During the last 5 years, major advances have been made in our understanding of the pathogenesis of human immunodeficiency virus (HIV) disease and in the development of new potent antiviral agents. With regard to HIV pathogenesis, several recent observations have not only changed our perspectives of HIV disease, but have been critical for the design of therapeutic strategies.

It has become commonplace to say that the decline of rheu matic fever in Europe and North America has little, if any thing, to do with medicine; but to conclude that efforts to control the disease are futile would be an error leading to what could be termed public health malpractice. The need for adequate treatment of patients suffering from acute rheu matic fever or chronic rheumatic valvular heart disease is obvious; but control also means prevention, and here, too, the need is obvious, if only to lighten the burden on health care, due especially to the treatment of patients with advanced forms of the disease. The feasibility of and justification for rheumatic fever control programmes in developing countries has been often questioned. A co-operative study co-ordinated by the World Health Organization has now demonstrated that systematic prevention of rheumatic fever recurrences not only benefits the patients concerned but also has economic advantages. Primary prevention by systematic penicillin treatment of all streptococcal throat infections is at present beyond the reach of many health care systems, and anti-streptococcal vac cination is still in the research phase. The mainstay of the combat against rheumatic heart disease thus remains 7 RHEUMATIC FEVER secondary prevention - the long-term monthly administ ration of penicillin injections to identified patients. This requires, among other things, that penicillin be available."

The accelerated globalization of the food supply, coupled with toughening government standards, is putting global food production, distribution, and retail industries under a high-intensity spotlight. High-publicity cases about foodborne illnesses over recent years have heightened public awareness of food safety issues, and momentum has been building to find new ways to detect and identify foodborne pathogens and eliminate food-related infections and intoxications. This extensively revised 4e covers how the incidence and impact of foodborne diseases is determined, foodborne intoxications with an introduction noting common features among these diseases and control measures that are applicable before and after the basic foodstuff is harvested.
Providesa summary of the"

A series of remarkable discoveries in the past three decades have led to the molecular and genetic characterization of the transmissible pathogen causing scrapie in animals and a quartet of human illnesses: kuru, Jakob-Creutzfeld disease, Gerstmann-Straussler-Scheinker disease, and fatal familial insomnia. To distinguish this pathogen from viruses and viroids, the term "prion" was introduced to emphasize its proteinaceous and infectious nature.
Stanley B. Prusiner, editor of this volume, was awarded the 1997 Nobel Prize in Physiology and Medicine for his pioneering discovery of prions. The book reviews advances in studies of prions, which - as considereable evidence indicates - are novel pathogens composed only of protein."

G. Petursson and Rikke Hoff-J0rgensen The concept of slow viral infections was first put forward in 1954 by Dr. Bjorn Sigurdsson, an Icelandic physician who had been studying some sheep diseases which were introduced into Iceland with the importation of a foreign breed of sheep in 1933. Sigurdsson's main criteria for defining slow infec tions were a very long initial period without clinical signs lasting months or even years following infection and a rather regular protracted, progres sive course, once clinical symptoms had appeared, usually ending in serious disease or death. Sigurdsson included in this list of slow infections maedi -visna, infectious adenomatosis of sheep, scrapie in sheep, Bittner's mam mary carcinoma and Gross' leukemia in mice. All of these diseases, except scrapie, are caused by retroviruses. The characteristics of slow infections as described above are of prac tical importance for epidemiology, diagnosis and control of these diseases. For many years the slow infections remained primarily a veterinary problem, mainly affecting sheep and goats in certain countries. In recent years, how ever, the human immunodeficiency virus (HIV) causing acquired immunodefici ency syndrome (AIDS), has suddenly appeared in many countries of the world and brought the slow infection concept forcefully to the attention of the medical profession. The disease problems and the economic effects of slow infections of sheep and goats are increasingly recognized in various coun tries. For the reasons stated above we feel that this book should be useful for veterinarians and physicians alike."

