Evolution of Proteinuria After Conversion From Calcineurin Inhibitors (CNI) to Sirolimus (SRL) in Renal Transplant Patients: A Multicenter Study

Conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) has become an option in patients with chronic allograft nephropathy or other conditions. However, in some cases an increase of proteinuria has been reported after such therapeutic intervention. The aim of this study was to characterize the clinical course of this so far unexplained proteinuria after conversion. We performed a retrospective analysis evaluating 94 renal transplant patients from various Spanish centers. Proteinuria (629 determinations) and clinical developments were analyzed between 6 months before and 6 months after conversion. Patients were divided into three groups according to mean proteinuria before conversion (group A: <300 mg/d; group B: 300 to 2000 mg/d; and group C: >2 g/d). The mean proteinuria level was 1.69 g/24 h (n = 312 determinations) before and 2.36 g/24 h after conversion (n = 317 determinations; P = .006), which corresponds to an overall increase of 25% (1.55 to 1.69 g/24 h considering only determinations of 1 month before and 1 month after conversion; P = NS). We could not detect any clear correlation between proteinuria and serum creatinine nor between changes of proteinuria and changes of serum creatinine. A variance analysis for repeated measures showed an increase in proteinuria compared to the preconversion values (P = .003), and when the three groups of preconversion proteinuria were evaluated separately it could be observed that this change in the evolution of proteinuria was almost completely dependent of an increase in the group C (preconversion proteinuria greater than 2 g/d; P = .03), whereas in the other two groups changes were almost irrelevant. Finally, the switch to SRL in renal transplant recipients is followed by an increase in the level of proteinuria predominantly dependent of an increase in patients with high levels of preconversion proteinuria, whereas it seems to be irrelevant in patients without or with light or moderate proteinuria. These results suggest that this might not be a direct effect of SRL.

First Report of Xylella fastidiosa Infecting Citrus in Costa Rica

Citrus variegated chlorosis (CVC) is an important disease mainly of sweet orange (Citrus sinensis (L.) Osbeck) cultivars. It was first described in Brazil in the state of Sā Paulo in 1987 (4). The disease has spread to all Brazilian states that grow citrus and is affecting more than one-third of the orange trees grown in Brazil. CVC is caused by Xylella fastidiousa, a xylem-limited, gram-negative bacterium. During the last 4 years, symptoms including leaf interveinal chlorosis, stunting, canopy dieback, and hard and undersized fruits, similar to those caused by CVC (3), appeared in sweet orange trees used as shade plants for coffee plantations and as fence posts in Costa Rica. Necrotic lesions on the abaxial side of the leaves as reported in Brazil were rarely observed. Leaf petiole samples from 25 symptomatic sweet orange trees reacted positively with a X fastidiosa-specific antiserum (AGDIA Inc., Elkart, IN) in a double-sandwich antibody enzyme-linked immunosorbent assay (DAS-ELISA). A fastidious, gram-negative bacterium identified as X. fastidiosa using DAS-ELISA was isolated on perwinkle wilt (PW) medium plates (1) from citrus stems showing CVC symptoms, but not from asymptomatic trees. The isolated colonies were circular and opalescent with diameters of 2 to 3 mm and were clearly visible within 6 to 7 days after streaking. Petiole sections from symptomatic plants observed with scanning electron microscopy showed rod-shaped bacteria with rippled cell walls tightly packed in xylem vessels, as described for X. fastidiosa previously (2), and with transmission electron microscopy, the bacteria were morphologically similar to those reported previously for CVC (2). To our knowledge, this is the first report of X. fastidiosa associated with citrus in Costa Rica. References: (1) M. J. Davis et al. Curr. Microbiol. 6:309, 1981. (2) J. S. Hartung et al. Phytopathology 84:591, 1994. (3) R. F. Lee et al. Summa Phytopathol. 19:123, 1993. (4) V. Rossetti et al. 1990, C.R. Acad. Sci. (Paris) 310:345-349.

