Integron-bearing methicillin-resistant coagulase-negative staphylococci in South China, 2001–2004

A total of 53 methicillin-resistant coagulase-negative staphylococci strains isolated in a hospital in Guangzhou, China, were analyzed to detect class 1 integrons and SCC mec typing. Thirty strains had the class 1 integrase ( intI1 ) gene and 26 strains possessed the 3' conserved region of qacE Δ 1 - sul1 . Four different types of gene cassette arrays were found and a highly prevalent array of dfrA12-orfF-aadA2 gene cassettes was observed. Thirty class 1 integron-positive coagulase-negative staphylococci strains were subjected to Southern hybridization analysis; the result showed that class 1 integrons were located on chromosome, not plasmid. According to the results of SCC mec typing for 30 integron-bearing MRCNS strains, five, 15 and five strains belonged to type I, II and III SCC mec , respectively, and five strains were untypeable. For 23 non-integron-bearing methicillin-resistant coagulase-negative staphylococci strains, four, nine and seven strains belonged to type I, II and III SCC mec , respectively, and three strains were untypeable. None of the strains belonged to type IV or V. Twenty-three coagulase-negative staphylococci isolates of three Staphylococcal species that contained the dfrA12-orfF-aadA2 gene cassette array were phylogenetically unrelated to each other by randomly amplified polymorphic DNA, indicating that the gene cassettes might be disseminated in the clinical strains by a horizontal gene transfer.     

Integron-bearing methicillin-resistant coagulase-negative staphylococci in South China, 2001-2004.

A total of 53 methicillin-resistant coagulase-negative staphylococci strains isolated in a hospital in Guangzhou, China, were analyzed to detect class 1 integrons and SCCmec typing. Thirty strains had the class 1 integrase (intI1) gene and 26 strains possessed the 3' conserved region of qacEDelta1-sul1. Four different types of gene cassette arrays were found and a highly prevalent array of dfrA12-orfF-aadA2 gene cassettes was observed. Thirty class 1 integron-positive coagulase-negative staphylococci strains were subjected to Southern hybridization analysis; the result showed that class 1 integrons were located on chromosome, not plasmid. According to the results of SCCmec typing for 30 integron-bearing MRCNS strains, five, 15 and five strains belonged to type I, II and III SCCmec, respectively, and five strains were untypeable. For 23 non-integron-bearing methicillin-resistant coagulase-negative staphylococci strains, four, nine and seven strains belonged to type I, II and III SCCmec, respectively, and three strains were untypeable. None of the strains belonged to type IV or V. Twenty-three coagulase-negative staphylococci isolates of three Staphylococcal species that contained the dfrA12-orfF-aadA2 gene cassette array were phylogenetically unrelated to each other by randomly amplified polymorphic DNA, indicating that the gene cassettes might be disseminated in the clinical strains by a horizontal gene transfer.     

Cytohistologic correlation between AGUS and biopsy-detected lesions in postmenopausal women

OBJECTIVE: To evaluate histologic findings in patients aged 50 and older whose cervical smears revealed atypical glandular cells of undetermined significance (AGUS). STUDY DESIGN: Computerized records spanning a four-year period were retrospectively analyzed. Thirty patients over age 50 had cervical smears interpreted as AGUS and had follow-up biopsies within 12 months following the abnormal smear. The most important histologic diagnosis from the biopsy specimens was correlated with the subcategory of the cervical smear. RESULTS: Five smears interpreted as AGUS, favor reactive, revealed abnormal histology in four cases: three endometrial polyps and one squamous carcinoma. Two smears interpreted as AGUS, favor dysplasia, revealed squamous intraepithelial lesions on biopsy in both cases. Seventeen smears interpreted as AGUS, favor endometrial cells, revealed abnormal histology in 13 cases: 1 endocervical polyp, 6 endometrial polyps, 3 endometrial hyperplasias and 3 adenomyosis. Six patients with smears interpreted as AGUS, unclassifiable, revealed abnormal histology in five cases: two endocervical polyps, one endometrial polyp, one endometrial carcinoma and one ovarian carcinoma. CONCLUSION: The presence of AGUS in cervical smears from women over 50 was highly predictive of abnormal lesions detected by histologic examination. Although three cancers were detected on histologic follow-up, the most common lesions detected were endometrial polyps.     

