases . The predictive value of the equation was especially good for those wash water samples obtained from stations that had used a chlorinated alkaline detergent, 90.4 and 100% for the modeling and validation data, respectively . Maintenance of wash water at recommended levels for temperature and pH (i.e., > or = 40 C and pH > or = 10) was insufficient to ensure bacterial numbers would be < or = 10(5) cfu/mL . Under normal operating conditions a minimum total available chlorine concentration of .45 mg/L should be maintained in wash water to ensure that bacterial numbers are kept at an acceptable level . Monitoring of temperature, pH, total chlorine, and %T will assist in maintaining wash water quality and minimize the number of samples returned to laboratories for microbiological analysis.

J Paediatr Child Health, 1993 Aug, 29(4), 298 - 301
Severe thrombocytopenia in extremely low birthweight infants with systemic candidiasis; Dyke MP et al.; The clinical, haematological and microbiological features of 12 extremely low birthweight (ELBW) infants with Candida infection were compared with 36 gestational-age and birthweight matched controls who experienced 42 episodes of bacterial septicaemia . Thrombocytopenia was the feature observed most commonly, occurring in 12 of 12 study infants and 23 of 42 controls (P = 0.004) . Minimum platelet counts were below 50 x 10(9)/L in 11 of 12 study patients compared with seven of 42 controls (P < 0.0001) . Severe thrombocytopenia may be a useful indicator of systemic Candida infection in ELBW infants.

Aging (Milano), 1993 Aug, 5(4), 317 - 23
FRAR course on laboratory approaches to aging . Microbiological effects and quality control in laboratory rodents; van der Logt JT; Numerous viruses, mycoplasmas, bacteria and parasites have been associated with infectious diseases in laboratory animals . It is clear that pathogenic agents causing overt disease represent a serious hazard to research results in both short- as well as long-term studies . However, these organisms may contaminate colonies without causing any clinical or pathological symptom . This makes research less reliable because of the more subtle effects of the silent infections, especially in long-term studies as in aging research . The establishment of animal colonies that were free from these (micro-) organisms has increased substantially the value of animals used in biomedical research . Characterization of the health status and microbiological monitoring of the animals in experiments are particularly important . This paper reviews many of the major considerations in the efforts to maintain animals free of unwanted organisms, including quality and sources of animals, transportation and quarantine, maintenance during experimentation, microbiological characterization and monitoring of animals and environment.

Tuber Lung Dis, 1993 Aug, 74(4), 273 - 9
The impact of HIV on resource utilization by patients with tuberculosis in a tertiary referral hospital, Nairobi, Kenya; Nunn P et al.; By using routinely collected data and results from research studies at the Infectious Diseases Hospital (IDH), Nairobi, we have begun to determine the scale of the increase in resource utilisation and treatment costs for tuberculosis control services caused by the HIV epidemic . New cases of tuberculosis registered annually at the IDH rose 61%, from 447 in 1985 to 720 in 1990 . HIV seroprevalence among patients with tuberculosis rose from 7.5% in 1986 to 42% in 1990 . The inpatient mortality rate rose from 8.4% in 1985 to 16.8% in 1989, but fell to 13.5% in 1990 . HIV-positive patients were admitted to hospital on 2 or more occasions more often than HIV-negative patients (Relative risk (RR) = 2.46, 95% confidence intervals (CI), 1.1-5.7), but average duration of admission was similar for the 2 groups . Significantly more HIV-positive patients were prescribed antibiotics, antifungal agents, antidiarrhoeal agents, analgesics and corticosteroids than HIV-negative patients . Microbiological investigations, apart from those for tuberculosis, were performed more commonly among HIV-positive patients (RR = 2.0, 95% CI 1.0-4.2) . Using this data, the average cost of ideal drug therapy, including antituberculosis drugs and treatment for intercurrent infections and other complications, was estimated using 1992 prices (ECHO, Coulsdon Surrey, UK) . The costs were US$16.62 and US$32.94 for HIV-negative patients using 'standard' therapy (2STH/10TH) and short course therapy (2SHRZ/6TH) respectively, and US$41.18 for HIV-positive patients using a short-course regimen without thiacetazone (2EHRZ/6EH) . The HIV epidemic is causing both an increase in the numbers of patients requiring treatment and an increase in the average cost of treatment per patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultraschall Med, 1993 Aug, 14(4), 193 - 9
{Prenatal diagnosis of type II Arnold Chiari malformation}; Heinrich G et al.; During a 7-year-period 22 foetuses with an Arnold-Chiari deformity were diagnosed . The reason for referring to our centre were severe additional malformations . In 2 cases protrusion of the fetal brainstem is documented by sonography prenatally . Prenatal diagnosis of an ACM has not been documented in the literature . The cytogenetic and microbiological findings including the additional malformations are presented . Pathogenesis, outcome and treatment options are discussed.

J Dent Symp, 1993 Aug, 1, 70 - 2
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.

Int Ophthalmol, 1993 Aug, 17(4), 201 - 10
Ocular pharmacokinetics of tobramycin . A comparative radioimmunoassay and microbiological assay; Desai S; The ocular pharmacokinetics of tobramycin were studied in human and rabbit eyes following topical and subconjunctival administration in humans and following intravitreal administration in rabbit eyes . Each aqueous and vitreous sample was analysed by radioimmunoassay and microbiological assay . Topical instillation of 0.3% eyedrops by a loading dose schedule provided rapid penetration of the drug into the aqueous humour with a peak titre of 3.24 mg/l (RIA) at 2-hour intervals and therapeutic levels up to 6 hours . A subconjunctivally administered standard dose of 20 mg/0.5 ml of the drug also showed rapid penetration in therapeutically effective concentration with a peak titre of 22.34 mg/l (RIA) and 16.80 mg/l (MBA) at 2-hour intervals and therapeutic levels of the drug remained up to 20 hours later . A study of vitreous clearance following the administration of a single intravitreal injection in rabbit eyes showed bioavailability of the drug at therapeutically effective levels for more than 72 hours . Mostly two, but sometimes only one sample at each time interval, were studied . Radioimmunoassay and microbiological assay results showed excellent correlation, with correlation coefficient > 0.90 at 1.0% level of probability.

Ann Intern Med, 1993 Jul 1, 119(1), 16 - 22
Minocycline compared with doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis; Romanowski B et al.; OBJECTIVE: To compare the efficacy and tolerability of minocycline versus doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis . DESIGN: Randomized, double-blind trial . SETTING: Sexually transmitted disease clinics . PATIENTS: 151 men and 102 women with nongonococcal urethritis, mucopurulent cervicitis or whose sexual partner had either condition or a positive culture for Chlamydia trachomatis . INTERVENTIONS: Minocycline, 100 mg nightly, or doxycycline, 100 mg twice daily, each administered for 7 days . MEASUREMENTS: At each visit (days 14 +/- 3, 28 +/- 5, and 49 +/- 7) patients were questioned regarding symptoms, signs, drug compliance, and sexual contact . Cultures for C . trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis were obtained at each visit . RESULTS: 253 patients were enrolled (133, doxycycline; 120, minocycline) . Chlamydia trachomatis was initially isolated from 31% of men and 39% of women . Men with a positive smear had a higher symptom/sign score (P < 0.001) and were more likely to have chlamydia (P = 0.004) . Positive endocervical smears were not associated with symptoms or signs (P > 0.2) but correlated with isolation of chlamydia (P < 0.001) . One hundred sixty-two patients (64%) completed the study . The proportion with urethritis or cervicitis did not differ by treatment group at any follow-up visit (P > 0.08) . Unprotected sexual contact did not affect clinical or microbiological cure rates . Adverse effects occurred more frequently in the doxycycline group (men: 43% versus 26%; P = 0.05; women: 62% versus 35%; P = 0.009) . Although the proportion with dizziness did not differ by drug administered (P = 0.1), dizziness was reported more often by women (11% versus 3%) . CONCLUSIONS: Minocycline, 100 mg nightly, was as effective as doxycycline, 100 mg twice daily, each given for 7 days in the treatment of nongonococcal urethritis and mucopurulent cervicitis . Vomiting and gastrointestinal upset occurred more frequently in the doxycycline group.

J Parenter Sci Technol, 1993 Jul-Aug, 47(4), 152 - 4
"Microbiological evaluation and monitoring of cleanroom environments" (meeting summary); Agalloco J; It was clear that there was little consensus among the panel with regard to the need for an informational chapter in USP on microbial classification of cleanrooms . The articulated positions of the individual panelists remained essentially unchanged throughout the session . What agreement was achieved was in a willingness to continue the dialogue, to await the outcome of the PDA activities cited above with the hope that a mutually acceptable compromise can be realized through that process.

Int J Food Microbiol, 1993 Jul, 19(2), 87 - 108
Current microbiological considerations in food preservation; Sofos JN; Changes in the composition and properties of certain foods, as well as development of food products to meet consumer demands relating to health, nutrition and convenience lead to concerns about the microbiological safety of such products . Concerns also arise from emergence or recognition of the importance of certain microbial food pathogens or spoilage organisms, as well as from modifications in food processing, handling, storage and preparation procedures . These facts necessitate continuous reevaluation of factors involved in the control of microbial growth in order to preserve foods and maintain their quality and safety.

J Periodontol, 1993 Jul, 64(7), 637 - 44
Subgingival minocycline hydrochloride ointment in moderate to severe chronic adult periodontitis: a randomized, double-blind, vehicle-controlled, multicenter study; van Steenberghe D et al.; The safety and efficacy of subgingivally-applied 2% minocycline ointment was evaluated in a randomized, double-blind study of 103 adults with moderate to severe periodontitis . Two groups were compared; one received the test minocycline ointment and the other a vehicle control . Both groups had scaling and root planing at baseline, after which the test or control ointments were applied with an applicator into the periodontal pockets at baseline, and at 2, 4, and 6 weeks . Assessment of clinical response was made by measuring probing depth and probing attachment level and gingival bleeding . These measurements were made at baseline prior to scaling and root planing, and at weeks 4 and 12 . Microbiological assessment of the subgingival flora was carried out with DNA probes at baseline, and at weeks 2, 4, 6, and 12 to identify and quantify Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans . Subgingival minocycline ointment resulted in statistically significantly greater reduction of P . gingivalis at weeks 2, 4, 6, and 12; P . intermedia at weeks 2, 4, 6, and 12; and A . actinomycetemcomitans at weeks 6 and 12 . Probing depth reductions were seen for both groups at weeks 4 and 12; however, this reduction was statistically significantly greater in subjects treated with minocycline ointment . Reduction in gingival index and probing attachment gain were seen in both groups, however, the differences between the groups were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Clin Pharmacokinet, 1993 Jul, 25(1), 6 - 19
Lomefloxacin clinical pharmacokinetics; Freeman CD et al.; Lomefloxacin is a quinolone antibiotic with chemical and microbiological properties similar to most commercially available agents of this class . There are differences, however, between lomefloxacin and other quinolones in activity against specific micro-organisms, a situation that is typical of most antibiotic classes . The pharmacokinetics of lomefloxacin support once- or twice-daily dosage, depending on the pathogen or site of infection . This is a result of its relatively high serum concentrations and long half-life . The outstanding pharmacokinetic features of lomefloxacin are its high degree of tissue distribution, lack of significant metabolism (and, therefore, no competitive drug interactions with other metabolised drugs showing a common metabolic pathway), and good oral absorption . Like most fluoroquinolones, lomefloxacin can chelate with heavy metals . However, this interaction can be eliminated by administering lomefloxacin 2h before the cation-containing products . Dosage adjustments are required in patients with renal dysfunction . However, patients with liver disease do not require alterations in lomefloxacin dosage regimens . The safety profile, lack of significant drug interactions and convenience of administration make lomefloxacin a useful agent in specific clinical settings.

Arzneimittelforschung, 1993 Jul, 43(7), 795 - 800
{The effect of mistletoe lectins on the limulus amebocyte lysate test}; Scheer R; Former reports about too high and from batch to batch changing endotoxin contents in mistletoe preparations and phytopharmaceuticals for parenteral administration correlated with clinically observed side effects led to investigations of the endotoxin content of ABNOBA-viscum . For that purpose the endotoxin levels of the raw materials, the equipment and the production steps were observed by using the limulus amebocyte lysate (LAL) test . The mean value found in the preparation containing the highest available concentration (dilution level 2 containing 15 mg of plant extract from 20 mg of fresh mistletoe in 1 ml) came to 66.7 endotoxin units (EU) per ml, corresponding to about one fifth of the commonly accepted limit value of 350 EU/ml, the human pyrogenic dose . Depending on their dilution level, lower concentrated preparations led also to lower LAL test results . It could be proved that lectins contained in mistletoe preparations cause false positive LAL tests . Such results implicate false too high contents of endotoxin . Different lysates, i.e . Limusate, Pyrogel, Pyrogent, and Pyroquant showed approximately the same results . Microbiological and LAL test results indicate that only 10% of the total amount of the LAL test result was caused by endotoxins . So it is necessary to form a new estimation of the former results of determination of the endotoxin content of mistletoe preparations.

Mikrobiyol Bul, 1993 Jul, 27(3), 254 - 8
{Actinomycosis abscess developing in the rectus muscle . (One case history)}; Kiraz N et al.; A 36 year old male patient having an abscess in right rectus muscle's cover 2 years after stomach operation; attended to our hospital . The abscess was discharged . Following this, at 6 months intervals new abscess were formed in left lower and right upper rectus cover and discharged . Samples from abscess were routinely observed microbiologically and for tuberculosis; but the etiologic agent could not be identified . Six months later the patient attended to our hospital with abscess in right lower rectus cover again . The sample taken from the patient was examined thinking actinomycosis . After clinical and microbiological observation, the causative agent was identified as Actinomyces israeli.

Mikrobiyol Bul, 1993 Jul, 27(3), 196 - 202
{Identification of dermatophytes as possible agents in clinically and microbiologically diagnosed dermatophytosis}; Kilic H et al.; In this study we have investigated the distribution of dermatophyte species clinically and microbiologically on 110 patients with dermatophytosis . The distribution of the dermatophytes according to the localization sites are: Tinea Capitis 13 (11.8%), T . Corporis 12 (10.9%), T . Inguinalis 22 (20%), T . Pedis et Manum 47 (42.7%), T . Unguinum 16 (14.5%) . The species of dermatophytes which have been cultured were, Trichophyton rubrum 32 (29%), T . mentagrophytes 32 (29%), T . schoenleini 4 (3.6%), T . tonsurans 1 (0.9%), Epidermophyton floccosum 16 (14.5%), Microsporum canis 1 (0.9%), M . audouini 1 (0.9%), various molds 3 (2.7%) and also number of negative cultures obtained were 20 (18.1%).

Jikken Dobutsu, 1993 Jul, 42(3), 371 - 6
Serological evidence of pneumonia virus of mouse (PVM) infection in laboratory rats; Miyata H et al.; PVM specific antibody was determined using 3 serological tests (Parker's original hemagglutination-inhibition {HI} test, modified HI test, and indirect fluorescent antibody {IFA} test) . IFA test was found to be the most sensitive method, so that IFA test was considered to be the method of choice for a small scale microbiological monitoring in animal facilities . A total of 1,280 sera including rats, mice, hamsters and rabbits were tested for PVM antibody . The prevalence of PVM antibody was 17.2% (116/674) in conventional rats and 30.0% (160/200) in SPF rats obtained from commercial breeders and research facilities . Furthermore, two samples of 144 conventional rabbits (1.4%) were showed specific antibody positive to the virus . However, hamsters and mice showed no evidence of PVM infection . These results suggest that PVM infection is prevalent, especially in laboratory rats in Japan.

Clin Infect Dis, 1993 Jul, 17(1), 114 - 6
Mixed cutaneous phaeohyphomycosis in a cocaine user; Lavoie SR et al.; The dematiaceous fungi rarely cause serious disease in humans . We report a case of mixed cutaneous phaeohyphomycosis caused by two dematiaceous fungi, Exserohilum rostratum and Curvularia species, and review the microbiological characteristics and clinical significance of these organisms.

J Bone Joint Surg Br, 1993 Jul, 75(4), 582 - 91
Chronic multifocal osteomyelitis; Carr AJ et al.; We describe 22 patients who presented between the ages of 4 and 14 years with gradual onset of malaise and pain at the sites of multiple bone lesions . The symptoms from the bone lesions were sometimes sequential in onset and often relapsing . The radiological findings were typical of osteomyelitis . Radioisotope bone scans identified some clinically silent lesions . Bone biopsies were performed in 20 patients and the changes of osteomyelitis were seen in 17; microbiological culture was positive in only one . Seven patients had polyarthritis, two had palmoplantar pustulosis and one had psoriasis . Some symptomatic relief was obtained with anti-inflammatory agents and, to a less extent, with antibiotics . No patient had primary immunodeficiency . The mean duration of symptoms from the bone lesions was two years (1 to 4) . When arthritis was present the joint symptoms lasted considerably longer (mean 7 years; range 4 to 10) . The long-term prognosis was generally good . There was no evidence of altered bone growth or abnormal joint development . One patient developed a progressive kyphosis requiring fusion, but no other surgical intervention was necessary.

J Med Microbiol, 1993 Jul, 39(1), 64 - 8
The inflammatory response of the gastric mucosa of mice experimentally infected with "Gastrospirillum suis"; Moura SB et al.; To establish an experimental model to study gastric spiral non-cultivable bacteria, 30 4-week-old female CFW (LOB) mice were inoculated with porcine gastric mucus containing "Gastrospirillum suis" and 25 mice were inoculated with mucus without "G . suis" . Mice were examined 3, 7, 14, 21, 28 and 60 days after inoculation . Fragments from the membranous, oxyntic and antral gastric mucosa and from the duodenal mucosa were obtained for histological and microbiological analysis . Tightly spiralled bacteria were seen in smears and in histological sections of the antral and oxyntic mucosa from all G . suis-infected mice . The pre-formed urease test also gave positive results in both tissues . In control mice, no tightly spiralled bacteria were seen . By 7 days after inoculation, the test animals had developed an inflammatory infiltrate of mononuclear cells, some neutrophils and a few eosinophils, mainly in the lower third of the antral and oxyntic mucosa, which persisted for the remainder of the observation period . This model can assist in the understanding of several clinical, pathological and immunological aspects of infection with spiral gastric bacteria, particularly those associated with non-cultivable spiral bacteria.

Indian J Pathol Microbiol, 1993 Jul, 36(3), 245 - 52
Microbiological study of mycetoma patients from Bombay with special reference to actinomyces immunofluorescence; Tendolkar UM et al.; 17 of the 21 clinically diagnosed mycetoma and actinomycosis cases studied yielded positive cultures . Foot, leg, inguinal region, chest wall, jaw and scalp were the affected sites . 15 of the patients were from Bombay, 13 of them had infection due to Nocardia species and 2 had Actinomyces israelii infection . The other two patients from South India had Madurella mycetomi infection . N.brasiliensis was commonest isolate (8) . Other isolates were N.asteroides (2), N.pelletieri (2), N.caviae (1) and A.israelii (2) . A direct fluorescent antibody test to detect actinomyces was used in selected cases (4) . Two of whom gave positive immunofluorescence with A.israelii FITC labeled globulin, in primary smears as well as in cultures.

Indian J Pathol Microbiol, 1993 Jul, 36(3), 238 - 44
Actinomyces species associated with intrauterine contraceptive devices and pelvic inflammatory disease; Tendolkar U et al.; Swabs from 112 removed intrauterine contraceptive devices (IUCD), endocervical swabs from these women and from 65 women with pelvic inflammatory disease (PID) were studied for actinomyces, using direct fluorescent antibody test and culture . Endocervical swabs from 50 control subjects were also studied . Actinomyces species could be detected in 23 (20.5 percent) of IUCD wearers and 8 (12.3 percent) of patients with PID . In control cases, no actinomyces were detected . The isolation rate using a selective medium (Actino Blood Agar) was 71.4 percent . Actinomyces israelii, Actinomyces naeslundii and Actinomyces viscosus were isolatedPIP: Actinomycetes have been recognized in association with IUDs and pelvic inflammatory disease (PID) although the exact origin and routes by which the actinomyces arrive in the vagina are unknown . It is clear, however, that once in the vagina, bacteria may be pulled into the uterus by the tails of IUDs like the Dalkon Shield . The authors report findings from the collection and study of endocervical swabs after decontamination of vagina and with IUDs in situ from 112 women attending for IUD removal . The mucus debris adherent to the removed IUD was also swabbed for microbiological study along with endocervical swabs from 65 clinically diagnosed cases of PID . The presence of Actinomyces was sought using direct fluorescent antibody test and culture . Actinomyces species isolated included Actinomyces israelii, Actinomyces naeslundii, and Actinomyces viscosus, and were identified in 20.5% of IUD wearers and 12.3% of patients with PID . A 71.4% isolation rate resulted using the selective medium Actino Blood Agar . No actinomyces were detected in the 50 control subjects . Studies suggest that the presence of any type of IUD, regardless of the duration of use, predisposes a patient to colonization or infection with Actinomyces . Symptoms of vaginal discharge, pain, and menstrual disturbance in association with Actinomyces have also been noted in other studies . The authors, in closing, stress the need to isolate and properly identify the Actinomyces species, with the presence of Actinomyces in IUD wearers warranting removal of the device .

Br J Clin Pract, 1993 Jul-Aug, 47(4), 187 - 9
Helicobacter pylori prevalence in a routine upper gastrointestinal endoscopy population; Sandikci MU et al.; The presence of Helicobacter pylori (HP) in gastric biopsy specimens of 500 patients referred for routine upper gastrointestinal endoscopy for various abdominal complaints was investigated histologically and microbiologically . HP was detected in 429 of the 500 patients (86%) . Antral biopsy specimens revealed gastritis in 457 out of 500 cases (91.4%) . In the 43 patients who had normal histological findings, only 3 had HP infection (7%) . The prevalence of HP in the patients with gastric and duodenal ulcers was 91% . In 95.6% of the ulcer patients, biopsy specimens showed gastritis . There was a statistically significant rise in the prevalence of HP with age . The correlation between histologic and microbiologic diagnostic methods was good . This study shows that HP positivity and gastritis are common in a routine endoscopy population and that there is a strong association between H . pylori, gastritis and peptic ulcer disease.

Infection, 1993 Jul-Aug, 21(4), 235 - 40
Nosocomial outbreak of legionellosis in a rehabilitation center . Demonstration of potable water as a source; Nechwatal R et al.; Ten patients from a rehabilitation center were admitted to hospital with serious respiratory infections within ten weeks . An outbreak of Legionnaire's disease was suspected based on the epidemic and atypical manifestation of pneumonia and could be proven microbiologically . Pulmonary and extrapulmonary complications included respiratory failure, lung abscess, transitory renal impairment in five patients and acute renal failure requiring dialysis in one, tetraparesis caused by peripheral neuropathy and acute psychosis . Three patients died despite immediate institution of therapy with erythromycin . Legionella pneumophila serogroup 1 subtype Pontiac was isolated from a bronchial lavage sample of one patient and from the water supply of the rehabilitation center . Monoclonal antibody subtyping and restriction endonuclease analysis were performed on both environmental and patient isolates . Potable water was identified as the source of the outbreak based on identical patterns on restriction endonuclease analysis . Despite thermic and chemical disinfection with chlorination (up to 15 ppm) in the rehabilitation clinic, an eleventh case of Legionnaire's disease was detected 11 months later.

Gig Sanit, 1993 Jul, (7), 35 - 8
{Microbiological evaluation of water pollution in the Volga delta}; Pogorelova NP et al.; Bacterial contamination of water and fish in the Volga delta region was studied . Water near large enterprises contained more bacteria than at 75 km a distance of downstream . All organs and tissues of sturgeon contained opportunistic bacteria . Bacterial contamination of water is responsible incidences for acute intestinal diseases of the population.

