Resistance to cefoperazone-sulbactam in Klebsiella pneumoniae: evidence for enhanced resistance resulting from the coexistence of two different resistance mechanisms.

We investigated the in vitro activity and the in vivo efficacy of the beta-lactam-beta-lactamase inhibitor combination cefoperazone-sulbactam against an isogenic series of Klebsiella pneumoniae strains. Both cefoperazone and cefoperazone-sulbactam were active in vitro against a susceptible clinical strain, and the combination was highly effective in the treatment of rat intra-abdominal abscesses. Loss of expression of a 39-kDa outer membrane protein resulted in at least a fourfold increase in the MICs of cefoperazone and cefoperazone-sulbactam but did not appreciably affect the in vivo efficacy of either regimen. Introduction of plasmid RP4, which encodes the TEM-2 beta-lactamase, into the susceptible strain resulted in the loss of in vitro activity and in vivo efficacy for cefoperazone. The in vitro activity of cefoperazone-sulbactam against this strain was diminished, but the antibiotic combination remained highly active in vivo. Introduction of RP4 into the strain lacking the 39-kDa outer membrane protein resulted in a fourfold increase in the in vitro MIC of cefoperazone-sulbactam in comparison with the beta-lactamase-producing susceptible strain and resulted in a loss of in vivo efficacy against infections caused by this strain. These results suggest that the combination of different resistance mechanisms, neither of which alone results in substantially diminished cefoperazone-sulbactam efficacy in vivo, can cause in vivo resistance to the beta-lactam-beta-lactamase inhibitor combination in K. pneumoniae.     

Spinal sonography and magnetic resonance imaging in patients with repaired myelomeningocele: comparison of modalities.

The goals of this study were to evaluate the feasibility of using ultrasonography of the spine in the follow-up evaluation of patients with repaired myelomeningocele at birth and to compare sonography with the accepted modality of magnetic resonance imaging. Over a period of 4 years we performed 165 sonographic studies in 101 patients; 107 sonographic studies had MR imaging results for comparison. We collected our data prospectively. The quality of the sonograms was good in 110 of 129 studies, acceptable in 17 of 129, and poor in two of 129. The sonographic examinations failed in 33 of 165 studies (20%). Concordant information was obtained between ultrasonography and magnetic resonance imaging in the following percentage of studies: level of the distal end of the cord in 82%, position of the cord in the canal in 59%, presence of hydromyelia in 63%, cord duplication in 96%, adhesions in 16%, intradural mass in 37%, cord measurements in 85%, and dural sac measurements in 83%. At the lumbosacral level, we saw no cord pulsation in 57% of the studies in patients with cord adhesions and in 20% of those without adhesions. At the lower thoracic level, we saw no pulsation in 35% of the studies in patients with cord adhesions and in 7% of those without adhesions. Postoperative studies of cord release surgery in eight patients showed varied findings. We conclude that in those patients who have a spinal defect or interlaminar space allowing proper visualization of the lumbosacral spinal canal, ultrasound can provide fairly similar information to that obtained with magnetic resonance imaging of that area with no need for sedation and at a reduced cost. Ultrasonography seems more sensitive than magnetic resonance imaging in the detection of cord adhesions, which is particularly relevant in the diagnosis of tethering.     

Experimental induction of athero-arteriosclerosis by the synergy of allergic injury to arteries and lipid-rich diet. I. Effect of repeated injections of horse serum in rabbits fed a dietary cholesterol supplement

In rabbits that received a dietary supplement of cholesterol, 0.5% by weight, and concommittant injections of horse serum (group III) over a period of 80 days, coronary arterial lesions developed that in the main were different in quality and distribution from those in rabbits that received the cholesterol supplement alone (group I), and of different quality from but in distribution similar to those in rabbits that received horse serum alone (group II). Fatty lesions developed in small, rarely in medium, but never in large arteries of rabbits in group I, and these changes do not resemble coronary athero-arteriosclerosis in man. Proliferative lesions without fatty change developed in large, medium, and small arteries of rabbits in group II, and some of these closely resemble human coronary arteriosclerosis without fatty change. The changes that developed in large, medium, and small arteries of rabbits in group III were in very large majority fatty-proliferative lesions. Some of these closely resemble the changes that in some cases constitute coronary athero-arteriosclerosis in man. Nuclei with caterpillarlike chromatin pattern in longitudinal section and owl eye appearance in transverse section were observed to occur in many of the proliferating cells in thickened arterial intima in hearts of rabbits in groups II and III and in some of the lipid rich "foam" cells in arterial intima and subjacent media in hearts of rabbits in group III. Such nuclei have been observed to occur in some reacting smooth muscle cells and normal immature and reacting mature striated muscle cells of the heart. These observations indicate that at least many of the cells, including "foam" cells, in thickened intima in the experimentally induced and in naturally occurring coronary athero-arteriosclerosis are smooth muscle cells that evolved in proliferative reaction to arterial injury. Fatty change developed in aortas of the rabbits in groups I and III, and was significantly greater in group III. Results of this investigation support the hypothesis that the synergy of allergic injury to arteries and lipid-rich diet can lead to athero-arteriosclerosis.     