Characteristics of bird species using forest and agricultural land covers in southern Costa Rica

Our understanding of why tropical forest species differ in their ability to inhabit agroecosystems is limited, despite the link between this ability and the likelihood of population decline for species inhabiting regions undergoing widespread conversion of forest to agriculture. We used logistic regression and data from southern Costa Rica to develop a model based on natural history characteristics to distinguish between forest species that did or did not use agricultural land covers. We sampled birds along 15 3.0-km routes, seven in forest and eight in agriculture, five times over three years. Each species was classified as an F-species, detected only in forest, a G-species, detected in both forest and agriculture, or an A-species, detected only in agriculture. Thirty percent of species were F-species, 42% were G-species, and 28% were A-species. Based on the logistic regression model, the likelihood of being a G-species, as opposed to an F-species, was low for species that were dependent on forest interior, had a stenophagous diet, and a small elevational range. Weight, resident versus migrant status, and whether or not a species was insectivorous, were not significant predictors of being a G-species. For all F–G species pairs, the model correctly predicted the G-species 70% of the time. The model provides a first step in identifying those characteristics that predispose forest species to use agricultural land. In addition, our results indicate that the structurally simple agricultural systems of the study region are of limited value for a large proportion of the regional species pool.     

睡莲科的属间关系研究

本文用谱系分支法分析睡莲科的属间关系,３５个衍征中,分析了３１个特征的进化趋势,根据分析将睡莲科提升为睡莲目,分为３个科,莲科、水盾草科、睡莲科。     

How predictive is a cervical smear suggesting invasive squamous cell carcinoma?

How predictive is a cervical smear suggesting invasive squamous cell carcinoma? Features have been described in severely dyskaryotic cervical smears that suggest frankly invasive or microinvasive squamous cell carcinoma. These are reported in three separate categories in our department. The aim of the current study was to assess the positive predictive value of these categories for invasive disease on histology. All smears reported in these categories over a five year period were correlated with the histology results. 527 smears were assessed. The positive predictive value of a smear suggesting frank invasion was 55.7% for all invasive squamous carcinomas and 40% for stage IB or above. Smears suspicious of invasion or microinvasion predicted invasive disease in 22.3% and 17.2%, respectively, most carcinomas being stage IA. Invasive squamous cell carcinoma may be predicted to a limited degree by cervical cytology especially when the smear suggests frank invasion.     

Variations of stiffness and strength along the human cervical spine

The load-displacement response and strength of the mid (C2-C5) and lower (C5-T1) cervical regions were determined for combinations of sagittal loads, in vitro. In unpaired t-test comparisons, the mid cervical region was significantly stiffer in compression and extension than the lower region. In tests to failure, failure in six out of seven mid cervical specimens resulted from flexion alone, while combined compression-flexion was required to fail five of the eight lower cervical specimens. Post-test dissections revealed no regional differences in the pattern of failure. In addition to sagittal tests, the load-displacement responses of three-vertebrae cervical specimens were measured with the upper body axially rotated with respect to the lower body. The effect of this pre-torsion was to diminish the zone of low slope near zero load for axial, shear, and flexion motion. Three of the four axially rotated specimens failed in flexion without added compression. These controlled load-displacement measurements of cervical spine specimens describe for the first time the continuous flexion-compression response up to failure, and suggest that consideration of the biomechanics of three apparently distinct mobile regions of the cervical spine (C1-C2, C2-C5, C5-T1) may facilitate the interpretation of hazardous conditions and the diagnosis of injury. These data also provide basic information for the in vitro investigation of passive cervical spine protection such as helmets and head-rests, suggesting that the head should be kept in a non-rotated position to reduce risk of injury.     

Asian patients attending a diabetic clinic.

Patients of Asian origin comprised 8% of the patients attending a diabetic clinic. Of the 201 Asian patients (120 male), 110 had been diabetic for more than five years, and although 141 were 40 to 60 years old, over one quarter had been aged under 40 at diagnosis. Thirty patients were being treated with insulin, but only eight were truly dependent on insulin compared with 18% of the white patients attending the clinic. Insulin was stopped in eight patients who were receiving insulin inappropriately; control was achieved by diet plus oral hypoglycaemics or diet alone. Over three years 37 patients were admitted with ketoacidosis but none was Asian. During the same period, however, five Asians were admitted in hyperosmolar coma. Asian diabetics have a low prevalence of insulin dependence, possibly related to genetic and environmental factors, and some may be treated with insulin inappropriately.     

