First Report of Powdery Mildew Caused by Podosphaera xanthii on Sechium edule in Korea.

Sechium edule (Jacq.) Sw. (Cucurbitaceae, chayote, mirliton) is native to Mexico and Central America. Several trials have recently been conducted to determine the ability of chayote cultivars to grow under the climatic and soil conditions of South Korea. In April 2013, chayote plants were observed showing typical symptoms of powdery mildew in a glasshouse in Jeju City, Korea. Powdery mildew colonies were circular to irregular, forming white patches on both sides of the leaves. As the disease progressed, entire leaves were covered with white mycelium, followed by leaf withering and premature senescence. The same symptoms were also found on chayote plants in a polyethylene-film-covered greenhouse in Iksan City, Korea, in 2014. Voucher specimens were deposited in the Korea University Herbarium (KUS-F27289, F27422, F28186). Hyphae were flexuous to straight, branched, septate, and 5 to 7 µm wide. Appressoria on the mycelium were nipple-shaped or nearly absent. Conidiophores were straight, 150 to 240 × 10 to 12 µm and produced three to seven immature conidia in chains with a crenate outline. Foot-cells of conidiophores were straight, cylindric, and 52 to 85 µm long. Conidia were hyaline, ellipsoid-ovoid to barrel-shaped, measured 27 to 36 × 16 to 23 µm with a length/width ratio of 1.3 to 2.0, and had distinct fibrosin bodies. Simple to forked germ tubes were produced from the lateral position of conidia. No chasmothecia were found. These structures are typical of the powdery mildew Euoidium anamorph of the genus Podosphaera. Dimensions of foot-cells and conidia were within the ranges provided for P. xanthii (Castagne) U. Braun & Shishkoff, and the length/width ratio of conidia, appressorial characteristics, and conidial germination patterns also conformed to the standard description (2). To confirm the identification, the complete internal transcribed spacer (ITS) region of rDNA of isolate KUS-F27289 was amplified with primers ITS1 and ITS4 and sequenced directly. The resulting 473-bp sequence was deposited in GenBank (Accession No. KM657960). A GenBank BLAST search of the Korean isolate showed 99% similarity with P. xanthii isolates from cucurbitaceous hosts (e.g., AB774155 to AB774158, AB040321, JQ340082, etc.). Pathogenicity was confirmed through inoculation tests by gently pressing a diseased leaf onto young leaves of three asymptomatic, potted chayote plants. Three non-inoculated plants were used as controls. Plants were maintained in a greenhouse at 24 to 34°C. Inoculated leaves started to develop symptoms after 5 days, whereas the control plants remained symptomless. The pathogenicity test was carried out twice with similar results. Powdery mildews of chayote caused by Podosphaera species have been reported in Australia, South Africa, Portugal, India, China, and the United States (1,3,4). To our knowledge, this is the first report of powdery mildew caused by P. xanthii on chayote in Korea. Since chayote production was only recently started on a commercial scale in Korea, powdery mildew infections may pose a serious threat to the safe production of this vegetable. References: (1) P. Baiswar et al. Australas. Plant Dis. Notes 3:160, 2008. (2) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab. Online publication, ARS, USDA, Retrieved October 4, 2014. (4) R. Singh et al. Plant Dis. 93:1348, 2009.

A comparative study of perchlorate degradation in acute toxicity and chronic toxicity.

