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The opportunistic fungus Candida albicans is a major cause of oral and esophageal infections in immuno-compromised patients, individuals on drug therapy, and the chronically ill. Because it has been observed that persons suffering from hyposalivation have an increased prevalence of oral candididiasis, we developed an animal model of infection based on hyposalivation. The objectives of our studies were to understand the mechanisms by which C. albicans causes oral disease and to begin to elucidate the role played by saliva in controlling C. albicans in the oral cavity. Our results showed that (i) oral Candida infection was established by a small challenge inoculum, (ii) mucosal lesions developed in the oral cavities and esophagi of infected rats, and (iii) transmission of oral Candida infection from an inoculated rat to uninoculated cagemates occurred rapidly. In addition, we compared the abilities of a clinical isolate and a spontaneously derived morphological mutant from that isolate to infect hyposalivatory rats and to induce disease. Infection was induced by the morphological mutant in hyposalivatory rats; however, the morphological mutant took significantly longer to transmit oral infection to uninoculated cagemates than did the parental strain.

The mucosal exudate from the gastrointestinal tract of six adult female New Zealand rabbits was studied using scanning electron microscopy and without any attempt being made to clean the luminal surface before screening. The exudate consisted of mucus, debris and bacteria. Qualitative assessment showed that the nature and distribution of exudate varied along the length of the gastrointestinal tract from the oesophagus to the anal canal, with little variation from animal to animal. Bacterial counts for rod-shaped bacteria were carried out on areas randomly selected from the upper, middle and lower oesophagus and the oesophageal-cardiac junction. The degree of bacterial colonisation was found to decrease along the length of the oesophagus from upper to lower parts, but it was increased at the oesophageal-cardiac junction. This assessment was not undertaken in the other regions of the gastrointestinal tract as the mucosal surface areas could not be easily measured owing to their undulating nature. The study indicates the variability of the mucosal exudate, which should be recognised as part of the true interface between ingested food and the cell surface along the gastrointestinal tract.

Uptake, replication, and transneuronal passage of a swine neurotropic herpesvirus (pseudorabies virus, PRV) was evaluated in the rat CNS. PRV was localized in neural circuits innervating the tongue, stomach, esophagus and eye with light microscopic immunohistochemistry. In each instance, the distribution of PRV-immunoreactive neurons was entirely consistent with that observed following injection of cholera toxin-horseradish peroxidase conjugate (CT-HRP). Injections of the tongue resulted in retrograde transport of PRV and CT-HRP to hypoglossal motor neurons, while preganglionic neurons in the dorsal motor vagal nucleus or somatic motor neurons in the nucleus ambiguus were labeled following injections of the stomach or esophagus, respectively. At longer times after infection, viral antigens were found in astrocytes adjacent to infected neurons and their efferent axons and second-order neuron labeling became apparent. The distribution of second-order neurons was also entirely dependent upon the site of PRV injection. Following tongue injection, second-order neurons were observed in the trigeminal complex, the brain-stem tegmentum and in monoaminergic cell groups. Injection of the stomach or esophagus led to second-order neuron labeling confined to distinct subdivisions of the neucleus of the solitary tract and monoaminergic cell groups. Comparative quantitative analysis of the number of PRV immunoreactive neurons present in the diencephalon and brain stem following injection of virus into both the eye and stomach musculature of the same animal demonstrated that retrograde transport of PRV from the viscera was more efficient and occurred at a much faster rate than anterograde transport of virus. These data demonstrate projection-specific transport of PRV in the nervous system and provide further insight into the means through which this neurotropic virus infects the nervous system.

Endoscopic signs of esophageal fungal lesions were established in 7.5% of patients with chemical impairment of the gastrointestinal tract on day 10-15 since the burn. Endoscopically, there were two forms of the esophageal lesion. To make the diagnosis more reliable, specific evidence at endoscopy and bacterioscopy should be used while the differential diagnosis should be based on biopotentialometry. Early diagnosis of fungal involvement may provide better response in the treatment of patients with chemical burns.

