The increasing threat to European forests from the invasive foliar pine pathogen, Lecanosticta acicola.

European forests are threatened by increasing numbers of invasive pests and pathogens. Over the past century, Lecanosticta acicola, a foliar pathogen predominantly of Pinus spp., has expanded its range globally, and is increasing in impact. Lecanosticta acicola causes brown spot needle blight, resulting in premature defoliation, reduced growth, and mortality in some hosts. Originating from southern regions of North American, it devastated forests in the USA's southern states in the early twentieth century, and in 1942 was discovered in Spain. Derived from Euphresco project 'Brownspotrisk,' this study aimed to establish the current distribution of Lecanosticta species, and assess the risks of L. acicola to European forests. Pathogen reports from the literature, and new/ unpublished survey data were combined into an open-access geo-database (http://www.portalofforestpathology.com), and used to visualise the pathogen's range, infer its climatic tolerance, and update its host range. Lecanosticta species have now been recorded in 44 countries, mostly in the northern hemisphere. The type species, L. acicola, has increased its range in recent years, and is present in 24 out of the 26 European countries where data were available. Other species of Lecanosticta are largely restricted to Mexico and Central America, and recently Colombia. The geo-database records demonstrate that L. acicola tolerates a wide range of climates across the northern hemisphere, and indicate its potential to colonise Pinus spp. forests across large swathes of the Europe. Preliminary analyses suggest L. acicola could affect 62% of global Pinus species area by the end of this century, under climate change predictions. Although its host range appears slightly narrower than the similar Dothistroma species, Lecanosticta species were recorded on 70 host taxa, mostly Pinus spp., but including, Cedrus and Picea spp. Twenty-three, including species of critical ecological, environmental and economic significance in Europe, are highly susceptible to L. acicola, suffering heavy defoliation and sometimes mortality. Variation in apparent susceptibility between reports could reflect variation between regions in the hosts' genetic make-up, but could also reflect the significant variation in L. acicola populations and lineages found across Europe. This study served to highlight significant gaps in our understanding of the pathogen's behaviour. Lecanosticta acicola has recently been downgraded from an A1 quarantine pest to a regulated non quarantine pathogen, and is now widely distributed across Europe. With a need to consider disease management, this study also explored global BSNB strategies, and used Case Studies to summarise the tactics employed to date in Europe.

Endoscopic treatment of superficial colorectal neoplasms. Retrospective analysis of a single center technique and results.

Endoscopic Submucosal Dissection (ESD) is a technique developed in Japan for "en bloc" resection of larger superficial neoplasms of the gastrointestinal tract as an alternative to the traditional Endoscopic Mucosal Resection (EMR), with removal of the lesion in multiple fragments ("piecemeal"). ESD offers a lower recurrence rate and allows a more accurate histopathological examination. This procedure is however considered technically difficult and therefore requires an adequate learning curve, it is time consuming with more discomfort for the patient, it has a higher complication rate, it is more expensive. To overcome these disadvantages, in the Western countries a hybrid technique called Circumferential Submucosal Incision - Endoscopic Mucosal Resection (CSI-EMR) has been developed and is especially employed for colonic lesions. This article analyzes retrospectively the results obtained in a single centre by a single operator in the treatment of 23 patients (12 men and 11 women, average age 65,6 years), all suffering from superficial, larger than ≥ 20 mm colorectal neoplasms: 9 were treated with ESD for rectal lesions and 14 were treated with CSI-EMR for colonic lesions. Findings show a technical success rate of 66,6% for ESD and 78,5% for CSI-EM, and a 0% recurrence rate during follow-up, 4,3% bleeding and 13% perforation complications. The histology of the removed lesions showed 13 (56,5%) low grade dysplasia adenomas, 8 (34,7%) high grade dysplasia adenomas, one grade 1 sigmoid colon adenocarcinoma infiltrating the submucosal layer without lymphovascular invasion, with free margins (R0), treated conservatively, and one grade 1 cecum adenocarcinoma, infiltrating the submucosal layer, with lymphovascular invasion and involved excision margin, treated surgically with no residual neoplastic disease in the surgical specimen. These data are in line with the most significant ones in literature, except for the higher complication rate, which the authors ascribe to the "learning curve" and the smaller number of treated patients.

