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On the background of the EU Directve 92 46 resp. the German MilchVO '95 5 ; it should be shown whether the demanded maximum values for S.aureus in raw milk and raw milk soft cheese are realistic under practical conditions. This concerns especially the multiplication of S.aureus and the production of enterotoxins and TNase. For this purpose enterotoxin producing reference strains in different initial counts were experimentally inoculated in raw ex-farm bulk milk for manufacturing raw milk camembert cheese. Besides the varying S.aureus counts different starter concentrations and activities were used. The increase of S.aureus counts during the first day of manufacturing was also described by others 12, 13, 14 ; and may be explained besides the multiplication by a physical enrichment by the cheese curd 15, 16 ; . Generally, this phenomenon depends on the kind of cheese and its stage during ripening and storage. In hard cheese a decrease is usual 16, 17 ; while at a higher water activity in soft cheeses counts of 106 - 107 cfu g were observed 18, 19 ; . In the beginning of manufacturing the concentration and activity of starter cultures have a clear effect on the multiplication of pathogens 16, 20, 21, ; . In our experiments the concentration seems to have a more distinct influence than the activity. When low concentrations and or low activities were used yet in the early stage of manufacturing S.aureus counts of 106 cfu g can be reached. Especially, under non-professional conditions on farms this may happen. The counts of S.aureus in our experiments exceed by far the maximum M ; of 10, 000 cfu g as it demanded in the EU Directive 92 46. These counts in any case are high enough to produce detectable amounts of enterotoxin 2 ; . The described relation of TNase- and enterotoxin production regarding the S.aureus counts of at least 106 g 2, 16 ; could also be proved by our own experiments as well as the fact that TNase mostly occurs earlier than the enterotoxin 13 ; . In ten from eleven lots enterotoxin could be detected in a more or less early stage of manufacturing. Regarding the standards for raw milk cheese on the level of manufacturing our results show that a maximum M ; of 10, 000 cfu g acc. to the EU Directive easily may be exceeded latest at the end of the ripening . Similar results were obtained from examinations for Brie and red smear cheese produced from naturally contaminated raw milk in dairy plants 23 ; . For the postulated examination for toxins if M is exceeded, therefore, the TNase test as a rapid and reliable screening can be recommended. Summing up, from our experiments it could be demonstrated that during the manufacturing process even at "allowed" counts of S.aureus in the milk may lead to a multiplication which enables the production of detectable amounts of enterotoxins. The methods used in the presented paper are feasible and reliable also for routine laboratories to fulfil the demands of the EU Directive and
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Neuroblastoma NB ; is one of the most frequent solid tumors in children and NB in children over one-year-old is known to be very difficult to cure even with stem cell transplantation. It has been observed that NB in some infants regresses spontaneously and its mechanism has not yet been elucidated. NB is derived from a neural crest which also derives malignant melanoma for which immunotherapy has already been established after identification of melanoma-associated tumor specific antigens such as gp100, MART-1 Melan-A, tyrosinase and MAGE-1. It is possible that some immunological mechanism may play a role in the behavior of infant NB. Currently, we are preparing a gene therapy for recurrent neuroblastoma. In collaboration with Dr. Malcolm Brenner at Baylor College in Houston, USA, we plan to use a tumor vaccine transduced with IL-2 and lymphotactin. It was shown that the vaccination of neuroblastoma cells transduced with IL-2 into patients with relapsed neuroblastoma exerted regression of tumors. It is possible that gene-transduced neuroblastoma cells may become immunogenic and evoke an antitumor effect of the body. The addition of lymphotactin to IL-2 is expected to attract lymphocytes to the vaccinated neuroblastoma cells. Preclinical experiments showed the feasibility of this therapy. The institutional review board and the committees of the government already approved the protocol. We started enrollment of the patients and
