Neurofibroma of kidney: an uncommon neoplasm and diagnostic dilemma with solitary fibrous tumor

Neurofibroma of kidney is an extremely rare tumor. To our knowledge, only five such cases have been reported worldwide till date. Here, we report a solitary neurofibroma of right kidney in a 54-year-old woman. Radiological investigations (ultrasonography and computed tomography) detected a solid mass in the upper pole of right kidney and clinicoradiologically renal cell carcinoma was suspected. A radical nephrectomy was performed under diagnosis of cancer. Microscopically, tumor consisted of benign spindle-shaped cells accompanied by fibrous tissue. Differential diagnoses of neurofibroma and solitary fibrous tumor (SFT) were made on morphological features. Immunohistochemically, the tumor cells were positive for S-100 protein, but negative for CD34 and CD99. Thus, a diagnosis of neurofibroma was established.

Micro-albuminuria: a predictor of 7-day mortality in acute myocardial infarction

A study was undertaken amog 80 non-diabetic patients of acute myocardial infarction (AMI) admitted within 24 hours of the onset of pain, to investigate the prevalence and significance of microalbuminuria (MA) as a predictor of in-hospital mortality, and also to correlate it with other well-established prognostic markers. Spot urinary albumin-to-creatinine ratio (ACR) was measured in first morning sample on day 1 (D1), day 4 (D4) and/or day 7 (D7). Haemodynamic status was assessed clinically by Killip's class and the ejection fraction was measured by echocardiography on D1, D4, and/or D7. Total 7 days mortality was recorded. MA (>30 microg/mg) was found in 95% of patients on 1,. In the group with higher value of MA (>100 microg/mg) on D1, there was significantly more deaths (p <0.01). Also there was significantly more deaths with static or increasing MA value from D1 to D4/D7 (p <0.01). Increasing or static MA had a positive correlation with deteriorating Killip's class in non-survivors, and also there was a correlation between decrease in left ventricular ejection fraction from D1 to D4/D7 and an increasing trend in MA over that period. Thus, MA was found to be a reliable predictor of short-term in-hospital mortality in AMI.

Synchronous multicentric giant cell tumor

Multicentric giant cell tumors represent less than 1% of all giant cell tumors of bones. We report a case of multicentric giant cell tumors around both the knee joints in a mentally and physically challenged adult male that resulted in rapidly progressive painful swelling, restricted mobility and, ultimately, fixed deformity. These tumors had typical radiological appearance and the diagnosis was confirmed on histopathology.

Mediastinal teratoma mimicking massive pleural effusion

Immature mediastinal teratoma is very rare, found in only 1% of all mediastinal teratomas. Raised serum alpha feto-protein acts as important surrogate marker for both diagnosis and follow up in such cases. Surgery and adjuvant chemotherapy are keys in the management, especially in patients older than 15 years of age. We present a 14-year-boy presenting clinico-radiologically as left sided massive pleural effusion. Raised serum marker as well as excision biopsy of the mediastinal mass following thoracotomy were indicative of a diagnosis of immature teratoma.

An enhancer-like element present in the promoter of a T-DNA gene from the Ti plasmid of Agrobacterium tumefaciens

The promoter of the 780 gene of T-right [Thomashow, M., Nutter, R., Montoya, A., Gordon, M. & Nester, E. (1980) Cell 19, 729-739] from Agrobacterium tumefaciens Ti plasmid (pTi15955) was shown to contain an upstream cis-acting element (activator) having enhancer-like properties. To characterize the properties of this promoter element, it was placed in both polarities, upstream and downstream of a Delta-37 deletion mutant of the 780 gene. The Delta-37 deletion contains the entire 780 gene with the 5' flanking sequences deleted upstream of TATA to -37. The effect of the activator on in vivo transcriptional activity was assessed by S1 nuclease mapping utilizing a homologous reference gene as an internal standard. Transcript levels from sunflower crown gall tumors were between 127% and 90% of the wild-type 780 gene depending on the polarity of the activator element when placed directly upstream to the 780 gene Delta-37 promoter. Repositioning the activator element 613 base pairs further upstream increased transcription by 2-fold regardless of polarity. However, the activator element did not promote transcription when placed in either polarity approximately 200 base pairs downstream of the poly(A) addition site. Upstream promoter fragments (TATA-distal) from the octopine synthase (ocs) and agropine synthase (ags) genes were also tested for activation of the Delta-37 construction. The ocs sequences activated transcription of the Delta-37 deletion to 14% of wild-type levels when placed upstream in the B (reverse) orientation. All other constructions with the ocs and ags sequences showed no enhancement of promoter activity.

Inherited dysfibrinogenaemia presenting with portal vein thrombosis

A 15 years old female presented with recurrent episodes of gum bleeding, easy bruisibility and recurrent soft tissue haematoma following trivial trauma since childhood. Subsequently the patient developed features of extrahepatic portal vein obstruction due to formation of thrombus. Defective fibrinogen structure due to underlying inherited dysfibrinogenaemia led to the manifestations of both bleeding due to coagulation failure and thrombosis due to failure of abnormal fibrin to get lysed.

Profile of tuberculous meningitis with or without HIV infection and the predicators of adverse outcome

OBJECTIVES

To compare the clinical, radiological and cerebrospinal fluid (CSF) findings, at hospital admission, among adult patients with tuberculous meningitis (TBM) with or without HIV infection and to identify the factors that predict adverse outcome at six months.

METHODS

A total of 82 adult patients with TBM were included (40 HIV-positive and 42 HIV-negative). Several clinical (duration of illness, Glasgow Coma Scale score, presence of high temperature, headache, cranial nerve or sphincter abnormality, seizures and endocrine dysfunction), radiological (presence of hydrocephalus, cerebral infarction and oedema, meningeal enhancement, granuloma) and cerebrospinal fluid parameters (glucose, protein, lactate, lymphocytes, neutrophils and adenosine deaminase values) were recorded along with CD4 count in the peripheral blood. Statistical analysis was performed using the chi-square test. Individual variables were evaluated as prognostic factors for adverse outcome in both groups by calculating the relative risk of association for each.