Effect of exogenous glycine on peptidoglycan composition and resistance in a methicillin-resistant Staphylococcus aureus strain.

A highly homogeneously methicillin-resistant Staphylococcus aureus strain was grown in the presence of various concentrations of exogenous glycine. Increasing concentrations of glycine in the medium resulted in a decrease in methicillin resistance and the appearance of a heterogeneous resistance phenotype. Parallel to the gradual changes in resistance was an alteration in the muropeptide composition of peptidoglycan. Increasing concentrations of glycine in the medium resulted in peptidoglycan in which muropeptides with a D-alanyl-D-alanine terminus were replaced with D-alanyl-glycine-terminating muropeptides. The disappearance of D-alanyl-D-alanine-terminating muropeptides in peptidoglycan and the concomitant decrease in resistance indicate a central role for D-alanyl-D-alanine-terminating precursors in methicillin resistance.     

Differences in d-[3H]lysergic acid diethylamide binding in mouse cortex and hippocampus in vivo and in vitro revealed by radioautography and rapid filtration studies

The localization of d-[3H]lysergic acid diethylamide ([3H]LSD) binding sites in mouse brain was compared in vivo and in vitro. Radioautography of brain sections incubated with 6 nM [3H]LSD in vitro revealed substantial specific binding in cortex (CTX), especially in layers III to IV and anterior cingulate gyrus, and in areas CA1 and dentate gyrus of hippocampus (HIP). In sections of brains from mice that received 100 nmol of [3H]LSD per kg and were killed 10, 15 or 30 min later, specific [3H]LSD binding in CTX had a pattern of distribution similar to that observed in vitro. In contrast, the pattern of specific [3H]LSD binding in HIP in vivo differed from the results obtained in vitro, in that it was sparse and lacked differential subregional distribution. The low specific [3H]LSD binding in vivo in HIP but not in CTX was confirmed by homogenate filtration studies of brain areas from mice that received 100 nmol of [3H]LSD per kg. The levels of free [3H]LSD, obtained after correction for time-dependent metabolism of [3H]LSD, did not vary among regions, but [3H]LSD specifically bound in HIP was 30 to 50% of that in CTX. In contrast, steady-state binding studies in vitro in membrane preparations from CTX and HIP demonstrated a similar density and affinity of [3H]LSD binding sites in the two regions. Comparison of [3H]LSD binding characteristics in vivo and in vitro suggests possible mechanisms causing the lower specific binding in HIP in vivo, including modulation of the binding sites that differ in CTX and HIP.     

Effect of beta-lactams on peptidoglycan metabolism of Haemophilus influenzae grown in animals.

We have examined bacterial determinants that influence beta-lactam activity in Haemophilus influenzae cells cultivated in a system that reproduces in vivo growth conditions. Bacteria grown in diffusion chambers were recovered from the peritoneal cavities of rats, and their cell properties were compared with those of bacteria grown in broth cultures by various tests performed in vitro. The rate of peptidoglycan synthesis was measured as the incorporation of [14C]alanine into cell wall material in the presence of chloramphenicol. The total incorporation of [14C]alanine into peptidoglycan was markedly increased in cells grown in rats prior to the assay but was efficiently reduced by the beta-lactams. The extent of cross-linking was lower in the peptidoglycan of in vivo-grown bacteria, as estimated by sodium dodecyl sulfate- to trichloroacetic acid-insoluble radioactive cell wall material ratios. A whole-cell labeling assay with 125I-penicillin was used to characterize the penicillin-binding proteins (PBPs). Four PBPs showed a striking reduction in the binding of the labeled penicillin in cells grown in rats. Such changes resembled the PBP alterations seen in beta-lactamase-negative clinical strains that were resistant to the beta-lactams. Although ampicillin and moxalactam showed delayed inhibitory activities in vitro for cells collected from rats, cells recovered from beta-lactam-treated rats showed evidence of antibiotic effectiveness (binding of the beta-lactams to PBPs in vivo and altered morphology), and the killing of cells exposed to antibiotics in broth or in peritoneal fluid was equally good. Finally, the frequencies of spontaneous resistance or tolerance to ampicillin or moxalactam were estimated, and there was no significant difference for in vitro- or in vivo-grown cells. These data demonstrated that the cultivation of H. influenzae in animals created changes in PBPs and the overall peptidoglycan metabolism. Such alterations did not impair the bactericidal activities of the beta-lactams, although they resulted in delayed bacterial inhibition, a phenomenon that may have important consequences in antibiotherapy.     

