Identification and Chemical and Biological Management of Fusarium Root and Crown Rot Disease of Oakleaf Hydrangea

Oakleaf hydrangea (Hydrangea quercifolia) is an important ornamental plant grown in Tennessee. In May 2018, after late spring frost, cultivars Pee Wee and Queen of Hearts showed root and crown rot symptoms and identification and management of the disease was a major concern. The objective of this research was to identify the causal organism of this disease and develop management recommendations for nursery growers. Isolates from the infected root and crown parts were subjected to microscopy, and the morphology of fungi resembled Fusarium. Molecular analysis was conducted by amplifying the internal transcribed spacer of ribosomal DNA, β-tubulin, and translation elongation factor 1-α regions. Fusarium oxysporum was identified as a causal organism based on molecular analysis. A pathogenicity test was done to complete the Koch's postulates by drenching containerized oakleaf hydrangea with a conidial suspension. Experiments were conducted to evaluate different chemical fungicides and biological products with different rates for Fusarium root and crown rot management in container-grown Queen of Hearts. Plants were inoculated by drenching containerized oakleaf hydrangea with 150-ml conidial suspensions of F. oxysporum, maintaining the concentration of 1 × 106 conidia/ml. Root and crown rot were assessed using a scale of 0 to 100%. Recovery of F. oxysporum was recorded by plating root and crown sections. Chemical fungicides such as mefentrifluconazole (BAS75002F), the low rate (1.09 ml/liter) of difenoconazole + pydiflumetofen (Postiva), and the high rate (1.32 ml/liter) of isofetamid (Astun) and biopesticide were applied; the high rate (1.64 g/liter) of ningnanmycin (SP2700 WP) effectively reduced Fusarium root rot severity and pyraclostrobin effectively reduced Fusarium crown rot severity in both trials.

First Report of Root Rot of Redbud Caused by Phytopythium vexans in Tennessee and the United States

The eastern redbud (Cercis canadensis L.) is an esthetically and economically important landscape tree with vibrant blossoms and attractive heart-shaped leaves. One-year-old eastern redbud seedlings grown in field condition in two commercial nurseries in Warren Co., Tennessee exhibited severe root rot in October 2021. Dark brown to black lesions and rot were observed in the affected roots (Fig. 1a). Disease severity was 50-75% of root area and disease incidence was approximately 30-40% of 10,000 plants. Surface sterilized (10% NaOCl; 1 min) symptomatic tissues were plated on V8-PARPH and incubated at 25°C. Whitish cottony mycelia with radiate and chrysanthemum flower-like growth patterns were observed within 4 days of incubation. Subglobose papillate sporangia (10.24 to 20.98 µm, n=50), filamentous to globose smooth oogonia, bell-shaped antheridia and spherical zoospores that are characteristic of Phytopythium vexans (de Cock et al. 2015) were observed in older cultures that were subjected to specific growth conditions as previously described by Ghimire & Baysal-Gurel (2023). Pathogen identification was confirmed by extracting total DNA using the DNeasy PowerLyzer Microbial Kit from 7-day-old cultures of isolates FBG0874, FBG1998, FBG2009 grown on V8-PARPH. P. vexans specific LAMP assay was conducted for the rapid molecular screening and confirmation of the isolates (Ghimire et al. 2023). Primer pairs ITS1/ITS4 (White et al. 1990), NL1/NL4 (Baten et al. 2014), Levup and Fm85mod (Robideau et al. 2011) were used to amplify and sequence the internal transcribed spacer (ITS), 28S large subunit (LSU) of ribosomal RNA and the cytochrome c oxidase subunit I (CoxI) of mitochondrial DNA genetic markers, respectively. The sequences (GenBank accession nos. OR204701, OR205212, OR205213: ITS; OR205214, OR205215, OR205216: LSU; OR220805, OR220806, OR220807: CoxI) were 100% similar to ITS, LSU, and CoxI genetic markers of P. vexans isolates in the NCBI database (MK011121: ITS, KX092469: LSU and KT692908: CoxI). Pathogenicity tests were performed on one-year-old eastern redbud seedlings grown in 1 gal containers to fulfill Koch's postulate. Eastern redbud seedlings were drench inoculated (150 ml/plant) with pathogen slurry (two plates of 7-day-old culture/liter) (Panth et al. 2021) of isolates FBG0874, FBG1998, and FBG2009 (five plants/isolate). Control plants were drenched with agar slurry without pathogen. The study was conducted in a greenhouse maintained at 21 to 23°C, 70%RH, with 16-h photoperiod and irrigated twice a day for 2 min using an overhead irrigation system. Fourteen days after inoculation dark brown to black lesions developed in the root of all inoculated plants that were identical to the symptoms observed in the original samples (Fig. 1b), while the roots of non-inoculated plants remained asymptomatic (Fig. 1c). Isolates resembling P. vexans morphological characteristics were recovered from inoculated plants, and their identity was confirmed as P. vexans using LAMP assay. P. vexans has been previously reported to cause root and crown rot in flowering cherry, ginkgo, and red maple in Tennessee (Baysal-Gurel et al. 2021, Panth et al. 2021). To our knowledge, this is the first report of P. vexans causing root rot of eastern redbud in Tennessee and the United States. Identification of this pathogen as the causal agent is important in designing and implementing effective management practices to mitigate this threat to redbud production.