RESULTS

Temperature more than 38.33 degrees C was more common in the HIV-negative group while seizures, hydrocephalus, cerebral infarction and low CD4 count occurred significantly more commonly in the HIV-positive group. Hydrocephalus had strong association with severe neurological deficit and seizure with death in both the groups.

CONCLUSION

Several clinical and laboratory features of TBM in patients who are HIV-positive are distinctly different from those without HIV infection; some of these have an association with the probability of adverse outcome.

Pathogenic variation of Phakopsora pachyrhizi infecting soybean in Nigeria

Soybean rust, caused by Phakopsora pachyrhizi, is an important disease in Nigeria and many other soybean-producing countries worldwide. To determine the geographical distribution of soybean rust in Nigeria, soybean fields were surveyed in the Derived Savanna (DS), Northern Guinea Savanna (NGS), and Southern Guinea Savanna (SGS) agroecological zones in Nigeria between 2004 and 2006. Disease severity in each zone was determined and analyzed using geostatistics. Prevalence of infected fields and disease severity in surveyed fields were significantly (P < 0.05) different between geographical zones with both variables being higher in the DS zone than in either NGS or SGS zones. Geostatistical analysis indicated that the spatial influence of disease severity at one location on severity at other locations was between 75 and 120 km. An exponential model best described the relationship between semivariance and lag distance when rust severity was high. Spatial interpolation of rust severity showed that locations in the DS zone were more conducive for the rust epidemic compared to areas in the NGS zone. In the 2005 survey, 116 purified isolates were established in culture on detached soybean leaves. To establish the nature of pathogenic variation in P. pachyrhizi, a set of four soybean accessions with Rpp(1), Rpp(2), Rpp(3), and Rpp(4) resistance genes, two highly resistant and two highly susceptible genotypes were inoculated with single uredinial isolates. Principal component analysis on the number of uredinia per square centimeter of leaf tissue for 116 isolates indicated that an adequate summary of pathogenic variation was obtained using only four genotypes. Of these four, PI 459025B (with Rpp(4) gene) and TGx 1485-1D had the lowest and highest number of uredinia per square centimeter, respectively. Based on cluster analysis of the number of uredinia per square centimeter, seven pathotype clusters were determined. Isolates in cluster III were the most virulent, while those in cluster IV were the least virulent. Shannon's index (H) revealed a more diverse pathogen population in the DS zone (H = 1.21) compared to the rust population in SGS and NGS with H values of 1.08 and 0.91, respectively. This work will be useful in breeding and management of soybean rust by facilitating identification of resistant genotypes and targeting cultivars with specific resistance to match prevailing P. pachyrhizi pathotypes in a given geographical zone.

Prognostic factors in haemotoxic viper bite: analysis of data from a referral hospital

To identify the predictors of severe outcomes in patients with haemotoxic viper bite certain independent variables were recorded like age, sex, ethnicity, bite sites, duration of prehospital period, prehospital treatment, onset of systemic bleeding, local oedema, ecchymoses, blister, hematocrit, platelet count, whole blood clotting time, serum electrolytes, renal function and urinary examination findings in 62 hoptalised patients. Forward stepwise logistic regression was used for analysis of the independent factors predicting outcomes. Systemic bleeding was the commonest complication (45%). On multivariate analysis, alteration in coagulation parameters (like thrombocytopenia and prolonged whole blood clotting time) predisposed to systemic bleeding while local factors like bite site, faulty tourniquet application, and herbal treatment were responsible for local complications. Factors like massive envenomation and delayed hospitalisation significantly contributed to major organ damage. Predictors of death were anuria and systemic bleeding. It is concluded that several epidemiological, clinical, and laboratory features predict adverse outcomes in haemotoxic viper bite.

Micro-albuminuria: a predictor of short-term mortality in acute ischaemic stroke

We studied 89 non-diabetic patients of acute ischaemic stroke, confirmed by imaging, admitted within 24 hours of onset, to investigate the prevalence and significance of micro-albuminuria (MA) as a predictor of in-hospital mortality. Two control groups consisted of 70 patients with non-stroke chronic neurological diseases and 60 age- and sex- matched healthy individuals. Spot urinary albumin-to-creatinine ratio was measured in first morning sample on days 1, 4 and/or 7. Functional status was assessed daily for 7 days by National Institute of Health Stroke Scale (NIHSS). Outcome data were recorded for 14 days. MA was found in 61.79% of acute ischaemic stroke patients on day 1 compared to 13% in non-stroke neurological patients and 7% of healthy controls. Patients with MA were older and had a higher systolic blood pressure. The 14-day disease-specific mortality was higher in patients with MA (25.45%) compared to patients without it (5.88%). High day 1 MA (>100 microg/mg) and rising or static value from day 1 to day 4 or day 7 correlated with statistically more chance of death. Increasing MA had a positive correlation with higher NIHSS score. Thus, MA was found to be a reliable predictor of shortterm in-hospital mortality in acute ischaemic stroke.

