These companion volumes have been edited by two of the leading personalities in British obstetrics and gynaecology. Both have made notable contributions to their subjects, and each is an outstanding teacher who has always subscribed to the dictum that teaching needs research and research needs teaching. With such a philosophy inspiring their professional work, it would follow, therefore, that any publication of theirs would be devoid of pedantry. The reader will not be disappointed and will find an original, lucid, and constructive presentation. Their aim has been to present, so far as possible, a description of obstetrics and gynaecology as practised in Britain. It may be pertinently asked in what way British practice differs from that in other countries. The editors have forestalled this question. They believe that in obstetrics the chief modern contribution from Britain has been \" the results of the study of the relation of social and economic conditions to the health of the pregnant woman and the condition of her child.\" In gynaecology it is conservatism that has been the characteristic British contribution. Sir Eardley Holland has been responsible for the general editorship of the volume on obstetrics and has been assisted by 38 contributors selected from almost all the university and teaching centres. Professor Bruce Mayes, of Sydney University, is the sole overseas contributor. Included in this obstetric oligarchy are physicians, paediatricians, anatomists, a psychiatrist, a venereologist, a medical statistician, and a barrister. The co-authors have been allocated subjects in which they are acknowledged experts; thus each chapter is authoritative and at the same time original. Mr. Aleck Bourne has enlisted the help of 21 authors for the volume on gynaecology, and among these is an anatomist, a psychiatrist, a venereologist, and a barrister. He has always emphasized the importance of the basic sciences in relation to clinical medicine ; the reader will appreciate this from the contents and their presentation. It is doubtful whether a general work of this calibre should contain even brief accounts and exiguous illustrations of operations. The excellent chapter on the cervix uteri is impaired by the descriptions (and diagrams) of the operations for amputation of the cervix and trachelorrhaphy. Those who need pictorial assistance for their surgical technique would refer to a tome on operative surgery. Both volumes are illustrated with diagrams and plates of artistic distinction, and the publishers are to be congratulated on their production. The editors have succeeded in their aim. Their task has been sisyphean, but they have produced a magnunm opus which for many years will be indispensable to those who practise obstetrics and gynaecology. W. C. W. NIXON.

https://www.bmj.com/content/bmj/1/4957/29.2.full.pdf

Identification of enterobacteriaceae

Adherence and receptor relationships of Candida albicans.

http://www.diva-portal.org/smash/get/diva2:893673/FULLTEXT01

Towards an integrated phylogenetic classification of the Tremellomycetes

https://mmbr.asm.org/content/mmbr/42/1/161.full.pdf

Genome comparison in yeast systematics: delimitation of species within the genera Schwanniomyces, Saccharomyces, Debaryomyces, and Pichia.

Two standardized enzyme immunoassays for the serological diagnosis of candidiasis were developed. The first one detects antimannan antibodies, while the second one detects mannan with a sensitivity of 0.1 ng/ml. These tests were applied to 162 serum samples retrospectively selected from 43 patients with mycologically and clinically proven candidiasis caused by Candida albicans. Forty-three serum samples were positive for mannan, and 63 had significant antibody levels. Strikingly, only five serum samples were simultaneously positive by both tests. When the results were analyzed per patient, 36 (84%) presented at least one serum positive by one test. For 30 of them, positivity by one test was always associated with negative results by the other test for any of the tested sera. For six patients whose sera were positive for either an antigen or an antibody response, a balance between positivity by each test was evidenced by kinetic analysis of sera drawn during the time course of the infection. Controls consisted of 98 serum samples from healthy individuals, 93 serum samples from patients hospitalized in intensive care units, and 39 serum samples from patients with deep mycoses. The sensitivities and specificities were 40 and 98% and 53 and 94% for mannanemia or antibody detection, respectively. These values reached 80 and 93%, respectively, when the results of both tests were combined. These observations, which clearly demonstrate a disparity between circulation of a given mannan catabolite and antimannan antibody response, suggest that use of both enzyme immunoassays may be useful for the routine diagnosis of candidiasis.

New enzyme immunoassays for sensitive detection of circulating Candida albicans mannan and antimannan antibodies: useful combined test for diagnosis of systemic candidiasis.

The classification of living beings is achieved by delimitation based upon their common properties. For this purpose, characteristics of living organisms should refer to those which have been mentioned or published. During such grouping processes, the morphology and growth, as well as biochemical properties reflecting the intermediate metabolism, are first taken into consideration. While there is no contradiction with respect to the classification of higher plants and animals, the criteria mentioned above are not always sufficient to classify microorganisms which are very minute and simple. Therefore, antigenic properties have been considered for the classification of bacteria, mainly pathogenic, but not as yet for yeasts. Furthermore, the serological characteristics of yeasts presented by several investigators (1, 28) have not been routinely adopted as appropriate tools for the classification as have not the GC contents of the DNA of yeasts (14), the coenzyme Q system (35), and the proton magnetic resonance (PMR) spectra of cell wall polysaccharides (7), although the chemical composition of the yeast cell or cell wall is considered to be of prime importance in indicating the relationships among various yeasts. This paper deals with the experimental results of antigen analyses of yeasts, rapid identification recently performed and serological characteristics in the classification of yeasts.