Demonstration of differential immunohistochemical localization of the neuron-specific enolase antigen in rat pinealocytes

A refined method for the immunohistological demonstration of neuron-specific enolase (NSE) on 1- to 2-micron Epon-812 section gave characteristic staining of cerebral and cerebellar neurons. This method has made it possible to obtain a more detailed characterization of the heterogeneity of rat pinealocytes in the superficial portion of the rat pineal complex. Thirty adult male rats have been studied, five of which were used in a photometric analysis of the distribution of NSE. Pinealocytes stained either intensely or weakly for the NSE antigen and exhibited an uneven distribution within a given region. Further analysis of the gland revealed a distal to proximal decrease in stain intensity. It is suggested that the more strongly stained cells, being concentrated distally, are under sympathetic control.     

The psammic rotifer structure in three Lobelian Polish lakes differing in pH

Thirty five species of rotifers were found in the psammon of three lakes of differing pH in open water. The largest number of rotifer species and their highest abundance was found in lake Rekowskie which had a slightly acid to neutral water pH. The lowest quantity and the number of rotifers species were observed in the lake with lowest pH. The results suggest that pH is one of the most important factors affecting the number and diversity of psammic rotifers in these lakes.     

Quality of care in managing hypertension by case finding in north west London.

The records of patients who were registered with general practice in inner London and outer London (both training and non-training practices) were examined for details of blood pressure recordings. A blood pressure recording was found in the past five years in only 22% of the notes of inner London practices but in 43% of notes in outer London practices, there being no difference between training and non-training practices. In 31% of the notes with a blood pressure recording the blood pressure had been raised (greater than or equal to 160/90) at some time: in 62% of these notes for patients aged 65 or more and in 52% of these notes for patients aged under 65 treatment had been given at some time. Thirty eight per cent of patients in the older group and 33% in the younger group were being treated at the time of the survey, thiazides being the most commonly used drugs. Thirty four per cent of all those with a raised blood pressure at some time had a latest recording of under 90 mm Hg diastolic. There seems to be a continuing need for general practitioners to detect and treat hypertension, and it is suggested that general practitioners should consider using systematic case finding for hypertension in their practices.     

Contamination of human milk with nitrates and nitrites

Human milk nitrates and nitrites were assayed colorimetrically. Colostrum samples were collected on the 3rd postpartum day from 59 women inhabiting Pu?awy region and being potentially exposed to nitrogen compounds emitted from the industrial sources. Thirty five Lublin inhabitants serving as a control group were matched in age, parity and duration of pregnancy. Geometric mean value of nitrates and nitrites concentration in the human milk being 2.83 mg/L and 0.46 mg/L, respectively were higher in the examined group than those in the control group /2.76 mg/L and 0.32 mg/L/ but difference was statistically insignificant. Ratio of nitrates and nitrites in the examined samples was 7.38 on the average and the concentration of those compounds was related statistically significantly /p less than 0.001/. The average daily intake of nitrates and nitrites by the breast-fed neonates was 0.12 mg/kg body weight and 0.02 mg/kg body weight, respectively. These values did not exceed corresponding ADI recommended by the Joint Expert Committee of FAO/WHO in none case. Significantly positive correlation of examined mothers' age and parity with nitrates content in their colostrum was seen. In view of the obtained results is may be assumed that the examined colostrum samples contain low amounts of both nitrates and nitrites.     

Preliminary results of a district call scheme for cervical screening organised in general practice.

A recognised problem with the cervical screening programme in the United Kingdom is the failure to include women who have never had a cervical smear test, who are a high risk group. The implementation of a district based call scheme in East Berkshire in 1986 is described whereby women aged 20-64 with no record of a cervical smear test who were judged to be eligible for testing by their general practitioner were sent a personal invitation from their general practitioner to attend for a test. A list of high risk unscreened women was kept by each practice, and a duplicate sent to the cytology laboratory to update the central records. Six months after each batch of invitations had been sent the resulting number of women having a smear test was assessed. Forty three of 51 practices approached agreed to participate in the five year scheme. During the first year lists were sent to the 43 participating practices. The first list was returned to the cytology laboratory by 37 practices and the second by 33; practices varied in their responses, however, some needing considerable persuasion to return the lists. Of 972 identified unscreened women from the total 3757 women listed in the lists of the family practitioner committee, 247 (25%) had a cervical smear test in response to the invitation, representing an overall increase of 7% in the screened population. The preliminary findings of the five year study have shown that screening can be improved by a systematic call scheme. Coordinated support from the area health authority in health education, monitoring of screening, and feedback of data from the scheme to practices is required to reduce the proportion of unscreened women.     

