Successful reversal of threatening carotid artery occlusion in HIV-associated non-aneurysmal vasculitis

We report a case of HIV-associated carotid vasculitis, causing cerebral infarction. Immediate corticosteroid treatment was followed by improvement, with radiological documentation of reversal of the vasculitic changes, preventing arterial occlusion. Vasculitis should be considered as a diagnosis in stroke in HIV and steroid treatment considered as a potentially life-saving intervention.

Successful treatment of disseminated fusariosis with posaconazole during neutropenia and subsequent allogeneic hematopoietic stem cell transplantation

We report the case of a 16-year-old girl with acute myelogenous leukemia with disseminated fusariosis, who responded to salvage posaconazole therapy. She subsequently received additional cytotoxic chemotherapy and allogeneic hematopoietic stem cell transplantation with posaconazole continued as secondary prophylaxis. Despite intensive immunosuppressive therapy for graft-versus-host disease, no recrudescence of infection occurred.

Progranulin gene mutations associated with frontotemporal dementia and progressive non-fluent aphasia

Frontotemporal lobar degeneration (FTLD) refers to a focal, non-Alzheimer form of cerebral degeneration that encompasses the distinct clinical syndromes of frontotemporal dementia (FTD), progressive non-fluent aphasia (PNFA) and semantic dementia. Some patients show tau-based pathological changes and in familial cases mutations have been identified in the microtubule-associated protein tau gene (MAPT) on chromosome 17q21. However, many cases are tau-negative, showing instead ubiquitin-immunoreactive (UBQ-ir) neuronal cytoplasmic inclusions and neurites, and in some familial cases UBQ-ir neuronal intranuclear inclusions of a lentiform appearance. Very recently, mutations have been identified in familial cases in the progranulin (PGRN) gene, also on chromosome 17q21. Clinical, pathological and molecular diversity within FTLD highlights the importance of careful examination of clinical-pathological-genetic relationships. This paper reports, for the first time, a clinico-pathological investigation of two FTLD families with PGRN mutations, and compares the clinical characteristics with those of patients studied in the department with MAPT mutations. The clinical profile associated with PGRN mutations constituted, in some patients, a prototypical picture of FTD and in others one of PNFA, both profiles occurring within the same family. Patients with PGRN mutations exhibited phonological deficits, whereas in patients with MAPT mutations language abnormalities, when present in addition to the prominent behavioural disorder, take the form of semantic disturbance. The findings provide compelling evidence for the link between FTD and PNFA, while raising the possibility of identifiable clinical differences between FTLD patients with MAPT and PGRN mutations.

The apolipoprotein E epsilon4 allele selectively increases the risk of frontotemporal lobar degeneration in males

OBJECTIVE

To determine whether polymorphic variations in the apolipoprotein E gene (APOE) are associated with increased risk of frontotemporal lobar degeneration (FTLD) when mutation in tau gene is absent.

METHODS

The APOE gene was genotyped by polymerase chain reaction from DNA routinely extracted from blood or brain tissues. The APOE epsilon4 allele frequency in 198 patients with FTLD not associated with mutations in tau gene was compared with that of a control group of 756 normal individuals drawn from the same geographical region. Analyses were done according to clinical subtype or sex.

RESULTS

The APOE epsilon4 allele frequency (19.4%) was increased (p = 0.01) in FTLD v the whole control group (14.1%), while the APOE epsilon2 allele frequency in FTLD (6.5%) was slightly lower than in controls (8.0%) (NS). The APOE epsilon4 allele frequency in men with FTLD (22.3%) was greater (p = 0.002) than in male controls (12.3%); the frequency in women (16.3%) was similar to that in female controls (14.8%) (NS). The APOE epsilon2 allele frequency in men with FTLD was 4.9% while in male controls it was 9.5% (p = 0.06), but there was no difference in women (7.5% v 7.9%, NS). Neither the APOE epsilon2 nor APOE epsilon4 allele frequency varied significantly between any of the clinical subtypes.

CONCLUSIONS

In FTLD not associated with mutations in tau gene, possession of APOE epsilon4 allele in men roughly doubles the chances of developing disease, whereas this has no impact upon disease risk in women.

Patterns of interaction between Populus Esch5 and Piriformospora indica: a transition from mutualism to antagonism

Piriformospora indica (Sebacinaceae, Basidiomycota) is an axenically cultivable, plant growth promoting root endophyte with a wide host range, including Populus. Rooting of Populus Esch5 explants started within 6 days after transfer to WPM medium. If such plantlets with roots were inoculated with P. indica, there was an increase in root biomass, and the number of 2nd order roots was increased significantly. A totally different observation was recorded when the explants were placed into WPM with pre-grown P. indica. The interaction led to complete blocking of root production and severely inhibited plant growth. Additionally, branched aerial roots appeared which did not penetrate the medium. On contact with the fungal colony or the medium, the ends of the aerial roots became inflated. Prolonged incubation stimulated the fungus to colonize aerial parts of the plant (stem and leaves). Mycelium not only spread on the surface of the aerial parts, but also invaded the cortical tissues inter- and intracellularly. Detached Populus leaves remained vital for 4 - 5 weeks on sterile agar media or on AspM medium with pre-grown P. indica. When the fungus was pre-grown on culture media such as WPM, containing ammonium as the main source of nitrogen, leaves in contact with the cultures turned brownish within 4 - 12 h. Thereafter, the leaves bleached, and about one day later had become whitish. Thus, cultural conditions could alter the behaviour of the fungus drastically: the outcome of the interaction between plant and fungus can be directed from mutualistic to antagonistic, characterized by fungal toxin formation and extension of the colonization to Populus shoots.

