Insect Floral Visitors of Ptelea trifoliata (Rutaceae) in Iowa, United States.

Ptelea trifoliata L., is a North American tree that supports insect communities through floral rewards. Our objectives were to determine the importance of insects as pollinators of P. trifoliata; describe the community of floral visiting insects of P. trifoliata in Iowa, where no such information was available; and to note insect preferences for male or female flowers. Over two years, inflorescences on 13 trees were covered with mesh bags before blooming and the amount of fruit produced was compared to uncovered inflorescences from the same trees. In one year, insects were collected from male and female trees with an insect vacuum every 3 h between 7 am and 7 pm from four sites in Iowa, USA between 30 May and 16 June 2020. In 2019 and 2020, almost no fruit set occurred from inflorescences covered with mesh bags while an average of 51.2 fruits formed on unbagged inflorescences (P < 0.0001), suggesting insects larger than the 600 µm pore diameters mesh were responsible for pollination of P. trifoliata. Insects from five orders, 49 families, and at least 109 species were collected. Most insects were Hymentoptera (48.3%) or Diptera (28.2%). Male flowers attracted 62.3% of all insects collected. Since most of the insects found visiting P. trifoliata were not bees, the floral rewards of the flowers may be a valuable resource for a wide variety of insects in the central United States.

The Effect of an Interspersed Refuge on Aphis glycines (Hemiptera: Aphididae), Their Natural Enemies, and Biological Control.

Soybean production in the north central United States has relied heavily on the use of foliar and seed applied insecticides to manage Aphis glycines (Hemiptera: Aphididae). An additional management strategy is the use soybean cultivars containing A. glycines resistance genes (Rag). Previous research has demonstrated that Rag cultivars are capable of preventing yield loss equivalent to the use of foliar and seed-applied insecticides.However, the presence of virulent biotypes in North America has raised concern for the durability of Rag genes. A resistance management program that includes a refuge for avirulent biotypes could limit the frequency at which virulent biotypes increase within North America. To what extent such a refuge reduces the effectiveness of aphid-resistant soybean is not clear. We conducted an experiment to determine whether a susceptible refuge mixed into resistant soybean (i.e., interspersed refuge or refuge-in-a-bag) affects the seasonal exposure of aphids, their natural enemies, biological control, and yield protection provided by aphid resistance. We compared three ratios of interspersed refuges (resistant: susceptible; 95:5, 90:10, 75:25) to plots grown with 100%susceptible or resistant soybean. We determined that an interspersed refuge of at least 25% susceptible seed would be necessary to effectively produce avirulent individuals. Interspersed refuges had negligible effects onyield and the natural enemy community. However, there was evidence that they increased the amount of biological control that occurred within a plot. We discuss the compatibility of interspersed refuges for A. glycines management and whether resistance management can prolong the durability of Rag genes.

One gene versus two: a regional study on the efficacy of single gene versus pyramided resistance for soybean aphid management.

The soybean aphid (Aphis glycines Matsumura) is a threat to soybean production in the Midwestern United States. Varieties containing the Rag1 soybean aphid resistance gene have been released with limited success in reducing aphid populations. Furthermore, virulent biotypes occur within North America and challenge the durability of single-gene resistance. Pyramiding resistance genes has the potential to improve aphid population suppression and increase resistance gene durability. Our goal was to determine if a pyramid could provide improved aphid population suppression across awide range of environments. We conducted a small-plot field experiment across seven states and three years. We compared soybean near-isolines for the Rag1 or Rag2 gene, and a pyramid line containing both genes for their ability to decrease aphid pressure and protect yield compared with a susceptible line. These lines were evaluated both with and without a neonicitinoid seed treatment. All aphid-resistant lines significantly decreased aphid pressure at all locations but one. The pyramid line experienced lower aphid pressure than both single-gene lines at eight of 23 location-years. Soybean aphids significantly reduced soybean yield for the susceptible line by 14% and for both single-gene lines by 5%; however, no significant yield decrease was observed for the pyramid line. The neonicitinoid seed treatment reduced plant exposure to aphids across all soybean lines, but did not provide significant yield protection for any of the lines. These results demonstrate that pyramiding resistance genes can provide sufficient and consistent yield protection from soybean aphid in North America.