胸部地震伤的影像诊断价值

目的探讨胸部地震伤的影像诊断价值。方法回顾性分析30例胸部地震伤的影像学及临床资料,30例患者均行X线平片检查,11例行CT检查,3例行MRI检查。结果影像学检查均能明确诊断,30例患者均为复合伤,其中肋骨骨折18例,胸椎骨折8例,肩胛骨骨折3例,锁骨骨折3例,胸骨骨折1例,胸壁软组织伤5例,肺挫裂伤5例,肺内血肿1例,肺部感染4例,气胸及液气胸6例,双侧胸腔积液1例,发生肺不张1例。结论影像学检查有利于胸部地震伤的及时准确诊断和治疗方式的选择。     

Detection of peripheral blood and bronchoalveolar lavage fluid lymphocytes in rat lung transplantation for early diagnosis of rejection

Left lung transplantation was performed in two combinations of rat strains. In group 1, lung grafts were rejected within 7 day postoperatively, and in group 2, grafts were rejected within 18 day postoperatively. The histological appearance of rejection was classified into 4 stages, and lymphocytes from peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) were collected at each stage. In group 1, a significant decrease in the number of lymphocytes in PB was observed as the rejection progressed, whereas the number of lymphocytes in PB increased slightly in group 2. The number of total cells in BALF increased significantly as the rejection progressed in both groups. A marked increase in the value of spontaneous blastogenesis (SB) was observed in stage 2 in BALF lymphocytes, whereas that in PB lymphocytes was found to increase after stage 3 in both groups. The ratio of T-helper/T-nonhelper did not change significantly in PB lymphocytes in both groups. On the other hand, a significant decrease in the value of T-helper/T-nonhelper (less than 1.0) was observed in BALF at stage 3 and 4 in both groups. These results show that the studies of BALF lymphocytes were very useful for early diagnosis of rejection in lung transplantation.     

数字化成像在泌尿系检查中的临床应用

目的 评价数字化成像在泌尿系统检查的临床应用价值。方法 采用数字化成像对112例患者进行尿路造影检查，包括38例静脉尿路造影（IVP），74例逆行尿路造影。结果 运用数字化成像能较好地显示尿路全程，对输尿管结石有较高的诊断价值，对尿路梗阻能作出准确的定位及定性诊断。IVP检查38例中，5例显影正常，肾结石12例，输尿管结石13例，输尿管狭窄6例，肾母细胞瘤2例。逆行尿路造影74例中，输尿管良性狭窄31例，输尿管结石27例，输尿管息肉2例，尿道结石8例，尿道良性狭窄6例。结论 数字化成像技术在泌尿系统疾病诊断中有较大的应用价值。     

Studies on the in vivo and in vitro distribution of apolipoprotein A-IV in human plasma and lymph.

To investigate the unique distribution in plasma of apolipoprotein A-IV (apo A-IV) we have determined, in a series of in vitro and in vivo studies, the redistribution among lipoproteins of 125I-apo A-IV. Free 125I-apo A-IV associated predominantly with high density lipoprotein (HDL) (72 +/- 3.5%) in incubations with plasma, and with triglyceride-rich lipoproteins (TRL) (65 +/- 3.0%) in incubations with lymph, rather than with the lipoprotein-deficient fraction (LDF) where greater than 90% of apo A-IV resides. Incubations with 125I-apo A-IV (incorporated within HDL or TRL) also resulted in similar redistributions of label. Specific radioactivities of apo A-IV in HDL and in TRL were of a similar order and 15-fold higher than those in LDF. However, when 125I-apo A-IV in LDF was incubated with plasma, 57 +/- 2.6% of label remained in the LDF, though the specific radioactivity of apo A-IV in HDL was 15-fold higher than in LDF. Thus, apo A-IV apparently exchanges freely between TRL, HDL, and a part of apo A-IV in LDF, but most of apo A-IV in LDF is refractive to free exchange or transfer. In vivo experiments carried out in five subjects, in which 125I-apo A-IV was injected within TRL, HDL, or LDF, were consistent with the in vitro data in showing rapid exchange of label among plasma apo A-IV containing fractions with much higher specific radioactivities in HDL than in LDF (10-30-fold). However, the small fraction of apo A-IV in LDF that did become labeled was removed from plasma in a biexponential fashion and at the same rate as from HDL. Thus, only a small fraction of the bulk of apo A-IV in plasma LDF exchanges freely with apo A-IV in TRL and HDL, suggesting that apo A-IV in LDF exists in at least two pools. This is consistent with our previous findings that apo A-IV in plasma is present in two distinct complexes with lipids and other peptides.     