Since the discovery of perchlorate in water system, the public has been concerned about its human health effect. In practice it was reported that chronic exposure to perchlorate may lead to damage in thyroid hormone activity. This study introduced a method of perchlorate reduction, using autotrophic bacteria which utilise hydrogen as an electron donor. Two experiments were conducted to compare the effects of acute and chronic perchlorate toxicity on bacterial perchlorate reduction potential. One was a batch-fed operation generating acute toxicity and another was a continuous-fed operation generating chronic toxicity. Acclimation period of the batch-fed operation was 14 days while that of the continuous-fed operation was 31 days as commensurate with double. Lots of batch tests using the mixed culture passing through acclimation were conducted to figure out kinetics of biological perchlorate reduction. The maximum perchlorate utilisation rate (q(max)) of the mixed culture acclimated by acute toxicity was 2.92 mg ClO(4)(-)/mg dry-weight (DW)/d, while that of chronic toxicity was 0.27 mg ClO(4)(-)/mg DW/d. Half-maximum rate constants (K(s)) of acute and chronic toxicity were 567.3 and 25.6 mg ClO(4)(-)/L respectively. This result showed that acute toxicity acclimated the mixed culture more rapidly and produced a higher activity for biological perchlorate reduction than chronic toxicity.

A compulsive collecting behavior following an A-com aneurysmal rupture.

Hoarding behavior associated with focal brain injury is rarely reported. The authors report a 46-year-old man with pathologic collecting behavior after a left orbitofrontal and caudate injury from an aneurysmal rupture of anterior communicating artery. His hoarding, an impulse control disorder or an ego-syntonic compulsion, was restricted to one specific item (toy bullet). Treatments with sertraline or fluoxetine were not effective for the hoarding.

Immediate and long-term outcomes of rotational atherectomy versus balloon angioplasty alone for treatment of diffuse in-stent restenosis.

This study was performed to compare the effects of rotational atherectomy (RA) plus balloon angioplasty (BA) with those of BA alone for treatment of diffuse in-stent restenosis. RA+BA or BA alone was performed in a consecutive, prospective (not randomized) manner in 81 patients with 81 diffuse in-stent restenotic lesions (lesion length > 10 mm): 36 patients underwent RA+BA, and 45 patients BA. Clinical recurrence was the primary end point of this study, and was defined as angina associated with objective evidence of myocardial ischemia on stress testing. Mean follow-up duration was 277 +/- 109 days. In the BA group, acute lumen gain after repeat intervention was significantly lower than that of the original stenting procedure (1.94 +/- 0.63 vs 2.37 +/- 0.51 mm, p <0.05). In the RA + BA group, however, acute lumen gain of repeat intervention was similar to that of the original stenting procedure (2.16 +/- 0.52 vs 2.26 +/- 0.66 mm). Clinical recurrence rate at 6 months follow-up was significantly lower in the RA+BA group than in the BA group (25% vs 47%, p <0.05). Clinical events (death, myocardial infarction, repeat intervention) occurred in 6.7% (3 of 45) of patients in the BA group, but in no patient in the RA+BA group during the follow-up period. The long-term angina-free survival rate was significantly higher in the RA+BA group than in the BA group (72% vs 49%, p = 0.02). In conclusion, RA+BA seems to be a more effective therapeutic modality than BA alone for treatment of diffuse in-stent restenosis.

Comparison of outcomes of percutaneous mitral valvuloplasty versus mitral valve replacement after resolution of left atrial appendage thrombi by warfarin therapy.

This study assesses the efficacy of oral anticoagulation in resolving left atrial appendage (LAA) thrombi and evaluates clinical outcomes of percutaneous mitral valvuloplasty after resolution of LAA thrombi compared with mitral valve replacement. Warfarin therapy is successful in resolving LAA thrombi; percutaneous mitral valvuloplasty after resolution of LAA thrombi is an effective alternative to surgical treatment.

Stenting of unprotected left main coronary artery stenoses: immediate and late outcomes.