A study on endocrine dysfunction in thalassaemia

The aim was to study the prevalence and severity of hormonal imbalance affecting growth, gonadal and thyroid function in thalassaemic patients and to find out whether any correlation exists between the degree of tissue iron-overload and several patients characteristics like age, gender, foetal haemoglobin (HbF) level, type of thalassaemia (beta or E-beta), and the presence of specific endocrine abnormality. Sixty-eight consecutive non-chelated, transfusion-dependent patients of beta and E-beta-thalassaemia with significant tissue iron overload (serum ferritin more than 2000 microg/l) were included. Standing height was noted and clinical features of hypogonadism were recorded. Insulin tolerance test was done to assess growth hormone reserve. Serum oestradiol, T3,T4,TSH were measured in fasting clotted sample, while pooled sera (from 3 consevutive morning samples) was used for testosterone, FSH and LH. Hypogonadism was the commonest abnormality, both in males (52.28%) and females (35.89%) followed by growth retardation (20.58%) and reduced growth hormone reserve (7.35%). There was no significant difference in the prevalence of endocrine dysfunction with regard to patient's age, gender, type of thalassaemia (beta or E-beta) amd HbF level. Hypogonadic females had a significantly elevated mean serum ferritin level. Subclinical hypothyroidism was present in 23.52% of patients, related to the duration of disease. No association was found between pituitarty and thyroid dysfunction.

Sickle cell hepatopathy

Sickle cell hepatopathy is a well-documented entity that ranges from the self-limiting hepatic right upper quadrant syndrome to the potentially lethal intrahepatic cholestasis and acute hepatic sequestration syndromes. We describe a 26-year-male with homozygous sickle cell disease who had this unique hepatic presentation and was documented to have characteristic findings of cholestasis, portal inflammation and sinusoidal dilatation on histopathology.

Alteration of timing of secretion of vascular endothelial growth factors is responsible for progression of diabetic retinopathy

Diabetic retinopathy is one of the most common complications in diabetes mellitus due to persistent hyperglycaemia. Various biochemical mechanisms have been suggested to cause this complication. The authors' present study which included 100 patients of type-2 diabetes mellitus with different stages of diabetic retinopathy and without retinopathy shows that initiation of diabetic retinopathy is associated with increased anaerobic glycolysis and accelerated oxidative stress. Progression of this complication is guided by increased secretion of vascular endothelial growth factors. It is our assumption that increased secretion of vascular endothelial growth factors in early part of this disease e.g. before occurrence of morphological abnormality may modify this complication.

Evaluation of Soybean Germplasm for Resistance to Soybean Rust (Phakopsora pachyrhizi) in Nigeria

Soybean rust, caused by Phakopsora pachyrhizi, is one of the most important constraints to soybean production worldwide. The absence of high levels of host resistance to the pathogen has necessitated the continued search and identification of sources of resistance. In one set of experiments, 178 soybean breeding lines from the International Institute of Tropical Agriculture were rated for rust severity in the field in 2002 and 2003 at Ile-Ife, Yandev, and Ibadan, Nigeria. Thirty-six lines with disease severity ≤3 (based on a 0-to-5 scale) were selected for a second round of evaluation in 2004 at Ibadan. In the third round of evaluation under inoculated field conditions, 11 breeding lines with disease severity ≤2 were further evaluated for rust resistance at Ibadan in 2005 and 2006. The breeding lines TGx 1835-10E, TGx 1895-50F, and TGx 1903-3F consistently had the lowest level of disease severity across years and locations. In another set of experiments, 101 accessions from the United States Department of Agriculture-Agricultural Research Service and National Agriculture Research Organization (Uganda) were evaluated in the first round in 2005 under inoculated conditions in the screenhouse; 12 accessions with disease severity ≤20% leaf area infected were selected for evaluation in the second round in 2005 and 2006 under inoculated field conditions at Ibadan. Highly significant differences (P < 0.0001) in disease severity were observed among the 101 accessions during this first round of rust evaluation. Significant (P < 0.0001) differences in rust severity and sporulation also were observed among the 12 selected accessions. Accessions PI 594538A, PI 417089A, and UG-5 had significantly (P < 0.05) lower disease severity than all other selected accessions in both years of evaluation, with rust severities ranging from 0.1 to 2.4%. These results indicate that some of the breeding lines (TGx 1835-10E, TGx 1895-50F, and TGx 1903-3F) and accessions (PI 594538A, PI 417089A, and UG-5) would be useful sources of soybean rust resistance genes for incorporation into high-yielding and adapted cultivars.

Novel Sources of Resistance to Fusarium Stalk Rot of Maize in Tropical Africa

Fusarium stalk rot is one of the most widespread and destructive diseases of maize, and deployment of resistant genotypes is one of the most effective strategies for controlling the disease. Fifty inbred lines and four checks from the breeding program of the International Institute of Tropical Agriculture were evaluated in field trials at Ikenne and Ibadan, Nigeria in 2003 and 2004 to identify new sources of resistance to stalk rot caused by Fusarium verticillioides. Evaluations were conducted under artificial inoculation and natural infection at Ibadan and Ikenne, respectively. Disease severity was recorded using a severity scale (SS) and direct estimation of stalk discoloration (SD). The two methods of disease assessment were compared and combined to classify genotypes into resistance groups using results from rank-sum analysis. In 2003, disease severity ranged from SS = 1 to 5 and SD = 1.3 to 33.8% at both locations. Both SS and SD were significantly (P < 0.01) higher in 2003 than in 2004 at the two locations. In both years, inbred lines significantly differed in SS (P < 0.02) and SD (P < 0.04) at Ibadan. Similarly, inbred lines significantly differed in SS (P < 0.04) and SD (P < 0.04) when genotypes were evaluated at Ikenne. Disease assessments based on SS and SD were significantly correlated (0.68 < r < 0.95, P < 0.01) in both years. Based on the results from rank-sum analysis, inbred lines were separated into highly resistant, resistant, moderately resistant, moderately susceptible, susceptible, and highly susceptible groups. At Ibadan, 6 (11.1%) and 8 (14.8%) were identified as highly resistant and resistant, respectively, whereas 11 (20.4%) were identified as resistant at Ikenne. Inbred lines 02C14609, 02C14643, 02C14654, and 02C14678 were consistently classified as either highly resistant or resistant to stalk rot across locations and years while the check genotypes were classified either as susceptible or moderately susceptible to stalk rot. These four inbred lines identified to have high levels of disease resistance may be used for breeding maize with resistance to Fusarium stalk rot.

