Diversity of Backusella (Mucoromycotina) in south-eastern Australia revealed through polyphasic taxonomy.

Here we explore the diversity of one morphologically distinguishable genus in the Mucoromycotina, Backusella, in south-eastern Australia. We isolated more than 200 strains from locations across the states of Victoria and Tasmania. Characterization of these strains using a combination of approaches including morphology, sucrose utilization and whole genome sequencing for 13 strains, revealed 10 new species. The genetic basis for interspecies variation in sucrose utilization was found to be the presence of a gene encoding an invertase enzyme. The genus Backusella is revised and a new key for species identification produced. Given that we have more than doubled the number of species in this genus, this work demonstrates that there may be considerable undiscovered species diversity in the early diverging fungal lineages. Citation: Urquhart AS, Douch JK, Heafield TA, et al. 2021. Diversity of Backusella (Mucoromycotina) in south-eastern Australia revealed through polyphasic taxonomy. Persoonia 46: 1-25. https://doi.org/10.3767/persoonia.2021.46.01.

Pex13p is an SH3 protein of the peroxisome membrane and a docking factor for the predominantly cytoplasmic PTs1 receptor.

Import of newly synthesized PTS1 proteins into the peroxisome requires the PTS1 receptor (Pex5p), a predominantly cytoplasmic protein that cycles between the cytoplasm and peroxisome. We have identified Pex13p, a novel integral peroxisomal membrane from both yeast and humans that binds the PTS1 receptor via a cytoplasmically oriented SH3 domain. Although only a small amount of Pex5p is bound to peroxisomes at steady state (< 5%), loss of Pex13p further reduces the amount of peroxisome-associated Pex5p by approximately 40-fold. Furthermore, loss of Pex13p eliminates import of peroxisomal matrix proteins that contain either the type-1 or type-2 peroxisomal targeting signal but does not affect targeting and insertion of integral peroxisomal membrane proteins. We conclude that Pex13p functions as a docking factor for the predominantly cytoplasmic PTS1 receptor.

Recent advances in compartmentalized synthetic architectures as drug carriers, cell mimics and artificial organelles.

Compartmentalization is a key feature of biological cells which conduct their metabolic activity in individual steps isolated in distinct, separated compartments. The creation of architectures containing multiple compartments with a structure that resembles that of a biological cell has generated significant research attention and these assemblies are proposed as candidate materials for a range of biomedical applications. In this Review article, the recent successes of multicompartment architectures as carriers for the delivery of therapeutic cargo or the creation of micro- and nanoreactors that mimic metabolic activities, thus acting as artificial cells or organelles, are discussed. The developed technologies to assemble such complex architectures are outlined, the multicompartment carriers' properties which contribute to their performance in diverse applications are discussed, and their successful applications are highlighted. Finally, future directions and developments in the field are suggested.

Highly discriminating heptaplex short tandem repeat PCR system for forensic identification.

We describe a highly discriminating multiplex short tandem repeat PCR human identification system that gives a matching probability for Caucasians of European ancestry of 2.94 x 10(-8) or 5.66 x 10(-10) when used in combination with a previously described system. The system produces discrimination equal to or greater than four single locus probes (restriction fragment length polymorphism [RFLP] typing of variable nucleotide tandem repeat [VNTR] loci). The test is robust and reproducible and works with 1-10 ng of template DNA, using fluorescent detection of PCR products from either 4 or 6 short tandem repeat loci and the X-Y homologous gene amelogenin, giving simultaneous sex diagnosis.

Short tandem repeat typing of bodies from a mass disaster: high success rate and characteristic amplification patterns in highly degraded samples.

We have used a PCR-based DNA-typing method, involving the coamplification of four tetrameric short tandem repeat loci, in the analysis of a large number of severely degraded tissue samples taken from the scene of a mass disaster in which bodies were exposed to extreme thermal, physical and chemical insult. Analysis of the amplified DNA in a number of the samples revealed uniquely sized artifact PCR products resulting from the amplification of degraded genomic DNA as well as characteristic patterns in the amounts of PCR products generated from differently sized loci. This system has proved to be very reliable and robust, and we were successful in typing all of the four loci in 66% of the samples tested and at least one locus in 83% of the cases. A PCR-based sex test also proved to be very effective when applied to the degraded samples.

Fluorescent Vi antibody test in the screening of typhoid carriers.

