First Report of Endophytic Candida ipomoeae Isolated from Ovules of Upland Cotton in Mississippi.

Cotton is grown on approximately 34.5 million ha worldwide to provide fiber, food oil, and animal feed. To our knowledge, this report is the first of Candida ipomoeae on cotton, and this yeast was found on ovules of the most commercially important cotton species in a major cotton-growing region. The yeast was isolated from ovules of upland cotton grown in vitro. A culture (NRRL Y-48065) was sent to Microbial ID Inc. (Newark, DE) where a partial 176-bp sequence for the D2 domain of the large subunit rDNA was obtained. A BLAST search on the GenBank database ( www.ncbi.nih.gov/Genbank/index.html ) found a 100% match between our sequence and accessions from two strains of C. ipomoeae (Accession Nos. AF050148 and AF050149). In addition, the distinctive colony morphology (white pseudomycelium with a raised stellate to lobate edge) was consistent with previous descriptions of C. ipomoeae (1). No growth was observed at 37°C for the current and previously described isolates. C. ipomoeae is a recently described asexual species (1) that has been isolated from morning glory (Ipomoea spp.) flowers and their insect visitors in Hawaii and the Americas (2). C. ipomoeae has also been found on insects that have visited flowers of the indigenous wild Hawaiian cotton species, Gossypium tomentosum (2) but it has not been isolated previously from cotton per se. Endogenous microbes are common in field-grown upland cotton and can be an impediment to obtaining aseptic plant tissue cultures. During August and September 2005, as part of an effort to rescue interspecific cotton hybrids, ovules were cultured in vitro for 4 days after pollination from plants grown in a field at Stoneville, MS. Fruit were washed in soap and water, surface sterilized in a laminar flow hood by immersion in an aqueous solution of 2.6% sodium hypochlorite and 0.1% Tween 20 for 10 min with intermittent shaking, followed by immersion in ethanol for 10 min, and then allowed to air dry. This surface sterilization protocol is >99% effective on greenhouse-grown fruit. For each fruit, ovules were placed on a single 100 × 25-mm petri dish containing 25 ml of modified Murashige and Skoog media with Gambourg's B5 vitamins (M0404; Sigma-Aldrich, St. Louis, MO) plus 1.9 g l-1 KNO3, 0.5 g l-1 asparagine, 1.0 g l-1 glutamine, 20.0 g l-1 glucose, 0.25 g l-1 cefotaxime, and 2.2 g l-1 gelrite, with a pH of 5.8. Plated ovules were incubated at 30°C with 12 h of fluorescent light each day. C. ipomoeae was first observed on ovules of the cv. Deltapine 90 crossed with G. arboreum; other fungal contaminants were also observed but all of these contaminants originated from ovules within 2 weeks of culture, indicating that the contaminants were endogenous. Subsequently, ovules from the self-pollination of cv. FiberMax 832 were grown on media containing 50 mg l-1 benomyl. On the benomyl-containing plates, the only fungal contaminant observed was C. ipomoeae and it was found on 22 of 120 plates. On plates with or without benomyl, C. ipomoeae grew slowly but caused the infected ovules to become necrotic and die, in contrast to uninfected ovules. Over time, the cultured ovules were completely overrun by the C. ipomoeae colonies. By identifying the contaminant as C. ipomoeae, pursuit of a targeted strategy for controlling it in cotton tissue cultures will now be possible. References: (1) M. A. Lachance et al. Can J. Microbiol. 44:718, 1998. (2) M. A. Lachance et al. FEMS (Fed. Eur. Microbiol. Soc.) Yeast Res. 1:1, 2001.

Convergent evolution of perenniality in rice and sorghum.