Colony counts and light microscopy were used to assess the capacity of Candida albicans to colonize, infect the alimentary tract, and cause disseminated disease in athymic (nu/nu), euthymic (nu/+), beige (bg/bg), black (bg/+), beige athymic (bg/bg nu/nu), or beige euthymic (bg/bg nu/+) germfree mice. The alimentary tracts of all six genotypes of germfree mice were quickly colonized after exposure to yeast-phase C. albicans. Only bg/bg nu/nu mice showed obvious morbidity and mortality after mucosal colonization with C. albicans. Histopathology of C. albicans-colonized immunocompetent (nu/+, bg/+) and singly immunodeficient (nu/nu, bg/bg, bg/bg nu/+) mice showed minimal to moderate mucosal infections, whereas doubly immunodeficient (bg/bg nu/nu) mice showed extensive yeast and hyphal infection of the palate, tongue, esophagus, and stomach. A progressive systemic infection in C. albicans-colonized mice occurred only in bg/bg nu/nu mice 12 to 16 weeks after colonization and mucosal infection. Thus, it appears that a combination of defective cell-mediated immunity and phagocytic cell defects (polymorphonuclear leukocytes and/or macrophages) predisposed mice to severe mucosal and systemic candidiasis of endogenous origin. This is the first report of a mouse strain that is not only naturally susceptible to mucosal and systemic candidiasis of endogenous origin but also shows lethality at early (1 to 4 weeks) and late (12 to 16 weeks) times after alimentary tract colonization.

This report describes a patient with a 2-wk history of epigastric pain and dysphagia, and a mid-esophageal ulceration resulting from infection with Mycobacterium tuberculosis. This is an uncommon site of tuberculous involvement, and usually results from direct extension from adjacent mediastinal or hilar lymph nodes, reactivated lung infection, infected vertebral bodies or aortic aneurysms, or from extension from the pharynx or larynx. The endoscopic lesion is ulcerative, with shallow, smooth edges, granular, with small mucosal miliary granulomas, or hyperplastic, with fibrosis, luminal narrowing, and stricture formation. The patient responded well to antituberculous therapy, and is healthy 4 yr after therapy.

To investigate the value of Papanicolaou-stained endoscopic brush samples in the diagnosis of Campylobacter pylori infection of the upper gastrointestinal tract, 138 brush and biopsy samples from the esophagus, stomach, and duodenum, taken concomitantly, were reviewed retrospectively. In 35 cases, Campylobacter-like organisms (CLOs) were found in both cytology and biopsy samples. In 15 cases, CLOs were seen in biopsy material only, and in 8 cases, CLOs were found in cytology material only. CLOs were found in 49% of the gastric specimens and 33% of the Barrett's esophagus specimens by histologic or cytologic examination or by both methods. CLOs were found by at least one method in 64% of the gastric samples with active gastritis 40% with borderline gastritis, 15% without gastritis, and in 64% with adenocarcinoma. Cytologic examination of endoscopic brush samples is a valuable technique for the diagnosis of gastric Campylobacter infections and can be performed easily in cytopathology laboratories.

In 79 patients, with carcinoma of the oesophagus, oesophageal aspirates obtained at oesophagoscopy were cultured for aerobic and anaerobic organisms in an attempt to identify the microbial flora. The aspirate culture was correlated with the pathogens isolated when infective complications developed after operation. Bacteroides were isolated from the oesophagus in 39.2% of patients, streptococcus in 10.1% and coliform organisms in 7.6%. No growth was obtained in 35.4% patients. Forty-one patients underwent oesophageal resection. Six of these had the complication of empyema thoracis in the postoperative period. Two patients had identical organisms isolated from the oesophagus and the empyema. B. melaninogenicus was cultured from the pleural fluid in two patients whose oesophageal aspirate culture yielded no growth. Six patients developed wound infection, all with anastomotic cutaneous fistula. There was no demonstrable relationship between the organisms isolated from two sources. Prophylactic antibiotic administration should be directed against the bacteroides, since it is the most common organism isolated from within the oesophagus.

