Clinical characteristics of patients with tuberculosis-destroyed lung

SETTING

Multicentre study.

OBJECTIVE

To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB.

DESIGN

We reviewed patients with TB-destroyed lung between May 2005 and June 2011.

RESULTS

A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1).

CONCLUSION

Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.

First Confirmed Report of Powdery Mildew Caused by Podosphaera xanthii on Farfugium japonicum in Korea

Farfugium japonicum (L.) Kitam., known as Japanese silver leaf, is native to Japan, Korea, and Taiwan. It is grown as an ornamental plant for garden plantings and containers not only in East Asia but more recently also in Europe and North America. Since 2003, powdery mildew infections of F. japonicum 'Gigantea' have been consistently found in the southern part of Korea, including the districts of Jeju, Seogwipo, Busan, Wando, and Ulleungdo. Specimens have been deposited in the Korea University Herbarium (KUS). Signs of powdery mildew first appeared as circular to irregular white patches on both sides of the leaves. The infections were usually severe on young leaves and caused malformation and browning. Appressoria on the mycelium were nipple-shaped or nearly absent. Conidiophores, measuring 160 to 280 × 10 to 12.5 μm, were simple and produced 2 to 12 immature conidia in chains, followed by 2 to 3 cells. Foot-cells in conidiophores were relatively short, 50 to 95 μm long, and constricted at the base. Conidia were hyaline, ellipsoid to ovate, 32 to 48 × 17.5 to 25 μm (length/width ratio = 1.4 to 2.3), had distinct fibrosin bodies, and produced germ tubes on the lateral position. No chasmothecia were observed. The morphology and dimentions of reproductive structures were compatible with those of Podosphaera xanthii (Castagne) U. Braun & Shishkoff (1). To confirm the identity of the causal fungus, the complete ITS region of rDNA from isolate KUS-F26469 was amplified with primers ITS5 and P3 (4) and directly sequenced. The resulting sequence of 475 bp was deposited in GenBank (Accession No. KC155426). A GenBank BLAST search of this sequence revealed 100% identity (475/475 bp) with those of many P. fusca isolates on plants in the Aster family plants including Calendula officinalis, Euryops pectinatus, Syneilesis palmata, and F. japonicum from Japan (e.g., AB040346). The P. fusca isolates listed above are now placed in P. xanthii (1). Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of three healthy potted plants of the same cultivar. Three non-inoculated plants served as controls. Plants were maintained in a greenhouse at 25 ± 2°C. Inoculated plants developed typical signs and symptoms of powdery mildew after 8 days, whereas the control plants remained symptomless. The fungus present on the inoculated leaves was morphologically identical to that originally observed on diseased plants. Powdery mildew infections of F. japonicum caused by P. fusca (syn. P. fuliginea) have been reported previously in both Japan and Korea (2). In Korea, it was listed simply as a host fungus of Ampelomyces quisqualis, which is hyperparasitic to powdery midlews, without any data on its identity (3). To our knowledge, this is the first confirmed report of powdery mildew caused by P. xanthii on F. japonicum in Korea. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No.11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, ARS, USDA, Retrieved November 14, 2012. (3) M. J. Park et al. Fungal Biol. 114:235, 2010. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

Hidden decay of impact after education for self-management of chronic illnesses: hypotheses

People with chronic illnesses can benefit from self-management education. However, those benefits are said to decay over time (there is some evidence that this 'decay of impact' does occur), and the reinforcements used to prevent that decay appear to be ineffective. We hypothesize that the reinforcements appear to be ineffective because decay of impact occurs only in a subgroup of these programs' participants, so any benefits of reinforcements in that subgroup are concealed by whole-group summary statistics. We also hypothesize that reinforcements can benefit those who need them - those who would otherwise have decay. One approach to testing these hypotheses requires analysis of individual-level data, which is uncommon in this field. Some useful data could come from studies that have already been completed, but the strongest evidence will require prospectively designed tests in future trials. If the hypotheses are false, then time and resources spent on reinforcements can be saved or redirected. If the hypotheses are true, then reinforcements can be implemented with less waste and they can be made more effective. These programs can also be improved to better fit their users' needs, and there can be a new basis for evaluating the programs' effectiveness.

First Report of Black Stem Caused by Botryosporium longibrachiatum on Sweet Basil in Korea

Sweet basil, Ocimum basilicum L., is cultivated mainly for fresh consumption in Korea. In March 2009, in Icheon, Korea, several dozen plants showing symptoms of black stems were found in an organic farm that used polyethylene tunnels for production. The black stems were usually covered with a fungus that gave the appearance of hoar-frost on the stems, especially when plants were grown under a cool and humid environment. According to the farmer, black stems appear during the winter season of November to March when the tunnels were mostly closed. The relative humidity (RH) during that period was around 100% every night due to poor ventilation. Beginning the middle of April when both sides of the tunnels were open, providing good ventilation, no further disease development was observed. The fungus on the stems had an elongate, upright conidiophore, reaching 5 mm in length. At intervals along its length, the main axis of conidiophores produced lateral fertile branches in acropetal succession. Each lateral branch terminated in a cluster of four or five ampullae. Conidia were hyaline, oval, and 5.5 to 9.5 × 3.5 to 6 μm. The fungus was non-pigmented and colonies on potato dextrose agar were chalk white. Morphological and cultural characteristics of the fungus were consistent with the previous reports of Botryosporium longibrachiatum (Oudem.) Maire (3,4). Voucher specimens (n = 4) were housed at Korea University Herbarium (KUS). An isolate from KUS-F24010 was deposited in the Korean Agricultural Culture Collection (Accession No. KACC44849) and used for molecular analysis and pathogenicity tests. The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 and sequenced. The resulting sequence of 592 bp was deposited in GenBank (Accession No. JX666334). A BLAST search in GenBank showed that there was no comparable sequence of B. longibrachiatum and thus this was the first ITS sequence for the species submitted in GenBank. To confirm the pathogenicity, colonized mycelial plugs (3 mm in diameter) from 10-day-old PDA cultures were placed onto the stem apices (n = 10) of 2-month-old sweet basil pot plants, which were topped as normally harvested. Control plants were inoculated with uncolonized agar plugs. All plants were incubated at 22 ± 2°C in a humidified chamber with a 12-h photoperiod for 48 h, and then maintained in a greenhouse (22 ± 2°C). Three to four days after inoculation, necrotic lesions developed around the points of inoculation on all stems and expanded downwards, leading to black stems covered with the hoar-frost like fungus after 14 days. B. longibrachiatum was successfully reisolated from all inoculated stems, while control plants remained symptomless. The pathogenicity test was conducted twice with the same result. The association of B. longibrachiatum and sweet basil was previously reported (4). Several other plants including burley tobacco are also reported to be infected by this fungus (1,2). To our knowledge, this is the first etiological report of B. longibrachiatum on sweet basil globally as well as in Korea. References: (1) T. R. Anderson. Plant Dis. 67:1158, 1983. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Systematic Mycology & Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , September 7, 2012. (3) C. V. Subramanian. Hyphomycetes. Indian Council of Agricultural Research, New Delhi, India, 1971. (4) H. T. Tribe and R. W. S. Weber. Mycologist 15:158, 2001.

