Microbiological

Cesk Farm, 1991 Nov, 40(4-5), 152 - 5
{Antitubercular agents . LIV . 3-Alkyl(or -alkyl) thio-2,5-pyrazindicarboxamides}; Dlabal K et al.; From 5-cyano-3-chloro-2-pyrazinecarboxamide) (II) hydrolysis in acid medium) yielded 3-chloro-2,5-pyrazinedicarboxamide (III), which in a reaction with sodium hydrogensulfide in dimethyl-formamide) yielded 3-mercapto-2,5-pyrazinedicarboxamide (IV) . This compound through condensations with alkyl- and arylhalogenides in triethylamine) yielded 3-alkyl(or aryl) thio-2,5-pyrazinedicarboxamides of type I . The structure of compounds was confirmed by elemental analysis, IR and 1H NMR spectra . A microbiological evaluation was carried out; the antituberculous effect of these compounds is not higher than that of pyrazinamide.

Int Endod J, 1991 Nov, 24(6), 326 - 9
Actinomycosis associated with a root-treated tooth: report of a case; Figures KH et al.; An unusual case of a persistent infection related to a root-filled tooth is reported . Microscopical evaluation revealed the cause to be a large mass of Actinomyces-like filaments, and microbiological culture yielded a low level of Actinomyces israelii . The significance of such a presentation is discussed.

Parodontol, 1991 Nov, 2(4), 287 - 98
{Microbiology of periodontitis . 2 . Microbiological diagnosis of periodontitis}; Purucker P; By common methods like scaling and root planing, flap procedures or surgical furcation treatment, a successful therapy of periodontal disease is possible in about 90% of the cases . The remaining 10%, mainly patients with juvenile or rapidly progressive periodontitis, are causing great problems, due to poor treatment response and frequent, local or general recidives . In the future, microbiological tests for a precise diagnosis of the pocket flora will be used in the dental office . They can provide better indications for additional antibiotic therapy . The present article reviews several microbiological investigation methods and their future use in the office during periodontal treatment.

Vnitr Lek, 1991 Nov-Dec, 37(11-12), 888 - 92
{Central venous sepsis in long-term catheterization of patients during intensive treatment of acute leukemia}; Slechtova J et al.; The authors evaluate the prevalence of central venous catheter sepsis and possible catheter sepsis in granulocytopenic patients with acute leukaemia after intensive treatment with cytostatics . The group comprises 42 patients subjected to 57 catheterizations of a central vein . The period of catheterizations was 18-89 days, the average period 43 days . Catheter sepsis was revealed in 15 patients, i.e . 26.3% of all performed catheterizations, possible catheter sepsis was recorded in four patients, i . e . 7.0% . In almost half of the catheter sepses (42.1%) the same microbiological finding was recorded in the haemoculture and skin smear at the site of insertion of the catheter . Twelve patients were cured (21.0%), seven patients (16.7%) from the group of 42 died . To reduce the incidence of catheter sepsis it is important in the authors' opinion to make available high quality protective materials (Tegaderm plasters) and the entire infusion line should be changed daily.

J Hered, 1991 Nov-Dec, 82(6), 443 - 6
Profiles in genetics: George Wells Beadle and the origins of the gene-enzyme concept; Dronamraju KR; Beadle's success in establishing biochemical genetics on a firm foundation was due to a combination of several circumstances . These include the following: 1 . Apt timing of his work, which Garrod's work clearly lacked, was important . Geneticists were receptive to his ideas and conclusions . As Beadle (1967, 1974) himself acknowledged, much ground was prepared earlier by Garrod and Haldane, who discussed gene action in terms of biochemical reactions, although it was largely ignored . The physiology of gene action was discussed and speculated on to a great extent in the preceding years by Bridges, Goldschmidt, Muller, and Wright . 2 . Beadle's selection of Neurospora was most appropriate . It was a haploid organism (with no complications of dominance and recessivity) that could be grown and manipulated easily for isolating mutants to study their segregation and recombination within a short time . Its cytogenetics and the method of growing on chemically defined media were already worked out . It was devoid of the long generation time and more complex sex cycle (among other problems) that complicated the biochemical study of higher plants (e.g., Primula), which Haldane and Scott-Moncrieff had attempted earlier . 3 . Beadle's striking ability to shift from one organism to another--from corn to Drosophila to Neurospora--must be acknowledged . He saw the limitations of existing methods and had the courage and skill to move on to more successful methods: from conventional breeding to tissue transplants to microbiological techniques . 4 . Beadle's own curiosity about the biochemical nature of gene action and his good fortune in having had such outstanding teachers as Emerson, as well as his ability to collaborate with Ephrussi and Tatum, contributed largely to his success.

Neurobiol Aging, 1991 Nov-Dec, 12(6), 669 - 72
Necessity of a more standardized virological characterization of rodents for aging studies; van der Logt JT; Characterization of the microbiological status is an important facet of a quality assurance program for laboratory animals . This paper addresses basic issues with regard to standardization of the characterization of murine viral status . Methods for such characterization include clinical signs, virus isolation, and serological tests . Significant considerations are screening profiles; sample collection, processing, and shipment; and sampling schedules . International standardization of programs and methods to control and characterize the microbiological status of laboratory animals is being developed, and will be highly significant in future efforts to produce, control, and maintain laboratory animals free of viral infections.

Neurobiol Aging, 1991 Nov-Dec, 12(6), 663 - 8
Necessity of a more standardized microbiological characterization of rodents for aging studies; Sebesteny A; The establishment of germ-free, gnotobiotic, and SPF animal colonies is a major component of any effort to develop suitable animal models for aging research . Epidemic and endemic disease in laboratory animals can lead to unacceptable losses, contamination of research results, and exposure of staff and investigators to unnecessary health risks . Monitoring the health status and microbiological burden of the animals is particularly important . These issues are discussed, with accompanying guidelines and protocols in pragmatic, tabular form.

Aust N Z J Ophthalmol, 1991 Nov, 19(4), 317 - 20
Corneal ulceration due to Nocardia asteroides; Douglas RM et al.; A case of corneal ulceration due to infection with Nocardia asteroides is described . Microbiological examination of corneal scrapings permitted accurate diagnosis and suggested appropriate therapy . Nineteen other cases that have been described in the world literature are reviewed.

Hautarzt, 1991 Nov, 42(11), 687 - 91
{The value of symptoms and clinical findings in cervical Chlamydia trachomatis infection}; Nher H et al.; The frequency of symptoms in the case histories of 68 female patients with and of 313 without Chlamydia trachomatis infections was investigated . Dysuria, vaginal discharge and/or burning/itching in the genital region were reported by 50% (n = 34) of chlamydia-positive women and 53.7% (n = 168) of chlamydia-negative women . Clinical investigation of the chlamydia-positive patients revealed discharge in 83.8% (n = 57), contact bleeding in 38.3% (n = 26) and ectopia in 27.9% (n = 19) . The corresponding investigations in chlamydia-negative women disclosed discharge in 72.8% (n = 228) women, contact bleeding in 19.8% (n = 62) and ectopia in 16.8% (n = 52) . The results were significantly different as far as contact bleeding and ectopia were concerned . Only when yellow or whitish yellow discharge was distinguished from clear discharge was the difference between the two groups significant (66.7% vs 43.9%) . Significant numbers of polymorphonuclear leucocytes (greater than 4 per high power field with oil immersion) were found in 52.9% of the chlamydia-positive women, as against 23% of the chlamydia-negative women . Overall, 48.7% of the women with a C . trachomatis infection were found to have notes of symptoms in the history and signs of cervicitis revealed by clinical investigation . Symptoms only were found in 1 woman, while in 36.8% of the patients signs only were found . Neither symptoms nor signs were mentioned by 13.3% of the women . These results indicate that microbiological detection of the infectious agent is obligatory for the diagnosis of C . trachomatis cervicitis.

Cutis, 1991 Nov, 48(5), 411 - 7
Second-generation tetracyclines, a dermatologic overview: clinical uses and pharmacology; Maibach H; Tetracycline and its derivatives are frequently used in the treatment of acne, soft tissue bacterial infections, Lyme disease (borreliosis), chlamydial-infections, and respiratory tract infections . Several pharmacologic and microbiological properties of these antibiotics make them particularly suitable for such uses . First-generation tetracyclines have long been in use; however, the second-generation tetracyclines minocycline, doxycycline hyclate, and doxycycline monohydrate have also become widely prescribed, and can offer advantages to the dermatologist over tetracycline . This paper reviews the important pharmacologic and microbiological characteristics of these three commonly used second-generation tetracyclines, and their clinical applications in dermatology.

J Appl Bacteriol, 1991 Nov, 71(5), 434 - 8
Continued successful operation of open-fronted microbiological safety cabinets in a force-ventilated laboratory; Osborne RW et al.; The considerable refinements necessary to enable Class I and II microbiological safety cabinets to operate in a force-ventilated laboratory and to meet appropriate safety criteria have been reported previously . The continued successful operation of such cabinets without a deterioration of operator protection is described . The performance of two Class II units, one meeting and one failing the current British Standard applied to four head KI-discus testing, is compared and discussed . In addition, some further potential difficulties within the environment, which could compromise cabinet containment, are highlighted.

J Assoc Off Anal Chem, 1991 Nov-Dec, 74(6), 912 - 7
Comparison of automated liquid chromatographic and bioassay methods for determining spiramycin concentration in bovine plasma; Sanders P et al.; The performance of a liquid chromatographic (LC) method for spiramycin measurement in bovine plasma has been compared with that of a microbiological method . Plasma samples were obtained from cattle administered spiramycin intravenously . Comparison tests used were intraclass correlation (r1), correlation (r), and Student's paired t-test . For concentrations lower than 2.5 IU/mL, microbiological values were higher than LC values . This difference in results modified pharmacokinetic interpretation and might be explained by the presence of microbiologically active metabolites.

J Anim Sci, 1991 Nov, 69(11), 4512 - 22
Plasma levels of oxytetracycline, doxycycline, and minocycline in pigs after oral administration in feed; Pijpers A et al.; Steady-state plasma levels were determined for oxytetracycline (OTC), doxycycline (DC), and minocycline (MC) after medication with different in-feed concentrations . Each concentration of the three tetracyclines was examined in six pigs . The animals were housed in individual pens and fed twice daily with an interval of 12 h . All pigs consumed their feed within 1 h after it was provided . Concentrations of 400, 800, 1,600, and 2,400 mg of OTC per kilogram of feed induced steady-state plasma levels ranging from .13 to .22, .19 to .50, .39 to 1.43, and 1.41 to 2.14 micrograms/ml, respectively . On a feed intake basis, pigs received 13, 26, 54 to 81, and 108 mg of OTC per kilogram of BW per day, respectively . Steady-state plasma levels after medication with 200, 400, and 800 mg of DC or MC per kilogram of feed ranged from .37 to .89, .71 to 1.14, and 1.62 to 3.18 micrograms/ml for DC and from .21 to .60, .43 to 1.05, and 1.19 to 2.62 micrograms/ml for MC . Pigs consumed 7, 13, and 26 mg of DC and 9, 18, and 36 mg of MC per kilogram of BW per day, respectively . For all three tetracyclines there was an increase in steady-state plasma levels when concentrations in feed or per kilogram of BW increased . Plasma levels were determined with both a HPLC method and a microbiological method . A good correlation existed between the results obtained by both methods . It was concluded that based on plasma levels and known in vitro activity DC and MC could be good alternatives for OTC to treat respiratory tract infections in pigs.

Br J Ophthalmol, 1991 Nov, 75(11), 675 - 9
Ofloxacin compared with chloramphenicol in the management of external ocular infection; Bron AJ et al.; The safety and efficacy of 0.3% ofloxacin in treating bacterial ocular infections was compared with that of 0.5% chloramphenicol in a parallel-group, randomised clinical trial at five sites . Clinical and microbiological improvement rates were studied in 84 culture-positive patients . Patients with suspected bacterial ocular infections were evaluated for clinical improvement and were included in drug safety and comfort analyses . Clinical improvement did not differ significantly between drug treatments . All patients completing the study (79 assigned ofloxacin, and 74 chloramphenicol) showed clinical improvement . Clinical improvement in the culture-positive groups was 100% (41/41) after ofloxacin treatment, and 95% (41/43) after chloramphenicol treatment . Microbiological improvement rates were similar for the two drugs: 85% (33/39) improved with ofloxacin, and 88% (38/43) improved with chloramphenicol . Both drugs were well tolerated . Adverse reactions possibly due to the study medication occurred in 1% (1/89) of those who received ofloxacin, and in 4% (4/93) of those who received chloramphenicol.

Environ Health Perspect, 1991 Nov, 95, 29 - 34
Microbiological agents as health risks in indoor air; Burrell R; Ambient air may be contaminated with or carry significant levels of a variety of potentially harmful microorganisms . There are three major sources of such microbes: a) those arising from microbial decomposition of various substrates associated with particular occupations (e.g., "moldy" hay leading to hypersensitivity pneumonitis), b) those associated with certain types of environments (e.g., Legionnaires' bacteria in water supplies), and c) those stemming from infective individuals harboring a particular pathogen (e.g., tuberculosis) . This presentation deals primarily with important microorganisms from occupational and environmental sources and clearly differentiates from case to case transmission via droplet nuclei infection . Microorganisms that are uniformly injurious are differentiated from those that are more opportunistic (i.e., those that cause problems only in people with preexisting debilities) . Such microorganisms are categorized according to whether they are allergenic, infectious, or capable of inducing toxic or inflammatory reactions when inhaled . Representative examples from each of these categories, which include bacteria, fungi, rickettsia, and amoebae, are discussed . The conditions responsible for the entrance of significant numbers of these microbes into the air, the mechanisms by which they produce injury, and the methods of prevention are also considered . With attention given to some of the basic sources and requirements for such microorganisms to reproduce and enter the ambient air environment, it is a relatively simple matter to prevent the occurrence of health problems.

Int Dent J, 1991 Oct, 41(5), 300 - 4
Detection and management of the high risk periodontal patient; Ciancio SG; Periodontal diseases and patients at risk for progression of disease can be diagnosed on the basis of age, previous episodes of periodontal disease and loss of attachment, as detected by periodontal probing and radiographic evaluation . For early onset periodontitis, family history may be important . Microbiological evaluations are excellent determinants of disease and also appear to be probable predictors of 'at risk' patients . Reliable tests, including chairside tests, are available for the three most probable pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia . Biochemical changes, although associated with various disease states, are not yet readily measurable at the chairside, with the exception of one test that measures aspartate aminotransferase and shows promise as a detector and predictor of periodontal disease . The diagnosis and 'at risk' prediction of periodontal disease is based on a number of criteria, some of which are highly reliable and others whose reliability is either probable or unclear . These criteria are reviewed with emphasis on those that may be indicative of the patient at high risk of developing periodontal disease or progressing to a more severe form of disease.

Histopathology, 1991 Oct, 19(4), 297 - 301
Pulmonary granulomatosis and angiitis; Dunnill MS; A wide variety of disease processes, each requiring different therapy, may give rise to granulomatous and vasculitic pulmonary lesions, making accurate aetiological diagnosis essential . For this, adequate sampling of tissue is necessary, and this usually requires open lung biopsy in order to obtain sufficient material for microbiological, immunocytochemical and ultrastructural as well as histopathological investigation . Many cases diagnosed as lymphomatoid granulomatosis are examples of extranodal lymphoma . It is suggested that this is an inappropriate name and that such cases should be referred to as pulmonary lymphomas and the phenotype specified.

Epidemiol Infect, 1991 Oct, 107(2), 393 - 404
Development of standardized inspections in restaurants using visual assessments and microbiological sampling to quantify the risks; Tebbutt GM; The relationship between visual inspections carried out by environmental health officers and microbiological examination was studied in 89 restaurants . Using 30 variables a standardized inspection procedure was developed and each of the premises was assessed in six main areas-structure and design, cleaning and cleanliness, personal hygiene, risk of contamination, temperature control, and training and knowledge about food hygiene . Selected foods and specimens from hands, surfaces, and wiping cloths were examined . There were significant associations between all six areas of the inspections . The structure and design were significantly related to the combined score from all the other areas (P less than 0.001) . There were no highly significant associations between microbiological examination and visual assessments . The microbial contamination of wiping cloths, however, was related to the cleaning and cleanliness (P = 0.005) . Microbial sampling provided additional information to inspections and was a valuable aid . Further development of this risk-assessment approach could provide an effective system for monitoring potential health risks in high-risk food premises.

Indian J Pathol Microbiol, 1991 Oct, 34(4), 276 - 9
Pollution and sanitary quality of river Narmada in relation to human use at Mandla; Joshi A et al.; Study of physico-chemical characteristics and indicator bacterial population of Narmada river water at six different sites during summer, revealed extremely poor microbiological sanitary quality for human use . Free CO2 was found to be absent from all the sampling sites studied which indicates the trophogenic activity in the river water at Mandla . BOD value ranged from 1.0 to 2.5 mgl-1 and were less than the permissible limits of BOD in fresh waters i.e . 3-6 mgl-1.

J Indian Med Assoc, 1991 Oct, 89(10), 289 - 91
Microbiological study of vaginal discharge associated with the use of CuT 200; Rewari N et al.; A microbiological study of the vaginal discharge was conducted on 75 women attending family planning outdoors . In 24 out of 25 symptomatic CuT 200 users suffering from non-specific vaginitis, Gardnerella vaginalis was isolated from 19 cases (79%) . The difference in the recovery rate of Gardnerella vaginalis was highly significant between symptomatic CuT 200 users and non-users (p less than 0.001) and that between symptomatic and asymptomatic CuT 200 users (p less than 0.05) . But the difference between asymptomatic CuT 200 users and non-users was not statistically significant . The presence of clue cells on direct Gram's staining of vaginal discharge is significantly (p less than 0.05) related to the recovery of Gardnerella vaginalis on culture.

Med Lab Sci, 1991 Oct, 48(4), 303 - 13
The microbiology of drinking water; Lee RJ; Standards for drinking water have been formalised in the United Kingdom by recent legislation . Routine microbiological monitoring of water supplies is primarily based on tests for coliforms . These organisms have been used successfully for indicating contamination and treatment failures, but may need supplementing with other organisms to further improve confidence in water supply hygiene . Novel techniques may greatly alter the water microbiology laboratory.

Enferm Infecc Microbiol Clin, 1991 Oct, 9(8), 488 - 90
{Tuberculosis in 34 patients with HIV infection}; Garcia-Martos P et al.; The clinical and microbiological finding of 34 patients with HIV infection and tuberculosis (30 were men), 32 were intravenous drug addicts . Fever, adenopathies, hepatomegaly and splenomegaly were the most encountered manifestations on admittance . 61.8% had a disseminated form of tuberculosis; the main locations were lymphatic (73.5%) and lung (64.7%) . The detection of circulating viral antigen was associated with disseminated form of tuberculosis.

Antibiot Khimioter, 1991 Oct, 36(10), 36 - 8
{Study of trans-placental transport of methylamphotericin B in albino rats after intravenous administration}; Moguchenok EA; Transplacental penetration of amphotericin B, an methyl derivative, was studied on rats after its intravenous administration . Microbiological and radioisotopic methods were used . When the microbiological method was applied the drug was administered on days 16 to 20 or on day 20 of pregnancy in a dose of 4 mg/kg . For extraction of the antibiotic dimethylformamide was added to the substrates . The labeled antibiotic was administered in a dose of 3.3 mg/kg on days 6 to 16 and on day 20 of pregnancy . It was noted that the antibiotic accumulated in the placenta . The accumulation was more pronounced after antibiotic use in the course doses . A significant part of the antibiotic was in the placenta in the bound state . The methyl derivative amphotericin B was not detected microbiologically in the umbilical cord serum, fetal organs and amniotic fluid . Neither was it detected by extraction with ++dimethylformamide . The labeled antibiotic was neither detected in the amniotic fluid and fetal organs during the whole observation period . Therefore, the methyl derivative amphotericin B did not penetrate through the placental barrier either in the free or bound state . The direct teratogenic action of amphotericin B, a methyl derivative, after its intravenous administration to female rats is likely possible.

Rev Invest Clin, 1991 Oct-Dec, 43(4), 285 - 92
{Usefulness and risks of transtracheal aspiration in the diagnosis of pulmonary infections}; Sanchez-Mejorada G et al.; OBJECTIVE . To define the diagnostic usefulness and the risks of the transtracheal aspirate in a group of patients studied at the National Institute of Nutrition in Mexico City . DESIGN . It is a retrospective and descriptive analysis of a group of patients in whom a transtracheal aspiration (TTA) was performed due to suspicion of pulmonary infection . The study period was from 1983 to 1987 . PATIENTS . On the study period 137 patients were submitted to a TTA; the clinical files of 126 of the cases were considered suitable for analysis . RESULTS . The procedure was performed because of a suspected bacterial pneumonia in 80% of the cases, and to study an interstitial infiltrate or pulmonary nodules in 14% and 6%, respectively . In the cases in which a bacterial pneumonia was suspected, the TTA had a sensitivity of 77% and a specificity of 95% when compared against a group of clinical, radiologic and microbiological data . Sensitivity increased to 84% when the patients who received antibiotics prior to the procedure were excluded . The specificity of the sputum's culture was sensibly less in this same group of patients . The TTA proved to be of value in five of nine pulmonary tuberculosis, two of three pulmonary mycoses and three of seven P . carinii pneumonias . Adverse events were noted in 6.3% of the cases; none of them was fatal, and specific corrective measures were necessary in only two patients . CONCLUSIONS . Our results agree with previous reports related to the usefulness of the TTA on patients with a suspected bacterial pneumonia . Our specificity is higher than that seen by other authors: we believe this is due to the low incidence of chronic respiratory diseases in the patients who attend our hospital . Transtracheal aspirate can be a valuable alternative in the diagnosis of non-bacterial pulmonary infections when the elective procedures cannot be performed . A modification on the technique is proposed to increase its usefulness in patients with interstitial pneumonia.

Int Surg, 1991 Oct-Dec, 76(4), 235 - 40
Long term peritoneal nutrition in dogs, both normal and after intestinal resection; Garcia-Gamito FJ et al.; We carried out total and prolonged peritoneal nutrition (PN) in a group of healthy dogs and in another group that had previously undergone an 80% resection of the small intestine . A third group of animals underwent the same operation but did not receive intraperitoneal nutrition, as they formed the control group . A nutritive mixture was used, composed of glucose fat emulsion, aminoacids, ions, trace elements, insulin and vitamins . The caloric rate was 45 kcal/kg/day . Peritoneal nutrition lasted 30 days . Periodical clinical controls were made for biochemical, hematological, microbiological and histopathological analyses . We found two episodes of peritonitis out of a total of 19 dogs subjected to PN . Hyper- and hypoglycemia occurred in the animals with PN and that had not undergone intestinal resection there were also increases in triglyceride, free fatty acid and cholesterol levels as well as a reduction of albumin . We observed a greater decrease in albumin and urea nitrogen and a greater weight loss in the animals underwent intestinal resection . The quantity absorbed was greater than 95% of the volume infused over the four week period . In all the animals subjected to PN we found hyperplasia and phagocytic phenomena in the peritoneal mesothelium cells after 30 days of peritoneal nutrition, symptoms which disappeared one month after this kind of nutrition was stopped.

Ann Plast Surg, 1991 Oct, 27(4), 355 - 7
Synchronous eruption of cotton-induced granulomas 45 years after exposure: report of an unusual case; Bentley B 2nd et al.; A 58-year-old woman developed multiple, recurrent abscesses and subcutaneous nodules over both buttocks during a 12-year period . Microbiological studies of surgical biopsy specimens were inconclusive for a specific infectious cause, but histochemical preparations on several separate occasions revealed an exuberant foreign body reaction to raw cotton fibers . Interestingly, the patient gave a detailed history of sliding down piles of cotton hulls during her childhood, some 45 years earlier . With a probable cause-and-effect relationship established, we postulate a dramatically delayed foreign body granulomatous reaction to cotton fibers.

J Periodontol, 1991 Oct, 62(10), 617 - 22
Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use; Kopczyk RA et al.; The purpose of this study was to test the efficacy and safety of sanguinaria-containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents . The study was a 6-month, double-blind, 4-cell, placebo-controlled, parallel investigation involving 120 subjects . Following screening procedures, subjects were randomly assigned to 4 groups . Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2 . Group 2 received identical products without SaE or ZnCl2 . Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2 in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2 . Group 4 products were identical to those of Group 3 but without SaE and ZnCl2 . Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months . Microbiological samples were taken from plaque, tongue, and cheek areas . The active products produced statistically significantly lower scores than the placebo agents for all indices (P less than .0001) . Six-month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products . When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos . Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores.(ABSTRACT TRUNCATED AT 250 WORDS)

J Periodontol, 1991 Oct, 62(10), 591 - 7
A microbiological comparison of young adults based on relative amounts of subgingival calculus; Brown CM et al.; This study compared the relative amounts of Actinobacillus actinomycetemcomitans (Aa), Eikenella corrodens (Ec), and black-pigmented anaerobic rods, and the proportions of coccoid forms, nonmotile rods, motile rods, spirochetes, and total motile organisms in subgingival plaque samples from 2 groups of young adults with generalized moderate to severe periodontitis . Two groups of 12 untreated patients were selected based on the relative amounts of subgingival calculus detected . Subgingival plaque samples (2 sites/patient) were taken with a sterile curet, dispersed, and plated under anaerobic conditions on ETSA, ETSA-kanamycin, ETSA-clindamycin, and TSBV agar . Appropriate biochemical tests were performed to confirm suspected microorganisms . Phase-contrast microscopy also was used to count the relative numbers of coccoid forms, nonmotile rods, motile rods, and spirochetes in each of the samples . Patients with no clinically detectable subgingival calculus harbored significantly greater proportions (%) of coccoid forms and Aa and greater amounts (CFU/mg) of Aa than did patients with obvious amounts of subgingival calculus . Subjects with clearly detectable subgingival calculus possessed greater proportions of motile rods, total motile organisms, and black-pigmented anaerobic rods than did subjects with little or no subgingival calculus . Young adult patients with generalized moderate to severe disease and little or no detectable subgingival calculus may possess a subgingival microbiota with relatively higher numbers of Aa and coccoid forms, and a lower percentage of BPB, motile rods, and total motile organisms as compared to similar patients with greater amounts of subgingival calculus.

Rev Clin Esp, 1991 Oct, 189(6), 278 - 82
{Splenic abscess: clinico-microbiologic study of 15 cases}; de Gorgolas M et al.; We have reviewed 15 cases of splenic abscesses diagnosed using a histopathological and microbiological study . Mean age was 48 years (range 18-78) . Eight of them were male and 7 female . Eighty per cent of them had predisposing diseases, amongst which the most frequent were endocarditis and bacteriemia of other origin (26.6% in both cases) . All patients presented fever and in 7 of them (47%) splenomegaly was appreciated . The most frequently isolated germs were gramnegative bacteria (33%), anaerobics (20%), and with a similar incidence grampositive bacteria, tuberculosis and fungii; in only one case cultures were sterile . Seven patients had multiple splenic abscesses and 8 patients single abscesses . Thorax x-ray showed alterations in more than half of the patients (53%) . Abdominal echography was the diagnostic method in 67% of the patients and TAC in all the cases in which it was performed . Eight patients underwent splenectomy and one was surgically drained being the mortality rate of this group of 22% . Overall mortality was 33% and was related to the presence of multiple splenic abscesses (5/7, 71.4%), positive hemocultures (6/6, 100%), extrasplenic abscesses (7/8, 87.5%), and endocarditis (4/4, 100%), fungii infections (2/2, 100%), and late diagnosis (6/6, 100%).

Chirurg, 1991 Oct, 62(10), 732 - 8
{Helicobacter pylori colonization in surgical patients}; Ludtke FE et al.; The prevalence of Helicobacter pylori (HP) was examined in 387 patients undergoing endoscopy of the upper gastrointestinal tract . Of central interest was the question to which extent surgical intervention influences the colonisation of the gastric mucosa with HP . The bacillic status was appraised using double microbiological examinations, histological determination and the CLO-test . In 229 patients a 13C-urea-breath test was also carried out (sensitivity 98%) . HP could be detected in 90% of all patients presenting with duodenal ulcers as well as in 70% of patients with gastric ulcers, whereas in those patients in whom a lesion of the upper gastrointestinal tract could be excluded through endoscopy . HP was found in only 27% . The prevalence of HP did not increase with age . In patients having undergone distal gastric resection due to gastric ulcers, HP was only rarely found (19%) in the mucosa in the vicinity of the anastomosis following removal of the apparently pathogenetically important antrum mucosa . There was no association between anastomosis ulcers and bacillic colonisation . Following selective proximal vagotomy in patients with duodenal ulcers, HP was found in 80% of all cases . In these patients there was also no association between recurrent ulceration and a HP-positive status . Our results describe the postoperative HP-status after different surgical procedures of ulcer therapy: whereas a distal gastric resection removes the antrum mucosa, which provides the necessary environmental milieu, the HP-colonisation rate after selective proximal vagotomy is similar to that in non-operated ulcer disease.

Aust N Z J Med, 1991 Oct, 21(5), 747 - 9
Invasive aspergillosis in AIDS; Fairley CK et al.; Invasive aspergillosis (IA) is a rare infection in patients with the Acquired Immune Deficiency Syndrome (AIDS) . We report the first Australian cases of histologically and microbiologically proven IA diagnosed antemortem in AIDS patients . We also describe the first case of laryngeal involvement and the unusual case of a pneumothorax due to IA . These three cases illustrate the varied clinical and pathological features of IA in AIDS and highlight some of the difficulties in diagnosis and treatment . The infections occurred in the setting of advanced immunodeficiency and multiple opportunistic infections and responded poorly to treatment.

Genitourin Med, 1991 Oct, 67(5), 374 - 7
Declining trends in some sexually transmitted diseases in Belgium between 1983 and 1989; Walckiers D et al.; OBJECTIVE--To examine trends in some sexually transmitted diseases in Belgium and to discuss them in the light of the European background . DESIGN--Analysis of the time trends of C trachomatis and N gonorrhoeae infections diagnosed by a network of microbiological laboratories, and of male urethritis diagnosed by a network of general practitioners . SETTING--Belgium . SUBJECTS--Reports of C trachomatis and N gonorrhoeae infections by a network of microbiological laboratories, and of male urethritis by a network of general practitioners, to the Institute of Hygiene and Epidemiology . RESULTS--Whereas an increase in the number of C trachomatis infections, more pronounced among women, was observed up to 1986, a small decrease has been observed afterwards in males . The mean number of chlamydial infections per laboratory and per year was 4.2 in 1983, 15.7 in 1986 and 13.9 in 1989 . A decrease in the number of N gonorrhoeae infections, more pronounced among men, has been observed . The mean number of cases of gonorrhoea per laboratory and per year was 10.9 in 1983 and only 2.2 in 1989 . The same declining trend has been observed in another surveillance programme of male urethritis, based on a network of general practitioners . The number of cases of male urethritis per 100 patient encounters went down from 0.06 in 1982-3 to 0.04 in 1988-9 . CONCLUSION--The declining trend in Western Europe in incidence of gonococcal infections and of urethritis in men is also occurring in Belgium, but genital chlamydial infections remain an important public health problem.

