Fusarioid community diversity associated with conifer seedlings in forest nurseries across the contiguous USA.

Introduction: Fusarioid fungi that cause damping-off and root diseases can result in significant losses to conifer crops produced in forest nurseries across the USA. These nurseries are vital to reforestation and forest restoration efforts. Understanding the diversity of Fusarioid fungi associated with damping-off and root diseases of conifer seedlings can provide an approach for targeted management techniques to limit seedling losses and pathogen spread to novel landscapes. Methods: This study identifies 26 Fusarium spp. (F. acuminatum, F. annulatum, F. avenaceum, F. brachygibbosum, F. clavus, F. commune, F. cugenangense, F. diversisporum, F. elaeagni, F. elaeidis, F. flocciferum, F. fredkrugeri, F. fujikuroi, F. grosmichelii, F. ipomoeae, F. lactis, F. languescens, F. luffae, F. odoratissimum, F. oxysporum, F. queenslandicum, F. redolens, F. torulosum, F. triseptatum, F. vanleeuwenii, & F. verticillioides), 15 potential species within Fusarium and Neocosmospora species complexes (two from F. fujikuroi species complex, nine from F. oxysporum species complex, three from F. tricinctum species complex, and one from Neocosmospora species complex), and four Neocosmospora spp. (N. falciforme, N. metavorans, N. pisi, & N. solani) and associated host information collected from conifer-producing nurseries across the contiguous USA. Results: Phylogenetic analyses identified Fusarioid fungi haplotypes that were associated with 1) host specificity, 2) localization to geographic regions, or 3) generalists found on multiple hosts across diverse geographic regions. Discussion: The haplotypes and novel species identified on conifer seedlings should be considered for further analysis to determine pathogenicity, pathogen spread, and assess management practices.

Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting.

OBJECTIVE: Given the widely recognized genetic basis for Gilles de la Tourette syndrome (TS) and the suggestion that the putative TS gene(s) may be expressed as or associated with a variety of psychiatric illnesses, this study was undertaken to assess the prevalence of tics and TS in a psychiatric inpatient population. DESIGN: Cross-sectional study. SETTING AND PATIENTS: 200 consecutive adult patients who were admitted to the psychiatric wards of University College London Teaching Hospitals. OUTCOME MEASURES: TS and related behaviours, as assessed by the comprehensive semi-structured National Hospital Interview Schedule. RESULTS: None of the 200 patients had definite TS, but 2 were observed to have motor tics; 10 had a history of tics (present for less than a year), and 7 reported a family history of tics. Thus, 19 (9.5%) inpatients qualified for inclusion in a broadly defined TS diathesis. These rates are significantly lower than those reported in a similar community based epidemiological study of adolescents (p = 0.018). CONCLUSIONS: Our findings do not support the theory that TS and related behaviours are over-represented among adult inpatients with psychiatric illnesses.

Serum lipid effects of a high-monounsaturated fat diet based on macadamia nuts.

BACKGROUND: Recent studies have identified potential beneficial effects of eating nuts, most of which have substantial amounts of monounsaturated fats. Macadamia nuts are 75% fat by weight, 80% of which is monounsaturated. OBJECTIVE: To examine variations in serum lipid levels in response to a high-monounsaturated fat diet based on macadamia nuts. METHODS: A randomized crossover trial of three 30-day diets was conducted in 30 volunteers aged 18 to 53 years from a free-living population. Each was fed a "typical American" diet high in saturated fat (37% energy from fat); an American Heart Association Step 1 diet (30% energy from fat); and a macadamia nut-based monounsaturated fat diet (37% energy from fat) in random order. Serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were measured. RESULTS: Mean total cholesterol level after the typical American diet was 5.20 mmol/L (201 mg/dL). After the Step 1 diet and the macadamia nut diet, total cholesterol level was 4.99 mmol/L (193 mg/dL) and 4.95 mmol/L (191 mg/dL), respectively. Low-density lipoprotein cholesterol level was 3.37 mmol/L (130 mg/dL) (typical diet), 3.21 mmol/L (124 mg/dL) (Step 1 diet), and 3.22 mmol/L (125 mg/dL) (macadamia nut diet). High-density lipoprotein cholesterol level was 1.43 mmol/L (55 mg/dL) (typical), 1.34 mmol/L (52 mg/dL) (Step 1), and 1.37 mmol/L (53 mg/dL) (macadamia nut). Lipid values after the Step 1 and macadamia nut diets were significantly different from those after the typical diet (P<.05). CONCLUSIONS: The macadamia nut-based diet high in monounsaturated fat and the moderately low-fat diet both had potentially beneficial effects on cholesterol and low-density lipoprotein cholesterol levels when compared with a typical American diet.