Identification and Management of Phytophthora Aerial Blight Caused by Phytophthora nicotianae on Catharanthus roseus

Phytophthora nicotianae is the most common pathogen in nurseries and gardens, infecting both woody and herbaceous ornamental plants. Phytophthora aerial blight symptoms such dull water-soaked lesions on shoot tips and leaf petioles, girdling on the main stem, necrosis, and wilting of annual vinca were observed in a commercial greenhouse in Warren County, TN, U.S.A., in May 2016. The objective of this study was to identify the causal agent of Phytophthora aerial blight and develop a fungicide management recommendation for ornamental producers. Attempts to isolate the pathogen from symptomatic leaf tissue were conducted, and excised leaf pieces were embedded in V8 agar medium. Morphological characterization, PCR, sequencing, and pathogenicity test of the isolate FBG2016_444 were conducted to confirm the pathogen identification. The sequence identity was 100% identical to P. nicotianae, and a combined phylogenetic tree (internal transcribed spacer, large subunit of rDNA, and ras-related protein gene) grouped isolate FBG2016_444 within the clade of P. nicotianae. In the pathogenicity study, all inoculated annual vinca plant showed Phytophthora aerial blight symptoms, and P. nicotianae was reisolated, whereas noninoculated annual vinca plant remained symptomless. These findings confirmed P. nicotianae as the causal agent of Phytophthora aerial blight of annual vinca. In addition, two rates (0.078 and 0.156 ml·liter^-1) and three application intervals (7, 14, and 21 days before inoculation [DBI]) of oxathiapiprolin (Segovis) were evaluated for their ability to reduce the Phytophthora aerial blight severity on annual vinca plants. The control groups were positive (nontreated inoculated) and negative (nontreated noninoculated) plants. Both rates and application timings of oxathiapiprolin significantly reduced Phytophthora aerial blight severity and disease progress (area under disease progress curve [AUDPC]) on annual vinca plants compared with the positive control. However, 0.078 and 0.156 ml·liter^-1 of oxathiapiprolin applied at 7 or 14 DBI were the most effective treatments in reducing the disease severity and AUDPC on annual vinca plants. The plant growth parameters such as increase in height and width, total plant weight, and root weight were not influenced by the application of oxathiapiprolin. The findings reported in this study will help ornamental producers with better management of Phytophthora aerial blight of annual vinca.

Fire Ant Venom Alkaloids: Possible Control Measure for Soilborne and Foliar Plant Pathogens

The purpose of this study was to evaluate fire ant venom alkaloids and an alarm pheromone analog against several plant pathogens, including Botrytis cinerea, Fusarium oxysporum, Phytophthora nicotianae, P. cryptogea, Pseudomonas syringae, Phytopythium citrinum, Rhizoctonia solani, Sclerotonia rolfsii, Xanthomonas axonopodis, and X. campestris. All pathogens were tested against red imported fire ant venom alkaloid extract and alarm pheromone compound for growth inhibition in in vitro assay. The venom alkaloid extract inhibited fungal and oomycete pathogens. Neither of the treatments were effective against bacterial pathogens. Three soilborne pathogens, P. nicotianae, R. solani, F. oxysporum, and one foliar pathogen, B. cinerea were selected for further in-vivo assays on impatiens (Impatiens walleriana ‘Super Elfin XP violet’). Total plant and root weight were higher in venom alkaloid treated plants compared to an inoculated control. The venom alkaloid treatment reduced damping-off, root rot severity, and pathogen recovery in soilborne pathogen inoculated plants. Similarly, venom alkaloid reduced Botrytis blight. However, higher venom rates caused foliar phytotoxicity on plants. Therefore, additional work is needed to evaluate rates of venom alkaloids or formulations to eliminate negative impacts on plants. Overall, these results suggest that red imported fire ant venom alkaloids may provide a basis for new products to control soilborne and foliar plant pathogens.

Identification and Chemical and Biological Management of Phytopythium vexans, the Causal Agent of Phytopythium Root and Crown Rot of Woody Ornamentals

Soilborne diseases caused by pathogens such as Phytophthora, Rhizoctonia, Fusarium, Verticillium, and Pythium species are the most important diseases of woody ornamentals. Ginkgo (Ginkgo biloba) and red maple (Acer rubrum 'October Glory') plants grown in containers and fields in Tennessee showed root and crown rot symptoms with dark brown to black lesions in 2017 and 2018. The objective of this research was to isolate and identify pathogens affecting ginkgo and red maple plants in Tennessee nurseries and to develop fungicide/biofungicide management recommendations for nursery producers. Isolations were made from the infected roots. Several Phytophthora-like colonies with spherical zoospores, filamentous to globose oogoni, and whitish mycelium were isolated on V8-PARPH medium. To confirm identity, total genomic DNA was extracted, followed by sequence analysis of the internal transcribed spacer regions, large subunit of nuclear rRNA, and cytochrome c oxidase subunits I and II of mitochondrial DNA. Based on morphological and molecular analysis, Phytopythium vexans was described as a causal agent of crown and root rot from the infected ginkgo and red maple plants. To complete Koch's postulates, a pathogenicity test was performed by drenching 100 ml of V8 agar medium slurry of Phytopythium vexans inoculum on 1-year-old potted ginkgo plant root systems as well as red maple October Glory. Necrotic lesion development was observed in the root system 45 days after inoculation and Phytopythium vexans was reisolated from the roots of both ginkgo and red maple. All control ginkgo and red maple plants remained disease free and no pathogen was reisolated. In addition, the efficacy of fungicides, biofungicides, fertilizer, and host plant defense inducers (traditionally recommended for management of oomycete diseases) for control of Phytopythium crown and root rot was evaluated on ginkgo and red maple October Glory seedlings in greenhouse and field trials. Fungicides such as Empress Intrinsic, Pageant Intrinsic, Segovis, and Subdue MAXX were effective in both greenhouse and field trials, and the biofungicide Stargus reduced disease severity caused by pathogen Phytopythium vexans on ginkgo and red maple plants in greenhouse trials. These results will help nursery producers make proper management decisions for newly reported Phytopythium crown and root rot disease of ginkgo and red maple plants.