OBJECTIVES: We examined the immediate and long-term outcomes after stenting of unprotected left main coronary artery (LMCA) stenoses in patients with normal left ventricular (LV) function. BACKGROUND: Left main coronary artery disease is regarded as an absolute contraindication for coronary angioplasty. Recently, several reports on protected or unprotected LMCA stenting, or both, suggested the possibility of percutaneous intervention for this prohibited area. METHODS: Forty-two consecutive patients with unprotected LMCA stenoses and normal LV function were treated with stents. The post-stent antithrombotic regimens were aspirin and ticlopidine; 14 patients also received warfarin. Patients were followed very closely with monthly telephone interviews and follow-up angiography at 6 months. RESULTS: The procedural success rate was 100%, with no episodes of subacute thrombosis regardless of anticoagulation regimen. Six-month follow-up angiography was performed in 32 of 34 eligible patients. Angiographic restenosis occurred in seven patients (22%, 95% confidence interval 7% to 37%); five patients subsequently underwent elective coronary artery bypass graft surgery (CABG), and two patients were treated with rotational atherectomy plus adjunct balloon angioplasty. The only death occurred 2 days after elective CABG for treatment of in-stent restenosis. The other patients (without angiographic follow-up) remain asymptomatic. CONCLUSIONS: Stenting of unprotected LMCA stenoses may be a safe and effective alternative to CABG in carefully selected patients with normal LV function. Further studies in larger patient populations are needed to assess late outcome.

Late clinical outcomes of cordis tantalum coronary stenting without anticoagulation.

This study was performed to evaluate clinical and angiographic restenosis rates after successful Cordis coronary stent implantation and intravascular ultrasound images were acquired to compare results with quantitative angiographic findings in a subgroup of patients. We conclude that (1) the angiographic restenosis rate of Cordis stent was 19%, which was comparable to that of other slotted-tube stents, and (2) the quantitative coronary angiographic calliper method is reliable for assessing Cordis in-stent restenosis, especially diffuse in-stent restenosis.

Factors determining the exercise capacity in mitral stenosis.

In mitral stenosis, peak pulmonary pressure after exercise rather than valve area at rest or mitral gradient, was found to be an important factor in determining the exercise capacity.

Increased basal tone and hyperresponsiveness to acetylcholine and ergonovine in spasm-related coronary arteries in patients with variant angina.

We compared the basal coronary artery tone and the constrictive responses to acetylcholine (Ach) and ergonovine (Erg) among three groups of patients: 31 patients (group 1) with variant angina in whom spasm was provoked by low doses of acetylcholine (intracoronary 20 micrograms) or ergonovine (intravenous 50 micrograms); 35 patients (group 2) in whom spasm was provoked by higher doses of acetylcholine (intracoronary 100 micrograms) or ergonovine (intravenous cumulative dose of 350 micrograms); and 26 control subjects. Patients with variant angina in whom spasm was provoked by low doses of acetylcholine or ergonovine, had a higher incidence of coexisting angiographic evidence of coronary artery disease, multi-vessel spasm and more frequent episodes of angina. The basal coronary artery tone at the spastic and non-spastic sites of the spasm-related artery was significantly elevated in group 1 compared to group 2 (44 +/- 17 vs. 14 +/- 11% and 26 +/- 14 vs. 16 +/- 10%, respectively, P < 0.05), but not in the non-spasm related artery. The magnitude of vasoconstrictive responses to acetylcholine and ergonovine at the non-spastic sites was also greater in group 1 than in group 2 and the control groups (acetylcholine: 40 +/- 20 vs. 26 +/- 11, 27 +/- 12%; ergonovine: 37 +/- 18 vs. 12 +/- 8, 13 +/- 10%, respectively, P < 0.05). However, the basal coronary artery tone was not elevated at the spastic and non-spastic sites in group 2 compared to that in the control subjects. These findings suggest that the basal coronary artery tone is increased in patients with variant angina, with increased frequency of angina suggestive of higher disease activity at the spastic and non-spastic sites of the spasm-related artery, and this may be related to pathogenesis of coronary artery spasm.

Ergonovine echocardiography as a screening test for diagnosis of vasospastic angina before coronary angiography.