Serologic aspects on yeast classification.

Several methods designed for the classification of yeasts have been published during the century, and among them the most universal method is that of LODDER & KREGER-VAN •IJ (1952), which is really the most distinctive and elaborate work in the field. LODDER & KREGER-VAN RIJ divided the yeasts into families, subfamilies, tribes and genera, depending upon their ability to form ascospores and their morphology. The genera were then subdivided into species mainly based on biochemical characteristics. Since the characteristics are, however, not necessarily as stable, various difficulties are sometimes encountered in the course of classifying and identifying yeasts. This is especially true when the classification is based on the characteristics alone, although they are regarded as fairly stable in outline. On the other hand, living beings as studied in zoology and botany are skillfully assembled into groups principally based upon distinct morphological differences; there is hardly any discrepancy. However, since microorganisms are minute and too simple to be distinguished on the basis of morphological properties alone, their antigenic characteristics are used as a criterion in addition to morphological and biochemical properties. Apart from higher Eumycetes, which has evolved into complicated forms, only the morphological characteristics were relied upon even in the classification of yeasts, which have minute forms and which closely resemble bacteria. Since the data on morphological properties, however, are not too adequate for use in the classification of yeasts, the ability to assimilate potassium nitrate, to ferment glucose strongly and to form a starch-like compound are used as the criteria. YUKAWA et al. (1928, 1929a, 19295), BENItAM (1931) and several other investigators have indicated that serological characteristics can serve in differentiating various species of yeasts. These informations, however, have been taken only as supplementary means for

Significance of serological studies on yeasts

Rabbit antibodies for Candida albicans, reacting in agglutination and fluorescent-antibody reactions, were present in both IgM and IgG protein fractions. The two types of immune globulins were separated from ammonium sulfate-precipitated gamma-globulin either by filtration through a column of Sephadex G-200 or by diethylaminoethyl column chromatography performed by stepwise elution with various concentrations of sodium chloride. In the fluorescent-antibody test, initial separation of the IgG fraction, prior to its conjugation with dye, proved to be essential for the high specificity of this reaction. Investigation of the specificities of the two types of antibodies revealed that the IgG was highly specific, whereas the IgM was not very specific. Each antigen fraction, extracted by various methods, demonstrated its own characteristic antibody response. Only the IgG fraction yielded serotype-specific antibody useful for detection of a serotype of C. albicans in agglutination and fluorescent-antibody tests. The results indicate the importance of IgG for specific serological reactions with the Candida species.

Response and Specificity of Antibodies for Candida albicans

Serological identification tests were carried out with many strains obtained from an otolaryngologic clinic, from oral cavities of dental patients and from other laboratories. The tests were performed through the slide agglutination method using monospecific or absorbed antisera based on the antigenic structures. The results of serological tests were compared with biological identifications. Since serological identifications alone were found to coincide well with the correlative identifications by biological and serological methods, it is concluded that the identification test using monospecific antisera, based on the antigenic structures of the genusCandida, is a useful and reliable method for a rapid identification of species.

A method for the rapid identification of the genus Candida.

Publisher Summary This chapter reviews the methodology and application of a serogrouping system, which can be applied to achieve rapid identification and reliable classification of yeasts. For the rapid and reliable identification of yeast species, serological investigations have become as important in clinical, biological, and industrial laboratories as in bacteriology. Because yeast species have specific antigenic structures, they can be identified by slide agglutination. The diagnostic antisera can be prepared by a researcher in the laboratory or commercially available reagents can be used, at least for the nine medically important Candida species. On the other hand, some yeast contaminants in beer can be detected by slide agglutination with absorbed antisera. Results to this effect have been confirmed by indirect fluorescent antibody techniques. However, reagents for the agglutination of yeasts of a primary industrial concern are not yet commercially available, probably because of the lack of demand from factories. Various immune reactions with sera from patients can be performed for clinical diagnosis of the systemic opportunistic infections.

Takeshi Tsuchiya

Papers

Serologic aspects on yeast classification.

Significance of serological studies on yeasts

Response and Specificity of Antibodies for Candida albicans

A method for the rapid identification of the genus Candida.

3 Serological Characterization of Yeasts as an Aid in Identification and Classification