First Report of Citrus Blight in Costa Rica

Citrus blight (CB), causing a chronic decline of citrus, has been an important disease in Florida for over 100 years. CB was first reported in Brazil in the 1980s and is now responsible for the removal of nearly 10% of the trees from production annually. No causal agent has been identified, but CB has been root-graft transmitted to healthy trees, suggesting that the causal agent is infectious (3). Since 1997, CB symptoms were observed in several groves in northern Costa Rica, the most important citrus area of approximately 25,000 ha. Symptoms observed include a general decline and wilt of the tree canopy, off-color leaves, leaf drop, twig dieback, small fruit, delayed blossom, poor growth, and death. A survey near Guanacaste revealed CB symptoms in 7-yr-old Valencia and Pineapple orange trees (Citrus sinensis (L.) Osbeck) grafted on Carrizo citrange (C. sinensis (L.) Osbeck × Poncirus trifoliata (L.) Raf.) rootstock. Since 1997, 6% of the trees in this area have been replanted annually because of CB symptoms. Similar situations were observed in other groves in the northern citrus area. Dot immunobinding assays (DIBA) (1) were used to detect the P12 protein associated with CB with 20 of 22 trees showing CB-like symptoms giving a positive test. Zinc (Zn) accumulation in trunk wood and water uptake tests were done according to Roistacher (2) in 8 healthy and 20 symptomatic trees which were positive for CB using DIBA. The average Zn concentration of 16 declining trees was 4.6 ± 1.9, whereas the average concentration for 8 healthy trees was 2.0 ± 0.9. The average water uptake in 1 min was 14 ml for healthy trees, and virtually zero for the 20 symptomatic trees. These diagnostic tests confirm the presence of CB in the northern citrus area of Costa Rica, and the surveys indicate the disease is beginning to spread and become economically important. To our knowledge, this is the first report of CB in commercial citrus in Costa Rica. References: (1) K. S. Derrick et al. Plant Dis. 74:168, 1990. (2) C. N. Roistacher. Pages 57-66 in: Graft-Transmissible Diseases of Citrus. Handbook for Detection and Diagnosis. C.N. Roistacher, ed. Food and Agriculture Organization, Rome, 1991. (3) D. P. H. Tucker et al. Plant Dis. 68:979, 1984.

Occurrence of Potato Powdery Scab Caused by Spongospora subterranea f. sp. subterranea in Costa Rica

Powdery scab of potatoes, caused by Spongospora subterranea (Wallr.) Lagerheim f. sp. subterranea Tomlinson, is important worldwide due to its effect on tuber quality and transmission of Potato mop-top virus. Although powdery scab-like lesions have been observed on potato in Costa Rica (1), the presence of the pathogen has not been confirmed. During a survey in 2001, powdery scab-on was observed from a field and a greenhouse in the high elevation zone of the main potato-producing area of Costa Rica. Commercial potatoes with scab-like lesions were also obtained at a farmers' market. Scraping the lesions, and observing spore balls or cystosori with a honey-comb-like structure under light microscopy confirmed the identity of S. subterranea. The identity of the pathogen was also confirmed by enzyme-linked immunosorbent assay using monoclonal antibodies specific for S. subterranea (BioReba Ag, Reinach, Switzerland). Pathogenicity of S. subterranea was confirmed by a bioassay on tomato plants grown in nutrient solution culture (2). Tomato cv. Supermarmande plants were grown from seed in pots filled with quartz and watered with nutrient solution. Three weeks after planting, the roots were trimmed to 60 mm, and the plants were transferred to the nutrient solution for additional growth. After growing for 1 week in the nutrient solution, tomato seedlings were inoculated by replacing the nutrient solution with nutrient solution containing cystosori (20 mg/liter, wt/vol) that were scraped from the scab lesions. Zoosporangia of S. subterranea were observed in root hairs and epidermal cells of the seedlings 2 weeks after inoculation. To our knowledge, this is the first report that confirms the presence of S. subterranea on potato in Costa Rica. References: (1) R. Amador. Invest. Agri. Costa Rica. 1(1):16, 1987. (2) U. Merz. Bull. OEPP 19:585, 1989.