Scleredema of Buschke: a rare post-streptococcal complication

A 19-year male presented with acute onset, gradually progressive symmetric indurations involving the skin over the face, neck, shoulders and upper part of chest following an upper respiratory tract infection. Detailed history and examination did not reveal evidence of Raynauds' phenomenon, nail changes, digital ulcers, pigmentation or any systemic involvement. Autoantibodies for systemic sclerosis were absent. Histopathology of skin biopsy documented scleredema. Antistreptolysin O (ASO) titer was elevated. We diagnosed a case of Scleredema adultorum of Buschke following a streptococcal throat infection. We report this case to highlight the importance of clinically differentiating this relatively benign, self-limiting disorder from systemic sclerosis.

First Report of Rust Caused by Phakopsora pachyrhizi on Soybean in Democratic Republic of Congo

Nigeria (1) and Uganda (3) are the closest countries to the Democratic Republic of Congo (DRC) where soybean rust caused by Phakopsora pachyrhizi has been reported. In February 2007, during a disease survey in DRC, soybean (Glycine max) leaves with rust symptoms (tan, angular lesions with erumpent sori exuding urediniospores) were observed in 10 fields in the following areas in Bas Congo Province: Bangu, Kimpese, Kolo-Fuma, Lukala, Mbanza-Ngungu, Mpalukide, Mvuazi, and Ntemo. Rust incidence in these fields ranged from 85 to 100%, while severity ranged between 3 and 35% of the leaf area on infected plants. Urediniospores were hyaline, minutely echinulate, and 23 to 31 × 16 to 20 μm. Within a week of collection, infected leaf samples were sent to the USDA-ARS Foreign Disease-Weed Science Research Unit (FDWSRU) for pathogen identification. DNA was extracted from sections of leaves containing sori with the Qiagen DNeasy Plant Mini kit (Valencia, CA), and all 10 field samples amplified in a real-time fluorescent PCR with the P. pachyrhizi-specific primers Ppm1 and Ppa2 (2). Infected leaves of cultivar Vuangi collected from one field each in the INERA Research Station, Kimpese-Crawford, and Kimpese-Ceco were separately washed in sterile water to collect urediniospores that were used to separately inoculate three detached leaves of susceptible cultivar TGx 1485-1D (4). Lesions on inoculated leaves developed 5 days after inoculation (DAI), and pustules (110 to 130 μm) formed 7 DAI and erupted 2 days later exuding columns of urediniospores similar in size to the initially collected isolates. Inoculation of another set of detached leaves with a spore suspension (1 × 10⁶ spores per ml) from the first set of detached leaves resulted in typical rust symptoms. Seedlings of cultivar Williams also showed typical rust symptoms when inoculated separately with urediniospores collected from nine fields (i.e., all except Kimpese-Ceco, which was infective in the detached leaf assay). Inoculation and incubation were carried out at the FDWSRU Plant Pathogen Containment Facility at Fort Detrick as described earlier (2). The PCR assay, morphological characters of the isolates, and pathogenicity tests demonstrate that P. pachyrhizi occurs in DRC. To our knowledge, this is the first report of P. pachyrhizi infecting soybean in DRC. References: (1) O. A. Akinsanmi et al. Plant Dis. 85:97, 2001. (2) R. D. Frederick et al. Phytopathology 92:217, 2002. (3) E. Kawuki et al. J. Phytopathol. 151:7, 2003. (4) M. Twizeyimana et al. Online publication. http://www.plantmanagementnetwork.org/ infocenter/topic/soybeanrust/2006/posters/41.asp. Plant Management Network, 2006.

Comparison of Field, Greenhouse, and Detached-Leaf Evaluations of Soybean Germplasm for Resistance to Phakopsora pachyrhizi

Fourteen soybean accessions and breeding lines were evaluated for resistance to soybean rust caused by the fungus Phakopsora pachyrhizi. Evaluations were conducted in replicated experiments in growth chambers using detached leaves and under greenhouse and field conditions. In growth-chamber experiments, inoculation of detached leaves with 1 × 10⁶ spores/ml resulted in a significantly (P < 0.0001) higher total number of pustules and spores per unit leaf area than inoculations with lower spore concentrations. Amending agar medium with plant hormones significantly (P < 0.0001) aided retention of green leaf color in detached leaves. Leaf pieces on a medium containing kinetin at 10 mg/liter had 5% chlorosis at 18 days after plating compared with leaf pieces on media amended with all other plant hormones, which had higher levels of chlorosis. Leaf age significantly affected number of pustules (P = 0.0146) and number of spores per pustule (P = 0.0088), and 3- to 4-week-old leaves had a higher number of pustules and number of spores per pustule compared with leaves that were either 1 to 2 or 5 to 6 weeks old. In detached-leaf and greenhouse screening, plants were evaluated for days to lesion appearance, days to pustule formation, days to pustule eruption, lesion number, lesion diameter, lesion type, number of pustules, and spores per pustule in 1-cm² leaf area. Plants also were evaluated for diseased leaf area (in greenhouse and field screening) and sporulation (in field screening) at growth stage R6. There were significant (P < 0.0001) differences among genotypes in their response to P. pachyrhizi infection in the detached-leaf, greenhouse, and field evaluations. Accessions PI 594538A, PI 417089A, and UG-5 had very low levels of disease compared with the susceptible checks and all other genotypes. Detached-leaf, greenhouse, and field results were comparable, and there were significant correlations between detached-leaf and greenhouse (absolute r = 0.79; P < 0.0001) and between detached-leaf and field resistance (absolute r = 0.83; P < 0.0001) across genotypes. The overall results show the utility of detached-leaf assay for screening soybean for rust resistance.

