Opening the black box: outcomes of interactions between arbuscular mycorrhizal (AM) and non-host genotypes of Medicago depend on fungal identity, interplay between P uptake pathways and external P supply.

We investigated the physiology that underlies the influence of arbuscular mycorrhizal (AM) colonization on outcomes of interactions between plants. We grew Medicago truncatula A17 and its AM-defective mutant dmi1 in intragenotypic (two plants per pot of the same genotype, x2) or intergenotypic (one plant of each genotype, 1 + 1) combinations, inoculated or not with Rhizophagus irregularis (formerly Glomus intraradices) or Gigaspora margarita. We measured plant growth, colonization, contributions of AM and direct P uptake pathways using (32)P, and expression of plant Pi transporter genes at two levels of P supply. A17 (x2) responded positively to inoculation only at low P. The response was enhanced with 1 + 1 even at high P where colonization in A17 was reduced. With R. irregularis P uptake by the AM pathway was unaffected by P supply, whereas with G. margarita, the AM pathway was lower at high P, and direct uptake higher. Gene expression varied and was unrelated to P uptake through the two pathways. There was no evidence of plant control of P uptake via R. irregularis at high P but there was via G. margarita. Importantly, growth responses of plant genotypes grown alone did not predict outcomes of intergenotypic interactions.

Arbuscular mycorrhizal colonization reduces arsenate uptake in barley via downregulation of transporters in the direct epidermal phosphate uptake pathway.

*Here, we used barley (Hordeum vulgare) grown in normal and compartmented pots to investigate sensitivity to arsenic (As) in the absence of a positive growth response to arbuscular mycorrhizas (AM). *We tested the hypothesis that upon inoculation with AM fungi downregulation of HvPht1;1 and HvPht1;2 genes (encoding high-affinity inorganic orthophosphate (P(i))-uptake systems in a direct pathway via root epidermis and root hairs) and upregulation of the AM-induced HvPht1;8 (encoding the P(i)-uptake system responsible for transfer of P(i) from the symbiotic interface to cortical cells) play a role in decreased As uptake and hence reduced As sensitivity in AM plants. *Barley did not respond, or responded negatively to colonization by Glomus intraradices in terms of growth. In terms of specific phosphorus (P) uptake (P uptake per g of root) barley was nonresponsive. There was a significant interaction between As treatment and colonization, resulting in a lower As concentration and uptake in AM compared with nonmycorrhizal (NM) plants. *The decreased uptake of As and higher P : As molar ratios in the AM barley can be explained by the operation of the AM pathway as indicated by induction of HvPht1;8 and by down-regulation of HvPht1;1 and HvPht1;2.

Arbuscular mycorrhizal inhibition of growth in barley cannot be attributed to extent of colonization, fungal phosphorus uptake or effects on expression of plant phosphate transporter genes.

Here, we used phosphorus-32 (32P) labelling in compartmented pots combined with quantitative real-time polymerase chain reaction (PCR) analysis of phosphate(Pi) transporter gene expression to investigate regulation of Pi uptake pathways in barley (Hordeum vulgare), an arbuscular mycorrhizal (AM) plant that does not show strong positive growth responses to colonization.Barley was colonized well by Glomus intraradices and poorly by Glomus geosporum,but both fungi induced significant and similar growth depressions compared with non mycorrhizal controls. The lack of correlation between per cent colonization and extent of growth depression suggests that the latter is not related to carbon drain to the fungus. The contribution of the AM Pi uptake pathway for the two fungi was, in general,related to per cent colonization and expression of the AM-inducible Pi transporter gene, HvPT8, but not to plant responsiveness. Glomus intraradices contributed 48%of total plant P whereas G. geosporum contributed very little.The growth depression in plants where the AM uptake pathway was functional suggests that the contribution of the direct Pi uptake pathway via root hairs and epidermis was decreased. This decrease was not correlated with downregulation of the epidermal-expressed Pi transporter genes, HvPT1 and HvPT2. We hypothesize post-transcriptional or post-translational control of this transport process by AM colonization.

Uptake of oxytetracycline and its phytotoxicity to alfalfa (Medicago sativa L.).