Human pancreatic thread protein, an exocrine thread protein with possible implications to Alzheimer's disease: secondary structure in solution at acid pH.

The secondary structure of human pancreatic thread protein (HPTP) in solution at acid pH was derived using Fourier transform infrared (FT-IR) and laser Raman spectroscopic studies. The experimentally derived secondary structure of HPTP was compared with the secondary structure obtained by the Chou-Fasman algorithm. Pancreatic thread protein is a major exocrine secretory protein that in vitro forms filamentous bundles reminiscent of the paired helical filaments of Alzheimer's disease (AD). PTP immunoreactivity in brains afflicted with AD has been demonstrated previously and high levels of its mRNA in the developing human brain have also been reported in the literature. The above studies suggest that AD is associated with enhanced expression of PTP-related transcripts with interneuronal accumulation of PTP-like proteins. The experimentally derived secondary structure of HPTP consists of a significant proportion of beta-sheets and beta-turns and lesser amounts of alpha-helical structures. The beta-sheet component presumably plays an important role in the pH-dependent globule-fibril transformation of HPTP leading to antiparallel beta-sheet structure in the aggregated state. The secondary structure of HPTP and its globule-fibril transformation lend credence to the belief that AD may be viewed as a conformational disease.

Surgery for coarctation of the aorta in infants younger than 3 months: end-to-end repair versus subclavian flap angioplasty: is either operation better?

OBJECTIVE: Recurrent coarctation is a complication which is seen at a consistent rate following all types of repair for coarctation of the aorta. Particularly disappointing late results are reported in younger infants, under 3 months of age. This retrospective analysis was undertaken to compare the outcomes on late follow-up between subclavian flap angioplasty and resection and end-to-end repair, in this age group. METHODS: Over a 12-year period, between 1982 and 1994, 86 infants under 3 months of age underwent surgical repair of coarctation (39 resections and end-to-end repair, and 47 subclavian flap angioplasty procedures). Operative mortality was not significantly different (P = 0.6) between resection and end-to-end repair (5.1%) and subclavian flap angioplasty (8.5%). All operative deaths (six patients) were in infants with associated ventricular septal defects. The mean follow-up for all patients was 7.95 years +/- 4.10 (range 0-14.5 years). The 5-year survival for resection and end-to-end repair was 87 +/- 5%, compared to 75 +/- 7% for subclavian flap angioplasty (P = 0.2). RESULTS: Recurrent coarctation occurred in nine patients who needed reoperation. The reoperation-free rates at both 5 and 10 years for resection and end-to-end anastomosis, and subclavian flap repair were 86 +/- 6% and 90 +/- 5%, respectively. The recurrence in the resection and end-to-end anastomosis group were due to constrictive scarring at the anastomosis, whereas periductal tissue and growth of posterior aortic ridge caused recurrence in the subclavian flap angioplasty group. There were no deaths during reoperation for recurrence. CONCLUSIONS: Both procedures are extremely effective for coarctation repair in young infants and run a similar risk of recurrence, which are due to completely different mechanisms. The surgeon's expertise is the major determinant of outcome.

Non-uniform triple helical structure in chick skin type I collagen on thermal denaturation: Raman spectroscopic study.

The individual chains in the triple helix of collagen occur in a conformation related to polyproline II because of the presence of large number of imino peptide bonds. However, these residues are not evenly distributed in the collagen molecule which also contains many non-imino residues. These non-imino regions of collagen may be expected to show preference for other than triple helical conformations. The appearance of several Raman bands in solution phase at 65 degrees C raises the possibility of non-uniform triple helical structure in collagen. Raman spectroscopic studies on collagen in the solid state and in solution at a temperature greater than its denaturation temperature, reported here suggest that denatured collagen may exhibit an ensemble of conformational states with yet unknown implications to the biochemical interactions of this important protein component of connective tissues.