Antonie Van Leeuwenhoek, 1991 Oct-Nov, 60(3-4), 145 - 58
Quantifying heterogeneity: flow cytometry of bacterial cultures; Kell DB et al.; Flow cytometry is a technique which permits the characterisation of individual cells in populations, in terms of distributions in their properties such as DNA content, protein content, viability, enzyme activities and so on . We review the technique, and some of its recent applications to microbiological problems . It is concluded that cellular heterogeneity, in both batch and continuous axenic cultures, is far greater than is normally assumed . This has important implications for the quantitative analysis of microbial processes.

J Periodontol, 1991 Oct, 62(10), 634 - 42
Clinical and microbiological patterns of adults with periodontitis; Kornman KS et al.; Although current data suggest that periodontitis may actually be multiple diseases each with varying responses to therapy, little evidence exists to support this theory in adult patients . This report describes the design and initial findings of a longitudinal field trial involving the diagnosis and treatment of adult and refractory periodontitis patients in private practice . Adult patients (N = 221) who met specific clinical criteria were selected from the private practices of 22 periodontists . Clinical characteristics were recorded and subgingival plaque samples were sent to microbiology laboratories at either UCLA or The University of Texas Health Science Center at San Antonio (UTHSCSA) . Samples were processed according to protocols standardized between the 2 centers . Five different combinations of the initial clinical and microbial findings were evaluated for patterns in the data by means of cluster analysis . Plaque, bleeding on probing, bone loss scores, probing depth distributions, and microbial findings produced multiple cluster solutions . Solutions involving 6 clusters explained 39.4% to 76.4% of the variation between patients and produced ratios for variation between clusters to variation within clusters of 5.2 to 15.3 . The optimal cluster solution incorporated both clinical and microbial findings, with some clusters characterized by high plaque and moderate bleeding on probing and bone loss, whereas others had low plaque but high bleeding on probing and bone loss . Microbial findings of each cluster exhibited distinct patterns with some clusters having a high prevalence (83% to 100%) of specific target bacterial species while other clusters had an absence of these species.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Clin Microbiol Infect Dis, 1991 Oct, 10(10), 859 - 61
High and prolonged pulmonary tissue concentrations of azithromycin following a single oral dose; Morris DL et al.; Antibiotic concentrations in pulmonary tissue samples and plasma were studied in this open investigation . Twenty-nine patients scheduled for elective pulmonary surgery received a single oral dose of 500 mg azithromycin 24, 72, 96 or 120 h prior to the operation; two patients received 250 mg b.i.d . Blood samples were taken before and at the time of resection, and tissue was obtained during surgery . Plasma and tissue concentrations of azithromycin were measured by high performance liquid chromatography (HPLC) and a microbiological bioassay . Only one patient had a detectable plasma concentration of azithromycin (0.13 micrograms/ml), measured 24 h post-dose by HPLC . However, high and sustained levels were found in lung tissue: mean concentrations measured by HPLC were 3.10 micrograms/g (SD +/- 2.17), 2.55 micrograms/g (SD +/- 1.36), 3.94 micrograms/g (SD +/- 2.40) and 3.13 micrograms/g (SD +/- 0.50) at 24, 72, 96 and 120 h, respectively . Bioassay results were similar to those for the HPLC assay . In summary, azithromycin levels in pulmonary tissue remained close to 3 micrograms/g for up to 5 days after a single oral 500 mg dose, in contrast to plasma levels which were much lower . The lung concentrations found are inhibitory for many sensitive respiratory pathogens and short-course azithromycin therapy is therefore a possibility.

Dent Cadmos, 1991 Sep 30, 59(14), 36 - 42, 45-54
{Endo-periodontal relations . Microbiological and clinical aspects}; De Sanctis M et al.; Periodontics and endodontics share common objectives and common field of interest . Both disciplines treat lesions of the periodontal tissues; in their marginal aspect the first, in the periapical aspect the latter . These relationships have not been well understood for a long time . This article is a review of the literature on the topic aimed at clarifying the anatomic, microbiological, pathogenetic relationship in the periodontal and endodontic lesions.

Eur J Obstet Gynecol Reprod Biol, 1991 Sep 13, 41(2), 129 - 33
Evidence that patients presenting with dyskaryotic cervical smears should be screened for genital-tract infections other than human papillomavirus infection; Byrne MA et al.; One hundred and fifty-four women with dyskaryotic cervical smears were referred for colposcopy from two distinct population groups, namely those who initially had attended a sexually transmitted disease (STD) clinic, and those who came from general practitioners and family planning and gynaecology clinics (non-STD group) . They were investigated to determine the prevalence and pattern of concomitant lower genital-tract infections . The mean age in each group was 25 years . Microbiological studies revealed that 79 (51%) of the women were infected, more than one infection occurring in 16 (10%) of them . Infection was present in 40% of the non-STD group and 66% of the STD group . The pattern of infection was remarkably similar in each group . Bacterial vaginosis was the most common disease in each group and accounted for more than one-third of all infections detected . Six patients had genital warts, 15 harboured Chlamydia trachomatis and 4 had gonorrhoea . Two-thirds of those with C . trachomatis and half of those with gonorrhoea were asymptomatic . We conclude that an abnormal cervical smear is frequently a marker of concomitant lower genital tract infection . Comprehensive microbiological investigations in order to effect appropriate treatment are easily achieved on women in the STD group, but the cost may be seen as prohibitive for those in the non-STD group . For these women we suggest a less comprehensive microbiological approach that provides a compromise strategy of management.

Microbiol Rev, 1991 Sep, 55(3), 335 - 48
Fluorogenic and chromogenic substrates used in bacterial diagnostics; Manafi M et al.; Methods based on the application of chromogenic and fluorogenic substrates enable specific and rapid detection of a variety of bacterial enzymatic activities . By using these techniques, enzymatic reactions can be examined simultaneously or individually, either directly on the isolation plate or in cell suspensions . For this purpose, various testing principles and test kits for clinical and food microbiology have been introduced successfully during the last few years . In this paper we present a survey of different enzymes of microbial origin that are utilized for microbiological identification and differentiation and the corresponding methods . Particular emphasis is given to the examination of Escherichia coli and the description of the different techniques as used in routine analysis.

J Dent Res, 1991 Sep, 70(9), 1239 - 51
Classification tree prediction models for dental caries from clinical, microbiological, and interview data; Stewart PW et al.; Caries prediction by Classification And Regression Tree (CART) analysis is an appropriate and powerful alternative or complement to the commonly used classification methods of logistic regression and discriminant analysis, both parametric and nonparametric . The binary classification tree method discussed in this article is designed for complex data and does not require assumptions about the predictor variables or about the presence or absence of interactions among the predictor variables . Furthermore, the results give insight into the structures and interactions in the data and are easy to interpret and apply . In preliminary applications of the CART algorithms to data from The University of North Carolina Caries Risk Assessment Study, the method produced prediction rules having sensitivities and specificities that were similar to or slightly better than those associated with logistic and discriminant analyses . The classification trees constructed tended to involve far fewer predictor variables than required for adequate logistic and discriminant models . For example, for first-grade children in Aiken, South Carolina, nine variables were used to define a prediction rule having 64% sensitivity and 86% specificity . Ten-fold cross-validation estimates for future data were 58% and 79%, respectively . For first-grade children in Portland, Maine, two variables were used to define a prediction rule having 62% sensitivity and 77% specificity . The cross-validation estimates for future data were 58% and 78%, respectively . A brief, and previously unavailable, explanation of the CART method is given for the special case of a dichotomous outcome variable.

Arch Latinoam Nutr, 1991 Sep, 41(3), 428 - 40
Chemical, microbiological and sensory evaluation of a dried salted product produced from sardines (Sardinops caerula) and cereals; Morales de Leon JC et al.; The chemical, microbiological and sensory stability of a dried salted product prepared from sardines and cereals was evaluated during a 12-week storage period . The product is named NUTRIPEZ and was produced in 20 kg/lots, both with and without smoke treatment . The product was stored under both tropical and room conditions in Mexico City, and packaged in two types of flexible packaging . Rancidity analyses were done by the peroxide value, TBA test and sensory evaluation . The results demonstrated that both the smoking of the product and the cellopolyal packaging, offered the best protection against oxidation.

Arch Latinoam Nutr, 1991 Sep, 41(3), 375 - 99
{Elaboration of a dried-salted and smoked product using aquaculture species}; Morales de Leon J et al.; The purpose of this work was to adapt the procedure developed at the Instituto Nacional de la Nutricion Salvador Zubiran (INNSZ) for the conservation of the sardine to aquaculture species such as carp (Ciprinus carpio) and tilapia (Tilapia sp) . The mixtures were designed on the basis of the chemical score method . The preparation of the patties included different fish presentations, and two methods were evaluated in order to obtain fish pulp . In the formulation of the final product, defatted soy, maize and wheat flour were included, as well as three different mixtures of condiments, which were then compared to the original formulation based on sardine . The raw materials and final products were subjected to sensory evaluation and to a shelf-life study . The results indicated that for these species, to obtain the fish pulp it is necessary to include one phase of the procedure, which can be manual or mechanical, because there are no significant differences between them . The formulations selected were: flour corn (10%)--flour soy (30%)--carp (60%), and flour corn (10%)--flour soy (22%)--tilapia (68%) . In both cases the condiment mixture was eliminated, and only common salt was used . The protein content was of 40g/100g of the dry product, with a minimum shelflife of 12 weeks at room temperature (22 degrees-23 degrees C) . During this period no rancidity developed, the product was microbiologically adequate for human consumption, and proved to have a higher sensory acceptance than sardine patties.

Acta Otorhinolaryngol Ital, 1991 Sep-Oct, 11(5), 483 - 9
{A rare case of isolated aspergilloma of the sphenoid sinus}; Avanzini F et al.; The authors report an interesting case of an isolated pathology of the sphenoid sinus (more precisely, in this case a mycotic infection of this paranasal sinus), up to a few years ago an extremely rare disease and still today an exceptional entity in the clinical practice of an otolaryngologist . The investigations carried out indicated that the infection was caused by Aspergillus candidus, a fungus which only rarely becomes pathogenic in man . The paper reports the main anamnestic data as well as the clinical and instrumental assessment of the disease . It furthermore describes the surgical procedure employed, the relative reports obtained and supplies data concerning the microbiological tests carried out on the material removed and the histological pattern observed . The surgery had an excellent outcome: the patient was cured and showed no sign of recurrence of the disease . The discussion briefly presents the clinical picture created in man by Aspergillus and stresses the rarity of the disease, noting that, including the case in question, only 23 reports, documented with histological and microscopic data, have been made in literature . The AA affirm that to their knowledge this particular case of sphenoid sinusitis caused by Aspergillus candidus {correction of Candida} is the first ever to be reported and in conclusion underline the extreme care necessary in dealing with this pathology and in making a "quoad vitam" prognosis.

East Afr Med J, 1991 Sep, 68(9), 702 - 6
Childhood liver diseases in Jos, Nigeria: a retrospective histopathological study; Obafunwa JO et al.; Forty eight needle biopsies of the liver, from children registered in the histopathological laboratory of Jos University Teaching Hospital (JUTH) were reviewed . Liver disease diagnosis was based on histopathological criteria without recourse to either clinical, biochemical or microbiological data . Hepatic Schistosomiasis (37.5%) and liver cirrhosis (25%) were the most frequently diagnosed lesions . There were only two cases of biliary cirrhosis secondary to biliary atrisia . Parasitic infestation of the liver was the most common cause of childhood hepatic dysfunction . Our results confirm the observations of workers in other tropical and subtropical regions, where infection is the commonest cause of childhood liver disease . This is in sharp contrast to the findings from European countries where neonatal hepatitis or biliary atresia are the most commonly diagnosed disorders . This retrospective study provides a good starting point for a prospective study, to determine the incidence and severity of childhood liver disease in Nigeria . This is a retrospective histopathological study aimed at establishing the pattern of liver disease in the paediatric age group in Jos . The indication for liver biopsy in all the cases was hepatosplenomegaly with or without biochemical abnormality.

J Clin Periodontol, 1991 Sep, 18(8), 577 - 80
Multiple idiopathic root resorption . A case report and discussion of pathogenesis; Moody GH et al.; A rare case of multiple idiopathic root resorption (MIRR) involving 5 adjacent anterior and posterior teeth is presented and the pathogenesis discussed . The proposition is made that MIRR results from microbiologically-induced osteoclast activity facilitated by prior osteoblast activation.

Xenobiotica, 1991 Sep, 21(9), 1171 - 7
Importance of oxygen functions in the biological hydroxylation of flavonoids by Absidia blackesleeana; Abul-Hajj YJ et al.; 1 . The synthesis and microbiological transformation of 2-phenyl-1-tetralone (compound 3, 1-deoxyisoflavanone), 3-phenyl-1-tetralone (compound 4, 1-deoxyflavanone), 2-phenylchroman (compound 7, 4-deoxyflavanone), 3-phenylchroman (compound 8, 4-deoxyisoflavanone) and 1,2-dihydro-3-phenylnaphthalene (compound 10, 1,4-dideoxy-dehydroflavanone) by Absidia blackesleeana are described . 2 . Compounds 3, 4, 7 and 8 were hydroxylated at the 4'-position while compound 10 was not utilized as a substrate . The two phenylchroman analogues 7 and 8 gave approximately the same yield (22% and 26%, respectively) of the 4'-hydroxylation products, while the phenyltetralone analogues 3 and 4 showed significant differences in 4'-hydroxylation (2% and 47%, respectively).

J Assoc Off Anal Chem, 1991 Sep-Oct, 74(5), 790 - 2
Modifications to the official method for testing chlortetracycline HCl in animal feeds; Hasselberger ML; Results are compared for the microbiological analysis of chlortetracycline using the AOAC method and a modified method applicable to potencies above 50 g/ton . Two modifications are presented: substitution of a pH range of 4.0-4.5 instead of the specified pH of 4.5 for the plating solution, and substitution of extraction by shaking instead of the blending procedure . There were no significant differences in results between the AOAC method and the modified method.

Trans R Soc Trop Med Hyg, 1991 Sep-Oct, 85(5), 681 - 4
Hygiene, skin infections and types of water supply in Venda, South Africa; Verweij PE et al.; The impact of the installation of a system to supply chlorinated drinking water in Venda, South Africa, on water quality, water use and health status was evaluated by means of questionnaires, examination for skin infections, and microbiological analysis of water samples . Although the water collection journey became shorter in comparison with use of traditional water supplies such as boreholes and unprotected springs, water use per caput showed no increase . The improved water supply showed no contamination with coliforms even after storage . Borehole water exhibited low coliform counts at the source, but after storage a 10- to 15-fold increase took place . Water samples from unprotected springs exhibited high coliform counts, which declined during storage . The prevalence of infectious skin diseases (27.5%) and diarrhoea (3.7%) among pre-schoolchildren showed no correlation with the quality of drinking water or the use of water per caput . Although the prevalence of infectious skin diseases did exhibit a negative correlation with the frequency of washing, no significant health benefit of the improved water supply could be demonstrated in this limited study.

Appl Environ Microbiol, 1991 Sep, 57(9), 2693 - 8
Rapid procedure for detecting enterohemorrhagic Escherichia coli O157:H7 in food; Padhye NV et al.; A sensitive, specific procedure was developed for detecting Escherichia coli O157:H7 in food in less than 20 h . The procedure involves enrichment of 25 g of food in 225 ml of a selective enrichment medium for 16 to 18 h at 37 degrees C with agitation (150 rpm) . The enrichment culture is applied to a sandwich enzyme-linked immunosorbent assay (ELISA) with a polyclonal antibody specific for E . coli O157 antigen as the capture antibody and a monoclonal antibody specific for enterohemorrhagic E . coli of serotypes O157:H7 and O26:H11 as the detection antibody . The ELISA can be completed within 3 h . The sensitivity of the procedure, determined by using E . coli O157:H7-inoculated ground beef and dairy products, including different varieties of cheese, was 0.2 to 0.9 cell per g of food . A survey of retail fresh ground beef and farm raw milk samples with this procedure revealed that 3 (2.8%) of 107 ground beef samples and 11 (10%) of 115 raw milk samples were positive for E . coli O157:H7 . Most-probable-number determinations revealed E . coli O157:H7 populations of 0.4 to 1.5 cells per g in the three ground beef samples . In addition to being highly specific, sensitive, and rapid, this procedure is easy to perform and is amenable to use by laboratories performing routine microbiological testing.

Minerva Stomatol, 1991 Sep, 40(9), 549 - 56
{Guided regeneration of the periodontal tissues with resorbable and nonresorbable membranes . II . Microbiological evaluation}; Sbordone L et al.; The present experimental study has been undertaken in order to analyze the influence of bacterial recolonization on periodontal wound healing following guided tissue regeneration therapy in humans . Two different surgical techniques has been carried out: one using a non absorbable membrane and the other a absorbable one . Microbiological data indicate no statistically significant difference between the techniques employed . Furthermore our data have confirmed the necessity of maintaining the healing sites free from the main periodontal pathogens.

Geburtshilfe Frauenheilkd, 1991 Sep, 51(9), 704 - 9
{Bacteriologic findings before and in transcervical chorionic villi biopsy and their clinical relevance}; Becker R et al.; Between August 1987 and May 1989, bacteriological examinations of smears from the cervical canal was performed in 358 pregnant women, who underwent transcervical sampling of chorionic villi . The outcome of 349 of these pregnancies is documented . 12 of these patients (3.5%) had an artificial abortion for genetic reasons . In 12 other patients, the pregnancy ended before 28 weeks (one child surviving) . Microbiological examinations showed that in 187 women (52%), it was possible to culture one or more microorganisms from the cervical canal . The most frequently detected pathogen was Chlamydia trachomatis (111 women, 31%) . In pregnancies, where more than one microorganism could be cultured, the risk of following abortion was 8.9 times higher than in those, where no pathogens could be found . In only two of the 12 women with a subsequent spontaneous abortion (16.6%), no microorganism could be found . The bacterial contamination of the cervical canal during TC-CVS seems to be a risk factor for subsequent abortion . Therefore, a bacteriological examination of cervical flora should be performed before as well as during TC-CVS, and antibiotic therapy should be initiated in case of positive results.

J Periodontol, 1991 Sep, 62(9), 558 - 61
Site selection criteria for microbiological testing of periodontal microorganisms; Savitt ED et al.; MICROBIOLOGICAL TESTING IS BECOMING an adjunct to the diagnosis and monitoring of periodontal patients . However, choosing which sites and how many sites among the many available in most patients is difficult . A study of 22 periodontitis patients was undertaken to attempt to provide some guidelines to these issues . All mesiobuccal sites along with sites with 4 mm or greater probing depth were sampled with endodontic points and analyzed by DNA probes for P . gingivalis, P . intermedia, and A . actinomycetemcomitans . The data suggest that sites with the deepest probing depths and sites that bleed on probing were most likely to harbor these pathogenic species . Using these clinical criteria, an approximation of the number of sites required for sampling was suggested.

J Chromatogr, 1991 Aug 16, 553(1-2), 35 - 40
High-performance liquid chromatographic determination of rifapentine and its metabolite in human plasma by direct injection into a shielded hydrophobic phase column; Riva E et al.; A simple high-performance liquid chromatographic method for determination of rifapentine, a cyclopentyl semisynthetic analogue of rifamycin belonging to the class of piperazinyl hydrazone derivatives of 3-formylrifamycin SV, and its metabolite, 25-desacetylrifapentine, in human plasma was developed using direct injection of the sample onto a Supelco LC HISEP column . The mean recovery was 100.3% for rifapentine and 99.7% for the metabolite and the precision of the assays was 3% and 7%, respectively . The limit of determination was 0.2 micrograms/ml and the method was validated for concentrations up to 64 micrograms/ml for rifapentine and 32 micrograms/ml for the metabolite . The results correlated well with those of the microbiological assay with Sarcina lutea as test organism.

Lancet, 1991 Aug 10, 338(8763), 364 - 6
Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation; Brisson-Noel A et al.; Various polymerase chain reaction (PCR) assays have been devised for the rapid identification of mycobacteria in clinical specimens . To assess the value of such assays in routine laboratory work the results obtained by PCR were compared with those obtained by standard microbiological methods for 514 specimens collected for investigation of mycobacterial infection . Specimens were tested for the presence of Mycobacterium tuberculosis complex and atypical mycobacteria in two assays, one based on amplification of the 65 kDa gene and the other on the IS6110 insertion sequence . For the 489 samples that did not contain inhibitors of the amplification reaction PCR findings correlated well with bacteriological and/or clinical data in 476 (97.4%) . 6 PCR results turned out to be false negatives, 3 to be false positives and 4 to be mis-identification of strains . Pre-treatment of samples with guanidium thiocyanate reduced the proportion of false-negative results and of samples that contained inhibitors . This study confirms the potential of DNA amplification for early diagnosis of mycobacterial infections.

Am J Med, 1991 Aug 8, 91(2A), 135S - 146S
The gastropulmonary route of infection--fact or fiction?
Tryba M.
Published studies relating to whether medicinal stress-bleeding prophylaxis leading to an increase of gastric pH favors the development of bronchopulmonary infections are reviewed . Results from studies in healthy humans, patients with ulcer disease, and patients in the intensive care unit (ICU) clearly show that the risk of gastric bacterial colonization significantly increases relative to increasing gastric pH . Moreover, a drug-induced increase of gastric pH leads directly to gastric bacterial colonization also in patients in the ICU, above all with bacteria typical of the gastrointestinal tract . Comparing the different bacterial spectra of the oropharynx, stomach, and upper small intestine, it becomes clear that the stomach is a reservoir of bacteria independent of the oropharynx and also subject to retrograde colonization due to the duodenogastric reflux . Both by means of microbiological and in particular direct detection procedures, it can be demonstrated that in at least 30-40% of intubated patients a gastropulmonary route of colonization occurs . In patient groups without a medication-induced increase of gastric pH the number of bacteria detected in the tracheal secretion is about 33% less than in the case of conventional stress-bleeding prophylaxis . These findings make it understandable that a highly significant increase in the pneumonia rate is seen in patients receiving pH-increasing stress-bleeding prophylaxis versus control groups without therapy essentially influencing gastric pH . A risk score was developed that allows an easy description of those patients who are at an increased risk of pulmonary infections due to the gastropulmonary route of colonization.

Aust N Z J Ophthalmol, 1991 Aug, 19(3), 193 - 6
Corneal biopsy in microbial keratitis; Whitehouse G et al.; Presumed microbial keratitis in the absence of a specific microbiological diagnosis is a particularly difficult clinical problem . Corneal biopsy may provide the diagnosis when corneal scrapings have been negative . We present two cases in which corneal biopsy was helpful and discuss the role of corneal biopsy in the management of chronic keratitis.

Vrach Delo, 1991 Aug, (8), 80 - 3
{Differential diagnostic principles and the classification of infectious-inflammatory diseases of the nervous system}; Golovchenko IuI; The author presents data on multifactorial principles of classification and differential diagnosis of infectious-inflammatory diseases of the nervous system with consideration of immune interaction of macro- and microorganisms, local factors of infection and inflammation, etiological principles, microbiological verification, bacteriology . The importance is stressed of pre-etiological diagnosis of the acute period in determining the trends of pathogenetic treatment.

Dtsch Tierarztl Wochenschr, 1991 Aug, 98(8), 303 - 6
Metabolic behaviour and tissue distribution of nalidixic acid in chickens; Atef M et al.; The metabolic behaviour and tissue distribution of nalidixic acid in normal and E . coli infected chickens were carried out using spectrofluorimetric and microbiological techniques following a single and multiple oral administration of 25 mg/kg b . wt . The obtained results revealed that free nalidixic acid (free NA) is the major fraction of the total drug concentration in serum, liver and kidneys . The free active nalidixic acid was in a higher concentration than hydroxynalidixic acid (free HNA) and both conjugates of NA and HNA following single and multiple oral administration . The obtained results showed that nalidixic acid was highly distributed in all tissues in normal and E . coli infected chickens, with the highest concentrations in kidneys, liver and heart and lowest concentrations in brain, muscles and intestine following oral administration of 25 mg/kg b . wt . twice daily for 5 successive days . Spectrofluorimetic technique was more sensitive for nalidixic acid determination than microbiological method . Nalidixic acid revealed longer withdrawal time in diseased chickens than in normal chickens.

Epidemiol Infect, 1991 Aug, 107(1), 157 - 70
Physical protection against airborne pathogens and pollutants by a novel animal isolator in a level 3 containment laboratory; Wathes CM et al.; A containment laboratory unit for research with aerosols of group 2 pathogenic microorganisms is described . The design criteria are based on current UK guidelines, which imply containment at group 3 level during aerosol production, storage, exposure of animals and sampling . Within the aerosol laboratory, primary containment is provided by a Henderson apparatus operating at a negative pressure to the external environment . Flexible film isolators under negative pressure are used for all hazardous microbiological work, e.g . tissue homogenization, and for housing infected laboratory rodents . A novel feature of the animal isolator is the separate ventilation of each cage, which minimizes the risk of cross-infection by aerosol transmission and ensures a similar environment within each cage . The results of an intentional release of a cloud of non-pathogenic microorganisms are presented to show the effectiveness of the containment barriers . Recommendations are given for the safe operation of a containment unit based upon practical experience.

Antimicrob Agents Chemother, 1991 Aug, 35(8), 1586 - 90
Clinical evaluation of teicoplanin fluorescence polarization immunoassay; Rybak MJ et al.; A teicoplanin fluorescence polarization immunoassay (FPIA) developed by International BioClinical (IBC) was evaluated by using serum samples from patients who had been receiving teicoplanin at Detroit Receiving Hospital (DRH) as part of a clinical investigation . Patient samples collected over a 1-year span were assayed at DRH and at IBC, and the results were compared with those of a standard microbiological assay performed at Merrell Dow Research Institute, Indianapolis, Ind . The FPIA has a rapid turnaround time (circa 20 min), utilizes small sample volumes (less than 100 microliters) and is sensitive and accurate in determining concentrations in the range of 5 to 100 micrograms/ml . The intra-assay and interassay coefficient of variation for controls (7, 35, and 75 micrograms/ml) was less than or equal to 13% . Concentrations greater than 100 micrograms/ml must be diluted prior to the assay, which may introduce additional error in determination . The FPIA compared well with the bioassay (r = 0.901) for 193 clinical samples . The results obtained utilizing the FPIA system were reproducible at two different sites, as illustrated by the high degree of correlation between the results at DRH and IBC (r = 0.92) . There was less than 7% interference noted when teicoplanin was assayed in the presence of other antibiotics . Patient samples stored for up to 1 year retained their potency: the mean recovery rate in these samples was 107% . The FPIA should be useful for monitoring and adjusting teicoplanin dosage regimens in patients.

Parodontol, 1991 Aug, 2(3), 207 - 22
{Microbiology of periodontitis . 1 . The infective nature of periodontitis}; Purucker P; In the last years, guided tissue regeneration (GTR) and implantology have opened new possibilities for practical periodontologists in the treatment of advanced cases . For both techniques the successful therapy of the local infection of the pocket is a prerequisite . In the near future rapid tests for microbiological diagnoses and slow release devices for antibiotics will be available to achieve this aim easier . The following article will present the microbiological aspects of periodontitis and plaque control and show their relevance for the practitioner.

Acta Paediatr Jpn, 1991 Aug, 33(4), 564 - 72
Infectious complications in childhood leukemia; Hirotsu T et al.; Since children with acute leukemia have prolonged periods of severe neutropenia due to the disease itself or its intensive chemotherapy, they often develop life-threatening infectious complications . A protected environment and prophylactic antibiotics for patients with severe neutropenia have been shown to decrease the incidence of infectious morbidity . In spite of the high mortality rate of infections, on the other hand, their diagnosis is not well established because the percentage of microbiological detectability by blood culture is low . The differentiation of infections may be possible by using some supplementary measures and particular laboratory parameters . Febrile neutropenic patients with leukemia should promptly receive empiric treatment with combinations of two or three broad-spectrum antibiotics that are bactericidal and synergistic toward the presumed pathogens, or with antifungal drugs if patients are resistant to antibiotics, as well as supportive measures such as granulocyte transfusion, intravenous gamma-globulin and granulocyte colony-stimulating factor.

J Chemother, 1991 Aug, 3(4), 250 - 4
The efficacy of mezlocillin-amikacin combination in febrile neutropenic children with oncologic disease; Zulfikar B et al.; The efficacy of mexlocillin-amikacin combination as empirical therapy for febrile neutropenic patients was studied in 30 children (21 males, 9 females) with various oncologic diseases aged 1-15 years (mean age 7.3 +/- 4.4) in the Istanbul Medical School, Oncologic Disease Research and Treatment Center, and Department of Pediatric Hematology-Oncology between January 1 and May 31, 1988 . The response rate was 76.6% . Profound persistent granulocytopenia (fewer than 100 ml) was present in 70% of the patients . In 63.3% of patients, the infections were microbiologically documented (60%) Gram(+) and 40% Gram(-) . The combination was well tolerated with hepatic and/or renal disturbances in 8 cases (26.6%) . We conclude that mezlocillin-amikacin is an effective empirical combination in the initial treatment of infections in febrile neutropenic children with various oncologic diseases.