Biogeographical patterns and determinants of invasion by forest pathogens in Europe.

A large database of invasive forest pathogens (IFPs) was developed to investigate the patterns and determinants of invasion in Europe. Detailed taxonomic and biological information on the invasive species was combined with country-specific data on land use, climate, and the time since invasion to identify the determinants of invasiveness, and to differentiate the class of environments which share territorial and climate features associated with a susceptibility to invasion. IFPs increased exponentially in the last four decades. Until 1919, IFPs already present moved across Europe. Then, new IFPs were introduced mainly from North America, and recently from Asia. Hybrid pathogens also appeared. Countries with a wider range of environments, higher human impact or international trade hosted more IFPs. Rainfall influenced the diffusion rates. Environmental conditions of the new and original ranges and systematic and ecological attributes affected invasiveness. Further spread of established IFPs is expected in countries that have experienced commercial isolation in the recent past. Densely populated countries with high environmental diversity may be the weakest links in attempts to prevent new arrivals. Tight coordination of actions against new arrivals is needed. Eradication seems impossible, and prevention seems the only reliable measure, although this will be difficult in the face of global mobility.

Randomised controlled trial between stapled circumferential mucosectomy and conventional circular hemorrhoidectomy in advanced hemorrhoids with external mucosal prolapse.

BACKGROUND: This randomized prospective study compared the outcome of circular hemorrhoidectomy according to the Hospital Leopold Bellan (HLB) technique (Paris) with Longo stapled circumferential mucosectomy (LSCM) in two homogeneous groups of patients affected by circular fourth-degree hemorrhoids with external mucosal prolapse. METHODS: From December 1996 to December 1999, 80 consecutive patients with fourth-degree hemorrhoids and external mucosal prolapse were randomly assigned to two groups. Forty patients (group A: 18 men, 22 women, mean age 50.5 years, range 21 to 82) underwent HLB hemorrhoidectomy, and 40 patients (group B: 15 men, 25 women, mean age 51.0 years, range 29 to 92) underwent LSCM. Before surgery, all patients were selected with a standard questionnaire for symptom evaluation, full proctological examination, flexible rectosigmoidoscopy, dynamic defecography, and anorectal manometry. No significant differences among the two groups were found. All patients were controlled with follow-up questionnaire and with clinical examination at 1, 2, 4, 12, and 54 weeks after the operation. A postoperative manometry was performed 3 months after surgery. RESULTS: The length of the operation was significantly lower in group B (25 +/- 3.1 SD versus 50 +/- 5.3 minutes, P <0.001). Mean hospital stay was 3 +/- 0.4 days in group A and 2 +/- 0.5 days in group B (P <0.01). Mean duration of inability to work was 8 +/- 0.9 days in group B and 15 +/- 1.4 days in group A (P <0.001). Postoperative pain was significantly lower in group B (P <0.001). Mean length of follow-up was 20 +/- 8.0 months in group A and 20 +/- 7.8 months in group B. Late complications were similar in the two groups, with 0%, at present, recurrence rate. CONCLUSIONS: Our results confirm that both operations are safe, easy to perform, and effective in the treatment of advanced hemorrhoids with external mucosal prolapse. However, the LSCM seems to be preferable owing to the fewer postoperative complications, easier postoperative management, and shorter time to return to work. A longer follow-up is required to confirm the true efficacy of this surgical method.

Mycosphaerella dearnessii, a Needle-cast Pathogen on Mountain Pine (Pinus mugo) in Italy.

