given at an infusion rate of 0 6 ml/hour for periods ranging from 30 minutes to 12 hours. During infusion the rats had free access to pelleted food and water. After the infusion blood was sampled for plasma amylase and lipase measurements and pancreatic tissue samples were excised for light and electron microscopic 1138 on 10 May 2018 by guest. Protected by copyright.

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ceptible, although resistance can develop rapidly to this agent (10). MATERIALS AND METODSA total of 168 clinical isolates of Streptococcus pneumoniae were obtained from patients with pneumococcal bacteremia, pneumonia, meningitis, and otitis, and from nasopharyngeal carriers during surveys for resistant pneumococci. Pneumococci were identified by their colonial morphology on blood agar plates, optochin sensitivity, bile solubility, and capsular typing with antipneumococcal serum (Statens Seruminstitut, Copenhagen, Denmark) (2). Strains were isolated in our laboratories from blood, cerebrospinal fluid, or nasopharyngeal swabs or were referred to us from other laboratories for serotyping and susceptibility testing. All resistant strains were isolated from patients in Johannesburg and Durban, South Africa. The strains chosen were selected to represent as complete a spectrum as possible of susceptibility to the antimicrobial agents selected and to include as many intermediate resistant strains as were available.MIC determination Minimal inhibitory concentrations (MICs) were determined by the plate incorporation method (15) in 9-cm plastic petri dishes containing 19 ml of Muelier-Hinton agar (lot no. K9DFNG; BBL, Cockeysville, Md.) and 1 ml of lysed horse blood, giving a concentration of 5% blood. Anti-

The 14.2% of COPD estimated prevalence indicates that COPD is a common disease in the Lisbon region. In addition, a large proportion of underdiagnosed disease was detected. The high prevalence of COPD with a high level of underdiagnosis, points to the need of raising awareness of COPD among health professionals, and requires more use of spirometry in the primary care setting.

Strains of Streptococcus pneumoniae resistant to penicillin have been reported from several countries around the world. Many South African isolates, in addition, exhibit resistance to tetracycline, chloramphenicol, erythromycin, clindamycin, and cotrimoxazole in varying patterns. A qualitative test of the ability of antibiotic-resistant pneumococci to inactivate penicillin, oxacillin, cephalothin, cefoxitin, chloramphenicol, tetracycline, minocycline, erythromycin, clindamycin, streptomycin, gentamicin, and cotrimoxazole revealed that only chloramphenicol was degraded. This finding was confirmed in a quantitative test in which the residual antimicrobial activity of broth containing chloramphenicol in subinhibitory concentrations was determined after incubation with antibiotic-resistant bacteria. Chloramphenicol resistance was shown to be associated with the production of inducible chloramphenicol acetyltransferase. No beta-lactamase activity was demonstrated. Plasmid deoxyribonucleic acid was not demonstrable in partially purified lysates of antibiotic-resistant strains of S. pneumoniae .

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