J Antimicrob Chemother, 1991 Aug, 28(2), 291 - 9
Relationship between cefpirome clearance, serum creatinine, weight and age in patients treated for infection; Wilcox MH et al.; Cefpirome serum concentrations were measured by microbiological assay in 30 patients after five to nine days of treatment with 1 or 2 g bd for moderate to severe infection of presumed bacterial origin . Patients with serum creatinine (SCr) greater than 220 mumol/L were excluded . The age of patients ranged from 34-86 years . Creatinine clearance (Clcr) was calculated from age, sex, weight and SCr . The range of SCr was 63-220 mumol/L and the range of Clcr was 18-169 mL/min . The correlation coefficient with cefpirome clearance was 0.464 for SCr and 0.747 for Clcr . More than half of the patients with Clcr less than 50 mL/min had SCr within the normal range of 70-150 mumol/L . Mean cefpirome clearance in patients with Clcr 18-50 mL/min was 42.7 mL/min, which is very similar to the figure of 43.5 mL/min reported in a single dose volunteer study in patients with renal failure . Mean cefpirome clearance in patients with Clcr greater than 80 mL/min was 107.6 mL/min . In conclusion, these data on cefpirome clearance obtained after multiple dose treatment of patients with presumed bacterial infection are consistent with data previously obtained from single dose volunteer studies and support the currently recommended dose regimens . Clinicians should take account of age, weight and sex when estimating renal function from SCr.

Anal Biochem, 1991 Aug 1, 196(2), 284 - 9
A sensitive radioenzymatic assay for (S)-5-formyltetrahydrofolate; Priest DG et al.; A highly sensitive, radioenzymatic method has been developed for the specific and quantitative estimation of (S)-5-formyltetrahydrofolate . This method is based on enzymatic cycling of the 5-formyl derivative to methylenetetrahydrofolate followed by entrapment into a stable ternary complex with thymidylate synthase and tritiated fluorodeoxyuridylate . Determination of bound radiolabeled ligand permits estimation of the original folate . The initial cycling step is catalyzed by the enzyme, methenyltetrahydrofolate synthetase, which is specific for the (S)-diastereomer of 5-formyltetrahydrofolate and generates a product which can be further cycled to tetrahydrofolate using either 10-formyltetrahydrofolate deacylase or glycinamide ribonucleotide transformylase . Tetrahydrofolate is ultimately converted to the entrapable methylene derivative in the presence of excess formaldehyde . Using this assay recovery of reference (S)-5-formyltetrahydrofolate was linear over the range 0.03-1.9 pmol with an average recovery of 83 +/- 2% . The method has been applied to estimation of plasma (S)-5-formyltetrahydrofolate from a volunteer who had been administered (R,S)-5-formyltetrahydrofolate . Where comparison was possible, estimation of plasma (S)-5-formyltetrahydrofolate by this one step ternary complex-based method yielded results that were very similar to those observed by Straw et al . (Cancer Res., 44, 3114, 1984) who used an HPLC-based method for separation of diastereomeric mixtures of reduced folates and microbiological growth dependence to determine (S)-5-formyltetrahydrofolate.

J Dermatol, 1991 Aug, 18(8), 438 - 46
Dermatophytosis in children and adolescents: epidemiological, clinical, and microbiological aspects changing with age; Zienicke HC et al.; During a four year period, a total of 84 cases of dermatophytosis were seen in patients from 0 to 17 years of age attending our out-patient department . The sex distribution was about equal in preadolescents . Males predominated among adolescents . A peak incidence at early school age was due to cases of tinea capitis, mainly caused by Microsporum canis . A peak among adolescents was due to cases of tinea pedis, mainly caused by Trichophyton rubrum . In general, patients with Trichophyton rubrum infections were older than those with other types of dermatophytosis (p less than 0.05) . Dermatophytosis due to Microsporum canis was most frequently seen in January and in September (p less than 0.01) . Although onychomycosis due to dermatophytes was a comparatively rare disease, it did occur within all age subgroups . Entities which were very frequent in former times and which have become rare during the last decades, such as tinea capitis due to Trichophyton schonleinii, still contribute to the spectrum of dermatophytosis in childhood.

Am J Reprod Immunol, 1991 Aug, 26(1), 42 - 6
Mouse model for the treatment of immune pregnancy loss; Toder V et al.; Spontaneous abortions can be associated with preimplantation embryo loss, implantation problems and a variety of postimplantation pregnancy failures . The long list of possible causes for the postimplantation pregnancy loss includes, among others, genetic abnormalities in fetus, anatomical abnormalities of the uterus, endocrinological insufficiency, and microbiological problems . However, more than 50% of recurrent miscarriages still have no recognized causes . The concept that many such abortions may be immunologically mediated has gained increasing support over the years . Moreover, immunization of such women with husband's or third party leukocytes has resulted in more than 70% of subsequent pregnancies resulting in live births . Since neither the mechanisms leading to pregnancy loss nor the success of immunotherapy are clear, the set-up of animal models for recurrent abortions would be of supreme significance . Our recent data show that immunopotentiation of maternal immune system by Complete Freund Adjuvant significantly improves pregnancy rate in CBA x DBA/2 mouse combination with high percentage of fetal resorptions . This effect is followed by decrease of IL 2 production in spleen; increase of MAC 1-positive cells at placenta; amplification of suppressive activity of local and systemic lymphocytes and by reverse of embryotoxic effect of maternal serum . Data obtained in this model seems to be valuable in substantiation of rationale for nonspecific immunotherapy of human abortions.

Prenat Diagn, 1991 Aug, 11(8), 539 - 50
Chorionic villus sampling: analysis of fetal losses to delivery, placental pathology, and cervical microbiology; Wilson RD et al.; A population of 1639 patients were seen for chorionic villus sampling (CVS) . Embryonic death was identified at ultrasound in 5.3 per cent of patients . The number of patients undergoing CVS was 1551, with 1416 transcervical procedures and 135 transabdominal procedures . The most common indication for CVS was advanced maternal age . Spontaneous pregnancy losses identified by increased risk of pregnancy loss with increasing aspiration attempts . The total fetal loss for this population was 5.4 per cent with the pregnancy loss estimated due to procedure being 1.2 per cent . Analysis of placentae from patients having CVS and amniocentesis showed no differences . Microbiological assessment prior to CVS was similar to previous publications.

Pharm Res, 1991 Aug, 8(8), 1056 - 8
Bioavailability of erythromycin acistrate from hard gelatin capsules containing sodium bicarbonate; Marvola M et al.; Erythromycin acistrate is a new prodrug of erythromycin . Its bioavailability from hard gelatin capsules containing the drug with or without sodium bicarbonate was studied in healthy volunteers . The plasma levels of erythromycin, anhydroerythromycin, and acetylerythromycin were measured using an HPLC method . Addition of sodium bicarbonate to the capsule markedly enhanced the plasma level of the microbiologically active substance, erythromycin, doubling the Cmax and AUC values (P less than 0.05) . At the same time, the lag time in the absorption curve was shortened to one-third . No changes in the plasma levels of the inactive metabolite anhydroerythromycin were noted . It is concluded that adding sodium bicarbonate to an erythromycin acistrate formulation enhances its bioavailability.

J Neurol, 1991 Aug, 238(5), 265 - 70
Familial myopathy with elevated serum angiotensin-converting enzyme, creatine kinase and lactate dehydrogenase isoenzyme 5; Henze T et al.; A family is reported in which two members presented with proximal myopathy associated with high serum levels of angiotensin-converting enzyme (SACE), creatine kinase (CK), and lactate dehydrogenase isoenzyme 5 . Examination of three relatives revealed elevated SACE levels in all of them, but no myopathy . No evidence of sarcoidosis, the most common disease associated with high SACE levels, could be found . Muscle biopsies of the two affected men revealed myopathic features without granuloma formation . Extensive biochemical, metabolic, immunological, and microbiological studies were all non-contributory . Corticosteroid and, in one patient, azathioprine treatment resulted in an improvement of muscle weakness and in a decrease of SACE as well as CK levels.

JAMA, 1991 Jul 24-31, 266(4), 555 - 8
Septic reactions to platelet transfusions . A persistent problem; Morrow JF et al.; OBJECTIVE . To determine the medical and laboratory characteristics of bacteremia secondary to transfusion of microbiologically contaminated platelet concentrates . DESIGN . Febrile transfusion reactions were prospectively monitored over 42 months . Units involved in reactions were evaluated with Gram's stain and culture tests . SETTING . Comprehensive cancer center . PATIENTS . Patients receiving platelet transfusions for thrombocytopenia secondary to bone marrow failure . RESULT . Seven cases of transfusion-associated sepsis were observed . Multidonor platelet products stored for 5 days resulted in an incidence of sepsis five times higher than those stored for 4 days or less (P less than .01) . Investigation indicates that contamination most likely occurred at the time of blood collection . Clinically, septic reactions were associated with greater temperature elevations (average increase, 2.0 degrees C) than febrile reactions to sterile products . CONCLUSIONS . Contamination of platelet concentrates remains a significant clinical problem . Septic episodes may be reduced by transfusion of platelets with shorter storage intervals.

Invest Ophthalmol Vis Sci, 1991 Jul, 32(8), 2272 - 80
The role of cholesterol in chronic blepharitis; Shine WE et al.; Chronic blepharitis has been a difficult disease to define either microbiologically or biochemically . Sterols from meibomian secretions of normal subjects and patients were analyzed, and important differences were observed . Based on analyses of these secretions, two significantly different (P less than 0.001) types of normal subjects were found, those with and those without cholesterol esters {Norm(CP) and Norm(CA), respectively} . All patients' secretions contained cholesterol esters . Evidence was obtained which suggests that oxysterols may control the ester cholesterol accumulation . Furthermore, only when cholesterol esters were present did wax and sterol esters containing unsaturated fatty acids accumulate . Over 90% of these unsaturated fatty acids were normal (unbranched); the rest were iso-fatty acids . Preliminary results also suggest that the ester fatty alcohols are much more complex than previously reported; seven alcohols were common to all samples analyzed . Additionally, highly oxygenated alcohols were detected, especially in the meibomian keratoconjunctivitis (MKC) disease group . The MKC samples also contained an alcohol (mass, M/Z 378) not present in any of the other samples analyzed . Based on analysis of variance and linear-regression models, it was determined that the long-chain (C20-28) fatty acids were more important in determining disease signs . Furthermore, in the MKC group, the ratio of unsaturated C18 fatty acids to cholesterol in the wax and sterol esters was significantly different (P less than 0.05) from the Norm(CP) group . The authors discuss the fact that rabbit meibomian secretions are stable, despite containing a very high percentage of ester sterols, and relate this to their high percentage of branched-chain fatty acids and low percentage of unsaturated fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

Avian Dis, 1991 Jul-Sep, 35(3), 601 - 5
Identification of F strain Mycoplasma gallisepticum isolates by detection of an immunoreactive protein; Thomas CB et al.; Commercial laying hens were examined microbiologically at necropsy 31 or 42 weeks after aerosol vaccination with the F strain of Mycoplasma gallisepticum (MG) . Mycoplasma isolates were studied in Western blots probed with polyclonal antiserum raised in rabbits to F strain immunogen . The persistence of the vaccine strain was demonstrated by detection of a 75-kilodalton immunoreactive protein, which was present in all MG isolates and thought to be a unique marker of the F strain . Use of PCA-F to probe Western blots allowed simultaneous identification of non-MG isolates, non-F strains of MG, and the F strain of MG.

Respir Med, 1991 Jul, 85(4), 313 - 7
The value of routine microbial investigation in community-acquired pneumonia; Woodhead MA et al.; The way in which microbiological investigations are used in routine clinical practice and the value of such tests in directing antibiotic prescribing, was studied in adults admitted to hospital with a diagnosis of community-acquired pneumonia . One-hundred and twenty-two consecutive patients admitted to one teaching and one district general hospital were studied between April 1988 and March 1989 . Blood cultures were performed in 81% of cases, sputum was examined in 45% and complete serological tests were performed in 28% . No causative pathogen was found in 74% of cases and results of microbial tests directed a change in antibiotic therapy in only 8% of cases . Routine microbial investigation of all adults admitted to hospital with community-acquired pneumonia is unhelpful and probably unnecessary . We suggest a strategy for microbial investigation linked to initial illness severity to replace the current haphazard approach.

Hautarzt, 1991 Jul, 42(7), 434 - 8
{The value of symptoms and findings in urethral Chlamydia trachomatis infection}; Naher H et al.; The history and the results of clinical investigations in 74 patients with and 262 men without urethral Chlamydia (C.) trachomatis infection were evaluated: symptoms such as dysuria, discharge and/or burning/itching in the genital region were reported by 77% (n = 57) of the patients with an infection and 63.4% (n = 166) of the men without an infection . Upon clinical investigation, discharge was found in 55.4% (n = 41) of the chlamydia-positive patients and in 47.7% (n = 125) of the chlamydia-negative men . Only when yellow, whitish yellow and clear discharge were distinguished from one another was the difference between the two groups of patients (56.1% versus 12%) significant . Microscopic signs of urethritis, i.e . significant numbers of polymorphonuclear leukocytes (greater than 4 per high-power field and oil immersion) were detectable in the smears of 59.5% (n = 44) of the chlamydia-positive patients, in contrast to 15.6% (n = 41) in the smears of chlamydia-negative men . Overall, 67.6% (n = 50) of the patients with a C . trachomatis infection reported symptoms in the anamnesis combined with signs of urethritis upon clinical and microscopic investigation . There were 9.5% (n = 7) of the patients who either mentioned symptoms or showed clinical signs, and 13.5% (n = 10) who neither mentioned symptoms nor showed clinical signs . These results indicate that microbiological detection of the infectious agent is obligatory for diagnosis of urethral infection with C . trachomatis.

Nucl Med Commun, 1991 Jul, 12(7), 583 - 92
Combined 67Ga citrate and 99Tcm-human immunoglobulin imaging in human immunodeficiency virus-positive patients with fever of undetermined origin; Buscombe JR et al.; Patients infected with the human immunodeficiency virus (HIV) suffer from serious and life-threatening infections . These patients often present with pyrexia but without localizing signs . Despite its high sensitivity in identifying focal infection 67Ga citrate scintigraphy lacks specificity; lymphoma and solid tumours may also be imaged . This presents particular problems in HIV-positive patients with pyrexia where the differential diagnosis is often between infection and lymphoma . In an attempt to improve the specificity of radionuclide imaging in these patients a combination of 67Ga citrate and the new agent 99Tcm-labelled human immunoglobulin (99Tcm-HIG) was used in 25 patients who were sequentially imaged with the two agents . Fourteen patients had 29 sites of microbiologically confirmed infection; 67Ga citrate identified 27 sites and 99Tcm-HIG identified 16 sites . Seven of the nine sites visualized with 99Tcm-HIG, but positive with 67Ga citrate, were intrathoracic . Abnormal concentration of 67Ga citrate, not due to infection, occurred at eight sites; five lymphoma, one gout, one recent fracture and one patient with prominent bone marrow islands . 99Tcm-HIG showed increased concentration of tracer in only one of the patients with lymphoma . A combination of 67Ga citrate and 99Tcm-HIG imaging in HIV-positive patients with pyrexia of unknown origin enables a differentiation between infection and lymphoma to be made more readily . The poor sensitivity of 99Tcm-HIG in the chest will limit its sole use in this patient group.

J Clin Microbiol, 1991 Jul, 29(7), 1372 - 5
Enzyme-linked immunosorbent assay using monoclonal antibodies for identification of mycobacteria from early cultures; Verstijnen CP et al.; A simple enzyme-linked immunosorbent assay (ELISA) for the identification of cultured mycobacteria belonging to the Mycobacterium tuberculosis complex, the Mycobacterium avium complex, and Mycobacterium kansasii has been developed (R . Schoningh, C . P . H . J . Verstijnen, S . Kuijper, and A . H . J . Kolk . J . Clin . Microbiol . 28:708-713, 1990) . The test for the routine identification of cultured mycobacteria was introduced in five clinical laboratories located in Tanzania, Thailand, Vietnam, and The Netherlands . The ELISA can be conducted without an ELISA reader since the test can be read visually . The results of identification of 255 strains of the M . tuberculosis complex by microbiological means and by ELISA were compared; the specificity and the sensitivity were 100% . For the M . avium complex, the specificity was 100% and the sensitivity was 64% . All 26 M . kansasii strains tested could be identified as M . kansasii . The ELISA described here proved to be useful in both well- and modestly equipped laboratories and may replace the microbiological method of identification of M . tuberculosis and M . kansasii.

Int J Food Microbiol, 1991 Jul, 13(3), 187 - 206
Public health implication of refrigerated pasteurized ('sous-vide') foods; Mossel DA et al.; Food that upon pasteurization is stored in hermetically sealed containers at food temperatures not exceeding 3 degrees C could be designated by the generic term Refrigerated Pasteurized Foods of Extended Durability, REPFEDs . If not properly processed or protected against recontamination, or if temperature-abused, REPFEDs may present serious health risks . However, control is readily available . Sound microbial ecology, supported by expert risk assessment, allows the design and introduction of longitudinally integrated manufacture, distribution, handling by outlets and consumers and culinary preparation, which result in the assurance of the wholesomeness of the commodity as eaten . Recent progress, including intrinsic preservation by the incorporation of starter cultures, bacteriocins or particular enzymes, opens vistas for attractive future developments . Once microbiological safety has been built into the REPFED-line, monitoring can be limited to (i) real-time tests particularly applied to the factory environment; and (ii) rapid, simple examination for marker organisms of freshly manufactured products versus those approaching expiration dates . Such audits will allow rapid retrieval of incidental process failure and its rectification . It also serves to substantiate measurements of food temperature and spot checks on intrinsic inhibitory attributes . The application of scientific knowledge and technological expertise should primarily be entrusted to the industry itself, heeding Lord Plumb's strategy of "partnership along the food production chain from farm to fork." It should be supported and validated by Public Health Authorities . At all stages safety communication with the public should be ensured.

J Clin Periodontol, 1991 Jul, 18(6), 447 - 54
Anti-plaque agents . Rationale and prospects for prevention of gingivitis and periodontal disease; van der Ouderaa FJ; Oral health surveys have shown that even in countries with established patterns of oral hygiene habits, most individuals have relatively poor gingival health . This is due to a low interest in complying with oral health procedures . A number of factors are apparent when investigating compliance to oral hygiene habits, viz only approximately 50% of the population brushes twice a day or more, brushing time is probably much too short and use of dental floss is not very prevalent . Studies of the effect of motivation on oral hygiene suggest that improvements can be achieved, but these are not maintained unless motivation is continuously reinforced . This suggests that topically applied anti-plaque agents should be used to augment mechanical plaque control . A number of product forms are available to delivery anti-plaque agents i.e., mouthrinses, dentifrices, aqueous gels, and additionally floss, chewing gum and lozenges . Any product form should provide a physically, chemically and microbiologically stable environment for the agent concerned . It should facilitate optimal bioavailability of the agents at the site of action and encourage patient compliance . Anti-plaque agents for topical administration should have the following properties: high intrinsic efficacy against a broad spectrum of oral organisms, toxicological and ecological safety, oral substantivity, no adverse reactions and good chemical stability . A number of classes of anti-plaque agents have been identified such as positively charged organic molecules, metal salts, phenols, enzymes, peroxides, sugar substitutes, fluorides and surface modifying agents . In order to achieve optimal bioavailability, the agent to be dosed should be compatible with the product form used . The 2 major product forms are rinses and dentifrices.(ABSTRACT TRUNCATED AT 250 WORDS)

Clin Microbiol Rev, 1991 Jul, 4(3), 243 - 55
Human infections associated with Bordetella bronchiseptica; Woolfrey BF et al.; This study examines the potential of Bordetella bronchiseptica to act as a human pathogen . After encountering two patients from whom B . bronchiseptica was isolated, we searched the literature and found 23 reports in which a human infection was reported in association with B . bronchiseptica . As a basis for evaluating these cases, we summarize the literature about the current microbiological status of B . bronchiseptica, the pathology and pathogenic mechanisms associated with the microorganism, and the likelihood of it acting as a commensal or colonizer . From this review we conclude that B . bronchiseptica has been rarely isolated from humans despite their considerable exposure to animal sources . Evidence suggests that B . bronchiseptica may be rarely encountered as a commensal or colonizer of the respiratory tract of humans and rarely in association with infection . When found as a probable pathogen, most infections have been respiratory tract in origin and have occurred in severely compromised hosts.

J Infect, 1991 Jul, 23(1), 57 - 63
Northwick Park Infection Consultation Service . Part II . Contribution of the service to patient management: an analysis of results between September 1987 and July 1990; Wilkins EG et al.; The establishment of Infectious Disease teams combining microbiological and clinical expertise has recently been recommended by a joint working part of the Royal College of Physicians and the Royal College of Pathologists . The Northwick Park Infection Consultation Service (ICS) has been operating on these lines since 1983; details are given in Part I . Part II assesses the contribution that the ICS has made to the management of infection in a study of 1038 patients undertaken between September 1987 and July 1990 . The areas of patient diagnosis, treatment, investigation and isolation were examined to assess the appropriateness of the attending doctor's management of infection and the benefits resulting from recommendations made by the ICS . At the time of consultation the correct diagnosis had already been made or considered in 93% of patients, essential investigations needed to confirm or refute the diagnosis performed in 92%, and side-room isolation correctly instituted in 81% of patients requiring it . However, 41% of 776 infected patients were receiving suboptimal treatment: this was significantly more frequent in unsolicited consultations (P less than 0.05) . Advice was given following consultation in 893 of 1038 patients (86%) and related to treatment (66%), investigation (41%), diagnosis (30%) and patient isolation (4%) . Of 844 patients where receipt of advice could be accurately assessed, it was taken fully in 708 (84%), partly in III (13%), and went unheeded in 25 (3%) . Advice on diagnosis or investigation enabled the correct diagnosis to be reached in 30% of consultations and in a further 47 patients (5%), the diagnosis was proposed by the ICS on initial consultation.(ABSTRACT TRUNCATED AT 250 WORDS)

Indian J Pathol Microbiol, 1991 Jul, 34(3), 186 - 92
Clinico-microbiological study of dermatophytoses; Verenkar MP et al.; In the present series, 80 cases of dermatophytoses were subjected to mycological examination including microscopy and culture the mycological findings were correlated with clinical presentation of the patients . The isolation rate was 62.5 percent . Fungal culture was successful in 36.25 percent of cases, Trichophyton rubrum being the commonest etiological agent accounting for 55.18 percent of cases.

Rev Argent Microbiol, 1991 Jul-Sep, 23(3), 166 - 71
{Prevalence of Mycoplasma orale as a contaminant of cell cultures in Argentina}; Coronato S et al.; Over a period of 4 years 200 cell cultures were analysed for the presence of mycoplasma . Cultures were established cell lines from different origins, namely monkey, mouse and human, hybrid cell cultures and primary cultures . The cultures belonged to various research and industrial laboratories located in different areas of the country . Seventy per cent of investigated cultures were found to be contaminated with mycoplasma using a DNA fluorescent stain . Fifty cultures, selected at random out of the contaminated cultures, were further investigated to identify the prevalent serotype . For that purpose immunofluorescent reactions were performed using immune sera raised against several mycoplasma strains routinely found among contaminated cultures . Forty one cultures were contaminated with a single type of mycoplasma, whereas in the remaining nine, two or even three serotypes were detected . Mycoplasma orale II contaminated 40% of single infected cultures, followed by M . hyorhinis and A . laidlawii-A (12% each), M . arginini (5%), M . orale III (8%), A . laidlawii-B (2%) . We were unable to serotype the remaining positive cultures, because of the lack of a full battery of immune sera against all known serotypes . The prevalence of M . orale in mycoplasma contaminated cultures thus far tested, indicates that human handling would be the main source of infection . This situation could be modified by avoiding mouth pipetting and adopting good microbiological techniques.

Zhonghua Wai Ke Za Zhi, 1991 Jul, 29(7), 417 - 8, 461-2
{Fungal endocarditis after open-heart surgery . Report of 4 cases}; Yu YF; Four patients with fungal endocarditis after open-heart surgery were confirmed microbiologically . Two of them died, and the other 2 were treated with intravenous administration of miconazole . Clinical symptoms of the disease were similar to those of bacterial endocarditis, but headache and sweating were more predominant . This complication was likely to be found and treated with effective anti-fungi drugs . We suggest that reoperation is the only possible way to cure those with residual shunt or vegetation, and that prevention of postoperative fungal endocarditis is of great importance because of its refractoriness . Measures of preventing fungal endocarditis after open-heart surgery are discussed.

J Parenter Sci Technol, 1991 Jul-Aug, 45(4), 177 - 80
Some aspects on the use of the Biotest RCS Air Sampler in unidirectional air flow testing; Ljungqvist B et al.; The Biotest Air Sampler RCS is often used for monitoring microbiological quality of air . Unidirectional air flow tests show that the dispersion region of contaminants around the RCS sampler is much larger than that of undisturbed parallel air flow . This must be taken into consideration when the RCS air sampler is used within pharmaceutical production, especially during aseptic operations.

Jikken Dobutsu, 1991 Jul, 40(3), 367 - 73
The advantage of enzyme-linked immunosorbent assay (ELISA) as a method of microbiological monitoring for rat virus (RV); Izumi Y et al.; An enzyme-linked immunosorbent assay (ELISA) was tested to detect antibodies against rat virus (RV) . The purified ELISA antigens were prepared from rat embryonic cells infected with RV-13 (prototype strain) and UT-2 (Japanese isolate), respectively . Western blotting analysis confirmed that both of these antigens had three structural polypeptides (81 K, 61 K, and 59 K) . Eleven laboratory and wild rat colonies in Japan were tested for rat virus contamination, serologically . No significant differences in the sero-positive ratio and the distributions of ELISA titers were demonstrated in the ELISA, using antigens from RV-13 and UT-2 . ELISA was more sensitive and specific for detecting antibodies against RV from rat serum rather than hemagglutination inhibition (HI) test . This study also confirmed that the RV contaminated widely in colonies of laboratory and wild rats in Japan, and suggested that RV would have to be checked during the microbiological monitoring of laboratory rats.

Med Clin (Barc), 1991 Jun 8, 97(2), 50 - 2
{Epidemiology of community-acquired pneumonia in the Health Area I of Navarra}; Carrillo de Albornoz MM et al.; BACKGROUND: During one year (1988), a protocol study of the community-acquired pneumonias was carried out in patients referred to the Hospital Virgen del Camino in Pamplona (Health Area I or Northern Navarra), so as to have an epidemiological and microbiological knowledge of this disease in this geographic area . METHODS: A clinical protocol, microbiological investigation, 3 blood cultures, Gram stain and sputum culture and serological tests at admission and 20 days later (complement fixing antibodies and indirect immunofluorescence) were carried out . Chest radiographs were carried out on admission, on the third and seventh hospital days and subsequently depending on the evolution . RESULTS: The causative organism was found in 141 of the 225 included patients (62%) . Two or more organisms were identified in 19 (8%) . In 84 (38%) no microorganism was found . The results for the causative organisms and their frequency were: Pneumococcus 12%, mycoplasma 12%, other bacteria (including Legionella) 11%, Q fever 8%, viruses 7%, and psitaccosis 4% . In 59% of patients there was an underlying disease and 39% developed complications . 4% of patients died . CONCLUSIONS: 22% of the community acquired pneumonias were cared for in the hospital, representing 6% of the admissions to the Internal Medicine Service . The etiologic diagnosis was made in 62% of the community-acquired pneumonias . 23% were of bacterial origin (including Legionella) and 31% were nonbacterial . There was a high incidence of pneumonias caused by Mycoplasma pneumoniae and Coxiella burnetii.

Ugeskr Laeger, 1991 Jun 3, 153(23), 1651 - 2
{Therapeutic monitoring of aminoglycoside treatment . The value of early clinical contact}; Olesen B et al.; For several years, in the Microbiological Department of Bispebjerg Hospital, it has been the routine practice that the clinical departments were contacted in connection with every sample sent for determination of aminoglycoside . During a period of 14 weeks a prospective investigation of the effect of this practice was carried out . During this period, the department received a total of 77 samples from 60 patients . Concerning 20 of these (26%), no arrangement with the department concerned could be demonstrated . The commonest causes were that the aminoglycoside treatment had been suspended at the time of taking the sample by the department concerned (14), that the sample had been taken too early (2) and the sample was not relevant (2) . Considerable uncertainty reigned in the clinical departments about the exact time of taking the sample in relation to administration of antibiotics . Greater attention to these circumstances and possibly altered procedures concerning taking of samples would be useful changes . The annual saving for the department amounts to approximately 14,000 Danish crowns (approximately 1,000 pounds) but the most important advantage is considered to be early clinical contact and thus greater possibilities for therapeutic monitoring.

Genitourin Med, 1991 Jun, 67(3), 232 - 4
Comparison of vaginal flora after treatment with a clotrimazole 500 mg vaginal pessary or a fluconazole 150 mg capsule for vaginal candidosis; Boag FC et al.; The effect of antifungal therapy on the vaginal microbial flora was studied in 23 patients suffering from culture-positive, symptomatic vaginal candidosis . They were randomly allocated to receive either a 500 mg clotrimazole vaginal pessary or a 150 mg fluconazole capsule . Quantitative microbiological examination was carried out on samples of vaginal secretions obtained prior, and at intervals up to 10 days after, treatment . No significant difference was found in the vaginal flora before or after therapy in individual patients or between the treatment groups . In patients with C glabrata or C krusei, the yeasts persisted longer in the vagina with poorer response to either of the medications.

Schweiz Med Wochenschr, 1991 Jun 1, 121(22), 826 - 31
{Infectious endocarditis: reasons for a delayed diagnosis}; Misteli M et al.; The diagnosis of infectious endocarditis (IE) remains difficult . The delay until diagnosis is remarkably long . Despite progress in microbiological culture technology and the use of echocardiography, no improvement has been seen in recent years . We analyze the causes of delay in all patients with IE admitted to the Cantonal Hospital Aarau between 1976 and 1987 . 60 patients with 62 episodes were included in the study . The delay from first medical consultation with IE-related symptoms to hospital admission was 46 days . In cases of antibiotic pretreatment (45%) it extended to 66 days . IE was included in the differential diagnosis by the referring physicians in 29% only, whereas it was considered in the hospital on admission in 64% . Despite long lasting fever of unknown origin, only in one case was a blood culture performed before hospitalization . The symptoms of IE were different at the beginning of the disease compared to the time of admission (general malaise in 35% and 87% respectively, fever 80% and 85%, night sweat 2% and 66%, weight loss 0% and 56%, chills 21% and 47%, joint pain 16% and 27%, dyspnea 13% and 24%) . We conclude that the main reasons of the diagnostic delay in IE are antibiotic therapy prior to microbiological workup, different symptoms at the onset of IE and at the time of hospitalization, insufficient awareness of the disease among general practitioners and omission of blood cultures in patients with fever of unknown origin, especially where there is a history of valvular heart disease.

