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[Participation of the antibiotics of Bac. pumilus and Bac. subtilis in the regulation of bacterial spore formation].

Sporulation and antibiotic production, as well as the effect of exogenic antibacterial substances on bacterial sporogenesis were studied in various strains of Bac. pumilus and Bac. pumilus and Bac. subtilis. The bacteria were grown on a solid sporulation medium with and without the antibiotics. After 5-day incubation the presence of refractyl spores was determined with a phase-contrast method. It was found that in the strains of Bac. pumilus producing antibacterial substances the sporulation was normal. The loss of the capacity for synthesizing such substances resulted in asporegenicity or oligosporogenicity. This allowed a conclusion on existence of phenomenological connection between sporulation and antibiotic production. The study of the antibiotic effect on bacterial sporogenesis showed negative results which are discussed in the paper along two directions: (1) the antibiotics did not probably participate in regulation of the bacteria cell differentiation, (2) the antibiotics regulated the bacterial sporogenesis though their effect was not as yet detected because of methodical difficulties. Therefore, the problem of the antibiotic participation in regulation of sporulation in Bac. pumilus and Bac. subtilis remains open.

Anti-Bacterial Agents

[Ultrastructure of Bac. anthracis and Bac. cereus].

A study was made of the ultrastructure of Bac. anthracis and Bac. cereus (strains 1835 and 205). There were established definite morphological differences between the bacilli under study. The cell wall was much thicker in the causative agent of anthrax, it was permeated by tubules; the surface of the wall was covered by a thick layer of osmiophilic material. The spore membrane of Bac. anthracis was multistratal in character; osmiophilic filaments were seen on the surface of exosporium. Fungoid processes from the cell wall were present in Bac. cereus (strain No. 205); intraplasmic membrane structures were considerably developed; a crystal located on the contralateral end of the cell was formed with the spore, both processes coinciding in time.

Bacillus anthracis

Identification of an early activation antigen (Bac-1) on human B cells.

We have produced a monoclonal antibody, Bac-1, that appears to identify a novel antigen on activated human B cells. The Bac-1 antigen can be detected between 8 to 16 hr, as well as transferrin receptors (T9), after activation of small resting B cells with phorbol myristic acetate, anti-IgM antibody, Staphylococcus aureus Cowan I, or Epstein-Barr virus. The expression of the Bac-1 antigen precedes that of IL 2 receptors (Tac-1). Peak expression of the Bac-1 antigen was observed on day 3 after activation, and decreased thereafter. The Bac-1 antigen was present on a minor subpopulation of relatively large B cells isolated from blood samples, and on "preactivated" B cells of heterogeneous size isolated from spleens and tonsils. It was not detected on bone marrow pre-B cells, blood small B cells, or plasma cells, nor was it expressed by resting or activated T cells or nonlymphoid cells. Certain B cell neoplasms and B lymphoblastoid cell lines were Bac-1+, but neoplastic cells of non-B lineage were Bac-1-. With immunoperoxidase staining, Bac-1+ cells were detected predominantly in the germinal centers of tonsil sections. The Bac-1 antigen on activated B cells was destroyed by protease treatment and was enhanced by neuraminidase treatment, suggesting that the Bac-1 antibody detects a cell surface molecule via an antigenic determinant which is partially obscured by neighboring sialic acid residues. The reactivity pattern of Bac-1 differs from the patterns of cellular reactivity reported for other monoclonal antibodies with specificity for activated human B cells.

Antibodies, Monoclonal

Variability in behavioral impairment involved in the rising and falling BAC curve.

The purpose of this pilot study was to measure variability in behavior impairment at specific levels of the rising and falling blood alcohol concentration (BAC) curve. Behavior impairment was measured for anticipation and reaction time in addition to a variety of visual skills. Also of interest was the variability in impairment involved at specific BAC levels under single-dose and double-dose conditions. The experimental design was a variation on a 2 x 2 factorial with repeated measures on the dose of alcohol. All subjects took part in two experimental sessions, single-dose and double-dose. Sixteen (8 male and 8 female) paid subjects ages 21-40 participated in the study. Testing procedures included repeated measures on reaction time, anticipation time, perceptual vision acuity and depth perception. Breath-alcohol measures were sampled continuously at 5-minute intervals and used to plot absorption time, peak BAC and elimination time. Results showed that the average peak BAC for the double-dose was significantly higher than that of the single-dose condition. However, there were no significant differences between the single-dose and double-dose condition in either absorption time or elimination time. The performance pattern for reaction time, anticipation time and depth perception showed more impairment in the rising BAC limb than in the falling BAC limb. It is noteworthy that specific individuals exhibited different levels of impairment at a given BAC level, depending on whether the session was single- or double-dose, suggesting that one's current BAC level is less a measure of impairment than is the total quantity of alcohol consumed. A follow-up procedure to examine practice effects was conducted on eight volunteer students. Identical testing procedures, using no alcohol, produced no significant practice effects after a 3-hour period.