Functional neurological disorder, physical activity and exercise: What we know and what we can learn from comorbid disorders.

Functional neurological disorder (FND) is a common neurologic disorder associated with many comorbid symptoms including fatigue, pain, headache, and orthostasis. These concurrent symptoms lead patients to accumulate multiple diagnoses comorbid with FND, including fibromyalgia, chronic fatigue syndrome, postural orthostatic tachycardia syndrome, persistent post-concussive symptoms, and chronic pain. The role of physical activity and exercise has not been evaluated in FND populations, though has been studied in certain comorbid conditions. In this traditional narrative literature review, we highlight some existing literature on physical activity in FND, then look to comorbid disorders to highlight the therapeutic potential of physical activity. We then consider abnormalities in the autonomic nervous system (ANS) as a potential pathophysiological explanation for symptoms in FND and comorbid disorders and postulate how physical activity and exercise may provide benefit via autonomic regulation.

Soybean aphid (Aphididae: Hemiptera) population growth as affected by host plant resistance and an insecticidal seed treatment.

The soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae) is a significant soybean pest in the north central United States. Insecticidal seed treatments and host plant resistance are two commercially available management tools. Here we investigate the efficacy of both management tools throughout the season. Soybean lines containing the soybean aphid resistance genes Rag1, Rag2, or both Rag1 + Rag2 were compared with a near-isogenic aphid-susceptible line. Each line was grown in field plots both with and without thiamethoxam applied to the seed. Individual plants from each plot were caged and infested with soybean aphids to measure the efficacy and potential interaction of aphid resistance and thiamethoxam. Aphid population growth rate was measured for each caged plant for 9-12 d after infestation. New cages were established each week from 34 d after planting (dap) to 92 dap to track seasonal variations in efficacy. Thiamethoxam reduced population growth only at the 42 dap time point and only for the susceptible, Rag1, and Rag2 lines. The lack of an effect of thiamethoxam on the Rag1 + Rag2 line was likely because of already high mortality from two resistance genes. Aphid resistance alone reduced population growth compared with the susceptible line at least till 55 dap for single-gene resistance and 63 dap for the two genes combined. Aphid resistance provided suppression of soybean aphid population growth throughout the season unlike the insecticidal seed treatment.

Developing a Curriculum for Functional Neurological Disorder in Neurology Training: Questions and Answers.

Functional neurologic disorder (FND) is a common condition for which neurology residents often receive little to no formal teaching. Using a question-and-answer format, this article puts forward a case for why an FND curriculum is needed and aims to provide guidance on possible curricular content including medical knowledge, clinical skills, communication, and team-based collaboration. The authors also discuss methods for teaching and evaluating this knowledge and associated clinical skills, linking this to current Accreditation Council for Graduate Medical Education neurology milestones. Finally, the authors consider how to better engage and energize neurology trainees around this underserved yet challenging patient population.

Measuring the benefit of biological control for single gene and pyramided host plant resistance for Aphis glycines (Hemiptera: Aphididae) management.

The soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), is an economically important pest in the north central United States. In the state of Iowa, economically damaging populations occurred in seven of 11 growing seasons from 2001 to 2011. The high frequency and economic impact of the soybean aphid makes it an ideal candidate for management by using host plant resistance. We compared an aphid-susceptible line to near-isolines that contain Rag1 and Rag2, both alone and pyramided together, to suppress aphid populations and protect yield. Each of four near-isolines, were artificially infested with aphids and grown in small plots in which the exposure to natural enemies was controlled by the use of cages, resulting in the following treatment groups: natural enemy free (only aphids), biocontrol (both aphids and natural enemies), and aphid free (no aphids or natural enemies). The seasonal accumulation of aphids and the population growth rates were measured for each line and an estimate of yield was measured at the end of the season. Soybean aphid population growth rate was reduced 20% by natural enemies alone, 44% by pyramided resistance, and 63% by the combination of natural enemies and pyramided resistance. This reduction in population growth rate resulted in a 99.3% reduction in the pyramid line's seasonal exposure to aphids. In the presence of natural enemies, all three resistant lines maintained aphid populations below the economic injury level and prevented yield loss. This study demonstrates the compatibility of biological control with soybean aphid host plant resistance and its utility, especially for single resistance gene lines.