The comparative efficacies of direct bacterial agglutination and immunofluorescent antibody for the estimation of serum Vi antibody were determined in the detection of typhoid carriers. Sera from all 12 typhoid carriers gave significant titers of 1/10 or more in the direct bacterial agglutination test; however, 26 of 119 (21.8%) sera from culture-negative individuals were also falsely positive. In the fluorescent Vi antibody test, 11 of 12 typhoid carriers showed significant serum antibody levels, while only two of 119 (1.7%) culture-negative subjects had significant antibody titers. In view of the much lower false-positive rate, the immunofluorescent Vi antibody test is considered to be superior to the direct bacterial agglutination test in the screening of typhoid carriers.

Pubic symphysis repair strength in simulated bladder exstrophy using a sheep model.

OBJECTIVES: To investigate the mechanical strength of various pubic symphysis suture material in a simulated animal model of neonatal bladder exstrophy. METHODS: Neonatal lamb pelves, which are the approximate size of neonatal human pelves, were used. Twenty-four neonatal lamb pelves were divided into four equal groups. A midline symphysotomy was made through the cartilaginous pubic symphysis in three groups and repaired using two figure-of-eight sutures (size 0) placed through the cartilaginous pubis using polypropylene, braided polyester, or polyglactin. The fourth group served as the control. The pelves were then tested to ultimate load in pure tension at a strain rate of 0.25 mm/s until failure. RESULTS: There was a highly significant difference between the intact specimens and the repaired specimens (P = 0.0008). For the repaired specimens, there was a significant difference in the ultimate load normalized by pubic height between those repaired with polypropylene and polyglactin (P = 0.025), but not for those repaired with polypropylene and braided polyester (P = 0.11) or braided polyester and polyglactin (P = 0.11). CONCLUSIONS: Braided resorbable sutures are recommended for pubic symphysis repair, because they have a lower tendency to cut out of the cartilage.

Catecholamines and cholinergic enzymes in pre-senile and senile Alzheimer-type dementia and Down's syndrome.

Noradrenaline, dopamine, homovanillic acid (HVA), choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) levels were measured in post-mortem brains from 8 cases of pre-senile Alzheimer-type dementia (ATD), 5 cases of senile ATD, 4 cases of Down's syndrome aged 53-57 years, one 27-year-old case of Down's syndrome and 13 controls. In the controls, the concentration of noradrenaline in hypothalamus (P less than 0.05) and mamillary body (P less than 0.02) decreased with age. Compared with age-matched controls, noradrenaline levels in these areas were more markedly reduced in pre-senile ATD (P less than 0.01), the 53-57-year-old cases of Down's syndrome (P less than 0.001) and in the 27-year-old Down's, than in senile ATD (hypothalamus P less than 0.05, mamillary body, n.s.). Dopamine and HVA concentrations in caudate nucleus were unaltered in pre-senile or senile ATD but dopamine was decreased (P less than 0.01) in the older cases, although not in the 27-year-old case, of Down's syndrome. In the olfactory tubercle in ATD the level of HVA was unaltered but the activity of ChAT was decreased (P less than 0.01). ChAT activity was reduced in pre-senile ATD (P less than 0.001), the older Down's cases (P less than 0.01) but not the young Down's case, and senile ATD (P less than 0.001) in the temporal cortex and in pre-senile ATD (P less than 0.001) and the older Down's cases (P less than 0.001) but not senile ATD in the caudate nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

Lysosomal enzymes in cerebral atrophy.

In seven patients with cerebral atrophy due to pre-senile dementia and/or cerebrovascular disease, the activity of acid phosphatase in lumbar cerebrospinal fluid (CSF) was higher (p less than 0.05) than in six controls. The activity of arylsulphatase and beta-galactosidase in CSF was the same in the two groups. In the serum, the activities of acid phosphatase and arylsulphatase were the same in the two groups but the activity of beta-galactosidase was lower (p less than 0.02) in patients with cerebral atrophy.

A new complication of hypothyroid coma: neurogenic dysphagia: presentation, diagnosis, and treatment.

We report the case of a patient with severe hypothyroid coma in whom hypothyroid-related neurogenic oropharyngeal dysphagia was suspected, videoscopically confirmed, and successfully treated. This complication has not previously been described, and may have contributed to the historically high mortality associated with severe cases of hypothyroid coma. In the future, the early detection and aggressive treatment of this complication and its sequelae should ensure a further reduction in mortality from hypothyroid coma.

The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios.

