Plasmid-mediated beta-lactamase (TEM-7) involved in resistance to ceftazidime and aztreonam

TEM-7, a novel TEM-type beta-lactamase (pI 5.41) encoded on a plasmid of approximately 85 kilobases, was found in a clinical isolate of Citrobacter freundii. Strains containing this enzyme exhibited decreased susceptibility to ceftazidime (64-fold) and aztreonam (16-fold) but not to other third-generation cephalosporins. Addition of a beta-lactamase inhibitor--clavulanic acid, sulbactam, or YTR 830--restored normal susceptibility to associated compounds such as ampicillin, piperacillin, ceftazidime, and aztreonam. DNA-DNA hybridization of an intragenic probe of TEM-1 occurred with a 19-kilobase EcoRI fragment of the plasmid encoding TEM-7. A TEM-2 derivative, TEM-201, with characteristics similar to those of TEM-7 was selected spontaneously in the presence of ceftazidime in vitro.

[Kinetic parameters of anion adenosine triphosphatase of erythrocytes]

Effect of anions on kinetic properties of ATPase from rat erythrocyte membranes was studied. The ATPase activity was competitively inhibited by thiocyanate in mixtures containing sulfite. Thiocyanate, chlorine-anion, bicarbonate and sulfite affected noncompetitively the enzymatic activity as compared with Mg2+-ATP, ADP and calcium. Dicyclohexylcarbodiimide inhibited similarly Mg2+- and Mg2+, SO2-(3)-ATPase activities of membranes. Effect of anions on kinetic parameters of anion-dependent ATPases appears to be analogous in erythrocytes and mitochondria; the data obtained corresponded to early proposed hypothesis of the anion effect on ATPases.

Concurrence of malignant and benign heterologous mixed tumors of the uterus

A large polypoid uterine mas was composed to two distinct and separate parts: a malignant mixed müllerian tumor (MMMT) and a benign mixed mesenchymal tumor (BMMT). It was considered a collision of two neoplasms rather than a malignant degeneration of the BMMT. Malignant transformation of benign mesenchymal uterine tumors is a controversial concept which is difficult to prove or disprove. Concerning the histogenesis of MMMT it appears, at least in some cases, that they originate not from a single multipotential mullerian cell, but rather from two, a stromal cell and an epithelial cell. It is suggested furthermore, that in certain instances presence of one neoplastic component, e.g., adenocarcinoma, can incite proliferation of the second, sarcomatous element of the MMMT.

Oral contraceptives and cervical carcinoma

In a case-control study, 689 consecutive patients with cervical carcinoma were studied for their use of oral contraceptives. The control patients were matched for age, ethnic origin, age at first pregnancy, age at first coitus, and socioeconomic status. There was no significant difference between case and control subjects in the duration or oral contraceptive use, the type of estrogen used, or the years in which oral contraceptives were used. The mean duration of oral contraceptive use was 30.9 months by the case subjects and 30.2 months by the control subjects.

Incidence, significance, and follow-up of para-aortic lymph node metastases in late invasive carcinoma of the cervix

One hundred and four patients with Stages II and III of cervical carcinoma underwent para-aortic node biopsies. Of these, 12.5 per cent of patients with Stage IIA, 14.9 per cent of patients with Stage IIB, and 38.4 per cent of patients with Stage III carcinoma of the cervix had positive para-aortic nodes. They subsequently recieve 6,000 rads to the para-aortic area. The radiotherapy complication rate was high. Within four years, 50 per cent of the patients with positive para-aortic nodes had other distant metastases. The two- and four-year follow-up is presented. Only one of 13 patients with positive para-aortic nodes was alive at the end of four years.

Plasma ribonuclease: a marker for the detection of ovarian cancer

There were no significant differences between the mean blood plasma (leukocyte-free) RNAase activity among 128 healthy women volunteers age 13-70 and 49 women with benign gynecological tumors. Exceptions to this finding were three apparently healthy women volunteers who had plasma enzyme activity which was higher than two standard deviations from the mean of the control subjects. Increased plasma RNAase activity was also demonstrated for 21 of 22 patients with ovarian carcinomas of differential histological types. This group included two patients with Stage IA, two patients with Stage IC ovarian carcinoma, and 17 patients with advanced ovarian carcinoma. The one exception was a patient with a well encapsulated, mucinous cystadenocarcinoma, Stage IA. The plasma RNAase activity returned to normal values in all of the cancer patients who had no clinical evidence of residual malignant tissue after surgical treatment. However, the enzyme activity also returned to a normal value in one of the 17 women in whom all of the malignant tissue was not removed. These data indicate that plasma RNAase activity can be utilized as a tumor marker for the presence of ovarian malignancies of various histological types, and to differentiate between malignant and benign neoplasms.

Closure of the human umbilical artery: a physiological demonstration of Burton's theory

30 umbilical cords of normal full-term infants were examined immediately after birth for closure of the arteries. Multiple constrictions were observed in the arteries at birth, which increased in number and degree with time. Between the constrictions there were segments of dilatations with trapped blood. Cutting through the constrictions in the cords clamped later than 1 min after birth did not result in leakage of blood from the adjoining dilated segments which contained trapped uncoagulated blood indicating complete closure. This behavior of the vessels is a physiologic example of critical closure of small arteries according to Burton's theory.

Ureterovaginal fistula as a complication of radical pelvic surgery

The main objection to radical hysterectomy and pelvic node dissection as a method of primary treatment for cervical carcinoma is the inherent danger to the ureters that may result in ureterovaginal fistula formation. The purpose of this paper is twofold: (1) to show that with adoption of certain surgical and clinical measures our incidence of fistula formation has been significantly reduced, and (2) to discuss the management of ureterovaginal fistula when it occurs.

The barrel-shaped cervical carcinoma

Twelve patients had barrel-shaped cervical carcinoma among 493 new patients with primary invasive cervical carcinoma, at the Downstate Medical Center, New York from January, 1964 to December, 1972. The incidence of barrel-shaped lesions among invasive carcinoma of the cervix was 2.43%. All 12 patients were treated with external radiation to the whole pelvis followed by two radium applications. In six patients an extrafascial hysterectomy was performed 6 to 12 weeks after radiation. Six patients died and six survived (50%). Six patients survived for over 2 years after therapy with no evidence of recurrence. Of these, four are alive and well for over 5 years. All six patients died within 20 months after therapy. The barrel-shaped cervical carcinoma fared poorly (six deaths among 12 patients or 50%) when compared with the over-all Stage I and Stage II cervical carcinoma (87 deaths among 339 patients or 25.5%).