Soybean aphid (Hemiptera: Aphididae) development on soybean with Rag1 alone, Rag2 alone, and both genes combined.

Aphis glycines Matsumura (Hemiptera: Aphididae) can reduce the yield of aphid-susceptible soybean (Glycine max (L.) Merrill) cultivars. The Rag1 and Rag2 genes conferresistance to some biotypes of A. glycines. These genes individually can limit population growth of A. glycines and prevent yield loss. The impact of these genes when combined is not known. We compared the development of A. glycines on soybean with Rag1 alone (R1/S2), Rag2 alone (S1/R2), both genes combined (R1/R2), or neither gene (S1/S2). In addition, we determined the impact of different levels of aphid infestation on seed yield. The genotypes were grown in cages and artificially infested with A. glycines to achieve five treatment levels: aphid-free, 675 aphids per plant, 25,000 cumulative aphid days (CAD) (25K), 50,000 CAD (50K), and 75,000 CAD (75K). The S1/S2 line reached the 50K treatment, but did not reach the 75K treatment. Aphid development on R1/S2 and S1/R2 soybeans after two infestations reached a maximum of 25K. The maximum treatment reached on R1/R2 was only 675 aphids per plant after two infestations, at which there was no significant yield reduction when compared with the aphid-free treatment. The maximum yield reduction of S1/S2 was 27% at 50K treatment compared with 2% for R1/S2 and 12% for S1/R2 at the 25K treatment. Our results indicated that for A. glycines used in our study, cultivars with both Rag1 and Rag2 had less aphid exposure and less yield reduction than soybeans with only one resistant gene.

What is the economic threshold of soybean aphids (Hemiptera: Aphididae) in enemy-free space?

Soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), is a serious pest of soybean, Glycine max (L.) Merr., in the North Central United States. Current management recommendations rely on the application of insecticides based on an economic threshold (ET) of 250 aphids per plant. Natural enemies are important in slowing the increase of aphid populations and can prevent them from reaching levels that can cause economic losses. However, biological control of A. glycines is inconsistent and can be affected negatively by the intensity of agricultural activity. We measured the impact of a natural-enemy-free environment on the capacity of the current ET to limit yield loss. In 2008 and 2009, caged microplots were assigned to one of three treatments: plants kept aphid-free (referred to as the control), plants that experienced a population of 250 aphids per plant (integrated pest management [IPM]), and plants that experienced unlimited aphid population growth (unlimited). The population growth rate of aphids in the unlimited treatment for the 10 d after the application of insecticides to the IPM treatment was calculated using linear regression. The linear equation was solved to determine the mean number of days between the ET and the EIL for an aphid population in absence of predators. The number of days was determined to be 6.97 +/- 1.11 d. The 2-yr average yield for the IPM treatment was 99.93% of the control treatment. Our study suggests the current soybean aphid ET of 250 aphids per plant can effectively protect yield even if the impact of natural enemies is reduced.

Temperature thresholds and degree-day model for Marmara gulosa (Lepidoptera: Gracillariidae).