Med J Aust, 1993 Jun 7, 158(11), 735 - 8, 740
Extrapulmonary tuberculosis in children; McIntosh ED et al.; OBJECTIVE: To investigate an apparent increase in the number of children admitted to the Royal Alexandra Hospital for Children with extrapulmonary tuberculosis (TB) . Further, to highlight both the seriousness of this disease and the difficulty of its diagnosis, and to draw attention to factors such as ethnic origin in identifying children at risk . DESIGN: Clinical and microbiological data were collected for all children admitted to the hospital with a confirmed diagnosis of TB . A standardised incidence ratio (SIR) was used to analyse the number of children admitted with extrapulmonary TB in 1990-1991 compared with 1982-1989, and in 1987-1991 compared with 1982-1986 . RESULTS: Eleven children (five of these in 1990 and 1991) had extrapulmonary TB (4, central nervous system; 3, osteomyelitis; 2, cervical lymphadenitis; 2, abdominal) . One was Aboriginal and 10 were from families of overseas origin . Twenty-one others had pulmonary TB and 17 of these were from families of overseas origin . The apparent increase in the number of admissions for extrapulmonary TB was not statistically significant . CONCLUSION: There has been a recent increase in the number of children hospitalised with extrapulmonary TB but when this is compared with the increase in children hospitalised for all causes, the increase is not significant . Immigration and the continuing contact of children with infected adults appear to account for most cases of TB in this series.

Nurs Stand, 1993 Jun 30-Jul 6, 7(41), 25 - 9
Nurses' knowledge of infection control; Horton R; The article is based on a research study examining infection control in nurse education and practice . A survey of a large population was carried out to establish the perceived importance of microbiological knowledge to nurses and to ascertain whether this knowledge was present . The results suggest that although microbiological knowledge is considered necessary for safe infection control practice, nurses' actual knowledge falls far short of the level required for 'informed' practice . What this implies in relation to patient care, and recommendations regarding education and practice, are discussed.

Transplantation, 1993 Jun, 55(6), 1418 - 21
Xenotransplantation: baboons as potential liver donors? Scientific and ethical issues; Chiche L et al.; The dramatic development of liver transplantation compared to a relative shortage of donors has brought a renewed interest to xenotransplantation . Because of anatomical and immunological compatibilities, nonhuman primates are the most appropriate donors . The aim of this work was to analyze the different problems of a baboon-to-man liver xenotransplantation . Thirty baboons bred in a French Primatology Center were studied . The analysis of anatomical, microbiological, and immunological data showed that only 8 baboons out of 30 were suitable as donors for xenotransplantation . Considering these data and the ethical issues, the actual feasibility of xenotransplantation programs is discussed.

Am J Gastroenterol, 1993 Jun, 88(6), 925 - 8
Comparison of three methods to obtain upper small bowel contents for culture; Leon-Barua R et al.; In this study of 27 patients with dyspepsia, we compared three methods for obtaining upper small bowel contents for culture: 1) the Enterotest or string capsule method, 2) duodenal intubation using a closed polyethylene tube filled with water that had been boiled for sterilization and removal of dissolved oxygen, and 3) brushing of duodenal mucosa with a cytology brush protected by a sheath (the last two done during endoscopy) . In 12 of the 27 patients, duplicate intubations and brushings were performed . The samples obtained were cultured aerobically . Parameters used to compare the three methods were: the contribution of each method to the diagnosis of upper small bowel bacterial overgrowth (USBBO), agreement between the methods in diagnosis of USBBO and in detailed microbiological findings, and the reproducibility of diagnosis of USBBO and of microbiological findings in duplicate intubation and brushing . Intubation and brushing were highly reproducible and superior to the Enterotest in all of the tested parameters . Intubation and brushing are equally efficacious, but intubation is preferred because of the slight cost advantage, ease of specimen processing, and the ability to obtain anaerobic specimens.

J Chemother, 1993 Jun, 5(3), 147 - 50
In vitro activity of cefodizime (HR-221) in combination with beta-lactamase inhibitors; Segatore B et al.; Cefodizime (formerly HR221) was tested either for in vitro microbiological activity or for its stability to beta-lactamases in the presence of two beta-lactamase inhibitors (clavulanic acid, tazobactam) . Cefodizime was a poor substrate of class C enzymes but hyperproducer strains were generally resistant with or without a beta-lactamase inhibitor used in combination . On the contrary, class A enzymes were able to hydrolyze cefodizime . However, strains expressing class A beta-lactamase were susceptible to cefodizime in combination with clavulanic acid.

Br J Gen Pract, 1993 Jun, 43(371), 239 - 44
Vaginal symptoms of unknown aetiology: a study in Dutch general practice; Dekker JH et al.; Vaginal symptoms are frequently presented by women to general practitioners . In many cases, the aetiology of these symptoms remains unknown . This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors modifying this course . In a group of 610 women presenting to their general practitioner with vaginal symptoms (itching, irritation, abnormal but non-bloody discharge) the distribution of diagnoses was studied and factors associated with symptoms of unknown aetiology were identified using logistic regression analysis . During a three month follow up, the course of symptoms and signs was studied in 139 women with unexplained vaginal symptoms, using survival analysis methods . It was found that 25% of all the women had symptoms of unknown aetiology . A larger number of these women, compared with women with other diagnoses, were Caucasian, married, more highly educated, used oral contraceptives and reported psychological distress . During the follow-up period, a specific infection was diagnosed in less than 20% of the women with unexplained vaginal symptoms . Over half of the women (54%) recovered within three months . Short duration of symptoms before presentation was associated with a higher probability of recovery . From the study, it was found that many women visiting the general practitioner for vaginal symptoms had no demonstrable microbial disorder . Often these symptoms were transient and disappeared without intervention . Persistent symptoms may call for further examination where somatic, as well as psychosocial, factors should be taken into account.

Acta Ophthalmol (Copenh), 1993 Jun, 71(3), 332 - 5
Treatment of concomitant eye and genital chlamydial infection with erythromycin and roxithromycin; Stenberg K et al.; A single blind study of 10 days' randomly allocated treatment with erythromycin (1000 mg/day) and roxithromycin (300 mg/day) in 14 (group A) and 13 (group B) adults, respectively, all with culture-proven chlamydial conjunctivitis was performed . For comparison, 14 days' treatment with 1 g erythromycin daily given to 35 adults (Group C) with chlamydial conjunctivitis was also evaluated . Follow-up was made approximately one month after start of therapy . Only 2 of the 37 men and 1 of the 25 women studied, all of whom had signs of conjunctivitis, had noticed concomitant symptoms of infection from the genital tract . Nasopharyngeal cultures were chlamydia-positive in 7 (50%), 7 (54%) and 20 (57%) of the patients in Group A, B and C, respectively, while for genital cultures the corresponding figures were 9 (64%), 8 (62%) and 23 (66%), respectively . The course with erythromycin in group C cured the conjunctivitis in 34 (97%) of the patients both clinically and microbiologically . Ten days' treatment with the same dose (Group A) did not eradicate chlamydiae from the eye in one, from the nasopharynx in 5 and from the genital tract in still another patient . The roxithromycin treatment (Group B) resulted in negative chlamydial cultures from the eyes in all 13 cases, while the nasopharyngeal and genital cultures were still positive in one patient each . The study showed that in spite of the eye being cured by macrolide therapy, other sites like the nasopharynx and the genital tract may still be colonized, why sampling for C . trachomatis from these sites should be made in tests for cure in chlamydial conjunctivitis cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Clin Microbiol Infect Dis, 1993 Jun, 12(6), 425 - 9
Multicentre evaluation of a biphasic culture system for recovery of mycobacteria from clinical specimens; Tortoli E et al.; A new biphasic system (MB Check, Roche) for isolation of mycobacteria from clinical specimens was evaluated by eight different microbiological laboratories in comparison with methods routinely used in the respective laboratories . Altogether 1125 clinical specimens were processed; pretreatment, if performed, was by a variety of methods . Mycobacteria were recovered from 167 specimens with the biphasic system and 165 specimens with the other methods . The average time required for isolation of Mycobacterium tuberculosis was 22.6 days with the biphasic system and 24.7 days with egg-based media; for other mycobacterial species it was 23.5 versus 20.8 days . The inclusion of a chocolate agar section in the biphasic system facilitated the early detection of contaminants, while the NAP-containing section appeared unable to differentiate Mycobacterium tuberculosis from other mycobacterial species . The biphasic system, which enables recovery of mycobacteria in small laboratories without specialized equipment, is more practical than conventional methods and at least as sensitive.

Kokubyo Gakkai Zasshi, 1993 Jun, 60(2), 301 - 12
{Clinical and microbiological study concerning effects of scaling and root planing . 2 . The effects of mechanical debridement until one year and of minocycline application topically}; Hagiwara S et al.; This study was performed to assess the effect of scaling and root planing clinically and microbiologically during one year . Nine patients with moderate to severe periodontitis were studied . After the process of plaque control, the selected single rooted teeth with 5mm probing depth were debrided mechanically under non-local anesthesia four times biweekly . Observing the results of the treated teeth until three months, the experimental teeth were divided into two groups . The standard of division was whether they showed good response to the mechanical debridement or not . Observation was continued until one year after the debridement according to the following criteria: 1 . The sites which showed good responses at three months were continued to be observed biweekly . 2 . The sites which showed no improvement at three months were applied the gel of minocycline (Periocline) four times biweekly . 3 . The untreated sites used as control until three months received mechanical debridement four times biweekly . The following results were obtained: The sites that showed good responses to the mechanical debridement at three months were maintained in good condition continuously during one year . The topical application of Periocline was effective in reducing the inflammation and probing depth clinically and microbiologically until three months.

Rev Clin Esp, 1993 Jun, 193(1), 31 - 4
{Acute pharyngo-tonsillitis . Penicillin, yes or no?}; Sanabria Gomez F et al.; Acute tonsillitis and acute pharyngitis show a high incidence in the healthy population . Recent microbiological studies have demonstrated changes in the frequency with which different microorganisms promote such infections . This fac, together with the variations in sensibility or resistance of germs to the diverse therapeutic agents, have led to the conclusion that penicillin must not be considered as the solo drug of choice in these infections.

Rev Clin Esp, 1993 Jun, 193(1), 12 - 6
{Tuberculosis and HIV infection . Evaluation of 132 cases}; Carcaba V et al.; Tuberculosis is currently one the more frequent opportunistic infections in patients infected by Human Immunodeficiency Virus (HIV) in our setting . Its extrapulmonary localization is considered as diagnostic of the Acquired Immunodeficiency Syndrome (AIDS) . We have evaluated the epidemiological, clinical, microbiological, histological and immunological characteristics of 120 patients in the Asturias region who had a tuberculosis diagnosed in any localization, during the period between 1984 and 1991, belonging to a series of 570 patients infected by HIV . Pulmonary types were comparatively analyzed to the extrapulmonary and disseminated ones . Tuberculosis was pulmonary only in 44 occasions (PT), in 36 it was extrapulmonary (EPT) and in 52 disseminated (DT) . The more frequent risk factor for the HIV infection was the parenteral consumption of drugs (78.8%) . The final diagnosis was microbiologic in 81% of the cases, while bacilloscopia was positive in 62% of the cases . The histologic study showed the presence of granulomas in 86% of the tissues studied and necrosis in 81% . EPT and DT were related with a worse immune situation, bigger mortality rates attributed to tuberculosis and worse survival (p 0.069) . Tuberculosis in patients infected by HIV appears mainly in CDVP, being its symptoms the normal ones; but extrapulmonary forms are clearly predominant and within this group those with a ganglionar localization . Normal diagnostic procedures yield a good result . EPT and DT are significantly related to a more severe immunodeficiency in comparison with PT . Survival and prognosis are better in the PT group.

J Periodontol, 1993 Jun, 64(6), 497 - 508
Non-human primates used in studies of periodontal disease pathogenesis: a review of the literature; Schou S et al.; The inability to examine initiation and progression of periodontal disease and to assess certain therapies in humans has led to a great interest in the use of animal models in periodontal research . Some of the most prominent animals used are non-human primates . This article reviews the characteristics of non-human primate models in periodontal health, in the transition from health to gingivitis to periodontitis, and in experimental gingivitis and periodontitis . Where possible, the results of these studies are compared with results from human studies . Only a few studies have compared in detail the anatomy, physiology, immunology, and tissue interactions in monkeys with those of humans . With the exceptions of differences and variations in size of the dentition, the number of each tooth type as well as larger canines, presence of diastemata between anterior teeth, and an edge-to-edge relationship of the incisors, the dental and periodontal anatomy of non-human primates seem quite similar to that of humans . Clinically healthy gingiva can be established and maintained in non-human primates, and gingivitis as well as periodontitis occur in these animals . It is possible to induce experimental periodontitis by placement of peri-dental silk ligatures or orthodontic elastics as well as by surgical removal of alveolar bone . Although the most appropriate model for studies of periodontal disease pathogenesis in non-human primates appears to involve the application of silk ligatures, some difficulties may occur in establishing periodontal break-down by using this model . Many clinical, histological, microbiological, and immunological characteristics of spontaneous and experimental marginal inflammation in most non-human primates are similar to those in humans . The most significant differences between small non-human primates and humans are the very limited number of lymphocytes and plasma cells in the inflammatory infiltrate of squirrel monkeys (Saimiri sciureus) and marmosets . Therefore, the use of squirrel monkeys and marmosets may not be appropriate in many studies of periodontal disease pathogenesis . The most significant microbial differences between macaque species and humans are a lower proportion of Actinomyces species, the presence of a catalase-producing Prevotella melaninogenica strain, and the high carrier rate for Actinobacillus actinomycetemcomitans in subgingival plaque of macaque species . The significance of these differences is presently unknown . It is concluded that the use of many non-human primate species due to the apparent close anatomic and biologic similarities to humans is appropriate in experimental studies of periodontal disease, provided the use of laboratory animals is requisite and lower species are not applicable.(ABSTRACT TRUNCATED AT 400 WORDS)

An Med Interna, 1993 Jun, 10(6), 271 - 4
{Usefulness of IgG and IgM detection against antigen 60 in the diagnosis of thoracic tuberculosis}; Querol JM et al.; We conducted a prospective study in order to assess the use of the "ELISA" method (Anda-Tb) for the detection of antibodies IgG and IgM against antigen 60 in mycobacterias for the initial diagnosis of thoracic tuberculosis . 215 serum samples from 44 patients with tuberculosis and 171 control cases were studied . The threshold value for IgG in our environment is 200 U, resulting in a specificity of 98% and a sensitivity of 34% . The IgM test has a low sensitivity, although when combined with the IgG, the sensitivity of the test increases while its specificity is reduced . This method is not useful in patients with HIV infection and immunodepression (AIDS) . We have not observed any relationship between the serology and the response to PPD intradermorreaction . We conclude that this method could be used in our environment as a supplementary test, but in any case as a substitute of the traditional microbiological diagnosis.

Bull Acad Natl Med, 1993 Jun, 177(6), 1013 - 20; discussion 1020-1
{Conservation of tap water in metallo-plastic bags: observed modifications and possible health risks}; Rudelle D et al.; Conservation of tap water kept in soft plastic bags and stocked at different temperatures (20, 37 and 55 degrees C) and its health incidences were studied over one year by samples taken at regular intervals . Pollutants generated were studied by investigating the consequences of the choice of the plastic and of the aseptic agent used at different temperatures versus the length of the period of contact . Microbiological, chemical, and physico-chemical characteristics reported here showed the existence of an exchange between the contents and the container . The presence of two toxic substances indicates that one should be careful when using inadequate material . This is a matter to think about without further speculation.

Arch Latinoam Nutr, 1993 Jun, 43(2), 161 - 7
{Formulation and evaluation of a beverage based on whole milk and precooked rice flour}; Guaipo B et al.; The objective of this research was to formulate and evaluate a beverage based on powdered whole milk and precooked rice flour, with good nutritional contribution, good acceptability and stability, which permits to be included in the nutritional Protection Programs carried out by the National Institute of Nutrition of Venezuela . Six different mixtures were prepared and evaluated organoleptically in liquid form . The preferred one was submitted to nutritional evaluation, acid determination and microbiological analysis during seven months, while samples were kept at temperatures of 5 degrees C, 27 degrees C and 37 degrees C . The nutritional composition of the selected mixture expressed by 100g was the following: kcal 423, proteins 11g, fat 9.1g, niacin 1 mg, thiamine 0.2 mg, riboflavin 0.6 mg, calcium 295.8 mg and phosphorous 287.5 mg . The protein quality was determined by the Protein Efficiency Ratio (PER) and Net Protein Ratio (NPR) was 3.01 +/- 0.2 and 3.74 +/- 0.3 respectively, compared with casein of 3.54 +/- 0.3 . This data showed that the product developed represents from the nutritional point of view a good alternative to prevent undernutrition in the country . The stability study reported a useful life time of seven months at temperatures of 5 degrees and 27 degrees C and less than two months at 37 degrees C.

Ugeskr Laeger, 1993 May 31, 155(22), 1708 - 12
{Polymerase chain reaction: use in microbiological diagnosis}; Lisby G; The discovery of the polymerase chain reaction (PCR) enables the detection of just a few target gene copies present in almost every kind of tissue . The PCR technique uses two separated specific DNA-sequences for identification of a desired genetic sequence . This identification is followed by an almost unlimited production of the specific target gene sequence by a heat stable DNA-polymerase . The PCR technique will revolutionize several diagnostic areas, and especially the identification of virus, fungi and slowly growing bacteria will benefit from this new genetic technology . The impressive sensitivity is, however, the greatest pitfall of the technique, as just a few contaminating DNA fragments can initiate a false positive result . Great care is therefore needed when designing a PCR laboratory, as well as high demands upon the motivation and technical skills of the personnel involved . PCR is so far limited to research, but is expected to be released for routine diagnostic purposes in 1993.

Qual Health Care, 1993 Jun, 2(2), 91 - 5
Use of laboratory testing for genital chlamydial infection in Norway; Aavitsland P; OBJECTIVE--To assess the use of laboratory tests for genital chlamydial infection in Norway . DESIGN--Questionnaire survey of general practitioners' practice in chlamydial testing, retrospective survey of laboratory records, 1986-91, and prospective study of testing in one laboratory during four weeks . SETTING--All 18 microbiological laboratories in Norway (4.2 million population), including one serving all doctors in Vestfold county (0.2 million population) . SUBJECTS--302 general practitioners . MAIN MEASURES--GPs' routine practice, methods used for testing, 1986-91, and sex specific and age group specific testing in 1991 . RESULTS--201(69%) GPs replied to the questionnaire: 101(51%) would test all women younger than 25 years at routine pelvic examination, 107(54%) all girls at first pelvic examination, 131(66%) all pregnant women, and 106(54%) all men whose female partner had urogenital complaints . Nationwide in 1986, 122,000 tests were performed (2.9 per 100 population); 10% were positive and 51% were cell culture tests . In 1991, 341,000 tests were performed (8.0 per 100 population); 4.5% were positive and 15% were cell culture tests . 13,184 tests were performed in Vestfold in 1991 (6.6 per 100 population) . The age group specific rates (per 100 population) among women were: age 15-19 years, 22.0(95% confidence interval 18.2 to 25.8); 20-24 years, 47.2(42.1 to 52.3); 25-29 years, 42.3(37.1 to 47.5); 30-34 years, 29.8(25.4 to 34.2); and 35-39 years, 12.5(9.5 to 15.5) . CONCLUSIONS--GPs use liberal indications for testing . The dramatic increase in testing, especially by enzyme immunoassays, in populations with a low prevalence of infection results in low cost effectiveness and low predictive value of positive tests, which in women over 29 years is estimated as 17-36% . IMPLICATIONS--Doctors should be educated about the limitations of enzyme immunoassays in screening low prevalence populations, and laboratories should apply a confirmatory test to specimens testing positive with such assays.

Lancet, 1993 May 8, 341(8854), 1175 - 9
Epidemiology of diarrhoeal illness associated with coccidian-like organism among travellers and foreign residents in Nepal; Hoge CW et al.; A newly described organism called CLB (coccidian-like or cyanobacterium-like body) has been identified in cases of prolonged diarrhoea . To confirm an association of CLB with disease and identify risk factors for transmission, we conducted a case-control study of travellers and foreign residents at two outpatient clinics in Kathmandu, Nepal . Patients without diarrhoea were matched to CLB cases by clinic and date of visit . For comparison, patients with other causes of diarrhoea were also studied . Stools were examined for enteric pathogens with standard microbiological and molecular genetic techniques . CLB was identified in 108 (11%) of 964 individuals with gastrointestinal symptoms compared with only 1 (1%) of 96 symptom-free controls (p = 0.003) . 7% of residents in the US Embassy community acquired the infection . The diarrhoeal illness associated with CLB lasted a median of 7 weeks (interquartile range 4-9) compared with 9 days (4-19) for individuals with other causes of diarrhoea (p < 0.0001) . The prevalence of other enteric pathogens was no higher among CLB cases than among symptom-free controls . Patients with CLB infection were more likely than controls to report consumption of untreated water (odds ratio 3.98; 95% CI 1.29-13.14); organisms of the same appearance were identified in an epidemiologically implicated water sample . The significant association of CLB with prolonged diarrhoea, and the low rate of other enteropathogens in CLB cases, strongly supports the hypothesis that CLB is a new pathogen . Epidemiological and environmental data suggest that the organism is waterborne.

J Clin Periodontol, 1993 May, 20(5), 307 - 13
The role of supragingival plaque in the control of progressive periodontal disease . A review; Corbet EF et al.; Levels of supragingival plaque and calculus have been related to progressive periodontal disease, and control of supragingival plaque in conjunction with professional tooth cleaning subgingivally forms the basis for the management of progressive periodontal disease . However, the contribution towards the management of progressive periodontal disease brought about by supragingival plaque control alone is not clear . There are studies which address, directly or indirectly, the contribution of supragingival plaque control alone towards the management of progressive periodontal disease . The effects of supragingival plaque control alone have been evaluated clinically, histologically and microbiologically, and taken together, the evaluations suggest that these effects may not be as marked as when professional subgingival tooth cleaning is also performed . These studies, however, given the patterns of periodontal disease found in adults in many communities, can form the basis for advocating high individual levels of supragingival plaque control as a community measure in the management of periodontal disease . Further long-term investigations into this approach may be warranted.

Neurochem Res, 1993 May, 18(5), 617 - 23
Modulation of potassium evoked secretory function in rat cerebellar slices measured by real time monitoring: evidence of a possible role for methylfolate in cerebral tissue; Lucock MD et al.; The real time dynamics of K+ evoked neurosecretion in cerebellar slices has been monitored electrochemically . In the presence of 5-methyltetrahydrofolate a statistically significant diminution in secretory response occurs . Agonists to probe the pharmacological basis for this indicate it is not due to voltage sensitive Ca2+ channel blockade, nor does it show any similarity of effect with kainate, whose receptor is a putative binding site for 5-methyltetrahydrofolate . The method is fully validated, although no account is taken of individual molecular species . High performance liquid chromatography combined with off line microbiological assay could only detect 5-methyltetrahydrofolate in cerebrospinal fluid . We therefore discuss our findings in relation to possible cerebral roles for cerebrospinal fluid 5-methyltetrahydrofolate in the context of both membrane and transmitter related interactions.

J Clin Periodontol, 1993 May, 20(5), 340 - 5
Transmission of Porphyromonas gingivalis between spouses; van Steenbergen TJ et al.; Porphyromonas gingivalis has been associated with severe forms of periodontitis . The question can be raised about the origin of this suspected periodontal pathogen . The purpose of the present investigation was to study the possibility of transmission of P . gingivalis between spouses . 18 patients were selected with severe periodontitis and colonized with P . gingivalis . 10 of their spouses appeared to be colonized with P . gingivalis too . 8 of the patients and their spouses were investigated further clinically and microbiologically . Microbiological evaluation revealed mostly high %s of P . gingivalis in the pockets, not only of the patients (5-48% of the cultivable flora), but also in 7 of the 8 spouses (0.2-61%) . Furthermore, this species was isolated often from the saliva, the tongue, the buccal mucosa and the tonsillar area from both patients and spouses . For typing purposes, bacterial DNA was isolated, treated with the restriction endonucleases Bam HI or Pst I, after which the DNA fragments were separated by agarose gelelectrophoresis . With one exception, each individual was colonized with only one clonal type of P . gingivalis . The DNA patterns of all P . gingivalis isolates from unrelated individuals were found to be distinct . In contrast, in 6 of the 8 couples, the DNA patterns of isolates from husband and wife were indistinguishable . From these data, it can be concluded that it is most likely, that P . gingivalis can be transmitted between spouses . It remains to be investigated whether transmission of P . gingivalis is a risk factor for developing periodontal destruction.