Annual and perennial habit are two major strategies by which grasses adapt to seasonal environmental change, and these distinguish cultivated cereals from their wild relatives. Rhizomatousness, a key trait contributing to perenniality, was investigated by using an F(2) population from a cross between cultivated rice (Oryza sativa) and its wild relative, Oryza longistaminata. Molecular mapping based on a complete simple sequence-repeat map revealed two dominant-complementary genes controlling rhizomatousness. Rhz3 was mapped to the interval between markers OSR16 [1.3 centimorgans (cM)] and OSR13 (8.1 cM) on rice chromosome 4 and Rhz2 located between RM119 (2.2 cM) and RM273 (7.4 cM) on chromosome 3. Comparative mapping indicated that each gene closely corresponds to major quantitative trait loci (QTLs) controlling rhizomatousness in Sorghum propinquum, a wild relative of cultivated sorghum. Correspondence of these genes in rice and sorghum, which diverged from a common ancestor approximately 50 million years ago, suggests that the two genes may be key regulators of rhizome development in many Poaceae. Many additional QTLs affecting abundance of rhizomes in O. longistaminata were identified, most of which also corresponded to the locations of S. propinquum QTLs. Convergent evolution of independent mutations at, in some cases, corresponding genes may have been responsible for the evolution of annual cereals from perennial wild grasses. DNA markers closely linked to Rhz2 and Rhz3 will facilitate cloning of the genes, which may contribute significantly to our understanding of grass evolution, advance opportunities to develop perennial cereals, and offer insights into environmentally benign weed-control strategies.

Bilateral simultaneous orbital decompression for Graves' orbitopathy with a combined endoscopic and Caldwell-Luc approach.

Graves' orbitopathy can lead to cosmetic deformity, orbital pain, and visual impairment. Surgical intervention can improve proptosis, cosmetic appearance of the eyelids, vision, and orbital pain with minimal morbidity. Ten patients with dysthyroid orbitopathy underwent concurrent bilateral orbital decompressions. Of these, 9 underwent simultaneous bilateral endoscopic and transantral decompressions, and 1 had only bilateral endoscopic decompressions. Medical management of keratopathy was attempted before surgery. All patients were previously treated with radioiodine and high-dose corticosteroids, and 2 patients had prior low-dose orbital irradiation. Preoperative and postoperative visual acuity, color vision testing, and measurement of proptosis were recorded for all patients. In addition, photographs and CT scans of the orbit and sinuses were done. After surgery, visual acuity improved in 8 patients and remained unchanged in 2 patients. Diplopia in the primary and downward gaze improved in 1 patient and remained unchanged in the 3 others who had it before surgery. Color vision deficits in the blue/yellow range were present in 8 patients before surgery and all reversed within 2 weeks after surgery. Proptosis decreased by an average of 4.83 mm (range 4-7 mm) in patients undergoing the combined decompression and decreased by 4 mm in the 1 patient who had the endoscopic decompression only. Ethmoid sinusitis developed in 1 patient but resolved with oral antibiotics, and another patient had an asymmetric result requiring additional unilateral surgery, which corrected the asymmetry. Overall, this approach avoids external incisions and allows excellent visualization in the regions of the orbital apex and ethmoid roof, facilitating maximal decompression without the increased risk of bleeding or visual disturbances.

Endonasal laser-assisted dacryocystorhinostomy.

Dacryocystorhinostomy is a procedure that is performed to allow drainage of tears from the lacrimal sac directly into the nasal cavity. Endonasal telescopes facilitate performance of this operation with better visualization and decreased morbidity. We present our experience with endoscopic laser-assisted DCR. In the last 31 months, we have performed 31 procedures on 23 patients with either the holmium:YAG laser or the argon:HGM laser. We have a 97% overall success rate with a mean follow-up of 16 months. Our series includes both adult and pediatric patients as well as five revision procedures after failed external DCR. We present our technique, results, and the reasons for our change in laser delivery systems. Most importantly, we discuss the technical factors that contribute to our overall success. These include a large rhinostomy size, simultaneous correction of intranasal and/or sinus pathology, the avoidance of laser use within the lacrimal sac, and close postoperative monitoring with intranasal debridement. We conclude that endoscopic laser-assisted DCR is a better alternative to standard external DCR because it avoids a cutaneous scar, excessive tissue injury, and postoperative morbidity.

Radiation therapy of metastatic pheochromocytoma: case report and review of the literature.