Occurrence of Volutella Blight Caused by Pseudonectria foliicola on Boxwood in Tennessee

Boxwood (Buxus sp. L.) is a very popular evergreen shrub in the United States which is widely used as landscape plant and fresh greenery. Boxwood 'Green velvet' (B. sinica var. insularis x B. sempervirens) plants grown in field condition exhibiting Volutella blight symptoms were found in a commercial nursery in Warren Co., Tennessee in May 2019. Leaves appeared red, brown or tan color on affected plants. Waxy, salmon pink colored fruiting bodies (sporodochia) were observed underneath the affected leaves using a hand lens (Figure 1). Leaf drop was also observed on plants. Black lesions under the bark were observed in some of the plants. The disease severity (percentage leaf area diseased) was nearly 40% and the disease incidence was nearly 30% of 1,000 plants. Infected leaf and stem tissues collected from four symptomatic plants were surface sterilized with 70% ethanol and washed with sterile distilled water. Culturing the infected leaf and stem pieces, 5-mm in size, on potato dextrose agar (PDA) consistently yielded white fluffy aerial mycelium growth with scattered salmon-color slimy masses of conidia forming from sporodochia after 10 days incubation at 25°C in a 12-h fluorescent light and dark cycle. A total of two isolates (FBG2020_396 and FBG2020_405) were hyphal tip purified on PDA. The conidia (n = 50) were hyaline, aseptate, fusiform to ellipsoidal measuring average of 7.8 × 3.3 μm (range: 4.84 to 13.2 μm × 2.2 to 4.64 μm). To confirm the pathogen identity, total DNA was extracted using UltraClean Microbial DNA Isolation Kit (MO BIO Laboratories, Inc., Carlsbad, CA) directly from a 5-day old culture of isolates (FBG2020_396 and FBG2020_405) on PDA. The ribosomal DNA internal transcribed spacer region (ITS), β-tubulin (tub2) and part of 28S large ribosomal subunit (LSU) regions were amplified by PCR using the primer pairs ITS 5/ITS 4, T1/BTb2 and LR0R/LR5, respectively (Glass and Donaldson 1995; O'Donnell and Cigelnik 1997; Rehner and Samuels 1994; Vilgalys and Hester 1990; White et al. 1990). Newly generated sequences - GenBank/NCBI acc. nos. MW459251, MW465902 (ITS), MW464656, MW464657 (tub2) and MW459255, MW465903 (LSU) were 100% identical to Pseudonectria foliicola L. Lombard & Crous ex-type (CBS 123190) sequences KM231776, KM232035 and NG_058095, respectively. To complete Koch's postulates, six boxwood 'Green velvet' plants grown in 10 cm square pots (containing 40% coarse sand and 60% ground pine bark) were inoculated by spraying conidial suspension of P. foliicola [FBG2020_396 (1 × 105 conidia/mL)] obtained from 2-wk-old PDA cultures. Plants were covered with clear plastic humidity domes for 3 days and then they were maintained in a growth chamber at 25°C and 60% RH in a 12-h fluorescent light and dark cycle. Six control boxwood plants were maintained in the same environment without pathogen introduction. Pathogenicity test was conducted twice. After 10 days, typical symptoms of Volutella blight developed on the inoculated plants and microscopic examination revealed the same pathogen morphology as the original isolate. Pseudonectria foliicola was consistently re-isolated from leaves and stems. All control boxwood plants remained symptom-free and P. foliicola was not isolated from the leaves or stems. Pseudonectria foliicola causing Volutella blight has been reported on B. sempervirens in Czech Republic (Spetik et al. 2020), New Zealand (Lombard et al. 2015); Buxus sp. in Illinois, Maryland, Massachusetts, North Carolina and Washington (Salgado-Salazar et al. 2019). To our knowledge, this is the first report of Volutella blight of boxwood caused by P. foliicola in Tennessee. Pseudonectria foliicola is an opportunistic pathogen and infects weak, stressed, and injured boxwood plants/cuttings (Rivera et al. 2018). This pathogen could cause a serious economic loss to boxwood nursery growers, as it can significantly affect the ornamental value of boxwood plants and fresh greenery. Integration of sanitation practices with other disease management strategies such as biorational products and reduced-risk fungicides will be necessary for limiting the spread of pathogen and successful management of P. foliicola on boxwood in both field and postharvest conditions.

First Report of Powdery Mildew on Physocarpus opulifolius Caused by Podosphaera physocarpi in Tennessee

Eastern ninebark (Physocarpus opulifolius (L.) Maxim.) is a popular native perennial plant used in landscapes because of its colorful foliage and spring flower display. Powdery mildew symptoms were observed on container-grown eastern ninebark 'Mindia' Coppertina® plants in a commercial nursery in DeKalb County, TN in May 2016. The disease severity was nearly 40% and the disease incidence was nearly 60% of 1,000 plants. Affected plants displayed witches'-brooms with cream to white colored, thickened shoots with stunted, curly leaves as well as patches of white powdery fungal growth on the surface of young and old leaves, inflorescences, infructescences and stems (Figures 1 and 2). Microscopic observation revealed masses of conidia and mycelium covering symptomatic tissues. Conidiophore foot cells measured 19.2 to 66.7 μm (mean = 38.3 μm) × 5.4 to 15.1 μm (mean = 9.7 μm) (n = 30). Conidia were ovoid and measured 11.4 to 28.5 μm (mean = 20.9 μm) (n = 30) in length and 8.2 to 14.8 μm (mean = 11.7 μm) (n = 30) in width. Conidiophores produced two to six conidia in chains. Fibrosin bodies were observed after treating conidia with a 3% KOH solution. Chasmothecia were numerous, 60.0 to 85.0 μm (mean = 74.2 μm) (n = 30) in size and contained one ascus [60.0 to 82.0 × 52.0 to 69.0 μm; mean = 73.4 × 59.4 μm (n = 30)] with 8 ascospores [25.2 to 28.0 × 14.8 to 16.0 μm; mean = 26.5 × 15.5 μm (n = 30)]. To confirm pathogen identity, total DNA was extracted directly from plant tissue with the UltraClean Microbial DNA Isolation Kit (MO BIO Laboratories, Inc., Carlsbad, CA) following the manufacturer's instructions. The ITS region of the ribosomal DNA was amplified by PCR using primer pair ITS1 and ITS4 (White et al. 1990). The sequence (GenBank acc. no. MT605142) of the amplicon had 100% coverage and 100% identity to that of Podosphaera physocarpi (U. Braun) U. Braun (= Podosphaera aphanis var. physocarpi (U. Braun) U. Braun & S. Takam.) (GenBank acc. no. MT106654). Pathogenicity was confirmed three times by inoculating leaf surfaces of five eastern ninebark 'Mindia' Coppertina® plants by tapping fungal spores from infected eastern ninebark leaves onto the surfaces of healthy leaves. Inoculated plants were maintained in a greenhouse (21 to 23°C) using drip irrigation system until symptoms developed. Five non-inoculated control plants were maintained in the same greenhouse. After two weeks, typical symptoms of powdery mildew developed on the inoculated plants and microscopic examination revealed the same pathogen morphology as the original isolate. All non-inoculated control plants remained disease-free. To our knowledge, this is the first report of powdery mildew caused by P. physocarpi on P. opulifolius in Tennessee. Powdery mildew is known to be a disease problem on eastern ninebark grown in its native range in landscape plantings. Lubell et al. (2011) reported varying levels of powdery mildew resistance among eastern ninebark cultivars. Timely application of fungicides with no phytotoxic effect will be necessary to manage this disease on susceptible eastern ninebark cultivars in affected nurseries.

