It is essential to understand the natural history of hereditary nonpolyposis colorectal cancer, inclusive of the need for surveillance colonoscopy in patients at increased risk by virtue of their position in their family pedigree.

This report describes a study of 212 isolates of group B streptococci from sore throats over an 8-year period. A small but increasing percentage showed increased resistance to penicillin G when tested in an in vitro system.In 1938, Fry reported that group B, betahemolytic streptococci were causative agents of human disease (1). Subsequently, the syndromes of neonatal sepsis (5) and neonatal meningitis (4) due to group B streptococci were characterized.During the evaluation of a throat culture program serving physicians and dentists in our community, it was apparent that non-group A streptococci were being isolated from throat swabs of clinically ill individuals on a constant basis. Dacron swabs received from clinicians were routinely processed by culturing them on blood agar plates containing 5% sheep erythrocytes. After overnight incubation at 350C in an atmosphere of 5% C02, these plates were examined for streptococcal colonies demonstrating beta-hemolysis. All such isolates were screened by the fluorescent antibody technique (3) to identify group A streptococci. Non-group A isolates were examined by precipitin testing methods (2) to determine the isolates of groups B, C, D, and G. Isolates identified as group B streptococci, which by colony count appeared to represent at least 25% of the throat flora, were suspended in 0.5 ml of sterile sheep erythrocytes. These suspensions were stored at -20°C until antibiotic susceptibility tests could be performed. Before freezing, one of every 10 isolates was tested against penicillin G to determine a preliminary minimal inhibitory concentration (MIC). Representative isolates of group A streptococci (one per month) and group D streptococci (one per month) were similarly isolated, identified, tested, and stored. Later comparison with these preliminary MICs enabled us to determine the effects of time and freezing on the stored streptococci.Streptococcal isolates were tested against penicillin G in a twofold dilution series using Todd-Hewitt broth as the antibiotic diluent. The concentrations of penicillin G prepared ranged from 2.50 to 0.009 units/ml. The MIC for each isolate was measured in duplicate with the same lot number of culture medium and antibiotic. Each series was inoculated with a suspension of 104 colony-forming units of test isolate per ml. All cultures were incubated at 350C in an atmosphere of 5% CO2. Results were read after 24 h of incubation. When a duplicate series differed from the original, the isolate was restudied to establish the true MIC. Streptococci isolated during the years 1968 through 1973 were evaluated in an initial study. A second study evaluated the isolates of 1974 and 1975. A total of 212 group B streptococci isolates were studied during an 8-year period.

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Background. There is a paucity of knowledge pertaining to the attitudes, feelings, and emotions of women who are at increased familial risk for breast cancer and how these concerns will affect their surveillance behavior. A review of the literature shows an unevenness in the conclusions about these matters, with some reports indicating that anxiety aroused in the familial cancer setting may abet surveillance behavior, whereas other data indicates a negative effect. Methods. The authors reported anecdotal accounts of such behavior in women from hereditary breast and hereditary breast‐ovarian cancer prone families. Results. Although these responses of fear, anxiety, and apprehension about cancer risk are not unique to this hereditary cohort, they nevertheless must have been tempered by often life‐long exposure of cancer occurrences that may have decimated their families. Conclusions. All accounts agree with the need to devote more research to the special needs—psychological, social, insurance, and general public health measures—of these high risk women.