Malignant pheochromocytomas are rare tumors, which are considered radioresistant on the basis of little information. We report a patient, with cranial nerve deficits from a pheochromocytoma metastatic to the parasellar region, who promptly responded to radiation therapy (2,500 cGy) with reversal of neurologic deficit. The disease recurred 2 years later and again promptly responded upon treatment to 2,000 cGy. Hepatic metastases were controlled for over 1 year with 3,240 cGy. The radiotherapy of pheochromocytoma and chemodectoma is reviewed, and the similarities between the two kinds of tumor are discussed. We speculate that a higher initial radiation dose might have resulted in a more sustained remission in our patient and recommend doses of 4,000-5,000 cGy if they can be safely administered, in 4-5 weeks for pheochromocytomas.

Gastrointestinal problems in airline crew members.

The presence of intestinal and extraintestinal symptoms was investigated by a symptom questionnaire in crew members (n = 190) - and as controls in age and sex matched ground based administrative employees (n = 100) - of a charter carrier and was related to the actual flight schedule of the flying staff during one month. In addition, health and illness behaviors and personal, job and life satisfaction were assessed and related to symptom scores and flight schedules. Flying staff did report significantly more dyspeptic symptoms than did ground staff, and this was found mainly with long-distance flying, since staff with short-haul experience only did not report as much upper intestinal complaints. Also, cabin crew reported significantly more intestinal symptoms than did cockpit members, and part of the upper GI symptoms could be explained by different eating behaviors, specifically more fibre intake in flying staff. With increasing intestinal symptom frequency, doctor visits and sick-days increased, and satisfaction with job and personal life decreased. Flying staff had, however, more awareness of the importance of health behaviors. It is concluded that frequent flying specifically on long distances may result in increased intestinal symptoms, presumably due to time-shift.

Evaluation of an aviator with chronic disequilibrium, oscillopsia, and central sleep apnea.

A case is presented of an aviator with chronic disequilibrium, oscillopsia, and central sleep apnea. History, physical examination, and special studies are presented establishing a diagnosis of epidermoid tumor at the foramen magnum. Differential diagnosis and relation of findings to the lesion are presented. The aeromedical significance of this case is to reinforce the importance of persistence and the team concept in establishing diagnoses when aviators present with confusing or unexplained symptoms.

Nonlinear heart model predicts range of heart rates for 2:1 swinging in pericardial effusion.

We analyze two mathematical models of Rigney and Goldberger (14) of heart swinging in large pericardial effusions. Both models represent the torques due to the outflow of blood from the heart. The first assumes that the duration of systole does not vary with heart rate (in beats/min), whereas the second assumes that it varies linearly with heart rate. We examine the motion of the heart for heart rates between 50 and 200 and for a range of initial positions and velocities. Both models predict that the heart swings once every other beat (2:1 swinging, giving rise to electrical alternans) in a discrete range of heart rates and swings once per beat otherwise; both models explain the appearance and disappearance of 2:1 swinging mathematically. The first model predicts a rate range from 105 to 116 for the occurrence of 2:1 swinging. The second model predicts the same qualitative behavior but with 2:1 swinging occurring at heart rates between 88 and 119, which agrees well with published clinical data showing 2:1 swinging at heart rates between 90 and 144. We describe an analysis program for ordinary differential equations that analyzed the models quickly and automatically.

Prospective comparison of plain abdominal radiography with conventional and digital renal tomography in assessing renal extracorporeal shock wave lithotripsy patients.

Most publications citing the effectiveness of renal extracorporeal shock wave lithotripsy have used plain abdominal radiography to assess residual calculi after treatment. We compared radiologist sensitivity and specificity in the detection of calculi on plain abdominal radiographs versus conventional film-screen and digital renal tomograms in extracorporeal shock wave lithotripsy patients. Of the patients 50 were imaged before and within 24 hours after lithotripsy. Six radiologists evaluated the resultant 300 studies for the presence and location of calculi. The mean sensitivity for digital tomograms was 83% for pre-lithotripsy and post-lithotripsy studies, which was significantly higher than for plain abdominal radiography and conventional tomography after lithotripsy. However, there were significantly more false positive stone diagnoses associated with digital tomogram interpretation. Signal detection analysis verified the over-all superiority of digital tomography for post-extracorporeal shock wave lithotripsy imaging. Calculus detection by conventional and digital tomography is superior to detection by plain abdominal radiography. However, because we did not perform delayed imaging, it is not possible to say what impact digital tomography might have on the management of extracorporeal shock wave lithotripsy patients.