Occurrence of Coffee ringspot virus, a Brevipalpus Miteborne Virus in Coffee in Costa Rica

Coffee ringspot virus (CoRSV) (family Rhabdoviridae) is transmitted by Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae). Coffee ringspot disease was first reported in coffee plants from Brazil in 1939 (1). In August 2000, severe symptoms of concentric ringspots and "oak leaf" patterns on coffee leaves (Coffea arabica L. cv. Catuai) were observed during field inspections conducted in two areas of San Gabriel de Desamparados, Costa Rica. The disease caused premature fruit and leaf drop in the affected plants. Some areas within the ringspot lesions remained green on senescent leaves. Because CoRSV particles remain restricted to lesion areas (1), this virus has not been purified, and antiserum for virus detection is not available. Therefore, leaves with symptoms were collected and examined by transmission electron microscopy. In ultrathin sections of symptomatic leaves, arrays of rhabdovirus-like particles were associated with the nucleus as described for CoRSV (2). Healthy tissues did not contain similar arrays of bacilliform and bullet-shaped particles. Twenty mites collected from the infected plants at the same locations and time were slide-mounted and identified as B. phoenicis. High populations of this mite were also observed infesting plants of Cajanus cajan L. that were intercropped with coffee at the same location. Sweet orange trees growing in the same fields as shade for the coffee did not show symptoms of citrus leprosis, a disease caused by another Brevipalpus-transmitted virus that was recently reported in Panama (3). To our knowledge, this is the first report of a virus similar to CoRSV in Costa Rica. The spread of this virus, presumably CoRSV, could seriously affect the coffee industry throughout Central America by increasing production costs. It may be necessary to apply one or more foliar acaricides to effectively control the mite vector. References: (1) A. Bitancourt. O. Biol. 5:33, 1939. (2) C. M. Chagas et al. Phytopathol. Z. 102:100, 1981. (3) F. S. Dominguez et al. Plant Dis. 85:228, 2001.

A high statistics measurement of the Lambda(+)(c) lifetime

A high statistics measurement of the Lambda(+)(c) lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis technique with particular attention to the determination of the systematic uncertainty. The measured value of 204.6 +/- 3.4 (stat) +/- 2.5 (syst) fs from 8034 +/- 122 Lambda(+)(c)-->pK(-)pi(+) decays represents a significant improvement over the present world average.

First Report of an Aster Yellows Subgroup 16SrI-B Phytoplasma Infecting Chayote in Costa Rica

An outbreak of a witches' broom disease affected approximately 20% of plants in several chayote (Sechium edule (Jacq.) Schwartz) fields in the commercial production area of the Ujarrás Valley, Cartago Province, Costa Rica during 2000 and 2001. Affected chayote plants exhibited symptoms, including basal proliferation with severe foliage reduction, aborted flowers, and deformed fruits, suggestive of phytoplasmal infection. Two other symptomatic cucurbit species growing near the chayote fields were also identified. These species were tacaco plants (S. tacaco (Pitt.) C. Jeffrey), an edible cucurbit for domestic marketing in Costa Rica, showing severe size reduction of leaves and fruits, and Rytidostylis carthaginensis (Jacq.) Kuntze, a weed in chayote and tacaco fields, exhibiting abnormal tendril proliferation. Plants were analyzed for phytoplasma infection by a nested polymerase chain reaction (PCR) assay, using the universal rRNA primer pair P1/P7 followed by R16F2n/R16R2 (2). Phytoplasmas were detected in all symptomatic samples (18 chayote, 6 tacaco, and 3 weed) tested but were undetectable in all asymptomatic samples (10 chayote, 6 tacaco, and 2 weed). Restriction fragment length polymorphism (RFLP) analysis of PCR products (16S rDNA sequences) by separate digestion with eight restriction enzymes (RsaI, HhaI, KpnI, BfaI, HaeIII, HpaII, AluI, MseI) revealed that a phytoplasma belonging to subgroup 16SrI-B in the aster yellows phytoplasma group (16SrI) was associated with chayote witches' broom (CWB). The same or very similar phytoplasmas were found in both symptomatic tacaco and R. carthaginensis plants. Phylogenetic analysis of 16SrDNA sequences also confirmed the CWB phytoplasma to be most similar to members of subgroup 16SrI-B. Similar diseases in chayote and other cucurbits have been reported in Brazil (3), Taiwan (1), and Mexico (4). The CWB phytoplasma differs from the phytoplasma (16SrIII-J subgroup) associated with chayote in Brazil. The identities of phytoplasmas associated with cucurbits in Taiwan and Mexico are unknown. The occurrence of an aster yellows group phytoplasma in chayote may pose a potential threat to continued production and exportation of this cash crop. To our knowledge, this is the first report of 16SrI-B subgroup phytoplasmas in naturally infected cucurbits in Costa Rica. References: (1) T. G. Chou et al. Plant Dis. Rep. 60:378, 1976. (2) I.-M. Lee et al. Int. J. Syst. Bacteriol. 48:1153, 1998. (3) H. G. Montano et al. Plant Dis. 84:429, 2000. (4) E. Olivas. Rev. Fitopatol. (Lima) 13:14, 1978.

