LDLR, GYPA, HBGG, D7S8 and GC allele and genotype frequencies in the northwest Italian population

Anaerobic culture is employed routinely in the primary isolation of periodontal pathogenic bacteria. However, little or no data exist on the relative abilities of the Coy anaerobic chamber (Coy Laboratory Products, Grass Lake, Mich.), the GasPak (Becton Dickinson Microbiology Systems, Cockeysville, Md.), and the AnaeroPack (Mitsubishi Gas Chemical America, Inc., New York, N.Y.) systems to grow important periodontal species, including Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Bacteroides forsythus, Eubacterium species, Campylobacter species, Fusobacterium species, and Peptostreptococcus micros. A total of 78 specimens from advanced periodontitis lesions were collected anaerobically, plated on enriched blood agar medium, and incubated at 35 degrees C for 5 to 7 days in each anaerobic culture system. The three culture systems were equally efficient in isolating Porphyromonas gingivalis and Prevotella intermedia/nigrescens. The Coy anaerobic chamber yielded the highest proportional recoveries of Campylobacter (P = 0.0001; nonparametric analysis of variance) and Eubacterium (P = 0.009). The Coy anaerobic chamber and the GasPak system demonstrated higher proportional recoveries of Bacteroides forsythus (P = 0.0006) and Peptostreptococcus micros (P = 0.0001) than the AnaeroPack system. The AnaeroPack system was most efficient in growing Fusobacterium species (P = 0.0001). Overall, the Coy anaerobic chamber and the GasPak system showed the highest proportional recoveries of putative periodontal pathogens, but the recoveries by the various anaerobic test systems varied considerably from sample to sample.     

Phospholipid molecular species distribution of Porphyromonas asaccharolytica ATCC 25260T: effects of temperature, culture age and pH

The aim of this study was to determine the extent to which phospholipid molecular species profiles are affected by different environmental factors in Porphyromonas asaccharolytica ATCC 25260T. Phospholipids were analysed by Fast Atom Bombardment Mass Spectrometry (FAB-MS) in negative-ion mode. Under standard growth conditions (37 degrees C, pH 7.0, 48 h), the most intense high mass anions were m/z 653 and 662. The latter is consistent with the expected presence of PE (30:0). The only changes in profiles were quantitative. These were compared using the Pearson Coefficient of Linear Correlation. The r-values for initial pH comparisons ranged from 0.82 (pH 7.0 vs pH 6.0) to 1.00 (pH 5.0 vs pH 8.0), for incubation period, from 0.86 (48 vs 72 h) to 0.97 (96 vs 168 h), and for temperature, from 0.57 (40 vs 37 degrees C) to 0.96 (37 vs 36 degrees C). Differences were also seen when plates were incubated in anaerobe jars as opposed to an anaerobic work station (r = 0.75). It is concluded that it is essential to standardize growth parameters, and to use an anaerobe jar or an anaerobe work station, but not both.     

Other methods of laparoendoscopic hernia repair: mini-hernia--inguinal hernia repair through a 2-cm incision

Ruminal lactic acid-producing bacteria were selectively isolated and enumerated using a one hour aerobic exposure prior to incubation on a semi-selective Lactobacillus medium, MRS, under anaerobic conditions. The technique allowed growth of pure cultures of ruminal Lactobacillus spp. and Streptococcus bovis without supporting the growth of pure cultures of any of the prominent ruminal bacterial species. In mixed cultures, the one hour aerobic pre-incubation inhibited the growth of the obligate anaerobic ruminal bacteria which can otherwise grow on the MRS medium, and the subsequent anaerobic incubation permitted maximal recovery of the weakly aerotolerant ruminal lactic acid-producing Lactobacillus spp. and Streptococcus spp. The efficacy of this technique in selecting exclusively for the lactic acid-producing bacteria was also demonstrated from populations of rumen bacteria from mixed culture end-point in vitro fermentation, continuous in vitro culture and isolations from fresh ruminal samples.     