Adult

Evaluation of the modified Bac-T-Screen and FiltraCheck-UTI urine screening systems for detection of clinically significant bacteriuria.

Previous evaluations of the Bac-T-Screen system (Vitek Systems, Inc., Hazelwood, Mo.) demonstrated excellent sensitivity with specimens from patients with clinically significant bacteriuria (including infections with small numbers of uropathogens) but poor specificity with specimens from noninfected patients. In the study reported here, the sensitivity and specificity of the Bac-T-Screen system with a modified decolorizing reagent were evaluated. A manual filtration system, FiltraCheck-UTI (Vitek Systems), for screening urine specimens, Gram stains of mixed urine specimens, and quantitative cultures were also evaluated. The test sensitivity for clinically significant bacteriuria was greater than 96% with the original Bac-T-Screen system as well as the modified system and the manual system. In comparison, the sensitivities of the Gram stains and quantitative cultures (greater than or equal to 10(5) CFU/ml) were 82 and 77%, respectively. Of the 375 patients classified as noninfected by clinical parameters, 34% had positive screening tests with the original Bac-T-Screen system, as compared with 13 and 11% with the modified Bac-T-Screen and FiltraCheck-UTI systems, respectively. Thus, the modified Bac-T-Screen system and the manual FiltraCheck-UTI system have sensitives comparable to that of the original Bac-T-Screen system and markedly improved test specificities.

Bacteria

Visual and clinical analysis of Bac-T-Screen urine screen results.

Of 337 urine specimens evaluated, 75 of the 113 that showed positive readings on the Bac-T-Screen urine-screening instrument were found by subsequent semiquantitative culture to yield either less than 10,000 CFU of mixed bacteria per ml or no growth (less than 100 CFU/ml by our criteria). We tried to determine what factors contributed to the positive Bac-T-Screen results by examining the 75 Bac-T-Screen-positive urine specimens with three visual methods: Gram staining, hemacytometer chamber counting, and filtering through a 5.0-microns-pore-size nitrocellulose filter with subsequent microscopic examination of the stained filter. Somatic cells and other particles present in those urine specimens that yielded positive readings by the Bac-T-Screen included epithelial cells in 43%, crystals and amorphous material in 33%, and leukocytes in 17% of the specimens. There was no relationship between the numbers of particles seen in urine and the magnitude of the relative absorbance reading obtained with the Bac-T-Screen. A retrospective chart review was conducted for patients with positive Bac-T-Screen results and negative cultures. Of the 75 patients, 6 were thought to have urinary tract infections on the basis of clinical criteria; the majority of the remaining 69 patients had clinical histories revealing systemic or urogenital conditions consistent with shedding of particles in the urine. A positive reading by the Bac-T-Screen system seemed to be related to the presence of somatic cells and other particles in urine; bacteriuria was not always detectable in these cases.

Bacteriuria

The limited utility of BAC for identifying alcohol-related problems among DWI offenders.

To see if blood alcohol concentration (BAC) is a significant indicator of problem drinking or an alcohol-related diagnosis, the relationships between BAC at arrest for drinking and driving, typical drinking, alcohol-related problems, problem drinking and an alcohol abuse or dependence diagnosis were examined for 235 drinking and driving offenders referred for alcoholism evaluation. BAC and typical drinking correlated weakly and no significant relationship between alcohol-related problems and BAC was found. Further, no significant relationship was found between BAC and alcohol abuse or dependence diagnoses, or between problem drinking and BAC. These findings cast doubt on the usefulness of a single report of BAC for diagnostic and screening purposes.

Accidents, Traffic

A protocol for butalbital, aspirin and caffeine (BAC) detoxification in headache patients.