The developmental thresholds for Marmara gulosa Guillén & Davis (Lepidoptera: Gracillariidae) were investigated in the laboratory by using 17, 21, 25, 29, and 33 degrees C. The lowest mortality occurred in cohorts exposed to 25 and 29 degrees C. Other temperatures caused >10% mortality primarily in egg and first and second instar sap-feeding larvae. Linear regression analysis approximated the lower developmental threshold at 12.2 degrees C. High mortality and slow developmental rate at 33 degrees C indicate the upper developmental threshold is near this temperature. The degree-day (DD) model indicated that a generation requires an accumulation of 322 DD for development from egg to adult emergence. Average daily temperatures in the San Joaquin Valley could produce up to seven generations of M. gulosa per year. Field studies documented two, five, and three overlapping generations of M. gulosa in walnuts (Juglans regia L.; Juglandaceae), pummelos (Citrus maxima (Burm.) Merr.; Rutaceae), and oranges (Citrus sinensis (L.) Osbeck; Rutaceae), for a total of seven observed peelminer generations. Degree-day units between generations averaged 375 DD for larvae infesting walnut twigs; however, availability of green wood probably affected timing of infestations. Degree-day units between larval generations averaged 322 for pummelos and 309 for oranges, confirming the laboratory estimation. First infestation of citrus occurred in June in pummelo fruit and August in orange fruit when fruit neared 60 mm in diameter. Fruit size and degree-day units could be used as management tools to more precisely time insecticide treatments to target the egg stage and prevent rind damage to citrus. Degree-day units also could be used to more precisely time natural enemy releases to target larval instars that are preferred for oviposition.

Landscape diversity enhances biological control of an introduced crop pest in the north-central USA.

Arthropod predators and parasitoids provide valuable ecosystem services in agricultural crops by suppressing populations of insect herbivores. Many natural enemies are influenced by non-crop habitat surrounding agricultural fields, and understanding if, and at what scales, land use patterns influence natural enemies is essential to predicting how landscape alters biological control services. Here we focus on biological control of soybean aphid, Aphis glycines Matumura, a specialist crop pest recently introduced to the north-central United States. We measured the amount of biological control service supplied to soybean in 26 replicate fields across Michigan, Wisconsin, Iowa, and Minnesota across two years (2005-2006). We measured the impact of natural enemies by experimentally excluding or allowing access to soybean aphid infested plants and comparing aphid population growth over 14 days. We also monitored aphid and natural enemy populations at large in each field. Predators, principally coccinellid beetles, dominated the natural enemy community of soybean in both years. In the absence of aphid predators, A. glycines increased significantly, with 5.3-fold higher aphid populations on plants in exclusion cages vs. the open field after 14 days. We calculated a biological control services index (BSI) based on relative suppression of aphid populations and related it to landscape diversity and composition at multiple spatial scales surrounding each site. We found that BSI values increased with landscape diversity, measured as Simpson's D. Landscapes dominated by corn and soybean fields provided less biocontrol service to soybean compared with landscapes with an abundance of crop and non-crop habitats. The abundance of Coccinellidae was related to landscape composition, with beetles being more abundant in landscapes with an abundance of forest and grassland compared with landscapes dominated by agricultural crops. Landscape diversity and composition at a scale of 1.5 km surrounding the focal field explained the greatest proportion of the variation in BSI and Coccinellidae abundance. This study indicates that natural enemies provide a regionally important ecosystem service by suppressing a key soybean pest, reducing the need for insecticide applications. Furthermore, it suggests that management to maintain or enhance landscape diversity has the potential to stabilize or increase biocontrol services.

Economic threshold for soybean aphid (Hemiptera: Aphididae).

Soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), reached damaging levels in 2003 and 2005 in soybean, Glycine max (L.) Merrill, in most northern U.S. states and Canadian provinces, and it has become one of the most important pests of soybean throughout the North Central region. A common experimental protocol was adopted by participants in six states who provided data from 19 yield-loss experiments conducted over a 3-yr period. Population doubling times for field populations of soybean aphid averaged 6.8 d +/- 0.8 d (mean +/- SEM). The average economic threshold (ET) over all control costs, market values, and yield was 273 +/- 38 (mean +/- 95% confidence interval [CI], range 111-567) aphids per plant. This ET provides a 7-d lead time before aphid populations are expected to exceed the economic injury level (EIL) of 674 +/- 95 (mean +/- 95% CI, range 275-1,399) aphids per plant. Peak aphid density in 18 of the 19 location-years occurred during soybean growth stages R3 (beginning pod formation) to R5 (full size pod) with a single data set having aphid populations peaking at R6 (full size green seed). The ET developed here is strongly supported through soybean growth stage R5. Setting an ET at lower aphid densities increases the risk to producers by treating an aphid population that is growing too slowly to exceed the EIL in 7 d, eliminates generalist predators, and exposes a larger portion of the soybean aphid population to selection by insecticides, which could lead to development of insecticide resistance.

