151 patients with benign giant pigmented nevi registered in the Danish Health system during the 60-year period 1915-75 were retrieved via the national register. A questionnaire was sent to all surviving patients asking for information about their health and especially whether they had had any treatment or had observed any changes in the nevus. All of the patients replied to the questionnaire. No patients had been cured from malignancy or were alive with known malignancy. Three patients had died from malignant melanoma during the period of observation. These case histories are reported. It is calculated that 4.6% of the patients with congenital giant nevi should be expected to develop malignant melanoma provided the incidence is the same in all age groups. Some uncertainty remains on account of the limited number of cases and an unsettled question about a higher incidence in childhood.

No abstract

The implantation of an artificial anal sphincter in five patients with anal incontinence of neuromuscular origin is described. The prosthesis, an AMS 800 artificial urinary sphincter (American Medical Systems), worked well with solid or semisolid stool, but less satisfactorily when diarrhea was present. Manometric and defecographic studies seem to indicate that the effect of the prosthesis may be ascribed partly to maintenance of an acute anorectal angle even during straining.

Background Oenococcus oeni is a lactic acid bacteria species adapted to the low pH, ethanol-rich environments of wine and cider fermentation, where it performs the crucial role of malolactic fermentation. It has a small genome and has lost the mutS-mutL DNA mismatch repair genes, making it a hypermutable and highly specialized species. Two main lineages of strains, named groups A and B, have been described to date, as well as other subgroups correlated to different types of wines or regions. A third group “C” has also been hypothesized based on sequence analysis, but it remains controversial. In this study we have elucidated the species population structure by sequencing 14 genomes of new strains isolated from cider and kombucha and performing comparative genomics analyses. Results Sequence-based phylogenetic trees confirmed a population structure of 4 clades: The previously identified A and B, a third group “C” consisting of the new cider strains and a small subgroup of wine strains previously attributed to group B, and a fourth group “D” exclusively represented by kombucha strains. A pair of complete genomes from group C and D were compared to the circularized O. oeni PSU-1 strain reference genome and no genomic rearrangements were found. Phylogenetic trees, K -means clustering and pangenome gene clusters evidenced the existence of smaller, specialized subgroups of strains. Using the pangenome, genomic differences in stress resistance and biosynthetic pathways were found to uniquely distinguish the C and D clades. Conclusions The obtained results, including the additional cider and kombucha strains, firmly established the O. oeni population structure. Group C does not appear as fully domesticated as group A to wine, but showed several unique patterns which may be due to ongoing specialization to the cider environment. Group D was shown to be the most divergent member of O. oeni to date, appearing as the closest to a pre-domestication state of the species. Electronic supplementary material The online version of this article (10.1186/s12864-019-5692-3) contains supplementary material, which is available to authorized users.

Oenococcus oeni is the lactic acid bacteria species most commonly encountered in wine, where it develops after the alcoholic fermentation and achieves the malolactic fermentation that is needed to improve the quality of most wines. O. oeni is abundant in the oenological environment as well as in apple cider and kombucha, whereas it is a minor species in the natural environment. Numerous studies have shown that there is a great diversity of strains in each wine region and in each product or type of wine. Recently, genomic studies have shed new light on the species diversity, population structure, and environmental distribution. They revealed that O. oeni has unique genomic features that have contributed to its fast evolution and adaptation to the enological environment. They have also unveiled the phylogenetic diversity and genomic properties of strains that develop in different regions or different products. This review explores the distribution of O. oeni and the diversity of strains in natural habitats.

Drainage after cholecystectomy In their paper on this subject (Annals, May 1982, vol. 64,p. 183) Messrs Ian Fraser, N W Everson, and J R Nash report a comparison of two cholecystectomy drainage methods in a randomised trial. We wish to take this opportunity to point out that the results of the trial should not be regarded as an appraisal of suction per se. The reason is simple. The trial compared suction drainage with passive (that is, static) drainage. The trial also made a comparison between drainage via two types of tube, one described as 'larger and more rigid' than the other. Thus two variables were involved in the comparison and there is no way of telling whether the differences which emerged should be ascribed to the difference in rigidity and size of the tubes or to the fact that suction was or was not applied. This is acknowledged by the authors and is apparent already from the title: 'A. .. trial of two drainage methods. .. ' With this in mind it is easier to understand why the results of the trial differ so much from those we obtained in a trial in which we tried to evaluate suction versus static drainage through the main wound versus a stab incision in a 2 by 2 design (1). In our comparison of suction versus static drainage the same medical grade polyvinyl chloride ester catheter was used with and without suction. In contrast to Fraser et al. we found that the amount of fluid drained was twice as large in patients with static drainage as in those with suction. Also in contrast to Fraser et al. we failed to detect a difference in the incidence of infection. The question submitted to a trial by Fraser et al. was practical in nature: what is the difference between drainage with Redivac bottle suction via a fine flexible tube on the one hand and static drainage using a more rigid 32-French Portex tube on the other? The question we submitted to a trial was: given a certain tube, what is the effect of suction? When questions are so different we cannot expect identical answers.

Low cellular activity and slow tissue turnover in human tendon may prolong resolution of tendinopathy. This may be stimulated by moderate localized traumas such as needle penetrations, but whether this results in a widespread cellular response in tendons is unknown. In an initial hypothesis-generating study, a trauma-induced tendon cell activity (increased total RNA and collagen I mRNA) was observed after repeated patellar tendon biopsies in young men. In a subsequent controlled study, 25 young men were treated with two 0.8-mm-diameter needle penetrations [n = 13, needle-group (NG)] or one 2.1-mm-diameter needle biopsy [n = 12, biopsy-group (BG)] in one patellar tendon. Four weeks later biopsies were taken from treated (5 mm lateral from trauma site) and contralateral tendons for analyses of RNA content (ribogreen assay), DNA content (PCR based), and gene expression for relevant target genes (Real-time RT-PCR) (NG, n = 11 and BG, n = 8). Intervention increased RNA content, and mRNA expression of collagen I and III and TGF-β1 (P < 0.05), with biopsy treatment having greatest effect (tendency for RNA and collagen I). Results for DNA content were inconclusive, and no changes were detected in expression of insulin-like growth factor-I, connective tissue growth factor, scleraxis, decorin, fibromodulin, tenascin-C, tenomodulin, VEGFa, CD68, IL-6, MMP12, and MMP13. In conclusion, a moderate trauma to a healthy human tendon (e.g., biopsy sampling) results in a widespread upregulation of tendon cell activity and their matrix protein expression. The findings have implications for design of studies on human tendon and may provide perspectives in future treatment strategies in tendinopathy.

Glucose, 25 g, was infused iv with or without sham-feeding in seven normal males. Sham-feeding improved glucose tolerance, incremental area of blood glucose being 63% (P < 0.05) of that during iv glucose without sham-feeding. The actual insulin secretion evaluated from the total area under the C-peptide and insulin curves did not differ during iv glucose with or without sham-feeding. These results suggest that the cephalic-vagal reflex improves glucose tolerance during iv glucose, independent of changes in \g=b\-cell function.