Carbon footprint of perennial bioenergy crop production receiving various nitrogen fertilization rates

Perennial bioenergy crops can reduce greenhouse gas emissions compared to fossil fuels, but little is known about their C footprints. We evaluated C footprint and C balance of perennial bioenergy crops receiving various N fertilization rates and visually compared them with an annual crop from 2012 to 2014 in the semiarid region of US northern Great Plains. Perennial bioenergy crops were intermediate wheatgrass (Thinopyrum intermedium [Host] Barkworth and Dewey, IW), smooth bromegrass (Bromus inermis L., SB), and switchgrass (Panicum virgatum L., SG), and N fertilization rates were 0, 28, 56, and 84 kg N ha^-1. The annual crop was spring wheat (Triticum aestivum L., WH). The CO₂ flux increased in the summer when air temperature and precipitation were greater. Cumulative annual CO₂ flux was greater for SB and SG than IW in 2012-2013 and greater for SB than IW and SG in 2013-2014. Shoot C increased with increased N fertilization rate and was greater for SG than IW and SB at most N fertilization rates in both years. Root and rhizosphere C varied with N fertilization rates and were lower for SG than IW and SB at 0 kg N ha^-1, but greater at 84 kg N ha^-1. Carbon balance also varied with N fertilization rates, being lower for SG than IW and SB at 0 kg N ha^-1, but greater at other N rates. Cumulative CO₂ flux was higher, but shoot, root, and rhizosphere C as well as C balance were lower for WH than perennial bioenergy crops. Because of greater total C input but lower CO₂ flux, SG with N fertilization can be C positive, retaining more C in plant residue and soil than other perennial bioenergy crops. Spring wheat remained C negative compared to perennial bioenergy crops, losing more C as CO₂ flux than total C input.

Soil total carbon and nitrogen and crop yields after eight years of tillage, crop rotation, and cultural practice

Information on the long-term effect of management practices on soil C and N stocks is lacking. An experiment was conducted from 2004 to 2011 in the northern Great Plains, USA to examine the effects of tillage, crop rotation, and cultural practice on annualized crop residue (stems + leaves) returned to the soil and grain yield, and soil total C (STC) and total N (STN) stocks at the 0–120 cm depth. Tillage practices were no-tillage (NT) and conventional tillage (CT) and crop rotations were continuous spring wheat (Triticum aestivum L.) (CW), spring wheat-pea (Pisum sativum L.) (W-P), spring wheat-barley (Hordeum vulgaris L.) hay-pea (W-B-P), and spring wheat-barley hay-corn (Zea mays L.)-pea (W-B-C-P). Cultural practices were traditional (conventional seed rates and plant spacing, conventional planting date, broadcast N fertilization, and reduced stubble height) and improved (variable seed rates and plant spacing, delayed planting, banded N fertilization, and increased stubble height). Crop residue and grain yield were greater with CW and W-P than W-B-P and grain yield was greater with the traditional than the improved practice. The STC at 10–20 and 90–120 cm was greater with CW or W-P than other crop rotations in CT and greater with CW than W-B-P in NT. The STN at 20–40 cm was greater with W-P than CW and W-B-P in CT. With NT and the improved cultural practice, STN at 0–5, 5–10, 20–40, and 60–90 cm was greater with W-P and W-B-C-P than other crop rotations. The STN at 0–10 cm correlated with annualized crop residue and grain yield (r = 0.94–0.97, P ≤ 0.05). Increased crop residue returned to the soil increased soil C stock with CW and W-P and N stock with W-P, but removal of aboveground crop biomass for hay decreased stocks with W-B-P. Increased soil N stock had a beneficial effect on crop grain yield.