Eight strains of lactobacilli isolated from conventional mice, rats, fowls, and pigs were tested for their ability to colonize squamous epithelia in the gastrointestinal tracts of gnotobiotic animals. Two of the strains isolated from rodents could colonize the nonsecretory epithelium of the stomach of gnotobiotic rodents, and one strain isolated from a fowl could colonize the crop epithelium of gnotobiotic chickens. The specificity of colonization of squamous epithelia by lactobacilli was demonstrated by these in vivo studies; strains of lactobacilli isolated from rodents could only colonize rodent epithelium; the strain from a fowl could only colonize crop epithelium.

Donor cattle infected with foot and mouth disease (FMD) virus subtype O1 were used to expose experimental cattle. The pharyngeal virus growth and viraemia patterns after contact exposure were quite different from those obtained after intranasal inoculation and suggested that the lower respiratory tract might provide an additional portal of entry for the virus. A tracheotomy was performed on experimental cattle to let the respiration bypass the pharynx, followed by exposure to FMD virus by different routes. The results confirmed that FMD virus can enter the bloodstream via the lung, followed by haematogenic infection of the pharynx and other replication sites simultaneously. These observations led to further experiments in which the intravenous route of infection was used to study the interaction of virus growth in the phayrnx, in other sites, and in viraemia.

The microbial colonization of the oropharynx, the esophagus and the stomach were studied in 60 patients. Patients with gastritis, carcinoma and a history of gastric resection harboured more microorganisms in their stomachs than patients with gastric or duodenal ulcers. Patients with gastric carcinoma were colonized with the highest numbers of different microorganisms.

Cytomegaloviruses (CMV) were recovered from lung tissue in 34 (6.8%) of 502 unselected autopsy cases. Inclusion bodies were detected in the lung in nine of these cases (26%) and in organs other than the lung in three others. Overall, the incidence of inclusion bodies in this series of 502 cases was 2.4%. Our data strongly indicate that virus isolation is more sensitive than histopathologic study in establishing the presence of CMV infection. However, CMV was not recovered from one kidney and one liver in which inclusion bodies were present, although the virus was isolated from lung. Four of five cases of renal allograft rejection were positive for both CMV and inclusion bodies. The incidence of CMV recovery and inclusion body detection in leukemia and lymphoma cases was more than twice that in cases with other diseases. CMV inclusion bodies with or without associated inflammation were found, in descending order of frequency, in the lung, kidney, liver, pancreas, adrenal gland, esophagus, prostate, testes, thyroid gland, parathyroid gland, stomach, small intestine, large intestine, and heart.

A qualitative and quantitative study was made of 2 adult horses to determine the effect of specimen preparation and the influence of anatomically separate regions on the microscopic structure of the esophagus. The effects of 3 fixative solutions (formalin, Bouin's fixative and Karnovsky's fixative) and 4 histologic staining procedures (hematoxylin and eosin, Gomori's trichrome, Laidlow's reticulum, and orcein-elastin) were compared. Density-dependent image analysis was used to compare the relative contributions of elastic and reticular fibers in esophageal connective tissue for each region. Cross-sectional dimensions of the tissue layers which comprise the esophageal wall were obtained by light microscopic measurement and were compared for each region. The mucosal surface structure was examined by scanning electron microscopy. Our results indicate that specimen preparation has significant effects on the structural integrity of esophageal tissues. Bouin's fixative was inferior to the other fixatives in this regard. Furthermore, there are extensive regional differences in esophageal microstructure. Formalin-fixed tissues stained with either hematoxylin and eosin or Gomori's trichrome appear the most suitable for routine quantitative morphologic studies of the equine esophagus.

Eight strains of lactobacillus isolated from the porcine gastrointestinal tract were tested for their ability to adhere in vitro to cells collected from stratified squamous epithelium in the digestive tracts of newborn piglets. Piglets were inoculated with individual strains, and their digestive tracts were sampled at intervals to determine the colonizing ability of the lactobacilli. The results of the in vitro test did not predict whether a lactobacillus strain would associate with stratified squamous epithelium in the piglet digestive tract, but epithelial association in vivo appeared to be an important factor in the maintenance of lactobacillus populations in the tract. None of the lactobacillus strains used as inocula was numerically dominant in the tract 7 days after inoculation of the piglets with a single dose of the bacteria.