The pathogen Mycosphaerella dearnessii Barr. (syn. Scirrhia acicola; anamorph Lecanosticta acicola), the causal agent of brown spot needle blight, was observed on Pinus mugo in the Botanical Garden in Gardone (Brescia), on the western side of Garda Lake in northeastern Italy. Symptoms were first noticed in the spring of 1997 by Klaus Lang (University of Freising, Germany). Two years later, all 12 of the P. mugo present in the Garden exhibited extensive necrosis, and defoliation of the crown starting from the bottom upward was more prevalent on the shaded portion of infected trees. The trees were about 50 years old and 2.0 to 2.5 m in height. Symptomatic needles were confined to the 2- and 3-year old internodes. Infected needles had several dark to purplish-brown spots surrounded by green tissue and usually had dead tips. Pycnidia and conidia of Lecanosticta acicola were observed. Conidia were 4-celled, curved, pointed at one end and blunt at the other, pale olive-brown and 20 to 30 × 3 to 4 µm. The fungus was isolated in pure culture. The pathogen causes serious losses in China, eastern United States, and central and South America, but was observed for the first time in Europe only 30 years ago. It is a major cause of needle blight on several European pine species, especially P. sylvestris, P. nigra, and P. mugo. In the last 7 years, there have been reports of the fungus in pine stands, first in France, Aquitaine, and the western Pyrenees on P. radiata (3), and more recently on P. mugo in the Alps in Austria (1), Switzerland (2), and southern Germany (4). This record of the fungus near Lake Garda poses a new serious threat especially for the pine plantations of P. nigra and P. sylvestris in the more humid locations in the Alps, Apennines, and elsewhere in the mountains of southern Europe where the climatic conditions are similar to that of central Europe. This is the first report of M. dearnessii on the southern slopes of the Alps and in Italy. References: (1) M. Brandstetter and T. Cech. Oesterreichische Forstzeitung 110:35, 1999. (2) O. Holdenrieder and T. N. Sieber. Eur. J. For. Pathol. 25:293, 1995. (3) A. Levy and C. Lafaurie. Phytoma 463:33, 1994. (4) L. Pehl L. Nachrichtenbl. Dtsch. Pflanzenschutzdienstes 47:305, 1995.

A New Phytophthora Root Disease of Alder in Italy.

A Phytophthora was found associated with wilt and mortality of Italian alder (Alnus cordata) seedlings in a nursery in northern Tuscany, Central Italy. This disease is one of the major constraints to alder survival in northern Europe (3). Symptoms included sparse yellowish brown foliage with abnormally small leaves, dark stained necrosis of the bark at the collar level, and reduction of the root system due to the death of the tap root and lateral roots. These symptoms resemble those on chestnut, walnut, and oak plantlets colonized by P. cambivora. The diseased seedlings were 1 to 2 years old and were grown on both beds and soil. Tissue isolation from infected parts of the plants yielded a P. cambivora-like species in culture. Pure cultures were appressed and felty in appearance with sparse or no aerial mycelium when grown on V8 agar, carrot agar, or potato dextrose agar. Sporangia were ovoid, non-papillate, and averaged 51.8 µm in length and 36.6 µm in width (range: 45 to 60 µm and 30 to 40 µm). The isolates were homothallic with smooth-walled oogonia with a diameter ranging from 20 to 45 µm and with two-celled, amphigynous antheridia. Colonies showed rapid development at 25°C (mean radial growth = 6 mm/day), but at 30°C growth was strongly inhibited, unlike P. cambivora isolates previously collected in the same area, which were more thermophilic. The morpho-physiological features of the alder isolates resembled those of the Swedish variant of the alder Phytophthora (2). Identification was confirmed by C.M. Brasier (Forestry Authority Research Station, UK). Two-year-old alder seedlings (1.3 cm diameter, height 70 cm) grown in pots were wound-inoculated in the trunk. Six weeks after inoculation, symptoms were produced identical to those described above, as well as necrosis of the bark tissue varying in length from 0.5 to 3 cm. Isolations from diseased bark tissue yielded fungal colonies resembling those described above. The pathogen, described for the first time in England in 1995 (1), is now present throughout northern Europe. This is the first report for the Mediterranean region, which suggests that the fungus will cause disease in the drier and warmer climates of southern Europe. References: (1) C. M. Brasier et al. Plant Pathol. 44:999, 1995. (2) C. M. Brasier et al. Proc. Natl. Acad. Sci. USA 96:5878, 1999. (3) J. N. Gibbs et al. Eur. J. For. Pathol. 29:39, 1999.

