The effect of spontaneous mutations on competitive ability

Understanding the impact of spontaneous mutations on fitness has many theoretical and practical applications in biology. Although mutational effects on individual morphological or life-history characters have been measured in several classic genetic model systems, there are few estimates of the rate of decline due to mutation for complex fitness traits. Here, we estimate the effects of mutation on competitive ability, an important complex fitness trait, in a model system for ecological and evolutionary genomics, Daphnia. Competition assays were performed to compare fitness between mutation-accumulation (MA) lines and control lines from eight different genotypes from two populations of Daphnia pulicaria after 30 and 65 generations of mutation accumulation. Our results show a fitness decline among MA lines relative to controls as expected, but highlight the influence of genomic background on this effect. In addition, in some assays, MA lines outperform controls providing insight into the frequency of beneficial mutations.

Identifying energy constraints to parasite resistance

Life-history theory suggests that energetically expensive traits may trade off against each other, resulting in costs associated with the development or maintenance of a particular phenotype. The deployment of resistance mechanisms during parasite exposure is one such trait, and thus their potential benefit in fighting off parasites may be offset by costs to other fitness-related traits. In this study, we used trade-off theory as a basis to test whether stimulating an increased development rate in juvenile Daphnia would reveal energetic constraints to its ability to resist infection upon subsequent exposure to the castrating parasite, Pasteuria ramosa. We show that the presumably energetically expensive process of increased development rate does result in more infected hosts, suggesting that parasite resistance requires the allocation of resources from a limited source, and thus has the potential to be costly.

Abstract 1171: Gastrointestinal stromal tumors (GIST) cell proliferation inhibition with combined adenoviral and molecular targeted therapy

Introduction: GIST, the most common mesenchymal malignancies of the GI tract, are characterized by gain-of-function mutations in KIT and PDGFRα receptors. Imatinib and sunitinib are tyrosine kinase inhibitors (TKI) currently approved for the treatment of GIST. Recent evidence suggests that GIST cells acquire secondary resistance to TKI through activation of alternative signaling pathways. We hypothesize that gene therapy with replicative vector oncolysis (virotherapy) can be utilized to improve efficacy of TKI and overcome GIST resistance to treatment.

Objectives: To determine if a panel of oncolytic adenoviruses in combination with imatinib and sunitinib, results in synergistic inhibition of GIST cell proliferation.

Results: GIST882 and GIST-T1 cells were subjected to imatinib and sunitinib treatment in combination with a panel of oncolytic adenoviruses (Ad5, Ad5RGD, Ad5pK7, and Ad5 - Ad3 fiber knob), to assess their inhibitory effects on cell proliferation. The Ad5/3 vector had the best rate of gene transfer and cytolytic effect. The greatest anti-proliferative effects were observed with 100 viral particles/cell of the Ad5/3 vector combined with TKI concentrations of 0.1 µM in GIST-T1 cell line. The combination of TKI and oncolytic adenoviruses showed greater inhibition of GIST cell proliferation (78% decrease) when compared to TKI alone (58% decrease) and viral therapy alone (23% decrease, p<0.01). Successful ex vivo infection and oncolysis of GIST by Ad5/3 particles was confirmed in cells obtained from patient surgical specimens (n=4).

Conclusions: The oncolytic adenovirus Ad5/3 infects and inhibits GIST cell proliferation both in vitro and ex vivo. Virotherapy with Ad5/3 has synergistic anti-proliferative effects with TKI and may help overcome GIST resistance to KIT targeted therapy.

Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1171.

Exploring the molecular landscape of host-parasite coevolution

Host-parasite coevolution is a dynamic process that can be studied at the phenotypic, genetic, and molecular levels. Although much of what we currently know about coevolution has been learned through phenotypic measures, recent advances in molecular techniques have provided tools to greatly deepen this research. Both the availability of full-genome sequences and the increasing feasibility of high-throughput gene expression profiling are leading to the discovery of genes that have a key role in antagonistic interactions between naturally coevolving species. Identification of such genes can enable direct observation, rather than inference, of the host-parasite coevolutionary dynamic. The Daphnia magna-Pasteuria ramosa host-parasite model is a prime example of an interaction that has been well studied at the population and whole-organism levels, and much is known about genotype- and environment-specific interactions from a phenotypic perspective. Now, with the recent completion of genome sequences for two Daphnia species, and a transcriptomics project under way, coevolution between these two enemies is being investigated directly at the level of interacting genes.