Antifungal potential of Spilanthes calva after inoculation of Piriformospora indica. Das antimyzetische Potential von Spilanthes calva nach Inokulation von Piriformospora indica

We investigated the influence of Piriformospora indica on the antifungal principle of Spilanthes calva, a plant of high commercial value. An antifungal efficacy was shown by aqueous and petroleum ether extracts of S. calva against Fusarium oxysporum and Trichophyton mentagrophytes. The petroleum ether extract of S. calva was more effective than the aqueous extract in inoculated as well as uninoculated plants. The antifungal activity of the plant was enhanced due to the increase in spilanthol content after inoculation of P. indica.

Variability in the coat protein gene of Papaya ringspot virus isolates from multiple locations in India

The coat protein (CP) sequences of eleven Papaya ringspot virus (PRSV) isolates originating from different locations in India were determined, analysed and compared with the sequences of other isolates of PRSV. The virus isolates from India exhibited considerable heterogeneity in the CP sequences. The CP-coding region varied in size from 840-858 nucleotides, encoding protein of 280-286 amino acids. Comparative sequence analysis revealed that the PRSV isolates originating from India were divergent up to 11%. Though the PRSV isolates were differentiated in to two clusters, yet the sequence variation could not be correlated with the geographical origin of the isolates. Implication of the sequence variation in the coat protein derived transgenic resistance in papaya is discussed.

First Report of the Association of a Nanovirus with Foorkey Disease of Large Cardamom in India

Large cardamom (Amomum subulatum Roxb.) is affected by the serious disease 'foorkey', which is of unknown etiology (1). Excessive sprouting and formation of bushy dwarf clumps at the base of mother plants that gradually die, characterize the disease. In surveys in the Sikkim-Darjeeling Hill area during 2002 and 2003, as much as 27% of plants were found to be affected. Electron microscopy of negatively stained, partially purified preparations from field-infected large cardamom plants showed the presence of isometric particles measuring 17 to 20 nm. The causal agent was successfully transmitted by the aphid Micromyzus kalimpongensis Basu, in a persistent manner. Ten randomly selected field samples gave A₄₀₅ 0.1 to 0.23 compared with 0.57 with positive control with enzyme-linked immunosorbent assay using antiserum to an Indian isolate of Banana bunchy top virus (BBTV). A fragment of approximately 850 bp was amplified from the diseased plants using polymerase chain reaction (PCR) with primers 5'-ATGGCGCGATATGTGGTATGC-3' and 5'-TCAGCAAGAAAACCAACTTTATTC-3', designed to amplify the putative Rep gene based on the sequences of DNA1 of BBTV. The PCR product was cloned and sequenced (GenBank Accession No. AY 485960) and showed 80 to 82% identity with the corresponding region of DNA1 of BBTV and 47.6 to 48.5% with other recognized nanoviruses. These findings indicate that a nanovirus is associated with 'foorkey' disease of large cardamom, which is tentatively named as Cardamom bushy dwarf virus. Reference: (1) P. M. Varma and S. P. Capoor. Indian J. Agric. Sci. 34:56, 1964.

First Report of Occurrence of Papaya ring spot virus Infecting Papaya in Bangladesh

Papaya (Carica papaya L.) is an important fruit crop in Bangladesh. During surveys conducted in Dhaka and Mymensingh regions from April to June 2003, >50% of papaya plants were observed to have leaf mottling, mosaic and mild distortion, and water-soaked streaks on petioles and stem, which are typical symptoms of Papaya ring spot virus (PRSV) infection. Electron-microscopic examination of negatively stained leaf-dip preparations from 10 symptomatic samples revealed the association of flexuous virus particles that were decorated with polyclonal antibodies raised to an isolate from India (PRSV-D). The identity of PRSV associated with the papaya disease in Bangladesh was further confirmed by reverse transcription polymerase chain reaction and sequence analysis (2). By using PRSV specific primers (2), the 3'-terminal region comprising a part of the nuclear inclusion b gene, the coat protein (CP) gene, and the untranslated region were amplified and sequenced (GenBank Accession No. AY423557). The CP gene consisted of 286 amino acids and the conserved regions common to the genus Potyvirus, such as WCIEN and QMKAA, were present. Like all known PRSV sequences (1), a stretch of glutamic acid and lysine repeats (EK region) after the aphid transmission motif (DAG) also was present. Comparative CP amino acid sequence analyses revealed that the virus infecting papaya in Bangladesh, designated as PRSV-Bd, shared 89 to 92% identity with PRSV isolates from India and 88 to 93% identity with isolates from other parts of the world. To our knowledge, this is the first report of occurrence of PRSV infecting papaya in Bangladesh. References: (1) M. F. Bateson et al. J. Gen. Virol. 83:2575, 2002. (2) R. K. Jain et al. Ann Appl. Biol. 132:413, 1998.