Comparative in-vitro and in-vivo activity of AM-1155 against anaerobic bacteria

The in-vitro activity of AM-1155, a 6-fluoro-8-methoxy quinolone, was compared with those of temafloxacin, sparfloxacin, tosufloxacin, ciprofloxacin, ofloxacin and cefmetazole, a cephamycin, against a variety of anaerobic bacteria. Although AM-1155 demonstrated only modest activity against the Bacteroides fragilis group and Prevotella bivia (MIC90s > or =3.13 mg/mL), 76% of the B. fragilis strains tested were inhibited at AM-1155 concentrations of 0.78 mg/L. AM-1155 was highly active against Prevotella intermedia, Porphyromonas gingivalis, Fusobacterium spp., Clostridium perfringens and Mobiluncus spp. (MIC90s < or =0.39 mg/L). An in-vivo study using a mixed infection with AM-1155- and tosufloxacin-susceptible B. fragilis and Escherichia coli strains in rat granuloma pouch was performed. AM-1155 was effective against both organisms whereas tosufloxacin was effective only against E. coli. These results correlated well to the higher pouch levels of AM-1155 than those of tosufloxacin. Clostridium difficile overgrowth was found in the caecum of mice treated with ampicillin both 1 and 7 days after 5 days dosing, but not in AM-1155-treated mice. These results suggest that the clinical efficacy of AM-1155 against infections involving most anaerobic bacteria except for the B. fragilis group and P. bivia should be evaluated further.     

Cytotoxic effect of endodontic bacteria on periapical fibroblasts

This study was conducted to investigate the effects of sonicated bacterial extracts (SBEs) from anaerobic Gram-negative bacteria on periapical fibroblast obtained from the apical portion of human periodontal ligaments. Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum were chosen from among the endodontic bacteria isolated from root canals having a periapical lesion and compared in terms of their cytotoxicity. The purpose of this study was to examine which bacteria are involved in the development of periapical inflammation. The anaerobes were cultured under strict anaerobic conditions, and the bacterial cells were then harvested by centrifugation after incubation. The concentrated cell suspensions were sonicated and subsequently centrifuged. An SBE was made of each of the filtered supernatants. Each SBE was added to cultures of periapical fibroblasts. The cell growth and proliferation were measured by the MTT method after 3, 5, and 7 days. The SBEs from P. endodontalis, P. gingivalis, and F. nucleatum inhibited the growth of the fibroblasts, whereas the SBE from P. intermedia did not inhibit it. The SBEs from P. gingivalis and F. nucleatum inhibited the fibroblast growth more strongly than did the P. endodontalis, P. gingivalis, and F. nucleatum may participate in the development of periapical lesions.     

Denitrification by actinomycetes and purification of dissimilatory nitrite reductase and azurin from Streptomyces thioluteus

Many actinomycete strains are able to convert nitrate or nitrite to nitrous oxide (N2O). As a representative of actinomycete denitrification systems, the system of Streptomyces thioluteus was investigated in detail. S. thioluteus attained distinct cell growth upon anaerobic incubation with nitrate or nitrite with concomitant and stoichiometric conversion of nitrate or nitrite to N2O, suggesting that the denitrification acts as anaerobic respiration. Furthermore, a copper-containing, dissimilatory nitrite reductase (CuNir) and its physiological electron donor, azurin, were isolated. This is the first report to show that denitrification generally occurs among actinomycetes.     

Pouchitis after ileo-anal anastomosis with a reservoir in hemorrhagic rectocolitis]

DEFINITION AND FREQUENCY: An ileoanal anastomosis with creation of an ideal pouch is proposed as the treatment for familial adenomatous polyposis and ulcerative hemorrhagic rectocolitis. The ideal pouch may become inflammatory in 10 to 30% of the cases. The diagnosis of pouchitis is based on a clinical, endoscopid and histological criteria. PATHOGENIC HYPOTHESES: Pouchitis is a late complication, mainly after ileoanal anastomosis for ulcerative rectocolitis. The pathogenic mechanism is a subject of debate. Fecal stasis, bacterial pollution, mucine secretion and the underlying inflammatory disease could be involved. TREATMENT: Antibiotics active against anaerobic bacteria, such as metronidazole, are generally given. In case of failure, common antiinflammatory agents used in inflammatory bowel disease are indicated.     