First Report of Soybean Rust Caused by Phakopsora pachyrhizi in Ghana

Nigeria is the only country in West Africa where soybean rust, caused by Phakopsora pachyrhizi, has been officially reported (1). During a disease survey in Ghana during October 2006, soybean (Glycine max) leaves with rust symptoms (tan, angular lesions with erumpent sori exuding urediniospores) were observed in 11 fields in the following districts: Kassena Nankana in the Upper East Region; East Gonja, Central Gonja, and Tolon-Kumbungu in the Northern Region; and Ejisu-Juabeng in the Ashanti Region. Disease incidence in these fields ranged from 50 to 100% and disease severity ranged between 3 and 40% of the leaf area on infected plants. Urediniospores were hyaline, minutely echinulate, and 23 to 31 × 14 to 18 μm. Within a week of collection, leaf samples were sent to the USDA-ARS Foreign Disease-Weed Science Research Unit for verification of pathogen identity. DNA was extracted from leaf pieces containing sori with the Qiagen DNeasy Plant Mini kit (Valencia, CA), and all 11 field samples amplified in a real-time fluorescent PCR with the P. pachyrhizi-specific primers Ppm1 and Ppa2 (2). Sequence alignment of the internal transcribed spacer (ITS) region 2 further confirmed the identification as P. pachyrhizi (2). Infected leaves from three fields were separately washed in sterile water to collect urediniospores that were used to separately inoculate three detached leaves (for each isolate) of susceptible cultivar TGx 1485-1D (3). The abaxial surface of detached leaves was sprayed with 400 μl of spore suspension (1 × 10⁶ spores per ml). A single leaf piece was placed in a 9-cm-diameter petri dish with adaxial side appressed on 1% technical agar amended with 10 μg/ml of kinetin. Lactic acid (1.5 ml/liter) and benomyl (12.5 mg/liter) were added to the agar medium to inhibit growth of saprophytic fungi and bacteria. Petri dishes were incubated at 20°C with a 12-h light/12-h dark cycle. Lesions on inoculated leaves developed 5 to 6 days after inoculation (DAI), and pustules (105 to 120 μm) formed 7 to 8 DAI and erupted 3 days later exuding columns of urediniospores similar in size to the initially collected isolates. Inoculating another set of detached leaves with a spore suspension (1 × 10⁶ spores per ml) from the first set of detached leaves resulted in typical rust symptoms. The PCR assay, alignment of ITS region 2, morphological characters of the isolates, and pathogenicity tests demonstrate that P. pachyrhizi occurs in Ghana. To our knowledge, this is the first report of P. pachyrhizi in Ghana. References: (1) O. A. Akinsanmi et al. Plant Dis. 85:97, 2001. (2) R. D. Frederick et al. Phytopathology 92:217, 2002. (3) M. Twizeyimana et al. Online publication. http://www.plantmanagementnetwork.org/ infocenter/topic/soybeanrust/2006/posters/41.asp. Plant Management Network, 2006.

Rapid Screening of Musa Species for Resistance to Black Leaf Streak Using In Vitro Plantlets in Tubes and Detached Leaves

This study investigated the utility of inoculation of in vitro plantlets in tubes and detached leaves as reliable and rapid assays for screening Musa genotypes against Mycosphaerella fijiensis, the causal agent of black leaf streak. In the first part of the study, three types of inocula were evaluated to determine suitability for in vitro inoculation. Inoculation of in vitro plantlets with mycelial fragments resulted in significantly (P < 0.05) higher levels of disease severity and faster rates of disease progress compared with inoculations using conidial suspensions. In the detached leaf assay, amending agar medium with plant hormones significantly (P < 0.0001) aided retention of green leaf color. Leaf pieces on medium containing gibberellic acid at 5 mg/liter had about 5% chlorosis at 52 days after plating. When in vitro plantlets in tubes and detached leaves of 10 Musa genotypes with different levels of disease resistance were inoculated with M. fijiensis, there were significant (P < 0.05) differences among genotypes in leaf area infected, incubation time, and symptom evolution time. For incubation time and leaf area infected, cultivars responded depending on their level of disease resistance, with resistant genotypes Calcutta-4 and PITA-17 having significantly (P = 0.001) longer incubation times and lower infected leaf areas compared with the susceptible cultivar Agbagba and moderately resistant cultivar FHIA-23. A similar pattern in cultivar response was observed for symptom evolution time. Leaf area infected was not significantly (P = 0.2817 for two-tailed t test) different when assessed using the two assays, and infected leaf areas in both assays were strongly correlated (r = 0.88, n = 48, P < 0.0001). Although incubation times were significantly (P = 0.0062 for two-tailed t test) different between the two assays, values from the two assays were strongly correlated (r = 0.69, n = 48, P < 0.0001). These results show that these two assays are rapid and space-effective, and can reliably be used for screening Musa genotypes for resistance to black leaf streak.

Evaluation of Maize Inbred Lines for Resistance to Fusarium Ear Rot and Fumonisin Accumulation in Grain in Tropical Africa