Tijdschr Diergeneeskd, 1991 Jun 1, 116(11), 558 - 62
{Cholera pandemic hits South America . Consequences for The Netherlands as import country of food and animal food}; Mossel DA; The cholera-pandemic raging in South-America calls for measures of health protection with respect to citizens of countries importing food or feed components from the areas where the disease has struck . Instead of ruggedly barring importation a more humanitarian policy is recommended, relying on assistance with the introduction of and adherence to rigorous measures of longitudinally integrated microbiological safety assurance, to be monitored in cooperation with importing countries . Examples of how canned foods of neutral pH, fishery products, vegetables, fruits and fishmeal should be processed-for-safety for this purpose are presented.

Am J Public Health, 1991 Jun, 81(6), 703 - 8
A randomized trial to evaluate the risk of gastrointestinal disease due to consumption of drinking water meeting current microbiological standards; Payment P et al.; BACKGROUND: This project directly and empirically measured the level of gastrointestinal (GI) illness related to the consumption of tapwater prepared from sewage-contaminated surface waters and meeting current water quality criteria . METHODS: A randomized intervention trial was carried out; 299 eligible households were supplied with domestic water filters (reverse-osmosis) that eliminate microbial and chemical contaminants from their water, and 307 households were left with their usual tapwater without a filter . The GI symptomatology was evaluated by means of a family health diary maintained prospectively by all study families over a 15-month period . RESULTS: The estimated annual incidence of GI illness was 0.76 among tapwater drinkers compared with 0.50 among filtered water drinkers (p less than 0.01) . These findings were consistently observed in all population subgroups . CONCLUSION: It is estimated that 35% of the reported GI illnesses among the tapwater drinkers were water-related and preventable . Our results raise questions about the adequacy of current standards of drinking water quality to prevent water-borne endemic gastrointestinal illness.

Voen Med Zh, 1991 Jun, (6), 60 - 2
{The results of a mass psychoprophylactic examination using computers in a military unit}; Frolov BS et al.; 84 patients who were wounded in Armenian earthquake (1988) have been examined . It was marked that all the purulent wounds of soft tissues of the extremities had been infected by bacterial associations . The most of them were resistant to penicillinum, tetracyclinum, laevomycetinum, kanamycinum, kefzol, keflin, and highly sensible to mezlocilinum, cyprofloksacinum, cefaperazonum and ceftazidimium . The article formulates the organization and methodical principles, determines a diagnostic algorithm for clinico-microbiological examination of patients with purulent wounds.

Immun Infekt, 1991 Jun, 19(3), 80 - 3
{The influence of the duration of infusion on the acute toxicity of amphotericin B . Comparison of two hour versus four hour infusions}; Arning M et al.; A prospective, randomized, double-blind crossover study was performed to compare the incidence and severity of amphotericin-B-induced acute toxicity (chills, fever, nausea and vomiting) after two- and four-hour infusions in 33 leukemic patients with suspected or microbiologically proven systemic fungal infections . Each patient was treated in an alternating fashion of two- and four-hour infusions every other day . Toxicity was graded according to modified WHO-criteria . Evaluation of 264 infusions revealed no difference between the two schedules neither in incidence nor severity of acute toxic reactions . These data indicate that amphotericin B given over 2 hours is equally well--or poorly (!)--tolerated than the four-hour regimen.

Eur Respir J, 1991 Jun, 4(6), 758 - 60
Isolated intrathoracic tuberculous lymphadenopathy; Van den Brande P et al.; We report an 82 yr old man with isolated intrathoracic lymphadenopathy of tuberculous origin, which is an extremely uncommon presentation of tuberculosis especially in elderly Caucasian patients . The diagnosis was suggested by the computerized tomographic (CT)-scan showing central hypodense areas after contrast, and was subsequently proved by mediastinoscopic biopsy with histological and microbiological analysis . The atypical presentation of tuberculosis together with a negative two-step 5 international units of purified protein derivative (IU-PPD) tuberculin skin test and a frequent contact with a cavernous index case points towards a primary infection in this patient.

Onderstepoort J Vet Res, 1991 Jun, 58(2), 59 - 62
Health status of salmonids in river systems in Natal . I . Collection of fish and parasitological examination; Bragg RR; A detailed microbiological and parasitological survey of salmonids and indigenous fish in the upper reaches of selected river systems in Natal was undertaken . Fish were collected from the rivers by electro-fishing, from dams by gill netting and from hatcheries along the rivers . A total of 678 fish from 26 different sites along 8 river systems were collected . No parasites could be detected on fish from four of the rivers tested . Parasites were, however, detected on fish from large production sites in Natal and in the rivers feeding these sites . Parasites which were detected were Ichthyopthirius multifiliis, various Trichodina spp., Apiosoma sp . and Gyrodactylus sp . The heads of all fish estimated to be less than one year of age were collected and examined for the spores of Myxosoma cerebralis . All of the samples were found to be free of this parasite.

Arch Latinoam Nutr, 1991 Jun, 41(2), 246 - 56
{Evaluation of fish silage prepared by microbiological route as a proteinic supplement in diets for fattening chickens}; Guevara YJ et al.; A bioassay in broilers was carried out during a six-week period, to evaluate, as a protein source, the quality of fish silage produced by microbiological means and to compare it with that of fish flour and soybean flour . A total of 28 broilers of the Cross by Cross strain were used, sexed and assigned at random . Additionally, the fish silage was subjected to moisture (8.1%), ash (18.4%), protein (59.5%), fat (7.55%), carbohydrates (6.47%), and pH (4.2) determinations for its inclusion in the diets formulation . The results obtained did not permit establishment of significant differences between the weight increments presented by chicks fed with fish flour, and those fed with fish silage . Nevertheless, the food conversion index of the chicks consuming the diet prepared with fish silage proved to be better that the conversion index of the diet prepared with fish and soy flours . No lesions in the organs of the animals studied were observed, and the sensory trials indicated that chicks fed with the fish silage did not present differences with those commercially acquired.

Boll Chim Farm, 1991 Jun, 130(6), 203 - 12
{Microbiologic validation in the production of sterile pharmaceuticals}; Pongiluppi S; Some microbiological validation procedures for sterile drug production are described . There concern the environmental microbial and particle "self-decontamination" time specified in the English "Guide to Good Pharmaceutical Manufacturing Practice 1983" and the EEC "Guide to Good Manufacturing Practice for Medical Products", the various methods for evaluating that sealing of sterile drugs is intact and the validation methods for aseptic filling of sterile powders and solutions . For these, the limits laid down in FDA regulations are indicated.

J Hosp Infect, 1991 Jun, 18 Suppl A, 524 - 9
A microbiological view of sterile service production; Atfield RD; The primary purpose of a Sterile Services Department is the prevention of infection . A specific guide to Good Manufacturing Practice (GMP) has been published by the Institute of Sterile Service Management to assist managers to ensure that the final products are of the nature and quality intended . The testing and monitoring of machinery, such as autoclaves, has an obvious microbiological relevance but other practices, such as expire dates and presterilization of used items, are of dubious microbiological advantage and can act against the main aim . GMP recommendations on environmental controls have received disproportionate attention to the remainder of the document, particularly relating to packing rooms . The standard should not be seen as a primarily microbiological measure but as a sensible control to limit the ingress of unwanted dust, flies and people and provide basic ventilation . Tests indicate that the standard for particle counts can be achieved without structural alteration in some departments . Microbiological counts are similar to those within operating theatres and additional protective clothing is of no apparent advantage . Process failure is the main cause of risks to the patient, and other practices, although both relevant and important, should not be given a false microbiological significance as these can detract and distract attention from the main issue.

J Hosp Infect, 1991 Jun, 18 Suppl A, 222 - 9
Cook-chill, cook-freeze, cook-hold, sous vide: risks for hospital patients?
Wilkinson PJ, Dart SP, Hadlington CJ.
Changes in eating habits and developments in food technology are occurring at the same time as an upward trend in foodborne infection in Britain . Vulnerable people such as the elderly and hospital patients are increasingly likely to consume food produced by new systems such as 'cook-chill' and 'cuisson sous vide' . The microbiological hazards of these systems are assessed as negligible, provided that production is controlled by appropriate methods such as the hazard analysis critical control point (HACCP) approach . The occurrence and control of bacterial contamination in a hospital cook-chill system is reviewed in this context.

J Hosp Infect, 1991 Jun, 18 Suppl A, 147 - 58
New strategies in microbiological diagnosis; Pallen MJ et al.; With the advent of the polymerase chain reaction (PCR), molecular biology is at last poised to enter the clinical microbiology laboratory . We describe this technique, and review its present and future applications in the diagnosis of infectious disease, with particular emphasis on its potential in diagnostic bacteriology . We discuss the suitability of different sequences as targets for DNA amplification . The disadvantages of PCR as a diagnostic strategy are covered, and current technical problems with the method are surveyed . We briefly mention two alternative strategies--the transcript-based amplification system and replicatable RNA reporter systems based on the Q beta replicase.

J Hosp Infect, 1991 Jun, 18(2), 123 - 30
Bacterial contamination of growth hormone solution and injection equipment during use by growth hormone deficient children; Zweens MJ et al.; The frequency of bacterial contamination of growth hormone solution and injection equipment use by 20 growth hormone deficient children was studied . In a cross-over study the children were randomized to begin using, for their growth hormone injections, either the recently developed growth hormone injection pen or the conventional syringe method . A comparison was then made of these two methods of injection over a 6-week period and the vials, pen-cartridges, syringes and needles were cultured . When the pen was used 5.3% of the 114 vials, 15.5% of the 110 cartridges and 11.2% of the 98 needles were found to be contaminated; when the syringe was used 3.5% of the 113 vials, 7.1% of the 98 syringes and 9.1% of the 99 needles were contaminated . To ensure microbiological safety during the preparation and injection of the growth hormone solution, regular instruction and reassessment of the injection technique for patients on long-term treatment are advocated . This applies even when disposable items are used . As no statistically significant difference was noted between the number of contaminated items used with either the pen or the syringe method, we conclude that the growth hormone pen is suitable for growth hormone administration.

Cas Lek Cesk, 1991 May 24, 130(14), 438 - 44
{Unasyn in severe hospital infections}; Sechser T et al.; A total 16 patients with moderate and serious surgical and urogenital infections were treated intravenously with the Unasyn IM/IV inj., combination of ampicillin and sulbactam, which is a beta-lactamase inhibitor . In this combination, sulbactam saves the ampicillin against the effects of beta-lactamases and extends the susceptibility to ampicillin of previously ampicillin-resistant strains . Clinical cure was observed in 69% of the patients, improvement in 19%, and failure in 12% . Microbiological elimination was proved in 50% of the patients, persistence in 6%, a in the rest of the patients (44%) were microbiological response unevaluable . The evaluation of subjective and objective tolerance of Unasyn IM/IV inj . was excellent . It follows from this study that the combination of ampicillin with sulbactam can be considered an effective and safe treatment of nosocomial infections, especially in the departments with an increasing rate of ampicillin-resistant strains due to production of the beta-lactamases.

Schweiz Med Wochenschr, 1991 May 18, 121(20), 764 - 6
{Sensitivity and specificity of a simplified, standardized 13C-urea breath test for the demonstration of Helicobacter pylori}; Good DJ et al.; A simplified 13C-urea breath test (UBT) for detection of Helicobacter pylori (Hp) infection was evaluated in 50 patients . Following upper gastrointestinal endoscopy the patients received 100 ml of a liquid test meal with 100 mg 13C-urea . Breath samples were obtained at baseline and 30 minutes respectively . The UBT was positive (difference of 13CO2 enrichment exceeding 5%) in 33/35 patients with culture-proven Hp infection and negative in 14/15 patients in whom microbiological culture, histology and a urease test (CLO-test) were negative . We conclude that in view of its high sensitivity (94%) and specificity (93%) the UBT is useful for rapid, non-invasive diagnosis of Hp infection.

Vet Rec, 1991 May 4, 128(18), 422 - 5
A new diarrhoeic syndrome with ataxia in young Charolais calves: clinical and microbiological studies; Espinasse J et al.; A new diarrhoeic syndrome was examined clinically in 19 one to two-week old Charolais calves . It differs from other digestive disorders in calves of this age in the discrete diarrhoeic signs, the absence of dehydration and the presence of signs of ataxia . The microbiological study carried out for three consecutive years in 58 sick calves and nine healthy control calves demonstrated the special role of E coli possessing virulence markers from septicaemic strains (CS31A, Col V) . The clinical signs could be the result of bacteraemia with subacute E coli endotoxaemia.

Nature, 1991 May 2, 351(6321), 81 - 2
Microbiological characterizations by FT-IR spectroscopy; Naumann D et al.; Infrared signals of microorganisms are highly specific fingerprint-like patterns that can be used for probing the identity of microorganisms . The simplicity and versatility of Fourier-transform infrared spectroscopy (FT-IR) makes it a versatile technique for rapid differentiation, classification, identification and large-scale screening at the subspecies level.

Khirurgiia (Mosk), 1991 May, (5), 82 - 6
{Surgical treatment of postoperative infected hernias}; Andreev SD et al.; The article deals with the results of examination and treatment of 153 patients with postoperative ventral hernias . In 109 (71.3%) of these patients the hernia formed due to suppuration of the wound after the first operation; 48 (31.4%) hab on admission a source of purulent surgical infection in the zone of the future operative intervention . According to the findings of microbiological examination of intraoperative biopsies and smears taken from wounds and fistulas, the patients were divided into three groups (group 1, 10(1) microbial bodies per kg tissue; group 2, 10(2); group 3, 10(5)) . Pharmacological studies showed that the necessary concentration of broad-spectrum antibiotics is produced only when they are injected by the infiltrative method . On basis of this, the authors developed a scheme for the prevention of purulent complications in herniotomy with the use of biological and synthetic prostheses for each group of patients . The method produced good results in the majority of patients with minimal suppurations (3.9%) and recurrent hernias (0.65%).

Khirurgiia (Mosk), 1991 May, (5), 19 - 23
{The role of lymphatic collector in the spreading infections in peritonitis}; Korotaev GM et al.; The article generalizes the result of experimental study of the features of hemolymphodynamics, toxic properties of biological body fluids, and microbiological findings in peritonitis . Experiments were conducted on 24 dogs . The development of the pyogenic process was visually studied . For this purpose the opened abdominal cavity was placed in a specially constructed transparent chamber in which a temperature of 37 /*C was maintained . Portal blood flow intensified and lymph production in the abdominal cavity reduced in the initial phase of peritonitis . Later lymph production increased while the portal blood flow decreased . The purulent process may develop according to two variants . In the first variant the functional activity of the liver is maintained and its toxic products and microorganisms are detoxified; the second variant the detoxification function of the liver is disturbed, the bacteria penetrate the peripheral blood, the production and flow of lymph in the thoracic duct increase sharply . The efficacy of external drainage of the duct and lymphosorption is much higher in the second variant of peritonitis development than in the first variant.

J Clin Periodontol, 1991 May, 18(5), 287 - 90
Therapeutic effects of combined treatment using tetracycline-immobilized collagen film and root planing in periodontal furcation pockets; Minabe M et al.; 46 upper and lower molars with furcation grade II involvement were selected from 16 patients with periodontal disease . The teeth were randomly allocated to the following groups according to treatment; (1) 4 consecutive administrations of tetracycline-immobilized cross-linked collagen film (TC film) at intervals of 1 week (TC group); (2) 1 root planing treatment (RP group); (3) combination treatment (TC + RP group); (4) no treatment (control group) . The therapeutic effects of each treatment were compared both clinically and microbiologically . Records of plaque index, gingival index, bleeding on probing, probing depth, probing attachment level and microscopic counts were obtained at 0, 4, 6 and 8 weeks . The results showed marked decreases in probing depth and density of micro-organisms in both the RP and TC + RP groups . In particular, the TC + RP group was characterized by a decreased rate of bleeding on pocket probing and an increased probing attachment gain . The above findings demonstrated that root planning is effective in the treatment of furcation involvement and that the effects are enhanced by the local administration of TC films.

Gut, 1991 May, 32(5), 467 - 9
Diagnostic efficiency of an ultrarapid endoscopy room test for Helicobacter pylori; Thillainayagam AV et al.; There are several reliable methods for detecting Helicobacter pylori but all have as a major disadvantage the time required to yield a definitive result . We have modified the standard urease test so that a positive result is available in one minute . We describe the use of this test in biopsy specimens from the gastric antrum from 220 consecutive patients referred for upper gastrointestinal endoscopy . The performance of the 'one minute test' was compared with a standard urease test, Gram stain, and microbiological culture . Using culture as the 'gold standard' 80 (36%) of the patients were H pylori positive . The one minute test produced no false positives and showed a sensitivity of 89% and specificity of 100%, while the predictive values of a positive and negative test were 100% and 94% respectively . The diagnostic efficiency of the test was 96% compared to 85% for both the Gram stain and direct urease test . All positive results using the one minute test were available within one minute . The test is easy to prepare and costs approximately pounds 0.04 . This new modification of the urease test should be superior to the currently available urease tests because a reliable result will be available in almost 90% of infected individuals even before endoscopy is completed.

Aust N Z J Surg, 1991 May, 61(5), 363 - 5
Comparative study of skin closure in hip surgery; Clayer M et al.; A prospective, randomized controlled study was performed to compare skin staplers for closure of skin following hip surgery . Patients were randomized to have their skin closed with either continuous subcuticular non-absorbable polypropylene 'prolene' suture (33 patients) or metal skin staples (Autosuture 'Premium' or Davis and Geck 'Oppose'; 33 patients) . All patients received prophylactic cephalosporin (Cephalothin) in pre- and postoperative antibiotic therapy . The wounds were examined daily and the presence of discharge, wound dehiscence and infection were noted . Any discharge at 7 days was swabbed for microbiological examination . The final cosmetic appearance was assessed at 8-12 weeks postoperatively . Scar length and width were measured and the presence of cross-hatching noted . Wound dehiscence occurred in 1 patient (closed with staples) . Wound infection developed in 2 patients at a rate of 3% (1 patient from each group) . At final review (8-12 weeks postop), the scar produced by subcuticular prolene was narrower than that produced by the skin stapler (P less than 0.05) . There was no significant difference in scar width between a wound which had staples removed at 10 days post operation and one where the staples were removed at 14 days . Staple insertion sites were more obvious in scars that had had the staples removed at the later time (P less than 0.05).

Fertil Steril, 1991 May, 55(5), 1017 - 9
Chlamydia trachomatis induces an inflammatory response in the male genital tract and is associated with altered semen quality; Wolff H et al.; U . urealyticum with 15.8% and C . trachomatis antibodies with 15.4% were the most prevalent microbiological findings in 209 male infertility patients . The inflammatory marker granulocyte-elastase was significantly increased in men with C . trachomatis; these men also showed significantly decreased citric acid levels indicating inflammatory damage of the prostate induced by C . trachomatis.

Zentralbl Veterinarmed A, 1991 May, 38(4), 306 - 20
{The pathology and pathogenesis of experimental Mycoplasma hyorhinis infection of piglets with and without thermomotoric stress . 1 . Pathologico-anatomic, histologic and immunomorphologic study results}; Kinne J et al.; The effect of an experimental Mycoplasma (M.) hyorhinis infection (3 times intranasal instillation of 3-5 ml bouillon with 10(7) Colony forming units {CFU}/ml) in combination with a standard thermomotoric stress (swim-test) was studied in piglets using pathomorphological, immunomorphological and microbiological methods . The 92 piglets were divided into the following 5 groups: swimmers with infection (S-I; n = 19); swimmers without infection (S; n = 19); control piglets with infection (K-I; n = 21); controls without infection, but direct (K1; n = 16) or indirect contact (K2; n = 17) with experimentally infected animals . The experimental or spontaneous infection (direct or aerogenous infection) with M . hyorhinis caused in 30.4% of the piglets an acute or subacute, catarrhal-purulent bronchopneumonia with an interstitial component . Incidence and intensity of pneumonia were significantly higher in the groups with thermomotoric stress (independent from the mode of infection) than in the non-stressed groups . The M . hyorhinis pneumonia was characterized by a limited expansion and a trend to restitution . The causal agent (M . hyorhinis) was demonstrated with immunomorphological methods (immunofluorescence and PAP) in the ciliary zone of the nasal, tracheal and especially on the bronchial mucosa, and occasionally in the bronchioles and alveoli.

Klin Monatsbl Augenheilkd, 1991 May, 198(5), 433 - 4
{Healed (?) amoebic keratitis}; Heinrich T et al.; Acanthamoeba keratitis was seen in two contact-lens wearers . In both cases, this finding was verified by microbiological examination of conjunctival swabs and of the lens solution . One patient had perforating keratoplasty . While neither vital amoebae nor cysts could be detected in the host corneal explant, immunohistochemical examination revealed fluorescence-positive fragments which probably correspond to incomplete cycstic walls.

J Parenter Sci Technol, 1991 May-Jun, 45(3), 128 - 31
Gowning training: the use of video recording together with microbial assessment; Beer CL; Following classroom training on proper aseptic gowning technique, clean room operators were filmed while gowning according to standard procedure . Subsequently, the exterior surface of each operator's gown was monitored for microbial contamination . Operators reviewed their personal videotaping with the trainer . Through careful and critical self-observation, the operator's ability to follow the gowning procedure in addition to using good gowning technique was ascertained . Furthermore, the operator's gowning technique was compared with the results of the microbiological monitoring data . A correlation between microbial contamination of the gown surface and improper technique was demonstrated . This correlation enhanced the operator's awareness of the consequences of improper gowning technique . Use of video replay enabled the operator and trainer to identify improper or subtle flaws in technique detected through microbial monitoring but undetected during actual gowning . This training program served to further emphasize the importance of using proper aseptic gowning technique . Clean room operators are more involved in maintaining clean room integrity and their awareness of the potential for contaminating the area by inadequate technique has been enhanced.

Pathol Biol (Paris), 1991 May, 39(5), 524 - 9
{Experimental study on the hepatobiliary kinetics and excretion of temafloxacin . Evidence for production of active metabolites by the rabbit liver}; Brogard JM et al.; Temafloxacin is a new fluoroquinolone derivative currently under evaluation . Its hepatobiliary disposition remains undefined as yet . The present study represents an experimental approach to this issue . Six isolated rabbit liver preparations were perfused for three hours with reconstituted and oxygenated blood in a closed circuit . A the onset of the procedures, temafloxacin 10 mg were added to the circulating blood . Both bile and blood were sampled throughout the perfusion time, and liver fragments were taken at the end of the experiments . Temafloxacin levels were measured by HPLC in serum and hepatic tissue, and by both HPLC and microbiological assay in bile . The percentage of drug undergoing hepatic biotransformation appeared to be high, i.e . 58.3% . This finding is substantiated by the comparison of temafloxacin levels in bile, as provided by HPLC and microbiological assay, the latter yielding concentrations twice as high (biliary peak: 33.5 +/- 2.8 micrograms/ml versus 19.3 +/- 3.1 micrograms/ml by HPLC assay) as those obtained by HPLC (p less than 0.05) . Consistently, the average amount of temafloxacin excreted into the bile (0-3 h) was, respectively, 92 micrograms (0.9% of the dose) and 204 micrograms (2.0%) as determined by HPLC and microbiological methods (p less than 0.05); this statistically significant difference suggests the presence of active metabolites in bile . The presented results bring out evidence for substantial biotransformation of temafloxacin by Rabbit liver . Extrapolation to other species, however, would be hazardous; further pharmacokinetic studies are needed in order to assess the relevance of these findings in humans.

Vopr Pitan, 1991 May-Jun, (3), 52 - 5
{Hygienic evaluation of smoked sausages produced by traditional and improved technologies}; Zav'ialov NV et al.; The results of the physico-chemical and hygienic investigations of smoked sausages produced according to the improved technology were compared to those of routine products . The changes in the content of smoking substances in uncooked smoked sausage depend on the duration of smoking and drying . Microstructural and microbiological data, as well as carcinogenic compounds detected in the samples studied have been presented . It has been shown that the use of vacuum evaporation improves the product structure and significantly decreases the content of carcinogenic substances in smoked sausages, as well as makes better their taste and scent, that leads to the improvement of consumer's properties of the product.

J Assoc Off Anal Chem, 1991 May-Jun, 74(3), 471 - 5
New microbiological method for determining spectinomycin in pelleted and meal feeds using trifluoroacetic acid as primary extractant; Stahl GL et al.; A new microbiological method, identified as the spectinomycin trifluoroacetic (SPE-TFA) method, was compared with the current AOAC method for analyzing spectinomycin in meal and pelleted feeds fortified with LS-20 premix . Feeds containing 3 concentrations of drugs and a zero level were tested in a correlation study . The data showed no significant differences in the percent of theory assayed between meal and pelleted samples using the SPE-TFA method, but the percent of theory found using the AOAC method was significantly lower for the pelleted samples than for the meal samples . The within-sample variation of the AOAC assay was also not the same for all samples; the SPE-TFA assay variation was relatively constant for all samples . The SPE-TFA method produced an overall average recovery of 98% with a range of 89-109% compared with an 85% recovery ranging from 64 to 102% for the AOAC method . In addition to producing better recoveries, the SPE-TFA method features a more sensitive response line, and final test solutions have viscosities and clarity more comparable to the standard solutions than those produced by the current AOAC method.

Dtsch Zahnarztl Z, 1991 May, 46(5), 366 - 70
{The effect of an extended initial therapy on molars and single-rooted teeth}; Schlagenhauf U et al.; The purpose of this study was to evaluate the benefits of an initial periodontal therapy consisting of a single subgingival root debridement procedure followed by repeated monthly subgingival irrigations over a period of 6 months in 23 patients with multiple advanced periodontal lesions . The clinical and microbiological data of the test group indicated that the applied irrigation scheme was successful in maintaining improvements of periodontal health over a period of 6 months . There were no statistically significant differences in effectiveness between sites in molars and single-rooted teeth . On the other hand, negative controls treated only by a single root debridement procedure displayed a tendency towards pretreatment levels.

Mycoses, 1991 May-Jun, 34(5-6), 261 - 6
Ocular histoplasmosis due to Histoplasma farciminosum in Egyptian donkeys; Soliman R et al.; In this study 19 donkeys suffering from face excoriations below the medial canthas and lesions in the lacrymal apparatus were subjected to clinical radiological and microbiological investigations . Also histopathological examination of biopsy materials from ocular lesions were made . Eleven out of 19 donkeys (57.9%) showed specific lesions in the lacrymal apparatus . Mycological examination revealed the isolation of Histoplasma cells from 10 out of 19 examined cases . The isolated Histoplasma culture, although not completely identical to H . farciminosum, was more related to this than to other Histoplasma species . Histopathological examination revealed the presence of marked tissue infiltration by lymphocytes, monocytes and macrophages . Also the fungal organism appeared as double-contoured yeast cells lying within macrophages and giant cells.

Diagn Microbiol Infect Dis, 1991 May-Jun, 14(3), 219 - 24
Use of lactophenol cotton blue mounts of corneal scrapings as an aid to the diagnosis of mycotic keratitis; Thomas PA et al.; Lactophenol cotton blue (LPCB) mounts of corneal ulcer scrapings were assessed as a diagnostic tool in cases of mycotic keratitis over a period of 15 months . We investigated 568 cases of ulcerative keratitis by microbiological techniques consisting of direct microscopic examination of LPCB mounts and Gram-stained smears as well as culture of material scraped from the ulcer . Fungi were isolated in large numbers on multiple media from the corneal scrapings of 179 patients (culture-proven mycotic keratitis) . Direct microscopic examination of LPCB mounts of corneal scrapings yielded positive results in 140 (78%) of 179 culture-positive patients and negative results in 371 (95%) of 389 culture-negative patients . There was a significant difference between the percentage of positive results obtained by LPCB mounts and by Gram-stained smears in the culture-positive cases . The LPCB mount was positive in greater than 80% of cases of keratitis due to Fusarium spp . and Aspergillus spp . The LPCB mount is strongly recommended as a simple, rapid, inexpensive, and sensitive diagnostic technique in cases of mycotic keratitis.

Pancreas, 1991 May, 6(3), 350 - 67
ERCP- and endoscopic sphincterotomy-induced pancreatitis; Sherman S et al.; Acute pancreatitis may occur after the performance of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy . During ERCP and endoscopic sphincterotomy, the pancreas is subjected to many types of potential injury--mechanical, chemical, hydrostatic, enzymatic, microbiological, allergic, and thermal . These factors may act independently or in concert to induce postprocedure pancreatitis . The potential role of each etiologic factor in the development of ERCP- and endoscopic sphincterotomy-induced pancreatitis is detailed . The management of this complication is reviewed . Patient factors that increase the risk for pancreatitis and techniques to prevent or limit this complication are described . A variety of agents have been shown to prevent or treat pancreatitis in animal models, but extrapolation to humans has been almost uniformly unsuccessful . Although postprocedure pancreatitis is unlikely to be completely eliminated, careful patient selection and attention to detail may reduce the incidence of this untoward event.

Arch Biochem Biophys, 1991 May 1, 286(2), 389 - 93
Electron transfer proteins of the purple phototrophic bacterium, Rhodopseudomonas rutila; Meyer TE et al.; The soluble electron transfer protein content of Rhodopseudomonas rutila was found to consist of two basic cytochromes and a (4Fe-4S) ferredoxin . Cytochrome c' was easily identified by its characteristic high spin absorption spectra . The native molecular weight is 29,000 and the subunit is 14,000 . Cytochrome c-550 has low spin absorption spectra and a high redox potential (376 mV) typical of cytochromes c2 . The molecular weight is about 14,000 . The ferredoxin is apparently a dimer (43,000) of approximately 18,000 Da subunits . There are 1.3 to 1.5 iron-sulfur clusters per monomer of 18- to 21-kDa protein . The N-terminal amino acid sequence is like the (7Fe-8S) ferredoxins of Rhodobacter capsulatus and Azotobacter vinelandii . Remarkably, there are only 2 or 3 out of 25 amino acid substitutions . Difference absorption spectra of Rps . rutila membranes indicate that there is not tetraheme reaction center cytochrome c, such as is characteristic of Rps . viridis . However, there are a high potential cytochrome c and a low potential cytochrome b in the membrane, which are suggestive of a cytochrome bc1 complex . Rps . rutila is most similar to Rps . palustris in microbiological properties, yet it does not have the cytochromes c-556, c-554, and c-551 in addition to c2 and c', which are characteristic of Rps . palustris . Furthermore, the Rps . rutila cytochrome c' is dimeric, whereas the same protein from Rps . palustris is the only one known to be monomeric . The cytochrome pattern is more like that of Rhodospirillum rubrum and Rb . capsulatus, which are apparently only able to make cytochromes c2 and c'.