[Follow-up of patients with Roux-technique gastric resection. Comparison of Billroth I and Billroth II gastric resections]. / Il controllo a distanza nei gastroresecati secondo Roux. Confronto con i gastroresecati secondo Billroth I e Billroth II.

The paper reports the results of a follow-up of 25 patients who underwent gastric resection using Roux's technique, 15 patients undergoing reconstructive surgery according to Pean-Billroth and 15 who underwent Billroth II operations. Controls were performed more than 5 years after surgery and included endoscopic tests with biopsy and the evaluation of the biliary salt reflux in the gastric stump. Roux's operation was preferred both as a routine operation following gastric resection and as a reconversion operation due to the absence of biliary reflux, the negative biopsy tests at the level of the stump and anastomosis, and negative clinical aspects.

[Grade II and III acute pancreatitis. Diagnostic classification and surgical treatment]. / Pancreatite acuta di II e III grado. Inquadramento diagnostico e trattamento chirurgico.

Thirteen cases of acute IIIrd degree pancreatitis and 5 homogeneous cases of IInd degree, treated surgically during the first 48 hours from onset of the symptomatology, are described. The importance of careful cardiorespiratory, haemodynamic and metabolic monitoring to establish the most appropriate moment for intervention after a period of intensive therapy designed to restore the basic parameters is stressed. In the present series, total mortality was 44%. Forms with biliary aetiology have the best prognosis and justify the earliest possible surgical intervention.

[Radical peritonectomy in 37 patients with stage II and III ovarian cancer]. / Peritonectomia radicale in 37 pazienti affette da neoplasia ovarica II e III stadio.

AIM: Radical peritonectomy followed by intraperitoneal early chemotherapy and systemic chemotherapy is the treatment of choice of stage II C and III ovarian cancer, due to the low 5-years survival rate (20%) of stage III and IV. METHODS: The authors present a 5-years experience in 37 patients affected by stage II C and III ovarian cancer treated by Sugarbaker's radical peritonectomy with some surgical technical differences. Intraperitoneal chemotherapy with adriamycin and cisplatin is started and followed after 25 days by a systemic chemotherapy with taxol and carboplatin. A 6-months second-look is performed. RESULTS: All the patients have been treated with radical peritonectomy with tumoral residual lesser than 2.5 mm; we performed 4 minor hepatectomies, 5 radical cystectomies, 35 resections of rectum and sigmoid colon with hysterectomies, bilateral salpingo-oophorectomies and pelviperitonectomies, 14 right hemicolectomies. We had no postoperative mortality, but we recorded a 40% minor morbidity rate. During the second look we found 7 recurrences (18%), 6 lesser than 6 mm, often located on the mesentery and treated with radical resections. The follow-up range is 2-60 months, 27 patients are still alive. Actually, 22 patients (80% of live patients) are in good health and disease free. CONCLUSION: Radical surgery associated with early postoperative chemotherapy followed by systemic chemotherapy in the treatment of ovarian cancer makes it possible to achieve the best survival results and long periods of disease free.

[Surgical therapy of liver metastases secondary to colorectal neoplasms]. / Considerazioni sulla terapia chirurgica delle metastasi epatiche secondarie a neoplasia colo-rettale.

Of the therapeutic aids currently available for the treatment of liver metastases, surgical treatment, when possible, has acquired an irreplaceable role. The exact criteria needed to establish a correct indication still have to be established. Various factors have been examined so far: number, site, dimensions of the metastases and features of the primary tumour whose prognostic importance does not lend itself to unequivocable interpretation. Personal experience of a series of 11 surgically treated cases seems to confirm that of the parameters analysed, the tumour-host relationship remains the most important prognostic factor.