J Clin Microbiol, 1993 May, 31(5), 1382 - 4
New method to assess dilution of secretions for immunological and microbiological assays; Virolainen A et al.; Accurate quantitation of pathogens and antibody concentrations in secretions has been difficult because of unpredictable dilution of secretion with th diluent at the time of sample collection . We added an inert substance, lithium chloride (LiCl), to the sample diluent and measured its concentration with an atomic absorption spectrometer before and after the specimen was added . LiCl, at a concentration of 2 mmol of Li per liter, has no negative effect on the survival of common respiratory pathogens or on the results of immunoassays . The method is applicable to any sample collecting in which dilution of the specimen is necessary.

Klin Monatsbl Augenheilkd, 1993 May, 202(5), 474 - 8
{Useful examinations and therapies in immunologic diseases}; Martenet AC; Screening by immune disease is useful for one part in the various ocular inflammatory processes, uveitis, vasculitis, (epi)scleritis and myositis, for the other in collagen diseases with possible eye complications . The various forms of uveitis can be related either to rheumatic disease, to some HLA antigen, to a microbiological agent, sometimes to sarcoidosis . Retinal vasculitis remains almost always of unknown origin, while scleritis and myositis are often related to rheumatic disease, eventually to Wegener's granulomatosis . On the other side, in collagen disease (SLE, polymyositis, sclerodermia a.s.o.) the eye can participate either with fundus, scleral or orbital changes . Concerning therapy, steroids and immunosuppressive cytostatic drugs are the most useful; since most cases remain with unknown etiology, they cannot take benefit from specific therapy, except for instance the retinochoroiditis due to toxoplasmosis.

Mikrobiologiia, 1993 May-Jun, 62(3), 499 - 508
{A new experimental approach to the search for chemical density factors in the regulation of microbial population growth}; Degermendzhi AG et al.; The feedback level (FBL) in growth regulation has been determined in the experiments on Escherichia coli O-124 on the basis of the theory developed by Degermendzhy et al (1989) . FBL is here determined as a function of variations in growth acceleration caused by discrete decrease in bacterium concentration, the medium chemical composition being preserved . It estimates by integration regular action of all chemical density factors . FBL has been determined on periodic cultivation with glucose . In various phases of growth the native culture was diluted with a filtrate of its own . As the sample had grown up, variations in growth acceleration were calculated against the reference specimens . The value of FBL was definitely anything but zero at the end of the experimental phase and in the phase of growth deceleration, and it was equal to -20 divided by -200 (h.g/l) . The feedback component was also calculated from the obtained dependence of the growth rate on the glucose concentration . It amounted to mumax = 0.55 +/- 0.05 h-1, Ks = 2.5 +/- 0.7 mg/l . Regulation relative to glucose was 0.5-40% of FBL . This indicates that there are other regulators of growth . Being sufficiently accurate, the new method may supplement microbiological means of determining the growth regulating cell-density factors.

Klin Padiatr, 1993 May-Jun, 205(3), 153 - 7
{Protracted croup syndrome . Bacteriologic findings and therapeutic consequences}; Schumacher RF et al.; BACKGROUND: Croup normally is characterized by acute onset and a self limited course of only few days . In 1990 and 1991 at the University Children's Hospital Freiburg an unexpected high number of patients were hospitalized for prolonged Croup syndrome . Expanded microbiological investigations were used to uncover etiologic factors . METHODS: Of a total of 138 inpatients with Croup 60 (17 in their first year of life, 21 in the second year of life and 22 infants older than 2 years) had bacteriological (37 nasopharyngeal-, 4 tracheal-aspirates or 19 throat swabs), and virological (antigen detection in nasopharyngeal aspirates, n = 28) tests . Of these patients 48% were hospitalized longer than 3 days (mean 4,7; range 1-18 days) . RESULTS: Bacteria found: B . catarrhalis 24/11 (total/pure-culture), S . pneumoniae 15/6, H . influenzae 10/3, S . group A 5/4 and S . aureus 4/1 . Sixteen specimen yielded more than one pathogen, one specimen was sterile . Nasopharyngeal secretions had the most reliable results: Pure cultures (72%) and associations of two pathogens (87%) were found in these aspirates, and only 26% of the unspecific mixed findings (p < 0.005; chi 2-Test) . Of the patients hospitalized longer than 3 days 27.6% had positive cultures for H . influenzae, whereas only 6.5% of those hospitalized shorter (p < 0.05; chi 2-Test) . The only microorganism with an age-bound distribution was B . catarrhalis found predominantly (54.2%) in the 2nd year of life, with 62% of patients positive (p < 0.05; chi 2-Test) . Virus found: RSV (n = 3), Parainfluenza 2 (1) and Parainfluenza 3 (1) . CONCLUSIONS: Nasopharyngeal aspirate is the most reliable specimen for a bacteriologic diagnosis in Croup . In the second year of life B . catarrhalis is present in most Croup cases, and H . influenzae was associated with a prolonged course of the disease . An appropriate antibiotic therapy therefore must cover these two pathogens.

Rinsho Byori, 1993 May, 41(5), 562 - 6
{The development of an information network for new techniques in clinical microbiology}; Sugahara K; In accordance with changes in our life styles and our social and biological environment, the techniques and methods of clinical microbiology must change and develop . New techniques, such as selected zone culture, direct drug susceptibility test, ATP bio-luminescence assay on membrane filter and expiratory gas analysis are among these developments . To ensure equal development among medical laboratories, an information network concerning these new microbiological methods in needed . An enormous quality of information can be contained and managed usefully by a two dimensional bar-code system . Clinical microbiology must not only contribute to clinical medicine but also respond to changes in the social and biological environment, and must include cost effectiveness, and preservation of natural resources . Using the new techniques effectively and introducing automatic systems will facilitate practical, useful and rapid clinical microbiological diagnoses.

Rinsho Byori, 1993 May, 41(5), 557 - 61
{Usefulness of microbiological test in clinical decision making--from the view point of clinician}; Inamatsu T; During the last 50 years, there have been changes in the types of infectious diseases causing death in Japan . Endemic diseases have decreased and nosocomial infection during the therapeutic course of various diseases have increased . Progress of various new medical technology for cancer therapy and transplantation are supported by developed infection control, and the target of microbiological tests has changed from endemic organisms to resident organisms . To manage infectious diseases, clinicians collect considerable information . Microbiological tests are only one part and sometimes are used to assess therapeutic results . In this situation, microbiological tests sometimes only reconfirm or guide changes in therapeutic strategy if the initial empiric therapy was inappropriate . Then, well designed statistical data are necessary for appropriate empiric therapy . Surveillance of hospital infection is another important role of the microbiological laboratory . To improve the functioning of the microbiological laboratory, we need not only automatic and rapid systems, but also effective communication with clinicians to respond to their needs with clinically useful data.

Rinsho Byori, 1993 May, 41(5), 541 - 2
{The past and future of the clinical microbiology}; Yamaguchi K et al.; The purpose of clinical microbiology is to provide accurate information about microorganisms in a given specimen . This information is of significance to the patient as well as to the clinician . In this symposium, we discussed ways in which the microbiological laboratory has contributed to controlling infectious diseases as well as the advanced technology needed in the laboratory of the to future to quickly identify suitable chemotherapy . First, Dr . Kudo reviewed the past activities of microbiological laboratories . Then Dr . Machida, Dr . Okada and Dr . Kanno discussed the current situation and existing problems in clinical microbiology . Following that, Dr . Inamatsu presented a paper on the clinician's view of which microbiological examinations are useful inpatient treatment . Lastly, Mr . Sugahara discussed advanced technology in the field of clinical microbiology, and Dr . Kobayashi described the activity of microbiological laboratory as a part of an infection control unit in the hospital.

Zentralbl Veterinarmed B, 1993 May, 40(3), 170 - 80
Dose-dependent pathophysiological changes in cattle experimentally infected Dictyocaulus viviparus; Schnieder T et al.; In two trials five calves were each experimentally infected on three consecutive days with a total number of either 30 Dictyocaulus viviparus larvae per kg body weight (trial A) or 3 larvae/kg body weight (trial B) . Five calves served as non-infected controls . Infected cattle in trial A developed severe clinical signs of dictyocaulosis and one calf died 37 days post infection (p.i.), whereas all cattle in trial B remained clinically healthy . Weight gains in both trials were not statistically different . Haemoglobin concentrations, packed cell volume (PCV), number of erythrocytes and leucocytes, blood pH and albumin concentrations were in the physiological range in all groups . Infected cattle in trial A showed increases in respiratory rates, body temperature, serum protein concentrations, and blood eosinophil counts and decreases in oxygen partial pressure . Infected cattle in trial B showed increased blood eosinophil counts . Antibody formation in infected cattle of both trials showed a similar pattern . Excretion of larvae from infected cattle reflected the different infection doses . Microbiological examinations showed an increase of facultatively pathogenic bacteria in the lung fluid.

Biotech Histochem, 1993 May, 68(3), 166 - 8
A rapid method for microbial sample preparation for the scanning electron microscope; Chaphalkar S et al.; A synthetic aromatic polymer has been used for preparing replicas of different microorganisms . This method of preparing highly concentrated (9.6 k) microbiological samples for scanning electron microscopy was compared with a standard method . The micrographs of the replicated samples are satisfactory . This method is rapid, cost effective and produces good results, especially in the case of spore-forming mycelial microorganisms.

Zentralbl Hyg Umweltmed, 1993 May, 194(3), 223 - 35
{Sterilization--the microbiology between claim and reality}; Spicher G; Sterilization means to free an object from all living and viable germs . To fulfill this claim, the microbiology is confronted with some fundamental problems . Under the action of a microbicidal agent the microorganisms do not die at the same time, even if there is a homogeneous population . The destruction of microorganisms follows a special destruction order . The number of dying organisms is always proportional to the number of viable organisms present . On theoretical grounds it is, therefore, impossible to free an object from all living and viable germs; there will ever be left a certain proportion of viable germs, even if this proportion may be very small . The aim of sterilization must be to keep that proportion very small . To reach this goal in a practical time without damaging the objects to be sterilized, microorganisms of high resistance should be excluded, i.e . the objects to be sterilized should not be contaminated by microorganisms of high resistance to the sterilizing agent(s) . The assurance level that an object is free from all living and viable germs must be so high that it is practically impossible to proof this by a test for sterility . On the other hand, the absence of microorganisms of high resistance in the objects to be sterilized makes it feasible to use microorganisms of high resistance as test organisms for the manufacture of microbiologic indicators . Such indicators enable to record as an integral the action of all microbicidal parameters of the noxious agent(s) far beyond the region for which the application of a test for sterility is sensible . Nevertheless, bioindicators have a similar status as the physical and physico-chemical controlling instruments . Microbiological indicators make it possible to guarantee the application of a certain (minimal) efficacy of the microbicidal agent(s) . Whether this efficacy is sufficient to reach the wanted sterility assurance level depends, last not least, on the microbiological contamination (bioburden) of the object to be sterilized . Each sterilization process has its own prerequisites.

Arch Esp Urol, 1993 May, 46(4), 271 - 5
{Fournier's gangrene . Presentation of 5 cases and review of the literature}; Catedra Garcia A et al.; Five cases of Fournier's gangrene that had been treated at our department over the last five years are described . The literature is reviewed with special reference to the pathogenic, microbiological and therapeutic aspects of this disease entity . Similarly, we underscore the significant drop in mortality with the availability of antibiotics.

Am J Otolaryngol, 1993 May-Jun, 14(3), 155 - 67
Infectious granulomatous diseases of the head and neck; Emmanuelli JL; Infectious granulomatous diseases of the head and neck are very important entities that can mimic or hide malignant tumors and a wide variety of diseases . The frequency of these diseases is increasing with the wider use of immunosuppressive drugs and the increasing incidence of AIDS . The diagnosis is simple, and does not require sophisticated diagnostic procedures, but a high index of suspicion is necessary . Although other studies are helpful to suggest the diagnosis or define the extent of the disease, the microbiological and histopathological analyses are the most specific studies for the diagnosis . The therapy is usually combined: medical and surgical . The medical therapy involves treatment for a long period of time, usually between 3 and 6 months . The follow-up should be kept for at least 3 years . The tendency of some of these diseases to relapse makes the therapy discouraging, and some patients will need multiple therapies throughout their life . An accurate diagnosis and specific therapy for adequate amount of time is the best way to achieve a complete cure or at least a better chance for a good prognosis.

J Antimicrob Chemother, 1993 May, 31 Suppl D, 97 - 102
Experimental models in the investigation of device-related infections; Zimmerli W; There has been an increasing concern with the problem of device-related infections, ever since foreign materials such as metal or plastic began to be used in implant surgery . The prophylaxis and treatment of such infections is difficult to evaluate in clinical studies, because placebo-controlled prophylaxis trials are thought to be unethical, and no single centre has enough patients for comparative treatment studies . For this reason different experimental models have been developed to study aspects of device-related infections . In this review, these infection models are presented . Different applications of the tissue-cage guinea pig model are summarized . This model allows the study of pathogenesis, natural course, prophylaxis, and treatment of device-related infection . In addition, by using this infection model, novel microbiological in-vitro tests could be developed, and questions of biocompatibility analysed.

Nutr Hosp, 1993 May-Jun, 8(5), 306 - 10
{Microbiological control in parenteral nutrition mixtures . Indices of contamination}; Gines Rubio F et al.; Potential contamination of nutritional mixtures during preparation in the Pharmacy Services has led to the need for microbiological controls . In our study, we set out the techniques used in the Son Dureta Hospital between 1986 and 1991 . During those six years 11,023 nutritional mixtures were prepared, and 1,714 bacteriological controls were carried out, representing 15.5% of the total . Between January 1986 and June 1989, the simple culture technique was used (culture of 10 ml of the prepared mixture) . The contamination rate was 1.27% . Between July 1989 and December 1991, the double sample technique was applied, involving a culture of 10 ml of the mixture, keeping a further 10 ml for subsequent verification culture . With this technique, the contamination rate was fixed at 0.34% . The advantages and drawbacks of the techniques used are described, along with the problem of initial false positives, and a review is made of the 39 germs isolated during the period of study.

Chirurg, 1993 May, 64(5), 400 - 5
{Microbiological and economic studies of abbreviated procedures for surgical hand disinfection}; Kappstein I et al.; An investigation was performed of whether shortened procedures for surgical hand disinfection (2 and 3 min, respectively) are equally effective as the usual German standard procedure of 5 min duration and, in addition, which saving of working time and costs would be achievable if shorter procedures were employed . The shortened procedures were: 1) 3 min alcoholic disinfectant (1 min prior handwashing) and 2) 1 min chlorhexidine detergent (Hibiscrub), 2 min 0.5% chlorhexidine in 70% isopropanol (Hibisol) . The two shortened procedures were equally effective as the standard procedure (test of equivalence, p < 0.05) . The savings of working time and costs calculated for 17708 operations were 1) 2360 h or 79768 German marks and 2) 3540 h or 119652 German marks, respectively.

Kinderarztl Prax, 1993 May, 61(3), 90 - 6
{Treatment of ocular toxoplasmosis . Part 1: Basic principles and diagnosis}; Mittelviefhaus H; Ocular toxoplasmosis is a frequent cause of ocular inflammation which threatens central visual acuity . New concepts of treatment are important alternatives for the well known therapy with pyrimethamine and sulphadiazine . They cause less side effects and result in better compliance . Up to know prospective randomized trials are still missing although they might prove the value of medical treatment in ocular toxoplasmosis . Nevertheless it is generally accepted that ocular toxoplasmosis should be treated when central visual function is threatened . Treatment strategy is influenced by general symptoms, especially in children and immunocompromised patients . In this paper opportunities for treatment are discussed . Relevant microbiological, immunological and epidemiological fundamentals are mentioned as well as serological tests.

J Nat Prod, 1993 May, 56(5), 755 - 61
Microbial transformation of L-696,474, a novel cytochalasin as an inhibitor of HIV-1 protease; Chen TS et al.; The microbiological transformation of L-696,474 {1}, a novel cytochalasin that is an inhibitor of HIV-1 protease, was investigated using Actinoplanes sp . ATCC 53771 . Six hydroxylated metabolites 2-7 of 1 were isolated and purified using reversed-phase hplc . All six metabolites were found to have undergone hydroxylation at the C-16 methyl group (C-22) of 1 . Three of the compounds, 3, 4, and 5, were further hydroxylated at the para (C-29), the meta (C-28), and both the para and the meta, positions of the phenyl ring, respectively . Metabolites 6 and 7 were shown to result from vicinal dihydroxylation on both C-16 and its attached Me (C-22) . The metabolite 7 was further hydroxylated on the meta position of the phenyl ring . The structures of the metabolites were established using spectroscopic techniques including ms, 1H nmr, 13C nmr, and various 2D nmr spectroscopy experiments.

Analyst, 1993 May, 118(5), 481 - 8
Intercomparison of methods for the determination of vitamins in foods . Part 2 . Water-soluble vitamins; Hollman PC et al.; An intercomparison of methods involving 18 European laboratories was organized to assess the state-of-the-art of vitamin determination in foods . Each laboratory received identical samples of dry food reference material (homogeneous powders, milk powder, pork muscle and haricot vert beans), which have recently been certified for major dietary components and elements . Each laboratory was requested to perform the analyses by its own routine methods . The results for water-soluble vitamins are reported . The reproducibility for the determination of vitamin B1 in milk powder, pork muscle and haricot vert beans with high-performance liquid chromatography (HPLC), fluorimetric and microbiological methods was good, with the relative standard deviation of reproducibility (RSDReprod) ranging from 11 to 18% . Differences between laboratories for the determination of the vitamin B2 content of milk powder, pork muscle and haricot vert beans determined using HPLC and microbiological methods were very high, with RSDReprod ranging from 28 to 74% . The extraction and hydrolysis procedures were probably the most important sources of variation . For vitamin B6 various HPLC and microbiological methods were used . The variation in the results for vitamin B6 was high, except in milk powder . The RSDReprod ranged from 18 to 51% . A major part of this variability was due to differences in the extraction and hydrolysis procedures and problems with the identification of the vitamin B6 vitamers by HPLC . Variation in the results for niacin obtained with the microbiological methods in milk powder, pork muscle and haricot vert beans, was small; RSDReprod = 9-15%.(ABSTRACT TRUNCATED AT 250 WORDS)

J AOAC Int, 1993 May-Jun, 76(3), 674 - 81
Microbiological screening method for indication of irradiation of spices and herbs: a BCR collaborative study; Wirtanen G et al.; A BCR1 collaborative study was conducted with a microbiological screening method based on the combined use of the direct epifluorescent filter technique (DEFT) and the conventional aerobic plate count method (APC) for detection of irradiation of spices and herbs . Collaborative samples of whole allspice, whole and powdered black peppers, whole white pepper, paprika powder, cut basil, cut marjoram, and crushed cardamom irradiated with doses of 0, 5, and 10 kGy were analyzed by 8 laboratories . The total number of the collaborative samples, with arbitrarily labeled codes, was 192 . The percentage of acceptable results was 95.5% . The identification of irradiated from nonirradiated spices and herbs was analyzed statistically by using explorative techniques . The average values of the differences between DEFT and APC in samples irradiated with doses of 5 and 10 kGy were 5.1 and 6.1 logarithmic units, respectively . The differences between DEFT and APC generally increased to at least 3.5 logarithmic units, whereas the difference in the case of unirradiated spices was insignificant . However, conclusive evidence of irradiation relies on the knowledge that the sample was not fumigated or heat treated . The reproducibility relative standard deviations for the differences were 12.3, 19.9, and 20.7% with the doses of 10 and 5 kGy and for unirradiated samples, respectively, indicating acceptable variabilities among laboratories.

Lik Sprava, 1993 May-Jun, (5-6), 52 - 4
{Hygienic study of an activated fibrous charcoal material as a sorbing filtering element for drinking water afterpurification}; Prokopov VA et al.; The results of complex toxicological and hygienic study showed that the quality of pipe water filtered through the activated carbonic fibrous material (ACFM) "Dnepr-F" forming a part of absorptive filtering element improved markedly . The content of organic substances decreased drastically as well as that of nitrates and iron . Microbiological indices did not suffer appreciable changes and were within permissible limits . The water filtered through the absorptive element with ACFM had no adverse influence on the organisms of warm-blooded animals . Proceeding from foregoing one can conclude that the "Dnepr-F" may be recommended as a part of absorptive filtering element for the final refinement of drinking water.

Support Care Cancer, 1993 May, 1(3), 139 - 44
Oral acyclovir as prophylaxis for bacterial infections during induction therapy for acute leukaemia in adults . The Leukemia Group of Middle Sweden; Lonnqvist B et al.; We prospectively tested the hypothesis that prevention of herpes simplex virus infection with acyclovir might also reduce the incidence of bacterial infections in adult patients with acute leukaemia . During the first induction therapy a double-blind, randomized and placebo-controlled study was undertaken . Fifty-two patients were treated with 200 mg acyclovir orally four times daily throughout the induction period, whereas 55 patients received placebo . The groups were comparable with regard to age, cytotoxic chemotherapy and duration of neutropenia . Bacteraemias were significantly fewer in the acyclovir group (20 versus 41 episodes; P = 0.007) . The number of isolated microorganisms causing bacterial or fungal infections was also lower during acyclovir prophylaxis (52 isolates, versus 93 isolates; P = 0.02) . There was no significant difference between the groups with regard to the number of clinically documented infections or fevers of unknown origin . Herpes simplex virus isolations occurred only in the placebo group (P = 0.001) . Thus, oral acyclovir prophylaxis was associated with reductions of all microbiologically documented infections suggesting that prevention of herpes simplex virus reactivation in acute leukaemia patients may reduce the occurrence of other infections.

J Hosp Infect, 1993 May, 24(1), 1 - 9
Monitoring of hospital water supplies for Legionella; Liu WK et al.; In order to determine the value of regular surveillance for Legionella in the prevention of hospital-acquired (nosocomial) legionellosis, water samples were obtained over a three-year period from 17 hospitals located in England and Scotland . Prior to the study, all of the hospitals had in operation defined protocols and maintenance schedules which followed national guidelines for the prevention of legionellosis in health care premises . Six samples, from key locations in the water system of each hospital, were taken at six-monthly intervals . Total viable bacterial count (TVC), coliform count and legionella cultures were performed on all the samples . No coliforms were detected in any of the samples, whereas the TVC was variable . Legionella pneumophila was isolated from both the hot and cold water supplies of two hospitals . The TVC was not related to the isolation of Legionella . Confirmation of the presence of Legionella was subsequently attributed to defects in the equipment and water maintenance programmes . It was concluded that the microbiological examination of water is an effective approach to the audit of the maintenance of hospital water systems in order to prevent legionellosis.

Br Dent J, 1993 Apr 10, 174(7), 245 - 8
The use of a caries detector dye during cavity preparation: a microbiological assessment; Kidd EA et al.; During cavity preparation conventional tactile and optical criteria are used to assess the caries status of the enamel-dentine junction, cavity preparation being considered complete when this area is hard to a sharp probe and stain free . In the present study 201 cavities were prepared under rubber dam . When caries removal was considered complete using the conventional tactile and optical criteria, a caries detector dye (1% acid red in propylene glycol), which is claimed to stain 'infected' tissue red, was applied . Fifty-two per cent of cavities showed caries dye stain in some part of the enamel-dentine junction . Subsequent microbiological sampling of dye-stained and dye-unstained sites resulted in the recovery of low numbers of bacteria and revealed no difference in the level of infection of the two sites . It is concluded that the conventional tactile and optical criteria are satisfactory assessments of the caries status of tissue during cavity preparation and that subsequent use of a caries detector dye on hard and stain-free dentine will result in unnecessary tissue removal.