Glucose management in the infant under six kilograms.

A retrospective, nonrandomized study of blood glucose levels in very young children under 6 kg was undertaken. Each patient underwent the repair of complex congenital heart defects using hypothermia and nonpulsatile cardiopulmonary bypass (CPB). Hyperglycaemia may cause metabolic changes, resulting in reduced glucose transport and cerebral ischaemia. To evaluate the frequency of the occurrence of hyperglycaemia, samples were evaluated for glucose levels in three groups of patients. Group 1 (n = 5) consisted of infants undergoing standard bypass and moderate hypothermia (26 degrees C). Group 2 (n = 5) were infants undergoing low-flow bypass and profound hypothermia (20 degrees C). Group 3 (n = 5) was comprised of infants undergoing total circulatory arrest and profound hypothermia (18 degrees C). Glucose samples were taken preoperatively, during hypothermic bypass, during rewarming and 1-h postoperatively. In group 1, blood glucose levels remained within the normal range (65-100 mg/dl) throughout bypass and in the 1-h postoperative sample. In group 2, blood glucose levels remained within the normal range preoperatively and during the hypothermic bypass period. However, during the rewarming period, the glucose level rose to 185 +/- 17.2 mg/dl. The 1-h postoperative level was also increased to 168 +/- 16.5 mg/dl. Group 3, like group 2, showed that the preoperative and hypothermic glucose values were within the normal range and the rewarming, 133 +/- 29.4, and the 1 h, 130 +/- 33.3 mg/dl, glucose values were hyperglycaemic. This study indicates that blood glucose levels should be monitored routinely, both during and after CPB.

Konno-aortoventriculoplasty with mechanical prosthesis in dealing with small aortic root: a good surgical option.

OBJECTIVE: This study was undertaken to evaluate the effectiveness and the results with the Konno-aortoventriculoplasty. METHODS: Over a 10-year period, 21 Konno-aortoventriculoplasties were performed in 20 patients utilizing mechanical cardiac valvular prostheses, in 14 male and 6 female patients for complex left ventricular outflow tract stenosis. The mean age was 9.2 years (range 1.7-25.7 years). The pre-enlargement mean aortic annular size was 11.5 mm (6-16 mm). The mean size of the prostheses implanted was 20.4 mm (19-23 mm). In a typical case, the aortic annulus was enlarged to twice its original size. RESULTS: The only operative death was in a 8 kg, 20-month old child with previous commissurotomy, due to intractable bleeding and low output state. The mean hospital stay was 9.4 days (1-15 days), and the mean ICU stay was 3.3 days (1-7 days). The only late death was in a patient who went on to have cardiac transplantation for progressive left ventricular dysfunction. The 10-year acturial survival was 90 +/- 7%, and the reoperation free survival was 89 +/- 7%. All of the 18 surviving patients are asymptomatic at the time of last clinic visit (mean follow-up of 61.1 +/- 31.7 months, range 0-139 months). All patients had resolutions of their left ventricular hypertrophy with insignificant gradient across the repair by echocardiography. CONCLUSIONS: Konno-aortoventriculoplasty is extremely effective in the treatment of small aortic annuli and complex left ventricular outflow tract obstruction. In the present era of increasing popularity of autograft and homograft operations, the Konno procedure should remain in the technical armamentarium of the cardiac surgeon.

Critical aortic stenosis in the neonate. Results of aortic commissurotomy.