First Report of Phytopythium vexans Causing Root and Crown Rot on Flowering Cherry in Tennessee

Flowering cherry (Prunus serrulata Lindl. 'Kwanzan') rooted cuttings grown in propagation beds containing 40% coarse sand and 60% ground pine bark in a commercial propagation nursery in Warren County, Tennessee were exhibiting root and crown rot in December 2016. Dark brown to black soft lesions were observed in the roots as well as the crown region of flowering cherry rooted cuttings and those rooted cuttings were non-marketable due to lesions. Disease incidence was approximately 60% of 10,000 plants. Phytophthora ImmunoStrip test (Agdia Inc., Elkhart, IN, USA) was performed and the test result was positive. Diseased plant tissues were surface sterilized with 70% ethanol and washed twice with distilled water. Culturing the affected root and crown parts (1 cm pieces) on V8-PARPH, an oomycete-selective medium consistently yielded whitish radiate mycelial growth pattern with spherical zoospores, filamentous to globose oogoni, elongated, and cylindrical antheridia with constrictions (De Cock et al., 2015) after 7 days of incubation at 25°C in a 12-h fluorescent light and dark cycle, which is the typical morphology of Phytopythium vexans (de Bary) Abad, de Cock, Bala, Robideau, Lodhi & Lévesque. To confirm pathogen identity, total DNA was extracted using the UltraClean Microbial DNA Isolation Kit (MO BIO Laboratories, Inc., Carlsbad, CA, USA) directly from a 3-day old culture of isolate (FBG2017010) on V8 medium. The internal transcribed spacer (ITS) and 28S large subunit of ribosomal RNA, and cytochrome c oxidase subunit I (CoxI) of mitochondrial DNA (mtDNA) genes/ region were amplified by PCR using the primer pairs ITS1/ ITS4 (White et al., 1990), NL1/ NL4 (Baten et al., 2014), and Levup and Fm85mod (Robideau et al., 2011), respectively. The PCR products were sequenced and the sequences (GenBank accession nos. MT533275, MT533451, and MT547980) were compared to the voucher specimens. They were 99.23, 99.60, and 98.92% similar to those of P. vexans isolates in the NCBI database (HQ643400, KR092144, and HQ708996, respectively). To complete Koch's postulates, 'Kwanzan' flowering cherry rooted cuttings grown on propagation substrate (10 cm pot containing 1 kg sterilized 40% coarse sand and 60% ground pine bark) were inoculated with identified pathogen and observations were taken on root rot disease symptoms. Five plants were inoculated with 100 ml of pathogen agar-slurry (1 plate of a 7-day old culture of isolate FBG2017010/1 L of sterilized water), and five control plants were drenched with agar slurry. The plants were maintained in the greenhouse condition (day/night temperature of 26/24°C), and irrigated twice a day for 2 min by overhead irrigation system. After 2 weeks, dark brown to black necrotic root lesions developed on all inoculated cuttings and P. vexans was consistently re-isolated from the inoculated plants. The morphology of the pathogen isolated on the V8-PARPH medium was identical to the original isolate. All control plants remained symptom-free and P. vexans was not isolated from the root tissue. To our knowledge, this is the first report of P. vexans causing root and crown rot in 'Kwanzan' flowering cherry in Tennessee, which can be a potential threat for the nursery crop production. The identification of P. vexans, the causal agent of Phytopythium root and crown rot is important in determination and implementation of effective management strategies.

Soil phosphorus dynamics following land application of unsaturated and partially saturated red mud and water treatment residuals

The secondary use of P-sorbing industrial by-products as a fertilizer or soil conditioner is gaining increased attention, particularly in light of diminishing reserves of rock phosphate traditionally used to manufacture P fertilizer. This study examined applications of red mud (RM) and water treatment residuals (WTR) at two levels of P saturation (i.e. 'as received' and partially saturated) in a soil incubation and runoff plot study. When incubated with soils ranging in texture and initial P concentration, P-sorbing residuals that were less enriched with P decreased water-extractable soil P (WEP) concentration to a greater extent than more P saturated residuals. In contrast to WTR treatments, not all of the RM applications decreased soil WEP concentrations below those of the control soils. The runoff study investigated soil P dynamics when partially P-saturated RM and WTR's were surface applied to grass plots at 2 t ha^-1 on Day 0, followed by three rainfall simulations (7 cm h^-1 for 30 min, Days 2, 7 and 28) and at 3 t ha^-1 on Day 70 followed by two more rainfall simulations (Days 77 and 96). Application of residuals at these rates did not significantly increase dissolved reactive P (DRP) in runoff compared with unamended controls during the study. Forage cuttings taken 90 days after the first rainfall simulation indicated that nutrient uptake was not compromised by the application of the residuals. Overall results indicate that WTRs may be a more suitable soil amendment than RM residuals given their greater ability to reduce soil WEP across a range of soils without simultaneously increasing Mehlich-3 extractable soil P concentrations above the upper threshold limit (150 mg P kg^-1), and their minimal impact on plant nutrient uptake.

Collaborating to Compete: Blood Profiling Atlas in Cancer (BloodPAC) Consortium

The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays.

What's the Optimum Computer Display Size?

Answering that question through scientific study can strengthen a product's chances in the marketplace.