Esmolol (Brevibloc) to assess dynamic subpulmonary stenosis in a child after repair of complete transposition: a case report.

Esmolol (Brevibloc), a new, ultra-short acting, cardioselective beta-adrenergic blocking agent with half-life of 9.2 min following i.v. administration was given to a 4-year-old child with known dynamic and fixed sub-pulmonary stenosis post Senning repair for complete transposition of the great vessels. The left ventricular systolic pressure increased from 48 to 100 mmHg, heart rate showed an increase from 65 to 140 bpm, the right femoral arterial pressures decreased from 115/58 to 77/35 mmHg following an infusion of Isoprel. Infusion of esmolol partially relieved the dynamic sub-pulmonary stenosis. There were no adverse effects and esmolol was tolerated well by the child. Esmolol might thus play a role in the pediatric catheterization laboratory during investigational procedures, electrophysiological studies and in the control of rapid supraventricular tachycardia, especially in adolescents with WPW pre-excitation. Esmolol would also be beneficial in emergency treatment of epinephrine or isoproterenol overdosage.

Immunophenotypic analysis of the inflammatory infiltrate in ocular cicatricial pemphigoid. Further evidence for a T cell-mediated disease.

Ocular cicatricial pemphigoid (OCP) is characterized by the deposition of immunoglobulin and complement along the conjunctival epithelial basement membrane zone (BMZ). In order to further elucidate the cellular populations of the local inflammatory infiltrates, the authors used a panel of monoclonal antibodies in cryostat tissue sections to delineate T cell subsets, B lymphocytes, dendritic cells, and macrophages in six patients with OCP. In comparison with matched controls of the epibulbar conjunctiva, the authors discovered a threefold increase in T lymphocytes within the epithelium and a 20-fold increase within the substantia propria. In contrast with the normal-standing population of conjunctival T lymphocytes, there were activated interleukin 2 receptor (IL-2R)-positive lymphocytes in both the epithelium and the substantia propria. Macrophages were the second most common cells in the substantia propria, accounting for 12.7% of the mononuclear population--a threefold increase over the normal percentage. B cells and plasma cells, normally absent from epibulbar conjunctiva, were the next most prominent populations, constituting 6.9 and 4.6%, respectively, of all mononuclear cells. Dendritic cells which process antigen locally constituted only 1.2% of the mononuclear cell population, but were increased 25-fold over normal controls. By elaborating cytokines that promote fibroplasia, the T cells in OCP may be effector cells along with macrophages and other inflammatory cells in bringing about scarification of the substantia propria, and may furthermore be responsible for an immunoregulatory defect that allows local B lymphocytes to produce autoantibodies to the BMZ.

Epibulbar fibroma of the conjunctival substantia propria.

A 39-year-old black woman had a 12-year history of slowly progressive left temporal juxtalimbal conjunctival swelling. The lesion was freely movable over the surface of the globe and was believed to be situated within the substantia propria. Histopathologic evaluation of the excised tissue disclosed that it was a collagenous mass of lamellar architecture, with a hypocellular dispersion of mesenchymal cells and a scattering of capillaries in the absence of inflammation. Electron microscopic examination revealed that the lamellar arrangement had regular lobular subdivisions composed of collagen fibers approximately 50 nm in diameter. Compressed fibroblasts occupied the peripheries of the lobules; the former exhibited abundant rough-surfaced endoplasmic reticulum and failed to elaborate basement membrane material. Delicate processes of the fibroblasts extended into the centers of the collagenous aggregates. To our knowledge, this is the first convincingly documented case of an acquired fibroma of the substantia propria of the epibulbar conjunctiva. The differential diagnosis in this case included related fibroblastic and simulating nonfibroblastic lesions.

Ectopic automatic atrial tachycardia in children: clinical characteristics, management and follow-up.