A series of experiments were conducted in a hydroponic system to investigate the uptake of oxytetracycline (OTC) and its toxicity to alfalfa (Medicago sativa L.). OTC inhibited alfalfa shoot and root growth by up to 61% and 85%, respectively. The kinetics of OTC uptake could be well described by Michaelis-Menten equation with Vmax of 2.25 micromol g-1 fresh weight h-1, and Km of 0.036 mM. The uptake of OTC by alfalfa was strongly inhibited by the metabolic inhibitor, 2,4-DNP (2,4-dinitrophenol), at pH 3.5 and 6.0, but not by the aquaporin competitors, glycerol and Ag+. OTC uptake, however, was significantly inhibited by Hg2+, suggesting that the inhibition of influx was due to general cellular stress rather than the specific action of Hg2+ on aquaporins. Results from the present study suggested that OTC uptake into alfalfa is an energy-dependent process.

Effects of arbuscular mycorrhizal inoculation on uranium and arsenic accumulation by Chinese brake fern (Pteris vittata L.) from a uranium mining-impacted soil.

A glasshouse experiment was conducted to investigate U and As accumulation by Chinese brake fern, Pteris vittata L., in association with different arbuscular mycorrhizal fungi (AMF) from a U and As contaminated soil. The soil used contains 111 mg U kg(-1) and 106 mg As kg(-1). P. vittata L. was inoculated with each of three AMF, Glomus mosseae, Glomus caledonium and Glomus intraradices. Two harvests were made during plant growth (two and three months after transplanting). Mycorrhizal colonization depressed plant growth particularly at the early stages. TF (transfer factor) values for As from soil to fronds were higher than 1.0, while those for roots were much lower. Despite the growth depressions, AM colonization had no effect on tissue As concentrations. Conversely, TF values for U were much higher for roots than for fronds, indicating that only very small fraction of U was translocated to fronds (less than 2%), regardless of mycorrhizal colonization. Mycorrhizal colonization significantly increased root U concentrations at both harvests. Root colonization with G. mosseae or G. intraradices led to an increase in TF values for U from 7 (non-inoculation control) to 14 at the first harvest. The highest U concentration of 1574 mg kg(-1) was recorded in roots colonized by G. mosseae at the second harvest. The results suggested that P. vittata in combination with appropriate AMF would play very important roles in bioremediation of contaminated environments characterized by a multi-pollution.

Arsenate (As) uptake by and distribution in two cultivars of winter wheat (Triticum aestivum L.).

Two cultivars of winter wheat (Triticum aestivum L.) (Jing 411 and Lovrin 10) were used to investigate arsenate (As) uptake and distribution in plants grown in hydroponic culture and in the soil. Results showed that without As addition, Lovrin 10 had higher biomass than Jing 411 in the soil pot experiment; in the hydroponic experiment Lovrin 10 had similar root biomass to and lower shoot biomass than Jing 411. Increasing P supply from 32 to 161 microM resulted in lower tissue As concentrations, and increasing As supply from 0 to 2,000 microM resulted in lower tissue P concentrations. Increasing P supply tended to increase shoot-to-root ratios of As concentrations, and increasing As supply tended to decrease shoot-to-root ratios of As concentrations. Both cultivars invested more in root production under P deficient conditions than under P sufficient conditions. Lovrin 10 invested more biomass production to roots than Jing 411, which might be partly responsible for higher shoot P and As concentrations and higher shoot-to-root ratios of As concentrations. Moreover, Lovrin 10 allocated less As to roots than Jing 411 and the difference disappeared with decreasing P supply.

Direct Evaluation of the Ca2+-Displacement Hypothesis for Al Toxicity.

One explanation for Al toxicity in plants suggests that Al displaces Ca2+ from critical sites in the apoplasm. We evaluated the Ca2+-displacement hypothesis directly using near-isogenic lines of wheat (Triticum aestivum L.) that differ in Al tolerance at a single locus. We measured both the growth and total accumulation (apoplasmic plus symplasmic) of 45Ca and Al into roots that had been exposed to Al alone or to Al with other cations. Root growth in the Al-sensitive line was found to be severely inhibited by low activities of Al, even though Ca2+ accumulation was relatively unaffected. In solutions containing the same activity of the Al3+ and Ca2+ ions as above, but also including either 3.0 mM Mg2+, 3.0 mM Sr2+, or 30 mM Na+, growth improved, whereas 45Ca2+ accumulation was significantly decreased. Since most of the 45Ca2+ accumulated by roots during short-term treatments will reside in the apoplasm, these results indicate that displacement of Ca2+ from the apoplasm by Al cannot account for the Al-induced inhibition of root growth and, therefore, do not support the Ca2+-displacement hypothesis for Al toxicity. We also show that total accumulation of Al by root apices is greater in the Al-sensitive genotype than the Al-tolerant genotype and suggest that cation amelioration of Al toxicity is caused by the reduction in Al accumulation.