BACKGROUND: Prosthetic impingement due to poor positioning can limit the range of motion of the hip after total hip arthroplasty. In this study, a computer model was used to determine the effects of the positions of the acetabular and femoral components and of varying head-neck ratios on impingement and range of motion. METHODS: A three-dimensional generic hip prosthesis with a hemispherical cup, a neck diameter of 12.25 millimeters, and a head size ranging from twenty-two to thirty-two millimeters was simulated on a computer. The maximum range of motion of the hip was measured, before the neck impinged on the liner of the cup, for acetabular abduction angles ranging from 35 to 55 degrees and acetabular and femoral anteversion ranging from 0 to 30 degrees. Stability of the hip was estimated as the maximum possible flexion coupled with 10 degrees of adduction and 10 degrees of internal rotation and also as the maximum possible extension coupled with 10 degrees of external rotation. The effects of prosthetic orientation on activities of daily living were analyzed as well. RESULTS: Acetabular abduction angles of less than 45 degrees decreased flexion and abduction of the hip, whereas higher angles decreased adduction and rotation. Femoral and acetabular anteversion increased flexion but decreased extension. Acetabular abduction angles of between 45 and 55 degrees permitted a better overall range of motion and stability when combined with appropriate acetabular and femoral anteversion. Lower head-neck ratios decreased the range of motion that was possible without prosthetic impingement. The addition of a modular sleeve that increased the diameter of the femoral neck by two millimeters decreased the range of motion by 1.5 to 8.5 degrees, depending on the direction of motion that was studied. CONCLUSIONS: There is a complex interplay between the angles of orientation of the femoral and acetabular components. Acetabular abduction angles between 45 and 55 degrees, when combined with appropriate acetabular and femoral anteversion, resulted in a maximum overall range of motion and stability with respect to prosthetic impingement. CLINICAL RELEVANCE: During total hip arthroplasty, acetabular abduction is often constrained by available bone coverage, while femoral anteversion may be dictated by the geometry of the femoral shaft. For each combination of acetabular abduction and femoral anteversion, there is an optimum range of acetabular anteversion that allows the potential for a maximum range of motion without prosthetic impingement after total hip arthroplasty. These data can be used intraoperatively to determine optimum position.

Acute spondylolytic spondylolisthesis. Risk of progression and neurological complications.

Acute spondylolytic spondylolisthesis was diagnosed after major trauma in five patients. The level of injury was between the third and fourth lumbar vertebrae in one patient and between the fifth lumbar and first sacral vertebrae in four. The initial spondylolisthesis was grade I in four patients and grade III in one. Four of the patients were initially managed non-operatively. The deformity did not progress in a five-year-old boy with grade-I spondylolisthesis who had been managed with immobilization in a body cast. The deformity progressed in two of the adolescents who had been managed non-operatively; the progression was from grade I to grade III in one of these patients and from grade III to grade V (spondyloptosis) in the other, in whom a cauda equina syndrome also developed. The latter patient was subsequently managed with posterior reduction and arthrodesis followed by an anterior arthrodesis, and the neurological deficits resolved. The deformity also progressed, from grade I to grade II over three years, in a fifty-seven-year-old woman who had been managed non-operatively. One patient who had a grade-I deformity was managed with immediate operative stabilization followed by immobilization in a thoracolumbosacral orthosis; the deformity did not progress. Although minor or repetitive trauma is often associated with spondylolysis, high-energy trauma may produce a more severe form of spondylolysis with spondylolisthesis. These deformities are more unstable, with instability similar to that of a fracture-dislocation, and they have a greater propensity to progress than the usual form of spondylolytic spondylolisthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Polyethylene wear after total hip arthroplasty: the effect of a modular femoral head with an extended flange-reinforced neck.

The use of modular components in total hip arthroplasty has been thought to contribute to accelerated polyethylene wear. Specifically, a modular femoral head with a flange extension and a longer neck may cause increased wear. The purpose of the current study was to evaluate the effect of a flange extension on polyethylene wear. Ninety-one patients who had had a total of 100 primary total hip arthroplasties were evaluated after an intermediate duration of follow-up. All of the acetabular components consisted of a hemispherical titanium-alloy fiber-mesh porous-coated shell with a nonelevated modular polyethylene liner; they were inserted without cement and with use of supplemental screws through the dome after so-called line-to-line reaming. All of the femoral components consisted of a modular head with a diameter of twenty-eight millimeters and either a long neck (with a flange extension) or a short or medium neck (without a flange extension). The study group comprised sixty-two patients (sixty-six hips) who had had radiographic evaluation that was adequate to allow the valid measurement of polyethylene wear. Thirty-two hips were in men, and thirty-four were in women. The mean age of the patients was fifty-six years, the mean weight was seventy-three kilograms, and the mean duration of follow-up was 6.1 years (range, four to eight years). The rate of polyethylene wear in the eleven hips in which the femoral component had a flange extension was significantly greater than that in the fifty-five in which the femoral component did not have a flange extension (mean, 0.17 compared with 0.11 millimeter per year; p = 0.009). Multivariate analysis showed that the presence of a flange extension was associated with increased polyethylene wear to a greater degree (F = 2.86) than were all other variables that were measured, including a younger age (F = 1.72), a more vertical angle of the acetabular component (F = 0.49), a heavier weight (F = 0.14), male gender (F = 0.11), and a smaller initial thickness of the polyethylene (F = 0.02). These data support an association between the presence of a modular femoral head with a flange extension and an accelerated rate of polyethylene wear. The presumed mechanism is an increase in peripheral, or so-called rim, impingement of the flange-reinforced neck on the acetabulum due to a decrease in the ratio between the diameters of the femoral head and neck.