Search for CP violation in the decays D+--> K(S)pi+ and D+-->K(S)K+

A high-statistics sample of photoproduced charm from the FOCUS experiment has been used to search for direct CP violation in the decay rates for D+-->K(S)pi+ and D+-->K(S)K+. We have measured the following asymmetry parameters relative to D+-->K-pi+pi+: A(CP)(K(S)pi+) = (-1.6+/-1.5+/-0.9)%, A(CP)(K(S)K+) = (+6.9+/-6.0+/-1.5)%, and A(CP)(K(S)K+) = (+7.1+/-6.1+/-1.2)% relative to D+-->K(S)pi+. We have also measured the relative branching ratios and found Gamma(D+-->K(0)pi+)/Gamma(D+-->K-pi+pi+) = (30.60+/-0.46+/-0.32)%, Gamma(D+-->K(0)K+)/Gamma(D+-->K-pi+pi+) = (6.04+/-0.35+/-0.30)%, and Gamma(D+-->K(0)K+)/Gamma(D+-->K(0)pi+) = (19.96+/-1.19+/-0.96)%.

Evidence that the proliferation stage of micropropagation procedure is determinant in the expression of banana streak virus integrated into the genome of the FHIA 21 hybrid (Musa AAAB)

Banana streak virus (BSV) is causing increasing concern in almost every producing area of banana and plantain (Musa spp.) worldwide. This situation appeared partially linked to some breeding lines and micropropagated hybrids. A complete BSV sequence integrated into the genome of a triploid plantain has been recently characterised and it has been hypothesised that it could give rise to infectious virus via recombination. In this study, we evaluated the effect of a routine micropropagation procedure on the expression of BSV in the FHIA 21 tetraploid hybrid. The widespread presence of integrated sequences and the absence of episomal BSV in thirty FHIA 21 "mother plants" selected for micropropagation were first confirmed by specific PCR and IC-PCR tests. The proliferation stage of the procedure, characterised by an intensive production of neoformed buds, appeared determinant in BSV expression whereas the rooting and acclimatisation stages had little or no effect. The duration in culture and the way of subdividing the clumps of proliferation influenced greatly the percentage of episomal BSV infections, reaching 58% of infected micropropagated lines after six in vitro subcultures. These data suggest that the expression of episomal BSV observed during the in vitro procedure is correlated with the presence of an integrated form.

[Total plasma homocysteine concentrations in Puerto Rican patients with ischemic heart disease]

INTRODUCTION AND OBJECTIVES

In Puerto Rico, it has been established that although coronary disease is the leading cause of death, the population has a lower incidence of coronary disease than in the continental United States. In addition, the severity of the disease is less aggressive in terms of a lower incidence of ventricular tachycardia and sudden death. One factor that could contribute to the lower incidence of coronary disease in Puerto Rico is that our population might have lower total plasma homocysteine concentrations (tHcys) than in the continental United States. Our main objective was to measure tHCys in the Puerto Rican population with atherosclerotic cardiovascular disease (ACD).

METHODS

We randomly measured tHcys concentrations in seventy Puerto Rican patients who were hospitalized at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division).