A hypothesis linking the concept of mucosal immune surveillance (Langerhans' cells and intra-epithelial lymphocytes) with recent evidence of human papillomavirus (HPV) infection of the oesophagus in a sequence of events which leads to squamous dysplasia and invasive carcinoma is presented. It is believed that the essential pathway to squamous carcinoma involves an aberration of the Langerhans' cell/lymphocyte network and its symbiotic relationship with squamous cells as a result of persistent HPV infection in the epithelium. Neoplastic transformation may occur when this 'at-risk' mucosa is exposed to one or several co-carcinogenic factors present in the environment. This hypothesis is supported by morphological changes present in acanthotic lesions of the oesophagus and by immunocytochemical evidence of HPV infection of the mucosa. In addition, this viewpoint offers a possible explanation for the regional variation of oesophageal carcinoma, the rising incidence of the disease, and the association with multifocal squamous carcinomas of the upper aerodigestive tract.

We report the electron-microscopic appearances of tissues from an immunocompromised patient who died of chickenpox. We observed structures consistent with some of the reported appearances of Varicella-Zoster virus in cultured cells, and tubular structures that have not to our knowledge been previously described.

Avian pox was determined to be the cause of death of a spectacled Amazon parrot (Amazona albifrons). Intracytoplasmic inclusion bodies were visualized by light microscopy in esophageal and bronchial epithelial lesions. Electron microscopy revealed pox-virus virions in the inclusions.

Histological examination of oesophagus and stomach specimens from 28 guinea pigs (Cavia porcellus) revealed microbes associated with the epithelial surface of these organs. Layers of Gram-positive cocci were associated with oesophageal tissue in all the animals. Yeasts (Torulop-sid pintolopesii) were associated with stomach tissue in most animals 1 week of age or older.

Infectivity and dot-blot hybridization techniques were compared for the detection of FMDV in esophageal-pharyngeal fluids from experimentally infected cows. The probe used includes the viral polymerase sequence which allows the detection of the three types of virus (A, O, and C) with equivalent sensitivity. Virus was detected by dot-blot hybridization as well as by infectivity, according to sample analysis of esophageal-pharyngeal fluids extracted seven days post-infection. It was not possible to recover infective virus from some samples extracted at 180 and 560 days post-infection, although specific viral RNA was detected by dot-blot hybridization. This could indicate the presence of a high ratio of non-infective viral mutants in FMDV carrier cattle. These results emphasize the usefulness of molecular hybridization techniques for FMDV carrier-state detection.

Campylobacter pylori organisms were found with similar frequency in the stomachs of patients with Barrett's esophagus and in age- and sex-matched controls (10 of 26 vs. 11 of 26). Campylobacter pylori was also observed in esophageal Barrett's mucosa in some patients with gastric C. pylori, but not when gastric infection was absent (4 of 10 vs. 0 of 16). Campylobacter pylori was not detected in esophageal squamous mucosa from patients with Barrett's esophagus or in 25 non-Barrett's patients with gastric C. pylori and histologic changes of esophageal reflux. Overall frequency of ulceration in Barrett's esophagus was 35% (9 of 26), and frequency of ulceration was similar whether or not C. pylori was noted in gastric or Barrett's mucosa.

