Observational study of Mallampati changes after prone spinal surgery.

STUDY OBJECTIVE: To evaluate airway changes in patients undergoing surgery in the prone position. DESIGN: Single-arm observational study. PATIENTS: Patients between 18 to 65 years old, scheduled for prone spinal surgery; 74 patients were enrolled and 54 patients were analyzed. INTERVENTION: The initial airway examination was graded according to the Samsoon and Young modification of the Mallampati classification (MMP). Airway photographs were obtained in a standardized manner and were repeated 20 minutes after extubation. The photographs were then randomized. MEASUREMENTS: Subjects' age, gender, race, weight, duration of surgery, amount of crystalloid fluid given, and estimated blood loss were recorded. Three senior anesthesiologists who were blinded to the origin of the photographs analyzed and graded the airways. MAIN RESULTS: All statistical tests showed significance between pre-MMP and post-MMP scores (P<0.001). There was no difference between pre and post interobserver MMP scores. The MMPs of 12 patients (22%) did not change and MMP scores were changed in 42 patients (78%): 30 (71%) patients by one class, 10 (24%) patients by two classes, and two patients (5%) by three classes. There was no correlation between patients whose MMP was changed and length of surgery or crystalloid administered. CONCLUSION: Modified Mallampati scores increased in the majority of patients after spinal surgery in the prone position.

A secreted effector protein (SNE1) from Phytophthora infestans is a broadly acting suppressor of programmed cell death.

Evasion or active suppression of host defenses are critical strategies employed by biotrophic phytopathogens and hemibiotrophs whose infection mechanism includes sequential biotrophic and necrotrophic stages. Although defense suppression by secreted effector proteins has been well studied in bacteria, equivalent systems in fungi and oomycetes are poorly understood. We report the characterization of SNE1 (suppressor of necrosis 1), a gene encoding a secreted protein from the hemibiotrophic oomycete Phytophthora infestans that is specifically expressed at the transcriptional level during biotrophic growth within the host plant tomato (Solanum lycopersicum). Using transient expression assays, we show that SNE1 suppresses the action of secreted cell death-inducing effectors from Phytophthora that are expressed during the necrotrophic growth phase, as well as programmed cell death mediated by a range of Avr-R protein interactions. We also report that SNE1 contains predicted NLS motifs and translocates to the plant nucleus in transient expression studies. A conceptual model is presented in which the sequential coordinated secretion of antagonistic effectors by P. infestans first suppresses, but then induces, host cell death, thereby providing a highly regulated means to control the transition from biotrophy to necrotrophy.

A functional screen to characterize the secretomes of eukaryotic pathogens and their hosts in planta.

Complex suites of proteins that are secreted by plants and phytopathogens into the plant apoplast play crucial roles in surveillance, assault, defense, and counter-defense. High-throughput genome-scale strategies are being developed to better understand the nature of these "secretomes" and the identity of pathogen-derived effector proteins that subvert plant defenses and promote pathogenicity. Although combined bioinformatic and experimental approaches recently have provided comprehensive coverage of secreted proteins from bacterial phytopathogens, far less is known about the secretomes and batteries of effectors of eukaryotic phytopathogens; notably fungi and oomycetes. The yeast secretion trap (YST) represents a potentially valuable technique to simultaneously target pathogen and host secretomes in infected plant material. A YST screen, using a new vector system, was applied to study the interaction between tomato (Solanum lycopersicum) and the oomycete Phytophthora infestans, revealing sets of genes encoding secreted proteins from both pathogen and host. Most of those from the oomycete had no identifiable function and were detectable in planta only during pathogenesis, underlining the value of YST as a tool to identify new candidate effectors and pathogenicity factors. In addition, the majority of the P. infestans proteins had homologs in the genomes of the related oomycetes R. sojae and P. ramorum.

Engineering an obligate domain-swapped dimer of cyanovirin-N with enhanced anti-HIV activity.

The anti-HIV cyanobacterial protein cyanovirin-N can undergo domain swapping to form an intertwined dimer. The dimeric form is stable at low pH and millimolar concentrations. By deleting an amino acid from the hinge linker about which domain swapping occurs, we have constructed an obligate domain-swapped dimer of cyanovirin-N that represents a new tetravalent carbohydrate binding protein that is stable over a large range of pH values. This obligate dimer displays enhanced anti-HIV activity relative to the wild-type cyanovirin-N monomer with an observed 3.5-fold decrease in IC(50) (9nM for the dimer vs 32 nM for the monomer) for inhibition of HIV-1 envelope-mediated cell fusion and, when expressed in Escherichia coli, can be rapidly obtained in >98% purity in a single chromatographic step.