Implantable control, telemetry, and solar energy system in the moving actuator type total artificial heart

The aim of this study was to determine whether a jejunal pouch would have a lower resting pressure, be more distensible, and have more interdigestive migrating myoelectric complexes and less fecal bacterial overgrowth than would an ileal pouch after proctocolectomy and pouch-distal rectal anastomosis. In six conscious dogs with a jejunal pouch-distal rectal anastomosis and six with an ileal pouch-distal rectal anastomosis (controls), pouch distensibility and motility were measured using a barostat and perfused pressure-sensitive catheters passed per anum, pouch electrical activity was recorded using chronically implanted electrodes, and the number of bacteria per gram of stool was assessed by culture. Dogs with a jejunal pouch had lower resting pouch pressures, more distensible pouches, faster frequencies of pacesetter potentials in the pouch, more phase 3 intervals of the interdigesive migrating myoelectric complex reaching the pouch, but similar numbers and types of bacteria in their stools compared to the dogs with an ileal pouch. We concluded that jejunal pouches have a lower resting pressure, are more distensible, have more cleansing contractions, but a similar fecal flora compared to ileal pouches. A jejunal pouch has features that make it an attractive alternative to an ileal pouch for pouch-distal rectal or pouch-anal canal anastomosis after proctocolectomy.     

Atmospheric growth requirements for Alloiococcus species and related gram-positive cocci

The growth of Alloiococcus otitis under different atmospheres and nutritional conditions was studied. The growth rates of 25 strains of gram-positive cocci representing five genera on heart infusion agar plates containing 5% rabbit blood and on brucella agar plates with and without sheep blood under aerobic, increased CO2, and anaerobic atmospheres were compared. Eight strains of alloiococci plated on heart infusion agar with rabbit blood and on brucella sheep blood agar grew under aerobic and candle jar atmospheres. Two of these strains showed poor anaerobic growth after 7 days. Strains of Aerococcus viridans, Aerococcus urinae, Helcococci kunzi, Dolosigranulum pigrum, Gemella haemolysans, and Gemella morbillorum grew well under all three atmospheres and on the three types of media and in thioglycolate broth. These results confirm all the aerobic atmospheric requirements for Alloiococcus strains and show that aerobic growth characteristics help distinguish the alloiococci from the other gram-positive cocci that are facultatively anaerobic.     

Aerobic and anaerobic microbiology of empyema. A retrospective review in two military hospitals

The microbiology and clinical features of empyema were studied retrospectively in 197 patients whose specimens yielded bacterial growth after inoculation for aerobic and anaerobic bacteria. Three hundred forty-three organisms (216 aerobic or facultative and 127 anaerobic organisms) were isolated. Aerobic bacteria were isolated in 127 (64 percent) patients, anaerobic bacteria in 25 (13 percent), and mixed aerobic and anaerobic bacteria in 45 (23 percent). The predominant aerobic or facultative organisms were Streptococcus pneumoniae (70 isolates), Staphylococcus aureus (58), Escherichia coli (17), Klebsiella pneumoniae (16), and Haemophilus influenzae (12). The predominant anaerobes were pigmented Prevotella and Porphyromonas species (24), Bacteroides fragilis group (22), anaerobic cocci (36), and Fusobacterium species (20). beta-Lactamase-producing organisms were recovered in 49 (38 percent) of 128 tested specimens. These included all 42 tested S aureus and 15 B fragilis group, 4 of 9 K pneumoniae, 3 of 9 H influenzae, 3 of 8 pigmented Prevotella and Porphyromonas species, and 2 of 6 E coli. Most patients from whom S pneumoniae and H influenzae were recovered had pneumonia, and most patients with S aureus had pneumonia, aspiration pneumonia, and lung abscesses. The recovery of anaerobic bacteria was mostly associated with the concomitant diagnosis of aspiration pneumonia, and lung, subdiaphragmatic, dental, and oropharyngeal abscesses. These data highlight the importance of anaerobic bacteria in selected cases of empyema.     