The Physiological Relevance of Na+-Coupled K+-Transport.

Plant roots utilize at least two distinct pathways with high and low affinities to accumulate K+. The system for high-affinity K+ uptake, which takes place against the electrochemical K+ gradient, requires direct energization. Energization of K+ uptake via Na+ coupling has been observed in algae and was recently proposed as a mechanism for K+ uptake in wheat (Triticum aestivum L.). To investigate whether Na+ coupling has general physiological relevance in energizing K+ transport, we screened a number of species, including Arabidopsis thaliana L. Heynh. ecotype Columbia, wheat, and barley (Hordeum vulgare L.), for the presence of Na+-coupled K+ uptake. Rb+-flux analysis and electrophysiological K+-transport assays were performed in the presence and absence of Na+ and provided evidence for a coupling between K+ and Na+ transport in several aquatic species. However, all investigated terrestrial species were able to sustain growth and K+ uptake in the absence of Na+. Furthermore, the addition of Na+ was either without effect or inhibited K+ absorption. The latter characteristic was independent of growth conditions with respect to Na+ status and pH. Our results suggest that in terrestrial species Na+-coupled K+ transport has no or limited physiological relevance, whereas in certain aquatic angiosperms and algae this type of secondary transport energization plays a significant role.

Day-to-day variability of serum cholesterol, triglyceride, and high-density lipoprotein cholesterol levels. Impact on the assessment of risk according to the National Cholesterol Education Program guidelines.

The National Cholesterol Education Program has recently published guidelines for the assessment of cardiovascular risk and goals for laboratory accuracy. To test the impact of biologic and analytic variability on the ability of a single lipid measurement to assess risk accurately, lipids were measured on three occasions in 51 volunteers. Notable day-to-day variability of total cholesterol (5%), triglyceride (20%), high-density lipoprotein cholesterol (10%), and calculated low-density lipoprotein cholesterol (8%) levels was found. Analytic variability contributed significantly to total variability of high-density lipoprotein cholesterol levels and calculated low-density lipoprotein cholesterol levels. Confidence intervals constructed around National Cholesterol Education Program cutoff points suggested that classification was reliable from a single measurement if total cholesterol value was below 4.78 (less than 185 mg/dL), between 5.56 and 5.81 (215 and 225 mg/dL), or above 6.59 mmol/L (greater than 225 mg/dL). Low-density lipoprotein cholesterol value classification from a single measurement was only accurate at below 3.00 (greater than 116 mg/dL) or above 4.50 mmol/L (greater than 174 mg/dL). This study documents significant day-to-day variability of serum lipids and suggests that patients near the National Cholesterol Education Program cutoff points may require repeated measurements to assign risk accurately.

Structure and function of the interfaces in biotrophic symbioses as they relate to nutrient transport.

In this review we compare the structure and function of the interfaces between symbionts in biotrophic associations. The emphasis is on biotrophic fungal parasites and on mycorrhizas, although necrotrophic parasitic associations and the Rhizobium/legume symbiosis are mentioned briefly. We take as a starting point the observations that in the parasitic associations nutrient transport is polarized towards the parasite, whereas in mutualistic associations it is bidirectional. The structure and function of the interfaces are then compared. An important common feature is that in nearly all cases the heterotrophic symbiont (whether mutualistic or parasitic) is located topologically outside the cytoplasm of the host cells, in an apoplastic compartment. This means that nutrient movements across the interface must involve transport into and out of this apoplastic region through membranes of both organisms. Basic principles of membrane transport in uninfected cells are briefly reviewed to set the scene for a discussion of transport mechanisms which may operate in parasitic and mycorrhizal symbioses. The presence and possible roles of ATPases associated with membranes at the interfaces are discussed. We conclude that cytochemical techniques (used to demonstrate the activity of these enzymes) need to he extended and complemented by biochemical and biophysical studies in order to confirm that the activity is due to transport ATPases. Nevertheless, the distribution of activity appears to he in accord with polarized transport mechanisms in some pathogens and with bidirectional transport in mycorrhizas. The absence of ATPases on many fungal membranes needs re-examination. We emphasize that transport mechanisms between mycorrhizal symbionts cannot be viewed simply as the exchange of carbon for phosphate. Additional features include provision for transport of carbon and nitrogen as amino acids or amides and for ions such as K+ and H+ involved in the maintenance of charge balance and pH regulation, processes which also occur in parasitic associations. Interplant transport of nutrients via mycorrhizal hyphae is discussed in the context of these complexities. Some suggestions for the directions of future work are made. CONTENTS Summary 1 I. Introduction 2 II. The availability of nutrients to the symbionts 3 III. Structure of interfaces between symbionts 4 IV. Identity of nutrients transferred: an overview 12 V. Membrane transport: basic principles 14 VI. Transport at the interface of biotrophic symbioses 15 VII. Regulation of pH in biotrophic symbioses 25 VIII. Conclusions: 26.