practitioner up to date on the various aspects of conditions and diseases considered to be sexually transmitted. REFERENCES 1. Crissey JT, Denenholz DA: Development of the modern forms and concepts of syphilis. Clin Dermatol, 2(1):1-10, 1984. 2. Panconesi E, Mazzi M: The day syphilis came. Int 1 Dermatol, 23:284-286, 1984. 3. Washington AE, Johnson RE, Sanders LL: Chlamydia trachomatis infections in the United States: What are they costing us? lAMA, 257:2070-2074, 1987. 4. Bulkley LD: Syphilis in the Innocent. New York: Bailey and Fairchild, 1894. 5. Syphilis: Major perinatal killer. Med World Trib, 28(16):2, 1987. 6. Renshaw DC: Management of impotence. I. Psychological considerations. Clin Therap, 9:142-148,1987. Acknowledgments. We are very grateful to our teachers for the stimulation they provided in our studies of dermatology and sexually transmitted diseases. We partic ularly acknowledge the impetus given by Herman Beerman, M.D., Emeritus Professor of Dermatology, University of Pennsylvania School of Medicine, Philadel phia. Our office staffs have been particularly helpful, and we would like to recognize the contributions of Mrs. Carmela Ciferni. Lastly, this book was conceived through the inspiration of Dr. Jerry Stone, late Senior Medical Editor of Springer-Verlag, New York. Philadelphia, Pennsylvania LAWRENCE CHARLES PARISH Vienna, Austria FRIEDRICH GSCHNAIT Contents Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Xl . . . . . . . . . . . . . . . What are Sexually Transmitted Diseases? Chapter 1 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . LOIS Y. MATSUOKA Chapter 2 Definition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . . . HARRY L. ARNOLD, JR. Diseases Chapter 3 Syphilis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . . . . . . . . . . JOHN THORNE CRISSEY Chapter 4 Endemic Treponematoses . . . . . . . . . . .. . . . . . . . . . . . . . . . 32 . . ."

''An essential book for people working in the area of sulfur compounds in the environment and should be in all institutional libraries....Well indexed, well presented.'' --- SGM Quarterly, November 1997 ''Extremely useful and well-produced symposium volume that should be of interest to many environmental scientists, microbial and plant physiologists, and aquatic ecologists.'' The Quarterly Review of Biology, June 1998

The World Health Organization estimates that at least five million people worldwide are infected with human immunodeficiency virus (HIV) Of these about 100,000 are in Asia and Oceania, 500,000 in Europe, 2 million in the Americas and 2.5 million in Africa (Mann, 1989). The acquired immunodeficiency syndrome is characterized by a derangement in cell-mediated immunity leading to opportunistic infections with for example Mycobacterium spp., Candida spp., Cryptococcus neoformans, Pneumocystis carinii, Toxoplasma gondii and Cryptosporidium. The third symposium on "Topics in Mycology" brought together 265 experts from 32 countries to discuss the epidemiology, immmunological and pathogenetic aspects of AIDS and its opportunistic infections in general and fungal infections in particular. Pneumocystis carinii pneumonia is by far the commonest opportunistic infection in AIDS patients. The nature and classification of P. carinii is still controversial. In search for its true taxonomic affinities an introductory paper formulates a number of key questions. Candidosis is another frequent opportunistic infection. A number of papers discuss the possibility that selective pressures may operate on Candida albicans within the AIDS population and influence its nature: this might have an impact on prophylaxis and curative and/or suppressive therapy.

Chronic hepatitis C is a major worldwide health problem affecting more than 170 million people. Chronic infections lead to cirrhosis and liver failure or hepatocellular cancer in many instances. This volume includes comprehensive reviews that cover much of the vast literature that has appeared since the identification of the hepatitis C virus RNA genome. It will be an invaluable collection for anyone wanting an up-to-date picture of HCV transmission, molecular virology, immune response, cellular/molecular pathogenesis, and possible avenues for developing effective new therapeutics and vaccines.

The Tenth International Conference on Intracellular Protein Catabolism was held in Tokyo Japan, October 30-November 3, 1994. under the auspices of the International Committee on Proteolysis (lCOP). ICOP meetings have been held biennially in the USA, Europe, and Japan in turn. The previous three ICOP meetings (7th to 9th) were held in Shimoda, Japan, in 1988. in WildbadKreuth, Germany, in 1990, and in Williamsburg. Virginia, in 1992. Previous meetings were held in resort areas, this was the first meeting held in a large city. Attendance has grown every year so that nearly 400 participants from 19 different countries attended the Tokyo meeting. At the meeting, novel and updated results on the structure-function. physiology, biology, and pathology of proteases and inhibitors were discussed, together with cellular aspects of proteolysis and protein turnover. Thirty-nine invited papers and eight selected posters were presented orally and 171 poster presentations were discussed. This book documents almost all of the lectures and some selected posters. Since the world of proteolysis and protein turnover is expanding very rapidly. far beyond our expectations, it is impossible to cover all the new aspects of this field. However, this book will give an idea of the current status, trends. and directions of the field, and information necessary to understand what is and will be important in this field. Further. the editors hope that the novel ideas, approaches. methodologies, and important findings described in this book will stimulate further study on proteolysis and protein turnover.