RESULTS

The mean tHCys concentration in these patients is similar to those reported for the Framingham study when adjusted by age (11.2 vs. 11.8 micromol/l). In the Puerto Rican population, males had a higher tHcys concentration than females (11.7 vs 9.5 micromol/l, p = 0.07). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with non-diabetics (10.1 vs. 11.2 micromol/l, p = 0.74). We did not see a direct correlation between tHcys concentrations and heart condition as measured by coronary angiography (normal = 11.1 micromol/l, light = 10.5 micromol/l, moderate = 10.9 micromol/l, severe = 10.5 micromol/l; Kruskal-Wallis = 0.45) either.

CONCLUSION

These results suggest that tHcys concentration is not a good predictor of the seriousness of ACD in the Puerto Rican patient population.

Relationship between bone marrow failure syndromes and the presence of glycophosphatidyl inositol-anchored protein-deficient clones

Because of the insensitivity of the Ham test, paroxysmal nocturnal haemoglobinuria (PNH) has been inaccurately viewed as a late clonal complication of aplastic anaemia (AA). To clarify the relationship between PNH and marrow failure, we tested for the presence of glycosylphosphatidyl-anchored protein-deficient (GPI-AP) granulocytes in large cohorts of patients with AA, myelodysplasia (MDS), and pure haemolytic PNH. A PNH clone was detected in 32% of new AA patients and 18% of MDS patients. In serial studies, this proportion did not change up to 15 years after diagnosis, suggesting that expansion of aberrant cells is an early event (i.e. prior to initial presentation). For all patients with a PNH clone, on average 14% of PNH granulocytes were found on presentation and 37% at 10 years. Patients with PNH but without cytopenia showed higher percentages of GPI-AP-deficient cells than did those with the AA/PNH syndrome. After immunosuppression, there was no change in the contribution of PNH clone to blood production, arguing against the "immune-escape" theory in PNH. Clinically, a high proportion of GPI-AP-deficient cells correlated with marrow hypercellularity. GPI-AP-deficient cells were similarly present in patients with and without karyotypic abnormalities. Our results indicate that the GPI-AP-deficient clones show quantitative and kinetic differences between classic haemolytic PNH and PNH with marrow failure, in which the evolution rate is low later in the course of the disease.

Measurement of the branching ratios of D(+) and D(+)(s) hadronic decays to four-body final states containing a K(S)

We have studied hadronic four-body decays of D(+) and D(+)(s) mesons with a K(S) in the final state using data recorded during the 1996-1997 fixed-target run of the Fermilab high energy photoproduction experiment FOCUS. We report a new branching ratio measurement of gamma(D(+)-->K(S)K-pi(+)pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0768+/-0.0041+/-0.0032. We make the first observation of three new decay modes with branching ratios gamma(D(+)-->K(S)K+pi(+)pi(-))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0562+/-0.0039+/-0.0040, gamma(D(+)-->K(S)K+K-pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0077+/-0.0015+/-0.0009, and gamma(D(+)(s)-->K(S)K+pi(+)pi(-))/gamma(D(+)(s)-->K(S)K-pi(+)pi(+)) = 0.586+/-0.052+/-0.043, where in each case the first error is statistical and the second error is systematic.

Field Survey of Cucumber mosaic virus Subgroups I and II in Crop Plants in Costa Rica

Leaf samples were collected from cucurbit and solanaceous crop plants and Musa spp. in 28 locations in five provinces of Costa Rica during the period from January to October 1996. Sampling sites were selected in dry, humid, and moist tropical regions ranging in altitude from 50 to 2,100 m above sea level. RNA-enriched total nucleic acid solutions were spotted onto nylon membranes and hybridized to RNA probes specific for Cucumber mosaic virus (CMV) subgroups I or II. The presence of CMV was confirmed in 13 crops in 23 of the 28 sampling sites. CMV subgroup I was found to predominate in Costa Rica. CMV subgroup II was detected in the Atlantic region only, and in only 1 out of 113 CMV-positive samples.