Surgical release of elbow stiffness after internal fixation of intercondylar fracture of the distal humerus

BACKGROUND

Loss of motion is common after intercondylar fracture of the distal humerus despite proper management. The purpose of the current study was to report the results of contracture release for stiffness that developed after open reduction and internal fixation (ORIF) of distal humeral intercondylar fractures.

METHODS

Twenty-four consecutive patients with a stiff elbow after ORIF of intercondylar fractures (20 AO type C2 and 4 type C3 fractures) were managed with contracture release at a median of 13 months. The surgical indication was total arc of motion of less than 100° despite physical therapy for more than 6 months. Plates and screws for ORIF were removed concomitantly in 16 patients. Each patient was evaluated by final arc of motion and Mayo Elbow Performance Score (MEPS).

RESULTS

The main lesions causing stiffness were heterotopic ossification or excessive callus in 13 patients and capsular fibrosis in 11. The mean total range of motion (ROM) was improved from 60.2° preoperatively to 104.8° postoperatively. At the final follow-up, 17 of the 24 elbows (71.8%) obtained a total ROM of more than 100°. The mean MEPS improved from 69 points preoperatively to 87 points at the final follow-up (P < .05). Refracture occurred during ROM exercise in 4 patients who had undergone concomitant implant removal during the contracture release.

CONCLUSION

Surgical release of a stiff elbow that develops after ORIF of intercondylar fractures can result in satisfactory restoration of ROM in most patients. However, potential risk of refracture after release should be considered when implants are concomitantly removed.

Spatial analysis for identifying hotspots of EDC and PPCP sources for monitoring systems

This study utilized spatial analysis to identify hotspots for endocrine disrupting chemicals (EDCs), pharmaceuticals, and personal care products (PPCPs) using data from potential sources including wastewater treatment plants, National Pollutant Discharge Elimination System (NPDES)-permitted pollution sources, septic systems, and agricultural and grazing areas. The study area is Lake Mead, to which the return of treated effluent is one of the largest water reuse practices in the USA. Based on Getis-Ord's Gi* statistic, clusters of pollution sources were identified based on the values of each feature and its neighboring features. Spatial analysis was applied to evaluate the impact from point and nonpoint source pollution. The results of spatial statistical analyses were used to evaluate the existing sampling locations in Las Vegas Wash. The results indicated that sampling locations with highest concentrations of EDCs/PPCPs were close to the outlets of subbasins with high susceptibility to EDCs/PPCPs, which confirms the suitability of sampling locations.

Preliminary study of online machine translation use of nursing literature: quality evaluation and perceived usability

Background

Japanese nurses are increasingly required to read published international research in clinical, educational, and research settings. Language barriers are a significant obstacle, and online machine translation (MT) is a tool that can be used to address this issue. We examined the quality of Google Translate® (English to Japanese and Korean to Japanese), which is a representative online MT, using a previously verified evaluation method. We also examined the perceived usability and current use of online MT among Japanese nurses.

Findings

Randomly selected nursing abstracts were translated and then evaluated for intelligibility and usability by 28 participants, including assistants and research associates from nursing universities throughout Japan. They answered a questionnaire about their online MT use. From simple comparison of mean scores between two language pairs, translation quality was significantly better, with respect to both intelligibility and usability, for Korean-Japanese than for English-Japanese. Most respondents perceived a language barrier. Online MT had been used by 61% of the respondents and was perceived as not useful enough.

Conclusion

Nursing articles translated from Korean into Japanese by an online MT system could be read at an acceptable level of comprehension, but the same could not be said for English-Japanese translations. Respondents with experience using online MT used it largely to grasp the overall meanings of the original text. Enrichment in technical terms appeared to be the key to better usability. Users will be better able to use MT outputs if they improve their foreign language proficiency as much as possible. Further research is being conducted with a larger sample size and detailed analysis.

Scaphotrapeziotrapezoid arthrodesis and lunate excision for advanced Kienböck disease

PURPOSE

To analyze the outcomes of lunate excision combined with scaphotrapeziotrapezoid arthrodesis for the treatment of advanced Kienböck disease.

METHODS

Sixteen patients with Lichtman stage IIIB Kienböck disease were treated with scaphotrapeziotrapezoid arthrodesis and lunate excision and were followed for a mean of 67 months (range, 49 to 108 mo). The indications for lunate excision included pain and limited motion associated with a collapsed lunate. Clinical evaluation included range of motion, grip strength, and modified Mayo wrist score. Based on plain radiographs, the carpal height ratio, ulnar carpal distance ratio, scaphoid translation ratio, and radioscaphoid angle were measured and any presence of degenerative changes was assessed. To investigate the effects of lunate excision on the radiologic results, we compared 12 patients with stage IIIB Kienböck disease who had only scaphotrapeziotrapezoid arthrodesis as the control group.

RESULTS

Range of motion tended to be preserved, with a trend toward an increase in extension after surgery. Grip strength and modified Mayo score improved significantly. Fourteen patients with lunate excision demonstrated radiographic ulnar translation of the scaphoid beyond the scapholunate ridge, and radioscaphoid arthritis was observed in 4 patients. Compared to initial postoperative radiographs, the scaphoid translation ratio was significantly decreased, but neither ulnar carpal distance ratio nor radioscaphoid angle showed significant differences. In the control group, neither ulnar translation of the scaphoid nor significant changes of radiologic parameters was found between initial postoperative and final radiographs.

CONCLUSIONS

Scaphotrapeziotrapezoid arthrodesis with lunate excision for advanced Kienböck disease provided favorable clinical results in terms of pain relief and functional improvement. With the absence of the lunate, however, the scaphoid had a tendency to shift toward the lunate fossa. This study suggests the risk of early development of radioscaphoid arthritis as a negative effect of lunate excision.