The abuse of the combination drug containing butalbital 50 mg, aspirin 325 mg and caffeine 40 mg (or BAC), is commonly recognized by headache specialists as causing headaches. Despite this widespread problem, there is not a published treatment regimen for the BAC detoxification of patients. I describe such a protocol which was used four times in three patients. These patients fulfilled the diagnostic criteria of the IHS Headache Classification for headaches induced by chronic substance abuse (8.2) and analgesics abuse headache (8.2.2). These patients took between 150 and 420 BAC/month for 2-15 years. Two patients had previously undergone inpatient detoxification. One patient unsuccessfully tried detoxification twice as an outpatient. All patients were required to have psychological support prior to hospitalization for this protocol. BAC was discontinued. A pentobarbital challenge test corroborated butalbital dosage. The patients were given phenobarbital and caffeine which were tapered over several days. Dihydroergotamine (DHE) with metoclopramide was used (Raskin). Propranolol 60 mg bid was started. No narcotics were permitted. After hospital discharge, patients were allowed to continue subcutaneous DHE, as needed. One patient restarted BAC use after 8 months without it. The other two patients were still BAC free 18 and 14 months after detoxification.

Adult

Comparative leukocyte esterase-nitrite and BAC-T-SCREEN studies using single and multiple urine volumes.

The Chemstrip LN and BAC-T-SCREEN filtration systems were used to evaluate 980 urine specimens rapidly for the presence of microorganisms. Multiple volumes of individual specimens were also tested using the BAC-T-SCREEN to determine whether this procedure enhanced test performance. Ninety-nine specimens (10%) could not be processed because of interfering substances or clogging of the BAC-T-SCREEN. Analysis of the remaining 881 samples showed these test results for the Chemstrip LN system: sensitivity, 48%; specificity, 93%; positive predictive value (PPU), 88%; and negative predictive value (NPV), 71%. The BAC-T-SCREEN results using multiple urine volumes were (for 1 mL) sensitivity, 88%; specificity, 98%; PPV, 97%; NPV, 92%; for 2 mL, sensitivity, 94%; specificity, 96%; PPV, 94%; NPV, 96%; for 3 mL, sensitivity, 98%; specificity, 95%; PPV, 93%; NPV, 98%. Analyzing multiple urine volumes permitted detection of 92% of urine samples with colony-forming units of 10(4) or less. The BAC-T-SCREEN system proved superior to Chemstrip LN for detecting microorganisms in urine specimens, and analyzing multiple urine volumes enhanced test sensitivity.

Bacteriuria

Screening for urinary tract infection using Bac-T-Screen bacteriuria device.

The Bac-T-Screen was used to process 795 urine specimens. Tests for urine specimens took slightly more than two minutes. The Bac-T-Screen predicted with 99 per cent accuracy if a specimen was negative for bacteriuria or pyuria. Thus, approximately one half of all carefully collected urine specimens need no further laboratory culture. In addition, the Bac-T-Screen detected bacteriuria with a sensitivity of 96 per cent at the 10(5) CFU/ml level of probability. Pyuria (1 +) was detected with a sensitivity of 98 per cent. The Bac-T-Screen can be used in an office practice as well as in the clinical laboratory.

Bacteriuria

[Locoregional therapy in patients with malignant pleural effusion--two different types of "BAC therapy"].

We used fibrin clot (FC) as a carrier of anticancer drug (AD) to provide a novel therapy for patients with serious malignant pleural effusion. After evacuating the pleural fluid, we enhanced an "FC-AD" formation in the pleural cavity of the patient to prevent this kind of effusion from reaccumulating. In an attempt to enhance FC-AD formation, we used two different procedures; either, fibrinogen/AD/G.T.XIII (procedure I) or fibrin glue/AD (procedure II). G.T.XIII is our newly devised compound drug, composed of biodegradable gelatin (G), thrombin (T) and a blood coagulation factor XIII (XIII). This therapy was termed "Bio-Adhesio-Chemo (BAC) therapy." We conducted BAC therapy 52 times on 44 patients using procedure I and 4 times on 4 patients using procedure II. Complete remission of the effusion was obtained, overall, in 83%, partial remission in 17%, and no non-effective case. The improvement of PS of the patients treated was 73%. Nineteen patients could be discharged with this therapy. Toxic effects with BAC therapy were within Grade 2 in all cases. We could favorably enhance FC-AD formation, in every case, by both procedure I and II. BAC therapy is very promising as a novel cancer chemopleurodesis for patients with malignant pleural effusion.

Antineoplastic Combined Chemotherapy Protocols