First Report of Association of Tomato leaf curl virus-New Delhi with Yellow Mosaic Disease of Luffa cylindrica in India

Sponge gourd (Luffa cylindrica), an important cucurbitaceous vegetable in India, is affected by a disease (2) causing yellow spots on newly emerged leaves, mosaic, mild leaf curling and distortion, small leaves, and misshapen fruits. Nearly 100% of sponge gourd plants were symptomatic in Delhi. Geminivirus-like particles were observed with electron microscopy of uranyl acetate-stained leaf-dip preparations of the diseased plants collected from experimental fields at the Indian Agricultural Research Institute in New Delhi during May and June of 2002. The virus was transmitted by the whitefly (Bemisia tabaci) to sponge and ridge gourd (L. acutangula) after an acquisition and inoculation access period of 24 h each. Whitefly-inoculated plants produced typical yellow mosaic symptoms and contained geminate particles. Nucleic acid extracted from the field-infected and experimentally infected plants hybridized with ³²P-labeled probe to DNA-A of Indian cassava mosaic virus, suggesting association of a begomovirus. The viral DNA, isolated by the alkali denaturation method (1) from the experimentally infected sponge gourd plants, was cloned in pBS SK+ at the EcoRI site. A clone with an insert of 2,658 bp was sequenced (GenBank Accession Nos. AJ557219, AJ555488, and AY309957) which shared 89.6 to 95.1% identity with the DNA-A of different strains of Tomato leaf curl virus-New Delhi (ToLCV-NDe). The highest sequence identity (95.1%) was with the severe strain of ToLCV-NDe (GenBank Accession No. U15015). The data suggest that the begomovirus associated with the yellow mosaic disease of L. cylindrica in India is a putative strain of ToLCV-NDe. Reference: (1) K. M. Srivastava et al. J. Virol. Methods 51:297, 1995. (2) A. Varma and B. K. Giri. Virus diseases. Pages 225-245 in: Cucurbits. N. M. Nayar and T. A More, eds. Oxford and IBH Publishing House Private Ltd., New Delhi, India, 1998.

First Report of Natural Infection of Luffa acutangula by Watermelon bud necrosis virus in India

In August 2002, ridge gourd (Luffa acutangula) plant samples exhibiting yellowing of leaves were collected from the experimental farm of Tamil Nadu Agricultural University, Coimbatore, India. Mechanical inoculations of ridge gourd seedlings using the above samples resulted in chlorotic spots on inoculated leaves and vein clearing followed by chlorotic rings and yellow netting along veins of newly developed leaves. The virus was reisolated from the chlorotic spots of the seedlings. Extracts from the field samples as well as mechanically inoculated seedlings reacted with antiserum to Watermelon silver mottle virus (WSMoV) in direct antigen coating enzyme-linked immunosorbent assay, suggesting the association of a tospovirus belonging to WSMoV serogroup (2). Symptomatic leaves from the second mechanical passage exhibiting yellow netting along the veins were subjected to reverse transcription-polymerase chain reaction (1) to identify the genus Tospovirus. Using the primer pair (5'TCTGTCCT(C/T) TTGAA (G/T) GTCCA3' and 5'AGAGCAATCGAGGCGCT3') derived from the conserved sequences of Groundnut bud necrosis virus (GBNV) and WSMoV, part of the nucleocapsid (N) protein gene and the complete noncoding region upstream of the N gene's coding sequence were cloned and sequenced. Comparative sequence analysis of 291-bp region of the N gene revealed that the genus Tospovirus infecting ridge gourd shared maximum identity both at nucleotide (94%) and amino acid (97%) levels with the corresponding region of Watermelon bud necrosis virus (WBNV), which is a distinct species of WSMoV serogroup infecting watermelon in India (1). In contrast, only 76 to 81% and 82% identity at nucleotide and amino acid levels, respectively, was observed with the corresponding region of the N genes of GBNV and WSMoV. Natural infection of WBNV in cucurbits except watermelon in India is not known. To our knowledge, this is the first report of natural infection of ridge gourd by WBNV. References: (1) R. K. Jain et al. Arch. Virol. 143:1637, 1998. (2) J. W. Moyer. Tospoviruses (Bunyaviridae). Pages 1803-1807 in: Encyclopedia of Virology. A. Granoff and R. G. Webster, eds. Academic Press, New York, 1999.

The clinical spectrum of neurocysticercosis in the Uttaranchal region

OBJECTIVES

To study the clinical and radiological spectrum of neurocysticercosis in the Uttaranchal region.

METHODS

A total of 592 patients of neurocysticercosis attending various health camps, medical outdoor and indoor department were studied for their clinical and radiological presentation.

RESULTS

Out of the total 15,000 patients screened, 592 patients (3.94%) were found to be suffering from neurocysticercosis. Majority of them were in the age group of 21-30 years. Most of them presented with generalized seizures (62.5%), others had headache (37.5%), focal seizures (20.8%), localizing neurological signs (16.6%), meningitis (4.1%), and dementia (1.3%). Radiologically, parenchymal lesions were most prevalent (81%). However, interventricular lesions were also not very uncommon (32%). Most of them had single lesions (53.5%), 26.7% had multiple lesions and 0.7% had midline shift. Significantly, large number of patients were vegetarians (39%); only 17.6% were pork eaters while the remaining 82.4% never had pork in their meals.

CONCLUSION

We believe that such high percentage is at least a rough indicator of high incidence and prevalence of neurocysticercosis in the Uttaranchal region. They had wide range of clinical and radiological presentation. Small number of pork eaters and a significant number of vegetarians suggest other modes of transmission and needs further evaluation.

The effect of antidepressants on serum melatonin levels in endogenous depression

OBJECTIVES

1. To assess the serum melatonin levels in patients suffering from endogenous depression and the effect of pharmacological therapy. 2. To establish possible correlation between the height from the mean sea levels and the patients suffering from endogenous depression.