Fusarium ear rot and fumonisin contamination is a major problem facing maize growers worldwide, and host resistance is the most effective strategy to control the disease, but resistant genotypes have not been identified. In 2003, a total of 103 maize inbred lines were evaluated for Fusarium ear rot caused by Fusarium verticillioides in field trials in Ikenne and Ibadan, Nigeria. Disease was initiated from natural infection in the Ikenne trial and from artificial inoculation in the Ibadan trial. Ear rot severity ranged from 1.0 to 6.0 in both locations in 2003. Fifty-two inbred lines with disease severity ≤3 (i.e., ≤ 10% visible symptoms on ears) were selected and reevaluated in 2004 for ear rot resistance, incidence of discolored kernels, and fumonisin contamination in grain. At both locations, ear rot severity on the selected lines was significantly (P < 0.0020) higher in 2004 than in 2003. The effects of selected inbred lines on disease severity were highly significant at Ikenne (P = 0.0072) and Ibadan (P < 0.0001) in 2004. Inbred lines did not affect incidence of discolored kernels at both locations and across years except at Ikenne (P = 0.0002) in 2004. Similarly, significant effects of inbred lines on fumonisin concentration were observed only at Ikenne (P = 0.0201) in 2004. However, inbred lines 02C14585, 02C14593, 02C14603, 02C14606, 02C14624, and 02C14683 had consistently low disease severity across years and locations. Fumonisin concentration was significantly correlated with ear rot only at Ikenne (R = 0.42, P < 0.0001). Correlation between fumonisin concentration and incidence of discolored kernels was also significant at Ikenne (R = 0.39, P < 0.0001) and Ibadan (R = 0.35, P = 0.0007). At both locations, no significant inbred × year interaction was observed for fumonisin concentration. Five inbred lines, namely 02C14585, 02C14603, 02C14606, 02C14624, and 02C14683, consistently had the lowest fumonisin concentration in both trials. Two of these inbred lines, 02C14624 and 02C14585, had fumonisin levels <5.0 μg/g across years in trials where disease was initiated from both natural infection and artificial inoculation. These lines that had consistently low disease severity are useful for breeding programs to develop fumonisin resistant lines.

Primary amyloidosis presenting as intrahepatic cholestasis

Hepatic involvement in primary amyloidosis is not rare but is often clinically silent. A mild elevation of the serum alkaline phosphatase level and hepatomegaly are the most common findings. We report a case of primary amyloidosis in an adult male presenting with intrahepatic cholestasis where viral, drug, alcohol, and autoimmune etiologies were all excluded and the definite diagnosis was established by liver biopsy with Congo red staining. Subsequently the patient was found to have monoclonal light chain disorder.

Observations of hepatic encephalopathy profile in a tertiary care centre

A study was conducted among 67 patients presenting with hepatic encephalopathy to establish the aetiological diagnosis and record the incidence of acute and chronic liver diseases. They all had undergone thorough clinical and laboratory evaluation. The factor precipitating encephalopathy was also identified. Among 67 patients 19 (28.4%) had acute liver disease and 48 (71.6%) had chronic liver disease. Majority of patients had grade 2 encephalopathy at presentation. Among the acute cases most common aetiology was acute viral hepatitis due to hepatitis B and E viruses whereas alcoholic liver disease was the most frequent cause of chronic liver disease. The most common precipitating factor was gastro-intestinal haemorrhage.

Microscopic dynamics of recovery in sheared depletion gels

We report x-ray photon correlation spectroscopy and diffusing wave spectroscopy studies of depletion gels formed from nanoscale silica colloids in solutions of nonabsorbing polymer following the cessation of shear. The two techniques provide a quantitatively coherent picture of the dynamics as ballistic or convective motion of colloidal clusters whose internal motion is arrested. While the dynamics possesses features characteristic of nonergodic soft solids, including a relaxation time that grows linearly with the time since shear, comparison with behavior of quenched supercooled liquids indicates that this evolution is not directly related to traditional aging phenomena in glasses.

Correlation of lipid profile and carotid artery plaque as detected by Doppler ultrasound in ischaemic stroke patients--A hospital-based study

Stroke is one of the leading causes of morbidity and mortality all over the world. Carotid plaque formation and intima media thickness can be a predictor of ischaemic stroke. In this regard studies from our country, are few and far between. This is a small hospital-based study to look in to this matter. We have assessed the intima media thickness of the common carotid as well as the internal and external carotid arteries by the ultrasound method. The lipid profiles were estimated and correlated with the intima media thickness. Results indicate that in the common as well as in the internal and external carotid arteries, the intima media thickness is a good predictor of ischaemic stroke. This thickness is also well correlated with the lipid levels in blood. Hence this non-invasive method can be used successfully to identify the high risk patients, prone to develop stroke.

Isolated massive thyroid metastasis in lung cancer

Metastasis to the thyroid gland is rare despite its rich vascular supply. Among the pulmonary malignancies metastasising to the thyroid, adenocarcinomas are the commonest. The appearance of metastatic disease in lung carcinoma indicates a poor prognosis and the average survival is two months. We report a 62-year-old woman with squamous cell carcinoma of lung metastatic to the thyroid that produced massive enlargement of the gland. The appearance of the secondary preceded the diagnosis of the primary malignancy by a few months. Ultimately, the patient succumbed to her disease.

Study of biochemical parameters of ascitic fluid in exudative ascites with special reference to tuberculous peritonitis

In an attempt to differentiate between three important but clinically similar conditions of exudative ascites like tuberculous peritonitis, spontaneous bacterial peritonitis (SBP) and malignant ascites, we evaluated the biochemical parameters of ascitic fluid as a diagnostic aid. The serum ascitic albumin gradient (SAAG), lactate dehydrogenase (LDH), pH, adenosine deaminase(ADA), carcino-embryonic antigen (CEA) and carbohydrate antigen (CA-125) levels were measured in 36 patients with tuberculous peritonitis, 30 patients with SBP and 30 patients with ascites due to malignant disorders. The LDH level was significantly lower in tuberculous peritonitis patients than in malignant and SBP groups. A value of < 110 U/l gave the assay a sensitivity of 94% and a specificity of 93%, positive predictive value of 89% and negative predictive value of 96% for tuberculous peritonitis. The ADA activity was significantly higher in tuberculous peritonitis group than in the other two groups. A cut off value > 33 U/l gave the ADA test a sensitivity of 89%, specificity of 100%, positive predictive value of 100 % and a negative predictive value of 94% for tuberculosis. A pH value of <7.26 with high SAAG (>11 g/l) predicted SBP with reasonable accuracy. Elevated ascitic fluid CEA (>2 ng/ml) and CA - 125(> 35 U/l) was found exclusively in cases of malignant ascites with a single case of tuberculous peritonitis showing CA-125 value > 35 U/l. All these tests are rapid, non-invasive, and easily reproducible and offer good predictive accuracy which is comparable to that of more invasive procedures like peritoneoscopy and biopsy.

