Metabolism of the Flavonoid Epicatechin by Laccase of Colletotrichum gloeosporioides and Its Effect on Pathogenicity on Avocado Fruits.

ABSTRACT During avocado fruit ripening, decreasing levels of the flavonoid epicatechin have been reported to modulate the metabolism of preformed antifungal compounds and the activation of quiescent Colletotrichum gloeosporioides infections. Epicatechin levels decreased as well when C. gloeosporioides was grown in the presence of epicatechin in culture. Extracts of laccase enzyme obtained from decayed tissue and culture media fully metabolized the epicatechin substrate within 4 and 20 h, respectively. Purified laccase protein from C. gloeosporioides showed an apparent MW of 60,000, an isoelectric point at pH 3.9, and maximal epicatechin degradation at pH 5.6. Inhibitors of fungal laccase such as EDTA and thioglycolic acid reduced C. gloeosporioides symptom development when applied to ripening susceptible fruits. Isolates of C. gloeosporioides with reduced laccase activity and no capability to metabolize epicatechin showed reduced pathogenicity on ripening fruits. On the contrary, Mexican isolates with increasing capabilities to metabolize epicatechin showed early symptoms of disease in unripe fruits. Transcript levels of cglac1, encoding C. gloeosporioides laccase, were enhanced during fungal development in the presence of epicatechin at pH 6.0, where avocado fruits are susceptible to fungal attack. But transcript increase was not detected at pH 5.0, where the fruit is resistant to fungal attack. The present results suggest that biotransformation of epicatechin by C. gloeosporioides in ripening fruits is followed by the decline of the preformed antifungal diene compound, resulting in the activation of quiescent infections.

Knowledge of legal terminology and court proceedings in adults with developmental disabilities.

This research compared 40 adults with mild developmental disabilities (DD) and 40 nondelayed adults (ND) in terms of knowledge of legal terms and court proceedings. For all of the 34 terms studied, with the exception of "police office" there were significant differences between the DD and ND groups with respect to degree of conceptual understanding of terms. Results indicate that all but 6 terms assessed (adjourn, allegation, crown attorney, defendant, prosecute, and court reporter) were well-defined by 85% or more of ND participants. In contrast, only 8 of the terms (police officer, lawyer, jail, court, lie, truth, judge, and witness) were reasonably conceptually understood by at least 75% of DD participants. Reported familiarity with terms in DD participants is not a reliable indicator of actual familiarity with terms. Results are discussed with respect to the need for education of DD individuals and legal professionals to support participation and fair treatment of DD individuals in legal situations.

Professionals' perceptions of psychotropic medication in residential facilities for individuals with mental retardation.

Professional staff in four state facilities for individuals with mental retardation were surveyed to determine their perceptions, knowledge and opinions regarding the use of psychotropic medication. A large majority of the 377 respondents indicated that the physicians in their facilities were primarily responsible for medication-related decisions. Under ideal conditions, however, all professional staff and parents were seen as having a greater influence in the decision-making process. Aggression, delusions and hallucinations, self-injury, other psychiatric disorders, and anxiety were rated as disorders most likely to result in medication therapy. Behaviour modification was viewed as a suitable alternative to drug treatment for acting out and aggression. The professionals indicated that behavioural observation was the most influential assessment technique in current usage, followed by global impressions and informal diaries. Over 80% of the respondents perceived their preservice and inservice training on issues related to the use of psychotropic medication to treat behaviour problems as inadequate, with 96% of them desiring continuing education. These findings were compared to data from similar studies of populations with other disabilities, and suggestions for modifications in the current decision-making processes related to the use of psychotropic medication in institutionalized individuals with mental retardation are discussed.

Effects of fentanyl administration on respiratory system compliance in infants.