2,3,7,8-Tetrachlorodibenzo-p-dioxin affects fluctuating asymmetry of molar shape in mice, and an epistatic interaction of two genes for molar size

Fluctuating asymmetry (FA), random variation between left and right sides in a bilaterally symmetrical character, is a commonly used measure of developmental instability that is expected to increase with increasing environmental stress. One potential stressor is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a powerful toxicant known to disturb tooth development. In this study, mice in the F(2) generation produced from an intercross between two inbred strains (C57BL/6J and AKR/J) were exposed in utero to TCDD. We hypothesized that TCDD would increase FA in the molars of exposed mice over that of the control mice. In addition, we hypothesized that we would discover genes for molar size, shape or asymmetry whose expression would be affected by TCDD. We detected a very small, but significant, increase in FA of molar shape (but not size) in the TCDD-exposed mice compared to the control mice, although molar size and shape did not differ between these groups. Although we did not uncover any genes that acted differently in the TCDD exposed and control groups, we did identify two genes whose dominance by additive epistatic effect on molar size was affected by TCDD. We concluded that although TCDD may be affecting the expression of some genes governing the development of molars in our population of mice, FA of molar size and shape is not a particularly sensitive indicator of this effect.

Effect of forage intake on bodyweight and performance

The horse evolved to survive on rations high in forage. Many performance horses are fed rations containing reduced levels of forage, with a corresponding increase in concentrate supply. Such reductions in forage intake are widely established to be associated with a corresponding number of physiological and psychological adaptations. Therefore, the influence of forage intake on bodyweight (bwt) and performance was investigated. Four Thoroughbred-type geldings in light to moderate work received 4 diets (100% forage [100H]; 80% forage:20% concentrate [80H]; 60% forage:40% concentrate [60H] and 50% forage:50% concentrate [50H]) in a 4 x 4 Latin-square design. A submaximal standardised exercise test (SET) was performed for each diet. Rate of passage, bwt and water intakes were measured throughout the trial and maximum, recovery heart rates and postexercise rectal temperatures recorded for each SET. Mean +/- s.e. bwt was significantly (P<0.001) higher for the 100H compared to the 50H ration (556.89 and 546.28 kg, respectively). Rate of passage of digesta was significantly (P<0.01) slower for the 100H compared to the 50H ration. Water intakes and SET maximum and 1 min recovery heart rates were significantly (P<0.05) higher (mean +/- s.e. 44.72 and 39.07 l/day, 186 and 165 beats/min, and 105 and 96 beats/min, respectively) for 100H compared to the 50H diet. Post-SET rectal temperatures tended to increase with increasing forage intakes, although these effects were not significant (mean 39.85 and 38.65 degrees C for the 100H and 50H diets, respectively). In conclusion, forage intake has significant effects on equine bwt and submaximal performance and a compromise needs to be made between the potential detrimental effects of high forage intake on performance and the potential detrimental effects of low forage intake on equine welfare.

2,3,7,8-tetrachlorodibenzo-p-dioxin affects size and shape, but not asymmetry, of mandibles in mice

Fluctuating asymmetry (FA), the random differences between the left and right sides of a bilaterally symmetrical character, is often purported to be a sensitive measure of developmental instability particularly in populations exposed to environmental stressors. As the level of developmental instability increases, often too does the level of FA. In this study we tested the hypothesis that exposure of pregnant mice to low doses of 2,3,7,8-tetrachlordibenzo-p-dioxin (TCDD) would increase the level of FA in the mandibles of their offspring. We used ten landmark coordinates around the mandible to create a single size variable (centroid size) and 20 Procrustes shape variables. These were used to test for effects of dioxin on mandible size and shape and their asymmetries. We found no detectable effect of TCDD on levels of FA in either size or shape of the mandible, but TCDD did produce a significant decrease in mandible size, and a significant effect on the overall shape.