In our contemporary world, scientific heritage is cal Mycology infrastructure are recognized for their often forgotten. Many important contributions dur- scholarly and authoritative contributions. This book ing the past 100 years in research, teaching, and is truly a landmark publication towards ensuring diagnosis have had a profound impact upon the that the past, present, and future are connected to evolution of Medical Mycology in the United States. each other. This book, written by Dr Espinel-Ingroff, makes a Libero Aje/lo, Ph. D significant contribution towards ensuring that those who have laid the foundation for our current Medi- Michael R. McGinnis, Ph. D vii Acknowledgments The invaluable editorial assistance and creative I owe a debt of appreciation to the following reinforcement of my husband, David Ingroff, was individuals for their assistance during the gathering especially important during the preparation of this of the data including the mailing of the question- book. Special thanks go to Drs Libero Ajello, naires: Drs Michael Rinaldi and William Merz, Michael McGinnis, and William Blake for their President and Treasurer, respectively, of the Medical Mycological Society support, guidance, encouragement, and continuous of the Americas in 1994; the Medical College of Virginia Tompkins McCaw's editorial assistance. I would like to thank the numer- ous medical mycologists who responded to the Library week-end staff and the Library Interloan questionnaire and/ or made themselves available for Service; J. Kerr, Archivist of the American Society interviews. Also, Drs Glenn Bulmer, Timothy for Microbiology; Drs W. Dismukes and M.

The chapters in this book represent detailed versions of papers presented at the Symposium on Viral Genes and Plant Pathogenesis held at Lexington, Kentucky on October 16 and 17, 1989. In selecting topics and authors, we attempted to have represented a spectrum of systems which are at the forefront of research on plant virus genes and gene products, particularly as they relate to plant disease. The book also contains pertinent discussion of the papers presented at the symposium, as well as summaries, observations and projections of future research directions prepared by the session chairmen. We wish to express our appreciation to Dr. D. L. Davis, of the RI. Reynolds Tobacco Company for suggesting the organization of the Symposium and the publication of the proceedings, and to the R 1. Reynolds Tobacco Company for the financial support which made the symposium possible. We also wish to thank those of our colleagues in the Department of Plant Pathology, University of Kentucky, who very ably and in many ways contributed to the organization and conduct of the conference. Thomas P. Pirone lohnG. Shaw v Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi INDUCTION OF HOST GENES BY THE HYPERSENSITIVE RESPONSE OF TOBACCO TO VIRUS INFECTION J. F. Bol, C. M. A. van Rossum, Bl. C. Cornelissen and H. J. M. Linthorst . . . . . . . . . . . . . . . . . l COAT PROTEIN MEDIATED RESISTANCE IN TRANSGENIC PLANTS Roger N. Beachy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 STRUCTURE AND FUNCTIONS OF TOBACCO MOSAIC VIRUS RNA Yoshimi Okada, Tetsuo Meshi, and Yuichiro Watanabe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cell signalling lies at the heart of many biological processes and currently is the focus of intense research interest. In multicellular organisms, it is central to how different types of cell communicate with each other and how they detect and respond to extracellular signals. Intercellular communication is vital to single-celled organisms as well, allowing them to respond to environmental cues and signals.

To date, much of the understanding of signalling mechanisms has come from research on specific cell types (eg mouse lymphocyte and cardiomyocyte) or on organisms in which communication systems such as nervous and endocrine systems are well established. This volume therefore aims to 'fill the gap' by concentrating on 'simple organisms' where the elements of those signalling systems first evolved. Many of the groups covered contain important pathogens or parasites, and the potential for manipulating signalling pathways for therapeutic intervention will be highlighted.

Although toxigenic fungi have been known since ancient times, modern mycotoxinology probably began with the early work of Joseph Forgacs and his colleagues in the 1950s. This science grew tremendously with the discovery of aflatoxins and aflatoxicoses in the early 1960s, particulorly following the finding of the carcinogenicity of aflatoxins in test animol species. The discovery and identification of new mycotoxins and mycotoxi- coses, development of analytical procedures, attempted measurement of human and animal exposure, evaluation of toxicological effects, estimotiol' of risk due to human exposure, and development of regulatory control programs have been the major research goals over the past 30 years. In recent years there has also been an explosive growth in our knowledge of the metabolites produced by the algae, especially the dinoflagellate-produced toxins, and the transmission of such toxins up ~,e food chain to reef fish and shellfish. This knowledge has been invalualdl' in understanding and controlling human illness resulting from ingestion of seafood. We are now, for the first time, able to deal with such common seafood-related human diseases as paralytic, neurotoxic and amnesic shellfish and ciguatera poisoning.