Decision tree analysis as a supplementary tool to enhance histomorphological differentiation when distinguishing human from non-human cranial bone in both burnt and unburnt states: A feasibility study

This feasibility study was undertaken to describe and record the histological characteristics of burnt and unburnt cranial bone fragments from human and non-human bones. Reference series of fully mineralized, transverse sections of cranial bone, from all variables and specimen states, were prepared by manual cutting and semi-automated grinding and polishing methods. A photomicrograph catalogue reflecting differences in burnt and unburnt bone from human and non-humans was recorded and qualitative analysis was performed using an established classification system based on primary bone characteristics. The histomorphology associated with human and non-human samples was, for the main part, preserved following burning at high temperature. Clearly, fibro-lamellar complex tissue subtypes, such as plexiform or laminar primary bone, were only present in non-human bones. A decision tree analysis based on histological features provided a definitive identification key for distinguishing human from non-human bone, with an accuracy of 100%. The decision tree for samples where burning was unknown was 96% accurate, and multi-step classification to taxon was possible with 100% accuracy. The results of this feasibility study strongly suggest that histology remains a viable alternative technique if fragments of cranial bone require forensic examination in both burnt and unburnt states. The decision tree analysis may provide an additional but vital tool to enhance data interpretation. Further studies are needed to assess variation in histomorphology taking into account other cranial bones, ontogeny, species and burning conditions.

Bizarre parosteal osteochondromatous proliferation: case report and review of the literature

Bizarre parosteal osteochondromatous proliferation of bone (BPOP) is a benign lesion that is occasionally misinterpreted as a malignant process. The original reports described lesions exclusively in the hands and feet. However, subsequent reports have included additional sites in the long bones, skull, and maxilla. The differential diagnosis of BPOP includes numerous benign and malignant lesions. The benign differential diagnosis includes osteochondroma and reactive processes. The most important malignant differential diagnosis is parosteal osteosarcoma. We present a case of an 11-year-old boy with recurrent BPOP and review the literature. We discuss the differential diagnosis and pathogenesis of the lesion.

Undergraduate environmental health education: preparing for the future

Attendees indicated that the workshop was beneficial and that the opportunity to communicate with faculty representing 23 programs accredited by EHAC and nine programs not accredited by EHAC was extremely useful. There was general agreement on a number of points: There is a need for undergraduate environmental health programs to collaborate on matters related to distance learning. Topics related to women, gender, diversity, ethics, and international environmental health should be incorporated into the environmental health curriculum. There are no major problems with current EHAC curricular guidelines, but the guidelines should be evaluated on a regular basis. Field experience or internship is an essential component in the academic preparation of undergraduate environmental health students. There is a significant need for increased funding for undergraduate environmental health programs. There is a need to increase the visibility and recognition of environmental health programs. There is a need to solidify ties with traditional partners and to establish new linkages at the local, regional, and national levels in the government, community, and private sector. It is essential that undergraduate faculty communicate with each other on matters relating to the preparation of environment health practitioners. There is a need for an association of undergraduate academic programs to provide leadership and a focal point for identification and resolution of issues common to all. The establishment of an association was viewed as the most practical and effective way to address these issues and to pursue related opportunities.

Beta-blocker use in patients with acute myocardial infarction treated by hospitalists

It is well recognized that the administration of beta blockers to patients after myocardial infarction improves survival. This retrospective cohort and prospective study sought to define the usage of a large hospitalist group and enhance this usage by education and the utilization of a uniform discharge summary. All patients with a discharge diagnosis of acute myocardial infarction were included for analysis. The use of beta blockers by the hospitalist group was initially collected retrospectively and compared with two large cohorts. The data were presented to the hospitalist group. Prospective data collection then commenced. Retrospective analysis of the use of beta blockers showed a rate of 68% as compared with 21% and 34% in two large cohorts (P < .0001). After data were reviewed and conference occurred, prospective use of beta blockers increased to 90% (P < .0005). Patients with myocardial infarction were extremely likely to be treated with beta blockers by this hospitalist group. Review of previous usage and review of contraindications along with the use of a uniform discharge summary resulted in a significant increase in the use of these life-saving drugs.

Human low density lipoprotein receptor fragment. Successful refolding of a functionally active ligand-binding domain produced in Escherichia coli

The low density lipoprotein (LDL) receptor plays a key role in cholesterol homeostasis, mediating cellular uptake of lipoprotein particles by high affinity binding to its ligands, apolipoprotein (apo) B-100 and apoE. The ligand-binding domain of the LDL receptor contains 7 cysteine-rich repeats of approximately 40 amino acids; each repeat contains 6 cysteines, which form 3 intra-repeat disulfide bonds. As a first step toward determining the structure of the LDL receptor, both free and bound to its ligands, we produced in Escherichia coli a soluble fragment containing the ligand-binding domain (residues 1-292) as a thrombin-cleavable, heat-stable thioredoxin fusion. Modest amounts (5 mg/liter) of partially purified but inactive fragment were obtained after cell lysis, heat treatment, thrombin cleavage, and gel filtration under denaturing conditions. We were able to refold the receptor fragment to an active conformation with approximately 10% efficiency. The active fragment was isolated and purified with an LDL affinity column. The refolded receptor fragment was homogeneous, as determined by sodium dodecyl sulfate or non-denaturing polyacrylamide gel electrophoresis and isoelectric focusing. The purified fragment did not react with fluorescein-5-maleimide, indicating that all 42 cysteines were disulfide linked. In addition, the refolded fragment exhibited properties identical to those of the intact native receptor: Ca2+-dependent binding and isoform-dependent apoE binding (apoE2 binding <5% of apoE3). Furthermore, antibodies to the fragment recognized native receptors and inhibited the binding of 125I-LDL to fibroblast LDL receptors. We conclude that we have produced a properly folded and fully active receptor fragment that can be used for further structural studies.

Phase II trial of tirapazamine combined with cisplatin in chemotherapy of advanced malignant melanoma

PURPOSE

A phase II study was undertaken to determine the efficacy of tirapazamine (TPZ) combined with cisplatin (cDDP) in patients with metastatic melanoma.