First Report of Xylella fastidiosa Infecting Coffee in Costa Rica

In 1995, severe symptoms were observed on 'Caturra' and 'Catuaí' coffee (Coffea arabica L.) varieties in farms in the southern part of the Central Valley in Costa Rica. Symptoms were reduced leaf size, malformation of leaves, curling of leaf edges, shortening of internodes, and severe leaf chlorotic mosaic, which sometimes became necrotic. Abortion of flowers and young beans was also observed, with a reduction in yield. Plants also showed irregular growth with an atypical curling appearance that gave rise to the Spanish name "crespera." Ten and three healthy plants were inoculated by grafting in the greenhouse, using infected and healthy budwoods, respectively. Approximately 6 months after inoculation, 3 of 10 grafted plants with infected budwoods showed symptoms of leaf chlorosis, curling, and malformation of leaves and bunched new flushes. Samples of 39 symptomatic plants collected from the field and samples of 3 healthy plants maintained in the greenhouse were tested by enzyme-linked immunosorbent assay (ELISA). All (100%) analyzed symptomatic samples were positive for X. fastidiosa, and all healthy controls were negative. The symptoms observed in Costa Rica are different from those described for coffee leaf scorch in Brazil (1,2), but the climatological conditions and soil type present in Costa Rica are also very different from the areas where X. fastidiosa occurs in Brazil. Leafhoppers were collected randomly in one of the most affected regions. Graphocephala permagna and Erythrogonia sonora were the most frequent insect species found associated with coffee. In ELISA, 34.5% (10 of 29) and 23.8% (5 of 21) of the collected specimens belonging to G. permagna and E. sonora, respectively, tested positive for X. fastidiosa. These positive ELISAs do not necessarily mean that the insect is a vector. The results presented here extend the known geographic distribution of X. fastidiosa. To our knowledge, this is the first report of X. fastidiosa in coffee in Costa Rica. References: (1) M. J. G. Beretta et al. Plant Dis. 80:821, 1996. (2) de Lima et al. Plant Dis. 82:94, 1998.

First Report of Sugarcane yellow leaf virus (ScYLV) in Costa Rica

In Costa Rica, sugarcane plants with symptoms similar to those described for yellow leaf syndrome (YLS) (1,2) were first observed in 1994 in research plots of imported material in the midland areas of San Carlos and Turrialba. Recently, the same symptoms have been observed in commercial plantations in Turrialba. Symptomatic plants were characterized by yellowing of the leaves and central veins, the yellowing being more intense near the leaf tips. In severe cases, veins became reddish, and necrosis developed along the leaf edges, beginning at the leaf tip and extending to the base of the leaf. Growth of stems and roots was also reduced in infected plants. Minipurifications of six plants of four different varieties were examined by immunospecific electron microscopy (ISEM) using polyclonal antibodies (1). They were: one symptomatic plant each of the varieties H782313 and H608521; two symptomatic plants of H657052, and one asymptomatic plant each of H608521 and H827318. Isometric particles of approximately 28 nm were observed in the asymptomatic H827318 plant and in all symptomatic plants, with the exception of one plant of H657052. The size and morphology of the particles was similar to those reported for Sugarcane yellow leaf virus (ScYLV) (2). The presence of ScYLV was verified by indirect enzyme-linked immunosorbent assay (ELISA) using polyclonal antibodies (1). Twenty-two of 24 symptomatic plants and five of 13 asymptomatic plants were positive for ScYLV. These findings confirm the association of ScYLV with the yellows syndrome of sugarcane observed in Costa Rica. However, as was also reported by Scaglusi and Lockhart (1), ScYLV was not detected in several symptomatic plants, and research is continuing to determine whether other pathogens are associated with this syndrome in Costa Rica. References: (1) S. Scagliusi and B. E. L. Lockhart. Phytopathology 90:120, 2000; (2) J. Vega et al. Plant Dis. 81:21, 1997.

Study of the decay D0 --> K+pi-

Using a large sample of photoproduced charm mesons from the FOCUS experiment at Fermilab (FNAL-E831), we observe the decay D0-->K+pi- with a signal yield of 149+/-31 events compared to a similarly cut sample consisting of 36 760+/-195 D0-->K-pi+ events. We use the observed ratio of D0-->K+pi- to D0-->K-pi+ (0.404+/-0.085+/-0.025)% to obtain a relationship between the D0 mixing and doubly Cabibbo suppressed decay parameters.