First Report of Leaf Blight Caused by Phomopsis ipomoeae-batatas on Sweet Potato in Korea

Ipomoea batatas (L.) Lam., belonging to the Convolvulaceae, is widely cultivated and used as an industrial resource as well as for food and feed worldwide (2). In September 2010, an unknown leaf blight was observed on leaves in Hoengseong County and Jecheon City in Korea. Symptoms were mostly observed in older leaves as cream to tan-brown lesions surrounded by purplish brown-to-dark brown margin. Each lesion was circular to irregular, not exceeding 10 mm, but coalesced to form larger lesions. Necrotic tissue fell out giving rise to shot-holes. A number of black pycnidia were present in the lesions of diseased leaves. The same symptoms were observed at several localities in Korea during 2010 and 2011 seasons. The voucher specimens (n = 5) were preserved in the Korea University Herbarium (KUS). Two isolates were obtained from the two samples (KUS-F25274 and KUS-F25361) and deposited in the Korean Agricultural Culture Collection (Accession Nos. KACC45680 and KACC45702). Pycnidia were amphigenous, but mostly epigenous, scattered, dark brown-to-rusty brown, globose, embedded in host tissue or partly erumpent, 110 to 170 μm in diameter, and with an ostiole of 25 to 40 μm in diameter. Alpha conidia were aseptate, lageniform, biguttulate, hyaline, and 5.5 to 8.0 × 3.5 to 4.5 μm. Beta conidia were absent. Based on the morphological characteristics, the fungus was consistent with Phomopsis ipomoeae-batatas Punith. (1,3). Preliminary identification of the fungal isolate was confirmed by molecular data. Genomic DNA was extracted from the two isolates. The D1/D2 region of 28S rDNA was amplified using the primers LROR and LR7, and sequenced. The resulting sequences of the two isolates were identical to each other, and were deposited in GenBank (Accession Nos. JX157848 and JX157849). A BLAST search showed that there was no matching sequence of P. ipomoeae-batatas. Therefore, these were the first 28S sequences for the species submitted to GenBank. The present sequences showed >98% similarity with 24 entries of Phomopsis spp. and Diaporthe spp. (teleomorph of Phomopsis spp.), indicating their close phylogenetic relationship. Pathogenicity was tested by spraying leaves of three potted plants with a conidial suspension (2 × 10⁶ conidia/ml), which was harvested from a 3-week-old culture on potato dextrose agar. Control leaves were sprayed with sterile water. The plants were placed in a dew chamber at 24°C in darkness and continuous dew for the first 24 h and then moved to a greenhouse bench. After 10 days, leaf blight symptoms that were identical to those observed in the field started to develop on the leaves inoculated with the fungus. No symptoms were observed on control plants. P. ipomoeae-batatas was reisolated from the lesions of inoculated plants, confirming Koch's postulates. Occurrence of leaf blight caused by P. ipomoeae-batatas on sweet potato has been reported in many countries (1,3). To our knowledge, this is the first report of the disease in Korea. The economic losses are of minor importance, because the disease is mostly present toward the end of growing season; however, attention must be paid considering that the pathogen may reduce the quality of vines used as fodder. References: (1) C. A. Clark and J. W. Moyer. Compendium of Sweet Potato Diseases. The American Phytopathological Society. St. Paul, MN, 1988. (2) I. G. Mok et al. J. Plant Biotechnol. 36:202, 2009. (3) E. Punithalingam. Phomopsis ipomoeae-batatas. IMI Descriptions of Fungi and Bacteria. Sheet 739, 1982.

First Report of Powdery Mildew Caused by Erysiphe sedi on Kalanchoe blossfeldiana in Korea

Kalanchoe blossfeldiana Poelln., belonging to the Crassulaceae, is a common ornamental houseplant with many cultivars. In May 2010, powdery mildew was observed on about 50% of 3,000 potted kalanchoe 'Rose Queen' plants in plastic greenhouses located in Yongin city of central Korea. Farmers producing potted kalanchoes in Yongin region stated that powdery mildew on kalanchoes was mild without causing problems for the last several years. The disease became severe from April 2010 and caused economic losses. The economic and esthetic value was reduced by the unsightly appearance of infected plants with most being unmarketable. Damage due to powdery mildew infections on kalanchoes appeared every year. A representative specimen was deposited in the Korea University herbarium (Accession No. KUS-F24911). Mycelial colonies were white, conspicuous and epiphytic on leaves and stems. Hyphae were septate, branched, and 3 to 6 μm wide. Appressoria on the hyphae were well developed, lobed, and mostly positioned in pairs. Conidiophores were cylindrical, 70 to 145 × 7 to 11.5 μm, and composed of three to four cells. Foot-cells of conidiophores were straight, cylindrical, and 28 to 48 μm long. Conidia produced singly were variable in shape, oval to cylindrical, oval or oblong-elliptical, 30 to 55 × 14 to 24 μm, lacked distinct fibrosin bodies, and showed angular/rectangular wrinkling of outer walls. Germ tubes were produced on the perihilar position of conidia. No chasmothecia were found. The morphological characteristics were consistent with descriptions of Erysiphe sedi U. Braun (1). To confirm the identity of the causal fungus, the complete ITS region of rDNA from KUS-F24911 was amplified with primers ITS5 and P3 as described by Takamatsu et al. (4) and directly sequenced. The resulting sequence was deposited in GenBank (Accession No. JX173288). A GenBank BLAST search using the present data revealed that the ITS sequence shares 100% (552/552 bp) similarity with those of E. sedi on Sedum spp. (Accession Nos. JX173289, JX173290). Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of five healthy potted kalanchoe plants. Five non-inoculated plants served as controls. Plants were maintained in a greenhouse at 22 ± 2°C. Inoculated plants developed signs and symptoms after 7 days, whereas the control plants remained symptomless. The fungus present on the inoculated plants was morphologically identical to that originally observed on diseased plants, fulfilling Koch's postulates. E. sedi is also known to infect Kalanchoe pinnata (Lam.) Pers. (= Bryophyllum calycinum Salisb.) in Romania (1,2) and other crassulaceous plants including Sedum spectabile in North America (3). To our knowledge, this is the first report of E. sedi infections of K. blossfeldiana in Korea. This disease seems to be a serious threat to the commercial production of kalanchoe plants which are cultivated under plastic greenhouses of poor ventilation and low light levels in Korea. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases, Systematic Mycology & Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , June 13, 2012. (3) L. Kiss and M. L. Daughtrey. Plant Dis. 85:1207, 2001. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

First Report of Powdery Mildew Caused by Erysiphe macleayae on Macleaya microcarpa in Poland