PATIENTS AND METHODS

Between June 1994 and November 1995, 48 patients with metastatic melanoma were treated with TPZ (260 mg/m2, administered intravenously over two hours) followed in one-hour by cDDP (75 mg/m2 over one hour) every 21 days. Sixteen patients had received prior chemotherapy, and 13 of these had failed to respond to prior cDDP. None of the patients had symptomatic brain metastasis.

RESULTS

Nine patients had partial responses, with an overall response rate of 19% (95% confidence interval (95% CI) of 9%-33%). The median duration of response was six months. None of the responders had received prior chemotherapy. Responses were seen in 8 (33%, confidence interval of 16%-55%) of 24 patients with primary cutaneous melanoma who had received no prior chemotherapy and in the only patient with previously untreated conjunctival melanoma. There were no responders among the seven patients with choroidal melanoma and 16 patients with previously treated cutaneous melanoma. Two patients with partial responses were rendered free of gross disease surgically three months after completing eight courses of TPZ-cDDP; they remain free of tumor recurrence. Responses were seen in lymph nodes (27%), lung (26%), skin (20%), adrenal gland (20%), soft tissues (17%) and liver (17%). Common toxicities included muscle cramps, fatigue, gastrointestinal effects and peripheral neuropathy. Fatigue, nausea, vomiting, anorexia, and muscle cramps were grade 3 or 4 in less than 10% of the courses. Neutropenia and thrombocytopenia were rare.

CONCLUSION

The TPZ-cDDP combination has definite activity against chemotherapy-naïve patients with cutaneous melanoma and warrant further studies in combination with other cytotoxic agents.

Novel mechanism for defective receptor binding of apolipoprotein E2 in type III hyperlipoproteinemia

The defective binding of apolipoprotein (apo) E2 to lipoprotein receptors, an underlying cause of type III hyperlipoproteinemia, results from replacement of Arg 158 with Cys, disrupting the naturally occurring salt bridge between Asp 154 and Arg 158. A new bond between Asp 154 and Arg 150 is formed, shifting Arg 150 out of the receptor binding region. Elimination of the 154-150 salt bridge by site-directed mutagenesis of Asp 154 to Ala restored the receptor binding activity to near normal levels. The X-ray crystal structure of apoE2 Ala 154 demonstrated that Arg 150 was relocated within the receptor binding region. Our results demonstrate that defective binding of apoE2 occurs by a novel mechanism of the replacement of one salt bridge with another.

Human apolipoprotein E. Role of arginine 61 in mediating the lipoprotein preferences of the E3 and E4 isoforms

Human apolipoprotein (apo) E4 (arginine at residue 112) preferentially associates with very low density lipoproteins (VLDL), and apoE3 (cysteine at 112) associates with high density lipoproteins. It has been postulated that the amino-terminal domain, which contains residue 112, influences the lipoprotein preference by interacting with the carboxyl-terminal domain, which contains the lipid-binding region. To delineate the region in the carboxyl-terminal domain mediating lipoprotein binding and involved in isoform preference, we produced truncated apoE3 and apoE4 variants (terminating at residues 251, 260, 266, or 272) in Escherichia coli and assessed them for lipoprotein association. This analysis suggested that residues 260-272 contain important determinants for complete lipoprotein association and isoform preferences. To determine whether positive charge at residue 112 was an absolute requirement for the apoE4 VLDL preference, we compared the distributions of rabbit apoE (equivalent to apoE3, with cysteine at a position corresponding to 112), canine apoE (arginine at the corresponding site), and cysteamine-treated rabbit apoE (cysteine converted to a positively charged residue). Surprisingly, all distributed like human apoE3, suggesting that positive charge at a position corresponding to 112 was not directly responsible for the isoform preference and that other residues in the amino-terminal domain were involved. To determine which residues were involved, the structure of the apoE4 22-kDa fragment (the amino-terminal two-thirds of the molecule) was determined to 2.5 A by x-ray crystallography. Compared with the known four-helix bundle structure of apoE3, the only significant differences in the apoE4 structure were that glutamic acid 109 formed a salt bridge with arginine 112 and that the arginine 61 side chain was displaced to a new position. Site-directed mutagenesis of glutamic acid 109 in apoE3 and arginine 61 in apoE4 demonstrated that the position of the arginine 61 side chain in apoE4 was critical in determining apoE4 lipoprotein distribution, suggesting that arginine 61 interacted with the carboxyl-terminal domain to direct binding to VLDL.

Salvage trial of trimetrexate-leucovorin for the treatment of cerebral toxoplasmosis in patients with AIDS

The clinical efficacy of trimetrexate, a dihydrofolate reductase inhibitor with potent in vitro antitoxoplasma activity, was assessed in 9 sulfonamide-intolerant patients with AIDS and biopsy-proven cerebral toxoplasmosis. The 9 patients were treated for 28-149 days with trimetrexate (30-280 mg/m2/day) plus leucovorin (20-90 mg/m2 every 6 h). Radiographic responses were documented in 8 patients, and clinical responses in 5 patients. Despite continued therapy, all patients deteriorated clinically and radiographically within 13-109 days of their initial improvement. Trimetrexate at very high doses for extended periods was not associated with serious toxicity. Trimetrexate alone had dramatic but transient activity in sulfonamide-intolerant patients and thus is not adequate as single-agent therapy for AIDS-associated toxoplasmosis.

Pacing lead survival: performance of different models

Recent reports have shown poor survival of some leads currently in use. Long-term survival analysis of 2,444 leads (1,059 atrial and 1,385 ventricular) implanted in this institution since January 1980, and having at least 1 month of follow-up was performed. The survival of 123 different models was compared with the average survival of all the leads implanted in the corresponding chamber. Failure was defined as inactivation of the lead (electrical abandonment, explant, or cap) due to insulator and/or conductor fracture.

RESULTS

The mean follow-up was 33 +/- 32 months. The cumulative survival for different atrial lead models was consistent with the average performance in the atrium. No atrial lead showed better or worse survival compared to the others. In the ventricular group, the Medtronic 4012 lead showed statistically significant poorer survival (P = 0.01) compared with the average survival of the ventricular leads. The Cardiac Pacemakers, Inc. (CPI) 4010 lead showed a nonsignificant (P = 0.12) worse performance than the average for ventricular leads.