Determination of MDA for a two count method for stripping short-lived activity out of an air sample

When measuring airborne activity of isotopes with very low annual limit of intakes, interference from natural radioactivity presents an obstacle to obtaining timely results. One method for solving this problem is to perform two separate counts of the sample and mathematically strip-out the contribution from the short-lived component. While this method can process a large volume of samples with little or no preparation time, the sensitivity of the analysis is hard to determine. In an attempt to determine the sensitivity of the analysis and to quantify the parameters that affect it, an equation for the minimum detectable activity was derived. Actual air sample data were then evaluated against this equation to determine its usefulness.

Schistosoma japonicum: immunolocalization of paramyosin during development

This paper describes the localization of paramyosin immunoreactivity in Schistosoma japonicum and represents the first comparative immunolocalization study among schistosome adult, cercariae and lung schistosomula by electron microscopy. A polyclonal antibody was utilized to immunolabel paramyosin or paramyosin-like proteins. Paramyosin was localized within the muscle layer of all 3 developmental stages. Furthermore, paramyosin was localized within granules of the post-acetabular glands of cercariae, and within the tegument matrix and surface of lung schistosomules. Adults and cercariae did not display any detectable paramyosin on the surface or within the tegument. The possible functions of paramyosin within S. japonicum and the relevance of these findings in relation to the reported protective properties of paramyosin as an anti-schistosome vaccine target molecule are discussed.

Alpha 2-adrenoceptor antagonism attenuates the diuretic response to acute cold exposure

Renal alpha 2-adrenoreceptors modulate the hydrosmotic action of arginine vasopressin (AVP) through suppression of AVP-stimulated adenosine 3',5'-cyclic monophosphate (cAMP) accumulation. Circulating catecholamines, likely candidates for the endogenous ligand, are elevated during cold exposure (CE). These studies therefore tested the hypothesis that the diuresis observed with acute CE in rats is due in part to modulation of AVP's tubular action via alpha 2-adrenoceptor activation. Subjects were five male Brattleboro homozygous diabetes insipidus (DI) rats (358 +/- 8 g) receiving chronic AVP replacement (1 microgram.kg-1 x day-1) and seven Long-Evans (LE) normal rats (395 +/- 5 g). In a CE protocol, baseline measurements at room temperature (RT, 24 +/- 0.3 degrees C) were followed by 60-min exposure to 5 +/- 0.5 degrees C. Results were compared with those from a RT time control protocol. The selective alpha 2-antagonist yohimbine (YOH; 10 micrograms.kg-1 x min-1) or vehicle (VEH) was infused throughout the CE and RT protocols. In VEH-infused rats, CE increased urine flow by 63 +/- 12 (DI rats) and 31 +/- 4 microliters.min-1 x 100 g body wt-1 (LE rats), and mean arterial pressure by 36 +/- 1 (DI rats) and 32 +/- 2 mmHg (LE rats). The increased flow was largely a water diuresis, with changes in free water clearance averaging 45 +/- 11 (DI rats) and 28 +/- 3 microliters.min-1 x 100 g body wt-1 (LE rats). YOH treatment completely blunted the cold-induced diuresis in both strains but did not alter the CE-induced hypertension. Glomerular filtration rate was not affected by either CE or YOH infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Mechanisms for the diuresis of acute cold exposure: role for vasopressin?

The hypothesis that inhibition of vasopressin (VP) secretion initiates cold-induced diuresis was tested in six Brattleboro homozygous (diabetes insipidus, DI) rats exposed to 60 min at 5 degrees C. For 9-14 days before cold exposure (CE) the rats were treated with VP (750 pg.kg-1.min-1) subcutaneously via osmotic minipumps. Eight vehicle-treated Long-Evans (LE) rats characterized the response to acute exposure at 5 degrees C. Additional groups of six to eight LE and six DI rats were infused with VP (30-90 pg.kg-1.min-1 iv) on the day of CE. The DI rats receiving chronic VP replacement and untreated LE rats exhibited cold-induced diuresis, with peak increases in urine flow (V) of 63 +/- 12 (DIs) and 29 +/- 4 (LEs) microliters.min-1 x 100 g body wt-1. LE rats acutely infused with VP exhibited a diuresis at the two lower doses (peak V was 18 +/- 3 at the 30 and 18 +/- 4 microliters.min-1 x 100 g body wt-1 at the 60 pg.kg-1.min-1 dose), but the diuretic response was completely blunted at the uppermost dose of VP. Cold-induced diuresis was absent at the lowest VP dose in the acutely infused DI rats. A pressor response (30-36 mmHg) to CE was noted with all treatment groups, including those that did not exhibit a diuresis. No changes in glomerular filtration rate (GFR) with CE were observed. These data suggest that when plasma VP levels are controlled by prolonged infusion of VP in the DI rats, other mechanisms can operate to initiate cold-induced diuresis.(ABSTRACT TRUNCATED AT 250 WORDS)