Ectopic automatic atrial tachycardia, an uncommon type of supraventricular tachycardia in children and adults, has been reported to be resistant to medical therapy, and surgical or cryoblation has been recommended. This report describes 10 infants and children (median age 6 months; range birth to 7.5 years) with automatic atrial tachycardia and their management and follow-up. Digoxin alone was unsuccessful in controlling tachycardia in all 10 patients but decreased the tachycardia rate by 5 to 20% in 8. Intravenous (0.1 mg/kg body weight per dose) and oral propranolol successfully suppressed tachycardia in three of five patients and oral propranolol successfully controlled tachycardia in two of five other patients. Class I antiarrhythmic agents--quinidine (three patients), procainamide (four patients) and phenytoin (three patients)--did not control tachycardia in any patients but made the tachycardia rate worse in three patients. Intravenous (5 mg/kg per dose) and oral amiodarone suppressed tachycardia in three of four patients and oral amiodarone suppressed it in another patient. Thus, intravenous propranolol and amiodarone were effective in acutely suppressing automatic ectopic atrial tachycardia and predicted the response to long-term oral therapy. One patient had persistent tachycardia after surgical ablation of the high right atrial ectopic focus, and another patient had unsuccessful catheter ablation of the high right atrial ectopic focus (25 J). During follow-up (10 to 28 months), ectopic atrial tachycardia resolved completely in four patients and was well controlled in four patients.

The immunoarchitecture of the normal human lacrimal gland. Relevancy for understanding pathologic conditions.

To delineate the immunoarchitecture of the normal human lacrimal gland, monoclonal antibodies that detect B- and T-lymphocyte, macrophage, and dendritic cell lineage, subset, and differentiation-associated antigens were used in combination with highly sensitive tissue-section immunoperoxidase techniques. Plasma cells, identified with monoclonal antibody OKT10, represented the predominant mononuclear cell population, accounting for 53.9% of all mononuclear cells present. A qualitative study of plasma cell cytoplasmic immunoglobulin heavy-chain expression in deparaffinized, formalin-fixed tissue sections showed that the vast majority of these plasma cells contained IgA. Rare plasma cells contained IgG, IgM, or IgD. T-cells, identified with monoclonal antibody OKT3, represented the second most common cell type in the normal human lacrimal gland, accounting for 40.3% of all mononuclear cells present. T cells were located predominantly in lymphocytic foci and singly in the interstitium. T8 antigen-positive (suppressor/cytotoxic) T cells predominated over T4 antigen-positive (helper) T cells, averaging 25.2 and 14.7%, respectively. The overall mean T4/T8 ratio was 0.56. T8 antigen-positive T cells were the most numerous cell population outside aggregates and follicles, being distributed almost equally between the acini and the ducts (49%) and the interstitium (51%). Only 16% of T4 antigen-positive cells preferred glands or ducts to the interstitium. B cells, identified with monoclonal antibody BL9, represented only 5.7% of all mononuclear cells present. B cells were exclusively found in the centers of primary and secondary follicles. The majority of the surface immunoglobulin-positive B cells expressed IgM, fewer expressed IgD, and still fewer expressed IgG or IgA. Rare LeuM1+ OKM1+ macrophages were present in the center of B-cell follicles, where rare OKT6+ dendritic cells and activated T cells (IL-2+) were also discovered. These results support the concept that the lacrimal gland belongs to the mucosa-associated lymphoid system.

Multifocal static creamy choroidal infiltrates. An early sign of lymphoid neoplasia.

Three patients, each more than 60 years of age at initial presentation, had early stage lymphoid infiltrates (formerly called reactive lymphoid hyperplasia) of the choroid and contiguous extraocular tissues. There were multifocal, confluent, and nonconfluent creamy patches in the choroid. These lesions changed very little over periods of observation ranging from 1 to 4 years and failed to produce ophthalmoscopically visible disturbances of the retinal pigment epithelium (RPE). Fluorescein angiography demonstrated dye collection within the lesions without leakage into the subretinal or subpigment epithelial spaces. Both ultrasonography and computed tomography (CT) showed thickening of the choroid with either anterior or posterior episcleral extensions of lymphoid tissue. Pathologic evaluation of biopsy specimens of extraocular portions of the lesions showed low-grade tumors that were diffuse infiltrates of mature lymphocytes, which exhibited lymphoplasmacytoid features, Dutcher bodies, or small residual germinal centers (so-called borderline lesions). Two patients had uniocular localized disease, whereas the third had bilateral ocular lesions, hypogammaglobulinemia, and another extranodal chest wall lymphoid tumor. Therapy for the localized ocular condition consisted either of oral administration of corticosteroids or low doses of radiotherapy.