CONCLUSIONS

(1) The Medtronic 4012 had a significantly poorer performance than the rest of the leads. A trend in similar direction was found for the CPI 4010, also in the ventricular group; (2) Atrial lead models showed a stable survival; and (3) Frequent follow-up is required for some leads, especially in pacemaker dependent patients.

Effect of atrioventricular synchrony on stroke volume during ventricular tachycardia in man

The hemodynamic consequences of atrioventricular (AV) synchrony during ventricular tachycardia were evaluated during cardiac electrophysiologic testing. The relationship between stroke volume and the AV interval was investigated on a beat-by-beat basis in six patients during induced monomorphic ventricular tachycardia. Stroke volume was calculated either (1) in the right ventricle using impedance catheter method (four patients) or (2) in the left ventricle using Doppler measurement of aortic blood velocity (two patients). The impedance catheter method underestimated stroke volume by a factor of 4.2 +/- 2.4 compared with the thermodilution cardiac output method. However, there was a highly linear relationship between both methods for computing stroke volume (r greater than 0.9). Five patients had complete AV dissociation during ventricular tachycardia, and different AV intervals spanned the entire tachycardia cycle lengths. Largest stroke volumes were associated with optimal AV intervals within 120 and 230 msec, resulting in a 97 +/- 59% increase in stroke volume over ventricular tachycardia cycles not associated with atrial activity. Customized atrial pacing during ventricular tachycardia may provide a valuable means for artificially establishing the hemodynamically optimal AV interval and eliminating the ventricular tachycardia cycles not preceded by atrial activity.

Signal-averaged electrocardiography for detection of ventricular tachycardia using fast Fourier transform filtering on a standard ECG cart

Signal-averaged electrocardiography has been advocated as a technique to predict the occurrence of ventricular tachycardia, especially in patients with ischemic heart disease. We studied a heterogeneous population of 77 patients referred for electrophysiologic testing using a recently developed fast Fourier transform filtering system available as part of a standard electrocardiography cart. The sensitivity, specificity, and positive predictive accuracy of this system were consistent with those previously determined using bidirectional Butterworth filters or finite impulse response filtering techniques. This new filtering approach in generation of signal-averaged ECG data for detection of ventricular tachycardia has promise but will require use in larger groups to establish its true clinical value.

Automatic implantable cardioverter-defibrillator implantation without thoracotomy using an endocardial and submuscular patch system

The automatic cardioverter-defibrillator lead system is implanted by a thoracotomy procedure that may result in atelectasis, pleural effusion, cardiac tamponade and lengthy convalescence. A new defibrillator lead system that allows selection of different defibrillating current pathways is implanted without a thoracotomy. Ten patients requiring a cardioverter-defibrillator for recurrent sustained ventricular tachycardia (five patients) or aborted sudden cardiac death (five patients) were evaluated for implantation of this lead system. A lead configuration with a bidirectional defibrillating current pathway was implanted in nine patients. The defibrillation threshold with this lead configuration was 15 J in five patients, 20 J in three and 30 to 35 J in one patient. In the remaining patient the lead system had a 40 J defibrillation threshold and was not implanted. No perioperative complications occurred. Induced ventricular fibrillation was successfully terminated at the predischarge and intermediate follow-up (8 to 12 weeks) electrophysiologic studies. During the follow-up period, there were three deaths (one sudden, two due to heart failure) and two lead system failures (oversensing with inappropriate shocks in one patient and patch lead fracture in another). Implantation of the cardioverter-defibrillator lead system by a nonthoracotomy approach is feasible, has no significant perioperative complications and is well tolerated by patients. Effective defibrillation was demonstrated immediately as well as at intermediate follow-up study. The occurrence of patch lead fracture and oversensing requires improvement in the present (nonthoracotomy) lead system technology.

Clinical performance of the implantable cardioverter defibrillator: electrocardiographic documentation of 101 spontaneous discharges

Records of 105 patients, who received an automatic implantable cardioverter defibrillator (AICD), were studied to investigate the causes of spontaneous AICD discharges and to correlate the symptoms with the arrhythmias triggering AICD discharges. During a follow-up period of 13 +/- 8 months, 46/105 (44%) patients had 566 spontaneous AICD discharges. A total of 101 discharges were documented with Holter monitoring in 23 patients. In this study group, there were 8 (8%) AICD discharges for 5 episodes of ventricular fibrillation, and 68 (67%) discharges for 63 episodes of sustained ventricular tachycardia. Patients lost consciousness in all episodes of ventricular fibrillation, but were symptomatic prior to only 36 (53%) discharges in ventricular tachycardia. Nonsustained ventricular tachycardia persisting for a period of 7.5 +/- 2 seconds resulted in 20 AICD discharges; patients were symptomatic prior to 13 (65%) discharges. Supraventricular tachycardias triggered three discharges. One patient had two spurious discharges during sinus rhythm. In conclusion, most of the spontaneous AICD discharges were appropriate for the detected rhythms, but only clinically appropriate for the management of arrhythmias in 75% of the cases. A significant portion of the patients with sustained or nonsustained ventricular tachycardias triggering AICD discharges were asymptomatic prior to discharge, which requires further assessment of the physiology of the arrhythmia as a component of the detection algorithm.

The effects of percutaneous catheter ablation on preexisting permanent pacemakers

STUDY OBJECTIVE

Determine the effect of percutaneous catheter ablation (CA) on permanent pacemakers.

MEASUREMENTS AND RESULTS

Twenty-three patients who underwent CA at The Cleveland Clinic Foundation from September 1983 to January 1990, and had a previously implanted pacemaker were studied. Electrocardiographic data during the CA procedure and clinic data including pacemaker evaluations were analyzed. Fifty-two percent (12/23) of the pacemakers malfunctioned: five developed transient ventricular loss of capture; two undersensing; one oversensing; three could not be interrogated or programmed, and one did not respond to the magnet test. Four patients developed syncopal episodes and two severe dizziness after the procedure. All had their pacemakers replaced. In total, seven were explanted. Destructive analysis by the individual manufacturer identified pacemaker circuitry failure in five. Unipolar pacemakers and anodal ablation procedures had more frequent and severe malfunctions, but the difference was not statistically significant.