Med J Aust, 1993 Apr 5, 158(7), 450 - 3
Homosexually acquired gonorrhoea in Victoria, 1983-1991; Sherrard J et al.; OBJECTIVE: To identify trends in the rate of gonorrhoea, particularly homosexually acquired infection . DESIGN: A retrospective descriptive study of records stored in a relational database . Records contain epidemiological, demographic and microbiological data of laboratory confirmed cases of gonorrhoea . SUBJECTS: Individuals with gonorrhoea diagnosed microbiologically in Victoria and from whom isolates were subsequently forwarded to the Microbiological Diagnostic Unit, University of Melbourne, for further bacteriological work for the years 1983-1991 . RESULTS: Overall, gonorrhoea is declining in Victoria in the general population but has risen sharply in recent years in homosexually active men . An increased number of cases of rectal gonorrhoea in men has also been noted . An age cohort effect in homosexually active men is only evident for the final year of the study . These men do not tend to acquire gonorrhoea abroad and beta-lactamase producing gonococci are rarely found in this group . CONCLUSIONS: Gonorrhoea in homosexually active men has increased disproportionately to the rate of infection in heterosexual men in recent years, despite intensive education and counselling aimed at the gay community . Implications for risk of acquisition of other sexually transmitted diseases, including the human immunodeficiency virus, are evident.

J Chemother, 1993 Apr, 5(2), 113 - 8
Piperacillin versus cefotetan as single-dose prophylaxis in abdominal hysterectomy: a prospective, randomized, multicenter study; de Lalla F et al.; Five hundred and sixty-six women, consecutively admitted to nine different hospitals for elective abdominal hysterectomy, were randomized to receive a single 2 g i.v . dose of either cefotetan or piperacillin at induction of anesthesia . Five patients were excluded and 561 (287 given cefotetan and 274 given piperacillin) could be evaluated . In 10 patients (5 for each drug) the concentrations of either cefotetan or piperacillin in serum and subcutaneous tissue at the beginning and at the end of surgery and in uterus, salpinx and ovary samples, were microbiologically assessed . No significant differences could be found between cefotetan and piperacillin groups for any of the considered infectious complications (bacteremia, wound or vaginal cuff infection, pelvic cellulitis and febrile morbidity) nor for the pooled data (cefotetan group: 4.9%, piperacillin group: 5.8%, p:NS) . As for the concentrations of prophylactic drugs, serum levels throughout surgery were found to be adequate.

Eur J Clin Microbiol Infect Dis, 1993 Apr, 12(4), 280 - 2
Endocarditis caused by a Leptotrichia buccalis-like bacterium in a patient with a prosthetic aortic valve; Hammann R et al.; The isolation of a Leptotrichia buccalis-like bacterium from the blood of a patient with endocarditis associated with a prosthetic aortic valve is reported . The organism was isolated from different blood cultures . It was similar but not completely identical to Leptotrichia buccalis . The microbiological identification was confirmed independently by three laboratories, including two reference institutions . The case and the characteristics of the microorganism are reported.

Minerva Med, 1993 Apr, 84(4), 199 - 201
{Decisive scintigraphic diagnosis in a case of Borrelia infective sacro-iliitis}; Giovanella LC et al.; The authors describe one case of infections sacro-iliitis caused by Borrelia, where the diagnostic procedures by conventional radiology, computerized tomography and nuclear magnetic resonance imaging have not permitted the localization and the assessment of joint inflammatory disease . The bone "theree phases" scintiscan by 99m Technectium-methylene diphosphonate (99mTC-MDP) has made it possible to localize on left sacro-iliac synchondrosis a modification of radioactivity, due to inflammations . Next microbiological studies gave a positive result for borrelia . The authors finish by underlying the importance of the nuclear medicine methods in the screening of infective osteo-arthritis.

J Appl Bacteriol, 1993 Apr, 74(4), 497 - 502
External quality assessment in water microbiology: statistical analysis of performance; Tillett HE et al.; A UK-based scheme of water microbiology assessment requires participants to record counts of relevant organisms . Not every sample will contain the target number of organisms because of natural variation and therefore a range of results is acceptable . Results which are tail-end (i.e . at the extreme low or high end of this range) could occasionally be reported by any individual laboratory by chance . Several tail-end results might imply a laboratory problem . Statistical assessment is done in two stages . A non-parametric test of the distribution of tail-end counts amongst laboratories is performed (Cochran's Q) and, if they are not random, then observed and expected frequencies of tail-end counts are compared to identify participants who may have reported excessive numbers of low or high results . Analyses so far have shown that laboratories find high counts no more frequently than would be expected by chance, but that significant clusters of low counts can be detected among participants . These findings have been observed both in short-term and in long-term assessments, thus allowing detection of new episodes of poor performance and intermittent problems . The analysis relies on an objective definition of tail-end results . Working definitions are presented which should identify poor performance in terms of microbiological significance, and which allow fair comparison between membrane-filtration and multiple-tube techniques . Smaller differences between laboratories, which may be statistically significant, will not be detected . Different definitions of poor performance could be incorporated into future assessments.

J Clin Microbiol, 1993 Apr, 31(4), 776 - 82
Progress toward a simplified polymerase chain reaction and its application to diagnosis of tuberculosis; Wilson SM et al.; The complexity, expense, and susceptibility to contamination of the polymerase chain reaction (PCR) are all issues which need to be overcome if PCR is to be used outside of research laboratories . We addressed these problems with respect to the diagnosis of tuberculosis . First, we simplified the procedure for extracting Mycobacterium tuberculosis DNA from sputum samples . Two methods of sample preparation were compared: the chaotrope-silica method and a novel, more simple chloroform method . Second, we developed a colorimetric method for product detection . This method was as sensitive and specific as agarose gel electrophoresis for detection of PCR product . By using a one-tube nested protocol, 5 to 50 genome equivalents of M . tuberculosis DNA were detected . The simplified colorimetric PCR was compared with microscopy and culture for detection of M . tuberculosis in clinical specimens of sputum . A total of 171 sputum samples were investigated from 108 patients, 12 of whom were subsequently found to have tuberculosis by culture and/or microscopy . PCR of samples prepared by the chaotrope-silica method had a sensitivity of 75% and a specificity of 100% whereas PCR of samples prepared by the chloroform method had a sensitivity of 92% and a specificity of 99% when compared with the sensitivities and specificities of the combined classical microbiological methods for the diagnosis of tuberculosis . The simplified colorimetric PCR in combination with the chloroform sample preparation method was at least as sensitive as microscopy but had a greater specificity because samples with atypical mycobacteria were not detected by PCR . The sensitivity of the method for detection of smear-negative and extrapulmonary tuberculosis remains to be investigated.

Microbiologia, 1993 Apr, 9(1), 1 - 13
Modern microbiological methods for foods: colony count and direct count methods . A review; Garcia-Armesto MR et al.; Over the last years methods for enumeration of microorganisms in foods are changing rapidly . Techniques based on totally new concepts as well as instruments and miniaturized systems that allow the automation and simplification of existing microbiological procedures have been developed . These rapid methodologies should satisfy the increasing requirements for effective quality assurance of foods . In the present paper we review some of the more interesting methods based on colony count or direct bacterial count.

Eur J Ophthalmol, 1993 Apr-Jun, 3(2), 77 - 82
Evaluation of efficacy and safety of ciprofloxacin ophthalmic solution versus chloramphenicol; Power WJ et al.; The results of this clinical study demonstrate that ciprofloxacin ophthalmic solution 0.3% is as safe and as effective as 0.5% chloramphenicol ophthalmic solution in the treatment of conjunctivitis and blepharitis of bacterial aetiology . Both agents achieved microbiological improvement rates in excess of 90% after 1 week's treatment . On ciprofloxacin 93.5% of patients were judged clinically cured or improved versus 84.6% on chloramphenicol after 1 week . There were no serious adverse affects . One patient in each group suffered drug-related side-effects (chemosis, erythema) which resolved on discontinuation or changing of therapy . Cirpofloxacin is not associated with the rare, but serious, side effect of aplastic anaemia which is associated with chloramphenicol use . On the evidence of this study ciprofloxacin would appear to be an appropriate agent for general use as a topical ophthalmic formulation.

Acta Paediatr, 1993 Apr, 82(4), 360 - 3
Comparison of radiological findings and microbial aetiology of childhood pneumonia; Korppi M et al.; Sixty-one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia . The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n = 27) or interstitial (n = 34) pneumonia at both evaluations were included in the present analysis . In addition, all patients had viral (n = 20), mixed viral-bacterial (n = 21) or bacterial (n = 20) infections diagnosed by viral or bacterial antibody or antigen assays . Viral infection alone was seen in 7 (26%), mixed viral-bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia . The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia . C-reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia . Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral-bacterial infection . Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia . We conclude that patients with alveolar pneumonia should be treated with antibiotics . In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible . In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings.

J Comp Pathol, 1993 Apr, 108(3), 311 - 6
Enzootic Mycobacterium avium infection in captive Parma wallabies (Macropus parma) with unusual spinal cord manifestations; Schoon HA et al.; Pathological, microbiological and clinical findings in Parma wallabies (Macropus parma) with an enzootic infection caused by Mycobacterium avium are described . Disorders of locomotion resulted from granulomatous myelitis, meningitis and radiculitis in the lumbosacral spinal cord . Lesions found in a number of internal organs suggested protracted systemic infection due to an alimentary or airborne infection with Mycobacterium avium . This organism was isolated and identified by methods that included microbiological examinations, based on microscopy, culture, in-vitro tests, animal inoculation, polymerase chain reaction and cycle sequencing.

Wiad Lek, 1993 Apr, 46(7-8), 271 - 3
{Incidence of Helicobacter pylori infections in patients with duodenogastric reflux}; Poniewierka E et al.; The purpose of the work was a comparison of the incidence of Helicobacter pylori (HP) infections in persons with dyspeptic symptoms of non-ulcer dyspepsia (NUD) character in relation to the presence or absence of duodenogastric reflux (DGR) . The study included 80 patients aged from 17 to 80 years, 21 males and 59 females . In all studied patients endoscopy of upper digestive tract segment was performed with biopsy specimen taking for microbiological investigations . From each patient two biopsy specimens were taken from the prepyloric part and the fundus . The specimens were subjected to a microbiological analysis using the rapid urease test, culturing, and direct preparation . The presence of duodenogastric reflux was evaluated during endoscopy . In persons with diagnosed NUD and duodenogastric reflux, lower incidence of HP infections was found than in patients with the same diagnosis but without the reflux.

J Hosp Infect, 1993 Apr, 23(4), 305 - 14
Improvements in the microbiological quality of food samples from a hospital cook-chill system since the introduction of HACCP; Shanaghy N et al.; A cook-chill system of catering was introduced in Waterford Regional Hospital in December 1989 . An intensive system of microbiological monitoring was put in place from day one and after 16 months a Hazard Analysis Critical Control Point (HACCP) system was introduced . Continuous monitoring showed an improvement in the microbiological quality of the food when using HACCP, with more than 90% of samples having total viable counts of less than 1 x 10(3) g-1 and the virtual elimination of pathogens . The introduction of HACCP allowed a reduction in the level of sampling and provided a useful set of records for quality assurance.

Commun Dis Rep CDR Rev, 1993 Mar 26, 3(4), R51 - 6
Microbiological aspects of Helicobacter pylori infection; Owen RJ; Helicobacter pylori colonises the human gastroduodenal mucosa, causes chronic active gastritis, is a co-factor for the development of duodenal ulceration, and is associated with gastric ulceration and gastric cancer . As there are no readily available typing schemes for identification of individual isolates, little is known about the acquisition, distribution and frequency of particular strains of H . pylori in different populations, communities and families . Molecular (DNA) typing studies carried out over the last three years on isolates from the United Kingdom and other countries at the National Collection of Type Cultures (NCTC) show considerable diversity in strains from different individuals, yet multiple isolates from different gastroduodenal sites in an individual are usually identical . Major routes of infection have not been established, but similarities of DNA sequence between isolates from some family members, and the serological data, indicate that some H . pylori infections are acquired in households during childhood . Molecular typing will have an important role in future studies on transmission.

Fortschr Med, 1993 Mar 20, 111(8), 134 - 8
{Characteristics of antibiotic therapy in the elderly}; Werner H et al.; In the elderly, the morbidity and mortality rates of infections are significantly increased . Atypical or nonspecific symptoms or their absence often delay the diagnosis . When providing treatment, in addition to microbiological specifics of infections in the aged, consideration must also be given to pharmacokinetic aspects when choosing a suitable antibiotic . Furthermore, any existing medication must be taken into account in order to avoid interactions and undesirable drug effects . In view of the elevated mortality and multimorbidity rates, the early use of antibiotics is of considerable importance . If no specific etiological diagnosis is available, a broad-spectrum antibiotic should be administered.

Med J Aust, 1993 Mar 15, 158(6), 375 - 8
Booster doses of hepatitis B vaccine: responses to low-dose inoculations; Thompson SC et al.; OBJECTIVE: To examine the anamnestic response to hepatitis B vaccine in previously vaccinated subjects . DESIGN: Subjects who had received a course of hepatitis B vaccine at least two years previously had a sample of blood taken before and seven days after a low-dose booster of hepatitis B vaccine . SETTING AND PARTICIPANTS: A pilot group of laboratory scientists in the Microbiological Diagnostic Unit; fifth year medical students, University of Melbourne; and a group of ambulance officers from the Geelong Ambulance Depot (Victoria) . All participants volunteered after having been informed of the study . OUTCOME MEASURES: Serum levels of antibody to hepatitis B surface antigen (HBsAg) were measured before and after the booster dose of vaccine and, when available, in serum taken a month after the end of the primary course of vaccine, and the changes in antibody level were studied . RESULTS: Although some individuals with a restricted antibody response were identified, most showed a quick response . There was limited evidence that this rise peaked early and began to fall within weeks . CONCLUSIONS: In many subjects, levels of antibody to HBsAg peak early after booster doses of vaccine but the rapid anamnestic response to small amounts of antigen make it probable that effective protection from symptomatic illness may be long lasting, when there has been a satisfactory primary response . This provides an argument for testing for adequate seroconversion after vaccination.

J Parenter Sci Technol, 1993 Mar-Apr, 47(2), 60 - 9
Interaction between air movements and the dispersion of contaminants: clean zones with unidirectional air flow; Ljungqvist B et al.; The purpose of this presentation is to describe the theoretical relations for the dispersal of airborne contaminants and to illustrate the validity of these equations occurring during factual situations, where a number of observations on air movements in open unidirectional air flow units supplied with HEPA-filters are described . In factual situations the aerodynamic system which governs the dispersion of contaminants in reality is always very complicated that risk situations must be mapped and assessed empirically . The presence of a person can give risk to wakes that may be stable or unstable . The unstable situations are in most cases caused by the influence of arms and hands . As part of the microbiological assessment of aseptic processes carried out in clean zones, it is important to investigate that such vortices do not occur in the clean working areas . As the level of airborne contaminants in the operational environment may have an effect on the level of product contamination, the microbiological assessment of aseptic processes is important . A system is described for microbiological assessment in unidirectional air flow units by using visual illustrative methods and particle challenge tests (measured by particle counter) for the dispersion and/or induction of particles.

Eur J Clin Microbiol Infect Dis, 1993 Mar, 12(3), 211 - 5
Cefotiam concentrations in the sinus fluid of patients with chronic sinusitis after administration of cefotiam hexetil; Cherrier P et al.; Cefotiam hexetil is a prodrug of cefotiam . The concentrations of cefotiam in plasma and sinus secretions were determined in 18 patients (10 males, 8 females, aged 39.3 +/- 13.0 years) with chronic sinusitis . All patients received two 200 mg oral doses of cefotiam hexetil 12 h apart and were divided into four groups according to the time which elapsed between the last dose and collection of secretion samples . The last dose was given 2 h (group I), 3 h (group II), 4 h (group III) or 6 h (group IV) before sinus puncture . Cefotiam concentrations were measured by high-pressure liquid chromatography and microbiological assay, results being very similar with both methods . Mean concentrations of cefotiam with the standard deviation in sinus exudates were 1.04 +/- 0.60 mg/l at 2 h (n = 6), 1.04 +/- 0.33 mg/l at 3 h (n = 4), 0.75 +/- 0.74 mg/l at 4 h (n = 4) and < 0.10 mg/l at 6 h (n = 4) . Mean sinus fluid concentrations were higher than mean plasma concentrations in all groups . These results suggest that cefotiam concentrations higher than the MICs for common pathogens are found in sinus secretions up to 4 h after oral administration of cefotiam hexetil.

Indian J Cancer, 1993 Mar, 30(1), 1 - 4
Actinomycosis mimicking carcinoma of the maxillary sinus; Pradhan S et al.; Human actinomycosis may pose a diagnostic problem at times and is often mistaken for a neoplasm . A thirty-five year old male was clinically diagnosed as a case of carcinoma of the right maxillary sinus on the basis of history, clinical presentation and radiologic findings . Tissue biopsy was negative for malignancy on three consecutive occasions . Microscopic examination showed bits of granulation tissue and fragments of filamentous structures . On microbiological examination, Actinomyces israelii was isolated and fungus culture was negative . Long term Penicillin treatment caused disappearance of all signs and symptoms . The report highlights the importance of bearing in mind the fact that certain rare, chronic, suppurative granulomatous infections, like actinomycosis, may mimic malignancy.

Cesk Epidemiol Mikrobiol Imunol, 1993 Mar, 42(1), 42 - 6
{Infectious diseases yesterday and today}; Bakoss P et al.; The authors present examples demonstrating that in the last decades we witnessed the discovery of new nosological units and their infectious agents, the detection of the infectious origin of "old" diseases the aetiology of which was still recently obscure, infectious attacks of people by diseases which were considered animal infectious only, as well as the more frequent incidence of opportune infections due to impairment of the immune state of the human organism . These changes have many reasons such as the development of properties of microorganisms, lifestyle changes of the human population, advances in medicine, and last but not least improving microbiological diagnosis . Attention is drawn to the fact that even in a time when so-called diseases of civilization are in the foreground of interest our awareness of infectious diseases must not slacken . Only all-round international surveillance can prove successful.

J AOAC Int, 1993 Mar-Apr, 76(2), 430 - 6
Incidence of fungi in shared-use cosmetics available to the public; Mislivec PB et al.; A survey was conducted to assess both the potential health risk from shared-use cosmetics caused by microorganisms and the microbial efficacy of preservatives in cosmetics . Samples of 3027 shared-use cosmetic products were collected from 171 retail establishments nationwide . Fungi were present in 10.4% of the products, and 3.9% contained fungal pathogens or opportunistic pathogens . The 423 fungal isolates identified represented 33 genera and at least 69 species . A disproportionately large share of the fungal isolates were from eye products; fewer were from lip products . Pathogenic or opportunistic pathogens made up 32.2% of the fungal isolates . A slightly lower percentage of samples that contained preservatives had fungi, a fact suggesting that preservatives reduce the incidence of fungi in cosmetics . Results of this survey indicate potential microbiological problems concerning the safety of shared-use cosmetics.

J AOAC Int, 1993 Mar-Apr, 76(2), 414 - 7
Comparison of liquid chromatographic method to AOAC microbiological method for determination of L-tryptophan in tablets and capsules; Kim HS et al.; A reversed-phase liquid chromatographic (LC) method coupled with precolumn derivatization of L-tryptophan with phenylisothiocyanate was compared to the AOAC microbiological method for determining L-tryptophan in tablets and capsules . For the microbiological method, the concentrations of L-tryptophan were 4-8% lower in autoclaved test samples (hot method) than in test samples that were not autoclaved (cold method) . When L-tryptophan values obtained by the LC method were compared to those obtained by the cold microbiological method, no significant differences were observed (P > 0.05) . The mean relative standard deviations were 2.9% for the LC method and 1.6% for the cold microbiological method . The mean recoveries of standard L-tryptophan added before analysis were 99% for the LC method and 101% for the cold microbiological method . These results demonstrate that both methods are reliable for determining free L-tryptophan contained in tablets and capsules . However, the LC method has the advantages of using a smaller test portion and having a shorter analysis time.

J AOAC Int, 1993 Mar-Apr, 76(2), 399 - 413
Analysis of milk-based infant formula . Phase V . Vitamins A and E, folic acid, and pantothenic acid: Food and Drug Administration-Infant Formula Council: collaborative study; Tanner JT et al.; In 1982, the U.S . Food and Drug Administration, the Infant Formula Council and its member companies, contract laboratories, and other government laboratories began a study of analytical methods for the nutrients listed in the Infant Formula Act of 1980 (P.L . 96-359) . Four phases of the study have been completed and are discussed in earlier reports . The present report provides data on Phase V, in which 13 laboratories collaboratively studied individual methods for folic acid, pantothenic acid, and vitamin E, in addition to 2 methods for vitamin A . Vitamins A and E are determined by liquid chromatography . Folic acid and pantothenic acid are determined by microbiological methods using acidimetric and/or turbidimetric assays as the determinative step . In most cases, relative standard deviations for repeatability, RSDr, and reproducibility, RSDR, are as good as those that would be predicted from other collaborative studies . RSDr and RSDR values obtained for the 5 methods are 9.35 and 25.44% for folic acid, 4.59 and 10.23% for pantothenic acid, 8.46 and 11.69% for vitamin E, 3.62 and 9.72% for vitamin A (retinol isomers), and 4.9 and 10.5% for vitamin A (retinol) . The 5 methods have been adopted first action by AOAC International.

J AOAC Int, 1993 Mar-Apr, 76(2), 390 - 3
Liquid chromatographic analysis of niacin in fortified food products; Chase GW Jr et al.; An ion exchange liquid chromatographic (LC) method using an anion exchange resin column was developed for the determination of niacin in fortified foods . Samples were extracted by autoclaving with H2SO4 (1 + 1) . Florisil open column chromatography was used to remove interferences from the sample extracts . Niacin levels were quantitated by an LC system using a 250 x 4.1 mm Hamilton PRP-X100 column, a mobile phase of 2% glacial acetic acid in water, and UV detection at 254 nm . The limit of detection was 0.11 micrograms niacin/mL, and the standard curve was linear from 0.24 to 0.80 micrograms niacin/mL . The system reproducibility was evaluated by completing 10 repetitive analyses on an infant formula and a macaroni product, which gave an average CV of 2.7% . Mean recovery (+/- standard deviation) was 99.8 +/- 7.7 (n = 15) . The results compared favorably with those by the AOAC microbiological method.

J AOAC Int, 1993 Mar-Apr, 76(2), 297 - 305
Automated technique for sampling milk from farm bulk tanks: collaborative study; Packard VS et al.; An automated, in-line, mechanical technique for sampling milk from farm bulk tanks was evaluated in a collaborative study . The automated sampling device, which is mounted on the milk intake line, contains an electronically controlled peristaltic pump . The device takes a representative sample of the entire volume pumped through the system . Samples taken can be analyzed for both composition and microbiological quality . The study was performed in 3 phases . In the first 2 phases, samples taken by manual and automated methods were compared in analyses for somatic cell count, antibiotics, fat, protein, lactose, and solids-not-fat . The third phase, using a modified procedure, was designed to compare sampling methods in analyses for total bacteria count (standard plate count), psychrotrophic bacteria count, and coliform count . Evaluation of the data by a nested ANOVA indicated no difference between results for samples taken by the automated and manual methods (P = 0.05) in Phases 1 and 2, irrespective of whether the bulk milk was agitated before sampling . By introducing a sanitizing step between farms in Phase 3, the automated method also provided samples comparable with those taken manually for microbial analyses . The automated method has been adopted first action by AOAC International.