Dissecting the patient stay in the UK

A method of analysing the factors which contribute to the length of stay in England as an acute medical in-patient has been developed, and applied in both real-time and cross-sectional studies. The major factors delaying discharge were found to be the time taken to respond to treatment and the actions of agencies other than the acute medical unit of the hospital. Areas where improvement could be made have been identified and some changes implemented. The system can be applied to monitor the effect of such changes.

Attitudes toward certification. A pilot study

The CNOR certification is a voluntary commitment that individual perioperative nurses make after considering financial, professional, and personal issues. The results of this survey indicate that CNOR certification is sought to fulfill personal and professional goals. A vital component in the delivery of quality perioperative patient care is the individual nurse. This is true whether or not the perioperative nurse is certified. One question is the value of the CNOR process in the validation of nurses for the delivery of perioperative patient care. It is easy to assume that if knowledge is present, the knowledge will be applied. Assumptions, however, can be misleading. These findings suggest that several nursing traits interact to promote quality perioperative patient care delivery, and CNOR certification is only one of those traits. Claims of CNOR outcomes should be based on documented support rather than assumption and speculation. Further investigation on a much larger and more inclusive scale is needed before suggesting specific changes to the present certification process. This project substantiates the process and the feasibility of conducting future studies. Using a modification of this survey tool in future studies would provide support to the reliability of these findings. This investigation shows that CNOR certification is an important topic to perioperative nursing. With current NCB:PNI proposals and other national considerations, CNOR certification will continue to be an important issue.

Thin histological sections prepared from large thick sections: a new technique

A method is described for obtaining thin (1 microm) sections for light microscopy from large area thick (100 microm) sections of low viscosity nitrocellulose embedded specimens of human spinal osteoligamentous material.

Effect of sympathectomy on renal and circulatory action of atrial natriuretic peptide

Sympathetic nervous system (SNS) involvement in cardiovascular (CV) and renal actions of atrial natriuretic peptide (ANP) was examined in eight chronically instrumented rats. Responses to 90-min atriopeptin II infusion (0.03 then 0.3 micrograms.kg-1.min-1) were compared with those to sodium nitroprusside (NP; 2 + 20 micrograms.kg-1.min-1) before and after sympathectomy (SX) with 6-hydroxydopamine (6-OHDA). The NP-induced drop in blood pressure (BP) was greater after SX (-12 +/- 1% before vs. -24 +/- 2% after SX). In contrast, 6-OHDA altered (blunted) only the bradycardic response to high dose of ANP (-23 +/- 5% before vs. -3 +/- 4% after SX). The decreased BP (-18 +/- 1% before vs. -12 +/- 2% after), depressed cardiac output (CO; -29 +/- 1% before vs. -22 +/- 3% after), and elevated systemic vascular resistance (SVR; 16 +/- 2 vs. 16 +/- 6%) were unchanged (paired t test, P greater than 0.05). The high dose of ANP increased urine flow by 43.2 +/- 7.2 microliters.min-1.100 g body wt-1 and sodium excretion by 1.76 +/- 0.56 mu eq.min-1.100 g body wt-1 but had no effect after SX. These results suggest that while withdrawal of SNS activity contributes to the CO-lowering effect of ANP, it does not mediate its action to elevate SVR. Attenuation of the capacity for reflex sympathoexcitation by SX did not reveal a vasodilator action. The lack of response after SX suggests that ANP's renal excretory actions are mediated in part by withdrawal of SNS activity.