METHODS

Forty patients, 18 males and 22 females, suffering from endogenous depression (according to DSM IV criteria), aged 48.3 +/- 12.32 years were evaluated and serum melatonin level was assayed between 9-10 am. They were not on any drugs/medication, which was likely to alter serum melatonin level for one month prior to study. The serum melatonin levels were assessed at 0, 3, 6 and 12 months while they were continued to be treated. It also included 30 controls of the matched age and sex and satisfying the inclusion criteria. The possible correlation was also studied between the serum levels and the height from the mean sea level at which the patients reside.

RESULTS

The two groups were comparable at the beginning of the study. The serum melatonin levels started falling from three months onwards (from 9.99 +/- 3.59 pg/nl to 8.49 +/- 3.16 pg/nl; p < 0.05). However, the decline was maximum between 3-6 months (from 8.49 +/- 3.16 to 5.589 +/- 1.96; p<0.05). The serum levels became stationary beyond six months. Highest melatonin levels were observed in patients residing at an altitude of 6001-8000 metres (14.32 +/- 2.68 pg/ml; p < 0.05) followed by 4,001-6,000 meters (11.137 +/- 2.62 pg/ml; p < 0.05). However, the levels were almost stationary below 4,000 metres (p = 0.05).

CONCLUSION

1. Higher serum melafonin values were observed in patients suffering from endogenous depression. 2. Morning serum melatonin values decreased with pharmacological therapies. 3. Patients living at higher altitudes had higher serum values for the hormone.

Migraine-like visual hallucinations in occipital lesions of cysticercosis

Four Indian patients with occipital lesions of cysticercosis presented with visual hallucinations. Neuro-ophthalmic and systemic examinations were normal in all cases except for one patient who had a partial homonymous hemianopia. Electroencephalography was normal in all cases. Neuroimaging revealed ring-enhancing lesions in the occipital lobe typical of neurocysticercosis. In endemic regions like India, neurocysticercosis should be suspected in patients presenting with visual hallucinations, even when there are no other clinical findings.

Serological and coat protein sequence studies suggest that necrosis disease on sunflower in India is caused by a strain of Tobacco streak ilarvirus

Serological and coat protein sequence studies were conducted to identify an ilarvirus associated with necrosis disease on sunflower in India. In electroblot immunoassay, sunflower ilarvirus reacted strongly only with antiserum to Tobacco streak virus (TSV). The coat protein gene of sunflower ilarvirus was cloned and sequenced. The sequence analyses also showed that the CP gene was most closely related to TSV, the member of subgroup I of Ilarvirus. The sunflower ilarvirus CP shared 90% amino acid sequence identity with TSV. On the basis of serological relatedness and sequence identity, it is proposed that the sunflower ilarvirus from India should be considered a strain of TSV belonging to subgroup I and designated as TSV-SF. This is the first report of the molecular characterization of TSV on sunflower from the Indian subcontinent.

Molecular characterization of the Rep protein of the blackgram isolate of Indian mungbean yellow mosaic virus

The complete nucleotide sequence of the blackgram isolate of mungbean yellow mosaic virus, IMYMV-Bg, which infects legumes in India, was determined and compared at the amino acid level with those of other whitefly-transmitted geminiviruses. The genome organization of IMYMV-Bg was similar to that of the begomoviruses. A unique feature of the genome organization was the sequence divergence of the common region (CR) between DNA-A and DNA-B. In order to understand the mechanism of viral DNA replication, the replication initiator protein, Rep, of IMYMV-Bg was overexpressed in E. coli. The recombinant and refolded Rep bound to CR-sequences of IMYMV-Bg in a specific manner. In this study, evidence is presented for ATP-upregulated cleavage function and ATP-mediated conformational change of Rep. It is hypothesized that, although ATP is not required for cleavage, ATP-mediated conformational changes may result in better access of Rep to the DNA-cleavage site. Evidence is also presented for a site-specific topoisomerase function of Rep, which has not been demonstrated before. The Rep protein can be classified as a type-I topoisomerase because of its nicking activity and sensitivity towards camptothecin, a topoisomerase type-I inhibitor.

Behaviour in frontotemporal dementia, Alzheimer's disease and vascular dementia

OBJECTIVES

The study aimed to increase understanding of behavioural changes in frontotemporal dementia (FTD) and identify features that best differentiate FTD from Alzheimer's disease (AD) and cerebrovascular dementia (CvD).

METHODS

A semi-structured questionnaire was administered to carers of 30 FTD, 75 AD and 34 CvD patients.

RESULTS

Behavioural changes that strongly discriminated FTD from AD and to a lesser extent CvD were loss of emotions and insight, selfishness, disinhibition, personal neglect, gluttony and sweet food preference, wandering, motor and verbal stereotypies, loss of pain, echolalia and mutism. Irritability, hyposexuality and hypersomnia did not discriminate. Emotional, eating and stereotyped behaviours correctly classified 95% of patients using regression analysis.

CONCLUSIONS

Behavioural characteristics accurately differentiate FTD from AD and CvD. The findings highlight the particular importance of affective change in FTD, and underline the role of the frontotemporal lobes in emotion.