One hundred and three gastroscopic biopsies from 80 patients were cultured for Campylobacter pyloridis and studied histologically. Active chronic gastritis, as shown by the presence of polymorphonuclear leucocytes, was diagnosed in 51 biopsies and C pyloridis was found in 47. Sixteen gastric biopsies showed normal histology (no inflammation); C pyloridis was detected in only one of these, and a second biopsy taken from this patient at the same time showed active gastritis. Biopsies could be kept at 4 degrees C for five hours without loss of viability of C pyloridis. An inoculum made by grinding the biopsy in a ground glass grinder consistently gave a much heavier growth of C pyloridis than one made by mincing the specimen. The campylobacter supplement ferrous sulphate, sodium metabisulphite, sodium pyruvate (FBP) (Oxoid) was inhibitory for some isolates; the inhibitory component was found to be sodium metabisulphite. Contaminants, but not C pyloridis, were inhibited by the incorporation of vancomycin 6 mg/l, nalidixic acid 20 mg/l, and amphotericin 2 mg/l, but higher concentrations inhibited C pyloridis. Undried plates kept in a plastic container at room temperature for up to two weeks were as satisfactory as freshly poured plates for the isolation of C pyloridis.

Puzzling rodlike structures overlying benign squamous cells in exfoliative cytologic specimens from the upper gastrointestinal and respiratory tracts were initially considered to be fungi, protozoa, bronchodilator crystals, hemoglobin tactoids or plastic fragments. Their morphologic similarity to Simonsiella, a gram-negative bacteria frequently found in the oral cavity, was ultimately recognized. Further studies of smears and cultures obtained from the oral cavities of the authors and from the American Type Culture Collection confirmed the nature of the original findings. These giant bacterial forms were usually found in caterpillarlike side-by-side arrangements of 10 to 12 organisms. Cytologists should be aware of their appearance to avoid possible confusion with pathogenic organisms.

The bacterial contamination of porcine oesophagi immediately after collection (100 samples) and of frozen just before preparation (40 samples) was assessed. The fresh oesophagi were found to show a rather high degree of contamination: aerobic count approximately 10(6)-10(7) and Enterobacteriaceae approximately 10(3)-10(4)/g. The frozen oesophagi showed even higher counts: total aerobic counts approximately 10(7)-10(8) and Enterobacteriaceae approximately 10(4)-10(5)/g. Hygiene during the collection of porcine oesophagi was visually assessed in six abbratoirs and found to be satisfactory in two, mediocre in three and poor in one. The effects of processing the oesophagus by cleaning and removing the mucous membrane on bacterial counts, pH, colour and odour were assessed before and during storage at 4 degrees C. and 20 degrees C. Both cleaning and removal of the mucous membrane caused up to a tenfold reduction of bacterial counts. After seven days' storage at 4 degrees C., the bacterial counts of the processed oesophagi were significantly lower than those of the non-processed oesophagi (p less than 0.01). The processed oesophagi stored at 4 degrees C. were four days' storage.

Serological evaluations of foot-and-mouth disease type SAT 2 viruses isolated in Kenya between 1979 and 1982 were performed using the two-dimensional microneutralization test. Nine field isolates of epizootiological significance were compared with four vaccine viruses. The results obtained identified Tan 5/68 as the most appropriate reference vaccine virus strain since it had the broadest serological spectrum. Potent Tan 5/68 vaccines would be expected to provide adequate protection against the contemporary SAT 2 field viruses. In the case of K183/74, which also was shown to have a broad spectrum with viruses isolated in Kenya, the results show that the 1982 isolate from central Kenya was significantly divergent (r less than 1.00 at P = 0.01) and warranted tactical revaccination for its control. The study highlighted the fact that strain R1215 which had been isolated from the oesophageal-pharyngeal swabs of asymptomatic carrier cattle had a narrow serological spectrum suggesting that such viruses could be unsuitable as vaccine for the national campaign.

Non-immunized, vaccinated, and recovered cattle were inoculated intranasally with various doses of foot-and-mouth disease virus. Samples of oesophageal-pharyngeal (OP) fluid were taken periodically for up to 7 days after inoculation and virus titres of these samples were plotted as pharyngeal virus growth curves. In non-immunized cattle, the length of the lag period and of the growth period were inversely proportional to the dose of virus given. Maximum titres were observed when clinical signs were first detected. Three of the 10 cattle studied had virus growth rates that were lower than rates of others given the same dose of virus, and clinical signs appeared later than expected in these three cattle. Cattle vaccinated with an inactivated virus oil-adjuvant vaccine had pharyngeal virus growth curves that were similar to those obtained from non-immunized cattle for 30 h. after inoculation. Titres of virus in OP fluid samples taken 2-7 days after inoculation were substantially lower in cattle with a high pre-exposure serum mouse protection index than titres from partly-immunized or non-immunized cattle. Nine of 14 cattle had detectable but reduced virus growth after intranasal inoculation with homologous virus. Five recovered cattle inoculated with heterologous virus reacted similarly to non-immunized animals.

