Pathogenicity and Virulence of Soilborne Oomycetes on Phaseolus vulgaris.

Dry bean (Phaseolus vulgaris L.) is a globally important leguminous food crop. Yields can be reduced by high incidence of soilborne oomycetes that cause seedling disease. Breeders have attempted to develop Pythium root rot-resistant bean varieties; however, relationships between dry bean and most soilborne oomycete species remain uncharacterized. Oomycete species (n = 28), including Pythium spp. and Phytopythium spp., were tested in a growth chamber seedling assay at 20°C and an in vitro seed assay at 20°C and 26°C to evaluate their pathogenicity and virulence on 'Red Hawk' dark red kidney bean and 'Zorro' black bean. Root size or disease severity was significantly impacted by 14 oomycete species, though results varied by bean variety, temperature, and assay. Of these 14 pathogenic oomycete species, 11 species exhibited significant differences in DSI due to temperature on at least one bean variety. Pythium aphanidermatum, P. myriotylum, P. ultimum, P. ultimum var. sporangiiferium, and P. ultimum var. ultimum were the most virulent species in both assays, causing seed rot and pre-emergence damping-off of dry bean. Oomycete species were clustered into three groups based on symptom development: seed rot pathogens, root rot pathogens, or nonpathogens. Intraspecific variability in virulence was observed for eight of the 14 pathogenic oomycete species. Improved understanding of Pythium and Phytopythium interactions with dry bean may enable breeders and pathologists to more effectively evaluate strategies for oomycete seedling disease management.

Fate of the ACL-injured patient. A prospective outcome study.

We followed 292 patients who had sustained an acute traumatic hemarthrosis for a mean of 64 months. The KT-1000 arthrometer measurements within 90 days of injury revealed the injured knee was stable in 56 patients and unstable in 236. Forty-five unstable patients had an ACL reconstruction within 90 days of injury. Surgical procedures performed > 90 days after injury included ligament reconstruction in 46 patients. Factors that correlated with patients who had late surgery for a meniscal tear or an ACL reconstruction (P < 0.05) were preinjury hours of sports participation, arthrometer measurements, and patient age. Follow-up data are presented for the patients divided into four groups: I, early stable, no reconstruction; II, early unstable, no reconstruction; III, early reconstruction; and IV, late reconstruction. No patient changed occupation because of the knee injury. Hours per year of sports participation and levels of sports participation decreased in all groups. Joint arthrosis was documented by radiograph and bone scan. Joint surface injury abnormalities observed at surgery and meniscal surgery showed greater abnormalities by radiograph and bone scan scores (P < 0.05). Reconstructed patients had a higher level of arthrosis by radiograph and bone scan.

Bone imaging after acute knee hemarthrosis.

Follow-up evaluations were carried out in 84 patients examined 5-8 years after sustaining an acute traumatic hemarthrosis of the knee. The initial examination performed within 2 weeks of injury had revealed 18 patients with a stable knee and 66 with anterior instability. Twelve of the patients underwent anterior cruciate ligament reconstruction within 3 months of injury and 11 more did so between 1 and 3 years after injury. To document joint deterioration at follow-up, bone scintigraphy and conventional anteroposterior, lateral, and tunnel X-rays were taken. Medial, lateral, patellofemoral and patellar uptake in bone scintigraphy was graded from 0 to 4. Six radiological variables were graded at eight different sites. Sixty-three patients (75%) had a positive bone scan and 69 patients (82%) showed radiological changes. Bone scan and X-ray scores were both significantly higher in the reconstructed knees.

Nonoperative management of splenic trauma. Conservative or radical treatment?

In a four-year experience with selective nonoperative management of splenic trauma in adults and children, 24 (35%) of 68 patients with documented splenic trauma were initially treated nonoperatively. In only one patient was an operation and laparotomy ultimately required. There was no morbidity or mortality in the nonoperative group. In the operative group (44 patients), 4% died after operation, largely of multiple injuries. Confirmation of splenic injury and follow-up of patients were mostly performed by splenic scintiscans. There was no significant difference in length of hospitalization between operative and nonoperative groups. Operative splenic repair and preservation of the spleen to prevent postsplenectomy sepsis often requires considerable experience and may be a lengthy, tedious procedure. Nonoperative therapy in adults and children is an attractive alternative in a selective group of patients.

Tarsal navicular stress fractures in runners.

The number of participants in running programs at all levels has increased in recent years. As a consequence, practitioners are more frequently dealing with diagnoses in symptomatic runners. Detection of tarsal navicular stress fractures in long distance runners, including the diagnostic value of radionuclide bone scanning, is discussed.

Detection and size estimation of acute myocardial infarction using 99Tc-glucoheptonate.

Twenty-seven patients with suspected acute myocardial infarction were studied by precordial scanning after intravenous administration of 99mTc-gluchoheptonate 2-48 hr after the onset of chest pain. Fifteen of the patients had clinically documented acute myocardial infarctions. Twelve of these 15 (80%) had areas of distinctly increased tracer uptake in the region of the heart. The three infarctions not identified by scan had peak serum CPK values of less than 300. In seven patients without infarction, no distinct areas of increased tracer uptake were found in the region of the heart. Five patients could not be classified as to whether infarction had or had not occurred. Three had abnormal scans, the significance of which is uncertain. Infarct size was estimated from the area of increased 99mTc-glucoheptonate concentration on scan and compared to peak serum CPK values. A linear correlation with a correlation coefficient of 0.77 was found. Technetium-99-m-glucoheptonate scanning was useful for the identification and size estimation of moderate- to large-size transmural and nontransmural acute myocardial infaractions.

Accumulation of 99mTc-glucoheptonate in acutely infarcted myocardium.

The distribution of 99mTc-glucoheptonate in normal mice and its accumulation in acutely infarcted myocardium were studied in animals. Rapid blood clearance and low concentration of the tracer in normal myocardium were found in tissue distribution studies performed in mice. Experimental myocardial infarction was performed in nine dogs. Four hours after the intravenous injection of 99mTc-glucoheptonate the uptake ratio of the myocardial infarcted area to normal myocardium was 20:1; to blood, 9:1; and to lung, 6:1. The greatest concentration of radiopharmaceutical in the infarcted tissue was noted in areas that had 20-40% of normal perfusion. Regions of infarction were clearly defined by external gamma scintigraphy. Clinical investigation of this tracer in humans appears warranted.