Ugeskr Laeger, 1991 Apr 8, 153(15), 1040 - 3
{Peritonitis with continuous ambulatory peritoneal dialysis . Status and future perspectives}; Nielsen H et al.; Peritonitis remains the major complication of continuous ambulatory peritoneal dialysis . A review is given of the clinical, microbiological, immunological, and pathogenic aspects of this problem and new fields of research for reducing the incidence of peritonitis are suggested.

J Oral Pathol Med, 1991 Apr, 20(4), 172 - 5
Angular cheilitis in a group of Sri Lankan adults: a clinical and microbiologic study; Warnakulasuriya KA et al.; The relative importance of various factors in the pathogenesis of angular cheilitis in a population of Sri Lankan adults was studied . Forty-nine patients with cheilitis were examined clinically and microbiologically . Only 5 of 49 patients were full denture wearers . The clinical presentation of the lesions could be categorized as mild (Type I), moderate (Type II) or severe (Type III) and the duration of the lesions ranged from 1 month to more than 4 yr . Hematologic investigations revealed 18 patients with low hemoglobin 8 of whom had hypochromic, microcytic anaemia . Pathogenic organisms were isolated from 59% of the lesions; Candida spp . in 24 patients and Staph . aureus in 11 patients . A significant positive relationship between commissural leukoplakia and an infective etiology of angles was noted . This study confirms the multifactorial etiology of angular cheilitis while highlighting the varied clinical presentation of the lesions in an Asian population.

Thorax, 1991 Apr, 46(4), 257 - 8
Bacterial colonisation of humidifier attachments on oxygen concentrators prescribed for long term oxygen therapy: a district review; Pendleton N et al.; A microbiological survey was undertaken on the eight patients in the Liverpool District who have a humidifier attachment on their oxygen concentrator . All but one of the humidifiers were contaminated with potentially pathogenic bacteria.

Dent Clin North Am, 1991 Apr, 35(2), 427 - 38
Infection control and hazards management . Economics of regulatory compliance; Runnells RR; Dentistry has become subject to rapid change in office safety, including infection control and hazards management . This change includes increasingly diverse governmental regulations and compliance with such regulations, influencing the very basics of dental practice . As all practitioners are moving toward compliance, costs are increasing substantially . Various sources estimate such increases at between 12.5% and 19%, and it is doubtful whether third-party reimbursement will offset these additional costs . As practitioners plan methods for offsetting the costs of office safety, consideration should be given to providing patients oral and printed information to preclude misinterpretation of the reasons for fee escalation caused by implementation of chemical hazards communication, infection control, and waste disposal programs mandated by OSHA, EPA, and state or other regulatory authorities . The decade of the 1990s may well become the period of meeting the formidable microbiological and regulatory challenges of the 1980s.

Epidemiol Infect, 1991 Apr, 106(2), 297 - 303
A sentinel network of microbiological laboratories as a tool for surveillance of infectious diseases in Belgium; Walckiers D et al.; In the development of a surveillance programme for infectious diseases in Belgium, a national network of microbiological laboratories has been responsible, since February 1983, for the weekly registration of certain pathogenic agents . Thus, the main epidemiological features of a selected number of infections in Belgium can be characterized.

Minerva Med, 1991 Apr, 82(4), 181 - 7
{The treatment of gastrointestinal infections with ciprofloxacin}; Ippolito A et al.; The authors have evaluated the efficacy and tolerability of ciprofloxacin, a new broad-spectrum fluor-quinolone, in the therapy of gastrointestinal infections . The authors have studied 24 patients suffering from above-mentioned infections clinically diagnosed (11 microbiologically diagnosed too) . All the patients took ciprofloxacin tablets 500 mg b.i.d . for 10 days (average) . All the patients were restored to health and the tolerability was excellent.

J Med Chem, 1991 Apr, 34(4), 1483 - 92
New derivatives of kanamycin B obtained by combined modifications in positions 1 and 6" . Synthesis, microbiological properties, and in vitro and computer-aided toxicological evaluation; Van Schepdael A et al.; Substitution of the C-1 atom in the 2-deoxystreptamine moiety of gentamicin C2, a broad-spectrum aminoglycoside antibiotic, by an axial hydroxymethyl group has been reported to confer protection against most clinically important bacterial enzymes inactivating aminoglycosides, while simultaneously reducing the nephrotoxic potential of this drug . We report here on a similar modification of kanamycin B . Microbiological evaluation, however, revealed no useful protection, as established by the almost complete lack of activity of 1-C-(hydroxymethyl)kanamycin B against an array of organisms producing defined types of aminoglycoside-inactivating enzymes and against which 1-C-(hydroxymethyl)gentamicin C2 and amikacin (1-N-{(S)-2-hydroxy-4-aminobutyryl}kanamycin A) are active . Moreover, toxicological evaluation, based on the in vitro measurement of the drug inhibitory potential toward lysosomal phospholipases, a predictive test of the intrinsic nephrotoxic potential of aminoglycosides, showed not decreased but rather increased toxicity . Comparative conformational analysis of the interactions of the drug with a phosphatidylinositol monolayer explained the lack of protective effect, since no significant change of the mode of insertion of the derivative in this monolayer was detected compared to that of kanamycin B . Combination of a 1-C-(hydroxymethyl) substituent with a 6"-chloro, 6"-acetamido substituent resulted in a partial improvement of the toxicological behavior with no loss of activity for the 6"-chloro and the 6"-azido derivatives, but not to the extent of obtaining better derivatives than kanamycin B itself . We, therefore, suggest that the advantages of an axial hydroxymethyl substituent at C-1 are probably restricted to the gentamicin family and do not extend to kanamycins . It might be concluded that the structural differences between gentamicins and kanamycins play an important, still undescribed role both in their effective recognition by aminoglycoside-inactivating enzymes, which are responsible for most of the clinically important cases of resistance to aminoglycosides, and also in the interactions with phospholipids, which in turn cause nephrotoxicity.

J Med Chem, 1991 Apr, 34(4), 1476 - 82
New derivatives of kanamycin B obtained by modifications and substitutions in position 6'' . 2 . In vitro and computer-aided toxicological evaluation with respect to interactions with phosphatidylinositol; Mingeot-Leclercq MP et al.; In a companion paper (previous paper in this issue), we report on the synthesis and microbiological evaluation of new derivatives of the aminoglycoside antibiotic kanamycin B carrying substitutions in 6" (halogeno, or amino, amido, thioalkyl, and alkoxy groups, each series with increasingly bulkier chains) . These modifications were intended to potentially modulate the interactions of kanamycin B with phospholipids since these are related to inhibition of lysosomal phospholipase activities and lysosomal phospholipidosis, an early and predictive index of the nephrotoxic potential of aminoglycosides . The new derivatives were therefore examined for inhibitory potency in vitro toward lysosomal phospholipase A1 acting on phosphatidylcholine included in negatively charged liposomes . No simple correlation was observed between the nature or the size of the 6''-substituent and the inhibitory potencies of the corresponding derivatives, although certain groups (diethylamino, isopropylthio) caused a significant increase in inhibitory potency, whereas an N-acetyl-N-methylamino substituent had the opposite effect . 6''-Deoxy-6''-chlorokanamycin B, however, was the only derivative showing both a decrease (albeit limited) of inhibitory potency toward phospholipase A1 associated with the maintenance of a satisfactory microbiological activity (actually equal or slightly better than that of kanamycin B) . Computer-aided conformational analysis showed that this chloro substituent did not allow the molecule to insert itself very differently compared to kanamycin B or 6''-deoxykanamycin B in a monolayer of phosphatidylinositol, all three drugs adopting an orientation largely parallel to the hydrophobic-hydrophilic interface and being largely "embedded" in the bilayer at that level . In contrast, the N-acetyl-N-methylamino and isopropylthio substituents caused the corresponding derivatives to adopt an orientation largely perpendicular to the interface, because of the attraction of this substituent, and therefore of the 3''-amino sugar moiety of kanamycin B into the hydrophobic domain of the monolayer, whereas the opposite part of the drug (2',6'-diamino sugar) protruded into the aqueous phase . No simple correlation, however, could be drawn between these changes of conformation and the relative inhibitory potencies of the derivatives.

Pharmazie, 1991 Apr, 46(4), 247 - 9
{2-Dichloromethyl-naphthimidazole quinones . 4 . Heterocyclic 1,4-naphthoquinine derivatives}; Kallmayer HJ et al.; 2-Arylamino-3-dichloroacetylamino-1,4-naphthoquinones 4 show in ethanolic hydrochloric acid the same reactivity as the corresponding 3-monochloroacetylamino-1,4-naphthoquinones 3 . After cyclisation from 4 to 6, 6 dehydrates to give 2-dichloromethyl-4,9-dihydro-1-phenyl-1H-napth {2,3-d}imidazole-4,9-diones 8 . Elimination of dichloromethane from 6 to 9 is not observed . The reaction of 4c in alkaline DMSO solution indicates, that ring closure to 3-hydroxy-benzo{g}quinoxalinetriones 2 is possible . The microbiological activity from 7 and 8 has been proved.

Thorac Cardiovasc Surg, 1991 Apr, 39(2), 85 - 8
Preoperative assessment of the likelihood of infection of the lower respiratory tract after cardiac surgery; Carrel T et al.; Lower-respiratory-tract infections are among the most frequent complications observed in the intensive care unit, leading to delayed postoperative recovery time and increased costs and mortality . We have tried to evaluate the prognostic value of perioperative bacteriology of tracheal aspirates in assessing the risk of such complications . In a prospective study aspirates of 100 patients undergoing cardiac surgery were taken immediately after intubation and were analysed for microorganisms by Gram-stain and microbiological cultures using standard procedures . All patients received perioperative antibiotic prophylaxis with a single dose of 2 g ceftriaxone intravenously . From 26 patients with bacteriologically positive tracheal secretion, 8 (30.7%) developed lower respiratory tract infection whereas only 1 of 72 patients (1.4%) with negative bacteriological results developed this complication . Smoking (p less than 0.01) and abnormal preoperative lung function (p less than 0.01) were significantly more frequent in patients developing postoperative pneumonia . Regarding the results of this study, the risk of developing pulmonary infection in the early postoperative course after cardiac surgery can be estimated from the tracheal aspirates.

Anasthesiol Intensivmed Notfallmed Schmerzther, 1991 Apr, 26(2), 102 - 4
{The importance of Pneumocystis carinii infection in patients with acute respiratory distress syndrome}; Hartel B et al.; Each year we treated approximately 40 patients with adult respiratory distress syndrome (ARDS) in our department of anaesthesiology . In these cases we found with bronchoalveolar lavage followed by microbiological examination, a high incidence (40 per cent) of pneumocystis carinii contamination . An infection with Pneumocystis carinii deteriorates the clinical course of ARDS . Effective drugs were the combination of trimethoprim and sulfamethoxazole . Under this therapy we always saw a decrease of infiltrations in the chest-x-ray as well as an improved gas exchange . No relapse was seen in any case.

Int Surg, 1991 Apr-Jun, 76(2), 77 - 80
Wound infection following biliary surgery . A prospective surgery; al-Awami SM et al.; Biliary surgery in general, with cholecystectomy in particular, is probably the commonest major elective abdominal operation worldwide . A prospective study has been completed on 141 biliary operations in which intra-operative bile swabs were taken, and other risk factors for wound infection sought . Patients' characteristics were: males 51, females 90 (1:1.8); mean age 42.4 +/- 16 years; mean Quetelet index for adults was 32 +/- 5 . The operations were: emergencies 10, simple-cholecystectomies 112, and choledochotomies (including other concomitant procedures) 29 . The observed wound infection rates were: overall 7.8%, simple cholecystectomy 3.6% and choledochotomies 24.1%, figures which agree closely with the national and international literature . The infected patients consumed, on average, 7 days more in hospital than the uninfected ones . We found three major risk factors for wound infection: patients aged 40 years or older (over 4-fold), choledochotomy (over 6-fold), and microbiologically proven wound co-ntamination (9-fold) . We conclude that, given the consistently low (less than 4%), incidence of wound infection following simple cholecystectomy, routine antibiotic prophylaxis in this subset is probably unjustified.

Electromyogr Clin Neurophysiol, 1991 Apr, 31(3), 181 - 6
Peripheral polyneuropathy complicating conditions of sepsis and multi-organ failure; Garcia Garcia A et al.; We studied five patients who developed evidence of acute mainly motor peripheral polyneuropathy complicating a condition of prolonged sepsis associated with multi-organ failure . In the electrophysiological studies we observed normal motor and sensory nerve conduction velocities but there were drops in the amplitudes of the compound action potentials in the muscles and sensory peripheral nerves as well as high denervation activity on electromyography . Analytical studies of cerebrospinal fluid and blood did not show any findings of interest except for a deterioration in the nutritional parameters without specific deficiencies . The immunological and microbiological studies failed to determine factors related to the development of polyneuropathies . Nerve and muscle biopsies showed axonal neuropathy with some demyelination changes and reinnervation . Three patients survived the critical state and were re-examined presenting a moderate improvement in the neurological condition accompanied with signs of reinnervation in the electromyographic study . Given the absence of known factors implicated in the development of acute polyneuropathies in our patients, we suggest that the relevant disorders of the cellular metabolism observed in patients with prolonged sepsis aggravated by the defective nutritional condition, may be factors related to the development of these polyneuropathies.

Orv Hetil, 1991 Mar 3, 132(9), 475 - 7
{Diagnostic and therapeutic problems in a severe case of bacterial contamination of the small intestine}; Biro L et al.; Five years case record of a 18 year old man is reported . Because of sustained diarrhea he was treated several times on departments for infectious diseases . The patient was operated on three times in various surgical departments because of vigorous abdominal pain, cachexia and CT scan finding . In addition extraintestinal complications and symptoms delayed the diagnosis . The diagnosis was verified by the H2 breath test and microbiological examination of intestinal juice . Complaints of patient ceaset after sustained Ciprobay therapy . The severe deficiency symptoms were relieved by complex substitution.

Infection, 1991 Mar-Apr, 19(2), 92 - 6
C-reactive protein in the management of children with fever after allogeneic bone marrow transplantation; de Bel C et al.; The value of C-reactive protein (CRP) determinations in the analysis of fever after allogeneic bone marrow transplantation (BMT) was studied prospectively by serial measurements of serum CRP levels during 30 BMT episodes in 28 children and adolescents . The treatments and procedures accompanying BMT did not elicit a significant CRP response . Forty-three febrile episodes were registered and analyzed, without previous knowledge of the results of CRP determinations . The incidence of bacterial infection and acute graft-versus-host disease (GvHD) was low, 8/30 and 5/30, respectively . Raised CRP levels occurred only once in association with GvHD . A CRP level higher than 50 mg/l was not sensitive as an indicator of bacterial infection (4/8) . A CRP level below 50 mg/l in the presence of fever, however, excluded bacterial infection with a specificity of 86% and a negative predictive value of 88% . When timed properly and interpreted together with clinical and microbiological findings, CRP measurements can be a valuable aid in the management of fever after BMT, especially as a negative predictor.

Infection, 1991 Mar-Apr, 19(2), 115 - 22
Linkage and independence of AIDS and Kaposi disease: the interaction of human immunodeficiency virus and some coagents; Eggers HJ et al.; Through epidemiological considerations we conclude that full-blown AIDS may occur only if the index patient is infected by the human immunodeficiency virus (HIV) and, in addition, by some other infectious coagent . Since the dynamical behavior of the spread of AIDS cases with manifestation of Kaposi's sarcoma differs fundamentally from that of the non-Kaposi cases, we conjecture that two independent coagents (together with HIV) are responsible for the outbreak of full-blown AIDS with or without manifestation of Kaposi's sarcoma, respectively . Our formal epidemiological considerations appear to be supported by recent microbiological findings.

Fam Pract, 1991 Mar, 8(1), 42 - 7
Patients with sexually transmitted disease: a well-defined HIV risk group in general practice?
Holtedahl KA, Doumenc M, Steinert S, Roghell PK.
Since patients with sexually transmitted disease (STD) form the most apparent risk group for HIV infection in general practice, differences in sexual behaviour in patients with and without STD were studied . Patients fulfilling at least one of four clinical criteria for suspicion of STD were offered four microbiological tests and a serological HIV test and were asked to complete a questionnaire concerning possible HIV exposure . Control patients were selected from a sample of ordinary consulting patients in general practice, without clinical suspicion of STD . The answers to the questionnaires given by six male and 52 female patients with a positive microbiological test for STD were compared with answers given by control patients matched for sex, age, education and geographical region . Females with STD had multiple male partners more often than controls . STD patients were more uncertain whether they had had sex with a HIV-positive person, and they reported more previous gonorrhea than the control patients . The proportion of patients who reported practicing oral sex was the same in both groups, while data for anal sex were insufficient . There were no significant differences in the use of condoms with a new partner, although there was a higher proportion of never-users of condoms among the STD patients . Identifying STD patients on clinical grounds is difficult in general practice . Clinical criteria have limited sensitivity because of asymptomatic infections, and the specificity is low . Patients with microbiologically confirmed STD should receive HIV-related attention, but attention to STD patients alone is not enough . Many people without STD have sexual behaviour which may exposure them to the HIV virus . The only means to a selective approach is increased attention to an appropriate sexual medical history.

Z Lebensm Unters Forsch, 1991 Mar, 192(3), 226 - 9
Evaluation of a microbiological method for detection of irradiation of spices; Manninen M et al.; The suitability of a microbiological method, a combination of the direct epifluorescent filter technique (DEFT) and the total aerobic plate count (APC), for the detection of irradiation of spices was evaluated . The evaluation was carried out using different kinds of spices including peppers, paprika, cardamom, cinnamon, ginger; herbs such as thyme, marjoram, basil, and oregano; and garlic powder . Ground spices were tested as well as cut and whole spice samples . Samples were analysed before and after gamma-irradiation mainly with doses of 5 and 10 kGy . Two different methods (centrifugation, filtration) for sample pretreatment were compared . Differences between the DEFT count and the APC with doses of 5 and 10 kGy varied between 3.9 and 6.8 and between 5.7 and 7.5 log units, respectively . The duration of storage after irradiation had no effect on the microbiological results . When applied to fumigated samples, the method might cause confusion in the absence of chemical analyses . The results of the analyses of samples treated by an unknown process indicated that the method could, in fact, detect irradiated samples, although it could not differentiate between irradiated and heat-treated samples.

World J Surg, 1991 Mar-Apr, 15(2), 240 - 7
Necrotizing soft tissue lesions after a volcanic cataclysm; Patino JF et al.; A volcanic cataclysm of major proportions, the fourth largest in terms of total casualties in the history of mankind, wiped out the town of Armero, Colombia, in 1985 resulting in over 23,000 deaths and 4,500 wounded . Among the hundreds of survivors who were transferred to hospitals in the capital city of Bogota, there was as overwhelming number who developed necrotizing fasciitis . These patients constitute, perhaps, the single largest group of this type of lesions in the recorded literature . Thirty-eight patients with well established necrotizing fasciitis were identified at 4 selected hospitals in Bogota; 8 of them presented with zygomycetic infection (mucormycosis), a highly lethal entity . Many additional cases were treated at other hospitals in Bogota and several cities in Colombia . The main clinical features of these 38 patients affected by necrotizing fasciitis are reviewed, with special emphasis on the patients with mucormycosis . Patients with necrotizing fasciitis had an overall mortality rate of 47.7%; patients with mucormycosis, 80% . A plea is made for an early diagnosis, utilizing tissue sampling and microbiological studies, so that prompt and radical treatment can be instituted . This is especially pertinent in situations of natural disasters resulting in massive numbers of casualties and seriously injured survivors.

Iowa Med, 1991 Mar, 81(3), 118 - 20
Experience with ciprofloxacin; Kresnicka D et al.; The authors report results of a multicenter study of 65 patients treated with ciprofloxacin . Twenty infections were microbiologically proven; eradication of the pathogen was achieved in 80%.

J Am Vet Med Assoc, 1991 Mar 1, 198(5), 857 - 61
Pulmonary hypertension in a group of dairy calves; Pringle JK et al.; An episode of pulmonary arteritis and sclerosis in twenty 5- to 6-month-old dairy calves was investigated . Sixteen of the calves died acutely, without marked premonitory signs of disease . Four calves evaluated clinically had lethargy, pallor, weakness, tachycardia, tachypnea, and jugular venous distention . Cardiac catheterization performed in 3 of the calves revealed pulmonary hypertension; 1 of these calves survived . Necropsy findings in 19 calves included pale lungs and excess free fluid in the pleural and abdominal cavities . In addition, 13 of 19 calves had a dilated and thin-walled right ventricle; 4 of the calves had right-sided cardiac hypertrophy, and 2 had dilatation of the pulmonary artery . Microscopically, pulmonary arteritis and sclerosis of the small to medium-sized arteries were evident in all calves submitted for necropsy . A lung biopsy specimen from a surviving calf had similar lesions . Centrilobular hepatic necrosis was found in 17 of 19 calves . Investigation of the disease episode, including feed analysis for toxins and serologic and microbiological studies of clinically affected calves and clinically normal in-contact penmates, failed to reveal any associated risk factor . The pulmonary arterial changes in the calves were similar to lung lesions in rats fed monocrotaline.

Arch Intern Med, 1991 Mar, 151(3), 582 - 5
Successful treatment of acquired immunodeficiency syndrome-related Mycobacterium avium complex disease with a multiple drug regimen including amikacin; Benson CA et al.; Disease due to Mycobacterium avium complex (MAC) in patients with the acquired immunodeficiency syndrome (AIDS) typically occurs late in the course of AIDS and is usually disseminated with evidence of multiorgan involvement . Most patients are persistently bacteremic . Previously published studies have noted a poor response to antimycobacterial chemotherapy . We describe successful treatment of MAC disease in an AIDS patient with a multiple drug regimen, including amikacin, clofazimine, rifampin, ethambutol, and ciprofloxacin . This patient, whose presentation and MAC disease course distinctly differ from most published experience, remains clinically and microbiologically MAC-disease free 25 months after initiation of therapy . We describe four additional AIDS patients with MAC disease who had a favorable clinical and microbiological response to this regimen without developing serious adverse effects after periods ranging from 4 to 12 months . We suggest a prospective, controlled clinical trial using this regimen for treatment of MAC disease in patients with AIDS may be warranted.

Baillieres Clin Gastroenterol, 1991 Mar, 5(1), 61 - 77
Disinfection of endoscopic equipment; Axon AT; Patients undergoing endoscopy are at risk of infection from the use of contaminated equipment . Dangers arise from the transmission of organisms from one patient to another and from the introduction of opportunist organisms which colonize endoscopic equipment on storage and can lead to sepsis and death in those who are immunocompromised and at ERCP . Staff are in danger from needle-stick injury and sensitivity to aldehyde disinfectants . These risks can be eliminated by careful attention to disinfection techniques . The most important part of endoscope disinfection is thorough mechanical cleaning first, followed by 5-10 min total immersion of the instrument and all channels in 2% glutaraldehyde (or the equivalent) . At the end of the endoscopy list, following the disinfection protocol, all equipment should be dried internally and externally prior to storage . Staff must be fully aware of the risks of infection in endoscopy, be protected from hepatitis B by vaccination, and be fully trained in disinfection techniques . Glutaraldehyde should be used only in closed systems or in well-ventilated areas with the operator protected from direct contact from splashing and fumes . Institutions should designate an individual to be responsible for preparing, monitoring and overseeing disinfection procedures within the endoscopy room and for ensuring that regular microbiological testing of equipment (including automatic disinfecting machines) is undertaken.

Allerg Immunol (Paris), 1991 Mar, 23(3), 81 - 7
Immunologic mechanisms in secretory otitis media-recent concepts (Part II); Borges Dinis P et al.; Increasing evidence has been accumulated in the last few years associating immunological mechanisms in the pathogenesis of secretory otitis media . If immunological processes were found to be involved in both of the previously accepted experimental pathogenic models (Eustachian tube obstruction; microbiologically induced) of the disease, recently published data has provided evidence for a third, not Eustachian tube- or microbiological-dependent, exclusively immunological, experimental model . This suggests that immunological mechanisms are probably always involved in the pathogenesis of a disease that is known to be multifactorial in origin, and thus eventually make Immunology the single most important factor in secretory otitis media . In the present article these recent concepts are extensively reviewed by the authors.

Indian J Pediatr, 1991 Mar-Apr, 58(2), 217 - 21
Serum levels of gentamicin at peak and trough in neonates and infants; Shahidullah M et al.; The peak and the trough levels of serum gentamicin were determined in 50 cases of neonates and infants by microbiological assay method . The peak levels in the neonates and the infants were 5.98 +/- 0.48 and 4.63 +/- 0.31 mcg/ml respectively . The trough levels in the corresponding group were 1.06 +/- 0.19 and 0.94 +/- 0.23 mcg/ml . The mean values of the peak and trough levels of the antibiotic were 5.57 and 1.02 mcg/ml respectively . It was observed that there was a significant lower peak concentration in the infants than in the neonates . A significantly higher peak concentration of gentamicin was observed in babies aged under 7 days than in those above 7 days . The route of administration (between I/M and I/V) did not seem to have any effect on the peak and trough levels of the antibiotics.

Minerva Stomatol, 1991 Mar, 40(3), 129 - 37
{The therapy of odontogenic abscesses . Pharmacological experimentation with lincomycin or amoxicillin}; Eftimiadi C et al.; A clinical and microbiological study was carried out to assess the therapeutic efficacy of two different antibiotics, lincomycin and amoxicillin, in the treatment of patients suffering from odontogenic abscesses . Microbiological analyses revealed that the majority of infections were supported by mixed aerobic and anaerobic bacterial flora . The assessment of clinical parameters clearly showed that patients receiving pharmacological treatment with lincomycin achieved a more rapid and efficacious recovery from disease in comparison to patients treated with amoxicillin.

Haematologica, 1991 Mar, 76 Suppl 1, 44 - 5
Detection of bacterial contamination in bone marrow graft; D'Antonio D et al.; A rapid method of determining bacterial contamination was used in a series of fifty-five bone marrow harvests (20 allogeneic and 35 autologous transplantations) . The microbiological culture assays executed on bone marrow samples soon after the harvest and before the manipulation, showed a positivity only in the autologous bone marrow group . Another positivity was revealed after the freezing process of bone marrows for autologous transplantation . Two samples in the bone marrow group submitted to purging were positive after treatment and freezing process . In this study, the increase of bacterial contamination frequency seemed to be related to extensive handlings, such as pharmacological in vitro purging and freezing procedures.

Enferm Infecc Microbiol Clin, 1991 Mar, 9(3), 154 - 8
{Evaluation of bronchoalveolar lavage in the microbiological diagnosis of pneumonia in patients at risk}; Gaztelurrutia L et al.; Bronchoalveolar washout was performed in 130 patients with pneumonia during a period of 28 months . Microbiological investigation involved common bacteria, Legionella, fungi, viruses (Cytomegalovirus, herpes, RSV), Mycobacterium, and Pneumocystis carinii . Infection HIV was present in 75% of patients . The remaining patients had malignant diseases or severe pneumonia . The overall sensitivity of the technique was 65.4% and the positive predictive value was 92% . The technique was less sensitive in cases of bacterial pneumonia (sensitivity = 34.4%) . This was attributed to the fact that 82.8% of these cases received antibiotic therapy . Pneumocystis carinii and Mycobacterium tuberculosis were the most common agents (44.8% and 34.5%, respectively) . In seven instances the clinical picture was related to cytomegalovirus, although this diagnosis can not be easily done.

Mycoses, 1991 Mar-Apr, 34(3-4), 125 - 8
Candida ciferrii: clinical and microbiological features of an emerging pathogen; de Gentile L et al.; The authors report six cases of toenail onyxis due to an unusual yeast species, Candida ciferrii . For half of these cases, direct microscopical examination showed the presence of blastospores and pseudo-to-true mycelium, demonstrating the parasitic transition of the fungus . In light of the literature and of their own experience, the authors suggest that C . ciferrii could be an etiological agent of onychomycosis, particularly for elderly patients with extensive trophic disorders.

Gig Sanit, 1991 Mar, (3), 39 - 42
{Preventive nutrition of industrial microbiology workers in a preventive-care sanatorium}; Dotsenko VA et al.; Prophylactic diet for the people working in microbiological industry exposed to the sensitizing action of microbiological synthesis products has been developed . The diet has been tested under the conditions of a prophylactic sanatorium . A protective effect of the diet has been observed manifest in the decrease of the state of sensitization, normalization of metabolic processes . It is recommended, that this kind of diet be used in the prophylactic sanatoria of the microbiological industry plants.

Vopr Pitan, 1991 Mar-Apr, (2), 27 - 31
{Evaluation of the effectiveness of preventive desensitizing nutrition in a preventive sanatorium}; Dotsenko VA et al.; The effectiveness of prophylactic desensitizing nutrition of workers at microbiological industry enterprises has been evaluated . Three groups of workers were under study . Two groups of subjects were in contact with microbiological synthesis products: one group (prophylactic) was given a specially developed prophylactic ration; the second one (control) received usual nutrition, the third group (intact) was composed of subjects who had no contact with the harmful production factors . Before the use of preventive measures, changes in the lipid and protein metabolism were recorded in workers of microbiological industry, and sensitization to microbiological synthesis products was observed enhancing the development of allergic diseases of the broncho-pulmonary apparatus and skin . The use of a specially developed ration has promoted metabolism normalization, the lowering of sensitization degree, and produced a favourable effect on the disease course . The prophylactic ration has been recommended for workers engaged in the microbiological industry.

Pathologica, 1991 Mar-Apr, 83(1084), 197 - 200
{Bilateral nodular pulmonary histoplasmosis: cytohistological correlation}; Visona A et al.; Nodular bilateral pulmonary histoplasmosis: cyto-histological correlation . A case of nodular pulmonary histoplasmosis is reported . A 29 year old man was admitted to hospital with temperature and general weakness following a short stay in a tropical country . Laboratory investigation showed an increased E.S.R . and a routine chest-roentgenogram revealed multiple bilateral nodular lesions confirmed by CT scan . Smears obtained from fine-needle-aspiration biopsy showed the presence of epithelioid cell's clusters with a few giant-cells in a background of inflammatory elements and necrotic debris . The cytological picture was consistent with an inflammatory process with necrotizing granulomatous features . The clinical evolution and the radiological picture progression caused, nevertheless, suspicion of a metastatic tumor . The histological examination of a resected peripheral nodule confirmed the inflammatory nature of the process, revealing the presence of multiple roundish encapsulated conidia 2-4 microns in diameter scattered within a granulomatous and necrotic tissue . The fungi are clearly pinpointed by using special stains like Grocott method . Serological and microbiological investigations are necessary in order to confirm the diagnosis.