Isolation of an Isometric Virus Causing Sunflower Necrosis Disease in India

Sunflower necrosis disease (SND) is becoming a potential threat to sunflower (Helianthus annuus L.) cultivation in the Indian subcontinent. The disease was first recorded in parts of Karnataka state in 1997. Since then the disease has become increasingly important in Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu, the four major sunflower-growing states of India, and is a limiting factor in sunflower production; up to 80% of the plants of some open pollinated and hybrids were affected during the 1999 survey in sunflower growing areas. Field symptoms of the disease include extensive necrosis of leaf lamina, petiole, stem and floral calyx and severe stunting with malformation of flowering head when plants are infected early. The association of a tospovirus, antigenically related to groundnut bud necrosis (GBNV) and watermelon silver mottle (WSMV) viruses, with the disease has been reported (1). However, the etiology of the disease remains unaddressed. In this study a sap-transmissible isometric virus was transferred to cowpea (cvs. Pusa Komal and C152) inciting localized chlorotic and necrotic lesions and systemic veinal necrosis. Electron-microscopic studies of leaf-dip preparations from field samples revealed two types of particles (isometric measuring 25 to 28 nm in diameter and flexuous rods with a length of about 600 nm). The sap-inoculated cowpea and sunflower contained only the isometric particles. Some preparations also showed the presence of tubules containing virus particles. The presence of flexuous particles in field samples could be due to mixed infection as the mosaic disease, known to be caused by a flexuous virus, was common in the sunflower fields surveyed in the present investigations. Extracts from the field collected samples or sap-inoculated plants did not react with antisera to cucumber mosaic (CMV) or potato Y (PVY) viruses in direct antigen-coated (DAC)-ELISA and immunosorbent electron microscopy tests. The isometric virus isolated from sunflower was purified from sap-inoculated cowpea plants by differential and sucrose density-gradient centrifugations. The virus was sap transmitted back to sunflower (cv. Morden), which developed symptoms identical to those observed under field conditions. Disease symptoms were also reproduced on sunflower upon mechanical inoculation with the purified virus. Polyclonal antiserum raised in rabbits using purified virus preparations, detected the virus from field and glasshouse collected sunflower plants in DAC-ELISA tests. This will help in epidemiological studies and breeding for disease resistance. The particle size and structure and the presence of tubule containing virus particles in plant extracts suggest that the virus belongs to ILAR group. An ILAR virus is reported to infect sunflower (2), but details of its natural occurrence are not known. This is the first report on the etiology of the sunflower necrosis disease in India. Further studies are in progress. References: (1) Anon. 2000. Annual Report (1999-2000), Indian Agricultural Research Institute, New Delhi, India. (2) A. A. Brunt et al. CAB International, Wallingford, UK, 1210, 1996.

Distinct behavioural profiles in frontotemporal dementia and semantic dementia

OBJECTIVE

To test predictions that frontotemporal dementia and semantic dementia give rise to distinct patterns of behavioural change.

METHODS

An informant based semistructured behavioural interview, covering the domains of basic and social emotions, social and personal behaviour, sensory behaviour, eating and oral behaviour, repetitive behaviours, rituals, and compulsions, was administered to carers of 41 patients with semantic dementia and with apathetic (FTD-A) and disinhibited (FTD-D) forms of frontotemporal dementia.

RESULTS

Consistent with prediction, emotional changes differentiated FTD from semantic dementia. Whereas lack of emotional response was pervasive in FTD, it was more selective in semantic dementia, affecting particularly the capacity to show fear. Social avoidance occurred more often in FTD and social seeking in semantic dementia. Patients with FTD showed reduced response to pain, whereas patients with semantic dementia more often showed exaggerated reactions to sensory stimuli. Gluttony and indiscriminate eating were characteristic of FTD, whereas patients with semantic dementia were more likely to exhibit food fads. Hyperorality, involving inedible objects, was unrelated to gluttony, indicating different underlying mechanisms. Repetitive behaviours were common in both FTD and semantic dementia, but had a more compulsive quality in semantic dementia. Behavioural differences were greater between semantic dementia and FTD-A than FTD-D. A logistic regression analysis indicated that emotional and repetitive, compulsive behaviours discriminated FTD from semantic dementia with 97% accuracy.

CONCLUSION

The findings confirm predictions regarding behavioural differences in frontotemporal and semantic dementia and point to differential roles of the frontal and temporal lobes in affect, social functioning, eating, and compulsive behaviour.

Target gland functional status in patients with non-Cushing's pituitary macroadenomas undergoing transsphenoidal microsurgery

OBJECTIVES

Hypopituitarism occurring in patients with pituitary macroadenoma may be reversible after pituitary microsurgery, and surgery itself can lead to hypopituitarism. This study was undertaken to evaluate target gland function prospectively in patients of non-Cushing's pituitary macroadenoma undergoing trans-sphenoidal microsurgery.

MATERIAL AND METHODS

A prospective study of fifty patients of non-Cushing's pituitary adenoma was carried out to evaluate target gland (thyroid, adrenal and gonadal) undergoing trans-sphenoidal microsurgery. Thirty-two patients completed postoperative evaluation before radiotherapy. Target gland functions were assessed by measurement of T3, T4, TSH, basal and stimulated cortisol, LH, FSH, testosterone and estradiol. GH and PRL were also measured. Tumor size was assessed on CT/MRI scan.

RESULTS

Hypothyroidism, hypoadrenalism and hypogonadism were present in 24%, 54% and 52% of patients. Preoperative hypopituitarism correlated with tumour size. Thyroid, adrenal and gonadal function improved in 87%, 50% and 31%; deteriorated in 4%, 29%, and 37%, respectively after trans-sphenoidal microsurgery.