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1.2. The degree of completeness and timelines for the national drug coding project and its potential usefulness to application developers and drug information resources 1.3. The data outputs from the EAN repository and an analysis of the degree of manipulation required to produce a basic drug formulary, which could be used as the basis of a national drug terminology. The UK NHS could be requested to provide access to the team who have developed the structure of their national drug terminology to conduct the above evaluation. 2. Exploration of the potential to build on existing drug databases used in Australia to create an interim standard drug terminology which can be linked with the EAN drug identification system. This project would create a map to the drug databases of systems which support its development. Subject to the outcomes of the above investigation, it is likely that this work would work in cooperation, but parallel to the development of the EAN drug information repository. Alternatives to be considered: Subject to the result of the review of current Australian and NZ work, wait for the outcomes of the current developments prior to planning an extension to support decision support and hospital applications. This is unlikely to meet the expressed industry need for standardisation to support integration of drug information. Selection of an existing drug information resource to provide a standard terminology. This option was rejected in 1999 due to the difficulties of achieving agreement on this approach given the competitive nature of the drug information market, and the failure to identify any particular system which met the basic design requirements for a standard drug terminology. This situation may need to be reviewed given the time and system developments which have occurred since. What is being done now? This analysis should draw on the experience of the UK M edicines Drug Dictionary Project which has been developed to support all of the above clinical requirements. Australia has been participating in an international workgroup with the US health department and UK NHS to explore the drug terminology models and drug dose forms used in various countries. Clearly the outcomes of the M edicines Coding Council work and current DoHA activities need to be considered as discussed above. New Zealand has had a system of standard drug codes for some years, however it is not clear to what extent this constitutes a drug terminology. What are the expected outcomes? Development of a drug terminology meeting the needs of all sectors using computer systems for drug information management. Identification of the degree to which current drug vocabulary work meets the needs of drug information and drug management systems and
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INTRODUCTION Mastitis is still one of the most economically important diseases for the dairy industry worldwide irrespective of the species of animals.1 Mastitis can cause devastating effects to farmers because of the serious economic losses and the danger that the bacterial contamination of milk from affected goats may render it unsuitable for human consumption.2 Contaminated milk can also serve as sources of a number of milk-borne infections to humans. In the various regions of Ethiopia, raw milk of goats is widely consumed mainly by the pastoralists.3 Previous studies conducted in different countries indicated the distribution, causes, and importance of mastitis in dairy goats.4-10 On the other hand there are currently very limited reports on antimicrobial resistance of mastitis pathogens isolated from dairy goats worldwide.11-13 Studies dealing with mastitis and antimicrobial resistance in small ruminants in Ethiopia are also very rare. The present study was undertaken to provide information on the prevalence of clinical and subclinical mastitis in lactating goats in the Southern Rift Valley Region of Ethiopia and to find out the associated bacterial pathogens and their antimicrobial susceptibility patterns to different antimicrobial agents. MATERIALS AND METHODS Study Animals The study was undertaken in Adami Tulu district situated in the Southern Rift Valley Region of Ethiopia, 167 km south of Addis Ababa Ethiopia ; . In the study areas, goats are preferred animals next to cattle, and goat milk is widely consumed. The study animals were randomly selected lactating goats in the district. Out of the total goat population in the district about 85, 365 goats; according to the district's agricultural office ; , 17% are lactating. The predominant goat breeds in the study area are Arsi-Bale breeds, which are managed under an extensive management system by individual.
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Recommendation 4 encouragement and support be given to the conduct of further research into the pharmacological basis for the actions of cannabinoids, and the development of novel synthetic cannabinoids, as licensed medicines which meet current safety and efficacy criteria.
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Center for Blood Research and Department of Medicine, Harvard Medical School, Boston, MA 02115; Unite de Virologie, Institut Pasteur du Cambodge, Phnom Penh, Cambodia; and Cambodian Health Committee, Phnom Penh, Cambodia Received for publication August 14, 2003. Accepted for publication November 11, 2003. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. This work was supported by grants from the National Institutes of Health to A.E.G. ; HL59838 ; and the Campbell Foundation to S.R, for instance, triamcinolone.
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Vided by a hospital under paragraph 1 ; shall be paid within 90 days of the filing of the hospital's most recently filed Medicare cost report. `` 4 ; OPT.
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