Dryland soil chemical properties and crop yields affected by long-term tillage and cropping sequence

Information on the effect of long-term management on soil nutrients and chemical properties is scanty. We examined the 30-year effect of tillage frequency and cropping sequence combination on dryland soil Olsen-P, K, Ca, Mg, Na, SO4-S, and Zn concentrations, pH, electrical conductivity (EC), and cation exchange capacity (CEC) at the 0-120 cm depth and annualized crop yield in the northern Great Plains, USA. Treatments were no-till continuous spring wheat (Triticum aestivum L.) (NTCW), spring till continuous spring wheat (STCW), fall and spring till continuous spring wheat (FSTCW), fall and spring till spring wheat-barley (Hordeum vulgare L., 1984-1999) followed by spring wheat-pea (Pisum sativum L., 2000-2013) (FSTW-B/P), and spring till spring wheat-fallow (STW-F, traditional system). At 0-7.5 cm, P, K, Zn, Na, and CEC were 23-60% were greater, but pH, buffer pH, and Ca were 6-31% lower in NTCW, STCW, and FSTW-B/P than STW-F. At 7.5-15 cm, K was 23-52% greater, but pH, buffer pH, and Mg were 3-21% lower in NTCW, STCW, FSTCW, FSTW-B/P than STW-F. At 60-120 cm, soil chemical properties varied with treatments. Annualized crop yield was 23-30% lower in STW-F than the other treatments. Continuous N fertilization probably reduced soil pH, Ca, and Mg, but greater crop residue returned to the soil increased P, K, Na, Zn, and CEC in NTCW and STCW compared to STW-F. Reduced tillage with continuous cropping may be adopted for maintaining long-term soil fertility and crop yields compared with the traditional system.

Hydrolase stabilization via entanglement in poly(propylene sulfide) nanoparticles: stability towards reactive oxygen species

In the advancement of green syntheses and sustainable reactions, enzymatic biocatalysis offers extremely high reaction rates and selectivity that goes far beyond the reach of chemical catalysts; however, these enzymes suffer from typical environmental constraints, e.g. operational temperature, pH and tolerance to oxidative environments. A common hydrolase enzyme, diisopropylfluorophosphatase (DFPase, EC 3.1.8.2), has demonstrated a pronounced efficacy for the hydrolysis of a variety of substrates for potential toxin remediation, but suffers from the aforementioned limitations. As a means to enhance DFPase's stability in oxidative environments, enzymatic covalent immobilization within the polymeric matrix of poly(propylene sulfide) (PPS) nanoparticles was performed. By modifying the enzyme's exposed lysine residues via thiolation, DFPase is utilized as a comonomer/crosslinker in a mild emulsion polymerization. The resultant polymeric polysulfide shell acts as a 'sacrificial barrier' by first oxidizing to polysulfoxides and polysulfones, rendering DFPase in an active state. DFPase-PPS nanoparticles thus retain activity upon exposure to as high as 50 parts per million (ppm) of hypochlorous acid (HOCl), while native DFPase is observed as inactive at 500 parts per billion (ppb). This trend is also confirmed by enzyme-generated (chloroperoxidase (CPO), EC 1.11.1.10) reactive oxygen species (ROS) including both HOCl (3 ppm) and ClO(2) (100 ppm).

Impaired clearance and enhanced pulmonary inflammatory/fibrotic response to carbon nanotubes in myeloperoxidase-deficient mice

Advancement of biomedical applications of carbonaceous nanomaterials is hampered by their biopersistence and pro-inflammatory action in vivo. Here, we used myeloperoxidase knockout B6.129X1-MPO (MPO k/o) mice and showed that oxidation and clearance of single walled carbon nanotubes (SWCNT) from the lungs of these animals after pharyngeal aspiration was markedly less effective whereas the inflammatory response was more robust than in wild-type C57Bl/6 mice. Our results provide direct evidence for the participation of MPO - one of the key-orchestrators of inflammatory response - in the in vivo pulmonary oxidative biodegradation of SWCNT and suggest new ways to control the biopersistence of nanomaterials through genetic or pharmacological manipulations.