Hemodynamic responses to leukotriene receptor stimulation in conscious rats

We evaluated the effects of leukotrienes (LTs) C4 and D4 on systemic and renal hemodynamics in conscious rats. Intravenous injections of LTC4 or LTD4 (0.5-10 micrograms/kg) caused dose-dependent decreases in cardiac output (CO), renal blood flow (RBF), and heart rate (HR). Flow alterations were accompanied by increased systemic and renal vascular resistances (SVR and RVR) and mean arterial blood pressure (MAP). No secondary hypotensive effect was observed. The HR response was biphasic, with tachycardia replacing the initial brief bradycardia. The changes in RBF and CO were not concurrent; the maximum RBF decrease (47.6 +/- 9.5%, P less than 0.05) occurred when CO was down only by 9.1 +/- 3.6% (P less than 0.05) and RBF had fully recovered in 3-4 min, while CO was still down by 26.3 +/- 3.5% (P less than 0.001). Hematocrit (HCT) increased after the injection of 5 and 10 micrograms/kg doses of LTC4 or LTD4, and its time course of recovery to basal level (30-60 min) paralleled that of CO. Sustained intravenous infusion of the selective LT receptor antagonist, SK&F 104353, dose-dependently inhibited the immediate hemodynamic changes after LTD4 injections. SK&F 104353 also attenuated the increase in vascular permeability and the prolonged decrease in CO, suggesting that the observed cardiac and vascular effects of LTs were mediated by stimulation of LT receptors.

Epidemiologic study of deaths and injuries due to tornadoes

A case-control study, using both matched and unmatched controls, was carried out on individuals who were injured or killed by a series of tornadoes that passed through Ontario, Canada, on May 31, 1985. Many serious injuries (25%) and almost all (83%) deaths were the result of becoming airborne, while most minor injuries (94%) were due to being struck by objects. Head injury was the most common injury type. Few (21%) of those in buildings chose the recommended location, and most (61%) were not in the least damaged part. Most (91%) had less than one minute's warning, and only 47% had a functioning radio at the time the tornado hit. The following risk factors for injury and death were identified: poor building anchorage; location other than in a basement, especially outdoors; age over 70 years; and high wind strength. These findings support previous findings and point to measures which have potential for preventing death or serious injury in future tornadoes: adequate warning systems and public education to ensure that individuals understand the warning and respond by seeking appropriate shelter. Those in adequately anchored buildings should shelter in an interior room or basement. Those who are outdoors, in poorly anchored buildings, mobile homes, or portable classrooms require access to an adequately anchored building, preferably with a basement, during severe storm warnings. This should be arranged by local authorities.

An investigation of managerial characteristics of health care managers: a comparison study

This study compared the managerial trait profiles of health care managers with hospital administrators and managers in the general business community. It focused on two central issues: (1) the preparedness of health care managers for managerial responsibility as compared with managers in other occupations; and (2) the impact of gender differences on the trait profiles. Results indicated that, while differences existed between the groups studied, health care managers exhibited characteristics associated with managerial success. Additionally, gender differences were evidenced, inasmuch as women had stronger managerial profiles than their male counterparts.

Cardioinhibitory effect of atrial peptide in conscious rats

The hemodynamic and renal excretory responses to 150-min atriopeptin II (AP II) infusion (330 ng X kg-1 X min-1) were assessed in five chronically instrumented rats with (FR protocol) and without (NR protocol) replaced urinary fluid losses. The observed changes were compared with those obtained by vehicle in the same rats. The hypotension seen with AP II infusion (120-min value: -27 +/- 2%, FR and NR responses combined) was due solely to a decreased cardiac output (CO; 120-min combined value: -34 +/- 3%). Total peripheral resistance remained unchanged or slightly elevated. A drop in stroke volume plus a later-developing (by 75-90 min) decrease in heart rate contributed to the CO decline. This latter bradycardic component, the opposite response to that typically produced reflexly by hypotension, was reversed by atropine sulfate treatment at 120 min and may thus be neural in origin. The finding of similar hemodynamic changes in the FR and NR rats and the lack of a significant effect of AP II on hematocrit suggest that volume depletion or a plasma extravasation were not contributors to the cardioinhibitory effect of the peptide.

Contrasting views on the action of atrial peptides: lessons from studies of conscious animals

In a rather short time, a consensus seems to have emerged among researchers regarding the mechanisms of the natriuretic and hypotensive actions of atrial natriuretic factor (ANF). According to the by now classic view, the natriuresis induced by ANF is mediated by changes in renal hemodynamics; vasorelaxation is proposed as the primary mechanism of its hypotensive action. Recent evidence, mostly from experiments with conscious animals, does not support this view. Results from experiments performed with chronically instrumented spontaneously hypertensive rats and normotensive (Wistar-Kyoto and Wistar) rats show that the natriuresis induced by a synthetic ANF is not accompanied by increases in glomerular filtration rate or renal blood flow. Measurement of cardiac output (CO) and blood pressure indicate that a decrease in CO, not a fall in total peripheral resistance, is the cause of the decrease in blood pressure. Based on this and other available evidence, a hypothetical scheme for the biological role of ANF is proposed.