Determining the Effectiveness of Three-Gene Pyramids Against Aphis glycines (Hemiptera: Aphididae) Biotypes.

Since the discovery of Aphis glycines Matsumura (Hemiptera: Aphididae) in the United States, the primary management tactic has been foliar insecticides. Alternative management options such as host plant resistance to A. glycines have been developed and their effectiveness proved. However, the use of host plant resistance was complicated by the discovery of multiple, virulent biotypes of A. glycines in the United States that are capable of overcoming single Rag genes, Rag1 and Rag2, as well as a two-gene pyramid of Rag1+Rag2. However, current models predict that the virulent allele frequency of A. glycines decreases in response to the use of pyramided Rag genes, suggesting that pyramids represent a more sustainable use of these traits. Previous research has demonstrated that virulent biotypes can be effectively managed using a three-gene pyramid of Rag1+Rag2+Rag3. Additional Rag-genes have been discovered (Rag4 and Rag5), but whether the incorporation of these genes into novel three-gene pyramids will improve efficacy is not known. We tested single-gene (Rag1 and Rag2) and pyramid cultivars (Rag1+Rag2, Rag1+Rag2+Rag3, Rag1+Rag2+Rag4) to multiple biotypes in laboratory assays. Our results confirm that the Rag1+Rag2+Rag3 pyramid effectively manages all known A. glycines biotypes when compared with cultivars that are overcome by the associated biotype. Our results indicate that Rag1+Rag2+Rag4 would be an effective management option for biotype-1, biotype-2, and biotype-3 A. glycines, but had a negligible impact on biotype-4.

Insect Pollinators in Iowa Cornfields: Community Identification and Trapping Method Analysis.

Availability of mass flowering plants in landscapes dominated by agriculture can have a strong positive impact on the density of generalist, native pollinators. Row-crop production in Iowa accounts for 75% of the arable acres, with corn, Zea mays, representing the majority of hectares planted. To date, there has been no description of the insect pollinator community found within Iowa cornfields. We report a field study to determine the optimal sampling methodology to characterize the community of insect pollinators within cornfields. During 2012 and 2013, 3,616 insect pollinators representing 51 species were captured using bee bowls, and 945 individuals representing 10 species were captured using sticky cards. We examined the effects of trap type, height, and bowl color on the described community. Bee bowls captured a more abundant and species rich community than sticky cards with all species captured on sticky cards also present in bee bowls. Traps deployed at the height of the tassels describe a more abundant and species rich community of pollinators than traps at ear height (2x as many individuals) or ground height (4x as many individuals). Blue bowls captured more bees than white (2.75x as many individuals) or yellow bowls (3.5x as many individuals); and yellow bowls captured more flies than white (2x as many individuals) or blue (2.3x as many individuals). To provide the most complete description of the community of insect pollinators using cornfields as a resource, we suggest sampling-using bee bowls at the height of the tassels using all three bee bowl colors.

Defining the Insect Pollinator Community Found in Iowa Corn and Soybean Fields: Implications for Pollinator Conservation.

