Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens

In conjugational crosses, three Klebsiella pneumoniae strains and one Serratia marcescens strain have been demonstrated to transfer resistance determinants to newer types of cephalosporins. While Klebsiella strains donated cefotaxime, cefamandole and cefuroxime resistance to Escherichia coli K-12 recipients, the genetic analysis of exconjugants after the transfer of plasmids from Serratia strains to Proteus or Salmonella recipients showed that the cefoxitin resistance determinant was also co-transferred. In subsequent transfer cycles of this plasmid, cefotaxime and cefoxitin resistance determinants segregated in contrast to the relative stability of plasmids derived from Klebsiella strains in subsequent transfer cycles. From results obtained in this study, it may be concluded that in some strains of nosocomial Enterobacteriaceae, resistance to newer cephalosporins could be transmissible and thus plasmid-located.

Perinatal transmitted acute icteric hepatitis B in infants born to hepatitis B surface antigen-positive and anti-hepatitis Be-positive carrier mothers

Three infants born to mothers who were hepatitis B surface antigen (HBsAg) positive and had antibody to hepatitis Be antigen (anti-HBe), developed acute icteric hepatitis B within three months of birth. All three infants clinically recovered and developed circulating anti-HBs. Contrary to previous studies, these three cases indicate that mother-infant transmission of the hepatitis B virus (HBV) does occur in infants born to HBsAg-positive, HBe-Ag-negative carrier mothers, and these infants may develop severe acute icteric hepatitis. Therefore, immunoprophylaxis in such newborns may be indicated.

Two Robertsonian translocations in a boy with mental retardation

An 8-year-old boy with mental retardation was found to be a mosaic, showing three different cell lines, 46,XY/46,XY,-21,+t(q21q21)/45,XY,-13,-21,+t(q13q21) in cultured peripheral blood cells.

Delayed hypersensitivity reactions in rats and their response to clinical dextran

Four colonies of rats were tested for their ability to produce adjuvant-induced arthritis, oxazolone contact hypersensitivity and the dextran anaphylactoid reaction. Tuck Wistar and Hooded Lister rats, both of which respond to dextran, showed disseminated inflammatory lesions after adjuvant and exhibited oxazolone sensitisation, regardless of the age of the animal. Spontaneously hypertensive rats, which at all ages respond to dextran, also responded to adjuvant and oxazolone but only when they were young; as they grew older, this response to these two agents diminished. Wistar NELP rats, which at all ages do not respond to dextran, responded to oxazolone; sensitivity to adjuvant, however, was maximal only in young animals. The link between the ability of rats to resist the dextran anaphylactoid reaction and their failure to respond to adjuvant with disseminated inflammatory lesions has not been confirmed.

Search for new antiamebic agents. I. Synthesis and bioassay of new Schiff bases of 1-phenyl-2-morpholinoethylidene-1-urea

As potential agents against E. histolytica 19 new Schiff bases of 1-phenyl-2-morpholinoethylidene-1-urea were synthesized by the condensation of the parent compounds with various carbonyl compounds. Thirteen of them were tested against the axenic culture of E. histolytica at concentration 125 microgram/cm3 but no significant amoebicidal activity was observed.

Cell-mediated immune responses of synovial mononuclear cells to sexually transmitted, enteric and mumps antigens in patients with Reiter's syndrome, rheumatoid arthritis and ankylosing spondylitis

3H-thymidine uptake responses by synovial mononuclear cells to stimulation with sexually transmitted, enteric and mumps antigens were studied in 12 patients with "sexually transmitted Reiter's syndrome", 5 with "enteric Reiter's syndrome", 5 with rheumatoid arthritis, 4 with ankylosing spondylitis and 10 with "indolent arthritis of one knee." The "sexually transmitted" and salmonella cases were distinguishable by the responses. Synovial responses were sometimes marked when peripheral blood responses were negligible.