Anal Biochem, 1993 Mar, 209(2), 318 - 22
Evidence for telluroamino acid in biological materials and some rules of assimilation of inorganic tellurium by yeast; Yu L et al.; A natural substance, telluroamino acid, was discovered in tellurium yeast by GC and GC/MS . This substance was obtained for the first time by means of the assimilation of inorganic tellurium by yeast, having 600 ppm of total Te and 150 ppm of telluroamino acid . Some rules for such an assimilation were found: the content of total Te and telluroamino acid in tellurium-yeast is closely related to the kind of culture media used and is proportional to the concentration of Te in culture media . This discovery is of theoretical and practical significance, especially for the production by a simpler microbiological synthesis of rare and expensive organic tellurium compounds which hopefully will prove to be anticarcinogens like the selenium-yeast, and for explaining the biochemical effect of tellurium on the human body.

J Dairy Sci, 1993 Mar, 76(3), 898 - 902
Strategies of mold control in dairy feeds; Nelson CE; Mold growth can occur in dairy feeds only when nutrients are available, correct temperatures exist, oxygen is present, and unbound water is available . Because elimination of any one of these four factors prevents mold growth, management of feed that accounts for these elements is essential . Use of multiple ingredient mold inhibitors recently has become another tool for affecting successful microbiological control of feed.

Rofo, 1993 Mar, 158(3), 197 - 200
{Radio-opaque structures in the lumen of the maxillary sinus--value of computerized tomography in the diagnosis of maxillary aspergillosis}; Krennmair G et al.; 11 patients with radio-opaque concrements in the sinus maxillaris underwent a preoperative computerized tomographic examination of the sinus maxillaris and the sinus concrements . 8 patients (72.7%) with the occurrence of radio-opaque concrements presented postoperative a histological and microbiological infection with aspergillus fumigatus . The CT-numbers of radio-opaque concrements in patients with aspergillus were 2802 +/- 302.4 HU (Hounsfield Unit) . Concrements of patients without aspergillus infection (n = 3) had lower density (368.6 +/- 149.1 HU; p < 0.001) . The root filling materials showed nearly the same CT-numbers in patients with aspergillus infection (2537 +/- 398.5 HU) and in patients without aspergillus infections (2544.3 +/- 460.6 HU) . Density of root filling material was at the same level as density of radiopaque concrements in patients with aspergillus infections . According to CT-examinations a direct connection between root filling materials and aspergillus infection was noted . Therefore in patients with radio-opaque concrements computerized tomographic examination helps to determine the kind of sinus infection.

Infection, 1993 Mar-Apr, 21(2), 83 - 8
Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiological findings; Strle F et al.; The effectiveness of azithromycin and doxycycline in the treatment of erythema migrans was compared in a prospective randomized trial . One hundred seven adult patients with typical erythema migrans, examined in the Lyme Borreliosis Outpatients' Clinic, University Department of Infectious Diseases in Ljubljana, were included in the study . Fifty-five patients received azithromycin (500 mg twice daily for the first day, followed by 500 mg once daily for four days) and 52 patients received doxycycline (100 mg twice daily for 14 days) . The mean duration of skin lesions after the beginning of treatment was 7.5 +/- 5.9 days (median value 5, range 2-28 days) in the azithromycin group and 11.4 +/- 7.8 days (median value 9, range 2 days--8 weeks) in the doxycycline group (p < 0.05) . Borrelia burgdorferi was isolated from erythema migrans in 28 patients before therapy: in 13 out of 52 in the doxycycline group and in 15 out of 55 in the azithromycin group . Three months after therapy, the culture was positive in four out of 13 patients treated with doxycycline and in one of the 15 patients who received azithromycin . A biopsy was repeated in all the patients with a positive isolation from the first skin specimen . During the first 12 months' follow-up, three patients treated with doxycycline but none in the azithromycin group developed major manifestations of Lyme borreliosis, while 15 doxycycline recipients and 10 azithromycin recipients developed minor consecutive manifestations.

Ann Acad Med Singapore, 1993 Mar, 22(2), 257 - 60
Hepatic candidiasis: persistent pyrexia in a patient with acute myeloid leukaemia after recovery from consolidation therapy-induced neutropenia; Ong ST et al.; Fever, a frequent manifestation in acute leukaemia patients who develop treatment-induced neutropenia, usually resolves when the neutrophil count returns to normal irrespective of whether an infective agent is isolated or not . A persistent pyrexia following neutrophil recovery and associated with multiple negative microbiological cultures should signal a careful search for a deep-seated fungal infection in any leukaemic patient who is complete remission . We report here a 39-year-old Chinese man with acute myeloid leukaemia in first complete remission whose unresolved fever after recovery from consolidation therapy-induced neutropenia was ultimately confirmed to be caused by focal hepatic candidal microabscesses by an open liver biopsy.

J Int Med Res, 1993 Mar-Apr, 21(2), 98 - 101
Treatment of lower respiratory tract infections with amoxycillin/clavulanic acid in adults; Tatsis G et al.; Patients with lower respiratory tract infections {pneumonia (n = 16), bronchiectasis (n = 5) and acute exacerbations of chronic bronchitis (n = 44)} were treated daily with amoxycillin/clavulanic acid given either 1.2 g intravenously three times daily or 625 mg orally three times daily for 7-15 days . Symptoms, signs and sputum volume and colour were monitored daily . Chest X-ray, sputum culture and Gram-stain examinations were also carried out on days 1 and 5, and immediately after the end of the treatment . There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 90.8% of the patients . Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in the same proportion of patients (90.8%) . In one patient, an adverse side-effect, diffuse exanthema, was noted . Amoxycillin/clavulanic acid possesses a high clinical and microbiological efficacy for lower respiratory tract infections.

J Hosp Infect, 1993 Mar, 23(3), 167 - 74
The microbiological quality of water in dental chair units; Pankhurst CL et al.; Infection control is an important issue in the dental surgery but the potential hazards associated with contaminated dental water have received relatively little attention in recent years . The complex design of the equipment results in stagnation of water within the dental chair and subsequent amplification of contaminating environmental organisms, including pseudomonads and legionellae, to potentially hazardous levels . Immunocompromised patients may be at particular risk of infection . Very poor water quality with total bacterial counts above 10(4) ml-1 is unpleasant for all patients, and the dental chair supply should be of drinking water quality . In addition to these problems, bacteria and viruses may be aspirated from the oral cavity and contaminate the handpiece . Measures to reduce microbial contamination of dental chairs and equipment include flushing water through the chair's equipment at the beginning of each day; continuous or pulsed water chlorination, or application of biocides other than chlorine; provision of sterile bottled water in the system; and autoclaving handpieces between patients . Future dental chair design must attempt to resolve the problems associated with microbial contamination of the water supply and aerosols generated during dental procedures.

Arch Latinoam Nutr, 1993 Mar, 43(1), 55 - 60
{Quality evaluation of a dehydrated product based on potato (Solanum tuberosum), lupin (Lupinus mutabilis) and eggs}; Glorio Paulet P et al.; After a mathematical evaluation of 20 mixtures containing different proportions of potato (P), lupin (L) and whole egg (E) on dry basis and kept the latter component in a constant amount of 6 per cent, a mixture of 60:34:6 (P:L:E) was chosen for a further experimental work at a lab level because of his better nutritional value for the pre-school children feeding . When an eighteen percent suspension of the mixture mentioned above was dehydrated in a drum drier an adecuate yield of flakes was obtained with an appropriate water absorption . The sensory evaluation test of the dehydrated product as a sauce indicated a higher acceptance than purees . On the other hand, during a 90 days period storage test of the product as flakes, it did not show microbiological problems, although after 45 days rancidity appeared in the dehydrated product.

Tidsskr Nor Laegeforen, 1993 Feb 20, 113(5), 577 - 8
{Meningoencephalitis after Mycoplasma pneumoniae infection}; Solli JD et al.; A 15 year-old boy developed meningoencephalitis two weeks after onset of a respiratory tract infection caused by Mycoplasma pneumoniae . Central nervous complications are seen in 2-7% of patients hospitalized for M pneumoniae infection . Meningoencephalitis, meningitis, ataxia, polyradiculitis, psychosis and a few cases of apoplexy have been reported . In clinical practice one should be aware of M pneumoniae in the differential diagnosis of patients with suspected microbiologically induced central nervous complications . The pathogenetic aspects and prognosis are briefly discussed.

Med J Aust, 1993 Feb 15, 158(4), 255 - 60
Microbiology laboratory clues to the diagnosis of HIV infection; Marriott D; Microbiological investigations can provide an early clue to the possibility of unsuspected underlying HIV infection . These case studies were randomly selected from the author's clinical practice and do not represent unusual or uncommon occurrences; they highlight the constant need to ask Could it be HIV? when interpreting laboratory results.

Nihon Kyobu Shikkan Gakkai Zasshi, 1993 Feb, 31(2), 186 - 92
{Detection and identification of tuberculosis by amplification of mycobacterial DNA from clinical cultured samples}; Kishimoto N et al.; We examined 57 cultured mycobacteria using a method based on polymerase chain reaction (PCR), slot blot hybridization and dideoxy sequencing of nucleotides for detection of M . tuberculosis . Using standard microbiological tests, 34 of 57 specimens were identified as M . tuberculosis and the rest as atypical mycobacteria . Two of 34 specimens that contained M . tuberculosis were not hybridized with a probe specific for M . tuberculosis . These two specimens were identified as atypical mycobacterium by nucleotide sequencing . An atypical mycobacterium specimen that was hybridized with a prove specific for M . tuberculosis was identified as M . tuberculosis using nucleotide sequencing . These results suggest that the approach using PCR and slot blot hybridization for detection of mycobacterium may be more accurate than standard microbiological tests in the rapid and definitive diagnosis of mycobacterial infection.

Nouv Rev Fr Hematol, 1993 Feb, 35(1), 9 - 11
Aspergillosis: advances in immunological diagnosis and therapeutic measures; Feuilhade de Chauvin M; Invasive aspergillosis has become the most frequent cause of death due to opportunistic infections in hematological units where neutropenic patients and bone marrow transplant patients are treated . This is largely a consequence of the difficulty of establishing an early clinical or microbiological diagnosis, and the ensuing delay in starting antifungal therapy . Furthermore, the more effective treatment is not really codified . In this article, we make a review of advances in immunological diagnosis and in therapy against invasive aspergillosis for the last years.

Eur J Clin Microbiol Infect Dis, 1993 Feb, 12(2), 105 - 9
Antibody response to a major human Pneumocystis carinii surface antigen in patients without evidence of immunosuppression and in patients with suspected atypical pneumonia; Lundgren B et al.; IgG and IgM antibodies to a purified human Pneumocystis carinii surface antigen (gp95) were measured in 694 serum specimens from two different population groups using an EIA technique . In a population of 441 patients with no evidence of immunosuppression, the percentage of persons positive for IgG antibodies to gp95 was significantly lower in the age group 1 to 9 years (30%, 23/77) compared to persons 10 to 19 years old (56%, 49/88) . In the age group 1 to 14 years there was a significant correlation between the percentage of persons with IgG antibodies to gp95 and age . In 106 consecutive patients under evaluation due to atypical pneumonia, 76 patients showed no change in the titre of antibodies to Legionella spp . or Mycoplasma pneumoniae in two consecutive serum samples . Three of these 76 patients (4%) demonstrated an increase in the level of IgG antibodies to gp95 in the paired samples . One of these patients had a verified Pneumocystis carinii pneumonia, and the two others were elderly men in whom no microbiological diagnosis of the pneumonia was established . Thus, it is concluded that IgG antibodies to gp95 develop in the majority of nonimmunosuppressed persons before the age of 13 . Furthermore, Pneumocystis carinii pneumonia should be considered in the differential diagnosis in patients suspected of having atypical pneumonia.

Zentralbl Hyg Umweltmed, 1993 Feb, 193(5), 419 - 39
{The behavior of Penicillium spores in air filters for automobile interiors . Testing of germination and propagation under static and dynamic test conditions using microscopic and microbiologic methods}; Senkpiel K et al.; Microbiological tests show, that 3-layer car-air filters (Polycarbonate-microfiber type AF 901) are not a substrate for fungi frequently present in outdoor air . Microscopical investigations of the filter samples, which were exposed to Penicillium spores under static and dynamic conditions show no growth and no germination . The particles of dust which are trapped in the car-air filter, have no components with fungicidal effect, but include substances for inhibition of spore germination . In static model experiments (without air stream) already driven car-air filters were tested and fungal growth was obtained by very high concentrations of substrate and spores . On the other hand, however, in dynamic tests (with air stream) fungal growth cannot be detected, because the liquid humidity is absent.

J Rheumatol, 1993 Feb, 20(2), 310 - 3
Lymphocytes from the site of disease suggest adenovirus is one cause of persistent or recurrent inflammatory arthritis; Ford DK et al.; The assessment of synovial lymphocyte reactivity to adenovirus antigen stimulation was undertaken in patients with persistent or recurrent inflammatory arthritis . The 3H-thymidine uptake procedure was employed, incorporating multiple microbiological antigens . Five patients were found with repeated maximal responses to adenovirus antigen; in one of these adenovirus nucleotide sequences were present in a synovial biopsy specimen . It is concluded that adenovirus may be one cause of persistent or recurrent inflammatory arthritis.

Nutr Hosp, 1993 Feb, 8(2), 115 - 9
{Control of the biological contamination index in total parenteral nutrition (TPN) preparations}; Llor Ferrandez B et al.; Possible microbiological contamination of 1,107 mixtures of TPN made up in the Pharmacy Department of the General Hospital of Albacete in 1991 are studied . In this department, the TPN mixtures are prepared in a horizontal laminar flow-chamber, under the aseptic conditions included in the literature . When we come to evaluate the contamination index of these preparations, we have to take the increase in the work load on days before public holidays into account . We observe that, when the preparation norms are rigorously followed, no significant contamination is produced, even on days when the number of mixtures to be made up is higher.

Ultraschall Med, 1993 Feb, 14(1), 28 - 31
{Ultrasound diagnosis of cervical lymph node tuberculosis}; Winkelbauer F et al.; Lymph node tuberculosis is the most frequent tuberculous manifestation in the otorhinolaryngological area . In 13 patients with histologically verified tuberculous lymphadenitis cervical sonographic examinations revealed characteristic findings . The sonographic features typical for this disease were multiple, enlarged, conglomerating roundish and oval lymph nodes . These lymph nodes were hypoechoic, exhibited dorsal sound amplification and had sharp margins . With caseation, however, there were blurred borders . In cold abscesses an inhomogeneous texture with inhomogeneous shadows was found . Differential diagnosis included non-specific abscess-forming lymphadenitis, lymph node metastases and malignant lymphoma . A tentative diagnosis of cervical lymph node tuberculosis may be made due to the polymorphous sonographic pattern if history and clinical findings are taken into account . A proper histological and microbiological work-up is still essential for confirmation of the sonographic diagnosis.

J Chemother, 1993 Feb, 5(1), 27 - 31
Possible influence of assay methods in studies of the pharmacokinetics of antibiotics; Miglioli PA et al.; In the present research, levels of gentamicin (GM) in serum and carrageenan pleural exudate from the rat have been compared, using three evaluation methods: microbiological assay (MA), enzyme-immunoassay (EMIT) and fluorescence-immunoassay (TDX) . In a first study, the evaluations carried out by MA and EMIT have furnished comparable data in serum, while statistically significant differences were verified at all times in pleural exudate . On the contrary, in a second study, while the evaluations carried out by MA and EMIT, at all times and in both biological fluids, have produced similar data, the evaluation carried out by TDX consistently supplied higher results, with statistically significant differences at some times (5 min and 60 min for serum, 30 min and 60 min for exudate) . Some possible interpretations of these results are discussed.

Z Lebensm Unters Forsch, 1993 Feb, 196(2), 137 - 41
{Determination of the folic acid content of vegetables and fruits using high-performance liquid chromatography (HPLC)}; Muller H; The folic acid content of vegetables (including potatoes) and fruits was determined by means of high-performance liquid chromatography (HPLC) . Free folate (monoglutamate forms) and total folate (monoglutamate+polyglutamate forms) are differentiated . Vegetables contained 27-187 micrograms/100 g and fruits 10-80 micrograms/100 g total folate . The free folate portion ranged from 6.3% to 96.8% (mean 35%) in vegetables and from 11.6% to 89.0% (mean 56%) in fruits . In addition, the results of the quantification of the main folate derivatives tetrahydrofolic acid (THF), 5-methyltetrahydrofolic acid (5-CH3-THF) and 5-formyltetrahydrofolic acid (5-CHO-THF) are presented . The mean values were 70% 5-CH3-THF, 20% 5-CHO-THF and 10% THF . Their total, resulting from the addition of pteroylglutamate equivalences, is comparable with the results of microbiological methods reported in the tables of nutritive values.

Hautarzt, 1993 Feb, 44(2), 106 - 9
{Atypical mycobacteriosis in immunosuppression}; Schafer U et al.; We report on a 50-year-old patient with bluish swellings on the forearms and hands . These symptoms were accompanied by arthralgia . The patient treated himself with about 120 mg methylprednisolone daily, which initially resulted in only slight improvement . Microbiological investigations from cutaneous abscesses demonstrated an atypical mycobacterium (Mycobacterium chelonae) . Occurrence of these bacteria is ubiquitous . In immunodeficient states infections are possible, which may be followed by dissemination of the mycobacteria in traumatic skin lesions . In the patient under discussion, dissemination was probably enhanced by the misuse of steroids . Despite chemotherapy, the patient died, perhaps as a consequence of dissemination.

Infect Control Hosp Epidemiol, 1993 Feb, 14(2), 67 - 72
Transmission of HIV-associated tuberculosis to healthcare workers; Di Perri G et al.; OBJECTIVE: A retrospective investigation was made to compare the occupational risk of tuberculosis in personnel assisting human immunodeficiency virus (HIV)-infected and uninfected subjects with active tuberculosis . DESIGN: We retrospectively reviewed 6 years of hospital activity in 3 units where HIV-infected patients with tuberculosis are hospitalized and in 2 units where non-HIV-infected tuberculosis patients are hospitalized . The risk of occupational tuberculosis in healthcare workers who assisted HIV-infected and non-HIV-infected patients with tuberculosis was investigated . PARTICIPANTS: The risk of occupational tuberculosis in healthcare workers was studied by considering the numbers of potential source cases (hospitalized patients with tuberculosis) in the two conditions investigated (HIV-positive and HIV-negative) . Both potential source cases and cases of tuberculosis in healthcare workers had to be microbiologically proven in order to be considered . RESULTS: Seven cases of tuberculosis occurred in persons who cared for 85 HIV-infected subjects with tuberculosis, while only 2 cases occurred in staff members who took care of 1,079 HIV-negative tuberculosis patients over the same period (relative risk = 44.4; 95% confidence interval = 8.5-438) . CONCLUSIONS: Tuberculosis seems no longer to be a neglectable risk in healthcare workers assisting patients with HIV infection . Further study is urgently needed to see whether such unexpectedly high dissemination of tuberculosis also is demonstrable in the community.

J Clin Periodontol, 1993 Feb, 20(2), 81 - 7
Alternative methods for screening periodontal disease in adults; Machtei EE et al.; Clinical measurements of periodontal attachment loss, while not always representing the histological changes, are used to establish the diagnosis of adult periodontitis . Such measurements are difficult to perform accurately and are labor intensive . To counter these problems, index teeth and index sites have been employed in an attempt to estimate the severity of the periodontal condition without the need to resort to elaborate attachment measurements . Unfortunately, such indices usually tend to underestimate prevalence while often overestimating severity . The purpose of the present study was to examine the correlation of alternative clinical, radiographic and microbiological parameters, with periodontal disease using the diagnostic criteria of established periodontitis . 508 adults included in this study received thorough periodontal examination which included probing pocket depth, clinical attachment level, plaque, gingival and calculus scores, together with radiographic analysis and assays of subgingival periopathogenic microorganisms . Radiographic alveolar bone loss and probing pocket depth had the highest correlation with clinical attachment loss (phi = 0.72 and phi = 0.75 respectively) . Plaque scores (phi = 0.17), like gingival scores (phi = 0.06) and calculus scores (phi = 0.42) had poor correlation with established periodontitis . Periodontopathogenic species demonstrated high specificity and negative predictive values; but low sensitivity and positive predictive values make for an overall low correlation of these species with established periodontitis . However, when used in a logistic regression model, the presence of P . gingivalis (odds ratio = 6.25) has shown to contribute significantly to the estimate of probability for established periodontitis . The use of these various alternative parameters for screening of periodontal disease is discussed in light of their sensitivity, specificity and predictive value.

Epidemiol Infect, 1993 Feb, 110(1), 1 - 7
A prospective study of exposure to verotoxin-producing Escherichia coli among Canadian children with haemolytic uraemic syndrome . The CPKDRC co-investigators; Rowe PC et al.; Haemolytic uraemic syndrome (HUS) is a leading cause of acute renal failure in childhood . Although infection with Escherichia coli O 157 . H7 has been associated with HUS in North America and Europe, only a limited number of studies have examined the role of other verotoxin-producing E . coli (VTEC) serotypes in this condition . To address this issue, we conducted a comprehensive, prospective microbiological study of patients treated for HUS at eight Canadian hospitals in the summer of 1990 . Of the 34 consecutive patients with HUS enrolled over 4 months, E . coli O 157 . H7 was isolated from the stools of 26, and other E . coli serotypes were isolated from four patients . In four subjects no pathogenic E . coli serotypes were identified on stool culture . Using oligonucleotide probes specific for VT-1 and VT-2, verotoxin genes were detected in the stool isolates of all patients with E . coli O 157 . H7, and from two with other E . coli serotypes . Two other patients had at least a fourfold rise in anti-verotoxin antibodies . Strong evidence of exposure to a verotoxin was present in 30/34 (88%) . Patients with E . coli O 157 . H7 infection were more likely to develop an antibody response to VT-2 than to VT-1 (22/22 vs 12/22; P = 0.002) . These results further strengthen the association of HUS with verotoxin-producing E . coli in North America, and confirm that E . coli serotypes other than O 157.H7 are isolated in a small proportion of summertime HUS episodes.

Hepatology, 1993 Feb, 17(2), 251 - 7
Spontaneous bacterial peritonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime; Toledo C et al.; Cefotaxime is the most commonly used antibiotic for initial therapy of spontaneous bacterial peritonitis in cirrhosis . However, since the introduction of cefotaxime no study has been performed to investigate factors influencing prognosis in cirrhotic patients with this type of infection . In this study, predictive factors for infection resolution and patient survival were investigated in 213 consecutive episodes of spontaneous bacterial peritonitis in 185 cirrhotic patients . All patients were initially treated with cefotaxime . One hundred sixty-five episodes (77%) resolved with cefotaxime alone, and two more episodes (1%), initially unresponsive to cefotaxime, were cured after modification of antibiotic therapy . In a multivariate analysis (stepwise logistic regression), only 4 of 51 clinical and laboratory variables obtained at the time of diagnosis of infection were identified as independent predictors of infection resolution: band neutrophils in white blood cell count, community-acquired vs . hospital-acquired peritonitis, blood urea nitrogen level and serum aspartate aminotransferase level . No patient experienced serious adverse effects related to cefotaxime . Eighty-two patients died during hospitalization (38% mortality rate in relation to the 213 episodes of peritonitis) . In the multivariate analysis, six variables were independently correlated with survival: blood urea nitrogen level, serum aspartate aminotransferase level, community-acquired vs . hospital-acquired peritonitis, age, Child-Pugh score and ileus . No microbiological data had predictive value for infection resolution or survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes, 1993 Feb, 42(2), 336 - 40
Effects of ponalrestat, an aldose reductase inhibitor, on neutrophil killing of Escherichia coli and autonomic function in patients with diabetes mellitus; Boland OM et al.; In diabetic subjects, polyol pathway activity might inhibit neutrophil function and cause nerve damage . The effects of ponalrestat, an aldose reductase inhibitor, were assessed on neutrophil intracellular killing of Escherichia coli and on autonomic function in diabetic subjects in a randomized double-blind, placebo-controlled, crossover trial . We studied 31 diabetic subjects with autonomic dysfunction and 21 age- and sex-matched control subjects . During two 12-wk treatment periods, the diabetic subjects took either 600 mg of ponalrestat or matching placebo once daily . Neutrophil killing of E . coli was measured by a microbiological assay technique . Kmax by neutrophils from the diabetic subjects was lower than in the control group (Kmax of diabetic subjects 54.5 +/- 26.4 vs . control subjects 67.3 +/- 16.3, P = 0.045) . Ponalrestat significantly increased bacterial killing in the diabetic subjects (Kmax of ponalrestat 75.1 +/- 16.5 vs . placebo 58.2 +/- 20.8, P = 0.003) so that there was no longer any significant difference in Kmax between the control subjects and the diabetic subjects on active treatment . Ponalrestat had no significant effect on a range of standard cardiovascular autonomic nerve function tests . We conclude that neutrophil killing of E . coli is impaired in diabetic subjects with autonomic dysfunction . This is restored to normal by ponalrestat.

