Generic realignment in primuloid families of the Ericales s.l.: a phylogenetic analysis based on DNA sequences from three chloroplast genes and morphology.

The phylogenetic interrelationships in Primulaceae, Myrsinaceae, and Theophrastaceae were investigated using DNA sequence data from the chloroplast genes atpB, ndhF, and rbcL. The three genes were analyzed separately, together, and in combination with morphology, using parsimony jackknifing. The sequence data are further explored by analyses of first and second codon position only, third positions only, and transversions only. The results show that all codon positions contribute group support to the ndhF tree, whereas third codon positions provide most of the structure in the atpB and rbcL trees. Analyzed separately, transversions in atpB and rbcL have little structure, whereas in ndhF they produce a well-resolved tree. We conclude that the most informative and robust results are obtained from analyses with all codon positions included and that the tree resulting from the combined analysis of all available data provides the best estimate of phylogeny.The results show that Maesa is sister to all other taxa from the three families. Theophrastaceae are well supported, but both Myrsinaceae and Primulaceae are paraphyletic. We conclude that four families should be recognized, Maesaceae, Theophrastaceae, Primulaceae, and Myrsinaceae. For all families to be monophyletic, Samolus was transferred to Theophrastaceae, and Lysimachia, Anagallis, Trientalis, Glaux, Asterolinon, and Pelletiera were moved to the Myrsinaceae together with the genera Coris, Ardisiandra, and Cyclamen.

Retinoblastoma: the Saudi Arabian experience.

During the period March 1983-May 1987, 74 cases of retinoblastoma were evaluated at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. 60% of the cases were unilateral with a female preponderance of 59.4% noted for this series. Additionally, the mean age at diagnosis was 22 months, and delay of retinoblastoma diagnosis since the first symptoms were observed ranged from two days to 36 months. Fifty-seven eyes were enucleated, and in 21 of these patients, this was the sole form of therapy. The remainder of patients were treated with radiotherapy alone or combined with chemotherapy, cryotherapy/photocoagulation. Overall, two-year survival statistics of this group of Saudi patients is 80% which compares favorably to other reports in the West. Emphasis is placed on management of the retinoblastoma patients by a multi-disciplinary group, and public educational efforts are imperative.

Neonatal infections with Streptococcus pneumoniae.

Three cases of neonatal Streptococcus pneumoniae infections acquired during delivery are described. The cases resembled clinically group B streptococcal infections, presenting either as an early septic-pneumonic type, or as a milder disease.

Familial Fanconi syndrome with malabsorption and galactose intolerance, normal kinase and transferase activity. A report on two siblings.

Two siblings of Turkish-Assyrian extraction, whose parents were first cousins, had poor appetite, slow weight gain and retarded psychomotor development. When given milk the galactose concentration in blood increased. An oral galactose load showed a markedly reduced capacity to metabolize galactose. Fanconi syndrome was present as in classical galactosemia. A galactose-free diet reduced the aminoaciduria but did not normalize the renal tubular function nor the children's general condition. Galactokinase and galactose-1-phosphate uridyltransferase activities in red blood cells were normal. The physical appearance of the children (sparse subcutaneous fat, thin extremities and distended abdomen) and the results of vitamin A and xylose absorption tests, were in accordance with a malabsorption condition. Glucose, however, seemed to be absorbed normally from the gut. There was no evidence of primary liver disease. Since the condition did not normalize with a galactose-free diet, an enzyme defect of galactose metabolism is unlikely. Instead, a more general transport defect with autosomal recessive inheritance is proposed.

Neonatal septicemia and perinatal risk factors.

Many methods for screening and prediction of neonatal septicemia have been tried. In this study a score, related to both perinatal risk factors and neonatal diseases, was tested upon healthy newborn infants, infants with septicemia and infants with other diseases. Statistical differences were found between infants with neonatal septicemia and infants with other neonatal diseases as well as normal newborns. It was also possible to find a relationship between certain predisposing factors and predominance of certain pathogens. Complications during pregnancy and delivery were most often found in the group B streptococcal, combinations of invasive procedures and neonatal diseases in the staphylococcal group and surgical procedures in the gram-negative group.