Ludwig's angina. The anaesthetic management of nine cases

We reviewed nine patients with Ludwig's angina who required surgical drainage over a 24-month period. This represents the largest series reported in world literature. All of these patients were managed successfully by a combination of tracheal intubation and early surgical intervention. None required tracheostomy, which is the previously recommended procedure of choice for airway management.

Maternal practice and attitudes toward breastfeeding

An age-graded sample of 411 New York City mothers is assessed to evaluate the direction and amount of change in incidence of breastfeeding. Social and demographic factors are considered and are found to have little trend effect. This limited sample fails to indicate any increase in breastfeeding in the 1970s, as compared to earlier decades. However, maternal attitudes are more positive toward breastfeeding than toward bottlefeeding; and some ethnic, economic, and sociocultural factors do affect decision to breastfeed.

Histochemistry of glomerular cells in animal models of crescentic glomerulonephritis

A histochemical enzyme profile has been used to determine the origin of the cells of glomerular crescents in rabbit and sheep models of rapidly progressive crescentic glomerulonephritis. Crescentic glomeruli were examined for beta-glucuronidase, esterase and acid phosphatase, the characteristic phagolysosomal enzymes of the monocyte-macrophage series and its transformed tissue counterpart, the epithelioid cell. More than 50% of the cells of the glomerular crescents of animals with experimental crescentic glomerulonephritis contained large amounts of all the enzymes, whereas the cells of normal glomeruli contained only trace amounts of acid phosphatase and esterase and no glucuronidase. These findings support the hypothesis that the major proportion of the cells of glomerular crescents are monocytes which have accumulated in Bowman's space rather than intrinsic glomerular cells which have proliferated.

Generalized microsporum audoninii infection and depressed cellular immunity associated with a missing plasma factor required for lymphocyte blastogenesis

Described herein is a 15 year old girl with a generalized, possibly systemic Microsporum audouinni infectin associated with anergy and defective lymphocyte transformation as a consequence of a deficiency of an uncharacterized plasma factor. Intravenous administration of plasma, obtained from normal donors, has produced consistent although incomplete clinical improvement. Defective lymphocyte transformation to M. audiouinii antigen cultured in autologous plasma became normal after infusions of normal plasma were instituted. Systemic administrations of griseofulvin, clotrimazole and miconazole produced transient and incomplete clinical improvement. Clearing of the cutaneous infection and stabillization of the neurologic status was finally achieved with plasma infusions combined with parenterally administered amphotericin B.

Dr. Ward's Case

Images

Robust metal complexes, ferrocenylmethyl carboxyhydrazide and 1-chloromercuriferrocene, as electron-opaque stains for aldehydes and thiol groups

Ferrocenylmethyl carboxyhydrazide has been used for the ultrastructural localization of glycogen, the glycocalyx of cat intestine and deoxyribonucleic acid. l-Chloromercuriferrocene is introduced as a stain for thiol groups in wool. Both compounds are examples of a potentially useful class of cytochemical stains made from a "robust" metal complex by inserting a suitable functional group on the periphery of the molecule. In such stains, where the metal is firmly bound, the need to carry out chelation reactions in the tissues is avoided and the risk of random metal deposition is greatly diminished.

Cutaneous infections due to Corynebacterium diphtheriae

Toxigenic Corynebacterium diphtheriae was grown from skin lesions of 44 indigent patients seen at the emergency or out-patient departments of this hospital, 43 of them within the last 16 months of the study period. In all cases staphylococci or hemolytic streptococci were also present in the wounds. An increase in the incidence of clinical diphtheria occurred in the few months preceding and overlapping the period of recognition of the cutaneous infections. The gravis strains, which accounted for the majority of the infections, were sensitive to erythromycin and to penicillin, but were relatively resistant to cloxacillin.

The intramuscular nerve endings in dystrophia myotonica--a biopsy study by vital staining and electron microscopy

Images