Eur J Surg, 1993 Feb, 159(2), 75 - 9
A burr-like device to facilitate temporary abdominal closure in planned multiple laparotomies; Wittmann DH et al.; OBJECTIVE: To describe and test a method for temporary closure of the abdomen . DESIGN: Open laboratory and clinical studies . SETTING: Department of Surgery, Medical College of Wisconsin, USA . SUBJECTS: 11 patients who underwent planned relaparotomy . MATERIAL: The burr consists of two adherent sheets of polyamide and polypropylene, which may be trimmed to accommodate any wound . One sheet consists of micro-mushrooms, the second of multiple slings . The two sheets stick to each other upon pressure and can easily be separated to open the wound . INTERVENTION: Planned relaparotomy or staged abdominal repair . OUTCOME MEASURES: Measurements of tensile strength and microbiological cultures . RESULTS: The shearing force required to separate the burr is 150 +/- 27 N/5 cm2 when gas sterilized and 77 +/- 11 N/5 cm2 when used in five subsequent laparotomies . No adverse microbiological effects were seen . CONCLUSION: The artificial burr can be used for temporary closure of the abdomen . It circumvents the problems that occur with zip fasteners, Marlex mesh, slide fasteners, and towel clips.

Acta Microbiol Bulg, 1993, 29, 9 - 16
Dependence of the microbiological degradation of aryl-containing xenobiotics on their concentration; Dimkov R et al.; The effect of concentration of the toxic substrates: phenol, oNph, mNph, pNph on their microbiological degradation was studied . The dependence was investigated at biocenotic and population levels . The aryl-catabolic properties of 55 biodegrading cultures were studied at an increasing gradient of phenol substrates . The degradation dynamics has been studied at different initial phenol concentrations on 3 bacterial and one yeast strains.

Pneumonol Alergol Pol, 1993, 61(1-2), 52 - 5
{The problem of allergic pulmonary aspergillosis in children in light of personal observations}; Najberg E et al.; 67 children (age range 4-17 years) with severe asthma were examined for the presence of allergic pulmonary aspergillosis 28 of these underwent long term steroid therapy . The following parameters were analysed: medical history, clinical state, chest radiograms, microbiological examination of the sputum, precipitating IgG antibodies, skin prick tests with aspergillus, level of specific IgE antibodies . The authors did not find any single child that met the diagnostical criteria of allergic pulmonary aspergillosis . Only in 4 serum specific IgE antibodies were found but the precipitin and skin prick tests were negative . The children did not present typical clinical symptoms of pulmonary allergic aspergillosis . It seems worthwhile to re-examine these children in a few years.

J Assist Reprod Genet, 1993 Jan, 10(1), 72 - 7
Complications of transvaginal ultrasound-directed follicle aspiration: a review of 2670 consecutive procedures; Bennett SJ et al.; PURPOSE: Complications following transvaginal ultrasound-directed follicle aspiration are rare, making it difficult to assess their true incidence . During a 4-year prospective study the complications arising from a series of 2670 consecutive procedures were monitored . RESULTS: Vaginal hemorrhage occurred in 229 (8.6%) of the cases, with a significant loss (> 100 ml) in 22 (0.8%) . Postoperative pelvic infection occurred in 18 (0.6%) of the cases . Hemorrhage from the ovary with hemoperitoneum formation was seen on two occasions and necessitated emergency laparotomy in one instance . A single case of pelvic haematoma formation from a punctured iliac vessel was also recorded; this settled without intervention . Of the 18 cases with infection, 9 were severe with pelvic abscess formation; microbiological examination of the pus from these cases suggests that the most common route of infection in such cases is probably by direct inoculation of vaginal organisms into the peritoneal cavity by the collecting needle . CONCLUSION: The low incidence of pelvic infection questions the value of using prophylactic antibiotics . No increased risk of infection was demonstrated in cases with preexisting peritoneal damage.

Schweiz Monatsschr Zahnmed, 1993, 103(4), 401 - 8
{The passage of antibiotics into human ginigival fluid . A review of the literature}; Rotzetter PA et al.; Many antibiotics are utilized in dentistry, particularly in periodontology, to treat aggressive forms of periodontitis . In order to be efficient, both on a clinical and on a microbiological point of view, these substances must be present in sufficient concentrations in the gingival sulcus . The aim of the present literature review was to summarize studies concerning the passage of the various families of antibiotics into the gingival fluid, together with their spectrum and clinical efficacy . Whereas certain antibiotics, such as natural or semisynthetic tetracyclines or spiramycin, are able to accumulate in gingival fluid comparatively to serum, others, like metronidazole, tinidazole and rifampicin, have been found in similar concentrations in the fluid as in serum . Some other antibiotics, such as erythromycin and ampicillin, are, on the contrary, less concentrated in crevicular fluid as compared to blood . One has to remember that any systemic antibiotic treatment will be useful, clinically and microbiologically speaking, only when a mechanical therapy is also applied.

Rev Epidemiol Sante Publique, 1993, 41(2), 161 - 8
{Evaluation and utilization patterns of antibiotic therapy . A study in 4 hospital departments}; Massari P et al.; The use of antibiotics in 480 cases in 4 hospital wards during 1988 was assessed by examination of medical records . Only the first antibiotic therapy administered during the first stay in the ward for each patient was included . Antibiotics were administered to 163 in-patients (37% of hospitalizations) for infections in 113 (26%) cases . Amoxycillin and macrolides were the drugs most frequently used . Sixty-eight percent of the treatments were administered in the absence of microbiological data . Single drug therapy was used in 60% of treatments . Fifty in-patients (11% overall; 41% of patients undergoing surgery) received antibiotics for prophylaxis . The exact indication(s) for the choice of therapy was not given in the medical records of 39% of cases . Treatment started within 48 hours of infection in 15% of the cases . Overall, 93% of the treatments given were indicated, but 53% were inappropriate because they were too expensive, unlikely to be effective or were multiple drug therapy without justification . There are a variety of factors that cause such inappropriate administration of antibiotics.

Izv Akad Nauk Ser Biol, 1993 Jan-Feb, (1), 112 - 20
{Microbial saprotrophic pharmacotherapy: the possible indications, the conditions for its realization and the overall strategy}; Piruzian LA et al.; Potential indications for bacterial strains-producers of biologically active substances to be utilized for microbial saprotrophic pharmacotherapy are presented . These indications include some infectious diseases and tumors, a number of noninfectious diseases, transplantation and contraception . The cardinal problem of microbial pharmacotherapy, the capacity of strains-producers of getting acclimatized to the patient organism, is discussed . For its solution, a "microbiological passportization of a patient" ("saprotrophic mapping"), that is drawing up a map of patient microbiological status, is proposed . This "saprotrophic secretory passportization (mapping)" of strains-producers is first submitted for consideration . A strategy of future microbial pharmacotherapy is stated . The necessity of careful approbation of this kind of therapy is emphasized.

Comput Biol Med, 1993 Jan, 23(1), 21 - 7
A computer program in QuickBasic for the selection of tests for the identification of Helicobacter pylori; Lim TS et al.; Reliable microbiological tests are needed for the identification of bacteria . A program has been written in QuickBasic to identify such tests by using a formula that is based on Gyllenberg's Sum of C(i) and Gyllenberg's Rank R(i) . A total of 139 papers on a newly isolated bacterium, Helicobacter pylori, was used as data source for the coding of test results into an input file . The program outputs a list that aids in the determination of suitable tests for the identification of H . pylori . These tests chosen by the formula were found to be correctly identified as supported by later publications on the bacterium.

Jikken Dobutsu, 1993 Jan, 42(1), 89 - 92
Comparison of plasma endotoxin levels in germ-free, SPF and conventional laboratory animals (mice and rats); Sugiyama Y et al.; Plasma endotoxin levels were examined in laboratory mice and rats sustained under germ-free (GF), SPF and conventional (CV) conditions . The values were 1.72 (GF mouse), 2.67 (SPF mouse), 2.44 (CV mouse), 2.05 (GF rat), 2.56 (SPF rat), and 3.13 pg/ml (CV rat) . The GF animals showed the lowest levels, followed by SPF and CV animals, in that order . When SPF animals were transferred into the conventional condition (conventionalization), the plasma endotoxin levels changed slightly, but not significantly . The present study demonstrates that the levels of plasma endotoxin in healthy laboratory animals are relatively stable and are not affected by microbiological conditions.

J Environ Pathol Toxicol Oncol, 1993 Jan-Mar, 12(1), 55 - 7
Environmental risk factors of cancer and their primary prevention; Dobrowolski JW et al.; The evaluation of the influence of different environmental carcinogenic factors requires interdisciplinary cooperation . Related studies include epidemiological surveys and air, water and soil, chemical, toxicological, and microbiological analyses, supplemented by experimental verification of suspected ecological pathogens and cofactors . A balance of carcinogens and protective agents in the external environment and in the human body is recommended for an ecologically oriented prevention . Toxicological control of the food chain using modern technology (Proton-induced X-ray emission (PIXE), nuclear activation analysis, and induced coupled plasma) should be integrated with microanalyses at the cellular level (by X-ray scanning electron microscopy, nuclear magnetic response, PIXE, and spontaneous and delayed chemiluminescence for balance of free-radicals and their scavengers) . A pilot cross-disciplinary study conducted in the area of a "cluster" of human neoplasms and cattle leukemia, in comparison with control villages in Poland, showed an excess in Pb, Hg, Ni, Rb, K, Mn, Cr, and Zn, accompanied by a nutritional deficiency in Mg, Ca, Fe, Co, and Se in the food chain of the "cluster." The living and breeding houses in this area were significantly more contaminated with the toxicogenic molds Aspergillus flavus and Penicillium meleagrinum and by nitrate and nitrite in the drinking water . Our experiments showed that selenium deficiency stimulated the growth of fungi and some bacteria and increased the immunosuppressive and teratogenic effects of aflatoxin B1 . New methods of protection of the indoor environment against microbiological contamination and laser-related biotechnology for nutritional prevention of selenium deficiency and associated risk of neoplasms have been introduced . Primary prevention requires a large scale application of highly sensitive methods for early detection of risk factors in the environment, food, water, and at the personal level, as well as education of the society and an integrated common corrective action.

J AOAC Int, 1993 Jan-Feb, 76(1), 39 - 43
Assay of oxytetracycline in animal feed by liquid chromatography and microbiological plate assay; Hasselberger ML; In a proposed method for determining oxytetracycline (OTC) in animal feed, OTC is extracted with acidic methanol, and the extract is centrifuged and assayed by microbiological plate assay and by reversed-phase liquid chromatography (LC) . Riboflavin and furazolidone elute at retention times similar to that of OTC . Successful separations are made by using both dimethylformamide and acetonitrile mobile phases . Variation between microbiological and LC results is comparable with variation within the microbiological assay . The relative standard deviation for 6 replicates of feed at the 100 ppm level is 3.6% for the LC assay and 3.1% for the microbiological assay.

J Microencapsul, 1993 Jan-Mar, 10(1), 77 - 88
Disposition of liposomal gentamicin following intrabronchial administration in rabbits; Demaeyer P et al.; Use of liposomes as carriers of gentamicin for intrabronchial pulmonary delivery was investigated in rabbits . Gentamicin, in isotonic glutamic acid buffer, pH 4.5, was encapsulated in multilamellar vesicles (MLVs) and administered intrabronchially . Higher drug concentrations were found at the pulmonary site of liposome instillation for 1 day as compared with free unencapsulated antibiotic . When time-course distributions of gentamicin given in the liposomal or free form were measured in bronchoalveolar lavages (BAL), similar accumulations were observed up to 4 h, but the drug remained longer (24 h) after administration of the liposomal formulation . Higher amounts of antibiotic were detected in BAL supernatant 1 h after instillation of plain gentamicin; this difference stopped being significant after 4 h . A microbiological assay outlined the bacteriostatic activity of gentamicin released from MLVs and recovered in BAL supernatant . Liposomal gentamicin accumulated in the BAL cell pellet 1 h after intrabronchial instillation; it decreased progressively but minute amounts were still detected after 1 day . On the contrary, no gentamicin was found in the pellet at any time after free drug administration . Comparison of aminoglycoside concentrations in plasma and kidneys indicated lower and constant levels when the liposomal form was instilled . Liposome encapsulation altered the disposition of gentamicin in a way suggesting improved pulmonary concentration and lower systemic toxicity.

J Hepatol, 1993 Jan, 17(1), 34 - 9
AIDS-related cholangitis: diagnostic features and course in 15 patients; Bouche H et al.; About 60 cases of cholangitis in patients with the acquired immune deficiency syndrome (AIDS) have been described . We report our experience concerning 15 patients infected with the human immunodeficiency virus (HIV) and who had cholangitis as defined by radiological findings . Cholangitis was the revealing event of AIDS or HIV infection in 4 patients (27%) . Twelve (80%) of the patients were homosexual men . The main diagnostic features were abdominal pain (73%), cholestasis without jaundice (100%), intestinal cryptosporidiosis (80%) and abnormal findings on abdominal ultrasonography (87%) . Endoscopic retrograde cholangiopancreatography appears to be essential for diagnostic and therapeutic purposes, particularly for patients with papillary stenosis who represented 64% of our population . Biological and morphological pancreatic abnormalities were associated in 2 of the 8 patients who underwent retrograde opacification of the Wirsung duct . The microbiological yield was highest in patients who underwent multiple biopsies (duodenal and papillary) and bile sampling . The organisms found included Cryptosporidium (57%) of cases), CMV (28%) and Microsporidia (7%) . Twelve-month survival after the diagnosis of cholangitis was only 14% and all deaths were related to AIDS progression . Endoscopic sphincterotomy relieved abdominal pain in 86% of the patients who underwent the procedure . Evaluation of medical treatment, particularly ursodeoxycholic acid, is necessary.

Nutr Hosp, 1993 Jan, 8(1), 30 - 7
{The stability of antibiotics administered in and with a parenteral nutrition mixture enriched with branched-chain amino acids . I . Amikacin and gentamycin}; de Juana P et al.; The combined infusion of antibiotics and parenteral nutrition makes it possible to maintain plasmatic nutrient concentrations over time, in turn facilitating the administration of the antibiotics in the dilution and infusion time recommended according to their pharmacokinetic parameters . On the other hand, this type of administration has care benefits for the patient, reducing the risk of infections, and adding to comfort . The technique is also cost-effective, reducing the cost of drug administration, saving on administrative personnel and nursing staff time . The stability of amikacin and gentamicin are determined in vitro at therapeutic concentrations jointly infused with a mixture of parenteral nutrition with polyols and enriched in ramified chain amino acids . A microbiological stability analysis was carried out of the antibiotics in the parenteral nutrition, along with an HPLC aminogram, in order to determine the concentration of amino acids in the combined infusion with the antibiotic . pH measurements were also taken, along with osmolarity and colour change . Both of the antibiotics and the parenteral nutrition employed, and of the combined infusion mixtures . Amikacin and Gentamicin are stable at a concentration of 5 mg/ml and 1.6 mg/ml respectively in a parenteral nutrition mixture enriched in ramified chain amino acids.

Geburtshilfe Frauenheilkd, 1993 Jan, 53(1), 61 - 3
{Tuberculous mastitis--a rare differential diagnosis of non-puerperal mastitis}; Seufert R et al.; Tuberculosis in a case of non-puerperal mastitis is a rare clinical finding . A special case of a 28-year old Thai patient was diagnosed and successfully treated with an antituberculous chemotherapy . The most important diagnostic procedure was the microbiological and histological investigation to enable the diagnosis to be made . Surgical therapy was not necessary.

Medicine (Baltimore), 1993 Jan, 72(1), 11 - 37
Mycobacterium bovis infections in San Diego: a clinicoepidemiologic study of 73 patients and a historical review of a forgotten pathogen; Dankner WM et al.; We have presented 73 patients (48 adults and 25 children) with microbiologically documented M . bovis infections identified over the 12-year period from 1980 through 1991 . Epidemiologic investigation of these patients revealed that the majority (80%) were of Hispanic origin . The non-Hispanic patients either had traveled extensively outside the United States, were born in the United States during its endemic period or in other countries with endemic bovine tuberculosis, or were exposed to a close relative with a positive PPD and known exposure to M . bovis . For Hispanic patients, the presence of reactivation disease in adults and primary disease in children indicate that this mycobacterium remains endemic in Mexican beef and dairy herds, a position supported by United States monitoring of Mexican cattle transferred across the border . Our review of the historical and contemporary efforts to eradicate this animal and human pathogen from the livestock industry in the United States and abroad shows that the implementation of similar methods could be effective in Mexico . The detailed presentations of selected patients and summaries of the clinical manifestations in the remainder of our 73 patients reveal striking similarities to historical accounts and to more contemporary studies of reactivated disease in England . Although M . bovis infections are still expressed predominantly in extrapulmonary sites (cervical and mesenteric nodes, the peritoneum, and the GU tract), as many as 50% of adult patients will present only with pulmonary disease . Underlying immunosuppressive disorders were particularly prominent in adults with extrapulmonary disease . For example, HIV positive patients accounted for 12 of 48 adults and 1 adolescent patient in our series . Overall, M . bovis infections accounted for almost 3% of all tuberculous disease reported in San Diego County during the study period . The intrinsic resistance of M . bovis to PZA could threaten the response of patients with bovine tuberculosis to the short-course chemotherapeutic regimens now recommended by the CDC and the American Thoracic Society . We strongly recommend continued surveillance for this forgotten pathogen because the importation of Mexican cattle, the migration of Hispanic immigrants from border areas to the United States interior, and the persistence of extrapulmonary disease in immunocompetent and HIV-infected United States citizens assure its persistence in this country.

J Clin Periodontol, 1993 Jan, 20(1), 7 - 13
Periodontal disease and dental caries in relation to primary IgG subclass and other humoral immunodeficiencies; Dahlen G et al.; 22 females and 3 males with primary hypogammaglobulinaemia (n = 6) or IgG subclass deficiencies with (n = 3) or without (n = 16) concomitant IgA deficiency were examined for periodontal disease and dental caries . Only 1 patient showed more tooth loss than that found in the normal Swedish population . 1 patient demonstrated advanced periodontal disease . No patient exhibited more severe dental caries than that of comparable normal Swedes . Microbiological samples from periodontal pockets and saliva showed recovery of potential periodontopathic and cariogenic bacteria within normal ranges . This study could not support the notion that immunodeficient subjects exhibit an increased risk of developing periodontal disease or dental caries.

AJR Am J Roentgenol, 1993 Jan, 160(1), 15 - 9
Disseminated histoplasmosis in AIDS: findings on chest radiographs; Conces DJ Jr et al.; OBJECTIVE . Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS . MATERIALS AND METHODS . Chest radiographs of 50 AIDS patients with documented extrapulmonary histoplasmosis were analyzed retrospectively . The radiographs were evaluated for the presence of parenchymal opacities, pleural effusions, adenopathy, cavitation, and calcified granulomas and lymph nodes . A modification of the International Labour Office scheme was used to classify parenchymal abnormalities as nodular, linear or irregular, reticulonodular, or air-space opacities . RESULTS . Abnormalities were present on radiographs in 23 patients . Nodular opacities were present in 10 patients and were diffusely distributed in nine patients . Linear or irregular opacities were present in seven patients, with diffuse distribution in four and limited involvement in three . Air-space opacities were present in seven patients; the distribution varied from segmental to diffuse involvement of the lung . Small pleural effusions were present in five patients . Adenopathy and Kerley's B lines were each present in three patients . In 27 patients, the chest radiographs were normal . Four of these patients had clinical or microbiological evidence of lung involvement . CONCLUSION . The chest radiographic findings of disseminated histoplasmosis in AIDS patients are varied and nonspecific . The presence of diffuse nodular or linear/irregular opacities in an AIDS patient, especially one who resides in or has resided in an endemic area, should suggest the possibility of disseminated histoplasmosis . Normal findings on chest radiographs do not exclude disseminated infection or lung involvement.

Intensive Care Med, 1993, 19(5), 256 - 64
Incidence and risk factors of pneumonia acquired in intensive care units . Results from a multicenter prospective study on 996 patients . European Cooperative Group on Nosocomial Pneumonia; Chevret S et al.; OBJECTIVE: To estimate the incidence of pneumonia acquired in the intensive care unit (ICU), and to define risk factors for developing such an event . DESIGN: European prospective survey, in which all patients admitted to the participating ICU from January, 17 to 23, 1990, were followed until ICU discharge . SETTING: 107 general ICUs from 18 countries . PATIENTS: Of 1078 admitted to the ICUs, 996 patients without pneumonia at admission were studied . MEASUREMENTS: Pneumonia was diagnosed by the staff physician on the basis of clinical, radiological and microbiological criteria, secondly validated by an expert committee who reviewed all the forms and even recontacted ICU physicians . Crude incidence and time to occurrence of pneumonia were estimated, then both used as end-points for prognosis analysis . RESULTS: 89 pneumoniae were observed: crude incidence was estimated at 8.9% 7-day and 14-day pneumonia rates at 15.8% and 23.4%, respectively . The risk of developing pneumonia increased when either coma, trauma, respiratory support, Apache II > 16 and/or imparied air-way reflexes were present at ICU admission . To predict time to occurrence of pneumonia, only two variables remained significant: the presence of impaired airway reflexes at admission and the use of mechanical ventilation during ICU course . CONCLUSIONS: The role of the injury to the respiratory system-with the subsequent need for respiratory support--appears central in determining the risk to acquire pneumonia in ICU . In the future, the predictive value of severity scores during ICU course should be otherwise assessed.

Eur J Clin Pharmacol, 1993, 44(6), 569 - 73
Pharmacokinetic comparison of leucovorin and levoleucovorin; Zittoun J et al.; The pharmacokinetic values of d,l-leucovorin and l-leucovorin were compared in eight healthy volunteers following oral administration of 25 mg d,l-leucovorin and 12.5 mg l-leucovorin . Serum levels of l-5-formyltetrahydrofolate, l-5-methyltetrahydrofolate, and total reduced folates were measured by an established microbiological method . Pharmacokinetic data for both preparations were consistent with those previously reported for d,l-leucovorin, with essentially complete first pass metabolism to l-5-methyltetrahydrofolate, the active metabolite . No differences were found between the two preparations in serum concentrations of active folate fractions, AUC, or Cmax, or in clearance and volume of distribution estimates . These data suggest that after administration of 25 mg of d,l-leucovorin, the d-diastereoisomer has no significant effect on the standard pharmacokinetic measurements of the active l-folates.

Acta Clin Belg, 1993, 48(3), 202 - 8
Long-term follow-up of pulmonary disease caused by Mycobacterium avium in a previously healthy patient; Stappaerts I et al.; A 64-year-old white male with cavitary lung disease is presented . Mycobacterium avium was isolated from sputa and gastric lavage and the American Thoracic Society criteria for nontuberculous mycobacterial disease were met . Seven years follow-up and treatment regimens are discussed . This case illustrates that medical treatment of M . avium pulmonary disease can be disappointing and requires regular clinical, radiological, microbiological and haematological reassessment to evaluate efficacy and toxicity of therapy . Despite in vitro resistance to the standard antimycobacterial agents, prolonged treatment regimens can be successful and are the therapy of choice . Another drug combination, based on in vitro susceptibility patterns, has to be started for patients who fail to respond or who relapse . Lifelong treatment may be necessary to keep the patient stable and to prevent further destruction of lung parenchyma.

