Nutritional requirements of Xylella fastidiosa, which causes Pierce's disease in grapes.

A defined medium (XF-26) containing 3 inorganic salts, 2 tricarboxylic acids, 17 amino acids, potato starch, phenol red, and agar was used as the starting point for the study. Deletions of one or more ingredients were performed to prepare various media. A medium was considered able to support growth of Xylella fastidiosa strains responsible for Pierce's disease in grapes, only after 10 serial passages had been completed. Of 3 inorganic salts, K2HPO4 and MgSO4 x 7H2O were essential, and (NH4)2HPO4 was nonessential for growth. Of the Krebs cycle intermediates, all (citrate, alpha-ketoglutarate, succinate, fumarate, malate, and oxaloacetate) but isocitrate supported growth of cultivated strains, whereas only citrate alone or citrate plus succinate supported the primary isolation of PD bacterium. Of 17 amino acids, 6 uncharged polar R groups (asparagine, cysteine, glutamine, glycine, serine, and threonine) supported growth, whereas 8 nonpolar R groups (alanine, isoleucine, leucine, methionine, phenylalanine, proline, tryptophan, and valine) or 3 positively charged polar groups (arginine, histidine, and lysine) did not. Starch proved to be nonessential.

Efficacy of MER immunotherapy when added to a regimen of 5-fluorouracil and methyl-CCNU following resection for carcinoma of the large bowel. A Veterans Administration Surgical Oncology Group report.

Two hundred four patients with a microscopically incomplete resection for carcinoma of the colon or rectum were accepted for study. All patients were treated with 5-fluorouracil and methyl-CCNU beginning about the second postoperative week. Concurrent immunotherapy with the methanol extraction residue of bacillus Calmette-Guérin (MER) was randomly assigned to 103 patients. Treatment was continued as long as acceptable to the patient, and until clinical recurrence. Toxic reactions to the drug were not increased by the addition of MER, and seldom were severe enough to require the discrimination of therapy. No evidence of improved survival was seen in treated patients. On the contrary, survival in patients who experienced severe reactions to treatment may have been impaired by MER, with the period of impairment continuing after all adjuvant therapy was stopped. Similar proportions of treated and control deaths were attributable to residual or recurrent disease.

Ovarian carcinoma presenting as a cervical metastasis.

An unusual presentation of an ovarian carcinoma masquerading as a primary cervical malignancy is reported with comprehensive review of the literature regarding metastatic disease to the cervix.

Cecal volvulus in pregnancy.

Cecal volvulus in pregnancy is an uncommon complication. A case is reported of a 28-year-old white female, gravida 2, para 1, who presented at 36 weeks' gestation with flu-like symptoms accompanied by regular uterine contractions every 3 minutes; she underwent repeat cesarean section without incident. The patient did well until the second postoperative day, when she developed obstructive bowel symptoms and underwent emergency laparotomy. Operative findings revealed cecal volvulus with partial malrotation of the small bowel, absence of the ligament of Treitz, agenesis of the left kidney, and a redundant sigmoid colon. Medical and surgical management of this case, as well as a general description of the symptoms of cecal volvulus, is discussed. Early diagnosis and operation are essential to avoid the high morbidity and mortality associated with this disease.

Myeloblastoma (granulocytic sarcoma) of the ovary.

Myeloblastic neoplasms occur in patients with leukemia. In women, the ovary is a common site. The cells of the tumor are identical histochemically to those in the peripheral blood. The Giemsa stain, PAS stain, and Leder stain assist in the diagnosis. The tumors are responsive to radiation therapy, chemotherapy, and operative removal, but tend to be associated with decreased survival. This report describes a case of myeloblastoma of the ovary in an 18-year-old woman. The clinical and pathologic features of these tumors are described. The literature is reviewed briefly.

The operative evaluation of patients with cervical carcinoma by an extraperitoneal approach.

Seventy patients with cervical cancer who were not candidates for primary operative treatment underwent operative evaluation prior to radiation therapy. Thirty-one were explored through a transperitoneal approach and 39 through an extraperitoneal approach. The operative procedure consisted of bilateral pelvic and periaortic lymphadenectomy and exploratory laparotomy, with additional intraperitoneal biopsies taken as indicated by operative findings. Poor correlation was seen between operative findings, lymphangiography, and clinical staging. Radiation therapy was extended to include sites of biopsy proven metastases. The group of patients operated on through a transperitoneal approach experienced a 30% complication rate secondary to small bowel damage following radiation therapy, and 2 patients died as a result of complications. All patients with small bowel complications explored in this manner required surgical correction. The group of patients operated on through an extraperitoneal approach had a 2.5% morbidity secondary to small bowel complications, and there were not deaths or serious complications in these patients. No patients explored in this manner required subsequent operation for complications following radiation therapy.

American Indian sign: a gestural communication system for the speechless.

American Indian sign, used as a gestural communication system for the speechless, served the daily life needs of patients with a variety of deficits, many with unfavorable prognosis for oral speech rehabilitation. The project included total glassectomees, laryngectomees, dysphonics, dysarthrics and apraxics. Many of the last named were hemiplegics. The sign was effectively interpreted by hospital personnel, patients and visitors, none of whom had received any instruction in interpreting the sign. This system may be a desirable new tool from an old culture for the professional repertoire of the speech clinician. An illustrated manual and instructional videotapes are in preparation.