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.

Altered yolk structure and reduced hatchability of eggs from birds fed single doses of petroleum oils.

Yolk deposited by Japanese quail was abnormal for 24 hours after the oral administration of a single capsule containing 200 milligrams of bunker C oil. Both the structure and the staining properties of the yolk were affected. Fewer eggs were laid during the 4 days after dosing, compared to controls, and hatchability was drastically reduced. Hatchability returned to normal in 4 days. Three other reference oils also affected yolk structure. Canada geese given 2 grams and chickens given 500 milligrams of bunker C oil produced eggs with abnormal yolk rings.

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.

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.

A hermetically sealed mercury cell pacemaker: advantages and early clinical results.

Despite the known advantages of hermetic encapsulation of implanted pacemakers, only a few conventionally powered models are totally hermetically sealed, and most of them are not yet clinically available. This report describes the results with a mercury cell unit which has been in clinical use since 1970 and has been totally hermetically sealed since 1974. The lowered premature failure rate with the newer model substantiates the theoretical advantages of hermetic encapsulation. The rate behavior of the pulse generator, upon which our telephone follow-up system is based, is essentially the same for both models.

Type and timing of permanent pacemaker failure.

Availability of lithium batteries will decrease the incidence of early pacemaker failure. Pacemaker malfunction, exclusive of that due to battery exhaustion, can still occur. Defined as any repeat surgical procedure required after initial implantation, pacemaker system failure occurred in 22 of 115 (19 percent) pacemaker patients. Failure occurred within the first month in 12 with ten being lead-related. Insertion site problems occurred in nine patients. Though most endocardial pacemaker complications occur early, patients continue to be at risk for as long as the units are in place. Despite improvements in the batteries, there continue to be sufficient problems with pacemakers to emphasize the need for selectivity in determining which patients receive permanent units.

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.

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.

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.

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.

'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.

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.

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.