Current Topics in Medical Mycology, is intended to summa- rize current research areas in medical mycology for medical mycologists and other scientists who are working in micro- biology and immunology. Topics to be included in each volume will serve as contemporary reviews, summaries of current advancements and future directions, and mecha- nisms to enhance the interdisciplinary use of medically im- portant fungi in understanding pathogenesis, epidemiology, mycotoxins, taxonomy, and other areas where basic, ap- plied, and clinical sciences are used. Michael R. McGinnis Marcel Borgers v Contents v Series Preface Contributors ix 1 Animal Models for Dermatomycotic Infections JAN VAN CUTSEM 1 2 Vaccines for the Management of Dermatophyte and Superficial Yeast Infections ESTHER SEGAL 36 3 Tissue-Bound Immunity: A Mechanism of Can- dacidal Activity HISASHI TAKAHASHI, KENICHIRO CHIKAKANE, MAsARU OKUDA, MARIKO HATANO, MANABU HOSHINO, OSAMU KANEKO, and YOKO KAWA 50 4 Rhinosporidiosis MERANI THIANPRASIT and KLEOPHANT THAGERNGPOL 64 Pathogenesis of Candida Vulvovaginitis 5 JACK D. SOBEL 86 6 Control of Extension of the Hyphal Apex NEIL A. R. Gow 109 7 Epidemiology and Ecology of Pityriasis Versicolor JAN FAERGEMANN 153 8 Fungal Cell Wall Synthesis and Assembly JOSE RUIZ-HERRERA, RAFAEL SENTANDREU 168 vii viii Contents 9 Lipids and Lipoidal Mycotoxins of Fungi MICHAEL A. GEALT, ABBAS ABDOLLAHI, and JOSEPH L.

Mycoplasmas are placed in a separate class, Mollicutes, which removes them from bacteria. Their main characteristics are lack of a cellular wall and inability to synthesize the peptidoglycan polymer. The lack of a cell wall accounts for the pleomorphism, osmotic sensitivity, sensitivity to antibiotics that inhibit pep tidoglycan polymerization and synthesis, susceptibility to lysis by alcohol and detergents, and the ability to grow on agar gel. At present, three families are placed in the class Mollicutes: Mycotaceae, Acholetaceae, and Spiroplasmataceae. The first pathogenic mycoplasmas were discovered in Pasteur's laboratory nearly 90 years ago as the causative agents of a sheep disease. They were first named PPLO, pleuropneumonia-like organisms. In 1928, Nocard in France coined the name mycoplasma for PPLO, but his publication and the new name remained practically unnoticed until Leonard Hayflick and Robert Channock succeeded in culturing the "PPLO" of human "atypical virus pneumonia" in the United States in 1960. Hayflick resurrected the name given by Nocard and since then, the causative agent of human "atypical virus pneumonia" is known as Mycoplasma pneumoniae. Other mycoplasmas cause diseases in dogs, sheep, birds, cattle, pigs, etc."

For more than ten years cell fusion techniques have been applied in studies on various lymphocyte functions. Ig expression was first studied in hybrids obtained by fusing myeloma cells with fibroblasts (1) or lymphomas (2), both of which do not produce Ig, and with Ig producing myelomas (3) or human blood lymphocytes (4). Kohler and Milstein (5) fused a myeloma with spleen cells from immunized mice. Up to 10% of the hybrids obtained secreted antibodies specific for the immunizing antigen. This suggested that plasma cells preferenti ally fused with the myeloma cells, a finding which was of enormous practical value. It was found that both Band T lymphocytes could be fused with the T cell tumor BW5147, which is however not permissive for Ig synthesis (6). A very large number of T cell hybridomas were generated by fusing BW5147 with cell populations containing in vivo or in vitro activated cells (7). The hybrids showed no specific T cell functions and binding assays for T cell receptors were not available. In particular, no hybrids were obtained which expreS1ed specific cytolytic activity that could be tested in short-term Cr release assays (8). However, the frustrations expressed about these failures, published in January, 1978 (9), were relieved by Taniguchi and Miller's publication a few months later of T cell hybridomas producing antigen-specific suppressor factors (10). Unfortunately, their hybrids rapidly lost factor production."