Risk factor analysis in ischaemic stroke: a hospital-based study

Stroke represents a major health burden in our country. Ischaemic stroke has got several risk factors associated with increased chance of atherosclerosis. A small hospital-based study was done to look into the risk factors associated with ischaemic stroke. Forty patients with CT-confirmed cerebral infarction were taken for the study and detailed history and clinical findings were obtained. Investigations like complete haemogram, fasting blood glucose, urea, creatinine, lipid profile, serum Lp(a), homocysteine, fibrinogen, ECG, chest x-ray, echocardiography, MRI/MRA where indicated, were done to identify the risk factors as well. Results indicated that hypertension was the most prevalent (87.5%) risk factor followed by ischaemic heart disease (35%) and diabetes. Dyslipidaemia was also found in a significant number of cases, mostly elevated LDL, low HDL and elevated Lp(a). Fibrinogen and homocysteine were of less significance.

Effects of Wetness Duration and Grain Development Stages on Sorghum Grain Mold Infection

Grain mold caused by a complex of fungi is an economically important disease of sorghum worldwide. Little is known about the epidemiology of sorghum grain mold, which is essential for its management. Studies were conducted to quantify the effects of wetness duration on grain mold development under controlled conditions at ICRISAT. Six major sorghum grain mold fungi determined from previous field experiments, Curvularia lunata, Cladosporium oxysporum, Bipolaris australiensis, Fusarium moniliforme, F. pallidoroseum, and Phoma sorghina, were used. Panicles of a pot-grown mold-susceptible sorghum line, IS 10513, were spray inoculated with each fungus at five growth stages: flowering (F), milk (M), soft dough (S), hard dough (H), and physiological maturity (P), and were incubated in dew chambers for 0, 16, 24, 40, 48, and 72 h. Then, the plants were placed on greenhouse benches at 25 ± 1°C to allow grain mold infection to develop. Eight days after treatments, grains from F, M, and S stages were plated onto potato dextrose agar, while those from H and P stages were incubated in blotter paper humid chambers at 28 ± 1°C. Fungal colonization of grains were scored after 7 days. Results indicated a significant (P < 0.01) correlation between wetness duration and grain mold development at different stages of inoculation. Generally, with increasing wetness duration, there was an increase in grain infection by all six fungi. However, infection frequency varied among fungi and grain development stages, indicating that individual fungi might have different windows for maximum infection during the grain development stages.

Evolution of particle-scale dynamics in an aging clay suspension

Multispeckle x-ray photon correlation spectroscopy was employed to characterize the slow dynamics of a suspension of highly charged, nanometer-sized disks. At wave vectors q corresponding to interparticle length scales, the dynamic structure factor follows a form f(q,t) approximately exp([-(t/tau)(beta)], where beta approximately 1.5. The relaxation time tau increases with the sample age t(a) approximately as tau approximately t(1.8)(a) and decreases with q as tau approximately q(-1). Such behavior is consistent with models that describe the dynamics in disordered elastic media in terms of strain from random, local structural rearrangements. The measured amplitude of f(q,t) varies with q in a manner that implies caged particle motion. The decrease in the range of this motion and an increase in suspension conductivity with increasing t(a) indicate a growth in interparticle repulsion as the mechanism for internal stress development implied by these models.

Insulin in type 2 diabetes: promises to keep

The concept which has evolved in the management of type 2 diabetes mellitus is early insulin therapy. In type 2 diabetes mellitus first phase insulin response is grossly impaired on eventually absent, overburdening phase 2 responses which obviously fail to compensate in the long run. Perpetuation of the age old practice to continue OHA while almost all beta-cells are exhausted is only buying time for starting insulin. Preservation of beta-cell function by early insulin therapy yields two important benefits: (1) Better glycaemic control at lower medication dose and (2) relative freedom from hypoglycaemia because of well preserved glucagon response. To ensure and to translate the proper action of insulin in the target organs we are now talking about designer insulins which are basically insulin analogues (short and long acting). So type 2 diabetes is a growing menace and is responsible for severe morbidity, mortality and poor quality of life. Good glycaemic control from the very beginning of diabetes has shown to favourably influence all of these and is accepted as a cardinal goal of proper diabetes care.

Glycaemic consequences of HIV and highly active antiretroviral therapy: a pilot study and review of literature

The metabolic consequences of HIV and AIDS are accentuated in the setting of highly active antiretroviral therapy. Peripheral lipodystrophy, central adiposity, hyperlipidaemia, insulin resistance and diabetes mellitus are frequent associations of protease inhibitor containing highly active antiretroviral therapy regimens. Ninety patients aged 25-50 years (males 52, females 38), seropositive for HIV 1 and 2 or both were selected to see the glycaemic profiles in asymptomatic early HIV disease with CD4 counts > 100/microl and to compare this with the glycaemic profile of (a) advanced HIV disease (CD4 counts < 200/microl), not on highly active antiretroviral therapy and (b) advanced HIV disease (CD4 counts < 200/microl), on uninterrupted non-protease inhibitor highly active antiretroviral therapy > 6 months. All the patients were grouped into 3: (1) Group A: CD4 counts > 500/microl (n=37), highly active antiretroviral therapy naive, (2) group B: CD4 counts < 200/microl (n=21), not on highly active antiretroviral therapy, and (3) group C: CD4 counts < 200/microl, receiving uninterrupted non-protease inhibitor based highly active antiretroviral therapy for > 6 months (n=32). The fasting blood glucose, glycosylated Hb (HbA1c) levels, were measured in all the patients in 3 groups and significance of difference between means was calculated among various groups. Body weight and waist-hip ratio were also measured. The results were analysed and compared with other studies.

