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Several mutations involving the fibroblast growth factor receptor (FGFR) gene family have been identified in association with phenotypically distinct forms of craniosynostosis. One such point mutation, resulting in the substitution of proline by arginine in a critical region of the linker region between the first and second immunoglobulin-like domains, is associated with highly specific phenotypic consequences in that mutation at this point in FGFR1 results in Pfeiffer syndrome and analogous mutation in FGFR2 results in Apert syndrome. We now show that a much more variable clinical presentation accompanies analogous mutation in the FGFR3 gene. Specifically, mental retardation, apparently unrelated to the management of the craniosynostosis, appears to be a variable clinical consequence of this FGFR3 mutation.

Objective: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits., Design: A longitudinal surveillance of the vaginal flora over an eight week period., Subjects: 26 female health care workers in local genitourinary medicine clinics., Methods: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum., Results: Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors., Conclusions: Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.

Objectives: Bacterial vaginosis (BV) is a prevalent vaginal infection that is now regarded as a risk factor in more serious pelvic and obstetric complications. Spermicides are known to have antimicrobial activity against other sexually transmitted diseases and the aim of this study was to test whether the causative organisms of BV were also susceptible to spermicides, in vitro., Design: Minimal Inhibitory Concentrations of five spermicidal compounds were determined for the organisms associated with BV, in an agar dilution technique., Location: The Department of Experimental and Clinical Microbiology, University of Sheffield Medical School, UK. SPERMICIDES AND ORGANISMS: Nonoxynol-9, Nonoxynol-11, Docusate sodium, Benzalkonium chloride and Menfegol were tested against 20 strains each of Gardnerella vaginalis, Bacteroides and Mobiluncus organisms, isolated from patients with BV who attended the Department of Genitourinary Medicine, the Royal Hallamshire Hospital, Sheffield., Main Outcome Measures: The susceptibility of BV-associated organisms to spermicidal compounds, in vitro., Results: G vaginalis, Mobiluncus spp, Bacteroides bivius and Bacteroides disiens were all susceptible to the five spermicides tested, with MICs ranging between less than or equal to 19 and 5000 mg/l (0.0019%-0.5%)., Conclusion: The concentrations of spermicides incorporated in contraceptive preparations are usually between 3% and 8%, which are far in excess of the MICs found for BV organisms. Their usage could exert a significant antimicrobial effect and be a useful prophylactic in preventing the infection.

Using an agar dilution technique with standardised inocula prepared by ultrasonication, the minimum inhibitory concentrations (MICs) of spectinomycin were determined for 66 strains of Haemophilus ducreyi, eight of which were beta lactamase producers. All strains were sensitive to concentrations of spectinomycin, which were well within the therapeutic ranges attained with normal dosage. The MIC50 and MIC90 were 8 mg/l, (range 0.007-16 mg/l).

Niridazole, an antischistosomal agent, was given to renal transplant recipients in addition to azathioprine and prednisolone, as there is experimental evidence that this combination of drugs is highly immunosuppressive. Sera obtained from kidney-graft recipients during the first two weeks after transplantation were examined for their ability to inhibit the one-way mixed lymphocyte reaction (MLR). Sera from seven patients receiving azathioprine, prednisolone, and niridazole (triple-drug treatment), five patients receiving azathioprine and prednisolone, and two other patients treated with niridazole alone for schistosomiasis produced MLR inhibition by comparison with pretreatment (control) sera.A mean of 78% inhibition was observed with sera taken after one day's treatment with the three-drug combination, whereas this level of in-vitro immunosuppression occurred only after eight days of treatment with azathioprine and prednisolone. Niridazole alone produced an effect similar to azathioprine and prednisolone. Concentrated dialysate of urine from a patient receiving triple-drug treatment not only inhibited the MLR but also significantly prolonged the survival of heterotopic heart allografts in rats, whereas dialysate from the same patient after niridazole had been stopped gave less MLR inhibition and failed to prolong heart allograft survival.Since niridazole thus increased the in-vitro and in-vivo immunosuppressive action of azathioprine and prednisolone, we suggest that this triple-drug combination might be useful for preventing early acute kidney graft rejection.