Early detection of Biscogniauxia nummularia in symptomless European beech (Fagus sylvatica L.) by TaqMan quantitative real-time PCR.

AIMS: To develop a quantitative real-time PCR (Rt PCR) assay for the early detection of Biscogniauxia nummularia, a xylariaceous fungus that causes strip-canker and wood decay on European beech (Fagus sylvatica L.). METHODS AND RESULTS: The molecular assay was based on TaqMan chemistry using species-specific primers and a fluorogenic probe designed on the ITS1 sequence of rRNA gene clusters. The specificity of the oligonucleotides and the probe were tested using the DNA of B. nummularia isolates from different geographic areas, of phylogenetically related species, and of some fungi commonly colonizing European beech bark and wood. A total of 31 symptomless and symptomatic shoots of European beech were collected from three forest sites in the Apennine Mountains of Italy. The percentage of positive detections of B. nummularia with the TaqMan assay was 78.6%, compared with only 14.3% of positive isolations on growth media for two sites. CONCLUSIONS: In shoots, the quantitative Rt PCR assay detected down to 8.0-fg fungal DNA per microgram of total DNA extracted. SIGNIFICANCE AND IMPACT OF THE STUDY: The assay developed in quantitative Rt PCR, by using TaqMan chemistry, revealed a rapid and sensitive method useful for the early detection of B. nummularia in symptomless European beech twigs.

Real-time PCR detection of Biscogniauxia mediterranea in symptomless oak tissue.

AIMS: Real-time PCR, based on TaqMan chemistry, was used to detect Biscogniauxia mediterranea, a fungal pathogen that after a long endophytic phase may cause charcoal disease in oak trees. METHODS AND RESULTS: Specific primers and probe were designed and tested on axenic cultures of B. mediterranea and other fungi commonly colonizing oaks. Twig samples were collected in Tuscany from apparently healthy oaks (Quercus cerris, Quercus ilex and Quercus pubescens) growing near trees infected with the fungus. Twigs were divided into two groups: one for isolation in agar plates, and one for real-time PCR after DNA extraction. The detection limit of the assay was 0.01 pg/DNA, whereas the amounts of fungal DNA detected in asymptomatic tissue were >0.5 pg microg(-1) total DNA extracted. In the apparently healthy twigs the frequency of isolation found on agar was 25.0%, much lower than that with real-time PCR (96.4%). CONCLUSIONS: Real-time PCR is a sensitive and fast technique able to specifically detect and quantify the DNA of B. mediterranea in oak tissue. SIGNIFICANCE AND IMPACT OF THE STUDY: This diagnostic method is a precise tool to localize fungi in symptomless plant tissues and promises to advance our understanding of fungal infection during their latent phase.

Genetic variation in eastern North American and putatively introduced populations of Ceratocystis fimbriata f. platani.

The plant pathogenic fungus Ceratocystis fimbriata f. platani attacks Platanus species (London plane, oriental plane and American sycamore) and has killed tens of thousands of plantation trees and street trees in the eastern United States, southern Europe and Modesto, California. Nuclear and mitochondrial DNA fingerprints and alleles of eight polymorphic microsatellite markers of isolates of C. fimbriata from these regions delineated major differences in gene diversities. The 33 isolates from the eastern United States had a moderate degree of gene diversity, and unique genotypes were found at each of seven collection sites. Fingerprints of 27 isolates from 21 collection sites in southern Europe were identical with each other; microsatellite markers were monomorphic within the European population, except that three isolates differed at one locus each, due perhaps to recent mutations. The genetic variability of C. fimbriata f. platani in the eastern United States suggests that the fungus is indigenous to this region. The genetic homogeneity of the fungus in Europe suggests that this population has gone through a recent genetic bottleneck, perhaps from the introduction of a single genotype. This supports the hypothesis that the pathogen was introduced to Europe through Naples, Italy during World War II on infected crating material from the eastern United States. The Californian population may also have resulted from introduction of one or a few related genotypes because it, too, had a single nuclear and mitochondrial genotype and limited variation in microsatellite alleles.