Critical aortic stenosis has been a challenging congenital heart defect in the neonate commonly due to severe circulatory failure and multiple organ dysfunction. Since January, 1982, 20 neonates with a mean age of 5.6 +/- 1.6 days and weight of 3.25 +/- 0.1 kg underwent aortic commissurotomy. Early surgical intervention, cardiopulmonary bypass with hypothermia at 30 degrees C, careful assessment of the aortic leaflets, commissures and sinuses, and extensive commissurotomy short of causing aortic regurgitation, were essential principles of the operation. There were three operative deaths (15.0%) and three late deaths. One-year and 7-year survival rates are 74 +/- 10% and 69 +/- 11%. There were five reoperations for recurrent stenosis and two of these are late deaths. At 7 years 80 +/- 11% of patients remain free of a reoperation. Growth curves of survivors have been excellent with only two patients below the 5th percentile for both height and weight; 80% of the patients are totally asymptomatic. Despite substantial improvements in the treatments of most heart defects in neonates in the past decade, critical aortic stenosis still carries a malignant behavior with significant early mortality and the need for reoperations. Close follow-up of the patients is essential due to recurrence of the stenosis and progressive left ventricular hypertrophy, even when patients are totally asymptomatic.

Adverse life events and breast cancer: case-control study.

OBJECTIVE: To investigate the strength of association between past life events and the development of breast cancer. DESIGN: Case-control study. A standardised life events interview and rating was administered before a definitive diagnosis. SETTING: Breast Cancer Screening Assessment Unit and surgical outpatient clinics at King's College Hospital, London. SUBJECTS: 119 consecutive women aged 20-70 who were referred for biopsy of a suspicious breast lesion. MAIN OUTCOME MEASURES: Odds ratio of the risk of developing breast cancer after life events in the preceding five years after adjustment for confounders. RESULTS: 41 women were diagnosed as having malignant disease while the remainder had benign conditions. Severe life events increased the risk of breast cancer. The crude odds ratio was 3.2 (95% confidence interval 1.35 to 7.6). After adjustment for age and the menopause and other potential confounders this rose to 11.6 (3.1 to 43.7). Multiple logistic regression analysis showed that all severe events and coping with the stress of adverse events by confronting them and focusing on the problems significantly predicted a diagnosis of breast cancer. Non-severe life events and long term difficulties had no significant association. CONCLUSION: These findings suggest an aetiological association between life stress and breast cancer.

Maternal mild hyperphenylalaninemia: results of treated and untreated pregnancies in two sisters.

The outcomes of mild hyperphenylalaninemia (MHP) in three children of two sisters were compared. The IQ of the child from an untreated pregnancy was 105; the developmental quotients of the two infant offspring from treated and untreated pregnancies were 122 and 114, respectively. The IQ of the sister with untreated MHP was 101; that of the sister who received dietary treatment for MHP during infancy was 90. Thus MHP and maternal MHP appear to have been clinically inconsequential in this family.

Clinical results of cryopreserved valved conduits in the pulmonary ventricle-to-pulmonary artery position.

Aortic valved homograft conduits (AVHC) have become valuable in the pulmonary ventricle (PV)-to-main pulmonary artery (MPA) reconstruction in congenital heart defects. Since 1985, 45 patients, ranging in age from 12 days to 32 years, underwent PV-to-MPA reconstruction utilizing cryopreserved AVHC. Operative deaths included seven patients (16%), six of whom died as a result of the complexity of their underlying heart defects. One late death (2%) occurred as a result of infective endocarditis 48 months after conduit placement. The 38 patients who survived the operation remained in the intensive care unit for a mean of 5.7 +/- 1.0 days (median: 4 days; range: 2 to 37 days). The mean hospital stay was 13.0 +/- 1.8 days (median: 9 days; range: 6 to 63 days). The mean follow-up was 40.0 +/- 3.6 months (median: 40 months; range: 10 months to 7.1 years). Only two patients (5%) required reoperation for conduit stenosis with systolic pressure gradients of 60 to 80 mm Hg at 10 and 14 months, respectively, after operation, and both reoperations were successful. During outpatient visits, 16 patients are totally asymptomatic, and 21 patients have minimal symptoms (New York Heart Association class II). Only 10 patients (26%) require digoxin, and 2 patients (5%) need diuretics as part of their medical regimen. Recent echocardiographic examinations show insignificant pressure gradients in all 37 currently surviving patients. Thus, barring operative mortality, which is almost always associated with the nature of the underlying heart defect, the use of cryopreserved AVHC is a safe and effective alternative for PV-to-MPA reconstruction.

'I thought it would go away': patient denial in breast cancer.