Rinsho Byori, 1991 Feb, 39(2), 208 - 12
{The changes in infectious diseases and the future of microbiological examination}; Kanno H; Infectious diseases have changed markedly, especially in the background of patients and causative organism . The incidence of immunocompromised hosts has increased in hospitals due to the advances in medical treatment and less virulent organisms now caused infection . The causative organism is very difficult to determine by the conventional microbiological examinations such as culture method . Many new microbiological techniques have been introduced to obtain more accurate results more rapidly . These new methods are mainly immunological and genetical techniques . But these new techniques could not obtain extensive information than culture method, so it is necessary to choose most suitable method for the characteristic of the infectious disease.

Antimicrob Agents Chemother, 1991 Feb, 35(2), 365 - 7
Fluconazole in the treatment of candidiasis in immunocompromised children; Viscoli C et al.; Fluconazole, a new triazole derivative, was evaluated in a pilot study of 34 episodes of candidiasis in 24 children . All the patients had predisposing conditions, such as human immunodeficiency virus infection, cancer, organ or bone marrow transplantation, neonatal age and malnutrition, and obstructive uropathy . The drug was administered at 6 mg/kg (body weight) once daily either orally or intravenously . Two patients with fungemia due to Candida parapsilosis required an increased dosage of 12 mg/kg . Clinical and microbiological success was achieved in 30 of 34 cases (88%) . Drug-related transaminase increases were observed in two cases (6%) . Fluconazole may represent an effective alternative to amphotericin B in the treatment of candidiasis in children . Comparative trials are necessary to assess optimal dosages and efficacy.

Leukemia, 1991 Feb, 5(2), 162 - 5
Elimination of mycoplasma from infected leukemia cell lines; Gignac SM et al.; The infection of cell lines with mycoplasma can cause severe problems as the contaminants affect virtually every cell parameter . We attempted to eliminate mycoplasma from contaminated cell lines using the fluoroquinolone antibiotic ciprofloxacin . Mycoplasma-infected cell lines were cultured with 10 micrograms/ml ciprofloxacin for 14 days . The elimination or persistence of mycoplasmal infection was monitored by diamidino-2-phenylindole (DAP) DNA staining, RNA hybridization test and broth-agar microbiological culturing . Seventeen out of 21 positive cell lines (81%) have been successfully treated using ciprofloxacin . Mycoplasma infections are unacceptable in experimental in vitro systems and require an elimination procedure of certain efficiency . The use of adequate detection methods in the routine control of cell lines and the avoidance of emerging resistant strains are of the utmost importance.

Am J Hosp Pharm, 1991 Feb, 48(2), 293 - 5
Stability of an extemporaneously compounded terbutaline sulfate oral liquid; Horner RK et al.; The stability of terbutaline sulfate in an extemporaneous oral liquid formulation refrigerated for 55 days was studied . A suspension was prepared by grinding commercially available 5-mg terbutaline sulfate tablets, adding Purified Water, USP, to form a paste, and then adding Simple Syrup, NF . A control solution was prepared from analytical grade terbutaline sulfate powder in Simple Syrup, NF . The final concentration of terbutaline sulfate in both preparations was 1 mg/mL . Three samples of each formulation were stored in 4-ounce amber glass prescription bottles in the dark at 4 degrees C . Immediately after preparation and at 10, 19, 35, and 55 days, samples were visually inspected, tested for pH, and assayed in duplicate by high-performance liquid chromatography . On days 0 and 35, 100-microL samples of each suspension and solution were placed on agar plates for microbiological testing . On day 55, the mean percentages of the initial terbutaline sulfate concentrations remaining were 103.8% in the suspension and 91.7% in the solution . Color, odor, and pH of the samples did not change appreciably, and colony counts of bacteria were within acceptable limits . An extemporaneously prepared liquid preparation of terbutaline sulfate in Simple Syrup, NF, is stable under the conditions studied for up to 55 days; however, since microbiological testing was not performed on day 55, it is recommended that the preparation be stored for no longer than 30 days.

Prof Nurse, 1991 Feb, 6(5), 265 - 6, 268-9
A sticky situation? Microbiological study of adhesive tape used to secure i.v . cannulae; Oldman P; Intravenous cannulae are often secured by adhesive tape . This study looks at the infection risk this poses and recommends good practice to protect a vulnerable group of patients.

Gan To Kagaku Ryoho, 1991 Feb, 18(2), 195 - 200
{Microbiological approach to the treatment of brain tumors}; Kuratsu J et al.; Growths factors, defined as polypeptides that stimulate cell proliferation, are major growth-regulatory molecules for cells in culture and probably also for cells in vivo . Evidence has been derived for autocrine system in which the cell produces its own growth factor . Several growth factors as well as their cellular receptors have been identified as productions of proto-oncogenes . Furthermore, these growth factors have been identified as mitogens in tumors of the central nervous system . The roles of growth factors including platelet-derived growth factor (PDGF), epidermal growth factor (EGF) and its receptor . Insulin-like growth factors (IGFs), transforming growth factors (TGFs) and fibroblast growth factor (FGF) on the proliferation of brain tumors, especially glioma were reviewed . The activation of cellular proto-oncogenes resulting in the autocrine system of growth factors and their receptors offers the opportunity for therapeutic interference . Therapeutic efforts will be based on the concepts of neutralization of growth factors, antagonizing growth factors at their receptors, irreversibly blocking receptors, and interference with oncogene product synthesis . Specific antibody for growth factors or receptors will be able to inhibit the proliferation . Trapidil, an antagonist for PDGF, can inhibit the proliferation of a PDGF-producing glioma cell . We can assume that the further analysis of growth regulatory mechanism will allow the design of new therapeutic approaches.

Gastroenterology, 1991 Feb, 100(2), 458 - 64
Multifocal colitis associated with an epidemic of chronic diarrhea; Janda RC et al.; An outbreak of a chronic diarrheal syndrome was detected between May and August 1987 in rural Henderson County, Illinois . Seventy-two individuals were affected . Epidemiological studies performed by the Center for Disease Control implicated the water of a local restaurant as the source of the outbreak . Five patients underwent a comprehensive evaluation . Their mean age was 51 years, and they had a mean of 12 watery stools daily (range, 6-40) . Detailed microbiological evaluations failed to identify a pathological organism . Stool studies showed a mean stool weight of 392 g/24 h with a normal fat content . Results of all biochemical studies of serum were normal . Chemical analysis of stool water suggested a secretory diarrhea . Colonoscopy revealed patchy erythema, and light microscopic examination of colonic biopsy specimens revealed multifocal areas of acute inflammation in the superficial mucosa in 4 of 5 patients . Electron microscopy of the affected areas revealed no viral particles . After 2 years, all of our patients continued to experience chronic diarrhea . One patient agreed to a follow-up colonoscopy; histological abnormalities of the colonic mucosa persisted after 2 years . We speculate that an infectious process arising from a contaminated water system induced a chronic, secretory diarrhea characterized by multifocal colitis . This histological abnormality may serve as a marker of an infectious, chronic diarrhea.

Vrach Delo, 1991 Feb, (2), 95 - 7
{A new method of cultivating Mycobacterium tuberculosis}; Bil'ko IP et al.; The possibility is shown of microcultivation of Mycobacteria tuberculosis on semipermeable cellophane membranes covering solid nutrients . The new method of cultivation may be used for enhanced microbiological diagnosis of tuberculosis, for determination of drug resistance of the tuberculous pathogen as well as for assessment of the biological properties of Mycobacteria tuberculosis in live unstained culture.

Ugeskr Laeger, 1991 Jan 7, 153(2), 91 - 4
{The polymerase chain reaction used in microbiologic diagnosis}; Ostergaard LJ et al.; Among the new DNA technological methods for microbiological diagnosis, the most promising seems to be the polymerase chain reaction (PCR) . The sensitivity of the method is approximately 100% and the specificity is between 90% and 100%, depending on the availability of an already existing test sufficient for comparison . The PCR is able to detect only one microorganism in clinical samples . Because of this high sensitivity, contamination of samples is one of the major problems . After certain preparation procedures, the method can be used on different kinds of human sample material . The PCR could be used for detection of a microorganism, for detection of a single gene (toxin gene) or for typing of microorganisms . It is expected that, in the immediate future PCR will be a prominent part of the methods used in microbiological diagnosis.

Ann Biol Clin (Paris), 1991, 49(3), 166 - 71
{Expert systems and antibiotic sensitivity test}; Flandrois J et al.; Artificial intelligence is a part of computer science that deals with programs mimicking intelligence of man . Artificial intelligence is now used to check the quality of the determination of antibiotics susceptibility of bacteria . This application is useful because antibiotic susceptibility is subject to biological and technical variation that have to be detected . Three types of reasoning are used either by the biologist or by expert systems: low level quality checking dealing with individual results, microbiological interpretation of the whole set of results and medical interpretation of the results . The use of artificial intelligence in these fields is sustained by the structured nature of the knowledge . Two type of expert systems are already of routine use, either based on production rules (ATB plus EXPERT, bioMerieux, La Balme-les-Grottes, France and SIR, 12A, Montpellier, France), or on object-oriented representation of the knowledge (EXPRIM from our laboratory) . The main problem is, as usually in artificial intelligence applications, to transfer human expertise into an adapted knowledge base . The advantage of experts systems over man are their reproducibility of answer and their availability.

Neuroepidemiology, 1991, 10(2), 62 - 5
Epidemiological investigation of the association between infectious mononucleosis and multiple sclerosis; Lindberg C et al.; By matching a cohort of 494 infectious mononucleosis (IM) cases with a multiple sclerosis (MS) register, 3 MS cases were retrieved . The interval between IM and MS was 12 years . This corresponds to a relative risk of 3.7 for MS to occur subsequent to IM (p = 0.05) . This relationship between a manifestation of a relatively late Epstein-Barr virus infection and MS may indicate that a microbiologically shielded environment is important in the pathogenesis of MS.

J Int Med Res, 1991, 19 Suppl 1, 29A - 35A
Sulbactam/ampicillin in the treatment of otitis and sinusitis; Nicoletti G et al.; The importance of beta-lactamase-producing strains in acute otitis media and acute/chronic sinusitis, and the effectiveness of sulbactam/ampicillin were ascertained in vitro and in vivo . Of the strains isolated from 19 patients with otitis media, 40% are beta-lactamase producers whereas 44% of strains isolated from 22 patients with sinusitis produced beta-lactamase . When the most commonly isolated strains were treated with a range of antibiotics in vitro, they all showed 100% sensitivity to sulbactam/ampicillin . The clinical results for otitis media showed 63% recovery and 26% improvement, with only one (5%) failure (one patient did not complete treatment) . For sinusitis the results were 55% recovery and 45% improvement, and no failures . For sinusitis, the end-of-treatment microbiological results showed complete eradication of the pathogens responsible for infection . The results indicate that sulbactam/ampicillin is an effective treatment for infections of the ear, nose and throat.

Ann Nutr Metab, 1991, 35(1), 25 - 33
Aspartate aminotransferase activity in experimentally induced asymptomatic vitamin B6 deficiency in chicks; Masse PG et al.; Forty-five male Lohmann chicks were grown up to 6 weeks of age . The experimental diet containing a high protein level (30%) was aimed at increasing the metabolic need for PN . Microbiological analysis on the basal ration revealed a marginal content of 4.7 mumol PN/kg . The vitamin B6 status was assessed at the end of the experiment according to the basal activity of aspartate aminotransferase (AspAT) in plasma and in erythrocytes, and the in vitro stimulated activity with pyridoxal 5'-phosphate (PLP) . None of the deficient chicks had any clinical signs attributable to malfunction of the nervous system, and they grew as well as those receiving the control diet . Vitamin B6 deficiency was biochemically confirmed by a significant depression of AspAT activity in plasma (p less than 0.001) and in erythrocytes (p less than 0.01) . The addition of PLP in vitro enhanced the catalytic activity of the plasma enzyme, but had negligible effect on the erythrocyte enzyme . The degree of stimulation in vitro of the apoenzyme of AspAT not only depends on the endogenous vitamin B6 content, but also on the basal activity of the enzyme . A 15-day repletion period with a daily oral dose (50 mumol PN) did not result in a complete restoration of the enzyme activity, indicating that the availability of apoenzyme had been curtailed . This experiment demonstrated that chicks fed a high protein corn-soyamin diet with a limited amount of PN but containing Saccharomyces yeast showed no nervous signs or perosis, but significant metabolic disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

Farmaco, 1991 Jan, 46(1), 33 - 44
Synthesis and pharmacological properties of 3-alkylthio derivatives of isothiazolothieno-1,2,3-triazine; Guerrera F et al.; Some 3-alkylthio- derivatives of 7-chloroisothiazolothieno-1,2,3-triazine and of isothiazolothieno-1,2,3-triazin-7(4H)one were prepared . The synthesized compounds were subjected to pharmacological screening for antiallergic, antiinflammatory and analgesic activity as well as to a microbiological test in order to evaluate potential antifungal activity.

J Acquir Immune Defic Syndr, 1991, 4(7), 659 - 66
The usefulness of diagnostic bone marrow examination in patients with human immunodeficiency virus (HIV) infection; Northfelt DW et al.; To determine the utility of bone marrow examination for the diagnosis of opportunistic infections and lymphoma in patients with known or suspected human immunodeficiency virus (HIV) infection, we retrospectively reviewed the medical and laboratory records of all patients undergoing diagnostic bone marrow examinations at San Francisco General Hospital between January 1, 1988 and December 31, 1989 . All marrow examinations of patients with known or suspected HIV infection in which specimens were examined histopathologically and/or microbiologically for opportunistic pathogens or lymphoma were analyzed . Bone marrow examination resulted in the diagnosis of mycobacterial infection in 16% of the patients studied . Blood culture was 77% sensitive and bone marrow culture was 86% sensitive for detecting disseminated mycobacterial infection . This difference was not statistically significant (p greater than 0.05) . Disseminated fungal infections occurred in less than 5% of the patients studied, and most were rapidly and accurately detected by examination of stained bone marrow samples . No case of lymphoma was diagnosed by bone marrow examination . Bone marrow examination may be useful for diagnosing opportunistic infections in patients with HIV infection . Mycobacterial blood cultures have a sensitivity comparable to bone marrow cultures in detecting disseminated mycobacterial infections, are less invasive, and may be less costly . Marrow examination is not useful for diagnosing lymphoma but can determine the extent of lymphoma that has been diagnosed by other means.

J Clin Periodontol, 1991 Jan, 18(1), 16 - 9
A 2-year follow-up on the clinical and microbiological conditions of periodontium in teenagers; Asikainen S et al.; 87 teenagers were included in a 2-year follow-up study on clinical and microbiological conditions of the periodontium . The clinical status was determined according to the Community Periodontal Index of Treatment Needs (CPITN) for subjects under 20 years of age . 59% of the subjects had at least 3 healthy sextants at the baseline and 68% at the 2-year examination . The microbiological conditions were assessed by using direct dark-field microscopy, and the culture of Actinobacillus actinomycetemcomitants (A.a.) . Subgingival bacterial samples were taken, 2 for the microscopy and 2 for the culture, from the mesial surfaces of the first molars of each subject . The presence of gingival bleeding after probing was separately recorded from the 2 sites sampled for dark-field microscopy . No gingival bleeding at these 2 sites was found at the 2-year examination in 55% of those subjects who were non-bleeding at baseline, in 46% of the subjects initially with 1 bleeding site and in 13% of the subjects with both sites bleeding at baseline . 55% of the subjects with neither fusiforms, motile rods nor spirochetes at baseline maintained their healthy flora for 2 years . A.a . was recovered in 4 subjects at baseline and in 5 subjects 2 years later, in 3 of them at both examinations . Longer follow-up periods are needed to reveal the significance of the constant recovery of A.a . from the same subjects.

Vasa, 1991, 20(1), 17 - 21
Tissue concentrations of ofloxacin in necrotic foot lesions of diabetic and non-diabetic patients with peripheral arterial occlusive disease; Mueller-Buehl U et al.; Six diabetic patients with infected foot lesions (mean age 64 years) and six male patients (mean age 71 years) with ischemic acral ulceration due to advanced peripheral arterial occlusive disease were treated with 200 mg ofloxacin b.i.d . The necrotic margin tissue concentrations of ofloxacin determined by HPLC and confirmed by microbiological assay were in the same range (1.6 to 6.4 mg/kg) as plasma levels (1.6 to 5.9 mg/l) . No difference of plasma and tissue concentrations was found between patients with peripheral vascular disease and diabetics, respectively . After three weeks treatment bacterial wound pathogens disappeared in 7 subjects, changed in 4 patients and were resistant in one patient . Clinical improvement appeared in 9 of 12 patients after three weeks of therapy . Satisfactory tissue levels of orally administered ofloxacin were achieved in the infected necrotic tissue area of diabetic and non-diabetic patients with impaired peripheral arterial circulation.

Enferm Infecc Microbiol Clin, 1991 Jan, 9(1), 39 - 42
{Value of studying the extraluminal and intraluminal surfaces in the detection of catheter colonization}; Coll P et al.; 612 catheters have been prospectively investigated . In all of them, both the external and the internal surfaces were cultured, the former with the semiquantitative technique of Maki and the latter with the semiquantitative technique of Linares . 102 of the 469 central venous catheters (22%), 21 of 70 catheters used for parenteral nutrition (30%), and 19 of the 73 arterial catheters (26%) were positive with one or both techniques . The external surface was positive in 95% of central venous catheters, in 90% of the parenteral nutrition catheters, and in 95% of the arterial catheters, whereas the internal surface was positive in only 59%, 62% and 42%, respectively . The routine study of the internal surface of the catheters does not appear as justified . In our opinion, the microbiological study of catheters should be individualized depending on the relative importance of the skin or the connections in a particular catheter type . The quantitative study of the intraluminal surface should only be carried out in those catheters where connections represent a significant pathogenetical route . These catheters constitute only a small proportion of those that we receive for culture in the Microbiology Laboratory; therefore, this approach represents a considerable simplification of our daily routine.

Sex Transm Dis, 1991 Jan-Mar, 18(1), 1 - 4
Genital infection with Chlamydia trachomatis in patients with chlamydial conjunctivitis: unexplained results; Stenberg K et al.; It is generally believed that a chlamydial eye infection in adults is the result of autoinoculation of the eye by infected genital secretion . Genital samples of 60 microbiologically verified, adult, non-trachomatous chlamydial conjunctivitis cases were investigated . Only two of the 38 men and none of the 22 women tested had symptoms of genital infection when the sampling was made for establishing the diagnosis of chlamydial infection . Of the men, 23 (61%), 20 (53%), 19 (50%), and 20 (53%) were positive in urethral samples by culture, ELISA (Chlamydiazyme, Abbott, USA), and immunofluorescence tests (Chlamyset, Orion, Finland and MicroTrak, Syva, Finland), respectively . The corresponding figures for the female urethral samples were 12 (55%), 11 (50%), 9 (41%), and 12 (55%) and for the cervical samples 15 (68%), 15 (68%), 14 (64%), and 14 (64%), respectively . Thirty-nine mothers to neonates with chlamydial conjunctivitis were also studied . In 34 (87%) of the mothers, a genital chlamydial infection could be verified . It has been a general belief that the eye in chlamydial conjunctivitis in adults is generally infected by autoinoculation of infected genital secretion . Different means to explain the discrepancy between the results of the diagnostic tests for the eye and genital samples are considered.

Scand J Infect Dis, 1991, 23(1), 119 - 22
Legionella pneumophila peritonitis in a kidney transplant patient; Arnouts PJ et al.; Legionella pneumophila serotype 6 was isolated from the peritoneal fluid of a 59-year-old immunosuppressed patient who developed peritonitis shortly after kidney transplantation . Clinical and radiological examination did not show pulmonary abnormalities until shortly before his death when multiple organ failure developed with adult respiratory distress syndrome (ARDS) . Post mortem examination showed L . pneumophila in the peritoneum and in a small pulmonary infiltrate, confirmed by positive cultures . A primary peritoneal inoculation via an indwelling Tenckoff catheter seems to have been the most likely route of infection . Positive L . pneumophila type 6 cultures were obtained from the shower and hot water tap in the room of the patient . L . pneumophila must be considered as a potential cause of peritonitis in which routine microbiological cultures remain negative.

Leber Magen Darm, 1991 Jan, 21(1), 9 - 14
{Manifestations of AIDS in the gastrointestinal tract}; Heise W et al.; Besides central nervous system, pulmonary and cutaneous manifestations, the gastrointestinal tract and the hepatobiliary system are major organs in AIDS . Gastrointestinal symptoms due to opportunistic infections or HIV-associated tumours are common in AIDS patients . Nevertheless, a huge variety of endoscopically diagnosed mucosal lesions may not always be correlated to microbiological findings, clinical symptoms and histological aspects . Cytomegalovirus being the most important opportunistic infection in the GI tract in symptomatic AIDS patients, is correlated with erosive and ulcerative lesions, often accompanied by complications like perforation or bleeding . HIV-associated tumours in the GI tract like Non Hodgkin-lymphoma or Kaposi sarcoma may present with atypical endoscopic findings . Diagnostic procedures should include microbiological and histological investigations of biopsies looking for opportunistic infections . Besides, typical immunological changes involving the mucosa as direct target organ of the HIV virus, are important to understand morphological and functional abnormalities in HIV-patients with GI symptoms.

Aust Vet J, 1991 Jan, 68(1), 5 - 8
Chloramphenicol 3 . Clinical pharmacology of systemic use in the horse; Page SW; The use of chloramphenicol in the horse is now prohibited as horses are classified as food-producing animals . However, chloramphenicol has until recently been widely available for oral, intramuscular or intravenous administration . A critical appraisal of the published literature on the use of chloramphenicol in the horse clearly demonstrates that there are sound pharmacokinetic and microbiological reasons for concluding that chloramphenicol is not an appropriate antibiotic for systemic use . The short half-life of chloramphenicol in the horse, together with the broad range of minimum inhibitory concentrations of target pathogens, preclude the use of practical dosage regimens . It can be concluded that the withdrawal of chloramphenicol will have no adverse effects on chemotherapy in the horse.

Biotechnology, 1991, 15, 41 - 55
Surface transport of microorganisms by water; Moore JA; Several studies have reported on the quality of runoff from land that has received either an application of livestock waste or been utilized as a pasture for livestock . Unfortunately, these studies have not directed their efforts to understanding and developing the relationships among several of the important parameters that influence runoff quality . One of the reasons for this deficiency is that the list of influencing parameters is quite long . Nevertheless, it is important to identify the parameters and their probable impact on movement of organisms in water . The microbiological aspects are influenced by the fate of organisms in the environment . Radiant energy (sunlight), temperature, available nutrients, presence of toxic materials, available moisture (precipitation and humidity), and soil pH all influence the death/growth rate of the organisms in question . Site characteristics, such as slope, vegetative cover, antecedent moisture content, soil type, organic matter content, infiltration rate, and surface condition of the soil, all influence microorganism movement . Hydrologic factors, such as frequency, duration, and intensity of rainfall, are very critical in determining the characteristics of runoff events that provide the transportation to move introduced organisms from their application site . There are very few models today that can be used to calculate the microorganism population in runoff . While many of the influencing parameters have been identified, there has been little research on the surface transport of microorganisms.

Nord Med, 1991, 106(2), 40 - 2, 47
{Programmable and portable infusion pump for advanced cytostatic multidrug treatment}; Smaland R et al.; A portable, battery-driven, programmable drug infusion system which administers up to four different drugs through a single i.v . line is described ("IntelliJect I.V . Drug Delivery System") . The IntelliJect System can be used for a wide range of simple and complex regimens, including cytostatic therapy, antibiotic therapy, antiemetic therapy or pain control . If the actual drugs are not compatible, one channel can be programmed for flushing with sodium chloride . The system assures infusion of the right drug at the right time, while allowing delivery of preferred regimens in all settings--hospital, outpatient and home . A central venous access is necessary when used in an outpatient setting . The system needs minimal nurse or patient manipulation . Chemical stability and questions concerning microbiological contamination must be clarified, because drugs will be in the pump from several hours to several days . Applications of the system for cancer treatment are described, and documentation of patient preference of such a system is demonstrated . "IntelliJect I.V . Drug Delivery System" has the potential of optimizing cancer therapy, with regard to both quality of life and scheduling of cytotoxic drugs which can reduce toxicity and thereby possibly allow dose escalation.

Clin Microbiol Rev, 1991 Jan, 4(1), 52 - 60
Melioidosis: the tip of the iceberg?
Dance DA.
For nearly 80 years clinical melioidosis has been considered a rare disease . This bacterial infection is caused by Pseudomonas pseudomallei, a saprophyte found in soil and surface water of endemic areas . Consequently, those who have most contact with soil, the rural poor, are likely to be at greatest risk of infection . Since the diversity of clinical manifestations necessitates the isolation and identification of the causative organism for a definitive diagnosis of melioidosis and the population at greatest risk within endemic areas rarely have access to an appropriate level of health care, the disease has probably been underrecognized . Melioidosis is now known to be an important cause of human morbidity and mortality in Thailand, and this may be true throughout Southeast Asia, which is usually regarded as the main endemic area for the disease . In Australia, melioidosis causes a smaller number of human infections, while disease among livestock has important economic and possible public health implications . Sporadic reports of the infection indicate its presence in several other tropical regions: in the Indian subcontinent, Africa, and Central and South America . Clinical melioidosis may be highly prevalent in these areas, but underdiagnosed as a result of a lack of awareness of the clinical and microbiological features of the disease, or simply because of a lack of health care facilities . Furthermore, during the last two decades the importation and transmission of melioidosis within nontropical zones have been documented . The causative organism is not difficult to grow, and modern antibiotics have improved disease prognosis . Further studies are needed to determine the true worldwide distribution and prevalence of melioidosis so that improved therapeutic and preventive measures can be developed and applied.

Arch Environ Health, 1991 Jan-Feb, 46(1), 25 - 9
A two-year study of microbiological indoor air quality in a new apartment; Macher JM et al.; Concentrations and types of bacteria and fungi in the air and on surfaces were measured in a new, one-bedroom apartment before occupancy and at 3-mo intervals thereafter for 2 y . Air samples were collected with a single-stage impactor at two locations in the kitchen, living room, bedroom, bathroom, and outdoors . Even though damp surfaces supported large populations of bacteria and yeasts, the air concentrations in the kitchen and bathroom were similar to those in other rooms . No changes in concentrations or types of microbiological contamination were observed between the first and second years of occupancy, but elevated outdoor humidity, lower air temperature, and winds from the northeast were associated with higher bacterial and fungal air concentrations . The median air concentrations of bacteria were 98 cfu/m3 (95% confidence interval 26-372 cfu/m3) indoors and 101 cfu/m3 (28-364 cfu/m3) outdoors . The median air concentrations of fungi were 198 cfu/m3 (58-673 cfu/m3) indoors and 362 cfu/m3 (113-1158 cfu/m3) outdoors . This information established useful baseline data against which measurements in neighboring complaint residences could be compared.

J Bone Joint Surg Br, 1991 Jan, 73(1), 29 - 32
Pseudo-abscess of the psoas bursa in failed double-cup arthroplasty of the hip; Howie DW et al.; Seven psoas bursae filled with purulent fluid and inspissated debris were revealed at revision operations for failed resurfacing hip arthroplasties, an incidence of 5.8% in such revisions . Histological and microbiological investigations demonstrated that the psoas bursa collections resulted from the tissue response to polyethylene wear debris . None was due to infection.

Eur J Haematol, 1991 Jan, 46(1), 42 - 6
Imipenem-cilastatin for empirical therapy in neutropenic patients with fever: an open study in patients with hematologic malignancies; Huijgens PC et al.; In adult neutropenic patients with hematological malignancies, we explored imipenem-cilastatin as empirical antibiotic therapy in a dose of 500 mg four times daily . Changing to second-line treatment was only resorted to if clinical deterioration, new infections or recurrence of fever occurred . A clinically or microbiologically documented infection was apparent in 115 of 150 episodes studied (76.7%) . Imipenem-cilastatin was successful in 70.7% of all episodes and in 67.8% of all proven infections . Modification was necessary and successful in 22.0% of all episodes . 11 patients died while still febrile, 6 of them by infection (4%) and 5 because of progressive disease (3.3%) . Imipenem-cilastatin is safe initial therapy in neutropenic febrile patients.

Eye, 1991, 5 ( Pt 3), 299 - 304
The antigenic specificity of the humoral immune response to primary and repeated ocular infections of the guinea pig with the GPIC agent (Chlamydia psittaci); Treharne JD et al.; The antigenic specificity of the humoral immune response in guinea pigs to primary and repeated ocular infections with the guinea pig inclusion conjunctivitis (GPIC) chlamydial agent was analysed using microbiological, serological and Western blotting techniques . The results indicate that although there was a response to many minor polypeptide antigens, there was a marked lack of reactivity to the major outer membrane protein (MOMP), particularly following reinfection of guinea pigs . It is suggested that, lack of a good antibody response to the MOMP, may be one of the reasons why guinea pigs are susceptible to repeated ocular infections with this chlamydial agent.

Acta Otolaryngol, 1991, 111(4), 756 - 61
Kinetic profile of miocamycin in middle ear fluid and mucosa; Fraschini F et al.; A group of 18 patients, before undergoing otoplastic surgery, was treated with miocamycin 600 mg in a single dose; middle ear tissue samples were collected at 2, 3, 4 and 6 h . A group of 20 patients suffering from secretory otitis media (SOM) was also treated with 600 mg of miocamycin in a single dose; collections of middle ear fluid (MEF) were performed at 1, 2, 4 and 6 h . Blood withdrawals from all patients occurred at the same time intervals . The miocamycin determination was performed by means of a microbiological method employing Sarcina lutea ATCC 9341 . The highest serum levels (1.06 +/- 0.13 mg/l) were found at 2 h in the group from which middle ear mucosa had been withdrawn and at 1 h (2.2 +/- 0.5 mg/l) in the group from which the MEF had been collected; at 6 h miocamycin could be determined in both groups, with values ranging from 0.1 to 0.2 mg/l . In middle ear mucosa the miocamycin concentration was 1.52 +/- 0.27 mg/kg at 2 h and 0.2 +/- 0.09 mg/kg at 6 h . In MEF, the miocamycin concentration was 2.1 +/- 0.27 mg/l at 1 h and 0.24 +/- 0.05 mg/l at 6 h . The miocamycin concentration determined at 1 h in MEF was virtually equal to that in serum at the same time . At the following experimental times of withdrawal, the miocamycin concentration in mucosa specimens, as well as in MEF samples, proved to be markedly higher than values simultaneously found in serum.