In a search for group B streptococci, vagina and urethra of 196 pregnant women entering the delivery room were cultured using a selective medium. Sixteen (8.2%) were positive. Fifteen (15%) of 101 nonpregnant women cultured similarly during a clinical consultation were positive. Esogastric aspiration fluid of 199 neonates from the former group of women was also cultured: 8 (4.0%) were positive. Thus, maternal genital colonization was accompanied by neonatal contamination in 7 of 16 cases (43%). Typing of the streptococci revealed identity between all maternal and neonatal isolates tested. These values are comparable with those obtained in other countries. Their epidemiological implications and the prophylaxis and therapy of the neonatal disease are discussed.

The pandemic, acquired immunodeficiency syndrome (AIDS) has been described in 40 nations throughout the world. This paper describes the wide spectrum of gastrointestinal tract manifestations seen in this syndrome, with particular attention to the epidemiology, etiology, and measurement of these problems. Discussion of candidiasis, herpes simplex, "hairy" leukoplakia, Kaposi's sarcoma, cytomegalovirus, anal warts and carcinoma, chlamydial proctitis (LGV), coccidiosis, and mycobacterial diarrhea, as well as "gay bowel syndrome," demonstrates the complex management problems associated with this condition.

The course of experimental infection of a type SAT 1 FMDV strain was studied in buffalo, sable antelope and eland following tongue inoculation and contact and has been compared with that in cattle. All species became infected, although disease was less severe in the game animals and larger amounts of virus were required to infect game animals than cattle. Neutralizing antibody titres were high and were maintained for an extended period in buffalo, sable antelope and eland. The carrier state was demonstrated in buffalo for the longest period. Cattle carried virus for up to 56 days. Virus persistence in sable antelope was transitory and did not occur in eland.

Since 1968, a total of 84 patients with bullous pemphigoid have been seen at the Mayo Clinic. Of these, 41 were given a trial of sulfapyridine or dapsone, and six showed a significant response. In five patients, the condition was controlled completely. All responsive patients showed indirect and direct immunofluorescent tests indistinguishable from typical bullous pemphigoid. The patients, however, were somewhat younger (mean 54 years) than others having pemphigoid; and in two patients, biopsy specimens showed a reversal of the usual eosinophilic predominance over neutrophils. Three of the six patients were also diabetic.

Biomaterials are essential for life support and monitoring of critically ill patients, but their use increases the risk of nosocomial infection. Of the various plastics used for life support and monitoring devices, polyvinylchloride is one to which bacteria most readily adhere. Through the use of qualitative culture techniques and scanning and transmission electron microscopy, we studied the surfaces of polyvinylchloride endotracheal tubes removed from 25 ICU patients, to determine if bacterial adhesion to those tubes was sufficient to provide a possible source for repeated contamination of the tracheobronchial tree. Of the surfaces studied, 16% were partially covered and 84% were completely covered by an amorphous bacteria-containing matrix. Some biofilm-enclosed bacterial aggregates projected from the matrix into the lumen of the tube. The mechanism by which endotracheal tubes repeatedly inoculate the lungs of intubated patients may prove to be dislodgment of such aggregates by suction apparatus.

Our experience with the cytology of esophageal brush specimens from patients who did not have either gastric or esophageal cancer but who received a variety of chemotherapeutic agents is reported. Ten patients received chemotherapy alone, and nine received combined chemotherapy and radiation therapy. Of the ten patients, three showed evidence of moderate to severe epithelial atypia, which was not seen in the combined treatment group or the control group. The cytologic atypias in the three patients consisted of variation in nuclear size with crowding and overlapping, an increased nuclear-cytoplasmic ratio and multiple nucleoli, many of which varied in size and shape. There was also evidence of cell death and keratinization. Although these patients had not been irradiated, other striking changes were similar to those seen following radiation therapy. The cytologic changes reported here pose a serious diagnostic problem because they may be so severe as to mimic malignant transformation. Evidence of infection by herpes simplex alone or herpes simplex associated with Candida was seen in 32% of the treated patients and in 4% of the control group.