Inhibition of ruminal cellulose fermentation by extracts of the perennial legume cicer milkvetch (Astragalus cicer)

Cicer milkvetch (Astragalus cicer L.) is a perennial legume used as a pasture or rangeland plant for ruminants. A study was undertaken to determine whether reported variations in its ruminal digestibility may be related to the presence of an antinutritive material. In vitro fermentation of neutral detergent fiber (NDF) of cicer milkvetch by mixed rumen microflora was poorer than was the fermentation of NDF in alfalfa (Medicago sativa L.). Fermentation of cicer milkvetch NDF was improved by preextraction of the ground herbage with water for 3 h at 39 degrees C. Such water extracts selectively inhibited in vitro fermentation of pure cellulose by mixed ruminal microflora and by pure cultures of the ruminal bacteria Ruminococcus flavefaciens FD-1 and Fibrobacter succinogenes S85. Inhibition of the cellulose fermentation by mixed ruminal microflora was dependent upon the concentration of cicer milkvetch extract and was overcome upon prolonged incubation. Pure cultures exposed to the extract did not recover from inhibition, even after long incubation times, unless the inhibitory agent was removed (viz., by dilution of inhibited cultures into fresh medium). The extract did not affect the fermentation of cellobiose by R. flavefaciens but did cause some inhibition of cellobiose fermentation by F. succinogenes. Moreover, the extracts did not inhibit hydrolysis of crystalline cellulose, carboxymethyl cellulose, or p-nitrophenylcellobioside by supernatants of these pure cultures of cellulolytic bacteria or by a commercial cellulase preparation from the fungus Trichoderma reesei. The agent caused cellulose-adherent cells to detach from cellulose fibers, suggesting that the agent may act, at least in part, by disrupting the glycocalyx necessary for adherence to, and rapid digestion of, cellulose.     

In vitro study on the integrity of a hydroxylapatite coating when challenged with staphylococci

An in vitro study was performed to evaluate the effect of Staphylococcus aureus and Staphylococcus epidermidis on the integrity of a hydroxylapatite coating. The coating plasma-sprayed on poly(L-lactide), showed dissolution during a 24 h incubation period. This was indicated by an increase in pH and calcium release in the buffer solution. After 4 h of incubation, calcium levels decreased due to the precipitation of calcium phosphate complexes on the coating. The bacteria digested or dissolved the coating, creating irregularly shaped holes. Although the integrity of the hydroxylapatite coating was focally damaged within 2-4 h of incubation with staphylococci, the extent of the damage was only marginal. Due to the formation of a layer of CaP precipitates though, bacteria could not be counted accurately after 4-8 h of incubation. This model could reveal part of the failure mechanism of infected hydroxylapatite coated implants.     

The effect of N-duopropenide (a new disinfectant with quaternary ammonium iodides) and formaldehyde on survival of organisms of sanitary interest in pig slurry

The counts of different groups of organisms (mesophilic total aerobic and anaerobic bacteria, enterobacteriaceae, faecal coliform bacteria and faecal streptococci type D), as well as the presence or absence of Pseudomonas spp. and Salmonella spp., were recorded in both unfiltered and filtered pig slurry samples at 1, 8 and 29 days of storage, before and after applying N-duopropenide (a new disinfectant with a quaternary ammonium structure) at 1, 2 x 1, 5 and 2 x 5% concentrations of the commercial product (equivalent to 0.11, 2 x 0.11, 0.55 and 2 x 0.55%, respectively, of active ingredient) for 1 h, or 0.5% commercial formaldehyde for 6 days. Before disinfection, anaerobic and aerobic organisms resulted in the highest counts (between 6 and 7 log units/ml), followed by enterobacteriaceae, faecal coliforms and streptococci (4-5 log units/ml). The unfiltered slurry showed higher bacterial counts than the filtered slurry. The variation in counts was similar for all the groups studied, with the highest count on day 1 of storage with a continuous decrease over the 3 days studied. N-duopropenide efficacy depended on the dose used, but a 2 x 5% concentration resulted in total inactivation (100% reduction) of all the bacteria studied, except for the total aerobic and anaerobic organisms present in unfiltered slurry. Formaldehyde efficacy was much lower. In respect of Pseudomonas spp., more isolates were obtained after using N-duopropenide at lower concentrations (1 and 2 x 1%) than before treatment, thus suggesting its suitability for selective isolation of this genus. Finally, no Salmonella spp. strains were isolated in any of the cases considered in this study.     