Structural diversity in (vesicular)-arbuscular mycorrhizal symbioses.

This review describes diversity in the structure of (vesicular)-arbuscutar (VA) mycorrhizas, i.e. endomycorrhizas formed by Glomalean fungi. In particular, we consider the extent in the plant kingdom of the two classes first described by Gallaud (1905). These are: (1) the Arum-type, defined on the basis of an extensive intercellular phase of hyphai growth in the root cortex and development of terminal arbuscules on intracellular hyphai branches; (2) the Paris-type, defined by the absence of the intercellular phase and presence of extensive intracellular hyphai coils. Arbuscules are intercalary structures on the coils. However, there have been many reports that in Paris-types arbuscules are relatively few in numbers, small, or absent altogether. A survey of the literature has revealed that Paris-types occur more frequently in the plant kingdom than Arum-types and predominate in ferns, gymnosperms and many wild angiosperms. The cultivated herbs that are the subject of much experimental work are mostly Arum-types. Although evidence is still limited, there are differences at the family level. In 41 angiosperm families there are records of only Poris-type VA mycorrhizas and in 30 families records of only Arum-types. Another 21 families have examples of both classes, or intermediates between them. Accordingly, we consider whether the original division into two classes is still useful. We conclude that it is when considering the physiology of the symbiosis and especially the issue of whether different fungus/host interfaces have specialized roles in transfer of inorganic nutrients and organic carbon between the partners, if there is no such specialization between hyphai coils and arbuscules, then the latter might not be necessary1 for the function of Paris-types. This would account for reports of the infrequency or absence of arbuscules in this class. The control exerted on structures by the genomes of host and fungus, and possible reasons (anatomical and physiological) for the existence of the VA mycorrhizal structures, are discussed. The presence or absence of extensive intercellular spaces and differences in the wall structure of cortical cells might be particularly important in determining which type of VA mycorrhiza is formed. CONTENTS Summary 373 I. Introduction: Arum-types and Pom-types 374 II. Possible functional implications 375 III. Extent of the two classes in the plant kingdom 377 IV. Is the distinction between classes useful? 383 V. The structural basis 383 VI. The role of the fungal genome 384 VII. Physiology revisited 384 VIII. Conclusions 385 Acknowledgements 386 References 386.

Transmembrane electric potential difference of germ tubes of arbuscular mycorrhizal fungi responds to external stimuli.

Measurements of the electric potential difference across the hyphal wall and the cell membrane were made on external hyphae of three species of arbuscular mycorrhizal fungus Gigaspora margarita, Scutellospora calospora and Glomus coronatum and on germ tubes of Gi. margarita. The values of transmembrane electric potential difference recorded (∼-40 mV) are less negative than those previously reported from hyphae of arbuscular mycorrhizal fungi closely associated with roots and from filamentous fungi. The external hyphae of arbuscular mycorrhizal fungi grown in soil had similar values of electric potential difference to those grown in soil-less culture, and to germ tubes. Thermodynamic calculations showed that despite these low values of electric potential difference, efficient high-affinity uptake of phosphate is possible. The transmembrane electric potential difference of germ tubes of Gi. margarita became more negative when plant root extract was added to the medium, showing for the first time that the early stages of interaction between plant and fungus occur via direct effects on the plasma membrane rather than via effects on gene expression. Addition of K+ reversibly depolarized the transmembrane electric potential difference of germ tubes of Gi. margarita, indicating that despite the low electric potential difference the fungus has control over the permeability of the plasmamembrane to K+ .

The effect of fungicides on vesicular-arbuscular mycorrhizal symbiosis: II. The effects on area of interface and efficiency of P uptake and transfer to plant.