Macleaya microcarpa (Maxim.) Fedde, also known as smallfruit plume poppy, is a perennial herb belonging to the family Papaveraceae. The plant, together with the better-known species M. cordata (Willd.) R. Br., is native to central China and is now planted worldwide for medicinal purposes. In October 2008 and August 2009, dozens of smallfruit plume poppy planted in the Kraków Botanical Garden, Poland, were found to be severely infected with a powdery mildew. White colonies with abundant sporulation developed on both sides of leaves and young stems, forming circular to irregular patches. Infections caused leaf yellowing and premature defoliation. The damage has been observed every year since 2009. Representative voucher specimens were deposited in the fungal herbarium of the W. Szafer Institute of Botany of the Polish Academy of Sciences (KRAM) and the Korea University herbarium (KUS). Appressoria on the mycelia were lobed, often in pairs. Conidiophores composed of three to four cells arose from the upper part of creeping hyphae, 65 to 120 × 7 to 10 μm, attenuated toward the base, sub-straight or slightly flexuous in foot-cells, and produced conidia singly. Conidia were hyaline, oblong-elliptical to doliiform, 25 to 38 × 12 to 18 μm with a length/width ratio of 1.8 to 2.6; lacked fibrosin bodies; and produced germ tubes on the subterminal position with club-shaped or lobed appressoria. The conidial surface was wrinkled to irregularly reticulate. No chasmothecia were found. The structures described above match well with the anamorph of Erysiphe macleayae R.Y. Zheng & G.Q. Chen (3). To confirm the identity of the causal fungus, the internal transcribed spacer (ITS) region of rDNA from KUS-F24459 was amplified using primers ITS5 and P3 (4) and directly sequenced. The resulting sequence of 553 bp was deposited in GenBank (Accession No. JQ681217). A GenBank BLAST search using the present data revealed >99% sequence similarity of the isolate with E. macleayae on M. cordata from Japan (AB016048). Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of three healthy potted plants. Three noninoculated plants served as controls. Plants were maintained in a greenhouse at 25°C. Inoculated plants developed signs and symptoms after 7 days, whereas the control plants remained healthy. The fungus present on the inoculated plants was morphologically identical to that originally observed on diseased plants. The powdery mildew infections of M. cordata associated with E. macleayae have been recorded in China and Japan (2), and more recently in Germany (1,3). To our knowledge, this is the first report of E. macleayae on M. microcarpa globally as well as in Poland. This mildew species was described in China and is endemic to Asia, where chasmothecia of the fungus were found. Only recently have powdery mildews been found on M. cordata in Germany (1,3) and now on M. microcarpa in Poland, indicating the fungus is spreading in Europe. References: (1) N. Ale-Agha et al. Schlechtendalia 17:39, 2008. (2) D. F. Farr and A. Y. Rossman. Fungal Databases, Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , February 7, 2012. (3) A. Schmidt and M. Scholler. Mycotaxon 115:287, 2011. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

Total volar extrusion of the lunate and scaphoid proximal pole with concurrent scapholunate dissociation

This article describes a case of a 24-year-old man with a total volar extrusion of the lunate and scaphoid proximal pole with concurrent scapholunate dissociation. The viability of the lunate and the proximal pole of the scaphoid are at high risk in this type of injury. Scaphoid nonunion, avascular necrosis of the lunate and proximal pole of the scaphoid, and carpal instability are inevitable unless the blood supply is restored. Thus, proximal row carpectomy at injury may be an acceptable option to avoid these complications and late sequelae, including chronic wrist pain and dysfunction. However, the authors attempted accurate reduction of the extruded bones and internal fixation.Final radiographs and magnetic resonance imaging 12 years postoperatively showed healing without avascular necrosis. Carpal indices involving the scapholunate angle, radiolunate angle, and carpal height ratio were similar in both wrists without evidence of carpal instability or collapse. Range of motion and grip power were 75% and 76%, respectively, compared with those of the uninjured wrist. Clinical scores showed good results, and the patient reported no pain during activities of daily living and was satisfied with his surgical results. Open reduction and internal fixation can be a viable option in this rare pattern of injury.

First Report of Powdery Mildew Caused by Oidium hortensiae on Mophead Hydrangea in Korea

Hydrangea macrophylla (Thunb.) Ser., known as mophead hydrangea, is native to Japan and is used as a potted ornamental or is planted for landscaping in gardens worldwide. In May 2011, powdery mildew occurred on potted mophead hydrangea cv. Emerald plants in polyethylene-film-covered greenhouses in Icheon, Korea. Heavily infected plantings were unmarketable, mainly due to purplish red discoloration and crinkling of leaves. Such powdery mildew symptoms on mophead hydrangea in gardens had been often found in Korea since 2001, and the collections (n = 10) were deposited in the Korea University herbarium (KUS). In all cases, there was no trace of chasmothecia formation. Mycelium was effuse on both sides of leaves, young stems, and flower petals. Appressoria were well developed, lobed, and solitary or in opposite pairs. Conidiophores were cylindrical, 70 to 145 × 7.5 to 10 μm, and composed of three to four cells. Foot-cells of conidiophores were straight to sub-straight, cylindric, short, and mostly less than 30 μm long. Conidia produced singly were ellipsoid to oval, 32 to 50 × 14 to 22 μm with a length/width ratio of 1.7 to 2.8, lacked fibrosin bodies, and showed angular/rectangular wrinkling of outer walls. Germ tubes were produced on the perihilar position of conidia. Primary conidia were apically conical, basally rounded to subtruncate, 32 to 42 × 14 to 18 μm, and thus generally smaller than the secondary conidia. The morphological characteristics are consistent with previous descriptions of Oidium hortensiae Jørst. (3,4). To confirm the identification, the complete internal transcribed spacer (ITS) region of rDNA from KUS-F25514 was amplified with primers ITS5 and P3 and directly sequenced. The resulting sequence of 694 bp was deposited in GenBank (Accession No. JQ669944). There was no ITS sequence data known from powdery mildews on Hydrangea. Therefore, this is the first sequence of O. hortensiae submitted to GenBank. Nevertheless, a GenBank BLAST search of this sequence showed >99% similarity with those of Oidium spp. recorded on crassulacean hosts (e.g. GenBank Accession Nos. EU185641 ex Sedum, EU185636 ex Echeveria, and EU185639 ex Dudleya) (2), suggesting their close phylogenetic relationship. Pathogenicity was confirmed through inoculation by gently pressing diseased leaves onto leaves of five healthy potted mophead hydrangea cv. Emerald plants. Five noninoculated plants of the same cultivar served as controls. Plants were maintained in a greenhouse at 22 ± 2°C. Inoculated plants developed signs and symptoms after 6 days, whereas the control plants remained healthy. The fungus present on the inoculated plants was morphologically identical to that originally observed on diseased plants, fulfilling Koch's postulates. Occurrence of powdery mildew disease on mophead hydrangea is circumglobal (1). To our knowledge, this is the first report of powdery mildew disease caused by O. hortensiae on mophead hydrangea in Korea. Powdery mildew infections in Korea pose a serious threat to the continued production of quality potted mophead hydrangea in polyethylene-film-covered greenhouses. References: (1) D. F. Farr and A. Y. Rossman. Fungal Databases, Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved March 19, 2012, from http://nt.ars-grin.gov/fungaldatabases/ . (2) B. Henricot. Plant Pathol. 57:779, 2008. (3) A. Schmidt and M. Scholler. Mycotaxon 115:287, 2011. (4) S. Tanda. J. Agric. Sci. Tokyo Univ. Agric. 43:253, 1999.

