Bovine microsomal albumin: amino terminal sequence of bovine proalbumin.
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Amino Acid Sequence↗
Biomedical subjects
J E Patterson
Publications and source records attributed to J E Patterson.
Aberrant canal to mandibular third molar area.
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Adult↗
Lingual sebaceous glands: report of case.
A 28-year-old dentist noticed a 9X5-mm yellow submucosal plaque in the midlateral dorsum of his tongue. After a period of observation an excisional biopsy was performed. The histopathologic examination of the specimen revealed normal sebaceous glands opening onto the tongue surface. This occurrence of ectopic sebaceous glands in the tongue is notably rare in contrast with their frequent occurrence in the lips and buccal mucosa.
Adult↗
An appliance that permits early mobilization after correction of mandibular prognathism.
With certain orthognathic surgery patients, such as epileptics, severe asthmatics, or those with other medical problems that increase risk during intermaxillary fixation, there occasionally may be an indication for a reduced fixation time. By using Vitallium mesh for stability, immobilization for 2 to 2 1/2 weeks has proved to be sufficient in a limited number of cases. Mobilization before two weeks has not been attempted. The procedure, however, is not recommended as a routine method of fixation.
Humans↗
Biopsy: rationale and technique.
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Biopsy↗
Time-kill kinetic studies of ampicillin/sulbactam for beta-lactamase-producing enterococci.
beta-Lactamase-producing (Bla+) enterococci have now been reported from several geographic areas. Most of these strains also demonstrate high-level aminoglycoside resistance, making therapy of serious infections due to Bla+ enterococci difficult. Using time-kill kinetic studies, we evaluated the activity of ampicillin-sulbactam (Am/SB) against five clinical Bla+ Enterococcus faecalis isolates from three geographically distinct areas. Am at fourfold minimum inhibitory concentrations (MIC) concentrations did not achieve bactericidal activity as determined by time-kill kinetic studies. Am/SB achieved 99.9% reduction in growth at 24 hr at twofold MIC concentrations without an aminoglycoside in four of five strains. SB alone had little independent activity against any of the strains, but synergy of killing was achieved in all five strains with a combination of Am + SB. No synergy was shown in a Bla- control strain. Am/SB may be useful for serious infections due to Bla+ enterococci.
Ampicillin↗
Antimicrobial resistance from enterococci in a pediatric hospital. Plasmids in Enterococcus faecalis isolates with high-level gentamicin and streptomycin resistance.
BACKGROUND: Enterococcus spp. is an important nosocomial and community-acquired pathogen. Recent studies have documented the increasing importance of this pathogen in children, particularly in the hospital setting. Our objective in this study was to report the frequency of antimicrobial resistance in enterococci and to determine the characteristics of high-level gentamicin resistance (HLGR) plasmids in Enterococcus faecalis clinical isolates. METHODS: Two hundred eighty-nine enterococcal isolates were collected during an 18-month period from a tertiary-care pediatric hospital in Mexico City. Isolates were screened for antibiotic resistance, including HLGR. High-level, gentamicin-resistant E. faecalis strains were selected for pulsed-field electrophoresis (PFGE) typing and plasmid analysis. Transferability of resistance markers was carried out using filter matings. RESULTS: Seventy-six percent of isolates were E. faecalis, 10% were E. avium, 5.2% E. faecium, 5.2% E. raffinossus, 1.38% E. malodoratus, 0.6% E. hirae, and 0.6% E. casseliflavus. Antimicrobial resistance was ampicillin and penicillin 29%, imipenem 17%, and vancomycin 3%, HLGR 5%. The following 15 high-level, gentamicin-resistant isolates were identified: six E. faecalis; four E. avium; three E. faecium, and two E. casseliflavus. Five of the six E. faecalis isolates were different by PFGE and transferred gentamicin and streptomycin resistance on filter membranes. Transfer frequencies ranged from 8.2 x 10(-4) to 6.92 x 10(-5) transconjugants/recipient cell. The plasmid content of donors and transconjugants were homogeneous (one plasmid of 47 kb). CONCLUSIONS: In this pediatric hospital, antimicrobial resistance in Enterococcus spp. is common. Frequency of high-level, gentamicin-resistant strains is low. Mechanism of HLGR appears to be due to a single plasmid dissemination.
Drug Resistance, Microbial↗
High-level gentamicin resistance in Enterococcus: microbiology, genetic basis, and epidemiology.
Antibiotic resistance is an ever-increasing problem in enterococci. These bacteria are remarkable in their ability to acquire and disseminate antibiotic resistance genes by a variety of routes. Since first described in 1979, high-level resistance to gentamicin (MIC, greater than 2,000 micrograms/mL) has spread worldwide and has been responsible for serious infections. Resistance is plasmid-mediated and due to aminoglycoside-modifying enzymes. High-level gentamicin resistance indicates that there will be no synergistic bactericidal activity with penicillin-gentamicin combinations. The epidemiology of nosocomial enterococcal infections is remarkably similar to that of nosocomial infections caused by methicillin-resistant staphylococci and by multidrug-resistant gram-negative bacilli. The most likely way these resistant bacteria are spread among hospital patients is via transient carriage on the hands of hospital personnel. Patient-to-patient and interhospital transmission of strains has been reported recently. However, clonal dissemination is not the cause of the increased frequency of resistant strains, since gentamicin resistance appears in a variety of different conjugative and nonconjugative plasmids in Enterococcus.
Cross Infection↗
Colposcopy.
Colposcopy has gained widespread acceptance in the United States only in the last ten years and today is considered standard practice for evaluating women with abnormal Pap smears. Colposcopy use has provided a less radical means of diagnosis and developed new ways of treating premalignant diseases of the cervix. Other uses of colposcopy include evaluation of cervical, vaginal, and vulvar lesions; monitoring gravidas with preinvasive disease of the cervix; and screening of DES-exposed women. In addition, colposcopy is used in conjunction with CO2 laser in selective treatment of patients with cervical intraepithelial neoplasia.
Biopsy↗
The pre-travel medical evaluation: the traveler with chronic illness and the geriatric traveler.
The pre-travel medical evaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed.
Aged↗
Relapsing malaria infection acquired in Kenya.
An American physician-traveler to East Africa presented with manifestations of cerebral malaria and was treated with intravenous quinidine for chloroquine-resistant falciparum malaria. He later relapsed with Plasmodium ovale infection, despite previous primaquine therapy. Treatment of chloroquine-resistant malaria is discussed. The difficulty in diagnosing P. ovale infections and the predominance of this malaria species over P. vivax in East Africa are reviewed.
Africa↗
Hospital-acquired gangrenous mucormycosis.
A post-operative diabetic patient who had been treated for Serratia marcescens bacterial sepsis developed recurrent thrombosis of the left femoral artery following intra-arterial instrumentation. Pathological examination of arterial thrombus ultimately demonstrated invasive mucormycosis of the femoral artery and cultures of this material grew Rhizopus oryzae. The occurrence of cutaneous and subcutaneous mucormycosis is reviewed, as well as recently recognized nosocomial risk factors for mucormycosis, such as elasticized bandages and wound dressings.
Bandages↗