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Corneal subepithelial nodular scarring treated with phototherapeutic keratectomy in a child with Rothmund-Thomson syndrome.

PURPOSE: To report the use of excimer laser phototherapeutic keratectomy (PTK) in the treatment of corneal subepithelial nodular scarring in a child with Rothmund-Thomson syndrome (RTS), a form of ectodermal dysplasia. METHODS: A case report and review of the literature. RESULTS: Excimer laser PTK successfully treated the recurrent anterior stromal fibrosis and irregular astigmatism, facilitating visual development. The use of excimer laser PTK prevented the development of dense amblyopia in this child. CONCLUSION: This case demonstrates an indication for excimer laser PTK in the pediatric population.

Child, Preschool↗

Relationship between menarcheal age and adult height.

Many factors contribute to the attainment of adult height, including genetic and environmental variables. To assess the relationship between menarcheal age and adult height, measured adult height and recalled menarcheal age were compared by regression analysis in 425 women. The overall regression equation, Height = 158.14 + .4321 (Age) - .1667 (Age - 13)2, was significant (P less than .003), as was the coefficient for the quadratic term (P not equal to .014). After exclusion of those in whom menarche occurred after age 16, the overall linear regression equation for the remaining 416 patients, Height = 153.95 + .7353 (Age), was still significant (P not equal to .001), but the coefficient for the quadratic term was not. These data suggest that menarcheal age significantly correlates with adult height as an independent variable.

Adult↗

Multicenter randomized trial of ofloxacin versus cefoxitin and doxycycline in outpatient treatment of pelvic inflammatory disease. Ambulatory PID Research Group.

A multicenter randomized comparative trial was done to assess the safety and efficacy of oral ofloxacin (400 mg twice daily for 10 days) versus cefoxitin (2 g intramuscularly) followed by doxycycline (100 mg twice daily orally for 10 days) for the outpatient treatment of uncomplicated pelvic inflammatory disease (PID). Neisseria gonorrhoeae (GC) grew on pretreatment endocervical cultures from 43 of 268 women (16%), and in 30 of 247 women (12%) cultures were positive for Chlamydia trachomatis (Ct). Ninety-five percent (122/128) of the women treated with the ofloxacin regimen and 93% (112/121) of those treated with the cefoxitin/doxycycline regimen had cure or improvement on examination at a minimum of one follow-up visit. All GC species were eradicated by both ofloxacin and cefoxitin. Among women who returned for follow-up, the eradication of C trachomatis was 88% (15/17) for the cefoxitin/doxycycline group and 100% (18/18) for ofloxacin. Side effects were more prevalent in the cefoxitin/doxycycline group (15%) than in the ofloxacin group (7%), nausea/vomiting being the most frequent adverse effect. In this study, it appears that ofloxacin and cefoxitin/doxycycline have similar clinical effectiveness for the outpatient treatment of uncomplicated pelvic inflammatory disease.

Adolescent↗

Paenibacillus (formerly Bacillus) gordonae (Pichinoty et al. 1986) Ash et al. 1994 is a later subjective synonym of Paenibacillus (formerly Bacillus) validus (Nakamura 1984) Ash et al. 1994: emended description of P. validus.

A polyphasic study in which we performed an amplified ribosomal DNA restriction analysis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins, a gas chromatographic analysis of methylated fatty acids, pyrolysis mass spectrometry, a random amplified polymorphic DNA analysis, a phenotypic analysis, and an analysis of the levels of DNA binding of Paenibacillus gordonae and Paenibacillus validus strains (including both type strains) showed that these organisms form a homogeneous group and that the names P. gordonae and P. validus are therefore synonyms. P. validus has nomenclatural priority, and an emended description of this species is given; the type strain is strain LMG 11161 (= ATCC 43897).

Bacillus↗

Reclassification of Paenibacillus (formerly Bacillus) pulvifaciens (Nakamura 1984) Ash et al. 1994, a later subjective synonym of Paenibacillus (formerly Bacillus) larvae (White 1906) Ash et al. 1994, as a subspecies of P. larvae, with emended descriptions of P. larvae as P. larvae subsp. larvae and P. larvae subsp. pulvifaciens.

A polyphasic taxonomic study of four strains of Paenibacillus larvae and four strains of Paenibacillus pulvifaciens (including duplicates of both type strains) supported the reclassification of both former Bacillus species into one species, P. larvae. Our conclusions were based on morphological and Analytab Products (API) tests, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of whole-cell proteins, gas chromatography of methylated fatty acids, pyrolysis mass spectrometry, DNA-DNA binding, and the following genomic fingerprinting methods: amplified ribosomal DNA restriction analysis, random amplified polymorphic DNA analysis, and AFLP analysis. The last method is a novel high-resolution DNA fingerprinting technique based on the selective amplification of restriction fragments. Despite more than 90% DNA relatedness between the strains studied, SDS-PAGE of whole-cell proteins, biochemical tests, and DNA fingerprinting (AFLP) distinguished between the P. larvae and P. pulvifaciens strains at the subspecies level. Taking this evidence along with differences in pathogenicity, we propose to reclassify the honeybee pathogens P. larvae and P. pulvifaciens as P. larvae subsp. larvae and P. larvae subsp. pulvifaciens. An emended description of the species and descriptions of the subspecies are given. The type strains are P. larvae subsp. larvae ATCC 9545 (LMG 9820) and P. larvae subsp. pulvifaciens NRRL B-3685 (LMG 6911 and ATCC 13537).

Bacillus↗

A polyphasic reassessment of the genus Paenibacillus, reclassification of Bacillus lautus (Nakamura 1984) as Paenibacillus lautus comb. nov. and of Bacillus peoriae (Montefusco et al. 1993) as Paenibacillus peoriae comb. nov., and emended descriptions of P. lautus and of P. peoriae.