CONCLUSIONS

A subset of patients with non-Cushing's pituitary macroadenoma suffers from hypopituitarism, which reverses after surgery. Failure of recovery correlates with preoperative lower serum prolactin levels.

Characterization of the L41 gene in Cryptococcus neoformans: its application as a selectable transformation marker for cycloheximide resistance

A transformation system using resistance to the antibiotic cycloheximide as a dominant selectable marker was developed for the pathogenic yeast Cryptococcus neoformans. A 3.5 kb DNA fragment containing a gene encoding the ribosomal protein L41 was cloned from a wild-type strain of C. neoformans which is sensitive to cycloheximide. The open reading frame of the L41 gene contains five introns and encodes a protein of 107 amino acids, which is similar to those reported for other yeasts. The cycloheximide resistance gene to be used as a marker was constructed by replacing a DNA segment of the wild-type L41 gene, which contained the amino acid proline at its 56th position with a homologous DNA segment from a mutant strain resistant to cycloheximide that contained leucine in that position. Cycloheximide resistant transformants were obtained by electroporation on YEPD plates, supplemented with 10-20 microg/ml cycloheximide, at a maximum efficiency of 300 transformants/microg plasmid DNA. While with other genes, most transformants of serotype D in C. neoformans maintain the transforming DNA as episomes, the cycloheximide-resistant transformants were all the result of ectopic genomic integration events.

Evidence for Association of a Viroid with Tapping Panel Dryness Syndrome of Rubber (Hevea brasiliensis)

Tapping panel dryness (TPD) is one of the most destructive maladies affecting rubber plantations and is becoming a matter of serious concern. Reduced latex yield leading to total drying of the tapping panel is the obvious symptom. The cause of TPD syndrome is unknown but has been mostly attributed to abiotic causes. In India, the high yielding commercial clone RRII 105 is affected by TPD, leading to enormous losses. We have observed that TPD-affected trees show symptoms of bark scaling, cracking, drying, necrotic streaking, and browning of internal bark leading to the decay of internal tissues. Often prominent abnormal bulges on the lower part of tree trunks occur where the first panel begins to dry. Investigations on TPD-affected rubber samples did not reveal the association of fungus, bacterium, virus, or a protozoan. Total nucleic acid extracts purified from leaf and bark tissues of affected samples and analyzed by polyacrylamide gel electrophoresis under denaturing conditions of low salt and high temperature showed the presence of nucleic acids similar in electrophoretic mobility to low molecular weight (LMW) RNA, of ~359 nucleotides such as potato spindle tuber viroid (PSTVd). The LMW nucleic acid detected from TPD-affected samples was found to be RNA based on its sensitivity to RNase and insensitivity to DNase, phenol, and heat treatments. The LMW RNA was purified and cloned in a pUC 19-derived vector by using primers specific to PSTVd (1). The cloned DNA, when random labeled and used as probe reacted specifically to nucleic acid extracts from TPD-affected rubber trees but not from healthy tissue in dot-blot hybridization assays. Based on the above findings, a viroid etiology for TPD syndrome is proposed. Reference: (1) R. A. Owens, A. T. Candresse, and T. O. Diener. Virology 175:238, 1990.

A novel episomal shuttle vector for transformation of Cryptococcus neoformans with the ccdB gene as a positive selection marker in bacteria

We report the engineering of a new shuttle vector featuring its episomal maintenance in Cryptococcus neoformans and the lethal Escherichia coli ccdB gene for positive selection in bacteria. Telomere-like sequences from C. neoformans and the STAB fragment confer episomal maintenance to the vector (pPM8) upon transformation in C. neoformans. The vector generated high transformation frequencies and each transformant was estimated to harbor thirty copies of the plasmid. The plasmids recovered in E. coli from the C. neoformans transformants showed no evidence of rearrangement. This construct will be very useful for cloning and studying the regulation of genes in C. neoformans.

In vitro resistance of Staphylococcus aureus to thrombin-induced platelet microbicidal protein is associated with alterations in cytoplasmic membrane fluidity

Platelet microbicidal proteins (PMPs) are small, cationic peptides which possess potent microbicidal activities against common bloodstream pathogens, such as Staphylococcus aureus. We previously showed that S. aureus strains exhibiting resistance to thrombin-induced PMP (tPMP-1) in vitro have an enhanced capacity to cause human and experimental endocarditis (T. Wu, M. R. Yeaman, and A. S. Bayer, Antimicrob. Agents Chemother. 38:729-732, 1994; A. S. Bayer et al., Antimicrob. Agents Chemother. 42:3169-3172, 1998; V. K. Dhawan et al., Infect. Immun. 65:3293-3299, 1997). However, the mechanisms mediating tPMP-1 resistance in S. aureus are not fully delineated. The S. aureus cell membrane appears to be a principal target for the action of tPMP-1. To gain insight into the basis of tPMP-1 resistance, we compared several parameters of membrane structure and function in three tPMP-1-resistant (tPMP-1(r)) strains and their genetically related, tPMP-1-susceptible (tPMP-1(s)) counterpart strains. The tPMP-1(r) strains were derived by three distinct methods: transposon mutagenesis, serial passage in the presence of tPMP-1 in vitro, or carriage of a naturally occurring multiresistance plasmid (pSK1). All tPMP-1(r) strains were found to possess elevated levels of longer-chain, unsaturated membrane lipids, in comparison to their tPMP-1(s) counterparts. This was reflected in corresponding differences in cell membrane fluidity in the strain pairs, with tPMP-1(r) strains exhibiting significantly higher degrees of fluidity as assessed by fluorescence polarization. These data provide further support for the concept that specific alterations in the cytoplasmic membrane of S. aureus strains are associated with tPMP-1 resistance in vitro.