Although corn (Zea mays L.) and soybeans (Glycine max L.) do not require pollination, they offer floral resources used by insect pollinators. We asked if a similar community of insect pollinators visits these crops in central Iowa, a landscape dominated by corn and soybean production. We used modified pan traps (i.e., bee bowls) in both corn and soybean fields during anthesis and used nonmetric multidimensional scaling (NMS) to compare the communities found in the two crops. Summed across both crops, 6,704 individual insects were captured representing at least 60 species, morphospecies, or higher-level taxa. Thirty-four species were collected in both crops, 19 collected only in corn and seven were collected only in soybean. The most abundant taxa were Lasioglossum [Dialictus] spp., Agapostemon virescens Cresson, Melissodes bimaculata (Lepeletier), and Toxomerus marginatus (Say), which accounted for 65% of the insect pollinators collected from both crops. Although social bees (Apis mellifera L. and Bombus spp.) were found in both crops, they accounted for only 0.5% of all insects captured. The NMS analysis revealed a shared community of pollinators composed of mostly solitary, ground nesting bees. Many of these species have been found in other crop fields throughout North America. Although corn and soybean are grown in landscapes that are often highly disturbed, these data suggest that a community of pollinators can persist within them. We suggest approaches to conserving this community based on partnering with activities that aim to lessen the environmental impact of annual crop production.

Survey of Soybean Insect Pollinators: Community Identification and Sampling Method Analysis.

Soybean, Glycine max (L.) Merrill, flowers can be a source of nectar and pollen for honey bees, Apis mellifera L. (Hymenoptera: Apidae), wild social and solitary bees (Hymenoptera: Apoidea), and flower-visiting flies (Diptera). Our objectives were to describe the pollinator community in soybean fields, determine which sampling method is most appropriate for characterizing their abundance and diversity, and gain insight into which pollinator taxa may contact soybean pollen. We compared modified pan traps (i.e., bee bowls), yellow sticky traps, and sweep nets for trapping pollinators in Iowa soybean fields when soybeans were blooming (i.e., reproductive stages R1-R6) during 2011 and 2012. When all trap type captures were combined, we collected 5,368 individuals and at least 50 species. Per trap type, the most pollinators were captured in bee bowls (3,644 individuals, 44 species), yellow sticky traps (1,652 individuals, 32 species), and sweep nets (66 individuals, 10 species). The most abundant species collected include Agapostemon virescens F. and Lasioglossum (Dialictus) species (Hymenoptera: Halictidae), Melissodes bimaculata Lepeletier (Hymenoptera: Apidae), and Toxomerus marginatus Say (Diptera: Syrphidae). To determine if these pollinators were foraging on soybean flowers, we looked for soybean pollen on the most abundant bee species collected that had visible pollen loads. We found soybean pollen alone or intermixed with pollen grains from other plant species on 29 and 38% of the bees examined in 2011 and 2012, respectively. Our data suggest a diverse community of pollinators-composed of mostly native, solitary bees-visit soybean fields and forage on their flowers within Iowa.

An Induced Susceptibility Response in Soybean Promotes Avirulent Aphis glycines (Hemiptera: Aphididae) Populations on Resistant Soybean.

Observations of virulent Aphis glycines Matsumura populations on resistant soybean in North America occurred prior to the commercial release of Rag genes. Laboratory assays confirmed the presence of four A. glycines biotypes in North America defined by their virulence to the Rag1 and Rag2 genes. Avirulent and virulent biotypes can co-occur and potentially interact on soybean, which may result in induced susceptibility. We conducted a series of experiments to determine if the survival of avirulent biotypes on susceptible and resistant soybean containing the Rag1 or Rag1 + Rag2 genes was affected by the presence of either avirulent or virulent conspecifics. Regardless of virulence to Rag genes, initial feeding by conspecifics increased the survival of subsequent A. glycines populations on both susceptible and resistant soybean. Avirulent populations increased at the same rate as virulent populations if the resistant plants were initially colonized with virulent aphids. These results are the first to demonstrate that virulent A. glycines increase the suitability of resistant soybean for avirulent conspecifics, thus explaining the lack of genetic differentiation observed in North America between A. glycines populations on resistant and susceptible soybean. These results suggest the occurrence of virulence toward Rag genes in North America may be overestimated. In addition this may alter the selection pressure for virulence genes to increase in a population. Therefore, insect resistance management models for A. glycines may need to incorporate induced susceptibility factors to determine the relative durability of resistance genes.