Vet Med (Praha), 1993, 38(7), 403 - 11
{The recovery and rearing of gnotobiotic lambs and their use in veterinary medicine}; Bomba A et al.; Our own innovated method of the hysterectomy recovery of gnotobiotic lambs, modified equipment for gnotobiote rearing, management and tending techniques were tested in this study . A hysterectomy hood (Fig . 1) was made from plexiglass and it fully met the requirements for simple and rapid handling . Our own modified isolator for gnotobiotic lamb rearing (Fig . 2) made out of glass-reinforced plastic with plexiglass sight holes was used for group rearing . It was more resistant to mechanical damage in comparison with the isolators equipped with PVC sheet pouches . The use of an isolator for feed and material (Fig . 3) and of an isolator for waste material storage with a PVC sheet pouch was found to be very practical; these isolators were connected to the rearing isolator through piping . The ventilation system was sufficient enough . An emasculator was used for hysterectomy . The method is simple and rapid, reliable and it enabled to preserve lambing ewes for other experimental purposes . Gnotobiotic lambs were successfully fed a milk replacer for calves . Samples of biological material (blood, rumen fluid, droppings) were taken from lambs kept in the isolator . The isolators were sterilized with 2% solution of peracetic acid sprayed as aerosol . Milk, materials made of glass and metal were autoclaved at a temperature of 121 degrees C, pressure 1.2 atm, for 30 minutes, and the concentrate mixture was sterilized with an X-ray dose of 2.5 Mrad . All the used methods of sterilization were fully efficient . A modified method reliably detecting lamb and isolator contamination was used for microbiological monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)

Int J Clin Pharmacol Res, 1993, 13(2), 75 - 9
Oral ciprofloxacin for treatment of chronic osteomyelitis; Yamaguti A et al.; Seventeen adult patients with chronic osteomyelitis were treated with oral ciprofloxacin, 750 mg twice daily . Treatment ranged from 28 to 254 days . Efficacy was considered to be good, based upon clinical resolution observed in 13 patients (76%) . Clinical and microbiological failure was observed in 3 patients (18%), and there was one case of reinfection . Tolerance was very satisfactory, since the adverse reactions were mild and transitory; these occurred in 7 patients (41%), being cutaneous rash in 4 patients and diarrhoea in 3 patients . No patient had to discontinue treatment . Thus, oral ciprofloxacin may be useful option for the prolonged treatment of chronic osteomyelitis, provided that it is always associated with surgical debridement . Due to the probable development of ciprofloxacin resistance in the S . aureus multiresistant strain, already observed in two patients in the present investigation, it is suggested that for the treatment of such infections another drug with antistaphylococcal activity should be associated with the ciprofloxacin.

Gig Sanit, 1993 Jan, (1), 36 - 40
{The protective efficacy of microbiological isolation compartments}; Dzhindoian LS et al.; Methodologic approaches to designed boxing system were offered . Security, aerosol concentrations, and so on were taken into consideration.

Aust Clin Rev, 1993, 13(2), 69 - 73
A hospital antibiotic policy resulting from a simple quality assurance activity; Surveyor M; The use of antibiotics on a medical ward was monitored for 4 weeks . Medication charts were perused to identify all antibiotics prescribed and the notes were searched for microbiological evidence of pathogenic organisms . Presentation of the results at a clinical meeting led to the establishment of a hospital-wide antibiotic policy, where none had previously existed . The survey was repeated 1 year after the policy was instituted.

Infection, 1993, 21 Suppl 1, S45 - 8
{Perioperative antibiotic prophylaxis in maxillofacial surgery}; Merten HA et al.; In surgical interventions in the maxillofacial area the intraoral approach often is chosen for technical and esthetic reasons . Because of the inevitable contamination of the surgical wounds with the facultative pathogenic mixed flora of the oral cavity, these operations are exposed to an increased risk of postoperative wound infections . Therefore, a perioperative antibiotic prophylaxis is justified . In a prospective, controlled open study in 112 patients the effect of a preoperative one-shot prophylaxis with cefuroxime was compared with that of a short-term prophylaxis for 48 hours . The low rates of postoperative infectious complications in both groups (3.5 resp . 4.5%) verify the efficacy of the perioperative antibiotic prophylaxis in head and neck surgery . For microbiological, practical and economic aspects however, the one-shot-prophylaxis should be preferred.

Ann Fr Anesth Reanim, 1993, 12(5), 505 - 7
{Massive pulmonary embolism caused by thrombosis formed on a central catheter in a child}; Mahe V et al.; A case is reported of a 9-year-old girl admitted with a subarachnoid haemorrhage . Her neurological recovery was favourable after the embolization of a cerebral arterio-venous malformation . She stayed in ICU with mechanical ventilation because of a bacterial pneumonia and a post-extubation laryngeal oedema . She required insertion of a polyurethane subclavian catheter, as a peripheral venous access was not available . Five days later, the child suffered a sudden respiratory distress without changes of the electrocardiogram and the chest X-ray . The diagnosis of pulmonary embolism was suspected because of the presence of the central venous catheter, a catheter dysfunction and a superior vena cava syndrome . A catheter tip thrombus was shown by angiography as well as a thrombus in the pulmonary artery, a 90% obstruction of the proximal valvular tree of the right lung, a 10 to 15% distal obstruction in the left lung, a complete obstruction of the superior vena cava (SCV) . The thrombolytic therapy was contra-indicated in this case because of the neurological pathology . Heparin was given by continuous intravenous infusion . When heparin concentration was at an appropriate level, the catheter was removed . Its microbiological culture remained negative . The next day, another angiography showed a partial permeability of the SVC and a better right pulmonary perfusion . During this procedure, the haemodynamic assessment showed only moderate abnormalities . Therefore the surgical treatment was not indicated and the heparin continued . The child recovered gradually with a normalization of the lung scintigraphy.

Med Dosw Mikrobiol, 1993, 45(2), 209 - 12
{Effect of bismuth salts in elimination of Helicobacter pylori from gastric mucosa in patients with duodenal ulcer}; Romanczyk T et al.; Bismuth salts belong do basic drugs used for elimination of Helicobacter pylori (HP), a microorganism which is postulated to participate in etiopathogenesis of duodenal ulcer . The study was aimed at evaluation of effectiveness of application of tripotassium bismuth citrate (Ventrisol-Polfa) in elimination of HP and its influence on treatment of the ulcer . In 30 patients with diagnosed endoscopically duodenal ulcer, Ventrisol in tablets was applied (2 x 2); it was also used in its fluid form (4 x 5 ml) . The time of treatment amounted to 28 days . During endoscopy, samples from various parts of the stomach were taken for microbiological inspection and they were studied in direct smear and in culture . HP was isolated from 20 out of 30 patients (37%) before treatment . After application of Ventrisol, the bacteria were present in 11/30 (34%) treated patients (p < 0.05) . There was no influence of the form of drug for elimination of HP . No dependence was also found between elimination of HP and healing of the ulcer.

Med Dosw Mikrobiol, 1993, 45(2), 205 - 8
{Occurrence of Helicobacter pylori in mucous membrane of stomach in patients with duodenal ulcer and inflammation of stomach mucous membrane}; Nowakowska M et al.; In 1990-1991 microbiological studies were performed aimed at determination of frequency of occurrence of Helicobacter pylori in patients treated because of peptic ulcer in Department of Gastroenterology in Katowice . Studies were performed in 112 patients . Out of these, in 73 duodenal ulcer was detected endoscopically (group I), in 26--inflammation of stomach mucous membrane with erosion (group II), and in 13--both duodenal ulcer and erosion of stomach membrane (group III) . Samples from mucous membrane of pylorus and of stomach taken endoscopically were tested microscopically and in culture . Helicobacter pylori was found in 74 patients (66.1%) . Frequency of isolation was different in individual groups . Helicobacter pylori was found in 51 patients (70%) of group I, 15 (58%) of group II and in 8 (61%) of group III . Helicobacter pylori was most frequently isolated from patients with duodenal and stomach ulcer (81.3%).

Adv Exp Med Biol, 1993, 338, 267 - 70
A microtitre plate method for measuring biopterin with cryopreserved Crithidia fasciculata; Leeming RJ et al.; The assay of biopterin derivatives in dried blood spots is used by us in initial screening for inherited defects in tetrahydrobiopterin synthesis . The previously described method (1) required aseptic technique and microbiological facilities . The modification detailed here has the advantages of antibiotic cover, which overcomes these needs and microtitre plate technology allowing the incubation time to be halved with precision and accuracy retained . Data reduction facilities may be applied.

An Otorrinolaringol Ibero Am, 1993, 20(5), 521 - 30
{Otomycosis: a microbiological study of 147 cases of otitis externa}; Sagnelli M et al.; An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients . The target of the AA . is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis . And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.

Probl Tuberk, 1993, (6), 30 - 2
{The microbiological diagnosis of tuberculosis in areas under strict radiation control}; Golyshevskaia VI et al.; Mycobacterial variability was studied in active tuberculosis patients from radioactive contamination area subject to close radiation control . For such areas it was noted that the patients discharge altered coccoid mycobacteria stained with routine luminescent dyes . Biological investigations of freshly isolated strains revealed potentiation of M . tuberculosis virulence in patients with respiratory tuberculosis . A large number of patients from the contaminated areas against control demonstrated primary resistance to rifampicin and isoniazid.

Postgrad Med J, 1993, 69 Suppl 3, S58 - 61
The efficacy of povidone-iodine pessaries in a short, low-dose treatment regime on candidal, trichomonal and non-specific vaginitis; Yu H et al.; Povidone-iodine pessaries (Betadine vaginal pessaries) containing 200 mg of povidone-iodine (PVP-I) in a water soluble base, are a widely used gynaecological preparation for treatment of vaginitis . We conducted a study on PVP-I pessaries at the reduced dose of one pessary daily for 7 days to suit conditions in Macau where patients are eager for a simple, short treatment course with confirmed clinical efficacy benefiting their professional and household essential requirements . Thirty-eight cases were selected for this particular clinical trial . These consisted of housewives, factory workers and professional girls (a sexually high risk group) who were suffering from vaginitis and complaining of vaginal discharge and irritation due to trichomonas, candida or non-specific vaginitis . After routine examination, including the collection of samples for microbiology, patients were treated with PVP-I pessaries 200 mg once a day for 7 days . The second microbiology samples were collected after the 7 day treatment period . Among the 38 cases, we had 30 cases with a complete record to allow us to make a summary and analysis of the trial . There were 14 cases of vaginitis due to yeasts and fungi infection, 3 cases of protozoa (trichomonas), and 13 cases due to non-specific pathogenic infections . 73.3% of cases had a complete symptomatic and microbiological cure and a further 16.7% had a microbiological cure with a good improvement in symptoms . No complications or side effects were found in the 7 days consecutive treatment course and inflammation quickly subsided during the course of treatment . PVP-I pessaries, used once daily for 7 days, seem to be an ideal treatment for cases who are likely to be unable to follow a longer treatment course.

Ann Ist Super Sanita, 1993, 29(2), 313 - 6
Assessment of the human risk associated with the presence of carcinogenic compounds in drinking water; Fawell JK et al.; Both organic and inorganic contaminants which have been implicated in causing cancer in man or, more commonly, in laboratory animals can be found in drinking water . Apart from arsenic there are none for which there is convincing epidemiological evidence of a significant risk to man . However environmental epidemiology is fraught with difficulties . There are also difficulties in interpreting laboratory animal data and extrapolating this to the low concentrations found in drinking water although mathematical models can be very useful if used sensibly . There is a danger that the rather extreme public perception of cancer could lead to over regulation of some contaminants in water, possibly with an increase in risk from other hazards such as microbiological contamination.

Neurosurg Rev, 1993, 16(3), 189 - 96
Non-traumatic brain abscess; Lunardi P et al.; Between 1953 and 1989 eighty cases of non-traumatic brain abscess were treated in our department . We have re-examined the clinical and neuroradiological features of this pathological process and present our therapeutic approach and results . We believe that the optimal treatment for brain abscess consists of surgical removal . The prognosis for these lesions has undergone a marked improvement over the last two decades in response to neuroradiological, microbiological and surgical advances . The most influential prognostic factor seems to be preoperative clinical status.

Intensive Care Med, 1993, 19(7), 377 - 82
Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter; Jorda R et al.; OBJECTIVES: To demonstrate that blind insertion of the protected telescoping catheter (PTC-NB) through the orotracheal tube can provide reliable pulmonary samples for the diagnosis of nosocomial pneumonia (NP) in ventilated patients . DESIGN: We performed a random comparison between the protected telescoping catheter introduced through a bronchofiberscope (PTC-B) and the PTC-NB to diagnose NP . SETTING: A general intensive care unit of a University Hospital . PATIENTS: 40 consecutive patients on mechanical ventilation and with suspicion of NP . The diagnosis of NP was suspected by clinical and chest X-ray findings . MEASUREMENTS AND RESULTS: NP was confirmed microbiologically in 26 (65%) patients and maintained in 8 patients by clinical and radiological criteria . PTC-NB confirmed the microbiological diagnosis of PN in 21 (80%) patients . The use of antibiotics prior taking respiratory samples reduced the sensitivity of PTC-NB and PTC-B from 100-74% and from 94-70% (p = 0.001) . Both techniques agreed in 24 of 33 (73%) patients but such agreement was better when PN was on the right lung . Two patients developed a self-limiting hemoptysis after the PTC-B procedure . CONCLUSIONS: PTC-NB is as sensitive as specific as PTC-B for diagnosing PN in mechanically ventilated patients, being a much easier technique to use.

J Gynecol Obstet Biol Reprod (Paris), 1993, 22(6), 621 - 4
{Anencephaly . 10 cases seen in 3 years in Brazzaville (Congo)}; Iioki LH et al.; The authors report ten cases of anencephaly diagnosed between 1989 and 1991 in the maternity units of Brazzaville (Congo) . The incidence of anencephaly was 0.12 per thousand . Although there was no geographical factors to definitely identify, there is a suspicion that the consumption of potatoes, infected by phytophotora infestans at the beginning of pregnancy may have had an effect; but this hypothesis would have to be confirmed by microbiological studies . The patients were young with a mean age of 27.5 years and were of low socio-economic levels . In this study female fetuses were often affected; which is also found in the literature but without any reasonable explanation . The means of diagnosis of anencephaly in Brazzaville have improved thanks to the recent acquisition of an ultrasound machine which made it possible to screen most of these cases.

Ann Pharm Fr, 1993, 51(3), 154 - 66
{Biological safety in the laboratory . Biological risk, standardization and practice}; Vidal DR et al.; Working with pathogens or genetically engineered micro-organisms is a potential hazard for scientists, health care workers, employees of pharmaceutical industry, and also for the environment . Carelessness, poor technique in the handling of infectious materials, needle sting or infectious aerosol exposure are the cause of laboratory acquired infection . Biosafety, corollary of biocontamination, is based on the combination of good microbiological techniques, facility design of the laboratory and safety equipment . So, four biosafety levels are appropriate for the operations performed and the hazard posed by the infectious agents.

Scand J Infect Dis, 1993, 25(4), 515 - 20
IgM response to a human Pneumocystis carinii surface antigen in HIV-infected patients with pulmonary symptoms; Lundgren B et al.; We have developed an ELISA to detect IgM antibodies to a major human Pneumocystis carinii surface antigen (gp95), and investigated the IgM response in 128 HIV-infected patients who underwent bronchoscopy for evaluation of pulmonary symptoms . Only 5 (4%) patients had IgM antibodies to P . carinii gp95 . Four of the 5 patients with IgM antibodies also had IgG antibodies to gp95 and microbiologically proven P . carinii pneumonia (PCP) . In 76/128 patients for whom serial samples were available, changes in antibody response were determined . In 3 patients we demonstrated an increase in IgM antibody response to gp95 . These patients also showed an increase in IgG antibodies to gp95 and had microbiologically proven PCP . Prior to the development of the IgM response, IgG antibodies to gp95 were detectable in all 3 patients . Thus, HIV-infected patients with PCP seldom produce IgM antibodies to the major human P . carinii surface antigen . The increase in IgM response during the course of PCP observed in 3 patients suggests either reinfection with a new strain, or antigenic drift of an already acquired strain of P . carinii.

Acta Med Austriaca, 1993, 20(4), 105 - 7
{Bacterial endocarditis: microbiological diagnosis}; Rotter M; The microbiological laboratory can assist in diagnosis and therapy of bacterial endocarditis with the following parameters: cultivation and identification of the causative organism, sensitivity testing including assessment of the minimal bactericidal concentration (MBC) and testing of antibiotic combinations with checkerboard titrations and time-kill curves . Serum bactericidal titers, although controversial with respect to their utility in prognosing the clinical outcome, are regarded useful by some authorities but not by others . Antibiotic assays, mainly for aminoglycosides and vancomycin, serve to monitor antibiotic serum levels.

Acta Derm Venereol Suppl (Stockh), 1993, 182, 15 - 20
Declining trends in some sexually transmitted diseases in Norway between 1975 and 1991 with special reference to a Lapp population; Falk ES et al.; Trends of N . gonorrhoeae (1975-1991) and C . trachomatis (1988-1991) infections in Norway were analysed by the National Institute of Public Health (SIFF) using data reported by physicians . The validity of the reporting system was evaluated by comparing reported data from the three northernmost counties and particularly the Kautokeino community to SIFF with confirmed positive specimens analysed by the two microbiological laboratories serving this area . The incidence of gonorrhoea in Norway has declined continuously from 300 cases per 100,000 annually in 1976 to 15 in 1991, whereas C . trachomatis infections with annual rates of 300 cases per 100,000 during the last 4 years has shown no significant decrease . The incidence of gonorrhoea in the county of Finnmark has shown the same declining trend as for the rest of the country, but is still four times higher than the national average . C . trachomatis infections show no obvious declining tendency in any part of the country and is three to four times higher in Finnmark than the average for the country . Kautokeino experienced a dramatic decrease in gonococcal infections from more than 1000 cases per 100,000 in 1976 to almost eradication in 1991, whereas C . trachomatis infections show a four times higher annual incidence than the national average . Although gonorrhoea is almost eradicated in Norway, C . trachomatis infections remain an important public health problem . This study indicates that young, sexually active individuals need to be targeted for effective health education in order to modify behaviour patterns which put them at risk of acquiring STDs.

Rev Mal Respir, 1993, 10(4), 325 - 32
{Invasive pulmonary aspergillosis in 4 patients with acute decompensation of chronic respiratory insufficiency}; Pouchelon E et al.; Invasive pulmonary aspergillosis (API) is a necrotising pneumonia generally occurring in profoundly immunodepressed subjects . These observations were based on four patients in the intensive care unit, suffering from chronic respiratory failure (IRC), without profound immunodepression . After a pathophysiological and clinical review, a focus on the diagnostic methods permits one to stress on the reliability, in this type of patient, of the evidence from direct examination of aspergillus filaments in the bronchoalveolar lavage (LBA) or protected bronchial brushings, taking account of the weak value of routine culture of spit or bronchial aspiration in IRC in whom patients are frequently colonised . These four cases permit one to discuss the factors which predispose to the development of API outside the usual immune suppression: IRC itself, by the disorder of mucociliary function, which it leads to; repeated antibiotic therapy which destabilises the saprophytic flora; viral infections which would be responsible for transitory immunodepression . But it is above all steroid therapy which seems to be the major factor favouring the development of API without producing profound immunodepression but probably because it inhibits phagocytosis of aspergillus spores . In these circumstances it is necessary to make an early diagnosis and to use fibre optic bronchoscopy with protected sampling and bronchoalveolar lavage with a complete microbiological . Only early treatment allows one to contemplate a cure.

Biol Cell, 1993, 78(1-2), 95 - 109
Recent advances of flow cytometry in fundamental and applied microbiology; Fouchet P et al.; This review focuses on the recent applications of flow cytometry (FCM) in microbiological research (1987-mid 1992) . It tries to give a scope of the important breakthroughs which occurred in this field during this period . The technical difficulties of microorganism analysis by flow cytometry is briefly appraised . The significance and the limits of the different microbial cell parameters attainable by flow analyses are systematically evaluated: light scatter for cell size and structure, fluorescence measurements for quantification of cellular components, microbial antigen detection and cell physiological activity estimation . Emphasis is given on the new technological advances which appeared in the last two years . The second part of the review is devoted to the analysis of the usefulness of flow cytometric approach in the different fields of microbiology: fundamental studies in microbial physiology, differentiation, microbial ecology and aquatic sciences, medical microbiology, parasitology, microbial pharmacology and biotechnology.

Rev Chil Obstet Ginecol, 1993, 58(2), 103 - 12
{Clinical and microbiological study of acute pelvic inflammatory disease}; Ovalle A et al.; Upper genital tract infection was investigated in 46 women admitted to hospital with clinic diagnosis of acute pelvic inflammatory disease (PID) and 62 control women accepted to hospital for laparoscopy Fallopian tubes sterilization . Diagnosis was ratified by laparoscopy in mild and moderate salpingitis; culdocentesis and ultrasonography were performed in severe salpingitis and endometrial sample was made in endometritis . Microbiological specimens were taken from the cervix and abdomen . Antecedents and complete clinical studies were obtained . Patients were treated with antibiotic association sodic G penicillin, chloramphenicol and gentamicin . Risk factors to development PID were: single female (p < 0.05), multiple sexual partner (p < 0.01), previous PID (p < 0.05), infertility (p < 0.05), mean year of IUD use in severe salpingitis (p = 0.05) and mean years of age from women with sexually transmitted bacterias (STB) vs endogenous bacterias (EB) (p < 0.05) . In the control group no abdomen bacterias were isolated . In patients with PID, C . trachomatis was detected by serology in 28.3% . N . gonorrhoeae was isolated from the cervix in 23.9% and from the abdomen 17.4% . Besides it was isolated from the abdomen: M . hominis 17.3% and E . coli 15.2% . STB were isolated in 54.3% and EB in 47.8% of the patients . Bacterial association was present on the 37% . Cervix isolation of G . vaginalis and Mycoplasma were not correlated with development of PID . Cervix microbiological samples were useful to know abdomen microbic etiology . They coincide with those in the 90.9% . EB were more frequently isolated from severe salpingitis (p = 0.05) and STB from mild and moderate salpingitis (p = 0.05) . Antibiotic association cured all the mild and moderate salpingitis with independence of bacterial etiology . Failure occurred in 2 diffuse peritonitis and 13/14 tubo-ovarian abscesses . Surgery used in severe salpingitis and diffuse peritonitis, principally consisted in anexectomy, peritoneal toilet and drainages . No hysterectomies were performed . Colpotomy drainage was used as a laparotomy complement or as unique drainage . Severe complications of surgery occurred in 10.5% . Failure in antibiotic treatment, surgery and complications were present with preference in PID with EB . After PID 26.5% of women had both Fallopian tubes damaged; in 39.7% tube damage was not evaluated and in 34.2% one tube rested in health . Damage did not depend of bacterial etiology . Conclusion on the necessity of adequate prevention of this disease and it should need education related to the roll of STB and standards about the IUD use.

Med Dosw Mikrobiol, 1993, 45(3), 361 - 71
{Biocenosis of vagina in women in light of microbiological examinations of vaginal content}; Kuczynska K; The study was aimed at microbiological evaluation of vaginal environment in 6810 women (19-75 years of age) . Diagnostic procedure was applied according to accepted scheme, including basic and selected methods . Evaluation was performed by investigation of fresh (Miller's method) and fixed (Gram method) smears of vaginal content of pregnant women, women in childbirth and in women not pregnant, as well in the menopause and the old age . Microbiological pictures of vaginal content were classified according to modified procedure of Manu Af Heurlin . At the same time, cultures were carried on enriched and differentiating media in aerobic and anaerobic conditions . Microbiological investigations of vaginal content permitted for establishment of physiological status of vaginal environment or normal biocenosis of vagina in 3910 (57.4%) of tested patients . Disturbed biocenosis was present in 2900 (42.6%) of women and this included very serious disturbances of biocenosis in 1077 patients . In disturbed biocenosis of vagina, sexually transmissible microorganisms were main cause.