Mentally abnormal prisoners on remand: II—Comparison of services provided by Oxford and Wessex regions

Most regional health authorities have or plan to have secure units for treating mentally abnormal offenders. A retrospective study was carried out to compare the effectiveness of the health care services for men remanded to Winchester prison from Oxford and Wessex regions over the five years 1979-83. Thirty seven (30%) of 124 prisoners from Oxford region were rejected for treatment compared with 36 (16%) of the 220 men from Wessex region. Men from Oxford region were significantly more likely to be recommended for admission to a special hospital than those from Wessex (13/124 (10%) v 9/220 (4%), respectively) and significantly less likely to be recommended for admission to a hospital in the catchment area (35/124 (28%) v 94/220 (43%)). Men on remand from Oxford region were significantly more often perceived as being disruptive or aggressive by hospital staff and more likely to be labelled as having psychopathic or personality disorders. These differences may have reflected different attitudes towards mentally abnormal offenders and the allowances in the services available in the two regions; in particular, Oxford region did not have a secure unit or a forensic psychiatrist.If mentally ill prisoners do not receive the treatment that they need they run the risk of being criminalised. Most such men are best treated in general psychiatric units; only a few require secure conditions and staff with specialised psychiatric skills.     

Predicting mortality from cervical cancer after negative smear test results.

OBJECTIVE--To assess the relative protection against death from cervical cancer after two or more negative smear test results and compare it with the protection against invasive cancer estimated by an International Agency for Research on Cancer (IARC) working group in an analysis of data from 10 large screening programmes. DESIGN--Comparison of risk of death from cervical cancer after two or more negative smear results with the risk in unscreened women by using a model constructed with data from the British Columbia screening programme. MAIN OUTCOME MEASURES--Mortality from and incidence of invasive cancer. RESULTS--In women with two negative smear results estimates of protection against cervical cancer were about 50% higher when lethal invasive cancer was used as the criterion rather than all invasive cancer. This difference was due to these women being more likely to attend for further tests at which invasive cancer could be detected: screen detected cancer has a better prognosis than clinically diagnosed cancer. Screening intervals could be longer than three years: screening women aged 35-64 every five years was predicted to result in a 90% reduction in mortality from cervical cancer. CONCLUSION--Because protection from mortality is higher than protection from disease and because of the high costs and negative side effects of frequent screening, screening intervals should be longer than three years.     

Haplotypic variation and characteristics across the toll-like receptor 3 locus in chickens

Toll-like receptor 3 (TLR3) has an important protective function against viral infection. The ability of an individual to respond properly to TLR ligands may be impaired by variants located in the TLR genes. By directly PCR sequencing four exons and their flanking sequence of chicken TLR3, a total of 50 nucleotide variants were identified from five breeds. Tibetan chickens and Silkies exhibited more abundant variation sites and rare alleles. Thirty haplotypes were reconstructed, with 31 variants whose minor allelic frequency was above 5% in five breeds, which revealed four divergent clades. Chicken TLR3 was partitioned into three haplotype blocks by the htSNPer program, and six tag SNPs could be used to distinguish these 30 haplotypes. Thirty variants were located in the coding sequence of chicken TLR3, and 16 of them were non-synonymous substitutions. It is predicted that p.Ser180Gly amino substitution could form an N-myristoylation site; the p.Lys240Thr amino substitution in chicken TLR3 could result in the loss of one protein kinase C phosphorylation site. These data provide a basic understanding of chicken TLR3 sequence variation and provide haplotypic markers for disease association studies.     

Floral vasculature in Alpinia hainanensis in relation to the nature of the labellum in gingers

Observations presented here on floral vasculature in Alpinia hainanensis indicate that the labellum incorporates elements of five androecial members rather than two or three, as suggested by previous authors for Zngiberaceae flowers. The pedicel contains an outer ring and a central region of vascular bundles. Three carpellary dorsal bundles (CDs) and three alternatively arranged parietal bundles (PBs) separate from the central region successively. The remaining bundles of the central region run upwards and become the placental bundles to supply ovules. The placental bundles terminate between the top of the locular region and the base of the prolongation. The three PBs divides into about five strands respectively. Of which the outer strand enters into the petal being its midrib and the remaining strands move into the stamen adaxially being the vasculature of the functional stamen and the labellum abaxially being the lateral strands of the labellum. The three CDs divide into about five traces, of which the outer strand becomes the midrib of each sepal and the inner strand runs into the style. The remaining traces re‐unite, re‐divide again in the course up and the two adaxial sets of carpellary dorsals finally enter into the labellum being the marginal traces of it while the abaxial single strand enters into the labellum being its midrib. The two antero‐lateral glands receive small traces without lignified tube elements from the vascular plexus, which fonn in prolongation from both PBs and CDs and a few small strands in the ovary wall. There are no subulate appendages differentiated in the flower of Alpinia hainanensis. Hereby, the median of the sepals, both the marginal portions and the median of labellum, and the style have the same origin in vasculature from the CDs and so do the stamen, the lateral portions of labellum and the median of the petals from PBs. The labellum is supposed to represent three members of the outer androecial whorl by its two marginal portions and the median and two members of the inner whorl by its two lateral parts except the median.     