Two experiments were conducted under controlled environmental conditions to determine the effects of the three fungicides, Benlate®. Aliette® and Ridomil®, on efficiency of P uptake from the soil and transfer across the living plant-fungal interface- of onion plants (Allium cepa L.) associated with Glomus sp. 'City Beach' (WUM 16), P applied to the soil did not apparently increase the rate of transfer (flux) of P to the plant via the fungal partner of the mytorrhiza. Benlate reduced P inflow and transfer across the interface in one of the experiments. The rate of P uptake per m living external hyphae was not affected but, as development of living external hyphae in the soil was reduced, the contribution of the fungus to P uptake was small. Aliette reduced growth of both shoots and roots, but apparently increased the accumulation of P in the tissues compared with controls. Ridomil reduced P inflow per m of root and P uptake per m living external hyphae, hut had no effect on the rate of P transfer across the interface. This led to a reduction in the overall contribution of the fungus to P nutrition.

Transfer of phosphate from fungus to plant in VA mycorrhizas: calculation of the area of symbiotic interface and of fluxes of P from two different fungi to A Allium porrum L.

The aim of the work described in this paper was to calculate the fluxes of phosphate (P) across the intraradical interfaces between two vesicular-arbuscular mycorrhizal fungi [Glomus mosseae (Nicol. & Gerd.) Gerdemann and Trappe and Glomus sp.' City Beach'(WL'M 16)] and Allium porrum L. The inflows of P into roots via the fungi were calculated from inflows into mycorrhizal and non-mycorrhizal plants for four harvest periods up to 84 d. The areas of interface between intercellular hyphae and roots, and arbuscules and roots were calculated for the same harvest periods using image analysis of sections in which the fungus was stained with nitroblue tetrazolium. The imagination of the arbuscular interface was calculated using methods based on previously published data. The fungi colonized the roots to approximately the same extent (% infection), but G. mosseae produced more intercellular hyphae and arbuscules, and hence larger interfacial areas than Glomus sp. City Beach (WUM 16). Hyphal inflows were higher for Glomus sp. City Beach (WUM 16) than G. mosseae for all except the last harvest period, but because of the lower interfacial areas, fluxes via this fungus were higher (3-7-12-8 nmol m-2 s-1 ) than for G, mosseae (0-8-3-2 nmol nmol m-2 s-1 . These fluxes are in the same range as values for P influx into plant cells and considerably larger than efflux from the fungal hyphae of ecto and ericoid mycorrhizal fungi measured in cultured mycelia. We conclude that enhanced efflux from the fungus must be essential for symbiotic phosphorus uptake by plants via VA mycorrhizal fungi.

Growth and phosphorus nutrition of a Paris-type arbuscular mycorrhizal symbiosis.

• Paris -type arbuscular mycorrhizas (AM) are reportedly the most common morphological type of AM; however, most research has focused on the Arum -type. Asphodelus fistulosus , a common weed in southern Australia, forms Paris -type AM when colonised by Glomus coronatum . It is often found in sites with low nutrient levels, and may therefore be dependent on its AM associations for growth and phosphorus (P) nutrition. • A. fistulosus was inoculated with G. coronatum and grown in pots containing a soil/sand mixture with P added to give five soil P concentrations. The plants were grown in a glasshouse and harvested 6 and 9 wk after planting, at which times growth, P nutrition and colonisation were measured. • At low soil P, A. fistulosus showed very marked positive responses to colonisation both in P uptake and growth; both responses decreased with increasing P supply. Colonisation was not greatly reduced by increasing P supply. • This study appears to be one of the first detailed investigations of P responses in a Paris -type AM, providing insight into what is reportedly the more common but less well studied morphological type of AM.

Inoculum type does not affect overall resistance of an arbuscular mycorrhiza-defective tomato mutant to colonisation but inoculation does change competitive interactions with wild-type tomato.

• The influence of inoculum type on colonisation of a mycorrhiza-defective tomato mutant, rmc, by the AM fungus Glomus coronatum was studied by comparing inoculum composed predominantly of spores with hyphae growing from mycorrhizal 'nurse plants', including the wild-type tomato progenitor (WT), other Lycopersicon species, and leek. • Colonisation of rmc was not primarily influenced by inoculum source; minor differences could be attributed to differences in inoculum potential. The mutation is therefore different from other mycorrhiza-defective tomato mutants. • Growth of rmc was reduced in the presence of nurse plants, because of competition with them, so a second experiment examined the effects of AM colonisation on competition between rmc and the WT tomato. This experiment was a replacement series in which rmc and WT were grown in competition and as single plants, inoculated with G. coronatum or uninoculated. • The WT did not respond to G. coronatum when grown alone, but responded positively when in competition with rmc. We conclude from the second experiment that mycorrhizal responsiveness is influenced by competition with (in this case) a surrogate nonhost plant rmc in a situation that mimics interspecific competition. It is therefore a community-based parameter. Results are discussed in the context of responses of mycorrhizal vs nonmycorrhizal species and competition in natural plant ecosytems.