CONCLUSIONS

Pacemaker malfunction is frequent during CA. It may be prevented by programming the pacemaker, when possible, to the nonfunctioning mode (000 mode). Temporarily disconnecting the pacemaker during ablation requires further evaluation as an alternative approach. Close follow-up can detect pacemaker malfunction and prevent complications.

Stature estimation from fragmentary femora: a revision of the Steele method

The skeletal remains presented to forensic anthropologists are often fragmentary. Previously described methods of estimating stature from segments of long bones have not proved satisfactory because of the difficulty involved in identifying the precise anatomical landmarks by which they are defined. This study represents an assessment of the feasibility of stature estimation from fragmentary femora. A sample of 200 males and females, blacks and whites (total sample = 800), was obtained from the Terry Collection. New regression equations for the estimation of maximum femur length and stature from three well-defined and easy-to-measure segments of the femur are presented. This technique represents an improvement over methods currently in use for estimating stature from femur fragments; the location of the anatomical landmarks and the accuracy of the prediction are enhanced. The applicability of these formulae to a modern forensic sample is addressed with regard to secular trends in stature increase and changes in body segment proportions.

Continuous right ventricular volume assessment by catheter measurement of impedance for antitachycardia system control

Current implantable defibrillators are unable to differentiate between hemodynamically stable and unstable arrhythmias. This may result in unnecessary high energy shocks during arrhythmias that are better managed with other interventions. This study assessed the efficacy of the impedance catheter in sensing relative volumetric changes in the right ventricle as a measure of the hemodynamic status during an arrhythmia. During electrophysiological testing, 37 arrhythmias were induced in 12 patients aged 28-74 years. Rhythms recorded were: (A) hemodynamically stable tachyarrhythmias (supraventricular tachycardia and sustained monomorphic ventricular tachycardia)--21 episodes; and (B) hemodynamically unstable ventricular arrhythmias causing syncope (hypotensive ventricular tachycardia and ventricular fibrillation)--16 episodes. During unstable arrhythmias, stroke impedance (32 +/- 17%), arterial systolic pressure (40 +/- 11%), and right ventricular pulse pressure (15 +/- 20%), expressed as percentages of corresponding sinus rhythm values, were significantly lower than in stable arrhythmias (84 +/- 26%, 72 +/- 8%, and 111 +/- 37%, respectively); P less than 0.001. There was a good correlation between stroke impedance and mean arterial pressure during arrhythmia (r = 0.84). Impedance sensing is a practical method for distinguishing between hemodynamically stable and unstable arrhythmias. Implementation of hemodynamic sensing into the algorithm of future antitachycardia systems may improve the management of arrhythmias by adding options for selective pace termination or cardioversion.

Effects of extracorporeal shock wave lithotripsy on cardiac pacemakers and its safety in patients with implanted cardiac pacemakers

Effects of extracorporeal shock wave lithotripsy (ESWL) were studied on 15 pacemakers (standard single chamber n = 5, dual chamber n = 6, rate responsive single chamber [Activitrax] n = 4). In-vitro testing involved suspending the pacemakers in a bath of degassified, deionized water firmly taped to a platform at the point of maximal pressure, i.e., second focal point (F2), where they received pressure shocks (means = 1300) from the HM3 Dornier lithotriptor. The pacemakers, programmed to their most sensitive setting, were continuously pacing at nominal outputs (atrial and ventricular pacing in the DDD mode). All units were assessed by a pacing system analyzer before and after the study, then underwent destructive analysis. During standard single chamber pacing (VVI) the pacing stimulus triggered ESWL. For dual chamber devices, ESWL was triggered by the atrial paced event which induced inhibition of the ventricular output in two pacemaker. This was eliminated by reprogramming to a less sensitive setting. The pacemaker can, hermetic seal and internal circuitry were undamaged in all units. Two rate responsive single chamber pacemakers had their activity sensing piezoelectric elements shattered when placed at F2. Two other units placed 5 cm from F2 were stimulated to their maximum upper programmed pacing rate with ESWL therapy, but were otherwise unaffected. Subsequent to this study, six patients with pacemakers programmed to the VVI (five), DDD (one) modes implanted in the thorax underwent successful ESWL without pacemaker or arrhythmic event.

CONCLUSIONS

(A) It is generally safe for patients implanted with standard single chamber devices in a ventricular application to undergo ESWL without modifying the pacing/sensing parameters. (B) Patients implanted with dual chamber devices who pace in the atrium should be reprogrammed to the VVI mode during ESWL. (C) Patients with piezoelectric activity sensing rate responsive single chamber pacemakers should have this feature programmed off during ESWL and, if implanted in the abdomen, probably should not undergo ESWL.

Genetic analysis of small nuclear RNAs in Saccharomyces cerevisiae: viable sextuple mutant

Saccharomyces cerevisiae contains at least 24 distinct small nuclear RNAs (snRNAs), several of which are known to be essential for viability and to participate in the splicing of pre-mRNAs; the RNAs in this subset contain binding sites for the Sm antigen, a hallmark of metazoan snRNAs involved in mRNA processing. In contrast, we showed previously that the single-copy genes for three other snRNAs (snR3, snR4, and snR10) are not required for viability, although cells lacking snR10 are growth impaired at low temperature. None of these RNAs associates with the Sm antigen. To assess this apparent correlation, we cloned and sequenced the genes encoding three additional non-Sm snRNAs. Comparison of these genes with nine additional yeast snRNA genes revealed a highly conserved TATA box located 92 +/- 8 nucleotides 5' of the transcriptional start site. By using the technique of gene replacement with null alleles, each of these three single copy genes was shown to be completely dispensable. We constructed multiple mutants to test the hypothesis that, individually, each of these snRNAs is nonessential because the snRNAs play functionally overlapping roles. A mutant lacking five snRNAs (snR3, snR4, snR5, snR8, snR9) was indistinguishable from the wild type, and growth of the sextuple mutant was no more impaired than that in strains lacking only snR10. This widespread dispensability of snRNAs was completely unexpected and forces us to reconsider the possible roles of these ubiquitous RNAs.