Vestn Akad Med Nauk SSSR, 1991, (8), 20 - 3
{Microbiological and immunological disorders in acute radiation disease patients, victims of the Chernobyl AES accident}; Ivanov AA et al.; As many as 138 patients with acute radiation sickness, grades O-IV, were examined over time . It has been revealed that disorders in microecology and humoral immunity agreed well with the severity of radiation damage.

Verh K Acad Geneeskd Belg, 1991, 53(4), 305 - 61; discussion 361-4
{Fever . A guideline in the development of medical thinking}; Janssens PG; Fever being one of the best known symptoms, and appearing so frequently that it is often assimilated to "illness", has brought us to try and find out what "fever" means in a general way; in other words, we examined its medical and scientific concept throughout the centuries . In the course of primitive and archaic periods, fever, as well as diseases, was placed in the supernatural sphere and was reserved to magico-religious practices . Hippocrates will change this method by devoting himself to meticulous clinical observation, considering fever as a sign of illness, and by characterizing the different types of fever . When considering the mechanisms of its appearance, he will stick to the theory of "body-humors" and the "theories of numbers." Galenos will adapt that theory to Aristotle's philosophy and, doing so, he made it last for several centuries . The Renaissance will place critical thinking higher than slavish acceptance of theories, but it will not start any revolution in the appreciation of fevers . The possibility of contagion is mentioned, but the latter will only be well established by Pasteur and Koch . The breakthrough of microscopy into pathology will have to wait for Virchow . Thermometry will have to wait two centuries between Santorio and Wunderlich . The fever-concept will stay vague until experimental physiology and medicine will acquire their vested rights owing to Magendie and Bernard . They will moreover be followed by the microbiological era . The breakthrough will be the consequence of experimental proofs of the existence of a temperature-centre located in the hypothalamus and the pre-optic area . The discovery of endogenous as well as exogenous pyrogens has contributed to the creation of rational models which cover nearly completely the problem of body-temperature and fever . This long way did not progress as a regularly favourable evolution but, now and again, appeared figureheads who allowed us to approach the truth nearer and nearer.

J Hyg Epidemiol Microbiol Immunol, 1991, 35(2), 167 - 88
Long-term yersiniosis surveillance project in Czechoslovakia; Aldova E et al.; The paper presents an epidemiological analysis of 8,232 cases of yersiniosis caused by Y . enterocolitica 03 over 1972-1988 as reported by Hygienic Stations . The steady epidemiological characteristics of yersiniosis were the prevalence of children and boys and a typical seasonal pattern with differences between the Czech and Slovak Republics . In the Czech Republic, there were several incidence peaks following, when summarized, the incidence curve of other alimentary infections, whereas in the Slovak Republic morbidity reached its peak during winter months . The numbers of isolated strains oscillated significantly between districts and by years . It appears that the number of positive findings in different districts is not only an objective value reflecting a mosaic-like pattern of incidence but also depends on the quality of microbiological diagnostics.

Cah Anesthesiol, 1991, 39(4), 281 - 4
{Acute adult respiratory distress syndrome in leptospirosis}; Hidou M; The respiratory manifestations of leptospirosis are usually benign . A case is reported of leptospirosis with serious pulmonary affection . Pulmonary involvement in leptospirosis is infrequently predominant and usually without bearing on prognosis . Clinical and roentgenological features are reviewed . Severe forms with massive hemoptysis or acute respiratory failure occur occasionally . The clinical symptoms, the radiological manifestations and haemodynamic investigation were suggestive of an acute respiratory distress by non haemodynamic pulmonary oedema . In accordance with other authors, one could be justified in including this acute respiratory failure as part of the adult respiratory distress syndrome . Since leptospirosis has extremely diverse clinical features, physicians should have this diagnosis in mind in many circumstances and should request the appropriate examinations at the right moment . Carefully performed microbiological techniques may reduce the problems encountered in isolating leptospires . Serological tests requested after the 12th day of the disease and repeated several times should improve the diagnosis confirmation . The potential severity of certain forms justifies curative antibiotic therapy.

Vestn Akad Med Nauk SSSR, 1991, (6), 9 - 13
{Elaboration of clinico-laboratory criteria of the Mycoplasma variants of rheumatoid arthritis in children}; Mitchenko AF et al.; To develop clinical and laboratory criteria for the differential diagnosis of Mycoplasma-induced arthritides in 78 children with documented rheumatic arthritis (RA), a comprehensive study involving microbiological, immunological, and clinical tools has been performed . Some specific signs of the clinical course of Mycoplasma-induced RA have been defined . However, a differential diagnosis of Mycoplasma-induced arthritis may be made on the basis of a comprehensive study of a patient.

Vestn Akad Med Nauk SSSR, 1991, (6), 21 - 2
{Detection of Mycoplasma infection in the postpartum period}; Gamova NA et al.; The comparative results of microbiological and serological testing of parturients with uneventful and complicated course of the postpartum period were presented . The data justified the etiological role of M . hominis and U . urealyticum in the development of postpartum complications.

Virchows Arch A Pathol Anat Histopathol, 1991, 419(3), 251 - 4
Sinus histiocytosis with massive lymphadenopathy (Rosai Dorfman disease) in an HIV-positive patient; Delacretaz F et al.; We report a case of a 31-year-old HIV infected black female, who presented with asymptomatic generalized lymphadenopathy . Three particularly enlarged lymph nodes were biopsied (2 cervical and 1 axillary) . The histological picture was consistent with a diagnosis of sinus histiocytosis with massive lymphadenopathy (SHML) or Rosai-Dorfman disease . Large histiocytes, positive for a variety of macrophage markers and for the S-100 protein, were observed in the distended sinuses . A few hyperplastic follicles, such as usually seen in HIV-infection-associated lymphadenopathy, were present at the periphery of one lymph node . No infections agent besides HIV could be detected by histological or microbiological analysis or by in situ hybridization . This is the first reported case of SHML associated with HIV infection . The possible relationship between the two diseases is discussed.

Drugs Exp Clin Res, 1991, 17(3), 181 - 5
Some pharmacokinetic data on miocamycin II . Concentrations in gynaecological tissues; Furneri PM et al.; The gynaecological tissue levels of miocamycin were studied in ten female patients after pre-operative administration . The patients were divided into two groups on the basis of the scheduled sampling time . All the patients received 4200 mg of the drug, divided in 7 tablets of 600 mg each every 8 h, last administration 2 or 3 h before surgery . The tissue levels, obtained by means of the microbiological method (Sarcina lutea 9341), were frequently higher than those obtained in the serum at the same time . Miocamycin reached the highest concentration in the endometrium (2.5 micrograms/g) and the lowest in the vagina (1.1-0.8 micrograms/g).

Drug Des Deliv, 1991, 7(3), 241 - 50
Structural and microbiological evaluation of a degradable sustained-release device for use in periodontal therapy; Friedman M et al.; Degradable protein matrices containing chlorhexidine were tested as intra-pocket drug delivery systems in the treatment of periodontal diseases . The properties of the device were mainly dependent upon the degree of cross linking in the matrix, which could be varied according to the preparative conditions . The degree of cross linking was determined by amino acid analysis based on the amount of free lysine in the protein . The release of chlorhexidine and of the plasticizer used in the preparation of the matrix were determined . The release of chlorhexidine from the matrix was prolonged for a period of 300 hours, and the release of plasticizer ceased after four hours . Limited clinical trials suggest that one of the degradable devices--that containing the highest amount of cross-linking--causes a significant reduction in the amount of perio-pathogenic bacteria following its insertion into the periodontal pockets of patients with periodontal disease.

Chemotherapy, 1991, 37 Suppl 3, 15 - 21
Outcome of a ceftriaxone/cefotaxime interchange programme in a major teaching hospital; Gutensohn A et al.; A two-stage intervention programme was performed to enable the effective substitution of ceftriaxone for cefotaxime in a teaching hospital with large numbers of transient prescribers . One hundred and sixteen patients with a variety of bacterial infections were randomized to an open, historical control comparative study to determine if ceftriaxone was an acceptable replacement for cefotaxime . For 6 months prior to the intervention, both cephalosporins were available on formulary . Following an initial informational stage, a therapeutic interchange programme was implemented to convert prescriptions for cefotaxime to ceftriaxone . Ceftriaxone and cefotaxime were equivalent in terms of microbiological and clinical efficacy and patient tolerance in 77 evaluable patients . No changes in prescriber service occurred after the changeover . Post-intervention treatment courses required a ceftriaxone/cefotaxime interchange in 28% of the cases . Ceftriaxone appeared to be a suitable and cost-effective alternative to cefotaxime in this hospital . The intervention programme successfully invoked the formulary change with minimal expense and prescriber opposition.

Gig Sanit, 1991 Jan, (1), 24 - 6
{Complex sanitary-microbiological criteria of evaluating the quality of water in increasing anthropogenic load}; Vinogradova LA et al.; It has been established with the help of sanitary-hygienic, microbiological and statistical methods, that the increasing ++anthropogenic stress on water reservoirs induce quantitative and qualitative changes of water biocenosis under the conditions of intensive use of water reservoirs for economic purposes . It can produce unfavourable health effects on the population, as well as on the equilibrium of the local ecological microsystems . The necessity has been substantiated of the use of complex sanitary-microbiological criteria of the assessment of the quality of water objects to provide their epidemic safety, to preserve and rehabilitate the processes of ++self-purification of water under the conditions of technogenic exposures.

Pathobiology, 1991, 59(4), 209 - 13
Regulation of cytokine and viral gene expression in monocytes infected with the human immunodeficiency virus; Meltzer MS et al.; Monocytes treated with interferon-alpha (IFN-alpha) at virus challenge show no evidence of human immunodeficiency virus (HIV) infection: no p24 antigen or reverse transcriptase (RT) activity, no viral mRNA and no proviral DNA . Levels of p24 antigen and RT activity in monocytes infected with HIV 1-3 weeks before IFN-alpha treatment gradually decrease to baseline . HIV-induced cytopathic changes are markedly reduced, as are levels of HIV mRNA: the frequency of productively infected cells is less than or equal to 1% . But, levels of proviral DNA in the IFN-alpha-treated and control HIV-infected cells are indistinguishable, and remain so through 3 weeks . Large quantities of proviral DNA in IFN-alpha-treated cells with little active transcription suggest true microbiological latency . The major potential source for IFN-alpha in HIV-infected patients is the macrophage . With any of 15 virus isolates, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, IFN-omega or IFN-beta are not detected nor the mRNA expressed in HIV-infected or uninfected monocytes . Both uninfected and HIV-infected monocytes produce high levels of these cytokines after treatment with synthetic double-stranded RNA (poly-I:C) . Uninfected monocytes also produce high levels of IFN-alpha after treatment with Poly-I:C, Newcastle disease virus or herpes simplex virus . In marked contrast, HIV-infected monocytes express no IFN-alpha activity or mRNA before or after treatment with any of these agents . The markedly diminished capacity of HIV-infected monocyte to produce IFN-alpha reflects a specific transcriptional block and may be an adaptive mechanism of virus to alter basic microbicidal functions of this cell.(ABSTRACT TRUNCATED AT 250 WORDS)

Akush Ginekol (Sofiia), 1991, 30(2), 67 - 70
{The treatment of vaginal candidiasis with a single oral dose of fluconazole}; Zlatkov V et al.; Fluconazole is a new oral absorbing triazolic antimycotic, inhibiting specifically the sterol synthesis of fungal membrane . Treatment with a single dose of 150 mg of fluconazole was carried out on 33 nonpregnant women with clinical and microbiological data for vaginal candidiasis . The high percentage of recovered patients, good tolerance to the preparation as well as easy scheme for usage gives ground to be recommended for wide gynecological practice.

Mikrobiyol Bul, 1991 Jan, 25(1), 80 - 6
{The effect of magnetic retainers used in dental prostheses on the pathogenic microorganisms in the oral flora}; Saygili G et al.; Patents for magnetic denture retainers in dental prosthesis, have issued since 1930, but recent developments rekindled interest . There have been many studies reporting the effects of magnetic fields on humans, animals, insects, tissue cultures, micro-organisms and enzymes . In some of these reports, damaging tissue effects were observed . In our study, the effect of these magnets to the growth of pathogen microorganisms found in oral flora were investigated with 2 different microbiological methods . In either of these methods, it was determined that the magnetic field didn't affect the colonization of bacteria.

Dtsch Zahn Mund Kieferheilkd Zentralbl, 1991, 79(2), 141 - 6
{Alginate with a chlorhexidine admixture in a torsion test}; Welker D et al.; The elastic properties of commercial alginate impression materials are not essentially influenced by chlorhexidin at microbiologically effective concentration . The torsion test proved to be a simple reliable method.

Probl Tuberk, 1991, (3), 9 - 13
{Complex methods of examination in the diagnosis of disseminated processes in the respiratory organs}; Lomako MN et al.; The efficiency of complex methods of examination, including that of the new special ones, for the diagnosis of disseminated processes in the lungs has been studied in 300 patients between the ages of 20 and 76 years . The following methods were used: microbiological (including a new nutritive medium for mycobacteria activation), immuno-enzymatic (detection of specific antigens), immuno-morphologic with determination of antigen determinants of tuberculosis mycobacteria and their L-forms with the help of specific antisera, cytologic, biochemical (the content of phospholipids and their fractions in the bronchoalveolar washing and blood plasma cortisol/insulin ratio), ++tracheo-bronchoscopic and surgical methods . A possibility of the verification of the clinical diagnosis of various diseases was established with the help of each method being used . Surgical intervention (thoracoscopy with lung biopsy and open lung biopsy) which confirm the diagnosis in 96.4% of cases proved to be the most informative diagnostic method.

Acta Obstet Gynecol Scand, 1991, 70(1), 73 - 8
Treatment of candidal vaginitis . A prospective randomized investigator-blind multicenter study comparing topically applied econazole with oral fluconazole; Osser S et al.; Two hundred and thirty-five women with clinically and microbiologically proven candidal vaginitis were randomly allocated for treatment with either one topically applied vaginal tablet of 150 mg econazole (114 women) or one orally administered capsule of 150 mg fluconazole (121 women) . The women returned for follow-up visits 7-10, 28-35, and 80-100 days after the recruitment visit . Women with clinical and/or mycological failures and/or a recurrence were successively excluded from the follow-up . At the 28-35-day follow-up visit, the women treated with fluconazole had a significantly higher clinical/microbiological cure rate than those given econazole (P = 0.022; Fisher's exact 2-tail test) . No significant such differences were observed at the 7-10 and the 80-100-day follow-up visits, although fluconazole tended to be more efficacious . Nine women administered fluconazole, and 2 women given econazole reported minor systemic side effects of the treatment . Three women out of 4 preferred oral to local therapy of candidal vaginitis.

Ter Arkh, 1991, 63(12), 14 - 7
{Exogenous and endogenous risk factors in the development of nonspecific lung diseases in young people}; Chumak GE et al.; An organized community numbering 900 normal subjects aged 18 to 19 years were examined . Acute pneumonia was encountered in 15% of persons of the group under study per year . To identify persons with premorbid condition of nonspecific pulmonary diseases, anamnestic screening and outpatient examinations (microbiological and immunologic studies) were performed . As a result, the group constituted by subjects at risk for disease accounted for 18.6%, whereas S . pneumoniae was found in 44.9% . The immunologic findings were compared to the data obtained in the anamnestic screening . It was inferred that certain anamnestic signs correlated with the immune status . The leading factor in the formation of the premorbid condition lies in integral shifts in the immunologic system during adaptation . It follows from the data obtained that persons with risk factors need immune correction.

Cesk Epidemiol Mikrobiol Imunol, 1991 Jan, 40(1), 49 - 55
{Immunochemical determination of gentamicin in serum . I . Preparation of gentamicin-carrier conjugate}; Ploczekova C; The author describes the procedure for the preparation of the complex gentamicin-carrier needed for the preparation of specific antibodies against gentamicin . As carriers bovine serum albumin, thyroglobulin and haemocyanin were used . The conjugate was purified by separation on a Sephadex G-25 column and its activity was tested by the microbiological diffusion method . The results indicate that the method described in the paper is suitable for the preparation of the complex gentamicin--bovine serum albumin and gentamicin--thyroglobulin.

Asia Pac J Public Health, 1991, 5(3), 245 - 8
Etiological investigation of farmer's lung disease: a serological study; Shen Y et al.; To confirm the main etiological antigen of farmer's lung in Dafeng County, Jiangsu Province, People's Republic of China, precipitins in serum from 30 patients with farmer's lung were tested with several strains of antigens . Reactions against two strains of T.vulgaris were shown in 46.7% and 66.7% of the patients group, which were significantly higher than in the controls, while the percentage of reactions against Faenia rectivirgula and A . fumigates were low in the patients group and had no significant difference with the controls . The results indicate that the main etiological agents were some strains of T . vulgaris . This finding was consistent with the microbiological study of sputum of the patients and moldy hay samples from the working area.

J Pharm Biomed Anal, 1991, 9(10-12), 1047 - 53
Comparative determination of salinomycin by high-performance liquid chromatography, microbiological and colorimetric methods in testing production processes and animal feed preparations; Sokolic M et al.; Salinomycin and other polyether antibiotics usually do not have a strong chromophore, nor electrochemical or fluorescence activity . Consequently, common liquid chromatography detectors cannot be used for the direct determination of these substances and LC methods that utilize a specific post-column reaction with vanillin have been developed to overcome this limitation . In this report, some modifications of previously published LC methods were made to optimize the analysis of salinomycin . Comparison with standard microbiological and colorimetric methods has been carried out . The LC method was found to provide the best way of precise, and accurate determination in low levels of salinomycin down to the concentration of 1 mg kg-1.

Eur J Drug Metab Pharmacokinet, 1991, Spec No 3, 102 - 7
Intestinal absorption kinetics of a series of aminopenicillins and azidocillin . A comparative study in the rat; Margarit F et al.; Intestinal absorption rate constants of amoxicillin, ampicillin, epicillin, cyclacillin and azidocillin, by means of a static in situ intestinal perfusion method has been estimated . Luminal remaining antibiotic concentrations were determined using a standard microbiological technique . In order to establish statistically better absorption kinetics, five dose levels were used, ranging from 10 to 1000 micrograms/ml, and first order, Michaelis-Menten and combined first-order and Michaelis-Menten differential model equations were fitted to experimental data found for each antibiotic . According to the AIC test, the best equation for absorption kinetics was selected . Amoxicillin and ampicillin absorption mechanisms were better described by combined kinetics, while for cyclacillin and epicillin the most probable kinetics was that of Michaelis-Menten . For azidocillin, the only non-aminopenicillin component of this series, first order kinetics should be statistically selected.

Dtsch Stomatol, 1991, 41(1), 30 - 4
{Microbiological parameters in periodontitis marginalis during local treatment}; Lindemann C et al.; Repeated professional removal of plaque and tooth-stone by means of deep scaling and root planning is able to avoid a further progression of marginal periodontitis . This therapeutical measures lead to changes in the bacterial composition of subgingival plaque . Important bacteria for the etiology of periodontitis are reduced . 8-12 weeks after therapy the recolonization of the complex periodontitis flora is finished . Therefore a repeated subgingival scaling is necessary to make the treatment successful.

Dtsch Stomatol, 1991, 41(1), 25 - 9
{Clinical-controlled valuation of the conservative and surgical therapy by periodontitis marginalis}; Gabbour G et al.; The present investigation describes in a two years study the effect of conservative local therapy with and without surgical intervention and the reliability of the parameters (SLI, GI, SBI, pocket depth, attachment level and finally the microbiological examination (GRAM-technique) . Reexamination was carried out in a recall system of 2, 4 and 12 weeks, also 6, 12 and 18 months after completing the determined therapy procedure . Analysis was carried out by means of the mean value, Student's t-test, correlation analysis and documenting the individual status respectively . Both treatment methods resulted in positive results . Individual variations among patients were noted . Deep pockets were initially more reduced by surgical intervention than by conservative local treatment alone . Principally, surgical intervention shows as a result more sites surfaces with progression of periodontitis than after conservative local treatment . Attachment loss is the most correct sign of periodontal progression . Decisions for surgical intervention should be based on follow-up documentation and individual patient reactions.

Optom Clin, 1991, 1(3), 79 - 93
Microbiological aspects of extended-wear soft contact lenses; Connor CG; Corneal ulcers are the most devastating complication associated with extended-wear soft contact lenses . The increasing prevalence of microbial keratitis associated with the wear of these lenses is a major concern for the optometrist . Studies of extended-wear and daily-wear contact lens patients strongly suggest that extended-wear patients face a greater risk of ulcerative keratitis than other cosmetic contact lens wearers . This discussion addresses the potential risks of extended-wear, with emphasis on ulcerative keratitis, the likely causes for these increased risks, and what the optometrist can do to reduce the risk of a microbial infection.

Fortschr Ophthalmol, 1991, 88(6), 861 - 4
{Cefmenoxime penetration in human lacrimal sac mucosa after systemic administration}; Duncker G et al.; Access to microbiological, pharmacokinetic and toxicological information is necessary for useful, controlled application of antibiotics in intraocular and periocular infections . It is important to know whether the antibiotic is effective against ophthalmologically relevant bacteria and if suprathreshold concentrations of the antibiotic can be achieved in the contaminated tissue . In the study presented we investigated the usefulness of cefmenoxime in cases of dacryocystitis . Lacrimal sac tissue--and serum specimens were obtained from 15 patients who underwent dacryocystorhinostomy 0.5 to 13 h after intravenous injection of 25 mg cefmenoxime kg . The usual Toti procedure was performed in 7 patients, whereas the other 8 underwent endonasal surgery . Out of the 15 patients 12 suffered from recurrent dacryocystitis . Before application of the antibiotic a serum control sample was obtained in all patients . The highest cefmenoxime levels in the lacrimal sac (72 mg/kg) were measured 30 min after injection . Thirteen hours after the injection, the cefmenoxime levels were too low to be measured . The levels of cefmenoxime in the lacrimal sac tissue were compared with the minimal inhibitory concentrations for the frequent occurrence of bacteria in lacrimal sac infections.

Wien Klin Wochenschr, 1991, 103(23), 695 - 703
{Significance of vaginal and cervix flora with reference to ascending infections}; Mayer HO; The role of the vaginal and cervical flora and the extent of alterations in the flora in ascending infections of the female genital tract were evaluated in a microbiological study of 86 patients with a clinical diagnosis of pelvic inflammatory disease (PID) . The patients were classified as having acute salpingitis (n = 15), an acute inflammatory adnexal tumour (n = 21), subacute salpingitis (n = 38), or chronic salpingitis (n = 12) . 100 symptom-free women formed a control group . The spectrum of microorganisms found in the two groups was similar . However, there were significant differences in the distribution of pathogenic and apathogenic organisms . Negative cultures and cultures with exclusively apathogenic organisms were found in 16% of the patients with PID and 43% of the healthy women . Growth of exclusively apathogenic aerobic organisms was seen in 3.5% of the patients with PID and 18% of the controls . Exclusively apathogenic anaerobic organisms were found in 7% of the patients with PID and 32% of the controls . Mycoplasmas were significantly more common in the PID group than in the controls (31% v . 10%) . The rates of Chlamydia trachomatis did not differ significantly (13% v . 10%) . Patients with pathogenic organisms had a 3.88 (odds ratio) or 2.27 (col-2 risk) higher risk of PID than those with negative cultures or exclusively apathogenic organisms . There were no significant associations between the microbiologic results and individual parameters of inflammation . The microbiologic results did not reflect the course or severity of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Akush Ginekol (Sofiia), 1991, 30(3), 40 - 4
{The assessment of the clinical and microbiological status of the lower genital tract in women with sterility}; Zlatkov V et al.; The study was carried out on 40 randomly selected patients with sterility, in whom microbiological examination of the lower genital tract was performed . Pathogenic microorganisms were isolated in the vaginal secretion of 10 out of 26 patients with primary sterility, but in the cervical secretion in 8 out of 26 women . Similar finding was found in 5 patients out of 14 patients with secondary sterility . The obtained results were compared with the complaints of women and their gynecological examination . Attention is paid again to the necessity of complex evaluation on the character of microbiological flora in view of the frequent usage of invasive methods in diagnosis and treatment of sterility.

Rocz Panstw Zakl Hig, 1991, 42(1), 9 - 13
{Effect of different amounts of KNO3 on the quality of "Zuławski" cheese . II . Microbiological and organoleptic values after addition of different amounts of KNO3}; Przybylowski P et al.; The present paper constitutes an integral part of the studies on "Zulawski" cheese quality that have been presented in the first part: "Changes of nitrates in ripening "Zulawski" cheese" . Physico-chemical and microbiological assessment of raw and pasteurized milk assigned to cheese production proved that the milk not always was of the highest quality . It was stated that ++saltpeter addition to cheese-making milk by 0.01% and 0.02% does not have an explicit effect on improvement of microbiological quality and organoleptic values of "Zulawski" cheese.

Shoni Shikagaku Zasshi, 1991, 29(1), 144 - 53
{Oral condition of infantile acute lymphatic leukemia with microbisme substitute}; Shinohara M et al.; The oral condition of a 7 year old boy at the 12th and 13th remission induction therapy sessions since contracting acute lymphatic leukemia was investigated clinically and microbiologically . The findings obtained were as follows: 1) The appearance of gingivitis coincided with the decrease of white blood cells 7 to 9 days after administration of the anti-leukopenic drugs . 2) Gingivitis appeared on the same site of the oral cavity at both remission induction therapies sessions . 3) The bleeding from the gingival lesions corresponded to the decrease of blood platelet at both remission induction therapies sessions . Conversely, gingivitis disappeared with the improvement of peripheral blood conditions . 4) The total number of oral bacteria decreased after administration of the antibiotics, although the ratio of Candida in the oral microbial flora increased markedly . 5) Typical symptoms of oral candidiasis were not observed after the appearance of the microbisme substitute.

Probl Tuberk, 1991, (11), 44 - 8
{Surgical treatment of tuberculosis of the respiratory organs and lymphadenitis in children and adolescents}; Ogai IV et al.; The many-year practice of surgical treatment of 488 children and adolescents (aged 6 months to 17 years) suffering from tuberculosis of the lungs, pleura, intrathoracic and other groups of lymph nodes and other concurrent pulmonary diseases is summarized . Considerable attention is attached to the clinical aspects of complicated and disseminated forms of diseases, indications for surgery with consideration of the changed course of a process during modern surgery . Morphologic and microbiological findings of the material obtained during surgery are given . The results of surgical treatment are provided whose efficiency in various forms reaches 100% . The postoperative clinical cure of tuberculosis is achieved in 98% of the cases, the mortality is 0.43%, as evidenced by long-term observations.

Drugs Exp Clin Res, 1991, 17(5), 253 - 7
Treatment of lower respiratory infections in outpatients with ofloxacin compared with erythromycin; Peugeot RL et al.; To assess the safety and efficacy of a ten-day oral course of ofloxacin (400 mg 12 hourly) as compared with erythromycin (400 mg every 6 hours) for treatment of lower respiratory tract infections, fifty-two adult outpatients with pulmonary infiltrates (pneumonia) or with a cough and purulent sputum (bronchitis) were evaluated . Expectorated sputum specimens were Gram-stained and cultured, and antibody titres to Mycoplasma pneumoniae, Legionella pneumophilia, and in most cases Chlamydia pneumoniae were measured on acute and convalescent serum samples . Patients were evaluated clinically, microbiologically and radiographically three to five days after concluding therapy; the incidence of adverse reactions was monitored throughout the study period . The ofloxacin group (N = 25) was comprised of nineteen patients with pneumonia and six patients with bronchitis . The erythromycin group (N = 27) was comprised of thirteen patients with pneumonia and fourteen patients with bronchitis . All fifty-two patients were either clinically improved or cured after therapy . Microbiological cure was documented in all fourteen cases (27%) in which causative pathogens were identified . Clinical cure was achieved with ofloxacin in 68% of patients with pneumonia and in 83% of patients with bronchitis, while clinical cure with erythromycin was achieved in 46% of patients with pneumonia and 54% of patients with bronchitis . Adverse reactions (mostly mild gastrointestinal or central nervous system symptoms) were reported by eight patients receiving ofloxacin and four patients receiving erythromycin . While the types of adverse effects were similar, ofloxacin showed a trend toward a higher rate of cure than erythromycin . Ofloxacin is a promising new antibiotic for the treatment of acute lower respiratory infections.

Caries Res, 1991, 25(5), 372 - 6
Caries prediction on the basis of past caries including precavity lesions; Helfenstein U et al.; The purpose of the present work was the construction of statistical models which allow the prediction of future high caries increments on the basis of the state of primary teeth and first molars taking into account both precavity lesions and DF experience . A child was considered to be experiencing 'high caries increment' when it had at least four new lesions (new DFS) 4 years after the first examination . Two data sets of children aged 7-10 years were analysed: (1) 803 children examined in 1980 and in 1984 . The proportion of children with 'high caries increment' was 25.0% . (2) 477 children examined in 1984 and in 1988 . In this group, the proportion of children with high caries increment was 16.6% . In the first group with higher prevalence of caries, sensitivity and specificity were found to be on average at 70% . In the second group, sensitivity and specificity were 77% on average . This results shows that caries prediction may be at least as successful when a 'refined' set of clinical data is used instead of a less extensive set of caries data complemented by salivary buffering capacity and microbiological data.

Adv Exp Med Biol, 1991, 302, 1 - 19
Hydration phenomena: an update and implications for the food processing industry; Franks F; The past decade has witnessed major revisions in our perception of the manner in which water affects the physical, chemical, and microbiological attributes of all manner of food-related systems . The growing realization that, during processing, most such systems are brought to, and maintained in, a state of thermodynamic instability is focussing attention on the dynamics of the various components in such systems . Older, equilibrium-based concepts, such as "water activity," equilibrium moisture sorption, and "bound" water are being discarded in favour of more appropriate descriptions, in terms of diffusion, nucleation, crystallization and relaxation rates, glass/rubber transitions, and steady states . It is being realized that food processing, materials science, and polymer technology have much in common, with water being the universal plasticizer of naturally occurring organic materials which form the basis of food products.