Differential expression of connexin26 and connexin32 in the pre-Bötzinger complex of neonatal and adult rat.

The pre-Bötzinger complex (pre-BötC) is hypothesized to be the site for respiratory rhythm generation in mammals. Studies examining the cellular mechanisms mediating rhythm generation have focused on the role of chemically mediated synaptic interactions; however, electrotonic synaptic interactions (i.e., electrotonic coupling), which occur by means of gap junctions, may also play a role. Here, we used immunoblot and immunohistochemical analyses to determine whether the pre-BötC contains the gap junction proteins necessary for electrotonic communication and whether the presence and distribution of these gap junction proteins show a developmental change in expression. We found that both connexin26 (Cx26) and connexin32 (Cx32) were expressed in pre-BötC neurons of neonatal and adult rats; however, the relative amounts and their distribution varied by age. Cx26 labeling was seen in a high proportion of pre-BötC neurons in neonatal rats < or = 7 days postnatal (P7) but declined with increasing age. In contrast, Cx32 labeling was sparse in pre-BötC neurons of neonatal rats < or = P7, but increased with increasing age; the highest proportion was seen in adult rats. These data suggest the potential for gap junctional communication in the pre-BötC of both neonatal and adult rats, and we propose that the gap junction proteins Cx26 and Cx32 form the neuroanatomic substrate for this gap junctional communication, which may be important in the synchronization of neural activity generating respiratory rhythm.

Pulmonary function abnormalities in thalassemia patients on a hypertransfusion program.

Pulmonary function tests were performed in 12 thalassemia patients on a hypertransfusion program (age 18.4 +/- 2.6 SEM years) to determine the presence of any abnormalities of lung function. These included spirometry, expiratory flow rates, body plethysmography, single-breath nitrogen washout, single breath carbon monoxide diffusing capacity, and arterial blood gases. Only one patient had normal pulmonary function. Arterial hypoxemia was present in ten of 12 patients at rest. The total lung capacity (TLC) was normal. The residual volume was abnormally increased in five of 12 patients. The slope of phase III of single breath nitrogen washout curve was abnormal in five of 12 patients, but the closing volume was normal. The maximal expiratory flow rate at 60% total lung capacity was decreased in four of 12 patients, suggesting the presence of small airway disease. The single breath carbon monoxide diffusing capacity was normal in all patients. These pulmonary function abnormalities did not correlate with age or the cumulative amount of iron via blood transfused. The small airway obstruction, hyperinflation; and hypoxemia observed in thalassemia patients on a hypertransfusion program may result from the basic disease, iron deposition in the lungs, or other factors.

Decreased endothelial pump function with aging.

Endothelial function may be affected by the endothelial cell loss and increased variability in cell shape and size (polymegathism) that accompany normal aging. Endothelial function can be evaluated by monitoring corneal hydration recovery following hypoxic stress. The authors compared corneal recovery and endothelial morphology between a group of younger (mean = 26.7 yr) and older (means = 65.7 yr) subjects with normal corneas. Edema (60 microns) was induced with hydrogel lenses worn with the eyes closed. Following lens removal, the decrease in corneal thickness was monitored for 4 hr with one eye open while the contralateral eye remained closed. For both age groups, corneal recovery followed a non-linear time course. The open eye required 2.5 hr and 3.0 hr to return to baseline for the younger and older age groups, respectively. Recovery during eye closure took 3.5 hr to reach the normal closed eye level for the younger subjects and was not complete at 4 hr for the older subjects. Recovery rates were significantly slower for the older vs younger subjects during the first 2 hr of closed eye recovery, 10.5 vs 15.0 microns/hr, and for the initial 1 hr of open eye recovery, 26.5 vs 35.6 microns/hr. For both age groups combined, the rate of recovery was negatively correlated with the coefficient of variation in cell area, r = -0.62 and -0.69 (P less than 0.01), for both closed and open eye recovery, respectively. When each morphological characteristic was isolated, the only significant correlation found was between the coefficient of variation in cell area and the rate of recovery during eye closure, r = -0.66 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)