Quantitation of bacterial adhesion to polymer surfaces by bioluminescence

Quantitation of microbes adhering to a surface is commonly used in studies of microbial adhesion to different surfaces. We have quantified different staphylococcal strains adhering to polymer surfaces by measuring bacterial ATP (adenosine triphosphate) by bioluminescence. The method is sensitive, having a detection limit of 10(4) bacterial cells. Viable counting of bacterial cells may yield falsely low results due to the presence of "dormant" and adherent bacteria. By using bioluminescence, this can be avoided. Cells of different bacterial species and cells of strains of the same species were shown to differ significantly in their basal ATP content (8.7 x 10(-13) - 5.2 x 10(-22) MATP). The size of adherent and planktonic bacteria decreased with time (0.7 micron-->0.3 micron, 20 days). During incubation in nutrient-poor buffer ("starvation"), the ATP content of adherent bacteria decreased after 24-96 h whereas that of planktonic bacteria was stable over 20 days. The presence of human serum or plasma did not interfere significantly with the test results. Since the ATP concentration of bacterial strains of different species varies and is also influenced by the growth conditions of bacteria (solid or liquid culture medium), a species-specific standard curve has to be established for bacteria grown under the same culture conditions. We conclude that the method is a sensitive tool to quantify adherent bacteria during experiments lasting for less than 6 h and constitutes a valuable method to be used in conjunction with different microscopical techniques.     

Quantitative bacteriological evaluation of a method for skin disinfection in blood donors

Skin disinfection at the site of venipuncture is a critical point in every blood transfusion collection procedure, as it contributes to ensure the bacterial safety of transfusion. Quantitative and qualitative analysis of bacteria present in the antecubital fossae before and after skin disinfection may be one method of assessing the anti-bacterial efficiency of disinfection. Swab culture systems and contact plates are the two techniques usually employed for this purpose. A washing and swabbing technique was used to quantify bacteria before and skin disinfection of the antecubital fossae in blood donors. This contra-placebo study was carried out on 32 donors, each of whom served as his own control, with a random choice of test arm and opposing control arm. Bacterial counts were determined in the antecubital fossae without skin disinfection (control, n = 32) and after a 3 step skin preparation procedure (cleaning, wiping, disinfection) using placebo (distilled water, n = 16) or an antiseptic product (mixture of chlorexidine, benzalkonium chloride and benzylic alcohol, n = 16). The absence of a statistical difference in bacterial counts between the right and left antecubital fossae without disinfection was controlled in a preliminary study of 20 subjects. Mean bacterial counts were 25,000/cm2 and 27,400/cm2 respectively for aerobic and anaerobic bacteria before disinfection, with a wide variation in results between individuals. When using placebo, preparation of the venipuncture site by the 3 step method (cleaning, wiping, disinfection) resulted in a non significant mean reduction of 0.56 log in aerobic and anaerobic bacteria. Using the antiseptic product, the same method resulted in a significant mean reduction of 1.8 and 1.7 log respectively in aerobic (p = 0.015) and anaerobic flora (p = 0.005). On an average, 2,750 aerobic bacteria/cm2 and 2,910 anaerobic bacteria/cm2 remained after disinfection, while qualitative analysis showed that disinfection suppressed the transitory flora in all cases but left part of the resident flora in 12/16 cases. These findings are comparable to those of other studies carried out to evaluate this kind of technique for the disinfection of operation sites. In comparison with other techniques classically employed for this type of evaluation (swab systems or contact plates), the method used in this study was the advantage of allowing the quantification of the reduction in bacteria. Hence this method could be employed for comparative assessment of skin disinfection techniques with the aim of improving their anti-bacterial efficiency and could also make possible the definition of a minimum bacterial count (resident flora) to be obtained in all cases after disinfection.     