Quantitative development of Paris-type arbuscular mycorrhizas formed between Asphodelus fistulosus and Glomus coronatum.

• Arum- and Paris-type symbioses are the two main morphological types of arbuscular mycorrhiza. Here, the developmental time-course of the Paris-type association formed from colonization of Asphodelus fistulosus (onion weed) by Glomus coronatum is presented. • Development was monitored over 27 d. Root colonization was assessed using a modification of the magnified intersects technique (MIT), for investigating the interdependence (thus IMIT) of structures. • Hyphal and arbusculate coils were found predominantly in the outer and inner cortex of the root, respectively. The interdependence of external hyphae, hyphal coils and arbusculate coils was determined during the relatively slow development of the symbiosis. • The time required for development of Paris-type arbuscular mycorrhizas is slower than for the Arum type, and both time and space influence the formation of hyphal coils. Use of IMIT for scoring colonization allows determination of the interdependence of different fungal structures, and thus the technique has potentially wide applications, such as in relating the presence of different structures to signals from molecular probes.

Vinyl chloride: inhalation teratology study in mice, rats and rabbits.

These studies evaluated the effects of inhaled vinyl chloride monomer (VCM) on mouse, rat and rabbit embryonal and fetal development. Groups of pregnant CF-1 mice, Sprague-Dawley rats and New Zealand white rabbits were exposed to 500 ppm VCM for 7 hr daily during the period of major organogenesis. Subsequently, other groups of mice were similarly exposed to 50 ppm VCM, and rats and rabbits were exposed to 2500 ppm. While maternal toxicity was observed, exposure to VCM did not cause significant embryonal or fetal toxicity and was not teratogenic in any of the three species at the concentrations tested. Simultaneous exposure of some of the pregnant animals to VCM by inhalation plus 15% ethanol in the drinking water resulted in toxic effects greater than those associated with exposure to VCM alone in the three species. The fetal effects observed were similar to those reported for these three species following administration of ethanol without VCM exposure.

Optimal procedures for detecting analytic bias using patient samples.

We recently described the performance characteristics of the exponentially adjusted moving mean (EAMM), a patient-data, moving block mean procedure, which is a generalized algorithm that unifies Bull's algorithm and the classic average of normals (AON) procedure. Herein we describe the trend EAMM (TEAMM), a continuous signal analog of the EAMM procedure related to classic trend analysis. Using computer simulation, we have compared EAMM and TEAMM over a range of biases for various sample sizes (N or equivalent smoothing factor alpha) and exponential parameters (P) under conditions of equivalent false rejection (fixed on a per patient sample basis). We found optimal pairs of N and P for each level of bias by determination of minimum mean patient samples to rejection. Overall optimal algorithms were determined through calculation of undetected lost medical utility (ULMU), a novel function that quantifies the medical damage due to analytic bias. The ULMU function was calculated based on lost test specificity in a normal population. We found that optimized TEAMM was superior to optimized EAMM for all levels of analytic bias. If these observations hold true for non-Gaussian populations, TEAMM procedures are the method of choice for detecting bias using patient samples or as an event gauge to trigger use of known-value control materials.

Exponentially adjusted moving mean procedure for quality control. An optimized patient sample control procedure.

The idea of using patient samples as the basis for control procedures elicits a continuing fascination among laboratorians, particularly in the current environment of cost restriction. Average of normals (AON) procedures, although little used, have been carefully investigated at the theoretical level. The performance characteristics of Bull's algorithm have not been thoroughly delineated, however, despite its widespread use. The authors have generalized Bull's algorithm to use variably sized batches of patient samples and a range of exponential factors. For any given batch size, there is an optimal exponential factor to maximize the overall power of error detection. The optimized exponentially adjusted moving mean (EAMM) procedure, a variant of AON and Bull's algorithm, outperforms both parent procedures. As with any AON procedure, EAMM is most useful when the ratio of population variability to analytical variability (standard deviation ratio, SDR) is low.