Apolipoprotein E epsilon4 allele has no effect on age at onset or duration of disease in cases of frontotemporal dementia with pick- or microvacuolar-type histology

Frontotemporal dementia (FTD) is the second most common cause of presenile dementia. Here we have investigated the frequency of the epsilon4 allele of the Apolipoprotein (APOE) gene in FTD and in other non-Alzheimer forms of dementia related to FTD such as Motor Neurone disease dementia, semantic dementia, progressive aphasia, progressive supranuclear palsy, and corticobasal degeneration. In none of these diagnostic groups did we find a significant increase in the APOE epsilon4 allelic frequency, compared to population values. Neither did we observe any affects of the epsilon4 allele upon age at onset or duration of disease. We conclude therefore that polymorphic variations in the APOE gene do not modulate either the occurrence or progression of these non-Alzheimer forms of dementia.

Purification and properties of growth stage-dependent antiviral proteins from the leaves of Celosia cristata

Two antiviral glycoproteins, active against mechanical transmission of two tobamoviruses, tobacco mosaic virus and sunnhemp rosette virus, and citrus ring spot virus (ungrouped), were purified from the dried leaves of Celosia cristata. These proteins, called CCP-25 and CCP-27, have M(r) 25 and 27 kDa, respectively. Their concentration was found to vary between the pre-flowering and post-flowering stages of C. cristata90% lesion formation at a concentration of 20-30 µg ml(-1). They were resistant to proteases in the native state, but were readily digested when denatured. Both of them imparted actinomycin D sensitive resistance by inhibiting local lesions on Nicotiana tabacum cv. Samsun NN by tobacco mosaic virus. Their application, individually, also resulted in high resistance in systemic hosts to sunnhemp rosette virus, and citrus ring spot virus, respectively.

Role of emergency surgery to reduce mortality from rebleed in patients with aneurysmal SAH

Potentially salvageable patients with aneurysmal subarachnoid hemorrhage may rebleed and die after admission to a hospital, awaiting an angiogram or surgery. In an attempt to reduce the number of patients thus lost, we are operating on such patients on an emergency basis. This report is a retrospective analysis of patients operated early after aneurysmal SAH, but during routine working hours, versus patients operated on an emergency basis. During an 18 month period 109 patients underwent surgery for intracranial aneurysm. Fifty two (Group 1) patients were subjected to emergency clipping of the aneurysm, and 57 (Group 2) patients underwent early clipping but during routine working hours. There was no selection bias between the two groups. Another 10 patients in Hunt and Hess Grade II and III rebled and died, after admission, awaiting an angiogram or surgery. The overall mortality for the two groups (Grade I to IV) was 11.9%. Mortality in Groups 1 and 2 was 9.6% and 14.0% respectively. At 1 month, good outcome was recorded in 86.6% patients in grade I, 69.2% patients in grade II and 42.8% patients in grade III in group I compared to 68.7% patients in grade I, 80% patients in grade II and 31.5% patients in grade III in group 2. However, the difference was not statistically significant. There was also no significant difference between the incidence of intraoperative brain swelling and delayed ischaemic neurological deficit between the two groups. Grade IV patients had a poor outcome in both the groups. Angiographic vasospasm was associated with poor out come, in either group, in grade IV patients. Patients in Grades I to III should undergo emergency surgery, if the surgeon is experienced and willing to operate at odd hours and necessary support facilities of neuroradiology and neuroanaesthesiology are available. This would avoid deaths in patients awaiting angiograms or surgery.

Molecular cloning and functional characterisation of a glucose transporter, CaHGT1, of Candida albicans

We have cloned the first glucose transporter CaHGT1 (Candida albicans high-affinity glucose transporter) of a pathogenic yeast, Candida albicans. The DNA sequence (GenBank accession number Y16834) analysis revealed an ORF encoding a novel protein of 545 amino acids with a predicted molecular mass of 60.67 kDa. The putative protein with 12 transmembrane domains has 51% identity with Kluyveromyces lactis high-affinity glucose transporter, HGT1. The protein signatures which are conserved and distinctive of the sugar transporters belonging to the major facilitator superfamily (MFS) were also found in CaHgt1p. When heterologously expressed, the ORF functionally complemented a mutant strain of Saccharomyces cerevisiae RE700A which was deleted in seven hexose transporter genes and thus was unable to grow or transport glucose. The expression of CaHGT1 in C. albicans showed a transcript of 1.6 kb which was enhanced in response to the human steroid hormone progesterone. Interestingly, the transcript levels were also enhanced in the presence of drugs, e.g. cycloheximide, chloramphenicol and benomyl. The results suggest that CaHGT1, which encodes a MFS protein, could be linked to the drug resistance phenomenon in C. albicans.

Piriformospora indica: a new biological hardening tool for micropropagated plants

Piriformospora indica is a novel plant growth promoting root endophyte. Regenerated plantlets of tobacco subjected to two different biological hardening techniques showed 88-94% survival when inoculated with P. indica as compared to 62% survival of uninoculated controls under similar conditions. The tendency of the plantlet to overcome the stress in terms of revival capacity was maximal in the case of P. indica as compared to the control. The fungus has the potential to render protection to the micropropagated plantlets and help them escape the 'transient transplant shock'.