Iron Metabolism in Porphyria Cutanea Tarda and in Erythropoietic Protoporphyria

Absorption of radioiron, plasma iron and iron-binding capacity,plasma iron turnover and utilization of radioiron, tissue ironstores, and hepatic biopsy histology have been studied in 20patients with porphyria cutanea tarda (PCT). Some of these facetsof iron metabolism were also studied in five patients with erythropoieticprotoporphyria (EPP). Iron absorption was increased in nine untreated patients withPCT, particularly in those with cirrhosis, and was inappropriatelygreat in a further three. It was markedly increased in six patientswith PCT in remission many months after treatment by repeatedphlebotomy. Iron absorption was normal in two patients withEPP and raised in another in whom marrow storage iron was absent. Plasma iron was elevated in 15 of the patients with PCT, butin eight it fell into the normal range after their admissionto hospital, probably in part as a result of their stoppingtaking alcohol. Total iron-binding capacity was usually normal.Plasma iron turnover was mildly increased in seven of 20 patientswith PCT, and was normal in three with EPP. Utilization of radioironwas slightly reduced in two patients with PCT, and normal in14 others with PCT and in two with EPP. Liver biopsy in 18 untreatedpatients with PCT invariably showed evidence of liver damage,with excess iron in parenchymal cells, Kupffer cells, and, withone exception, portal tract macrophages. Repeat biopsy in fourpatients with PCT in remission after repeated phlebotomy showedabsence of stainable iron in three with normal liver architecture,and a marked reduction in excess iron in one with cirrhosis.Reticulo-endothelial iron was increased in marrow smears fromsix of 14 patients with PCT, and was absent in one and minimalin two patients with EPP. Storage iron mobilized by repeatedphlebotomy amounted to from 0.4 to 1.8 g in 12 patients withPCT. One patient with EPP had recurrent iron-deficiency anaemiaand in three others mobilizable storage iron was less than 250mg. The observations confirm the invariable finding of excess hepaticiron in PCT, with often a modest increase in mobilizable storageiron. The increase appears to be due to an inappropriately highlevel of iron absorption of uncertain cause. In contrast, suboptimalstorage iron may be frequent in EPP.     

Changes of intracellular calcium homeostasis in brain cortical structures during anoxia in vivo and in vitro

This work characterizes the anoxia-evoked changes in the content of bound calcium (Cab) in brain cortex membraneous structures, studied in vivo, on living brain cortex preparation and in vitro, on subcellular fractions (synaptosomes, microsomes and mitochondria) in anoxic conditions. The chlorotetracycline (CTC) fluorescent chelate probe was used to monitor changes of Cab content in hydrophobic domains of intracellular membranes. In in vivo experiments the bioelectric activity of single neurons was recorded simultaneously with measurements of Ca-CTC fluorescence. In vitro experiments were supplemented with determinations of synaptosomal 45Ca-uptake. It was found that the response of cortical neurons to anoxia is manifested in a decrease of a portion of Ca2+ bound with membrane hydrophobic domains. These in vivo changes preceded the noticeable disturbances of neuronal electric activity. An anoxia-evoked drop in Cab was also clearly demonstrated in vitro, irrespective of K+ (for synaptosomes) or Na+ (for mitochondria) concentrations in incubation media, although the additional effect of Cab displacement was noted when Na+/K+ concentrations were modified in order to simulate their changes occurring in anoxic conditions. It was found that the membranes of different neuronal compartments are not uniformly vulnerable to anoxia in vitro as the anoxic decrease in Cab content occurred in synaptosomes and microsomes much sooner than in mitochondria. Therefore, in vivo and in vitro experiments visualized high sensitivity of Ca2+-binding mechanisms in different neuronal membranes to anoxia. The anoxia-evoked displacement of a portion of Cab to the free ionic form may trigger a complex intracellular response determining anoxic reactions and post-anoxic recovery.     