The nitroblue tetrazolium (NBT) reduction of neutrophil granulocytes from newborn infants and their mothers in relation to the occurrence of bacteria in amnion fluid and cord blood.

The nitroblue tetrazolium (NBT) reduction of granulocytes from cord blood, when measured without in vitro stimulation with bacteria, was significantly higher than that of maternal granulocytes. This elevated activity may be an adequate response to the presence in cord blood of degradation products from the placenta but also of potentially pathogenic bacteria, found in cord blood of infants with high NBT values. On in vitro stimulation cord blood granulocytes displayed the same high NBT activity as those of the mothers and of healthy non-pregnant women. All but one blood culture from the infants 25--48 h after delivery were sterile. The only child with a low non-stimulated NBT activity of cord blood granulocytes was also the only one presenting a clinical picture of neonatal septicemia, though not bacteriologically verified.

Longterm follow-up of neonatal septicemia.

The longterm prognosis of neonatal septicemia during the first four weeks of life has been estimated. Of 90 infants with the diagnosis of neonatal septicemia during a five-year period, 1969--1973, 65 infants survived the initial treatment. Another two infants died with complications of their main disease, intestinal atresia, at the age of two months. Thus the total mortality in neonatal septicemia in this series was 30%. The remaining 63 children have been investigated between ages of 2 1/2 and 6 1/2 years. Of these 63 children we have found 14 children (22% of the surviving) with handicaps where the septicemia can be regarded as a possible cause of the handicap. Of these 14 children only six had an "uncomplicated" septicemia while four of them had meningitis and four had osteomyelitis. Furthermore, of the 14 handicapped children nine were delivered preterm (28--36 weeks) and all of them had one or more additional neonatal diagnoses than septicemia. The prognosis, both immediate and longterm, of neonatal septicemia in the present series compares favourably to most international studies. The importance of early detection together with an aggresive treatment of the septicemia is stressed and is considered as the main reason for the good prognosis.

Periurethral aerobic microflora of pregnant and non-pregnant women.

Seventy-two pregnant and 88 non-pregnant women were examined to see whether the periurethral region had been colonised with group B streptococci (Streptococcus agalactiae), enterococci, and Gram-negative rods belonging to the Enterobacteriaeceae. A semi-quantitative method was used for periurethral sampling, and paired urethral swabs were also collected to compare the isolation rates of group B streptococci from the two sites and with the two sampling methods. A higher isolation rate was found with periurethral sampling. Most specimens showed no or scanty growth of Gram-negative rods. Pregnancy was often associated with heavy growth of enterococci. Sampling performed during menstruation and while oral contraceptives were being used produced high isolation rates of group B streptococci. These results seem to suggest that the periurethral area might protect against genital colonisation with group B streptococci as it does against urinary tract infection and that hormonal factors influence the carriage of these organisms.

Intrauterine death due to infection with group B Streptococci.

During the 6-year period 1970-1975 5 cases of late intrauterine death caused by group B streptococcal infection were seen in two obstetrical departments in the Stockholm area. During the same period 17 638 infants were born in the two departments, and in 117 cases intrauterine death occurred. Hematogenous spread of the infection from the mother was the most likely cause in the 5 cases. This figure should be compared with a carrier rate of 15-20% in pregnant women in the Stockholm area.

Immunologic investigation in children with recurrent pneumonia.

In vitro lymphocyte stimulation by phytohemagglutinin (PHA) and pokeweed mitogen (PWM) and tests for granulocyte function were performed in 12 children with recurrent pneumonia. Reduced lymphocyte stimulation was found at repeated tests in 2 children and transiently decreased lymphocyte stimulation in 6 more children. In 3 patients, reduced bactericidal capacity of granulocytes was demonstrated, and in 1 cast stimulation showed decreased NBT activity of granulocytes. One patient examined had immunoglobulin deficiency.

The persistence of group B streptococci in families.

Four years ago the relative occurrence of group B streptococci was studied in a group of 118 term pregnant women of which 17 were B-streptococcal carriers. Of these, 15 were investigated in connection with the delivery. 11 of these women were reexamined 45-50 months after delivery together with their families. A high frequency of positive cultures without symptoms (50%) was found in this small group of women and their husbands compared with male and female control groups. Persistence seems to be common, a fact to be remembered in subsequent pregnancies.