Hodgkin's and non-Hodgkin's lymphoma of the head and neck.

OBJECTIVES/HYPOTHESIS: Lymphomas are a frequent cause of malignant lymphadenopathy in the head and neck. This study was performed to evaluate the head and neck manifestations of lymphomas and to emphasize the different presentations of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). STUDY DESIGN: Retrospective review. METHODS: A retrospective review was made of all cases of lymphomas involving the head and neck at Marshfield Clinic (Marshfield, WI) between 1988 and 1996. Specifically, the clinical presentations, staging, and prognosis for HD and NHL with head and neck involvement were sought. RESULTS: Three hundred eleven patients were included in the study, 76 with HD and 235 with NHL. The median age at diagnosis for patients with HD was 27.7 years, and for patients with NHL, 67.2 years. This difference was highly significant (P <.001). No significant difference in gender was noted, with male patients occurring in 59% with HD and 49% with NHL (P=.135). Extranodal involvement including the oral cavity, oropharynx, nasopharynx, paranasal sinuses, and larynx occurred with HD in 3 patients (4%) and with NHL in 54 patients (23% P <.001). Cervical adenopathy consisted of a single node in 24% of patients with HD and 33% of those with NHL (no significant difference, P=.236). The difference in mediastinal nodal involvement was highly significant, occurring in 65% of patients with HD and 38% of patients with NHL(P <.001). Abdominal nodes occurred in 20% of cases of HD and 45% of cases of NHL (P<.001). A significant difference in constitutional symptoms was noted with 41% of cases in HD and 27% of cases in NHL (P=.020). For the percentage of patients with stage IV disease, there was a highly significant difference by diagnosis with 10% in HD and 36% in NHL (P <.001). The median follow-up time was 51 months, and 12% of patients with HD and 41% of patients with NHL died of their disease. Both the overall survival and survival from death attributable to disease were significantly better for HD(P<.001). CONCLUSIONS: Hodgkin's disease presents at a younger age and is less common than NHL. Cervical lymphadenopathy is the most common head and neck presentation for both diseases. Associated mediastinal adenopathy was more common with HD, and abdominal adenopathy with NHL. Constitutional symptoms were more common with HD. More advanced disease with a decreased overall survival was seen with NHL.

Zenker's diverticulum.

Symptomatic Zenker's diverticula are usually treated with diverticulectomy and myotomy. Other, more conservative open procedures consist of diverticulopexy, imbrication, and myotomy alone. These more conservative procedures do not result in a breach of esophageal mucosa and should have more rapid postoperative recovery. We performed a retrospective chart review of all open surgical procedures performed at the Marshfield Clinic and St. Joseph's Hospital between 1975 and 1996. Using Wilcoxon's rank sum test, the conservative procedures were compared with the standard diverticulectomy for duration of hospitalization and length of time to resumption of oral intake. Fifty-nine patients are reported. Statistically significant differences between the surgery groups were found for hospitalization (P < 0.001) and days to resumption of oral intake (P < 0.001). Conservative open surgical procedures for repair of Zenker's diverticula result in decreased hospitalization and earlier resumption of oral diet compared with diverticulectomy.

Preoperative computed tomography scans for parotid tumor evaluation.