Mechanically and structurally robust sulfonated block copolymer membranes for water purification applications

The effective removal of ionic pollutants from contaminated water using negatively charged nanofiltration membranes is demonstrated. Block copolymers comprising polystyrene (PS) and partially hydrogenated polyisoprene (hPI) were synthesized by varying chain architectures. A one step procedure of cross-linking (hPI blocks) and sulfonation reactions (PS chains) was then carried out, which was revealed as an effective method to enhance mechanical integrity of membranes while hydrophilic sulfonated chains remain intact. In particular, the control of chain architecture allows us to create a synergetic effect on optimizing charge densities of the membrane, water permeability, and mechanical integrity under water purification conditions. The best performing membrane can almost completely (>99%) reject various divalent cations and also show NO(3)(-) rejection > 85% and Na(+) rejection > 87%. Well defined nanostructures (tens of nanometers) as well as the periodically arranged water domains (a few nanometers) within hydrophilic phases of the hydrated membranes were confirmed by in situ neutron scattering experiments.

First Report of Brown Spot Needle Blight on Pinus thunbergii Caused by Lecanosticta acicola in Korea

Pinus thunbergii Parl., known as black pine, is a pine native to coastal areas of Japan and Korea. Because of its resistance to pollution and salt, it is planted as windbreakers along the coast. In March 2010, needle blight symptoms were found on several trees of black pine in Naju, southern Korea. Further surveys in 2010 and 2011 showed that these symptoms are rather common but disease incidence is less than 1%. Small, circular grayish green spots first appeared on the needles. The spots developed into brown bands reaching 1 to 2 mm long, sometimes with yellow margins. Dark olivaceous to dark grayish stromata were erumpent and conspicuous on the brown lesions in the later stage of disease development. Conidiophores were simple or occasionally branched, 1- to 2-septate, pale brown to olivaceous brown, and smooth walled. Conidia (n = 30) were olivaceous brown to grayish brown, verrucose, thick-walled, mildly curved, allantoid to fusiform, one- to five-septate (mostly three-septate), and 20 to 45 × 3.5 to 5 μm. Morphological characteristics of the fungus were consistent with those of Lecanosticta acicola (Thüm.) Syd. (anamorph of Mycosphaerella dearnessii M.E. Barr), previously known as the causal agent of brown spot needle blight of pines (2,4). The teleomorph was not observed. On potato dextrose agar, single-spore cultures of three isolates were obtained from conidia sporulating on needles. An isolate was preserved at the Korean Agricultural Culture Collection (Accession No. KACC44982). Genomic DNA was extracted using the DNeasy Plant Mini DNA Extraction Kit (Qiagen Inc., Valencia, CA) and the complete internal transcribed spacer (ITS) region of rDNA was amplified and sequenced with the primers ITS1/ITS4. The resulting ITS sequence of 543 bp was deposited in GenBank (Accession No. JQ245448). A GenBank BLAST search produced an exact match for the sequences of M. dearnessii (= L. acicola) on P. mugo Tura from Lithuania (HM367708) and P. radiata D. Don from France (GU214663), with 100% sequence similarity. To conduct a pathogenicity test, a conidial suspension (approx. 2 × 10⁵ conidia/ml) was prepared by harvesting conidia from 5-week-old cultures of KACC44982 and sprayed onto the needles of five 3-year-old healthy seedlings. Five noninoculated seedlings of the same age served as controls. Inoculated and noninoculated plants were kept in humid chambers for 48 h in a glasshouse. After 28 days, typical leaf spot symptoms started to develop on the needles of inoculated plants. The fungus, L. acicola, was reisolated from those lesions, confirming Koch's postulates. No symptoms were observed on control plants. The disease has been previously reported on several species of Pinus in the Americas (1) and recently in China (3), Japan (4), and Europe (2). To our knowledge, this is the first report of the Lecanosticta-Pinus association in Korea. Occurrence of the disease in Korea is a new threat to the health of black pine, especially in nursery plots. References: (1) D. F. Farr and A. Y. Rossman. Fungal Databases. Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.arsgrin.gov/fungaldatabases/ December 2011. (2) L. Jankovsky et al. Plant Protect. Sci. 45:16, 2009. (3) C. Li et al. J. Nanjing Inst. For. 1986:11, 1986. (4) Y. Suto and D. Ougi. Mycoscience 39:319, 1998.

Contrast-enhanced MR cholangiography: comparison of Gd-EOB-DTPA and Mn-DPDP in healthy volunteers

OBJECTIVE

The purpose of this study was to compare the biliary enhancement dynamics of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic-acid (Gd-EOB-DTPA) and mangafodipir trisodium (Mn-DPDP) for contrast-enhanced MR cholangiography (MRC) in healthy subjects.

METHODS

15 healthy volunteers underwent MRI at 1.5 T with volumetric interpolated breath-hold examination sequence. Each volunteer was scanned once for each contrast agent. The signal-to-noise ratio (SNR) of the liver parenchyma and common hepatic duct (CHD) and the contrast-to-noise ratio (CNR) of CHD to liver parenchyma were evaluated and compared before and at several time points (5, 15, 30, 45, 60, 90, and 120 min) after injection of each agent.

RESULTS

SNR was significantly higher for Gd-EOB-DTPA than for Mn-DPDP in liver parenchyma after 5 min and in CHD after 15 min (p<0.05). CNR of CHD to liver parenchyma using Gd-EOB-DTPA showed an initial decrease at 5 min post-injection followed by a steep increase to a peak at 15 min post-injection. CNR using Mn-DPDP showed a steady increase to a peak at 15 min post-injection without an initial decrease. At 15 min, the value of CNR was significantly higher for Gd-EOB-DTPA than for Mn-DPDP (p<0.05).

CONCLUSION

For both contrast agents, CNR reached a peak at 15 min after contrast injection. At this time point, CNR of Gd-EOB-DTPA was significantly higher than that of Mn-DPDP. Therefore, Gd-EOB-DTPA may provide better contrast-enhanced MRC than Mn-DPDP at 15 min after contrast administration.