Enzymatic degradation of multiwalled carbon nanotubes

Because of their unique properties, carbon nanotubes and, in particular, multiwalled carbon nanotubes (MWNTs) have been used for the development of advanced composite and catalyst materials. Despite their growing commercial applications and increased production, the potential environmental and toxicological impacts of MWNTs are not fully understood; however, many reports suggest that they may be toxic. Therefore, a need exists to develop protocols for effective and safe degradation of MWNTs. In this article, we investigated the effect of chemical functionalization of MWNTs on their enzymatic degradation with horseradish peroxidase (HRP) and hydrogen peroxide (H(2)O(2)). We investigated HRP/H(2)O(2) degradation of purified, oxidized, and nitrogen-doped MWNTs and proposed a layer-by-layer degradation mechanism of nanotubes facilitated by side wall defects. These results provide a better understanding of the interaction between HRP and carbon nanotubes and suggest an eco-friendly way of mitigating the environmental impact of nanotubes.

Encapsulation and enzyme-mediated release of molecular cargo in polysulfide nanoparticles

Poly(propylene sulfide) nanoparticles (<150 nm) have been synthesized by an anionic, ring-opening emulsion polymerization. Upon exposure to parts per million (ppm) levels of oxidizing agent (NaOCl), hydrophobic polysulfide particles are oxidized to hydrophilic polysulfoxides and polysulfones. Utilizing this mechanism, the encapsulation of hydrophobic molecular cargo, including Nile red and Reichardt's dye, within polysulfide nanoparticles has been characterized by a variety of microscopic and spectroscopic methods and its release demonstrated via chemical oxidation. Moreover, release of cargo has been enzymatically driven by oxidoreductase enzymes such as chloroperoxidase and myeloperoxidase in the presence of low concentrations of sodium chloride (200 mM) and hydrogen peroxide (500 μM). This oxidation-driven mechanism holds promise for controlled encapsulation and release of a variety of hydrophobic cargos.

The enzymatic oxidation of graphene oxide

Two-dimensional graphitic carbon is a new material with many emerging applications, and studying its chemical properties is an important goal. Here, we reported a new phenomenon--the enzymatic oxidation of a single layer of graphitic carbon by horseradish peroxidase (HRP). In the presence of low concentrations of hydrogen peroxide (∼40 μM), HRP catalyzed the oxidation of graphene oxide, which resulted in the formation of holes on its basal plane. During the same period of analysis, HRP failed to oxidize chemically reduced graphene oxide (RGO). The enzymatic oxidation was characterized by Raman, ultraviolet-visible, electron paramagnetic resonance, Fourier transform infrared spectroscopy, transmission electron microscopy, atomic force microscopy, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and gas chromatography-mass spectrometry. Computational docking studies indicated that HRP was preferentially bound to the basal plane rather than the edge for both graphene oxide and RGO. Owing to the more dynamic nature of HRP on graphene oxide, the heme active site of HRP was in closer proximity to graphene oxide compared to RGO, thereby facilitating the oxidation of the basal plane of graphene oxide. We also studied the electronic properties of the reduced intermediate product, holey reduced graphene oxide (hRGO), using field-effect transistor (FET) measurements. While RGO exhibited a V-shaped transfer characteristic similar to a single layer of graphene that was attributed to its zero band gap, hRGO demonstrated a p-type semiconducting behavior with a positive shift in the Dirac points. This p-type behavior rendered hRGO, which can be conceptualized as interconnected graphene nanoribbons, as a potentially attractive material for FET sensors.

Exploring the chemical sensitivity of a carbon nanotube/green tea composite

Single-walled carbon nanotubes (SWNTs) possess unique electronic and physical properties, which make them very attractive for a wide range of applications. In particular, SWNTs and their composites have shown a great potential for chemical and biological sensing. Green tea, or more specifically its main antioxidant component, epigallocatechin gallate (EGCG), has been found to disperse SWNTs in water. However, the chemical sensitivity of this SWNT/green tea (SWNT/EGCG) composite remained unexplored. With EGCG present, this SWNT composite should have strong antioxidant properties and thus respond to reactive oxygen species (ROS). Here we report on fabrication and characterization of SWNT/EGCG thin films and the measurement of their relative conductance as a function of H(2)O(2) concentrations. We further investigated the sensing mechanism by Fourier transform infrared (FTIR) spectroscopy and field-effect transistor measurements (FET). We propose here that the response to H(2)O(2) arises from the oxidation of EGCG in the composite. These findings suggest that SWNT/green tea composite has a great potential for developing simple resistivity-based sensors.