By 1960 the scientific community began observing an ever increasing explosion in the literature embrac ing the many facets of industrial microbiology. Many of the so-called traditional areas were being replaced by more modern provocative channels of endeavor. It was about this time that excellent review-type annual publications, such as Advances in Applied Microbiology, Progress in Industrial Microbiology and Developments in Industrial Microbiology emerged reporting the ex citing new work. It was soon, thereafter, that the Division of Microbial Chemistry shed its probationary status to become a bona fide unit of the American Chemi cal Society. A rash of new applied microbiological v vi FOREWORD textbooks arrived on the scene. The number of journals reporting the day-to-day scientific achievements also burgeoned. Early in my industrial career, I found it impera tive to devise a "workable" key to the ever increasing volume of literature that was emerging. This I com piled over the years on voluminous stacks of file cards which have in essence been reprinted here as "my" Guide to the Literature for the Industrial Microbiologist. The Guide has, indeed, served me well and through it, one can readily ascertain the state of the art of any of the many specialized subjects of industrial micro biology. Logically, one would first consult recent textbooks to obtain an overview of the subject being searched."

Neurovirology is an interdisciplinary field representing a melding of virology, clinical neuroscience, molecular pathogenesis, diagnostic virology, molecular biology, and immunology. Neuroviral Infections: General Principles and DNA Viruses covers recent developments in the area of neuroviral infections and discusses their role in related fields such as immunology, cell biology, and molecular biology. It offers a complete discussion of the major neuroviral infections caused by DNA viruses, including information on emerging basic principles, neuroviral infections, and future challenges in virology.

The science ofparasitology is particularlyrelevantto the health ofhumans and animals throughout the world. As such, it provides the core of the Rockefeller Foundation program ofbiomedical research called The Great Neglected Diseases of Mankind. While some bacterial, viral, and fungal diseases are included in this program, the parasiticdiseases caused bypro- tozoa and helminths almost uniformly fit into this category. Many ofthem infect vast numbers of people and animals (of the order of hundreds of millions), but theyare greatlyneglected bythe scientific establishmentof the modern world. The principal reason for this neglect, both scientific and financial, is the fact that these diseases are primarily problems ofthe developing world. Hence, no vaccines exist for anyofthe human parasitic diseases; for many, treatment is either nonexistent or highly toxic; and diagnosis still relies largely on the visual examination ofbiopsies, blood, and excreta. In contrast, the discovery ofa spate ofantibiotics has revolu- tionized treatment of bacterial diseases, and vaccines have been devel- opedfor manybacterial andviral diseases. Furthermore, the field ofmicro- biology, which deals largely with bacteriology and virology, has sparked the scientific revolutions ofimmunology and molecular biology. In order to examine the present status of parasitology and the reasons for its putative neglect, as well as to develop means of remedying the sit- uation, aseries ofconferences has been convened, bringing together clas- sical parasitologists and a new and complementary breed of parasite-ori- ented immunologists, biochemists, molecular biologists, and population ecologists.

It has been more than twenty years since the isolation of polyoma virus and SV40, and the reports that they could produce tumors in animals and transformation of cells in culture. What was startling was that these biologic properties are associated with viruses that contain genetic in formation that is able to code for only five or six proteins. Since that time, investigations with these viruses have been in four principal areas. One major area of study has been on cells transformed by viruses that show altered growth properties and specify new viral and cellular proteins. Transformation studies have focused on the tumor (T) antigens that are specified by the virus and are required to initiate and to maintain the transformed state. Current studies on transformation are summarized in Chapter 4. The second broad area of investigation concerns replication of viruses during a lytic cycle of infection. T-antigens that are the hallmark of transformed cells are also expressed in cells that are lytically infected and are required for viral DNA replication and also function to alter rates of transcription of the early and late viral genes. Except for T-antigen, virus replication depends on the cellular enzymatic machinery and so the description of viral macromolecular synthesis has provided valuable insights into the cellular biosynthetic pathways. These studies are described in Chapters 1-3. The studies that have medical relevance concern JC and BK viruses and there is evidence of widespread exposure of human populations to these agents."