Improved electrical and optical properties of ITO/Ag/ITO films by using electron beam irradiation and their application to ultraviolet light-emitting diode as highly transparent p-type electrodes

We have investigated the effect of insertion of a Ag layer in ITO film as well as electron beam irradiation to the multilayer films on the electrical and optical properties of the ITO-based multilayer deposited by magnetron sputtering method at room temperature. Inserting a very thin Ag layer between ITO layers resulted in a significant decrease in sheet resistance and increased the optical band gap of the ITO/Ag/ITO multilayer to 4.35 eV, followed by a high transparency of approximately 80% at a wavelength of 375 nm. We have also fabricated ultraviolet light-emitting diodes (LED) by using the ITO/Ag/ITO p-type electrode with/without electron beam irradiation. The results show that the UV-LEDs having ITO/Ag/ITO p-electrode with electron beam irradiation produced 19% higher optical output power due to the low absorption of light in the p-type electrode.

Failure analysis of InGaN/GaN high power light-emitting diodes fabricated with ITO transparent p-type electrode during accelerated electro-thermal stress

We have investigated the high-temperature degradation of optical power as well as electrical properties of InGaN/GaN light-emitting diodes (LEDs) fabricated with ITO transparent p-electrode during accelerated electro-thermal stress. As the thermal stress increased from 150 degrees C to 250 degrees C at a electrical stress of 200 mA, the optical power of the LEDs was significantly reduced. Degradation of the optical power was thermally activated, with the activation of 0.9 eV. In addition, the activation energy of the degradation of optical power was fairly similar to that of the degradation of series resistance of the LEDs, 1.0 eV, which implies that the increase in the series resistance may result in the severe degradation of optical power. We also showed that the increase in the series resistance of the LEDs during the accelerated electro-thermal stress can be attributed to reduction of the active acceptor concentration in the p-type semiconductor layers and local joule heating due to the current crowding.

First Report of Corynespora Leaf Spot on Ailanthus altissima Caused by Corynespora cassiicola in Korea

Ailanthus altissima (Mill.) Swingle, known as tree-of-heaven, is a deciduous tree belonging to the family Simaroubaceae, which is native to both northeast and central China and Taiwan. The trees often have the ability to replace indigenous plants and disrupt native ecosystems (3). In August 2010, a leaf spot disease was observed on young trees in Yangpyeong, Korea. Field observation in 2010 and 2011 showed that infections are common on 1- or 2-year-old trees. Adult trees were rarely infected. Symptoms usually started at the margin of leaves and expanded into irregular, dark brown leaf spots, eventually causing significant premature defoliation. Representative samples were deposited in the herbarium of Korea University (KUS-F25174 and -F25304). Conidiophores of fungi observed microscopically on the leaf spots were erect, brown to dark brown, single or occasionally in clusters, 80 to 550 × 5 to 8 μm, and mostly arose on the abaxial surface of symptomatic leaves. Conidia were borne singly or in short chains of two to four, ranging from cylindrical to broadest at the base and tapering apically, straight to slightly curved, pale olivaceous brown, 3 to 18 pseudoseptate, 70 to 450 × 8 to 22 μm, each with a conspicuous thickened hilum. On potato dextrose agar, single-spore cultures of five isolates were identified as Corynespora cassiicola (Berk. & M.A. Curtis) C.T. Wei on the basis of morphological and cultural characteristics (1,4). A monoconidial isolate was preserved at the Korean Agricultural Culture Collection (Accession No. KACC45510). Genomic DNA was extracted with the DNeasy Plant Mini DNA Extraction Kit (Qiagen Inc., Valencia, CA). The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 and sequenced with an ABI Prism 337 automatic DNA sequencer (Applied Biosystems, Foster, CA). The resulting sequence of 548 bp was deposited in GenBank (Accession No. JN974462). The sequence showed >99% similarity (1-bp substitution) with a sequence of C. cassiicola from Ipomoea batatas (GenBank Accession No. FJ852716). To conduct a pathogenicity test, a conidial suspension (~2 × 10⁴ conidia/ml) was prepared by harvesting conidia from 2-week-old cultures of KACC45510 and the suspension sprayed onto the leaves of three healthy seedlings. Three noninoculated seedlings served as control plants. Inoculated and noninoculated plants were kept in humid chambers for 48 h in a glasshouse. After 5 days, typical leaf spot symptoms started to develop on the leaves of all three inoculated plants. C. cassiicola was reisolated from the lesions, confirming Koch's postulates. No symptoms were observed on control plants. C. cassiicola is cosmopolitan with a very wide host range (2). To our knowledge, C. cassiicola has not been reported on A. altissima anywhere in the world. According to field observations in Korea, Corynespora leaf spot was most severe in August and September, especially following a prolonged period of moist weather. C. cassiicola may be a potential biocontrol agent for this highly invasive tree species. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute: Kew, Surrey, England, 1971. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Systematic Mycology and Microbiology Laboratory, ARS, USDA, Retrieved from http://nt.ars-grin.gov/fungaldatabes/ , October 28, 2011. (3) L. B. Knapp and C. D. Canham. J. Torrey Bot. Soc. 127:307, 2000. (4) J. H. Kwon et al. Plant Pathol. J. 17:180, 2001.

Surgical correction for supination loss following malunited radial fractures

We evaluated fourteen patients who had restricted supination as a major impairment related with a malunited radius fracture. All patients underwent an opening wedge corrective osteotomy, bone grafting, and volar plate fixation. Clinical results were assessed based on range of motion, visual analogue scale for pain, grip power, and a Modified Mayo Wrist Score. The mean supination increased from 24 degrees preoperatively to 71 degrees postoperatively (p < 0.01). Dorsiflexion range, grip power and pain score improved significantly after the operation. The mean value for the Modified Mayo Wrist score improved from 58.6 points to 83.9 points (p < 0.01). Radiological measurements showed that the degree of dorsal angulation decreased from a mean of 9.0 degrees to -2.5 degrees after the corrective osteotomy. This study demonstrated that a malunited radius fracture with dorsal angulation, even if the latter appears mild, can induce functional impairment due to limited range of supination. Supination can be restored by an appropriately performed corrective osteotomy.