Immunocytochemical detection of mitochondria-rich cells in the brood pouch epithelium of the pipefish, Syngnathus schlegeli: structural comparison with mitochondria-rich cells in the gills and larval epidermis

The brood pouch of the male pipefish (Syngnathus schlegeli) is a ventral organ located on the tail, with the anterior region closely associated with the genital pore. The embryos in the pouch are attached to highly vascularized placenta-like tissue which seals the pouch folds from inside during incubation. The epithelium of the placenta-like tissue consists of mitochondria-rich cells (MRCs) and pavement cells. Differences in MRC morphology in the brood pouch epithelium, the gills and the larval epidermis of the pipefish were examined by light and electron microscopy. Transmission electron microscopy revealed that the MRCs in the brood pouch and the gills shared common characteristics: the presence of numerous mitochondria packed among a well-developed tubular system and the close association of the basal parts with the capillaries running underneath the epithelia. The size of the apical opening of the elongate, flask-shaped brood pouch MRC was about one-tenth that of the apical pit of the gill MRC. The gill and larval epidermal MRCs formed a multicellular complex, in contrast to solitary brood pouch MRCs. The brood pouch MRCs were intensively stained by immunocytochemistry with an antiserum specific for Na+,K+-ATPase. The Na+ concentrations in the brood pouch were maintained near those in the serum rather than seawater during incubation. We conclude that the brood pouch MRCs function as an ion-transporting cell, absorbing ions from the brood pouch lumen, perhaps to protect the embryos from the hyperosmotic environment.     

Basal medium for the selective enumeration of rumen bacteria utilizing specific energy sources

A 40% rumen fluid basal medium has been developed that without added substrate will support growth of about 10% or less of the total colony count obtained with 40% rumen fluid-glucose-cellobiose-starch-agar medium (RGCSA). The basal medium is prepared by anaerobic incubation of all ingredients in RGCSA medium except the carbohydrates, Na2CO3, and cysteine for 7 days at 38 degrees C. After incubation, substrate(s), Na2CO3 and cysteine are added and the medium is tubed and sterilized as in normal medium preparation. When xylose was included with glucose, cellobiose, and starch as added carbohydrates in the incubated medium, colony counts were comparable to those obtained with RGCSA medium. The addition of specific carbohydrates or other substrates as energy sources to the basal medium suggested that the percentage of the bacterial population capable of utilizing these energy sources was influenced by the ration of the animal; however, considerable animal variation and day-to-day variation in a given animal was observed. Comparison of the population in animals fed either orchardgrass hay or 60% corn-40% orchardgrass (60-40) indicated little or no difference for the percentage of bacteria utilizing glucose, pectin, xylan, or mannitol. Increases in the percentages of xylose-, cellobiose-, Glycerol-, and lactate-utilizing bacteria occurred with the orchardgrass hay ration, whereas the percentage of starch-digesting bacteria was increased significantly (P less than 0.01) in the animals fed the 60-40 ration. A limited number of bacterial strains were isolated from the basal medium without added substrate, most of which were atypical with respect to the predominant rumen bacteria. Growth of these strains, even in complex media, was very slow and limited. Based on these data with isolated strains and colony counts obtained in roll tube medium containing only minerals, resazurin, agar, Na2CO3, and cysteine, the selective medium overestimated the percentage of bacteria able to use a specific energy source. This overestimate was 6 to 7% of the total culturable count.     