颅骨常见破坏性病变51例临床及影像学分析

目的 提高颅骨破坏性疾病类的鉴别诊断水平。方法 结合文献回顾分析51例资料完整的颅骨破坏性疾病。结果 51例中,骨髓瘤为15例,脑膜瘤及转移性骨肿瘤各10例,骨髓炎、垂体腺瘤及嗜酸性肉芽肿各3例,血管瘤、胆脂瘤各2例,结核、听神经瘤、动脉瘤样骨囊肿各1例。结论 颅骨破坏性疾病应密切结合临床及影像学检查特点进行鉴别诊断。     

Fas在子宫内膜异位症患者在位内膜中的表达及意义

【目的】检测Fas在子宫内膜异位症（内异症）组织中的表达,探讨内异症的发病机制。【方法】采用免疫组化SABC法,检测35例内异症患者在位内膜中Fas的表达,并与20例正常子宫内膜进行比较。【结果】内异症组在位内膜中Fas的表达水平显著低于对照组;内异症组在位内膜Fas的表达亦无周期性变化。且其分泌期Fas的表达显著低于对照组同期水平;正常子宫内膜组织中分泌期Fas的表达显著高于增生期。存在周期性的变化。【结论】Fas参与正常子宫内膜的周期性调节;Fas在月经周期的分泌期低表达可能在内异症的发生中起重要作用。     

Mechanism of hypercalciuria in genetic hypercalciuric rats. Inherited defect in intestinal calcium transport.

Excessive urine calcium excretion in patients with idiopathic hypercalciuria may involve a primary increase in intestinal calcium absorption, overproduction of 1,25-dihydroxyvitamin D3 or a defect in renal tubular calcium reabsorption. To determine the mechanism of hypercalciuria in an animal model, hypercalciuria was selected for in rats and the most hypercalciuric animals inbred. Animals from the fourth generation were utilized to study mineral balance and intestinal transport in relation to levels of serum 1,25(OH)2D3. Both urine calcium excretion and net intestinal calcium absorption were greater in hypercalciuric males (HM) than in normocalciuric males (NM) and in hypercalciuric females (HF) than in normocalciuric females (NF). However, serum 1,25(OH)2D3 was lower in HM than in NM and not different in HF than in NF. Net calcium balance was more positive in HM than in NM and in HF than in NF. In vitro duodenal calcium net flux was correlated with serum 1,25(OH)2D3 in HM and HF and in NM and NF. However, with increasing serum 1,25(OH)2D3 there was greater calcium net flux in hypercalciuric rats than in normocalciuric controls. Hypercalciuria in this colony of hypercalciuric rats is due to a primary intestinal overabsorption of dietary calcium and not an overproduction of 1,25(OH)2D3 or a defect in the renal tubular reabsorption of calcium.     

Deposits of IgD in renal disease. Immunohistological study of 180 renal biopsies

Abstract. IgD deposits have been investigated by an indirect immunofluorescence technique in 180 renal biopsies carried out on patients with various renal diseases. IgD was not present in nephrotic syndrome with minimal changes or focal glomerulosclerosis, in mesangial proliferative glomerulonephritis, in chronic advanced glomerulonephritis, in rheumatoid purpura and in other various nephropathies with predominant non-glomerular lesions. Significant deposits of IgD were identified in 12 out of 16 cases of membranoproliferative glomerulonephritis, in 15 out of 23 cases of membranous nephropathy, in 11 out of 21 cases of focal proliferative glomerulonephritis with mesangial IgA deposits, in 2 out of 5 cases of proliferative glomerulonephritis with crescents and in 1 out of 6 cases of proliferative exudative glomerulonephritis. All cases of lupus nephritis and nephritis associated with mixed cryoglobulinaemia showed IgD deposits. In diabetic glomerulosclerosis, IgD was found in 1 out of 4 biopsies and only in the exudative lesions. In 5 out of 8 cases of amyloidosis anti-IgD serum stained the amyloid substance irregularly. In such cases IgD was found in association with other immunoglobulins and complement with the same localization. These findings suggest that IgD may participate in the immunological processes which lead to the development of glomerular deposits, mainly in cases of chronic glomerular diseases.     