First Report of Powdery Mildew Caused by Erysiphe betae on the Invasive Weed Dysphania ambrosioides in Korea

Dysphania ambrosioides (L.) Mosyakin & Clemants (formerly Chenopodium ambrosioides L.), commonly known as epazote, is an herb that is native to Central America, South America, and southern Mexico. As well as in its native areas, it is used as an herb, tea, and food commodity in warm temperate to subtropical areas of Europe, the United States, and Asia. In Korea, however, this plant was accidentally introduced around the 1970s and has become widely naturalized by replacing indigenous plants and disrupting native ecosystems (3). Since 2006, powdery mildew infections of epazote have been consistently found in the southern part of Korea, including Jeju Island. Specimens (n = 8) have been deposited in the Korea University Herbarium (KUS). White mycelial and conidial growth was present mostly on leaf surfaces with sparse growth on young stems and inflorescences. Severely infected leaves were malformed. Slight purplish discoloration was present on the leaves contiguous with colony growth. Mycelial colonies were conspicuous, amphigenous, and epiphytic. Appressoria on the mycelia were lobed. Conidiophores were 110 to 200 μm long and produced conidia singly. Conidia were hyaline, oblong-elliptical, measured 30 to 48 × 13 to 18 μm, lacked fibrosin bodies, and produced germ tubes on the subterminal position. Chasmothecia were amphigenous, scattered or partly clustered, dark brown, spherical, 110 to 130 μm in diameter, and contained four to seven asci. Appendages were mycelioid, numbered 50 to 80 per chasmothecium, 0.5 to 1.5 times as long as the chasmothecial diameter, one- to three-septate, and brown at the base while becoming paler toward the tip. Asci were short stalked, 60 to 75 × 30 to 38 μm, and contained three to five spores. Ascospores were ellipsoid-ovoid with dimensions of 20 to 28 × 14 to 18 μm. On the basis of these morphological features, this fungus was identified as Erysiphe betae (Vanha) Weltzien (1). To confirm the identification, the complete internal transcribed spacer (ITS) region of rDNA from KUS-F23213 was amplified with primers ITS5 and P3 and sequenced (4). The resulting sequence of 560 bp was deposited in GenBank (Accession No. JQ041419). A GenBank BLAST search with the current data showed >99% (558 of 560 bp) similarity with the results for E. betae ex Beta vulgaris (sugar beet). Therefore, the sequence analysis verified the pathogen to be E. betae. Previous epazote infections by E. betae have been recorded in Argentina, Mexico, Romania, India, and Japan (1,2). In Taiwan, an epazote powdery mildew associated with Oidium erysiphoides f. sp. chenopodii J.M. Yen, an anamorph of E. betae, was recorded (1,2). To our knowledge, this is the first record of E. betae on epazote in Korea, and the first confirmation of epazote powdery mildew being identified as E. betae on the basis of holomorphic characteristics and ITS rDNA sequences. Our field observation suggests that the powdery mildew is acting as one of several limiting factors to suppress the expansion of this invasive weed in Korea. References: (1) U. Braun. Beih. Nova Hedw. 89:1, 1987. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , November 22, 2011. (3) C. G. Song and Y. H. Yang. The Naturalized Plants in Jeju Island. Nam-Jeju County, Jeju, Korea, 2005. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

Pathological correlation with diffusion restriction on diffusion-weighted imaging in patients with pathological complete response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer: preliminary results

OBJECTIVE

The objective of this study was to assess causative pathological factors associated with diffusion restriction on diffusion-weighted imaging (DWI) in patients who achieved pathological complete response (pCR) after treatment with neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer.

METHODS

In total, 43 patients with locally advanced rectal cancer (≥T3 or lymph node positive) who underwent neoadjuvant CRT, subsequent surgery and ultimately achieved pCR were enrolled. All patients underwent pre- and post-CRT 3.0 T rectal MRI with DWI. Two radiologists blinded to pathological staging reviewed pre- and post-CRT 3.0 T rectal MRI for the presence of diffusion restriction in the corresponding tumour areas on post-CRT DWI, with a third radiologist arbitrating any disagreement. The consensus of these findings was then correlated with pathological data such as intramural mucin and the degree of proctitis and mural fibrosis seen on surgical specimen. Additionally, the pre-CRT tumour volume was measured to define the effect of this variable on the degree of radiation proctitis and fibrosis, as well as the presence of intramural mucin.

RESULTS

Diffusion restriction occurred in 18 subjects (41.9%), while 25 subjects remained diffusion restriction-free (58.1%). The diffusion restriction group tended to have more severe proctitis and mural fibrosis when compared with non-diffusion restriction group (p<0.001). Intramural mucin was also more common in the diffusion restriction group (p=0.052). Higher pre-CRT tumour volumes were significantly predictive of the degree of proctitis (p=0.0247) and fibrosis (p=0.0445), but not the presence of intramural mucin (p=0.0944). Proctitis and mural fibrosis severity were also identified as independent pathological risk factors for diffusion restriction on multivariate analysis (p=0.0073 and 0.0011, respectively).

CONCLUSION

Both radiation-induced proctitis and fibrosis were significant and independent predictors of diffusion restriction in patients achieving pCR after treatment with neoadjuvant CRT for locally advanced rectal cancer, and pre-CRT tumour volume significantly affects both variables.

First Asian Report of Leaf Spot of Ambrosia trifida Caused by Septoria epambrosiae

Ambrosia trifida L., known as giant ragweed, is native to North America and was introduced in Korea in the 1970s (4). It is now widely naturalized, and since 1999, has been designated as one of 11 most 'harmful nonindigenous plants' by the Korean Ministry of Environment because of its adverse effects on native plants. Various strategies to eradicate this noxious weed have been unsuccessful (4). In June 2008, leaf spot symptoms on this weed were found in Inje, Korea. Hundreds of giant ragweed growing along stream banks contained leaf spots with leaf yellowing and premature defoliation. Leaf lesions were 1 to 5 mm in diameter, angular to irregular, dark brown without a distinct margin, later becoming pallid with a brown margin. Between 2008 and 2011, the authors observed the same symptoms in Dongducheon, Yangku, Namyangju, and Pocheon, Korea. Voucher specimens have been housed in the herbarium of Korea University. Numerous black pycnidia were formed on the lesion. Pycnidia were amphigenous, globose, dark brown, ostiolate, and measured 80 to 130 μm in diameter. Conidia were filiform, straight to mildly curved, eguttulate, hyaline, 18 to 36 × 1.5 to 2.5 μm, one to three septate, subtruncate at the base, and tapering to a rounded apex. Single-conidial isolations onto potato dextrose agar formed dark grayish colonies. Pycnidia matured after 5 weeks when plates were incubated under fluorescent illumination for 12-h photoperiods at 25°C. On the basis of morphological and cultural characteristics, the fungus was identified as Septoria epambrosiae D.F. Farr (2). Three isolates were deposited in the Korean Agricultural Culture Collection (KACC). Preliminary morphological identification of the fungal isolates was confirmed by molecular data. The internal transcribed spacer (ITS) region of rDNA was amplified using the ITS1/ITS4 primers and sequenced. The resulting sequences of 449 bp obtained from the three isolates were identical to each other. They showed 100% similarity when compared with a sequence of S. epambrosiae (GenBank No. AF279582). The nucleotide sequence of a representative isolate (KACC43850) was deposited in GenBank (No. JN695498). Pathogenicity was confirmed by inoculating the leaves of three seedlings with a conidial suspension (~2 × 10⁵ conidia/ml). Three noninoculated seedlings served as controls. Plants were maintained in a glasshouse at 100% relative humidity for 48 h. After 6 days, typical leaf spots, identical to the one observed in the field, started to develop on the leaves of the inoculated plants. No symptoms were observed on the control plants. The fungus was successfully reisolated from the symptomatic plants, fulfilling Koch's postulates. A leaf spot disease associated with S. epambrosiae has previously been recorded on A. artemisiifolia in Hungary (1-3) and A. trifida in North America (2,3). To our knowledge, this is the first report of S. epambrosiae on giant ragweed in Asia. Because of its potential as a biocontrol agent, further studies are needed. References: (1) G. Bohar and I. Schwarczinger. Plant Dis. 83:696, 1999. (2) D. F. Farr and L. A. Castlebury. Sydowia 53:81, 2001. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Systematic Mycology and Microbiology Laboratory, ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , September 20, 2011. (4) S. M. Oh et al. Impacts of Invasive Alien Weeds and Control Strategies of Noxious Weeds in Korea. National Institute of Agricultural Science and Technology, Suwon, Korea, 2007.

