Molecular analysis of the replication region of the pCIZ2 plasmid from the multiple bacteriocin producer strain Enterococcus faecium L50.

The sequence analysis of the 7383 bp plasmid pCIZ2 from Enterococcus faecium L50 enabled the identification of a DNA region involved in its replication. The structural organization of the pCIZ2 replication region is highly similar to those of well-known theta-replicating plasmids. It contains an untranslated region, the putative replication origin (ori), constituted by two sets of direct repeats of 12 and 22 bp (iterons), and followed by three open-reading frames (orf8 to orf10). orf8 encodes the replication initiation protein (RepE). The transcriptional start site of the replication locus was identified 13 nucleotides upstream of the repE start codon. A two-dimensional agarose gel electrophoresis analysis revealed pCIZ2 intermediates profile typical of the theta-type replication mechanism. Subcloning of different DNA fragments of the pCIZ2 replication region in Escherichia coli and, subsequently, in the plasmidless E. faecium L50/14-2 allowed the determination of the minimal replicon on a 1.2kb DNA fragment containing only the overall ori and repE which also act in trans. The involvement of orf9 in the plasmid copy number and in the plasmid stability was investigated. The pCIZ2 recombinant plasmids constitute narrow-host range shuttle cloning vectors (E. coli-E. faecium) that could be very useful for enterococcal genes studies, allowing an easy identification due to their histochemical recognition.

Persistent cauda equina syndrome following bilateral aortoiliac dissection as a complication of cardiac angiography.

Cardiac angiography is accepted as an invasive yet safe procedure with well-characterized complications. We present a complication heretofore not described to our knowledge, in which a patient experienced the cauda equina syndrome following bilateral aortoiliac dissection during cardiac angiography. Similarities are noted between this complication and those documented in abdominal aortic aneurysm repair surgery.

Effects of driving pressure and recurrent laryngeal nerve stimulation on glottic vibration in a constant pressure model.

Glottic phonatory parameters have been studied in constant flow models; however, the lung-thorax system is better viewed as a constant pressure source. Adjusting the driving pressure and recurrent laryngeal nerve stimulation as independent variables, rather than as dependent variables, may provide a more physiologic understanding of laryngeal function and glottic parameters, including subglottic pressure, airflow, fundamental frequency, and glottic area. In three dogs subglottic pressure and airflow were measured in two separate conditions: with constant recurrent laryngeal nerve stimulation and varying driving pressure, and with constant driving pressure and varying recurrent laryngeal nerve stimulation. Videostroboscopic measures on four dogs assessed glottic areas with constant recurrent laryngeal nerve stimulation at different driving pressures. With constant recurrent laryngeal nerve stimulation, increasing driving pressure had no effect on glottic areas, whereas subglottic pressure, fundamental frequency, and airflow increased significantly. However, changes in subglottic pressure were minimal in comparison with changes in driving pressure. At constant driving pressure, increasing recurrent laryngeal nerve stimulation increased subglottic pressure and fundamental frequency and decreased airflow. These findings suggest that during phonation subglottic pressure is primarily dependent on recurrent laryngeal nerve stimulation and laryngeal muscular contraction, but not on lung driving pressure.