Deposits of IgD in Renal Disease. Immunohistological Study of 180 Renal Biopsies

Abstract. IgD deposits have been investigated by an indirect immunofluorescence technique in 180 renal biopsies carried out on patients with various renal diseases.
IgD was not present in nephrotic syndrome with minimal changes or focal glomerulosclerosis, in mesangial proliferative glomerulonephritis, in chronic advanced glomerulonephritis, in rheumatoid purpura and in other various nephropathies with predominant non-glomerulor lesions.
Significant deposits of IgD were identified in 12 out of 16 cases of membranoproliferative glomerulonephritis, in 15 out of 23 cases of membranous nephropathy, in 11 out of 21 cases of focal proliferative glomerulonephritis with mesangial IgA deposits, in 2 out of 5 cases of proliferative glomerulonephritis with crescents and in 1 out of 6 cases of proliferative exudative glomerulonephritis.
All cases of lupus nephritis and nephritis associated with mixed cryoglobulinaemia Bhowed IgD deposits.
In diabetic glomerulosclerosis, IgD was found in 1 out of 4 biopsies and only in the exudative lesions.
In 5 out of 8 cases of amyloidosis anti-IgD serum stained the amyloid substance irregularly. In such cases IgD was found in association with other immunoglobulins and complement with the same localization. These findings suggest that IgD may participate in the immunological processes which lead to the development of glomerular deposits, mainly in cases of chronic glomerular diseases.     

STUDIES OF THE GENERALIZED SHWARTZMAN REACTION PRODUCED BY DIET : I. PATHOLOGY

The generalized Shwartzman reaction can be produced in pregnant rats by dietary means in the absence of injection of exogenous bacterial endotoxin. The experiment consists of a period of exposure to a diet low in tocopherol followed by exposure to a diet containing oxidized lipids during the gestation period. Pregnancy near term is an essential requirement for the development of the generalized Shwartzman reaction in these experiments. Fibrin thrombi were found in the renal glomeruli in 88.5 per cent, in the lungs in 94.2 per cent, in the liver in 11.4 per cent, in the spleen in 11.4 per cent, and in the adrenal in 40 per cent of animals that died spontaneously. There were pathologic alterations in the placenta which consisted of degeneration of the trophoblast, thrombosis of maternal blood channels in the giant cell trophoblast layer and in the labyrinth, congestion of the labyrinth, hemorrhage into the uterine cavity, placental separation, intra-uterine fetal death, decidual and uterine vein thrombosis, and placentitis in 10 per cent of the cases. The mechanism by which the diet is instrumental in causing this reaction remains to be demonstrated.     

Incidence of tuberculosis and BCG inoculation (author's transl)]

The incidence of tuberculosis in childhood has declined throughout the world during the last decades. It is difficult to evaluate the role of BCG inoculation in achieving a decrease in incidence of the disease. The practice of administering BCG to children in general is thus a matter which is still under discussion and in which unanimity has not yet been achieved. However, it is generally agreed to recommend BCG inoculation in areas with a high incidence of active cases. This study was initiated in order to elicit the necessity of BCG inoculation in the city of Graz and, more widely, in the province of Styria (Austria). The incidence of active tuberculosis was investigated in children and adults over the past 12 years period. The incidence of active tuberculosis in children proved to be higher in rural areas than in Graz. The incidence of active tuberculosis in adults showed only a slight decrease during this 12-year period, the decrease being definitely more pronounced in Graz than in the rural areas. Considering the incidence rates of active tuberculosis it is advisable to continue BCG inoculation in infants and children, not only in the rural areas of Styria, but also in the city of Graz.     

Thermographic semeiotics of food poisoning and its differential diagnosis

A thermographic study has revealed zones of hyperthermia in the epigastrium and other abdominal regions in 91.4 per cent of the patients with food poisoning. The temperature gradient in the epigastrium depended on the degree of severity of the disease (in mild course--0.60 +/- 0.11 degrees C, in moderately severe and severe course--1.15 +/- 0.09 degrees C). In salmonellosis a zone of hyperthermia was also found in the right iliac region. Clinical recovery in most cases preceded temperature normalization on the abdomen. In patients with acute dysentery the hyperthermic zone was constantly revealed in the left iliac region, in acute appendicitis in the right iliac region, in acute cholecystitis in the right hypochondrium, in acute pancreatitis in the epigastrium or in the hypochondrium with a clearly defined upper border. Thermography contributed to the differential diagnosis of food poisoning and the above diseases.