Arthroscopic reduction and percutaneous fixation of perilunate dislocations and fracture-dislocations

PURPOSE

The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations and fracture-dislocations treated with arthroscopic reduction and percutaneous fixation.

METHODS

Twenty patients who had an acute dorsal perilunate dislocation or fracture-dislocation were treated with an arthroscopic technique at a median interval of 3.9 days from the time of injury. They were retrospectively reviewed at a mean follow-up of 31.2 months (range, 18 to 61 months). Range of motion and grip strength were measured. Radiographic evaluations included time to scaphoid union, measurement of radiologic parameters, and any development of arthritis. Functional outcomes were determined by the modified Mayo wrist score; Disabilities of the Arm, Shoulder and Hand questionnaire; and Patient-Rated Wrist Evaluation score.

RESULTS

The flexion-extension motion arc and grip strength of the injured wrist averaged 79% and 78%, respectively, of the corresponding values for the contralateral wrists. The mean Disabilities of the Arm, Shoulder and Hand score was 18, and the mean Patient-Rated Wrist Evaluation score was 30. According to modified Mayo wrist scores, overall functional outcomes were rated as excellent in 3 patients, good in 8, fair in 7, and poor in 2. Nonunion developed in 2 patients with a trans-scaphoid perilunate injury; 1 of the 2 underwent scaphoid excision and midcarpal fusion. On the basis of radiographic parameters, reduction obtained during the operation was maintained within normal ranges in 15 patients. Arthritis had not developed in any patient by the last follow-up.

CONCLUSIONS

This study suggests that arthroscopic reduction with percutaneous fixation is a reliable minimally invasive surgical method for acute perilunate injuries in that it provides proper restoration and stable fixation of carpal alignment and results in satisfactory functional and radiologic outcomes on a midterm basis.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

First Report of Leaf Spot Caused by Ascochyta marginata on Aralia elata in Korea

Aralia elata (Miq.) Seem., known as Japanese angelica tree, is a deciduous shrub belonging to the Araliaceae, which is native to East Asia. The young shoots have long been used in various dishes in East Asia. Commercial cultivation of this shrub, especially in polytunnels, is expanding in Korea. Several diseases including Sclerotinia rot have been known to be present on this plant (1,2). In early September 2007, leaf spot symptoms were first observed on several trees in Hongcheon, Korea. Microscopic observations revealed that the leaf spots were associated with an Ascochyta sp. Further surveys of the Ascochyta leaf spot showed the occurrence of the disease in approximately 5 to 10% of the trees in the 3 ha of commercial fields surveyed in Chuncheon, Gapyeong, Inje, and Jinju, Korea. Initial symptoms on leaves were circular to irregular, brown to dark brown, becoming zonate, and finally fading to grayish brown in the center with a yellow halo. Representative samples were deposited in the herbarium of Korea University. Conidiomata on leaf lesions were pycnidial, amphigenous, but mostly epiphyllous, immersed or semi-immersed in host tissue, light brown to olive brown, and 60 to 200 μm in diameter. Ostioles were papillate, 20 to 35 μm wide, and surrounded by a ring of darker cells. Conidia were hyaline, smooth, cylindrical to clavate, straight to mildly curved, slightly constricted at the septa, medianly one-septate, sometimes aseptate, 8 to 16 × 2.5 to 3.5 μm, and contained small oil drops. These morphological characteristics were consistent with the previous reports of Ascochyta marginata J.J. Davis (3,4). A monoconidial isolate was cultured on potato dextrose agar (PDA) plates and accessioned in the Korea Agricultural Culture Collection (Accession KACC43082). The conidia were readily formed on PDA. Inoculum for the pathogenicity tests was prepared by harvesting conidia from 30-day-old cultures of KACC43082 and a conidial suspension (approximately 2 × 10⁶ conidia/ml) was sprayed onto leaves of three healthy seedlings. Three noninoculated seedlings served as controls. Inoculated and noninoculated plants were covered with plastic bags for 48 h in a glasshouse. After 7 days, typical leaf spot symptoms started to develop on the leaves of the inoculated plants. The fungus, A. marginata, was reisolated from those lesions, confirming Koch's postulates. No symptoms were observed on control plants. Previously, the disease was reported in Japan (4) and China (3). To our knowledge, this is the first report of A. marginata on Japanese angelica trees in Korea. According to our field observations in Korea, the Ascochyta leaf spot mostly occurred on plants growing in a humid environment, especially during the rainy season. The seedlings as well as the trees growing in sunny, well-ventilated plots were nearly free from this disease. Therefore, the growing conditions seemed to be the most important factor for the development and severity of the disease. References: (1) C. K. Lee et al. Plant Pathol. J. 26:426, 2010. (2) S. H. Lee et al. Diseases of Japanese Angelica Tree and Their Control. Research Report 08-10. Korea Forest Research Institute. Seoul, Korea, 2008. (3) J. Sun et al. Acta Mycol. Sin. 14:107, 1995. (4) M. Yoshikawa and T. Yokoyama. Mycoscience 36:67, 1995.