Seventy-seven strains representing 10 species in the Paenibacillus polymyxa 16S rRNA group and 3 other species that exhibit phenetic relatedness to members of this group, Bacillus lautus, "Bacillus longisporus," and Bacillus peoriae, were characterized genotypically and phenotypically by performing an amplified ribosomal DNA restriction analysis, a randomly amplified polymorphic DNA analysis, a fatty acid methyl ester analysis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins, pyrolysis mass spectrometry, and API and other routine phenotypic tests. These analyses revealed distinct clusters representing Paenibacillus alvei, Paenibacillus amylolyticus, Paenibacillus azotofixans, Paenibacillus durum, Paenibacillus larvae subsp. larvae, Paenibacillus larvae subsp. pulvifaciens, B. lautus, Paenibacillus macerans, Paenibacillus macquariensis, B. peoriae, P. polymyxa, and Paenibacillus validus, which confirmed the distinctness of these species, but appreciable within-species heterogeneity was observed in P. alvei, B. lautus, P. macerans, P. polymyxa, and P. validus. The type strain of Paenibacillus pabuli did not cluster with other strains of this species, and in several analyses a relationship between strains of P. pabuli and "B. longisporus" was observed. As the analyses showed that B. lautus and B. peoriae are closely related to the genus Paenibacillus, these species are reclassified as members of this genus.

Bacillus↗

The influence of ionic strength, pH and a protein layer on the interaction between Streptococcus mutans and glass surfaces.

The initial interaction between Streptococcus mutans and hard surfaces has been investigated using a rotating disc technique. The deposition to clean and BSA-coated glass of two strains of S. mutans, FA-1 (serotype b) and KPSK2 (serotype c), which exhibit different surface properties, was studied. Organisms were harvested from cultures grown in a chemostat at a dilution rate of 0.06 h-1 and suspended in NaCl solutions of defined ionic strengths and pH values. The deposition of both strains showed a strong dependence on electrolyte concentration, particularly at low ionic strengths, which was inversely related to the zeta potentials of the organisms. Similarly, the ionic strength at which maximum deposition was first noted (critical coagulation concentration) for the two strains correlated with their relative potentials. Deposition was insensitive to changes in pH at an electrolyte concentration of 0.05 M. The maximum observed deposition did not approach values predicted by theory, suggesting that a further barrier to deposition, other than electrostatic repulsion, might exist. Under all experimental conditions, some of the deposited bacteria were observed to be oscillating, suggesting that they were held at a distance from the collector surface. The cells did not, however, appear to be deposited in a secondary minimum predicted by DLVO theory hence it may be that long-range polymer interactions are also involved in the deposition of these organisms.

Glass↗

Curie-point pyrolysis mass spectrometry applied to characterization and identification of selected Bacillus species.

The use of pyrolysis mass spectrometry in the characterization and identification of Bacillus species was studied. Fifty-three strains of four closely related groups, Bacillus subtilis, B. pumilus, B. licheniformis and 'B. amyloliquefaciens', were used in a study of both sporulated and nonsporulated cultures. Pyrolysis was carried out using a Pyromass 8-80, a novel pyrolysis mass spectrometer specifically designed for fingerprinting complex samples. The pyrolysis data obtained were analysed using multivariate statistical techniques. All four groups could be differentiated using data from non-sporulated cultures but the data from sporulated cultures did not separate B. subtilis from 'B. amyloliquefaciens' or B. pumilus. In contrast, B. licheniformis was more clearly differentiated from the other three species using these data. Culture maturity affected the mass spectra obtained from non-sporulated cultures.

Bacillus↗

Identification of Bacillus strains using the API system.

A system is described for the rapid and accurate identification of Bacillus isolates using a matrix of results from tests in the API 20E and API 50CHB strips and from supplementary tests. API System tests have been shown to be more reproducible than the classical tests. A taxonomy based upon API tests is in good agreement with those obtained by other methods. The results matrix can also be used in computer assisted identification.

Bacillus↗

Identification of Bacillus anthracis by API tests.

API and morphological tests were examined for their ability to distinguish between 37 Bacillus anthracis strains (virulent and avirulent) and 194 strains of closely related Bacillus species (B. cereus, B. mycoides and B. thuringiensis). In addition, 34 strains of B. anthracis and four of B. cereus were tested by several other methods that included capsule formation, ability to grow on a selective medium, and sensitivity to phage. It was found that virulent strains of B. anthracis were easily separated from the closely related Bacillus species by most of the test methods; but separation of slightly virulent and avirulent strains of B. anthracis from the closely related species could be done only by API and phage-sensitivity tests.

Animals↗

Reproducibility of pyrolysis mass spectrometry: effect of growth medium and instrument stability on the differentiation of selected Bacillus species.

The discrimination of a set of 53 strains, taken from four closely related Bacillus species (Bacillus subtilis, B. pumilus, B. licheniformis and B. amyloliquefaciens), was examined using pyrolysis mass spectrometry. Strains were grown on six different media to examine the effect of media variation, especially batch-to-batch variation of a single medium, on the pyrolysis mass spectra and strain discrimination achieved. Long-term reproducibility over a period of 14 months was also examined. It was shown that batch-to-batch media variation is insufficient to affect spectra and strain discrimination significantly, but different media types do affect this. It was shown that species groups could still be recovered from the data, however, with an appropriate data-handling system. It was not possible to directly compare spectra produced 14 months apart, but the strain and species discrimination achieved using each data-set were highly comparable.

Bacillus↗