The virus growth in the pharyngeal area and the virus excretion in milk of susceptible and vaccinated dairy cows after intranasal instillation of foot-and-mouth disease (FMD) virus type O1 were examined. Ten vaccinated cows were purchased through a market. Of these, nine had delivered their first calf. The cows were inoculated 2-9 months after having received the last dose of vaccine. All vaccinated cows resisted the intranasal challenge. The virus multiplied in the pharyngeal area but, compared with two susceptible controls, to a limited extent. No clear relation was found between virus growth and the titre of circulating neutralizing antibody at the time of challenge. Virus was first detected in milk samples of the susceptible cows when generalized FMD lesions had developed on day four; the excretion lasted for 3-4 days. Up to 19 days after inoculation untreated milk of the vaccinated cows was examined for the presence of infectious FMD virus. Samples were inoculated onto cell cultures, fed to susceptible pigs and calves and injected intramuscularly and/or intradermolingually into susceptible steers. No infectious FMD virus could be detected, either in cell cultures or in susceptible animals. The animals did not develop neutralizing antibody against FMD virus and were subsequently shown to be fully susceptible to challenge. The results are discussed with particular reference to current problems regarding the export of milk products from countries where vaccination against FMD is practised to countries free of the disease.

Two hundred forty-six patients with a wide range of upper gastrointestinal tract disorders were investigated for the presence of Campylobacter pylori infection in esophagus, gastric antrum, and duodenum. C. pylori was identified in 52% of patients in at least one site, and microbiological and histological techniques were used to exclude the presence of the organism. Esophageal infection was not significant and is probably due to reflux. Antral C. pylori was significantly associated with active gastritis and active duodenitis and is possibly pathogenic.

Exophiala jeanselmei was isolated from three esophageal cultures over an 11-month period at Lutheran General Hospital. We believe this provides evidence for a new site of isolation, since previous reports of the organism's incidence were confined to skin and lung. Case 1 is an eight-year-old female with a three-year history of gagging and vomiting. Esophagoscopy revealed a mass biopsied as vegetable material. Case 2 is a 66-year-old retired male with a history of obesity, diabetes and spinal stenosis. Following back surgery, the patient developed odynophagia. Esophageal biopsies showed ulceration and bacterial colonies with no evidence of fungus. Case 3 is a 62-year-old male gardener who is also a nail biter. Esophagoscopy revealed a gastro-esophageal stricture with reflux and evidence of a hiatus hernia. Material biopsied was consistent with Barrett's esophagus and evidence of fungi was seen. The esophageal mass of case 1 and the esophageal brushings of case 2 and 3 grew E. jeanselmei. Aspiration, reflux, and mechanical disruption of the esophageal mucosa are possible predisposing factors in colonization of esophageal lesions by this ubiquitous, normally low virulence organism.