Lipid droplets in the lining epithelium of the crop of Columba livia

Presence and distribution of lipid were studied in the lining epithelia of three regions of the pigeon (Columba liva) crop: lateral lobes, median region near the cervical esophagus and median region near the thoracic esophagus. During the resting phase of the 'milk gland', insulated lipid droplets were observed within the lining epithelium of the three regions studied. On the other hand, during the activity of the 'milk gland' (under action of exogenous prolactin and in natural incubation), only the lateral lobes showed a remarkable increase in the amount of lipid, whereas both median regions showed only an inexpressive increase of lipid within their epithelium.     

Risk of significant gynaecological pathology in women with ?glandular neoplasia on cervical cytology

A. Talaat, D. Brinkmann, J. Dhundee, Y. Hana, J. Bevan, R. Irvine, S. Bailey and R. Woolas
Risk of significant gynaecological pathology in women with ?glandular neoplasia on cervical cytology Objective: To review the risk of pre‐invasive and invasive gynaecological pathology in women referred with cervical cytology reporting ?glandular neoplasia. Methods: Review of the case notes of all women referred with cervical cytology reported as ?glandular neoplasia between January 1999 and December 2008 at two UK hospitals: Portsmouth Hospitals NHS Trust and Queen Mary’s Hospital Sidcup. The category of ‘borderline nuclear change in endocervical cells’, result code 8 according to the national health service cancer screening programme (NHSCSP), was excluded from the study. Results: A total of 200 women were identified using the hospitals’ pathology computer systems. Invasive carcinoma was found in 48 women (24%): 28 endocervical adenocarcinomas, eight squamous cell carcinomas (SCC), ten endometrial and two ovarian adenocarcinomas. Pre‐invasive neoplasia was found in 115 (57.5%), including 14 cervical glandular intraepithelial neoplasia (CGIN), 31 cervical intraepithelial neoplasia (CIN) grade 2/3 and 70 concomitant CGIN and CIN2/3. CIN1/HPV was found in 25, simple endometrial hyperplasia in three and no histological abnormality in three. Thirty‐four (70.8%) of 48 invasive carcinomas (of which 23 were endocervical adenocarcinomas) were in asymptomatic women investigated for abnormal cytology. Fourteen of 34 (41.4%) of those with ?glandular neoplasia thought to be endometrial were CGIN or CIN2/3. Colposcopic appearances were normal in 47.6% of women with pure cervical glandular neoplasia (adenocarcinoma or CGIN) compared with 12.8% with squamous cell lesions (CIN2/3 or SCC): P = 0.0001. Thus, colposcopy was more sensitive for detecting squamous cell abnormalities than their glandular counterparts. Although cervical adenocarcinomas are less amenable to prevention by screening than cervical SCC, in our study cervical cytology predominantly detected these abnormalities at their early asymptomatic stages. Conclusion: At least CIN2 was found in 81.5% in women referred with cervical cytology reporting ?glandular neoplasia. A thorough evaluation of the whole genital tract is needed if colposcopy is negative.     

Diagnosis and treatment of cervical intraepithelial neoplasia in general practice.

OBJECTIVE--To audit the first five years of a colposcopy and treatment service for cervical dysplasia established within a general practice. DESIGN--A cervical smear register was established to determine which women were "at risk" of dysplasia. The results of colposcopy and treatment of dysplasia were analysed. SETTING--A large rural general practice with community hospital facilities in mid-Wales. PATIENTS--4437 Women at risk in a total practice population of 14,100. INTERVENTIONS--Colposcopy of women with dyskaryotic smear results, persistent inflammatory smear results, or vulval warts. Treatment of women with proved dysplasia by electrodiathermy of the cervix or cone biopsy. RESULTS--138 Women with dysplasia were diagnosed over five years: 36 mild, 97 moderate or severe, and five with microinvasion. Despite a 78% smear rate of at risk women over five years, nine invasive cancers still occurred. CONCLUSIONS--The results of treatment are acceptable. Cervical dysplasia has become very common, the risk of a dysplasia in women aged 20-39 who had smear tests being one in 14 over five years.