OBJECTIVE: To determine if the analgesic doses of fentanyl used in a pediatric intensive care unit (ICU) setting adversely affect dynamic total respiratory system compliance in awake, intubated infants. DESIGN: Prospective case-control study. SETTING: Pediatric and pediatric cardiac ICUs of a tertiary university hospital. PATIENTS: Thirteen awake and mechanically ventilated children < 6 months of age. INTERVENTIONS: Measurements of dynamic total respiratory system compliance were obtained during steady-state conditions for 6 mins and continued for 10 mins after the rapid, intravenous administration of 4 micrograms/kg of fentanyl. No patient had received a narcotic, benzodiazepine, or muscle relaxant within the previous 4 hrs. MEASUREMENTS AND MAIN RESULTS: After fentanyl administration, dynamic total respiratory system compliance was unchanged in three patients, improved in nine patients, and deteriorated in one patient. The mean value for the entire group increased from 0.76 mL/cm H2O/kg before infusion to 0.82 mL/cm H2O/kg after infusion (p < .02), representing a 9.6% increase. None of the patients showed oxygen desaturation as assessed by continuous pulse oximeter, or episodes of chest wall rigidity. CONCLUSIONS: This work corroborates our clinical impression that rapid infusions of fentanyl at the dose tested in small infants do not adversely affect dynamic total respiratory system compliance. To the contrary, the sedating and analgesic effects may improve synchronous breathing and decrease voluntary muscle tone, resulting in improved dynamic total respiratory system compliance.

Intratracheal pulmonary ventilation and congenital diaphragmatic hernia: a report of two cases.

Previous studies from our institution have shown that neonates with congenital diaphragmatic hernia (CDH), whose best postductal PaO2 (BPDPO2) was less than 100 mm Hg while on maximal conventional mechanical ventilation (CMV), had a mortality exceeding 90%. When combined with extracorporeal membrane oxygenation (ECMO), the mortality rose to 100% in those infants who developed hypercarbia following decannulation. Historically, those patients have required increasing ventilator support, leading to iatrogenic lung damage, and eventual death. Intratracheal pulmonary ventilation (ITPV) using the reverse thrust catheter (RTC) developed by Kolobow incorporates a continuous flow of humidified gas through a reverse Venturi catheter positioned at the distal end of the endotracheal tube. In animal studies, ITPV was shown to result in a reduced physiological dead-space (VD), to facilitate expiration, and to enhance CO2 elimination. In our current study, we have applied ITPV in two neonates with CDH who could not be weaned from ECMO because of uncontrollable hypercapnia, and who met above criteria for 100% mortality. In both cases, ITPV restored normal PaCO2 at low peak inspiratory pressure (PIP) with a substantial decrease in VD. We believe ITPV is suited to ventilating newborns with CDH in whom barotrauma is known to be common. Beyond its present use, ITPV may be useful to ventilate children with other forms of respiratory failure, and should be so considered along with other now available methods of mechanical pulmonary ventilation.

Informational needs of parents of sick neonates.

Sixty-one parents of 43 neonates in a neonatal intensive care unit were interviewed within 3 days of their first conference with the neonatologist to assess their needs for medical information. The conference with the physician and the interview with the investigator were audiotaped. Information given by the physician and information recalled by the parents was categorized and rated by the investigator. The physicians gave very detailed information about diagnosis in 77% of cases whereas 39% of the parents recalled diagnostic information in great detail. Respective percentages for prognosis were 16 and 33; for current management (eg, investigation, therapy), 28 and 66; and for cause of illness, 16 and 18. The statistical significance of the differences between the very detailed information int he physician-parent conferences and in the parent-investigator interviews was, by category, less than .002, less than .041, less than .004, and not significant, respectively. Information in the respective categories was described as "most helpful" by 20%, 67%, 90%, and 8% of parents. All but one of the parents stated that they wanted the whole truth. Physician uncertainty in providing information was significantly associated with severity of illness. It is concluded that while parents wanted information in all categories, they paid most attention to that relating to management. Physician-parent discordances with respect to information about management, diagnosis, and prognosis suggest directions for future investigation of the optimal content of information for parents in this context.