OBJECTIVES: In patients with chest pain suggestive of variant angina, we performed this prospective study to test the specificity and diagnostic validity of ergonovine echocardiography (detection of regional wall motion abnormality during bedside ergonovine challenge) as a screening procedure before coronary angiography. BACKGROUND: Spasm provocation test outside the catheterization room has generally not been accepted as a safe diagnostic method. METHODS: Ergonovine echocardiography was performed in 80 consecutive patients with chest pain syndrome after confirmation of negative treadmill or normal stress myocardial perfusion scan results using thallium-201. A bolus of ergonovine maleate was injected at 5-min intervals up to a total cumulative dosage of 0.35 mg with echocardiographic monitoring of left ventricular wall motion. A 12-lead electrocardiogram (ECG) was also recorded every 3 min after each ergonovine injection. Positive test results were development of regional wall motion abnormalities or transient ST segment elevation or depression >0.1 mV in any single lead of the 12-lead ECG. Coronary angiography was undertaken within 2 +/- 4 days (mean +/- SD) after ergonovine echocardiography, and the spasm provocation test with acetylcholine or ergonovine was performed in patients with normal angiographic findings or lumen diameter narrowing <70%. RESULTS: On the basis of angiographic criteria, 56 patients had coronary vasospasm; this finding was later ruled out in 19 patients with near-normal angiographic results by a negative response on the spasm provocation test. In the remaining five patients, coronary spasm provocation was not performed because they revealed a high degree of fixed stenosis (lumen diameter narrowing 97 +/- 4%). Ergonovine echocardiography could diagnose coronary vasospasm before angiography, with a sensitivity of 91% (51 of 56 patients, 95% confidence interval [CI] 84% TO 98%) and specificity of 88% (21 of 24 patients, 95% CI 75% to 100%). Of 53 patients showing regional wall motion abnormalities during ergonovine echocardiography, characteristic ST segment elevation in the simultaneously recorded ECG was observed in only 20 (38%). There were no complications, including myocardial infarction or fatal arrhythmia, during the test. CONCLUSIONS: Ergonovine echocardiography before coronary angiography is safe and can be used as a reliable diagnostic screening test for coronary vasospasm in patients with negative treadmill or normal stress myocardial perfusion scan results. These findings suggest that invasive coronary angiography can be avoided in selected patients for the diagnosis of vasospastic angina.

Increased basal tone and hyperresponsiveness to acetylcholine and ergonovine in spasm related coronary arteries in patients with variant angina--basal coronary artery tone in patients with variant angina.

In patients with variant angina, previous data have been inconclusive as to whether basal coronary artery tone is elevated at the spastic and non-spastic sites. Thus, the purpose of this study was to assess the basal coronary artery tone and the responsiveness to acetylcholine (Ach) and ergonovine (Erg) in patients with variant angina. We compared the basal coronary artery tone and the constrictive responses to Ach and Erg between 31 patients (Group 1) with variant angina in whom spasm was provoked by the low doses of Ach (intracoronary 20 micrograms) or Erg(intravenous 50 micrograms) and 35 patients (Group 2) provoked by higher doses of Ach (intracoronary 100 micrograms) or Erg (intravenous cumulative dose of 350 micrograms), and 26 control subjects. Patients with variant angina in whom spasm was provoked by low doses of Ach or Erg, had a higher incidence of mixed disease, multi-vessel spasm and higher disease activity. The basal coronary artery tone at the spastic and nonspastic sites of spasm related artery was significantly more elevated in Group 1 than that in Group 2 (44 +/- 17 vs 14 +/- 11% and 26 +/- 14 vs 16 +/- 10% respectively, P < 0.05), but not in the nonspasm related artery, The magnitudes of vasoconstrictive responses to Ach and Erg at the nonspastic sites were also greater in Group 1 than those in Group 2 and the control groups (Ach; 40 +/- 20 vs 26 +/- 11, 27 +/- 12%: Erg; 37 +/- 18 vs 12 +/- 8, 13 +/- 10% respectively, P < 0.05). However, the basal coronary artery tone was not elevated at the spastic and nonspastic sites in Group 2 compared to the in control subjects. These findings suggest that the basal coronary artery tone is increased in patients with variant angina with higher disease activity at the spastic sites and nonspastic sites of the spasm-related artery, and this may be related to the occurrence of coronary artery spasm.