Cell-mediated immune responses of synovial mononuclear cells in Reiter's syndrome against ureaplasmal and chlamydial antigens

Cell-mediated immune responses of cultured synovial mononuclear cells against ureaplasmal, chlamydial, Mycoplasma hominis and mumps antigens were measured by the 3H-thymidine uptake method. Specific responses against ureaplasmal or chlamydial antigens were found in 3 of 4 patients with venereally-acquired Reiter's syndrome, but not in 3 patients with arthritis after episodes of diarrhea and 4 patients with rheumatoid arthritis.

Simplified method of determining fetal brain weight in utero

Analysis of autopsy data shows that, from the 26th through the 38th gestational weeks, fetal brain weight (BrW) is a function of the 3.124 power of the largest head circumference (HC). Because there is excellent correlation between prenatal ultrasound measurement and postnatal tape measurement of the HC, it is possible to determine fetal BrW in utero. An alteration of the BrW:somatic weight (SW) relationship is an important physical stigma of asymmetric intrauterine growth retardation (IUGR). The value of longitudinal studies of fetal BrW and SW as a means of discriminating between normal and asymmetric growth is tested in a population at risk for IUGR.

Toxic effect of cadmium nitrate on the liver of Channa punctatus

Exposure of a fresh water fish, Channa punctatus, in a medium containing as low as 0.01 ppm of cadmium nitrate, resulted in the necrosis of hepatic cells. A temporary recovery of these cells was however observed when the animals were exposed to lower concentrations.

Hazards of amniocentesis: an unidentifiable fragment

A 38-year-old woman had amniocentesis performed for advanced maternal age. The karyotype of the cultured amniotic fluid cells showed a minute fragment in all cells analyzed, 47,XY+Fg. The fragment could not be identified. For medical reasons the pregnancy had to be terminated at 34 weeks. Both skin and blood cultures from the aborted fetus showed a 47,XY,21+ karyotype.

Autonomic dysreflexia: an unusual radiologic complication

Two cases of autonomic dysreflexia are reported in which patients with high spinal cord lesions developed untoward effects during a diagnostic radiologic procedure. One patient had a retrograde cystogram and the other had a femoral angiogram. Radiologists should be aware of this potentially hazardous complication which could occur in any patient with a spinal cord lesion at or above T6. It can precipitate severe acute hypertension, acute myocardial failure or intracranial hemorrhage. We reviewed clinical features, etiologies, pathophysiology, treatment and prophylaxis.

Alterations in plasma sialyltransferase associated with successful chemotherapy of a disseminated tumor. Case report

Levels of plasma sialyltransferase were measured in a patient with disseminated carcinoma of the testes. Initial enzyme values, elevated six fold above those in normal controls, were among the highest thus far encountered in a population of patients with various stages and types of malignancy. During a remarkable respose to chemotherapy with cis-diaminodichloroplatinum, plasma sialyltransferase levels fell markedly. Serial measurement of this enzyme may aid in evaluation of tumor responsiveness to therapy in patients whose disease is not readily measurable.

Incidence of bacterial endocarditis in ventricular septal defects

In summary, the population figures presented place the risk of bacterial endocarditis for cases of ventricular septal defect in the 5 to 14-year age group as 1 in 470 patient years, or 2.1 per 100 cases in 10 years. The estimated risks for the 5-year-old and 15-year-old patient up to the age of 70 years would be 13.6% and 11.5% respectively. In the city of Toronto, only four cases were seen in 10 years in the general population of over half a million, while in metropolitan Toronto with the population of 1.3 million, eight cases were seen in a similar period. If the clinical experiences of the various authors reported in the literature are pooled with that at The Hospital for Sick Children in Toronto, one would have 21 cases of bacterial endocarditis in 11,328 patient years. This would place the incidence as approximately 1 in 500 patient years.

It is suggested that the surgery for ventricular septal defect may itself initiate bacterial endocarditis as noted in three of our cases.

On the basis of the available data, there is insufficient evidence to designate the risk of future bacterial endocarditis as an adequate reason for surgical closure of the defect.