45 patients with acquired immunodeficiency syndrome (AIDS) were studied with gastrointestinal endoscopy (42 upper endoscopies and 12 colonoscopies). 28 patients had skin or buccal Kaposi's sarcoma with or without opportunistic infections and 17 had opportunistic infections. 12 patients out of 45 (27 per cent) had 1 or several Kaposi's sarcoma macroscopic gastrointestinal localisations, 12 documented by upper endoscopy and 4 by colonoscopy. Endoscopic biopsies confirmed the diagnosis 5 times out of 16 (31 per cent). 16 patients (38 per cent) had candidosis oesophagitis, 1 had ulcerative antritis, 2 had a erythematosus duodenitis, 6 had diffuse inflammatory mucosal colonic changes. The specific abnormalities documented by histology were 1 case of total villous atrophy and 2 cases of cytomegalovirus colitis. The patients with cutaneous Kaposi's sarcoma have more often shown gastrointestinal Kaposi's sarcoma than the patients without Kaposi's sarcoma. The prevalence of tumoral or major (diffuse candidosis oesophagitis, ulcerative antritis, active colitis) endoscopic abnormalities documented by upper endoscopy was 40 per cent (10 cases out of 25) in asymptomatic patients, 43 per cent in diarrheic patients (3 cases out of 7) and 60 per cent (6 cases out of 10) in patients with dysphagia, epigastralgic pain or vomiting and that of documented by colonoscopy was 75 per cent (3 cases out of 4) in patients with mucus or bloody stools and 14 per cent (1 case out of 7) in diarrheic patients. The main result of the endoscopy on AIDS patients has therefore been the diagnosis of visceral localisations of Kaposi's sarcoma. The appearance of the secondary major lesions related to opportunistic infections is unusual, especially in asymptomatic patients. A systematic endoscopy on these patients remains a disputed question.

Healthy waterfowl were found to be carriers of duck plague (DP) virus. Black ducks (Anas rubripes) and Canada geese (Branta canadensis) surviving a natural outbreak of DP at Coloma, Wisconsin, in 1973 yielded DP virus in cloacal swabs taken four years postinfection. Experimental infection of previously unexposed mallard ducks (Anas platyrhynochos) with the Coloma strain of DP virus CO-WI (73) also produced cloacal virus shedding for up to four years after infection. A second DP virus strain, LA-SD (73) from the Lake Andes, South Dakota, epornitic, was detected from cloacal swabs of pintail ducks (Anas acuta), gadwall ducks (Anas strepera), wood ducks (Aix sponsa), and Canada geese infected experimentally one year before. The frequency of swabs positive for DP virus varied between individuals within each of the tested species. The amount of detectable DP virus shed was about 100 plaqueforming units of virus percloacal swab. Oral erosions were present in all species tested except Canada geese and gadwall ducks. Erosions occurred at the openings of the sublingual salivary gland ducts. DP virus was isolated from erosions. All ducks with lesions proved to shed DP virus, although not necessarily at the time they had the lesion.

A study of the oesophageal microflora was undertaken in 51 normal adults and in 50 patients with carcinoma of the oesophagus. Aerobic organisms were present in every case. Anaerobic organisms were cultured from 41 (80%) of normal controls and 48 (96%) of patients with carcinoma. The isolation rate of all species of aerobic and anaerobic bacteria was similar in both groups. The antibiotic sensitivities of the oesophageal microflora were examined to determine appropriate antibacterial therapy for patients undergoing oesophageal surgery and for the treatment of oesophageal perforation.

A chick embryo-adapted strain of avian encephalomyelitis virus was inoculated subcutaneously and orally into 40-day-old (middle-aged) and 110-day-old (advanced-aged) chicks to examine the behavior of the virus in the chick body. In the middle-aged chicks, the virus appeared in the muscle at the site of inoculation, liver, spleen, pancreas, lumbar and cervical portions of the spinal cord, and brain 1 approximately 9 days after subcutaneous inoculation, and remained mostly in the central nervous system up to 17 days after the inoculation. The virus was found in large amounts in the muscle at the site of inoculation (10(3.1)), lumbar portion (10(2.5)) and cervical portion (10(2.1)) of the spinal cord, brain (10(1.9)), and in minute amounts in the other organs examined. It appeared in 11 of 21 organs examined. In the middle-aged chicks inoculated by the oral route, the virus was detected transiently in small amounts from esophagus, pancreas, and rectum 4 approximately 14 days after inoculation. In the advanced-aged chicks inoculated by the subcutaneous route, the virus was detected in titer of 10(2.1) approximately 10(3.0) from the muscle at the site of inoculation 2 approximately 7 days after inoculation. The virus was also found sporadically in several organs up to 17 days after inoculation. In the advanced-aged chicks inoculated by the oral route, no virus appeared in any organ, but these chicks turned to be weakly positive for neutralizing antibody in the 4th or later week after inoculation.