[A teenager presenting with vomiting, general malaise and weight loss]. / Een tiener met braken, algehele malaise en gewichtsverlies.

A 16-year-old girl had symptoms of vomiting, malaise and weight loss for two months. Blood tests revealed an elevated activity of liver enzymes and hyperthyroidism. Although the patient at first denied the possibility of pregnancy, a pregnancy was subsequently confirmed. Hyperemesis gravidarum was diagnosed based on the combination of the clinical symptoms, pregnancy and increased serum human chorionic gonadotrophin and oestradiol. Hyperemesis gravidarum also explained the demonstrated biochemical hyperthyroidism and elevated liver enzyme levels. Rapid alleviation of all the clinical symptoms was seen after termination of this unwanted pregnancy. Although vomiting, malaise and weight loss in children can have many different causes, in girls at a sexually mature age a pregnancy with possible hyperemesis gravidarum should certainly also be considered and a gynaecological examination performed.

Desulfobacca acetoxidans gen. nov., sp. nov., a novel acetate-degrading sulfate reducer isolated from sulfidogenic granular sludge.

A mesophilic sulfate reducer, strain ASRB2T, was isolated with acetate as sole carbon and energy source from granular sludge of a laboratory-scale upflow anaerobic sludge bed reactor fed with acetate and sulfate. The bacterium was oval-shaped, 1.3 x 1.9-2.2 microns, non-motile and Gram-negative. Optimum growth with acetate occurred around 37 degrees C in freshwater medium (doubling time: 1.7-2.2 d). Enzyme studies indicated that acetate was oxidized via the carbon monoxide dehydrogenase pathway. Growth was not supported by other organic acids, such as propionate, butyrate or lactate, alcohols such as ethanol or propanol, and hydrogen or formate. Sulfite and thiosulfate were also used as electron acceptors, but sulfur and nitrate were not reduced. Phylogenetically, strain ASRB2T clustered with the delta subclass of the Proteobacteria. Its closest relatives were Desulfosarcina variabilis, Desulfacinum infernum and Syntrophus buswellii. Strain ASRB2T is described as the type strain of Desulfobacca acetoxidans gen. nov., sp. nov.

Cervical carcinoma during pregnancy: outcome of planned delay in treatment.

OBJECTIVE: To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome. STUDY DESIGN: Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were examined retrospectively, and a literature survey was performed. RESULTS: The incidence of cervical carcinoma in our population was 1.1 per 10000 pregnancies. Ten patients had FIGO (International Federation of Gynaecology and Obstetrics) stage IB lesions, two patients stage IIA/B. Eight patients had squamous cell carcinoma, four adenocarcinoma. In six patients with a gestation of >20 weeks and stage IB/IIA we postponed treatment for 2 to 10 weeks to optimize fetal outcome. In six patients with a gestation of <20 weeks and stage IB/IIB we recommended immediate radical hysterectomy. Fetal outcome in the delayed-treatment group was excellent. Two patients, one in each group, died after a relapse. The remaining five patients of the delayed-treatment group are disease-free after a median follow-up of 82 months. CONCLUSION: Delayed treatment to achieve greater fetal maturity is a reasonable option for patients with cervix carcinoma of 20 weeks.

Echinococcosis of the liver during pregnancy.

A 20-year-old Turkish woman with three huge echinococcus cysts of the liver was admitted in the third trimester of pregnancy. During pregnancy she received albendazole and during vaginal delivery she received both albendazole and medication aimed at preventing anaphylactic reaction. We believe that the presence of large hydatid cysts during pregnancy should be managed conservatively with courses of albendazole after the first trimester of pregnancy.

Colonial heterogeneity of Thiobacillus versutus.

In acetate-limited chemostat cultures started with single-colony cultures of Thiobacillus versutus, a mutant appeared after approximately 85 volume changes. The inhomogeneity of the culture was detected by the development of two different types of colonies on agar plates. When a pure culture of the mutant was grown in a chemostat, parent colonies appeared after almost the same period of time. Electron micrographs of the mutant grown on butyrate showed the presence of fibrils surrounding the cells. The cells of the parent strain were bald when grown under the same conditions. The growth kinetics of the parent and the mutant were investigated in batch cultures with a variety of substrates and were found to be identical. Major differences between the two strains were observed during growth on mannitol; the mutant attained a lower yield and excreted large amounts of extracellular polysaccharides.

[1H]Spin-echo nuclear magnetic resonance in plant tissue. I. The effect of Mn(II) and water content in wheat leaves.

The effect of age-dependent Mn(II)-gradients, as observed by electron paramagnetic resonance (EPR), on the [1H]NMR spin-spin relaxation time (T2) was studied in wheat leaves. A non-exponential T2 spin-echo decay was always observed, revealing the presence of at least two different fractions of non- (or slowly) exchanging water in the leaves. No effect of the Mn(II)-concentration on T2 of the separate water fractions (covering approximately 90% of the total water content) has been found. From these observations we conclude that Mn(II) is present in bound form. The dependence of T2 on water content can be explained with a two-state model, demonstrating the occurrence of fast exchange within each of the two slowly exchanging water fractions.