Eye, 1991, 5 ( Pt 4), 395 - 411
Meibomian gland disease . Classification and grading of lid changes; Bron AJ et al.; In recent years attention has been paid to meibomian gland dysfunction (MGD) as a distinct clinical entity responsible for chronic symptoms and signs and occurring independently or in association with atopy, cicatrising mucosal disorders and rosacea . Attempts to correlate MGD with microbiological and lipid biochemical changes are confounded by the absence of a clear descriptive language for the disorder and its associated changes . Such a language is crucial for the conduct of cross-sectional and natural history studies and therapeutic clinical trials . We present a comprehensive classification and grading scheme of meibomian gland disease, supporting our observations with illustrations.

Zentralbl Mikrobiol, 1991, 146(5), 327 - 38
Microbial transformation of hexachlorocyclohexane; Straube G; Some microorganisms are able to accumulate and to metabolize the pesticide lindane (gamma-hexachlorocyclohexane, gamma-HCH) and other HCH-isomers . Microbial activities, detected metabolites, transformation rates, concentrating factors are reviewed . The results are discussed in respect to use microbiological processes for purification of contaminated water and soil and for recycling of waste HCH-isomers.

Pol Arch Weter, 1991, 31(3-4), 49 - 63
{The biochemical profile of calves' liver in the course of diarrhea during the first 10 days of life}; Grodzki K et al.; The total protein and total bilirubin levels as well as the GOT, GPT, alkaline phosphatase, GGTP and beta-glucuronidase activity in the blood serum and faeces from 121 diarrhoeic, Friesian-Holstein calves, aged from 1 to 10 days were investigated . As a control the results obtained in the previous investigations were used . Simultaneously the microbiological and histopathological examinations were performed . The changes of certain parameters in the blood serum, in the first 10 days of life, were parallel in both healthy and sick animals . The increase in alkaline phosphatase, GOT and GPT activity in calves with diarrhoea was observed . These changes may suggest the liver function damage during the neonatal calf diarrhoea . The decrease in GGTP activity, in the light of relationship between this enzyme and alkaline phosphatase activity, indicate the disturbances in intestinal absorption of colostral fraction of GGTP . The activity of beta-glucuronidase may be the sensitive index of liver function and indicate the range and the intensity of necrotic and/or dystrophic lesions . The activity of GOT and GPT in the faeces may be used as an indicator of liver function in the calves with diarrhoea while the additional investigations to explain the relationship between alkaline phosphatase, GGTP and beta-glucuronidase activity in faeces and intestinal lesions are needed.

Bull World Health Organ, 1991, 69(3), 277 - 83
Diagnosis of human herpesviruses: memorandum from a WHO meeting; A new approach to the newborn screening for hyperphenylalaninemias: use of L-phenylalanine dehydrogenase and microtiter plates; Kinderklinik, Heinrich-Heine-Universitat, Dusseldorf, FRGWe adapted the recently described colorimetric method for the specific determination of phenylalanine to a microplate assay using a NAD(H)-dependent L-phenylalanine dehydrogenase . With respect to sensitivity, analytical recovery and interrun imprecision this method for measuring phenylalanine in eluates of paper-dried blood spots is suitable for routine newborn screening for hyperphenylalaninemias . In contrast to the microbiological Guthrie assay, with the enzymatic method quantitative data may be obtained on the same day, also in the blood of newborns on antibiotic treatment.

J Antimicrob Chemother, 1990 Dec, 26 Suppl F, 89 - 99
Randomized multicentre study of ciprofloxacin and azlocillin versus gentamicin and azlocillin in the treatment of febrile neutropenic patients; Philpott-Howard JN et al.; In a randomized multicentre study ciprofloxacin combined with azlocillin was compared with gentamicin and azlocillin for the treatment of febrile episodes in neutropenic patients . In 147 evaluable episodes in 108 patients, 80 patients received ciprofloxacin/azlocillin and 67 received gentamicin/azlocillin . The two treatment groups were comparable in terms of age, underlying diagnosis, and duration of neutropenia . Microbiologically documented infections were the cause of fever in 34 (42.5%) and 29 (43.3%) episodes in the ciprofloxacin/azlocillin and gentamicin/azlocillin groups respectively . At the end of therapy, 46 patients (57.5%) receiving ciprofloxacin/azlocillin showed complete resolution compared with 30 (44.7%) for the gentamicin/azlocillin group (P = 0.14) . The clinical response rate for microbiologically documented episodes was 58.8% and 48.3% respectively (P = 0.45) . Among the microbiologically documented infections with follow-up cultures available, 24 (92.3%) of 26 isolates from patients receiving ciprofloxacin/azlocillin were eradicated, in comparison with 19 (86.4%) of 22 in the gentamicin/azlocillin group (P = 0.65) . There were five superinfections, all in the gentamicin/azlocillin group . Significant resistance to the study drugs was not seen . Of all evaluable patients, including those subsequently withdrawn because of early modification of therapy, there were 12 deaths within the study period; six (6.8%) of these occurred in 88 patients randomized to the ciprofloxacin/azlocillin group, compared with two of 80 (2.5%) in the gentamicin/azlocillin group . Both treatments were generally well-tolerated; one patient in the ciprofloxacin/azlocillin group developed convulsions, probably related to ciprofloxacin . The combination of ciprofloxacin and azlocillin is as effective as gentamicin plus azlocillin and offers a useful alternative for the empirical treatment of febrile neutropenic patients.

Anal Chem, 1990 Dec 1, 62(23), 2514 - 21
Near-infrared spectrometry of microorganisms in liquid pharmaceuticals; Galante LJ et al.; Biotechnology and pharmaceutical research have created a number of new and potentially life-saving drugs . Many of these drugs are formulated as injectable products . Some drug products do not survive autoclaving or other means of terminal sterilization . An aseptic filling process is typically used to sterilize such products, but it is less reliable than autoclaving, making detection of unsterile units even more essential . Invasive microbiological methods and turbidimetry are currently employed as inspection techniques . These processes are time-consuming, destroy product, and may not detect low levels of contamination . Near-IR light scattering is proposed as a new method of determining low levels of contamination noninvasively and nondestructively . The method is used successfully in the current study to detect contamination by a species of yeast, mold, and bacteria in intact plastic infusion bags at levels as low as three colony-forming units per milliliter for yeast . By use of the near-IR method, each injectable unit can be evaluated with its integrity maintained, allowing the product to be dispensed or evaluated by another analytical method.

J Clin Pathol, 1990 Dec, 43(12), 987 - 91
Helicobacter pylori in dyspeptic patients in Kuwait; Britt DP et al.; Two hundred and four patients, mainly Arabs, attending for upper gastrointestinal endoscopy at the gastroenterology clinic in Mubarak Al-Kabeer Hospital, Kuwait, were examined for evidence of infection with Helicobacter pylori and associated inflammation . Biopsy specimens of antrum, body, and duodenum; gastric juice; and antral mucosal brushings were investigated by microbiological, cytological, and histopathological methods . Clinical conditions diagnosed at endoscopy included gastritis, gastric ulcer, duodenitis and duodenal ulcer, but half the patients had endoscopically normal gastric and duodenal mucosae . H pylori was detected by one or more of the procedures in at least one specimen from 197 (96.6%) of the patients . Histological and cytological analysis showed equal sensitivity, but bacteriological culture was less reliable . The proportion of positive cases was high, compared with other reported series, which may have been accounted for by the variety of diagnostic techniques used in this study, the selected population (all with gastrointestinal symptoms) or genetic or environmental predisposing factors peculiar to the sample population.

Br J Urol, 1990 Dec, 66(6), 642 - 5
Acute epididymitis: why patient and consort must be investigated; Robinson AJ et al.; In this prospective study of 49 patients under 35 years of age with clinically diagnosed epididymitis, detailed microbiological investigation identified an infective cause in 67% . Chlamydia trachomatis was the commonest agent, present in 25 patients, but in 12 of these detection was based solely on raised antibody titres; 20 of the 28 female consorts screened were partners of men with chlamydial epididymitis and 80% of them were also positive for this infection . Isolating the micro-organism from 14 of 16 consorts indicated active infection despite the negative swabs from the men . If this important infection is to be adequately treated we recommend that all patients in this age group with epididymitis and their partners should be referred to a specialist unit with access to full chlamydia laboratory facilities.

Gig Sanit, 1990 Dec, (12), 7 - 9
{Evaluation of the risk of exposure to unfavorable environmental based on the results of sanitary, microbiological and clinical studies}; Vinogradova LA et al.; It has been established as result of studies with the use of complex sanitary-hygienic, microbiological, clinical and statistical methods, that the increasing antropogenic stress causes changes in microbiocenosis of water objects of the environment and of blood serum, which may produce unfavourable human health effects . The necessity to use integral complex indexes of the state of man and water medium for the assessment of the degree of risk of ++eco-technogenic effects has been found out.

Dtsch Tierarztl Wochenschr, 1990 Dec, 97(12), 515 - 8
{Effect of citric acid and calcium on the bioavailability of orally-administered oxytetracycline in piglets}; Wanner M et al.; The bioavailability of orally given oxytetracycline in dependence on calcium (0.7% and 1.4% calcium, respectively) and citric acid content in feed was examined in piglets (9.9 +/- 0.9 kg body weight) . In the first trial no citric acid was added to the two feeds, in the second trial 1.5% citric acid was added . In both trials each piglet received an i/v-injection of oxytetracycline (dosage 10 mg/kg body weight) and an oral dose of oxytetracycline (40 mg/kg body weight) . The blood samples, taken in definite time intervals, were analysed by a microbiological assay . With these results the kinetic parameters and the bioavailability were calculated . The results of the i/v-trials were identical . The kinetic parameters C1 = 14.91 micrograms/ml, lambda 1 = 3.46 h-1, Cz = 7.49 micrograms/ml and lambda z = 0.19 h-1 describe the graph after i/v-application . The calcium content of the feed had no significant influence on the kinetic parameters after p/o-application, but the piglets receiving citric acid showed a significant higher maximum concentration (Cmax) . The bioavailability of orally given oxytetracycline was significantly (26%) increased by the citric acid content . In spite of the citric acid the bioavailability only came to 4.9%.

Arch Mal Coeur Vaiss, 1990 Dec, 83(14), 2087 - 93
{Acute respiratory distress syndrome in the initial phase of myocardial infarction in adults}; Mansour M et al.; Four patients developed an acute respiratory distress syndrome characterised by clinical and radiological signs of pulmonary oedema, a protein-rich oedema, severe hypoxemia refractory to oxygen therapy, contrasting with normal left ventricular filling pressures and indicating increased permeability of the alveolo-capillary membrane, 24 to 72 hours after the onset of acute myocardial infarction . After having excluded the usual causes of the acute respiratory distress syndrome, the authors suggest that acute myocardial infarction, especially when extensive, may cause a lesion of the alveolo-capillary membrane by an unknown mechanism . Treatment consisted in mechanical ventilation with positive expiratory pressures in 3 cases and with continuous positive pressure during spontaneous respiration in the third patient and in relay with controlled ventilation in the other two . These techniques of ventilation improved the hypoxemia and led to complete cure in all cases without evolution to pulmonary fibrosis . In addition to mechanical ventilation, all patients were given systematic antibiotic therapy because of the possibility of an infectious etiology while waiting for the results of microbiological and serological testing and because of the high risk of superinfection which plays an essential part in the outcome of the condition . The immediate response to treatment was favourable in all cases . One patient died suddenly of cardiogenic shock two weeks after this episode . The other patients are still alive 39, 38 and 20 months after infarction . The importance of the diagnosis of the acute respiratory distress syndrome in the acute phase of myocardial infarction resides in its therapeutic implications which are quite different to those of cardiogenic shock.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Obstet Gynecol Reprod Biol, 1990 Dec, 37(3), 231 - 6
A further look at infection at the time of therapeutic abortion; Morton K et al.; Microbiological investigations and clinical follow-up were performed on 516 patients undergoing first-trimester termination of pregnancy, over a 2-year period . Chlamydia trachomatis was isolated by pre-operative microbiological screening in 6.7% of patients, gonococcus in 0.4% and Trichomonas vaginalis in 2% . Candida spp and Gardnerella vaginalis were isolated from 16% and 28% of the women, respectively . Patients who had positive cervical chlamydial isolation were significantly younger (less than 22 years) than those who did not . Doctor's clinical diagnosis of genital tract infection was found to be associated with a positive screening result but not with the likelihood of postabortal pelvic infection . Among the 175 patients followed up in the outpatient clinic, 4 of the 15 patients with a positive result for N . gonorrhoeae, C . trachomatis and/or T . vaginalis developed postoperative pelvic infection, which is significantly more than the group who did not harbour any of these three organisms (9/114).

J Chemother, 1990 Dec, 2(6), 384 - 9
Miocamycin distribution in tonsillar and pulmonary tissues after repeated administration; Scaglione F et al.; Twenty patients undergoing tonsillectomy were treated with a peroral administration of 600 mg of miocamycin every 12 hours for 4 days . On the 5th day, after a last administration of a dose of 600 mg the ablation of the tonsils was carried out on groups of 4 subjects, each one at the following times after oral intake of the drug: 2, 4, 6, 8, 12 h . Twenty-nine patients, admitted to hospital to undergo lung resection were treated with peroral administration of miocamycin in accordance with the above mentioned dose scheme . The operation was carried out on groups of 5 subjects, each on the fifth day at the following times after the last administration: 2, 3, 4, 6, 8 and 12 h (4 subjects) . Simultaneously blood was withdrawn for the determination of miocamycin in serum . Miocamycin was measured by a microbiological procedure using Sarcina lutea ATCC 9341 . The highest levels of miocamycin were observed after 2h in tonsils (3.2 +/- 0.82 mg/kg) and serum (1.3 +/- 0.33 mg/l) . After 12h miocamycin proved to be still measurable in the tissue (0.12 +/- 0.05 mg/kg), whereas it was not detected in serum . In pulmonary tissue, the highest levels of miocamycin were likewise identified at the 2nd hour (2.82 +/- 0.59 mg/kg), simultaneously with the highest serum levels (2.3 +/- 0.61 mg/l) . At the 12th hour miocamycin could still be dosed in 3 tissue samples, with values between 0.1 and 0.2 mg/kg and was found just at dosing limits in only one serum sample.

Z Ernahrungswiss, 1990 Dec, 29(4), 299 - 303
{Chemical and microbiological studies of microwave-treated milk}; Demel S et al.; Pasteurized milk was treated with microwaves for 2.5 minutes (2450 MHz, 650 W) . Important chemical components (vitamin A, beta-carotin, vitamins B1, B2, C, E; activity of peroxidase, xanthinoxidase; content of fat and peroxides, percentage of solids, content of raw protein, content of all microorganisms and storage stability were examined . Ascorbic acid (reduction of 36%) and alpha-tocopherol (reduction of 17%) were influenced by microwave treatment, whereas other chemical parameters, odor and flavor remained unchanged . The content of microorganisms was reduced from about 10(4) to 10(2) per milliliter . Untreated milk had a content of 10(7) microorganisms per milliliter after 10 days storage at 8 degrees C and a taste of acidity, whereas in milk treated with microwaves only 10(4) microorganisms per ml were identified and no organoleptic changes could be observed after 14 days storage at 8 degrees C.

Nippon Koshu Eisei Zasshi, 1990 Dec, 37(12), 962 - 6
{Microbiological and chemical analyses of indoor swimming pools and virucidal effect of chlorine in these waters}; Yamashita T et al.; Virological and bacteriological examinations and chemical analysis were made of 24 water samples from 6 public indoor swimming pools in Aichi Prefecture . In 3 of these swimming pools, sodium hypochlorite was used as a disinfectant and in the remainder trichloroisocyanurates . All samples were negative for adenovirus per 20 liters . Coliform group was detected in one sample with 26.7 mg/l cyanuric acid . Total plate counts ranged from 0 to 1 per ml in the swimming pools treated with sodium hypochlorite and 0 to 51 in those with trichloroisocyanurates . Turbidity, pH and potassium permanganate concentrations in the samples were within allowable limits . Seven of 24 samples did not meet the recommended value of 0.4 mg/l for free chlorine residuals . Ammonium nitrogen was detected in one pool water with trichloroisocyanurates . In 11 of 12 water samples of swimming pools using sodium hypochlorite, poliovirus 1 (2 x 10(4) PFU/0.2 ml) was inactivated within 1 min under the condition of 1.0 mg/l free available chlorine and 25 degrees C . In 11 of 12 water samples of 3 swimming pools using trichloroisocyanurates, poliovirus type 1 survived after 2 min contact while in 5 samples poliovirus type 1 survived after 5 min contact . This shows that the risk of viral infection is greater in swimming pool water treated with chlorinated isocyanurics than that with sodium hypochlorite . The operator of the swimming pool should pay special attention to the control of water quality and free residual chlorine value.

Int J Clin Pharmacol Ther Toxicol, 1990 Nov, 28(11), 462 - 70
Biliary pharmacokinetic profile of piperacillin: experimental data and evaluation in man; Brogard JM et al.; The purpose of the present experimental and clinical work is to revisit the biliary pharmacokinetic properties of piperacillin . Whereas the up to now published data result from microbiological assays, this work was realized by high performance liquid chromatography . In the isolated and perfused rabbit liver model (n = 5; 3 h), the biliary level peaked at 1,013 +/- 305 micrograms/ml between 30 and 60 min . During the experiments, 56.7% and 10.8% of the administered piperacillin (10 mg) were respectively eliminated in bile and submitted to hepatic biotransformation . In man, a single 2 g i.v . dose was administered to 6 volunteers . The excretion measured in the duodenal fluid was 1,681 +/- 601 micrograms in 4 h (0.08% of the administered dose) . In cholecystectomized patients (n = 10) provided with a T-drain, the biliary peak concentration was 211 +/- 64 micrograms/ml during the 2nd h, and the 24 h biliary elimination was 12,963 +/- 3,332 micrograms, representing 0.65% of the administered dose . The hepato-biliary clearance was 0.80 ml/min . On per-operatively collected serum, choledocal bile, gallbladder bile and gallbladder wall samples (n = 10 patients), the concentrations of piperacillin simultaneously measured 1 h after the i.v . administration of 2 g were respectively, 81.7 +/- 20.5, 382 +/- 110, 30.8 +/- 2.5 micrograms/ml and 10.5 +/- 2.6 micrograms/g.(ABSTRACT TRUNCATED AT 250 WORDS)

Ann Rheum Dis, 1990 Nov, 49(11), 932 - 4
Role of bone scintigraphy in the early diagnosis of discitis; Choong K et al.; Nine cases of recorded discitis are presented, in which scintigraphy played an important part in the diagnosis . The patients (five men (aged 21-75 years) and four women (aged 40-73 years)) had a history of back pain varying in duration from two days to three months . Final diagnosis was confirmed microbiologically (seven patients) or radiographically (two patients) . Bone scintigraphy was a valuable diagnostic procedure for discitis with earlier detection than plain radiography in three patients and similar initial detection to that of third generation computed tomography . Single photon emission computed tomographic imaging increased diagnostic confidence by indicating the involvement of the adjacent vertebral bodies rather than of the pedicles or spinous processes.

J Periodontol, 1990 Nov, 61(11), 674 - 9
Control of gingivitis and calculus by a dentifrice containing a zinc salt and triclosan; Stephen KW et al.; The effect of unsupervised brushing with a dentifrice containing two antiplaque agents, 0.5% zinc citrate and 0.2% triclosan, on gingival health, plaque, supragingival calculus, and the oral flora was compared to brushing with a non-active control dentifrice . Volunteers were given oral hygiene instruction and their teeth were professionally cleaned . They then used a placebo dentifrice for a pre-experimental phase of 1 month, before being stratified into two groups on the basis of their initial plaque, gingival bleeding, and calculus levels, sex, and age . Over the following 6 months, one group used the control while the other used the test dentifrice . Plaque levels, gingival bleeding, and calculus were assessed at baseline and at 3 and 6 months . Supragingival plaque was sampled for microbiological analysis at the initial examination, at 3 and 6 months (conclusion of study period) and 3 months after the study . Representative oral bacteria and the development of bacterial resistance to triclosan were monitored . Results showed that plaque was reduced and gingival health significantly improved during the 1-month pre-experimental period . During the experimental period, this improvement was not maintained by the control group as gingival bleeding and calculus increased . In contrast, gingival bleeding and calculus levels of the test group were maintained significantly below those of the placebo group . Plaque levels were lower in the test group after 3 and 6 months, but the groups were not significantly (P = 0.05) different . No shifts in oral flora or development of bacterial resistance to triclosan were detected.

J Virol Methods, 1990 Nov, 30(2), 215 - 27
Fast Multiplex polymerase chain reaction on boiled clinical samples for rapid viral diagnosis; Vandenvelde C et al.; An assessment of optimal conditions for rapid simultaneous amplification of multiple human papillomavirus (HPV) sequences has been made using Thermus aquaticus DNA polymerase . All variables of practical value were studied by amplifying known target-sequences from ten-fold dilutions of well characterized cell lines . In our hands, Fast Multiplex PCR (FM-PCR), the technique of running multiple PCR reactions simultaneously with minimum incubation time at each temperature, was highly sensitive (amplification factor = 5 x 10(9) after 50 cycles), specific (100%) and reproducible (100%) for several microbiological applications . Diagnosis was generally obtained in less than 5 h after sampling . The results show that, after optimization of assay conditions, efficiency and specificity of Multiplex PCR depends exclusively on the primers design and concentration of the primers.

Z Gesamte Hyg, 1990 Nov, 36(11), 625 - 6
{Experiments for physiologic improvement of disinfectants}; Beyer C et al.; The use of customary trade disinfectants lead to occupational disease no . 80 in many employers of public health . For that reason our aim is to improve the skin compatibility of this disinfectants . Its possible to achieve a pH-shift to a more physiological level eighter by buffer salt addition or by neutralization . Following this, disinfectants were investigated in a microbiological test.

Z Rheumatol, 1990 Nov-Dec, 49(6), 361 - 3
{Use of microbiologic-serologic studies for Chlamydia and Mycoplasma in differential diagnosis of inflammatory rheumatic diseases}; von Recklinghausen G; Chlamydiae are obligate intracellular bacteria that lack ATP-synthesis; mycoplasmas are free-living bacteria without cell walls . Chlamydia trachomatis and mycoplasmas may be associated with reactive rheumatic diseases . Local chlamydial infections are identified by isolating the bacteria in cell cultures or by detecting bacterial antigens in specimens containing epithelial cells . Disseminated chlamydial infection can be detected by specific serum antibodies . Mycoplasma infections of the genitourinary tract are detected by quantitative isolation methods . Diagnosis of Mycoplasma pneumoniae infections requires demonstration of a rise in specific serum antibodies using complement fixation or indirect hemagglutination tests . For the diagnosis of reactive rheumatic diseases, the microbiological and serological findings have to be connected synoptically with other laboratory data and with the clinical symptoms.

Anaesth Intensive Care, 1990 Nov, 18(4), 547 - 9
Contamination of parenteral nutrition solutions not a hazard with additions made at ward level; Breheny F et al.; Pre-mixed amino acid and dextrose solutions used for parenteral nutrition had additions made to them at a ward level by medical officers . Samples of the solutions of the study group and a control group were taken at six hours and at the end of the infusion time and were analysed microbiologically for growth of microorganisms . No organism was isolated from either group . We conclude that making additions to pre-mixed amino acid/dextrose solutions at the ward level does not constitute a microbiological hazard for the patient.

Parodontol, 1990 Nov, 1(4), 351 - 62
{The episodic progression of untreated adult periodontitis}; Schappi P et al.; Marginal periodontitis in humans and animals is characterized by site-specific episodes of accelerated clinical attachment loss, which are interspersed between periods of quiescence of variable length . Diagnosis of episodic periodontitis progression could allow for early interception and arrest of progression . Currently available diagnostic techniques are not sensitive enough to detect phases of periodontitis progression . Diagnostic tests should be developed which are sensitive and practical enough to determine need and success of periodontal treatment at specific sites or sections of a dentition . In a longitudinal study on untreated periodontitis in humans, progressing and nonprogressing periodontal lesions were identified and investigated using clinical, microbiological, histological and immunohistochemical methods . Ten adult patients with untreated advanced periodontitis were monitored monthly for ten months . Attachment levels and probing depth were determined at six sites of every tooth . Corresponding contralateral sites were identified where one site had lost 2 mm or more probing attachment since the previous session (P-site), and the other site had not (C-site) . The results showed that bleeding on probing was positively and statistically significantly correlated with episodic clinical attachment loss . The error in probing attachment level measurements varied with the tooth type and was greatest at molars . Over time the measurement error became smaller . In deeper pockets the probing error was greater than in shallow pockets . It appears that in order to accept clinical progression of periodontitis an increase in probing attachment loss or probing depth of more than 2 mm has to be observed . Using the mean attachment loss per site in a dentition at six or nine months after initial measurements should enable the dentist to discriminate patients with a higher rate of periodontitis progression from patients with a low rate . Darkfield microscopy used for assessment of subgingival bacterial populations seems to be without diagnostic value for differentiation between P- and C-sites.

Enferm Infecc Microbiol Clin, 1990 Nov, 8(9), 560 - 4
{Multicenter study of fluconazole in the treatment of oropharyngeal candidiasis in immunodepressed patients}; Munoz P et al.; We have evaluated the efficacy of fluconazole, 50 mg/day for 2 weeks, to treat oropharyngeal candidiasis in immunologically compromised patients . There were overall 27 patients, 25 of which were HIV+ and 2 had neutropenia . The rate of clinical response at the end of therapy, and one week and one month afterwards were 96%, 76% and 64%, respectively . The microbiological eradication was achieved in 36% of patients . The tolerance of the drug was satisfactory, although in 3 cases features of hepatic toxicity were detected . The convenience, good tolerance and clinical efficacy of fluconazole make it the therapy of choice for oropharyngeal candidiasis in immunologically compromised patients.

Enferm Infecc Microbiol Clin, 1990 Nov, 8(9), 544 - 7
{Candida esophagitis treated with a single dose of fluconazole in patients with HIV: presentation of 11 cases}; Roig P et al.; We have reviewed the efficacy of the use of fluconazole in patients with definitely proven Candida esophagitis (CE) associated with human immunodeficiency virus (HIV) infection, using a single 400 mg oral dose of fluconazole and evaluating the patient three days afterwards . This drug showed to be effective for the clinical and endoscopic cure in all patients (100%), and with microbiological cure in ten cases . There was no clinical feature of toxicity . The only side effect was an increased alkaline phosphatase and transaminase activity without hyperbilirubinemia, but this finding was not statistically significant (p greater than 0.05) . Fluconazole, given in a single 400 mg dose, was absolutely effective to cure esophagitis in AIDS, thus permitting to avoid parenteral amphotericin.

Acta Otorrinolaringol Esp, 1990 Nov-Dec, 41(6), 383 - 6
{Bacteriologic findings in ear exudates from ambulatory care patients}; Amores Lloret AE et al.; The results obtained in a microbiological survey carried out with 102 samples of otic effusions taken from 95 outdoor patients in a ORL surgery are shown . Sixty-eight of these patients had supurative otitis media symptoms and 25 had diffuse otitis externa . Results of microbiological cultures are commented according to different statistics variables (age, sex, supuration time and type of tympanic perforation) and compared with the results obtained by other authors.

J Nat Prod, 1990 Nov-Dec, 53(6), 1471 - 8
Microbiological transformation of chromone, chromanone, and ring A hydroxyflavones; Ibrahim AR et al.; Microbial transformation of chromone, chromanone, and 3 ring A hydroxyflavones (5-hydroxy-, 6-hydroxy-, and 7-hydroxyflavones) was attempted using thirty-two microorganisms . While chromone was not biotransformed, chromanone was transformed to chromone and chromanol by Aspergillus niger in 2% yield . Ring A hydroxylated flavones were transformed to the corresponding C-4' hydroxylated metabolites, and the yields and rate of product formation were found to correlate with the distance between the C-4 carbonyl group and the hydroxyl group in ring A.

Arch Fr Pediatr, 1990 Nov, 47(9), 653 - 6
{Cystic fibrosis in infants revealed by severe respiratory distress . Mid-term course}; Sardet A et al.; We report the follow-up of 13 infants aged 2.5 to 24 months in whom cystic fibrosis disease presented as respiratory distress . All infants received an intensive treatment . Mean clinical, radiological and microbiological follow-up was 3.1 years . Ten children aged 1.5 to 8.5 years are still alive . One of them presents with serious respiratory failure, with a Shwachman score of 50 . The Shwachman score is between 85 and 70 for 8 of 13 and 65 for one . The prognosis of this group did not differ from the one usually observed in the disease . It depends partially on early intensive care management and is not altered by mechanical ventilation.

Antimicrob Agents Chemother, 1990 Nov, 34(11), 2152 - 5
Pharmacokinetics of cefprozil in infants and children; Saez-Llorens X et al.; Twenty pediatric patients (ages, between 8 months and 8 years) received a single oral dose of cefprozil at levels of 15 and 30 mg/kg of body weight . Cefprozil consists of cis (BMY-28100) and trans (BMY-28167) isomers in an approximately 90:10 ratio . Six plasma samples were collected from each pediatric patient and assayed for drug concentrations . As measured by a microbiological assay, peak concentrations of 11.16 and 15.93 micrograms of cefprozil per ml occurred at 1 h for patients who received the 15- and 30-mg/kg doses, respectively . The respective mean half-lives of cefprozil were 1.77 and 2.14 h, and the respective mean areas under the curve were 28.05 and 45.28 micrograms.h/ml for patients who received the 15- and 30-mg/kg doses . When measured by a high-pressure liquid chromatography method, peak concentrations of 12.09 and 18.04 micrograms of the cis isomer per ml were obtained at 1 h, with mean half-lives of 1.63 and 2.06 h and mean areas under the curve of 30.48 and 49.34 micrograms.h/ml in patients who received the 15- and 30-mg/kg doses, respectively . For the trans isomer, peak concentrations of 1.16 and 1.63 micrograms/ml occurred at 1 h, respectively, with mean half-lives of 1.61 and 1.65 h and mean areas under the curve of 2.89 and 4.34 micrograms.h/ml in patients who received the 15- and 30-mg/kg doses, respectively.

Lancet, 1990 Oct 20, 336(8721), 960 - 3
Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis; Stacey C et al.; 23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied . Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis . 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment . The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID . Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis . This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract . Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigationPublication Types:

	Clinical Trial
	Multicenter Study

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