Alterococcus agarolyticus, gen.nov., sp.nov., a halophilic thermophilic bacterium capable of agar degradation

Five strains of facultatively anaerobic moderately thermophilic bacteria were isolated from two hot springs in the intertidal zone of Lutao, Taiwan. They produced extracellular agarase on agar medium, yielding reducing sugars and organic acids as the end products under either aerobic or anaerobic conditions. The growth temperature range was approximately 38-58 degrees C with an optimal temperature of about 48 degrees C. The five strains tolerated a relatively narrow pH range from 7.0 to 8.5. They were Gram-negative halophiles growing optimally at 2.0-2.5% NaCl (ca. 0.34-0.43 M). They were capable of anaerobic growth by fermenting glucose and producing various organic acids such as butyrate, propionate, formate, lactate, and acetate. Cells grown in liquid medium were motile monotrichous cocci, normally 0.8-0.9 micron in diameter. They possessed saturated anteiso-15-carbon acid (anteiso-C15:0) as the most abundant cellular fatty acid (46.0-51.3 mo1%) and had G + C contents ranging from 65.5 to 67.0 mo1%. They are the first thermophiles found to degrade agar and also the first halophilic thermophilic bacteria known to be capable of both aerobic and anaerobic fermentative growth. These bacteria are considered to represent a new genus that we named Alterococcus, and Alterococcus agarolyticus is the type species.     

Qualitative changes in enteric flora and short-chain fatty acids after intestinal resection

Our aim was to determine the effect of intestinal transection and resection on the prevalence of enteric flora and evaluate whether any such changes alter luminal SCFA and lactic acid content. Dogs underwent either 50% proximal (PR, N = 6) or distal (DR, N = 7) resection, distal resection with bypass of the ileocecal junction (DRBP, N = 9) or midpoint transection alone performed to serve as the appropriate control for luminal sampling for either proximal (PTC, N = 6) or distal (DTC, N = 7) resection. Studies were performed every four weeks for 12 weeks. Both jejunum and ileum had >10(5)/ml aerobic bacteria, most commonly E. coli. Streptococcal species were more common in the normal jejunum than ileum but were found in the ileal remnant after PR. Significant (>10(5)) anaerobic growth occurred infrequently in the jejunum, and DR did not increase anaerobic growth in jejunum unless DRBP was performed (93% vs 62% DR, 45% DTC, 20% normal jejunum, P < 0.05). Clostridium species increased significantly in the jejunal remnant after DRBP. Significant anaerobic growth occurred infrequently in normal ileum but increased after PR (89% vs 50% PTC, P < 0.05). Flora normally found in the jejunum tended to increase in the ileum after PR. Jejunal SCFA increased after DRBP (3126 +/- 577 microg/ml vs 1600 +/- 301 DTC, P < 0.05) but not DR (1791 +/- 321 microg/ml). Significant (>10(5)) anaerobic bacterial growth was associated with increased SCFA content (2717 +/- 381 vs 1029 +/- 170 microg/ml, P < 0.05) and the presence of lactic acid (30% vs 5%, P < 0.05), but there was no correlation between the presence of specific bacteria and SCFA and lactic acid. Following resection of the proximal small intestine, the intestinal remnant tends to assume the bacteriologic characteristics of the resected segment. Following a distal resection, the presence of an intact ICJ protects against the proliferation of a flora characteristic of the distal intestine; resection with bypass of the ICJ results in the appearance of coliforms in the jejunal remnant. These changes in enteric flora do not correlate with content of specific SCFA and lactic acid in the small intestine.     

Primary medical care. The cooperative solution to the volume problem

Neisseria gonorrhoeae were isolated from 1,019 (39.8%) of 2,558 male patients examined in a venereal disease clinic. Three specimens per patient were plated on Thayer-Martin medium. One plate was placed in a C02 -enriched environment and incubated immediately. The other two were held at room temperature in a standard atmosphere for 1-4 hours before similar processing. A statistically significant loss of N. gonorrhoeae was found when placement in a candle jar and incubation was delayed 2 or more hours. Morever, the appearance of colonies was delayed and colonial size and number were significantly reduced in specimens held 2 hours or longer before incubation in a candle jar.