Adult polycystic liver disease presenting as portal hypertension

Autosomal dominant polycystic liver disease is a systemic hereditary disorder associated with cyst formation in the ductal organs such as the kidney and liver. Multiple massive cysts are typically found in multiparous women. Portal hypertension as a presenting manifestation is very rare but may be caused by associated hepatic fibrosis or massive hepatic replacement of liver by the cysts. Two cases of adult polycystic liver disease, one in uniparous female and another in a 45-year-old male, both presenting with portal hypertension and without any demonstrable fibrosis in the liver, are reported here.

Intestinal neuronal disorders--a study of seven cases

Intestinal neuronal dysplasia (IND) has been reported as an innervation disorder that can present as isolated disease or may be associated with Hirschsprung's disease (HD). The interest in this disorder is growing as it mimics HD at clinical level but can be managed with a more conservative approach if an accurate diagnosis can be made. Many workers have tried to set up diagnostic criteria of this condition. But the importance of one criterion varied from one study to another. In our study we analysed seven cases of suspected innervation disorder that had undergone resection. A detailed histological study on these cases was performed and four of them were found to fulfill the diagnostic criteria of IND laid down by Kobayashi and his co-workers. These patients had hyperganglionosis, giant ganglia and ectopic ganglion cells in the lamina propria. In the other three cases some features were highly suggestive of the diagnosis of the IND and can be considered to be so if we follow other workers who have not given much importance to the simultaneous presence of all three criteria in a single case.

Pattern Analysis of Sorghum Genotype × Environment Interaction for Leaf, Panicle, and Grain Anthracnose in Mali

Resistance to anthracnose, caused by Colletotrichum graminicola, in sorghum was identified through field screening at two locations (Samanko and Longorola) in Mali. The occurrence and progress of anthracnose were monitored on 19 sorghum lines plus resistant and susceptible checks in the 1996 to 1998 rainy seasons. Foliar anthracnose severity was assessed at regular intervals throughout the season. Area under the disease progress curve (AUDPC) was calculated for each genotype. Anthracnose severity was also evaluated on the peduncle, rachis and glumes, panicle, and grain. For the characters under study, the site × year and site × year × line interactions accounted for the genotype × environment interactions. Pattern analysis was applied to the environment-standardized matrix of genotype × environment means to analyze these interactions and elucidate genotypic adaptation. None of the lines was completely (hypersensitive) resistant to the disease, but 12 showed high levels of stable resistance to both foliar and panicle anthracnose. Only one was moderately susceptible to both forms of the disease. In addition to identifying varieties that can be grown in zones to which they are adapted, additional genotypes were identified that can serve as sources of resistance in regional breeding programs.

Adrenal steroids act as inhibitory modulators of thyrofollicular cell morphology and proliferation in neonatal chicks (Gallus domesticus)

In the present study the effects of adrenal corticoids, both natural and synthetic, namely cortisol and dexamethasone respectively, was observed on the thyroid gland cell morphology and proliferation in neonatal male chicks (Gallus domesticus). Cortisol was injected at a dose of 4 mg/100 g body weight and dexamethasone at a dose of 1 mg/100 g b.w. subcutaneously daily for fifteen consecutive days. The control birds were similarly injected with normal saline at a daily dose of 0.2 ml per bird for the same time period. The results indicated that both cortisol and dexamethasone caused a significant decrease in thyrofollicular cell height. On the contrary, a significant increase in the ratio of the follicular diameter to the number of nuclei per follicle i.e. D/N value was observed in both cortisol and dexamethasone treated chicks. It was also observed that both cortisol and dexamethasone induced suppression of mitotic activity, as evidenced from a significant decrease in mitotic percentage compared with the control chicks. The present authors' studies thus indicate that adrenal corticoids act as inhibitory modulators of thyroid follicular activity as regards karyomorphology and cell proliferation.

Identification and characterization of satellite III subfamilies to the acrocentric chromosomes

The centromeres and the short arms of the five pairs of acrocentric chromosomes in humans are composed of tandemly ordered repetitive DNA. Previous studies have suggested that the exchanges between acrocentric chromosomes have resulted in concerted evolution of different DNA sequences in their short arms. The acrocentric chromosomes are clinically relevant since they are involved in Robertsonian translocation formation and non-disjunction resulting in aneuploidy. Here we have identified seven new satellite III repetitive DNA subfamilies, determined their nucleotide sequences and established their chromosomal distributions on the short arms of the acrocentric chromosomes. Knowledge of these related sequences may help to elucidate the molecular basis of Robertsonian translocation formation.

Satellite III sequences on 14p and their relevance to Robertsonian translocation formation

Robertsonian translocations (ROBs) are the most common rearrangements in humans, contributing significantly to genetic imbalance, fetal wastage, mental retardation and birth defects. Rob(14q21q) and rob(13q14q), which are formed predominantly during female meiosis, comprise the majority (approximately 85%) of all ROBs. Previous studies have shown that the breakpoints are consistently located within specific regions of the proximal short arms of chromosomes 13, 14, and 21. The high prevalence of these translocations, the consistent breakpoints found, and the fact that roughly 50% of cases occur sporadically suggest that the sequences at or near the breakpoints confer susceptibility to chromosome rearrangement and that the rearrangements occur through a specific mechanism. To investigate this hypothesis, we developed hamster-human somatic cell hybrids derived from de novo rob(14q21q) patients that contained the translocated chromosome segregated from the other acrocentric chromosomes. We determined the physical order of five satellite III subfamilies on 14p, and investigated their involvement in formation of these de novo translocations.