This book was written during a period when the technologies of genetic engineering were being applied to the study of animal viruses and when the organization and function of individual virus genes were being elucidated. This book, which uses human and animal viruses as models, aims to under stand the developments in molecular virology during the last 20 years. Al though molecular virology could also be taught by means of bacteriophages or plant viruses, the advantage of using animal viruses is in their ability to cause human and animal diseases as well as to transform cells, a primary problem in medicine. For the sake of clarity and convenience, not all the individual contributors to the various aspects of molecular virology were cited in the text. Instead, the reader is referred to review articles or key papers that list the numerous excel lent publications that have contributed to clarification of the various molecular processes. Thus the end-of-chapter bibliographies will guide the reader to the publications in which the original contributing authors are quoted. References given under the heading Recommended Reading are intended to assist those interested in pursuing a given subject further. I hope that this book will fulfill the purpose for which it is designed, and I urge readers to contact me if errors are found or updating is required."

The very first international working discussion on slow infections of the nervous system was entitled "Slow, Latent, and Temperate Virus Infec tions" and was held at the National Institutes of Health (NIH) in December 1964. The primary impetus was the discovery and investigation of kuru in New Guinea by D. Carleton Gajdusek, M. D. This working discussion brought together investigators in human and veterinary medicine, virolo gists, microbiologists, and neuropathologists actively engaged in laboratory work with viruses that illustrated properties of latency, masking, slowness, or temperateness, with emphasis on subacute and chronic neurologic dis eases of unknown etiology. In the Preface to the monograph of published papers presented at the working discussion, Gajdusek and Gibbs wrote the following: After microbiology had given solution to the etiology of most acute infections of the central nervous system and after fungi and bacteria had been incriminated in impor tant chronic disorders of the nervous system such as torula and tuberculosis men ingitis, we have been left, in neurology, with a wide range of subacute and chronic affections of the central nervous systems of unknown etiology. Some of these diseases, still listed as idiopathic, are among the most prevalent afflictions of the central nervous system. Many others with familial patterns of occurrence do not yet have their basic pathogenesis or underlying metabolic defect elucidated, although we tend to think of them as genetically mediated."

The papers published herein comprise the presentations given at the eighteenth of an annual series of clinical symposia arranged under the auspices of the Eastern Pennsylvania Branch of the American Society for Microbiology. This symposium allowed approximately 200 persons to gather and exchange ideas on the rapid laboratory diagnosis of infectious diseases. The institution of the Diagnosis Related Group (DRG) method for reimbursement by both government agencies and private insurance carriers has provided a financial aspect to the established clinical reasons for rapid laboratory diagnosis. Now the health of the institution, as well as the patient, is dependent on a timely diagnosis and, hopefully, cure. Accordingly, the goal of this symposium was to present the latest developments in "same-day microbiology." In the face of stable or diminishing resources, the laboratory director is presented with many choices. Do nucleic acid probes, non instrumental ELISA techniques, or time-resolved fluorometry have a place in his or her laboratory? Should the laboratory test for newly described human pathogens such as human immunodeficiency virus or human papilloma virus? Can rapid techniques supplant conventional methods? Or are they merely adjunctive? This symposium attempted to assist in the formulation of informed decisions. Bruce Kleger Donald Jungkind Eileen Rinks Linda A. Miller vii ACKNOWLEDGEMENTS We would like to thank the Eastern Pennsylvania Branch of t e American Society for Microbiology for sponsoring this symposium and for making this publication possible. We especially thank the Symposium Committee for their diligent work in organizing an informative and successful symposium."

Although there have been many books on HIV and AIDS, surprisingly little has been published that focuses on the immunology of retroviral infections in general, and HIV in particular. Retroviral Immunology: Immune Response and Restoration is the first book of its kind to address the most important aspects of the immunology of retroviruses, including not only the virus-specific immune responses, but also genetic and virologic factors modulating these responses. The book also deals directly with the emerging concept of immune restora tion in retroviral infections, a particularly important subject to the thousands of clinicians who deal with this problem on a daily basis. With the advent of highly effective antiviral drug regimens to slow down the replication of HIV and the progression of AIDS, new challenges and opportunities are arising. Restoration of general immune function has brought with it not only complica tions of immune restoration-mediated disease, but also the realistic hope for meaningful restoration of the ability to control HIV replication with the immune system. Leading scientists in the field have summarized the most current informa tion regarding experimental and clinical aspects of retroviral infections. Retroviral Immunology: Immune Response and Restoration should prove an impor tant point of reference for basic scientists and clinicians in this area of research. We are indebted to all of our authors for their excellent contributions."