Vaginal colonization with Group B beta-hemolytic streptococcus as a risk factor for post-cesarean section febrile morbidity

Vaginal colonization of mothers with Group B beta-hemolytic streptococcus (GBS) has been recognized as a risk factor for neonatal morbidity. The relationship of GBS colonization to risks for the mother who undergoes cesarean section has not been defined. In this study, we found that, among patients who underwent cesarean section, the 19% of them who were colonized with GBS had a higher incidence of standard fever (66.6% vs. 30.5%), clinical diagnosis of endomyometritis (61.1% vs. 12.5%), and use of antibiotics (61.1% vs. 26.3%) in relationship to a significantly increased frequency of premature rupture of the membranes (50.0% vs. 14.8%). Reasons for the association between vaginal colonization and increased morbidity are discussed.     

Dissolution of a radiolucent stone in the common bile duct by sodium cholate infusions through the T-tube (author's transl)

A case of a retained gallstone in the common bile duct after cholecystectomy (in a 38-year old man) is reported in which infusions with saline and spasmolytics failed to flush out the retained stone into the duodenum. An infusion with sodium cholate over nine days through the T-tube was successful in dissolution of the radiolucent stone.     

Minor and major lip reconstruction

Lip reconstruction has made significant advances over the past two decades with refinement of some old techniques and the introduction of new innovative methods. Small and medium defects can be repaired in a variety of ways with similar results. Local lip switch flaps are far superior to any distant tissue. Total lip loss is probably best handled with nasolabial flaps. Extensive resections including the lip, premaxilla, mandible, and skin of the chin and upper neck remain a challenge with all modern techniques, including myocutaneous flaps and free flaps, having little advantage over the standard visor forehead flap.     

Significance of adrenal hormones in brain energy metabolism

Intensity of glycolysis was studied under conditions of immobilization stress and adrenalectomy as well as with administration of adrenaline and hydrocortisone. The processes of aerobic glycolysis, activity of enzymes of the tricarboxylic acid cycle and mitochondria respiratory chain, content of total, free and protein-bound glycogen, glucose-I-phosphate, glucose-6-phosphate, pyruvate, alpha-ketoglutarate, cytrate and macroergs in the brain are shown to depend on the level of adrenal hormones producing a multilateral effect on a series of energy metabolism links.     

Sodium nitroprusside and intracranial pressure

The effects of sodium nitroprusside on intracranial pressure were studied in 10 patients, candidates for surgical treatment, prior to anaesthesia. Blood pressure was lowered to at least 50% of its initial value. In all cases, at the beginning of nitroprusside infusion, both the mean and the pulse intracranial pressures increased (mean increase: 83.2% of the initial value). At a certain moment, however, while the blood pressure continued to fall, the mean intracranial pressure did not increase any more; on the contrary, it decreased. On the other hand, in many cases, the pulse intracranial pressure continued to increase. No neurological or EEG changes were observed. The possible changes of cerebral circulation and CSF dynamics underlying the phenomena observed are discussed.     

Identification and characterization of a lysis module present in a large proportion of bacteriophages infecting Streptococcus thermophilus

A lysis module encoded by the temperate bacteriophage phiO1205 was identified. This lysis module contains a lysin gene, designated lyt51, and two putative holin-encoding genes, designated lyt49 and lyt50. lyt51 encodes a lytic enzyme specifically directed against streptococcal cell walls. Similar to other phage-encoded lysins, Lyt51 appears to have a modular design in which the N-terminal portion corresponds to its enzymatic activity while the C-terminal region is responsible for its substrate binding specificity. The two putative holin-encoding genes, lyt49 and lyt50, located immediately upstream of lyt51, were identified on the basis of their homology to other identified holin-encoding genes. Expression of lyt49 or lyt50 in Escherichia coli was shown to cause cell death and leakage of the intracellular enzyme isocitrate dehydrogenase into the growth medium without apparent lysis of the cells. Southern blotting experiments demonstrated that at least one of the three components of the identified lysis module is present in all members of a large collection of bacteriophages, indicating that components of this lysis module are widespread among bacteriophages infecting Streptococcus thermophilus.