OBJECTIVE: We sought to determine whether an advantage is obtained in the routine use of computed tomography (CT) scans in preoperative assessments of parotid tumors. METHODS: A prospective study of 32 consecutive cases of patients who underwent evaluation for parotidectomies was performed. Twenty-nine received preoperative CT scans. The scans were systematically reviewed to see if they correlated with the clinical findings. Specifically, we compared clinical and CT assessments of tumor size, location, density, and malignancy. Further comparisons were performed based on postoperative tissue pathology. RESULTS: In our series of patients, routine preoperative CT scans resulted in the discovery of details not revealed on clinical examination: some masses were found to be extra-parotid rather than primary parotid tumors, some tumors deemed to be deep were superficial, tumor density was more clearly identified, and certain pathology correlates were clarified. Most importantly, there were instances of detection of additional tumors in the same lobe, and in one instance in the opposite lobe, that were not otherwise noticed. CONCLUSIONS: To reduce errors of omission in the treatment of suspected parotid tumors, it would seem appropriate to consider the inclusion of CT scans for the routine preoperative evaluation of all parotid masses.

Drill-generated sensorineural hearing loss following mastoid surgery.

Drilling during mastoid surgery may result in temporary noise-induced hearing loss. This has practical implications for both the patient and surgeon. In a prospective study of 40 patients, audiometric testing was done both preoperatively and postoperatively to try to detect any significant hearing loss in the immediate postoperative period. The data were analyzed using the Student's paired t test. No statistically significant difference was found. A sensorineural hearing loss soon after mastoid surgery is not due to the noise generated by the drill. In the event of any hearing loss during this period, other causes should be sought.

Clinical signs of orbital ischemia in rhino-orbitocerebral mucormycosis.

Mucormycosis is the most acutely fatal fungus infection of man (Ferry and Abedi). The most common clinical type of infection is rhino-orbitocerebral mucormycosis. Prompt recognition of the clinical picture is essential if the appropriate urgent management is to be instituted without delay. The presence of black eschar in the region of the nasal passages, palate, midface, and orbit is the best-recognized clinical sign alerting the clinician to the diagnosis. Black eschar is, however, a feature in only a minority of these patients at the time of presentation. This paper discusses other clinical signs, particularly orbital ischemia, which should suggest the diagnosis. The clinical presentation of orbital ischemia in mucormycosis includes proptosis, total external and internal ophthalmoplegia, and early blindness. A lax, nontender periorbital puffiness, which does not feel warm to the examiner's touch, is typical. Proptosis and chemosis, if present, are mild. These signs are compared with those of pyogenic orbital cellulitis, with which the condition might most easily be confused.

Glomus vagale: paraganglioma of the vagus nerve.

Review of the experience of a single institution with a rare tumor may give inadequate and biased information. In an effort to better understand issues related to diagnosis and subsequent management of paraganglioma of the vagus nerve, review of the experience at two university medical centers was undertaken. A review of the records of all patients with a diagnosis of vagal paraganglioma at the University of Pittsburgh and the Eastern Virginia Medical School was undertaken. Presenting signs and symptoms, treatment, and subsequent outcome were assessed. Data on 19 patients with vagal paraganglioma were available. The most common initial finding was a neck mass. Forty-seven percent (9/19) had vocal cord paralysis at presentation. Angiography was beneficial in helping to make the diagnosis and in identifying synchronous tumors. History of familial paraganglioma was present in 47% (9/19). Multiple paragangliomas were diagnosed in 53% (10/19) cases in our study. Of the patients with familial vagal paraganglioma, 89% (8/9) had multiple paraganglioma. All patients treated with surgery had postoperative vocal cord paralysis. Elective management of patients with bilateral vagal paraganglioma is a special dilemma. Radiation therapy of selected "operable" patients may be indicated because of the potential for bilateral vocal cord paralysis in these patients and its attendant sequela.

The chest radiograph in leptospirosis in Jamaica.

A consecutive series of 44 patients with proven leptospirosis was studied to document the radiographic pulmonary abnormalities, assess their prevalence, correlate them with the clinical signs and symptoms and determine their prognostic significance. Abnormalities were found in ten patients (23%), this prevalence being less than previously noted. The abnormalities shown were non-segmental opacification (consolidation-eight cases), basal linear opacities (collapse-five cases) and pleural effusions (four cases). The first radiographic demonstration of a large pleural effusion in leptospirosis is recorded. Non-jaundiced patients had a higher prevalence (43%) of these abnormalities than jaundiced (13%). No other correlation with clinical signs or symptoms was found. The presence of these abnormalities had no prognostic significance. It is concluded that the presence of radiographic pulmonary abnormality in in-patients with leptospirosis is common. These abnormalities are non-specific and can mimic other diseases leading to diagnostic difficulty. Such abnormalities may be extensive in the absence of clinical signs and symptoms.