Obstetric anal sphincter injury: prospective evaluation of incidence

PURPOSE

An obstetrically damaged anal sphincter is the principal cause of the development of fecal incontinence in otherwise healthy females. Reports suggest that such damage complicates as many as 35 percent of primiparous vaginal deliveries, with 13 percent of first-time mothers becoming symptomatic. In maternity units delivering 3,000 patients annually, it would follow that 390 symptomatic patients would develop new symptoms each year. This incidence of dysfunction does not reflect current clinical practice. We have investigated this discrepancy to establish the actual incidence of anal sphincter trauma associated with childbirth.

METHODS

During a six-week period, 159 females (105 primiparous and 54 para-I) were prospectively assessed postnatally using a standardized symptom questionnaire, endoanal ultrasound, and anal manometry. This group constituted 84 percent of all eligible deliveries occurring in the unit during the study period.

RESULTS

One patient developed fecal urgency after this delivery; there were no reports of fecal incontinence. Anal sphincter injuries were identified ultrasonically in 6.8 percent of primiparous patients, 12.2 percent of para-I patients having vaginal deliveries, and 83 percent of patients having forceps deliveries overall. Manometric data provided confirmatory evidence, with significantly reduced maximum squeeze pressures in patients with a disrupted anal sphincter (P<0.0005).

CONCLUSIONS

A symptom questionnaire is inadequate to identify anal sphincter injuries. The incidence of sphincter injury in relation to vaginal delivery has been overestimated in previous published work. This study demonstrates that the true incidence is 8.7 percent overall and that symptoms of sphincter dysfunction are uncommon this is in keeping with current clinical practice.

Do routinely measured delivery variables predict anal sphincter outcome?

PURPOSE

Trauma to the anal sphincter is a recognized complication of primiparous childbirth. This damage may be compounded during subsequent deliveries leading to symptoms. Earlier work is inconclusive as to which delivery variables are associated with such damage and may prove useful in predicting its occurrence, thereby allowing the potential for intervention in these later deliveries to protect the traumatized anal sphincter. The purpose of the present study was to determine whether routinely recorded obstetric variables can be correlated to anal sphincter damage in a consecutive series of females.

METHODS

A prospective study was undertaken in a single maternity unit. Patients delivering were assessed before discharge using a symptom questionnaire and endoanal ultrasound. Delivery data were collected prospectively and analyzed statistically to see if a significant difference existed in the presence of an anal sphincter defect.

RESULTS

A total of 159 patients were assessed. Endosonography revealed sphincter injuries in 8.7 percent of the normal vaginal delivery group and 83 percent of the forceps delivery group. No correlation was found between head circumference, baby weight, maternal body mass index, epidurals, episiotomy, length of each stage of labor, and duration of active pushing. Forceps delivery was the only factor to be significantly associated with sphincter trauma.

CONCLUSION

Besides forceps delivery, commonly measured delivery variables are not useful predictors of anal sphincter trauma. Normal vaginal deliveries do not warrant routine postnatal anorectal assessment, but this should be routine for all instrument deliveries.

Piriformospora indica, a cultivable plant-growth-promoting root endophyte

Piriformospora indica (Hymenomycetes, Basidiomycota) is a newly described cultivable endophyte that colonizes roots. Inoculation with the fungus and application of fungal culture filtrate promotes plant growth and biomass production. Due to its ease of culture, this fungus provides a model organism for the study of beneficial plant-microbe interactions and a new tool for improving plant production systems.

Piriformospora indica, a cultivable plant-growth-promoting root endophyte

Piriformospora indica (Hymenomycetes, Basidiomycota) is a newly described cultivable endophyte that colonizes roots. Inoculation with the fungus and application of fungal culture filtrate promotes plant growth and biomass production. Due to its ease of culture, this fungus provides a model organism for the study of beneficial plant-microbe interactions and a new tool for improving plant production systems.

Characterization of the glyceraldehyde-3-phosphate dehydrogenase gene [correction of glyceraldehyde-3-phosphate gene] and the use of its promoter for heterologous expression in Cryptococcus neoformans, a human pathogen

The GPD gene encoding glyceraldehyde-3-phosphate dehydrogenase was isolated from Cryptococcus neoformans, a heterobasidiomycetous yeast that is pathogenic to humans. The gene contains 11 introns, differing from the conserved intron positions found in the GPD genes of Basidiomycetes. The predicted amino-acid sequence of this gene is extremely similar to that reported from GPD proteins of other basidiomycetes. The promoter region of the C. neoformans GPD gene was similar to those of other basidiomycetes. Plasmid constructs containing up to 1600 base pairs upstream of the native GPD open reading frame were used to express either the native URA5 gene in a ura5 mutant or the heterologous hphI gene (a bacterial gene that confers resistance to the aminoglycoside hygromycin) in a wild-type strain of C. neoformans. Transformation frequencies resulting from the plasmid-borne Gpdp::URA5 gene were at levels similar to those of the native URA5, which suggested that all the sequences necessary for proper expression were present. Transformation frequencies using the Gpdp::hphI gene constructs were poor. However, addition of DNA sequences flanking the 3'-end of an native C. neoformans gene significantly improved the transformation frequencies resulting from the expression of the heterologous hphI gene.