A significant proportion of patients with cancer present late to the doctor. The characteristics of these patients and the reasons behind their delaying behaviour is poorly understood. In this study a group of 30 women with breast cancer who delayed their presentation were compared with a randomly selected group with the same disease. The women who presented late did not appear to fit into any particular socio-demographic category, but examination of their histories revealed widespread denial of illness and a diversity of beliefs and behaviour.

Synthesis and biological properties of 4-norleucine-neuropeptide Y; secondary structure of neuropeptide Y.

Neuropeptide Y (NPY) is a 36 amino acid peptide amide isolated from porcine brain. The NPY analog, 4-norleucine-NPY was synthesized by a solid-phase method and purified to homogeneity in 20% yield by reverse-phase chromatography. Investigation of the biological properties indicated that the analog is an agonist of NPY. Secondary structural analyses revealed that NPY and the analog exhibited predominantly alpha-helical and beta-sheet structures, respectively; however, experiments in trifluoroethanol indicated that the analog has the potential of assuming an alpha-helical structure. Based on circular dichroism (CD), Raman spectroscopy and Chou-Fasman analyses, a model has been proposed for the secondary structure of NPY.

Cognitive processing of children with Williams syndrome.

The Illinois Test of Psycholinguistic Abilities was administered to 22 children with Williams syndrome and to 22 children with non-specific development disabilities, matched for age, sex and global intelligence. Visual processing abilities significantly differentiated the two groups. The children with Williams syndrome had substantially more problems with visual reception, visual closure and visual memory tasks. They appeared to adhere more rigidly than controls to a global deployment of visual attention. Their visual processing difficulties were not related to the level of mental ability. Visual reception, closure and memory scores correctly classified 82 per cent of the children with Williams syndrome and 68 per cent of the controls. Instructional and remedial programs are needed for these children.

Human T-cell activation: comparative studies on the role of different phorbol esters.

We confirm here previous studies that have shown synergy between anti-CD3 and phorbol esters in the induction of T-cell proliferation. However, for this study we have used tonsillar rather than peripheral blood T cells, and have compared the role of different phorbol esters rather than different anti-CD3 antibodies in the activation process. Three phorbol esters (phorbol myristate acetate, -dibenzoate and -didecanoate) showed a synergistic relationship. However, the concentration of the dibenzoate and the didecanoate forms required was higher than the concentration of myristate acetate. A second group of phorbol esters (alpha-phorbol didecanoate, a beta phorbol with no side chain, and a monomyristate) did not activate T cells. This difference in activation efficiency between the phorbol derivatives correlates with the pattern of neutrophil activation that has been described previously using the same compounds. In contrast to both the neutrophil and the proliferation studies, if the T cells were preincubated with the different phorbol esters and then subsequently cultured with anti-CD3, the pattern of response was different. Only phorbol myristate acetate induced a proliferative response; all the other compounds were inactive. Taken in conjunction with the known structural differences between the different phorbol derivatives, these results suggest that the relative lipophilic properties of the different molecules which activate T cells may be an important determinant in the induction of a response. Thus changes in the relative lipophilic properties of an antigen could be one way to alter its relative immunogenicity.

Conformational features of dynorphin A-(1-13), Laser Raman spectroscopic studies.

Conformational features of dynorphin A-(1-13) were examined by laser Raman spectroscopy. Dynorphin A-(1-13) appears to have a mixture of extended beta-pleated sheet and "random" structure.

Characterization of chronically implanted ventricular endocardial pacing leads.

The expected implant lifetime of pacemaker generators has been extended with the introduction of lithium power sources. Consequently, the pacing lead may become the component that determines the total implant lifetime of the pacemaker. This fact emphasizes the necessity for accurate assessment of the integrity of a chronically implanted lead. In this study, chronic threshold and impedance data from 61 patients having the same type of ventricular endocardial lead for up to 10 years were retrospectively analyzed. The mean acute current threshold was 0.81 +/- 0.33 mA. The chronic current threshold had a range of between 1 and 5 mA, which was approximately two to five times greater than the acute implant value. Chronic voltage threshold and impedance were 0.7 to 4 V and 335 to 775 omega, respectively. The findings of this study provide general guidelines for chronic lead parameters and illustrate some of the difficulties encountered in gathering and interpreting long-term lead data.