Akush Ginekol (Sofiia), 1993, 32(1), 12 - 4
{The current clinical approach in puerperal endometritis}; Pranchev N et al.; The authors report a study on clinical and microbiological aspects of endometritis in 50 parturients . The analysis of results shows that major risk factors for the development of puerperal endometritis are urgent Caesarean section, premature rupture of membranes for more than 15 hours and surgical vaginal delivery . In conclusion the authors propose their actual clinical view on diagnosis and treatment of puerperal endometritis.

Acta Vet Scand, 1993, 34(4), 371 - 7
Abortion and calf mortality in Danish cattle herds; Agerholm JS et al.; The aetiology of abortions and calf mortality in 65 Danish cattle herds consisting of both dairy and beef breeds during a 1-year period is described . All observed aborted foetuses, still-born calves, and calves dying before 6 months of age were necropsied, and relevant microbiological examinations were performed . A total of 240 calves and 66 abortions were submitted corresponding to a calf mortality rate of 7% . The abortion frequency could not be calculated . 43% of the calves died at day 0, while 22% were aborted, 15% died during the first week of life, 9% died from 1 to 4 weeks of age, and 11% died at the age of 1 to 6 months . The most common cause was neonatal pulmonic atelectasis (stillbirth) followed by foetal infections, pneumonia, and septicaemia.

Kardiologiia, 1993, 33(11), 25 - 7, 4
{Congenital heart defects with a left-to-right shunt: capillarotrophic failure of the microcirculatory system}; Nikolaeva TN; Microbiological and morphological methods were used to study abnormalities in the greater microcirculation in acyanotic heart disease . The bulbar conjunctiva (patients), greater omentum and cardiac serous membranes (autopsy material) were used as test objects . The most marked changes were revealed in the metabolic link of the microcirculatory system . They were characterized by progressive reduction in intrinsic capillaries and an increase in the modulus of microcirculation of microvessels (capillaries) of the great (exchange-shunting) type . The alternations in the structure of the microcirculatory system were accompanied by centralization of tissue blood flow and its decreased metabolic efficiency, which were clinically manifested by tissue capillary trophic tissue failure with the occurrence of a number of severe common symptoms of the disease and various organ lesions in children . Analyzing the results of the study enabled the author to be the first to reveal in the above cardiac pathology specific tissue blood circulatory disorders which are interpreted as a phenomenon of centralized microhemodynamics . The important results of the study is also the morphofunctional rationale for the concept "capillary trophic incompetence".

Gesnerus Suppl, 1993, 43, 1 - 222
{Epidemiology of the plague . Changes in the concept in research of infection chains since the discovery of the plague pathogen in 1894}; Kupferschmidt H; Three major plague epidemics have been recorded worldwide up to this day: the Justinian plague in the 6th century, the Black Death in the 14th century and the recent 20th century pandemic . The latter occurred at a time of advanced microbiological knowledge which permitted the etiology and the modes of transmission and spread of this bacterial infectious disease to be clarified . The present thesis is an attempt to describe the changes in plague research that occurred during that period of time . While the German, Austrian, British, Russian and Egyptian plague Commissions studying the Indian plague outbreak after 1896 contributed only little to the fundamental epidemiological knowledge on plague, several individual researchers succeeded in discovering some of the key facts in the etiology and transmission of the disease . Alexandre Yersin discovered the pathogenic agent of plague (Hongkong 1894), E.H . Hankin, P.L . Simond (Bombay 1898) and J.A . Thompson (Sydney 1900) recognized the role of rat plague, M . Ogata (Formosa 1897) and P.L . Simond (Bombay 1898) observed the transmission of the disease by fleas, and A.W . Bacot and C.J . Martin (1914) described the specific mechanism of transmission of plague . Accordingly, fleas transmit plague from rat to man, the efficiency of the flea as a vector depending on a blocking phenomenon specific of each flea species . The Indian rat flea (Xenopsylla cheopis) has been recognized the most efficient vector . Although the involvement of wild rodents was already known shortly after the turn of this century, the concept of sylvatic plague (the plague of wild rodents) as opposed to murine plague (the plague of commensal rodents) only emerged between 1920 and 1950 . It led to taking stock of all hosts and vectors of the disease and thereby defining the natural foci of plague . According to this concept plague is primarily a disease of wild rodents which have been carrying it together with their fleas since ever . As man and urban rats only become infected occasionally, they do not constitute chronic foci . The occurrence of persistent foci rather depends on the interaction of resistant and sensitive wild rodents (burrowing animals) as was discovered by French researchers in the Middle East as late as the 1950s and 1960s . The concept of rodent-dependent transmission was somewhat attenuated by the discovery of direct interhuman transmission by French researchers between 1930 and 1965.(ABSTRACT TRUNCATED AT 400 WORDS)

Adv Space Biol Med, 1993, 3, 237 - 61
European isolation and confinement study . Additional experiments; Novara M; Microbiological Experiments . The ISEMSI microbiological contamination experiments confirmed known hypotheses, such as: the trend toward uniformity of skin microbial flora across a group of individuals enclosed together; the rather fast "colonization" of the environment by microorganisms shed by human inhabitants; and the heavy growth of microorganisms in poorly accessible and wet areas (toilets, air conditioning) . In addition, possible disturbances of skin defense mechanisms against colonization by potentially pathogenic microbes were noted, as well as a difficulty in monitoring the microbial contents of the atmosphere (significant random variations occur between samples taken at different times and locations) . Sensors for Atmospheric Contaminants . Several different prototypes of "array sensors" for the monitoring of trace gas contaminants in the atmosphere were evaluated during ISEMSI . Their performance was promising when compared with results achieved with a more conventional (and more complex) gas chromatograph/mass spectrometer device, also used during ISEMSI . An overall picture of the most important chemical contaminants to be found in enclosed, manned habitats (including contaminants produced by man himself) was obtained via the use of Tenax gas-adsorption traps . This permitted monitoring the fluctuation of contaminants on a daily basis, as well as during the complete 4-week period . Results will provide a valuable input for designing systems to monitor and control atmospheric contamination in future spacecraft . Particular attention was devoted to the monitoring of carbon monoxide in the chamber . Results showing the correlation between its concentration in the atmosphere and the percentage of carboxyhemoglobin in the EMSInauts' blood will allow the evaluation of the correctness of the presently specified maximum allowable concentration for spacecraft . Telemedicine Experiment . The telemedicine experiment confirmed the feasibility and importance of applying to a space station scenario many aspects of remote health care already widely used in the maritime environment . ISEMSI successfully evaluated telemedical consultation procedures and training protocols for the crew . EMSInauts, trained as paramedical assistants, had to interview a "patient" (another EMSInaut, trained to feign illness symptoms), prepare an anamnesis, carry out a medical examination, assess the severity of the case, and administer effective medical care under remote medical advice . An expert system was used to provide step-by-step guidance to the paramedical assistant . ISEMSI demonstrated the great importance of practicing and rehearsing emergency procedures; it confirmed that simulation of medical emergencies during an actual long-duration space mission will be required to provide "refresher training" to astronauts trained as paramedical assistants.(ABSTRACT TRUNCATED AT 400 WORDS)

Scand J Gastroenterol Suppl, 1993, 198, 1 - 24
First attack of inflammatory bowel disease and infectious colitis . A clinical, histological and microbiological study with special reference to early diagnosis; Schumacher G; To investigate the possibilities of differentiating between inflammatory bowel disease (IBD) and infectious colitis on clinical, microbiological, laboratory and histological grounds, a prospective study of 105 patients with a first attack of colitis was undertaken . Rectal biopsy was performed on four occasions during 1 year . In 56% of the patients who proved to have IBD, the mode of onset of diarrhoeal symptoms was insidious and in 44% it was more acute, while in 81% of those who proved to have infectious colitis the onset was acute . Most patients with infectious colitis presented within 1 week, had early fever, and did not show any histological features characteristic of IBD . In most IBD patients with a non-insidious onset there were clinical warning signs of IBD, such as slight previous bowel symptoms, a late presentation time (> 1 week) and absence of early fever, or histological features characteristic of IBD . Moreover, 62% of the IBD patients with a non-insidious onset fell ill in connection with travelling abroad, gastrointestinal infection or treatment with antibiotics . Travel abroad seemed to be associated with an increased risk of developing IBD . The strongest histological predictor of IBD was basal plasmocytosis, followed by more than two vertical crypt branches/MPF, crypt distortion, villous mucosa, mucosal atrophy, epithelioid granulomas and Paneth cell metaplasia . These signs were rarely or never found among patients with infectious colitis . Their frequency increased with the interval between the initial symptoms and the first biopsy . The presence of focal basal plasmocytosis seems to be the earliest sign of IBD . The frequency of histological signs indicating IBD was maximal (88%) at the 1-week biopsy . During treatment the basal plasmocytosis and villous mucosa decreased, while crypt distortion and mucosal atrophy remained unchanged . Early treatment did not prevent the appearance of any feature . Nor did it prevent relapse . In 21% of the IBD patients microbial findings were positive . The findings consisted in known colitis-causing agents in 14% and other agents, such as viruses, in another 7% . In 78% of the patients with non-relapsing colitis (NRC), colitis-causing agents were found . Haemolytic strains of E . coli were detected more often in IBD . Among the IBD patients, 65% showed positive immunofluorescence reactivity to neutrophil granulocytes, indicating the presence of antineutrophil antibodies (ANCA) . The corresponding figure for NRC patients was 5% . Antibodies against beta-glucuronidase were found in 42% of the patients with granulocyte reactivity.

Ter Arkh, 1993, 65(3), 31 - 5
{A new conception of the pathogenesis of chronic bronchitis}; Vishniakova LA; Clinical microbiological and immunological comparisons and data on various pneumococcal pathogenetic factors suggest chronic pneumococcal infections affecting cells and tissues of the bronchial tree to underlie pathogenesis of chronic bronchitis (CB) . CB pathogenetic and clinical variants depend on the mechanisms regulating pneumococcal exudative and destructive inflammation . An obvious role of acute respiratory infections and acute bronchitis in the onset and aggravation of chronic bronchitis necessitates appropriate preventive measures.

Akush Ginekol (Sofiia), 1993, 32(3), 66 - 7
{Modern antimycotic therapy in obstetrics}; Damianov L et al.; The research includes 40 pregnant women in the second half of pregnancy with proved microbiological colpitis mycotica . Local treatment was applied with antimycotic Gyno-Pevaril . The following results had been achieved: 82% totally cured during the first course of treatment, 15%--after the second course and 3% (1 patient) needed to be treated a third course of a mixed microbiological flora . The clinical contents, pharmacokinetics and the local way of application secure the harmlessness of the treatment of the colpitis mycotica in pregnant women.

Akush Ginekol (Sofiia), 1993, 32(3), 38 - 41
{Asymptomatic bacteriospermia in men in infertile families}; Moskova P et al.; Bacteriological research of sperm has been done in 160 asymptomatic men from infertile families . A tendency of greater frequency of pathogenetic microorganisms is seen in persons with infringed inseminated capability, but the difference with the control group is not significant . The increased quantity of leucocytes in the sperm of asymptomatic men is not compulsory connected with pathological bacteriological find . The limited diagnostic value of routine microbiological research of sperm in men without symptoms of genital infection has been discussed.

Ther Hung, 1993, 41(4), 137 - 40
Local treatment of colpitis with Betadine vaginal suppository; Resch BA et al.; Observations made with Betadine vaginal suppository in the treatment of 60 women suffering from colpitis have been discussed . The results of microbiological examinations of vaginal discharge sampled before 1 week and 4 weeks after the onset of therapy were compared . The effectiveness, tolerance of therapy, and the subjective opinion of the treated women were analysed . According to the results of the examinations in response to Betadine vaginal suppository the positivity of vaginal discharge for Candida decreased from 16 to 3 cases, for Trichomonas from 8 to 1 case, for aerobic bacteria from 16 to 7 cases, and the occurrence of mixed infections from 20 to 2 cases . Subjective complaints, burning, stinging sensation were rapidly moderated . In 52 of the 60 women discharge ceased, in another 4 cases it significantly decreased . In 51 cases burning sensation in the vagina ceased, and in 5 women it significantly decreased . Recurrence was not observed when a control examination was done after 1 month . The women tolerated Betadine vaginal suppository well and found it effective and easily applicable . At the beginning of treatment burning sensation was aggravated in 3 cases . These patients refused to further participate in the examination and received systemic treatment . Due to its broad bactericidal, fungicidal, protozoicide action and its good tolerability Betadine suppository was found to be useful for the local treatment of colpitis.

Med Pregl, 1993, 46(3-4), 117 - 9
{Helicobacter pylori in patients with diseases of the upper part of the gastrointestinal tract}; Mrda Z et al.; Among the patients subjected to esophoagogastroduodenoscopy because of different clinical indications, 108 were examined for the presence of Helicobacter pylori in the antral gastric mucosa . Microbiological analysis of the antral gastric mucosa biopsies were conducted by direct microscopy, the urease test and by growing in nutritious media . Positive findings were recorded in 38 (86.36%) patients with endoscopically diagnosed chronic gastritis, 29 (80.56%) patients with duodenal ulcer and 19 (67.86%) patients with ventricular ulcer . The majority of the positive findings were recorded by direct microscopy--86 (79.63%) while the bacterial culture was positive in 66 (61.11%) cases.

Ann Trop Paediatr, 1993, 13(2), 107 - 19
Bacterial diarrhoea; Gracey M; Diarrhoeal disease caused by enteric bacterial pathogens has become less prevalent in industrialized countries, but remains an important cause of morbidity and mortality in developing countries . Although better management of acute diarrhoeal episodes has led to more favourable outcomes, persistent diarrhoea remains a problem for which risk factors are being recognized and associated bacterial pathogens identified . Unusual or intractable diarrhoea should alert health workers to the possibility of impaired immune function, which is associated with a range of enteric pathogens and opportunistic infections . Improved microbiological methods have resulted in more frequent detection of pathogens in association with diarrhoea, as well as greater understanding of pathogenesis . Clinical features of diarrhoeal disease and mechanisms involved in pathogenesis are discussed in relation to specific bacterial enteric pathogens.

Vestn Ross Akad Med Nauk, 1993, (1), 19 - 26
{The pharmacological problems of searching for and using antimutagens}; Durnev AD et al.; To design protectants of human genomic structures against mutagenic effects is defined as a new pharmacological problem; the perspectives of its solution are outlined . The experimental evidence that formed the biological basis for searching for pharmacological correctors of the mutagenic effects produced by xenobiotics is analysed, the basic principles for designing pharmacological protectants of genetic structures are formulated . Great emphasis is laid on the antimutagenic properties of antiradical agents . Evidence is provided for that there are no prospects of searching for pharmacological protectants among natural and synthetic phenol compounds . It is noted that the informative value of microbiological tests is poor . To design a corrector of the damaging action of each particular mutagen is shown to be an independent scientific problem which can be solved only by employing eukaryotic test systems . The areas of possible application of antimutagens are defined and some known examples of their use to protect human genetic structures are presented.

Probl Tuberk, 1993, (6), 2 - 5
{The use of DNA probes for the diagnosis of pulmonary tuberculosis}; Khomenko AG et al.; Mycobacterium-specific nonradioactive DNA probes have been tested able to detect mycobacteria in clinical samples (sputum, bronchoalveolar lavage) for 48 hours . The probes sensitivity makes up 1000-10,000 cells . Molecular hybridization confirms the results of DNA-probe diagnostic conclusion of tuberculosis more frequently than the results of standard microbiological tests.

BMJ, 1992 Dec 19-26, 305(6868), 1571 - 3
Does earwax lose its pathogens on your auriscope overnight?
Overend A, Hall WW, Godwin PG.
OBJECTIVES--To describe the organisms cultured from general practitioners' auriscope earpieces; and to explore general practitioners' perceptions of the possibility of cross infection from contaminated auriscope earpieces and of how their auriscope earpieces are cleaned . DESIGN--Microbiological survey of auriscope earpieces in two general practices and a semistructured questionnaire sent to 105 general practitioners . SETTING--General practitioners served by one district general hospital microbiology laboratory in the north of England . RESULTS--Organisms were cultured from 41 (93%) of 44 auriscope earpieces, of which 14 (32%) carried potential pathogens; four (9%) were heavily contaminated . Of the 85 (81%) general practitioners who responded, 72 (85%) believed that contaminated auriscope earpieces could cause serious infection, 66 (78%) did not clean earpieces between patients, and 70 (82%) thought that patients would mind if they knew that dirty earpieces were used . CONCLUSIONS--Almost a third of auriscope earpieces were contaminated by pathogenic bacteria . Although general practitioners suspected this, most did not ensure that a clean earpiece was used for each patient.

FEMS Microbiol Lett, 1992 Dec 15, 79(1-3), 529 - 34
Rumen microbiology, biotechnology and ruminant nutrition: the application of research findings to a complex microbial ecosystem; Wallace RJ; Research on rumen microorganisms has contributed greatly to our understanding of anaerobic microbial ecosystems, and has also influenced feeding practices and nutritional modelling with ruminants . However, it can be argued that rumen microbiology has not yet fulfilled its true potential . Growth-promoting ionophores, antibiotics and microbial feed additives were introduced before their microbiological effects had been determined . A more pro-active role for the microbiologist was predicted with the advent of recombinant DNA technology . Whether ventures in molecular biology can be applied successfully to benefit nutrition and health is likely to depend on whether means can be found for maintaining new strains in vivo.

Clin Mater, 1993, 12(3), 129 - 35
Ethylene oxide sterilisation of allogenic bone implants; Kearney JN et al.; We have evaluated the ability of ethylene oxide gas to penetrate bone matrices and subsequently kill a defined microbiological load . These experiments demonstrated that freeze-dried cancellous and cortical bone did not pose a barrier to the rapid diffusion of the gas . A normal cycle on a commercial ethylene oxide steriliser provided a sixfold overkill . Minor differences in the rate at which the microbiological load was killed (D-value) were seen between cortical and cancellous bone, processed and unprocessed bone, and bone of different thickness . These differences were negligible in comparison to the degree of overkill observed . Spore indicators placed freely in the steriliser chamber were shown to act as excellent monitors for the bone sterilisation process . Preliminary studies of ethylene oxide residuals indicated that processed, freeze-dried bone could be sterilised without leaving leachable toxic residuals in the matrix.

Scand J Work Environ Health, 1992 Dec, 18(6), 388 - 92
Work-related behavioral and dental risk factors among confectionery workers; Masalin K et al.; The dietary habits and dental health behavior of 294 employees in a Finnish confectionery company were studied to determine the reasons for their dental caries experience and their caries-promoting salivary microbiological findings . A diary and a questionnaire were used . A caries risk index was constructed for salivary microbiological findings . Daily dietary acidogenic exposures were calculated, and differences between low and high caries-risk groups were analyzed . Statistically significant differences in dietary habits between the low- and high-risk groups were found for the entire study population and for the men, the cookie markers, and the sweets makers . A significant positive correlation was found between untreated caries and the number of sugary meals . No differences were found in dental health behavior or dental knowledge between the study groups . The results show that the nature of between-meal snacks and confectionery workers' freedom to consume their products constitutes a potential hazard to dental health.

Steroids, 1992 Dec, 57(12), 593 - 616
Steroids, the steroid community, and Upjohn in perspective: a profile of innovation; Hogg JA; The announcement in 1949 at the Mayo Clinic of the dramatic effect of cortisone in alleviating the symptoms of rheumatoid arthritis triggered a competitive worldwide research and development effort directed toward a single goal, the practical synthesis of the rare corticosteroids . The confluence of an extraordinary coalescence of multiple events and circumstances in the growth of the Upjohn Company with the Mayo discovery, inclusive of a pioneering role in the steroid field, conspired to create an environment ripe for innovation . The breakthrough, which gave Upjohn an early competitive edge, followed with startling swiftness . A common mold of the genus Rhizopus was found to introduce enzymatically an 11 alpha-hydroxyl group directly into the female hormone progesterone, which had just been synthesized from the soybean sterol stigmasterol--a one-step solution to the known multistep alternatives for 11-oxygenation . Retrospective analysis of this event in perspective with other key developments before and after at Upjohn and in the steroid community reveals a striking profile of ongoing innovation . A parallel scenario in kind was repeated at Upjohn a quarter century later . The sister soybean sterol sitosterol was radically degraded microbiologically and concurrently oxygenated in ring C to produce 9 alpha-hydroxyandrostenedione, an alternative key intermediate for corticoid synthesis . New chemical processes, highly integrated with existing processes, assured the continuation of Upjohn's leading role in steroid hormone production.

AIDS, 1992 Dec, 6(12), 1499 - 503
Visceral leishmaniasis in HIV-1-infected individuals: a common opportunistic infection in Spain?
Medrano FJ, Hernandez-Quero J, Jimenez E, Pineda JA, Rivero A, Sanchez-Quijano A, Velez ID, Viciana P, Castillo R, Reyes MJ, et al.
OBJECTIVE: To investigate the epidemiological, clinical and biological features of visceral leishmaniasis (VL) in patients with HIV-1 infection . DESIGN: Retrospective study . SETTING: Three university hospitals in southern Spain . PATIENTS: Forty-seven adult patients with VL and HIV-1 infection diagnosed between January 1986 and November 1991 . RESULTS: Forty-five out of the 47 (96%) cases were diagnosed in the last 2 years . Fever (87%), hepatomegaly (74%), splenomegaly (72%) and pancytopenia (77%) were the most common presenting features . Most patients (79%) were strongly immunocompromised when VL was diagnosed, and were in stage IV of the Centers for Disease Control classification; 87% had a CD4 lymphocyte count < 200 x 10(6)/l . However, VL was the first severe infection diagnosed in 10 cases . Significant titres (> 1:40) of antileishmanial antibodies were detected by indirect immunofluorescence in five out of 16 (31%) cases only . Clinical response to the therapy was difficult to assess . Microbiological response was achieved in only 38% of the patients evaluated . CONCLUSIONS: Leishmaniasis is a relatively common infection in HIV-1-infected individuals in southern Spain . Its clinical picture is quite uniform and it can be the first opportunistic infection in individuals with HIV-1 . In endemic areas, a high index of clinical suspicion should be maintained in order to avoid underdiagnosis of leishmaniasisPIP: Physicians examined the records of 47 adults with visceral leishmaniasis (VL) and HIV-1 infection who were patients at 3 urban teaching hospitals in the Andalucia region in southern Spain between January 1986 and November 1991 . They wanted to identify the clinical, biological, and epidemiological features of VL in HIV-1 positive patients . 96% of the cases were diagnosed with both infections during the last 2 years of the study period and 79% between January and November 1991 . All the patients had risk factors for HIV infection (65.9% IV drug use, 21.3% sexual contact, and 12.8% blood transfusion) . 70% exhibited the classic symptoms of VL (fever, enlarged liver and spleen, and depressed counts of blood cells) . Most patients were already very immunocompromised when VL was diagnosed . 87% had a total lymphocyte count of less than 1000 x 1 million/1 and a CD4 lymphocyte count of less than 200 x 1 million/1 . In fact, 66% had full blown AIDS prior to diagnosis of VL . VL was the first severe infection in 10 cases . 68% also suffered from opportunistic infections, especially candidiasis, extrapulmonary tuberculosis, and Pneumocystis carinii pneumonia . Microscopic examination of Leishmania amastiogotes in tissue samples led to a diagnosis in 94% of cases, isolation of motile amastigotes in culture of bone marrow aspirate in 2%, and microscopic and culture in 4% . Just 46% completed a full course of treatment (pentavalent antimony, allopurinol, and/or pentamidine) . Only 38% had a microbiological response . Immunofluorescence detected sizeable titers (1:40) of antileishmanial antibodies in just 31% of cases . 17% experienced clear clinical improvement . Physicians in endemic areas should consider VL in every HIV-1 infected patient with fever, hepatosplenomegaly, or hematological abnormalities to avoid underdiagnosis of leishmaniasis .

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