Controlling the volumetric parameters of nitrogen-doped carbon nanotube cups

Analogous to multiwalled carbon nanotubes, nitrogen-doped carbon nanotube cups (NCNCs) have been synthesized with defined volumetric parameters (diameter and segment lengths) by controlling the catalyst particle size and the concentration of nitrogen precursor utilized in the chemical vapor deposition (CVD) reaction, allowing for tailored interior cavity space of cross-linked NCNCs, i.e. nanocapsules.

Carbon nanotubes degraded by neutrophil myeloperoxidase induce less pulmonary inflammation

We have shown previously that single-walled carbon nanotubes can be catalytically biodegraded over several weeks by the plant-derived enzyme, horseradish peroxidase. However, whether peroxidase intermediates generated inside human cells or biofluids are involved in the biodegradation of carbon nanotubes has not been explored. Here, we show that hypochlorite and reactive radical intermediates of the human neutrophil enzyme myeloperoxidase catalyse the biodegradation of single-walled carbon nanotubes in vitro, in neutrophils and to a lesser degree in macrophages. Molecular modelling suggests that interactions of basic amino acids of the enzyme with the carboxyls on the carbon nanotubes position the nanotubes near the catalytic site. Importantly, the biodegraded nanotubes do not generate an inflammatory response when aspirated into the lungs of mice. Our findings suggest that the extent to which carbon nanotubes are biodegraded may be a major determinant of the scale and severity of the associated inflammatory responses in exposed individuals.

Understanding the sensor response of metal-decorated carbon nanotubes

We have explored the room temperature response of metal nanoparticle decorated single-walled carbon nanotubes (NP-SWNTs) using a combination of electrical transport, optical spectroscopy, and electronic structure calculations. We have found that upon the electrochemical growth of Au NPs on SWNTs, there is a transfer of electron density from the SWNT to the NP species, and that adsorption of CO molecules on the NP surface is accompanied by transfer of electronic density back into the SWNT. Moreover, the electronic structure calculations indicate dramatic variations in the charge density at the NP-SWNT interface, which supports our previous observation that interfacial potential barriers dominate the electrical behavior of NP-SWNT systems.

Runoff phosphorus loss immediately after poultry manure application as influenced by the application rate and tillage

Excessive or N-based application of poultry manure for crops may result in significant risk of P loss with surface runoff. This study assessed P loss immediately after poultry manure application to soybean [Glycine max (L.) Merr.] residue with and without tillage at eight Iowa fields. Manure from chickens (Gallus gallus domesticus) or turkeys (Melleagris gollopavo) was applied at intended rates of 0, 84, or 168 kg total N ha(-1) (total P was 0, 21-63, 50-123 kg P ha(-1), respectively) with three replications. Simulated rainfall (76 mm h(-1)) was applied to 3-m2 sections of larger field plots with 2 to 7% slope, usually within 2 d of application, to collect runoff during 30 min. Runoff was analyzed for concentrations of sediment, dissolved reactive P (DRPC), bioavailable P (BAPC), and total P (TPRC). Non-incorporated manure consistently increased (P < or = 0.10) concentrations of all runoff P fractions in five sites, but there were increasing trends at all sites, and on average manure increased DRPC, BAPC, and TPRC 32, 23, and 12 times, respectively, over the control. Tillage to incorporate manure reduced DRPC, BAPC, and TPRC by 88, 89, and 77% on average, respectively, although in non-manured plots tillage seldom affected DRPC or BAPC and often increased TPRC. Tillage increased sediment concentration in runoff but not enough to offset the benefits of manure P incorporation. Runoff P loads generally followed trends of runoff P concentrations but were more variable, and significant treatment effects were less frequent. Overall, incorporation of manure by tillage was very effective at reducing P loss during runoff events shortly after poultry manure application under the conditions of this study.

Biodegradation of single-walled carbon nanotubes through enzymatic catalysis

We show here the biodegradation of single-walled carbon nanotubes through natural, enzymatic catalysis. By incubating nanotubes with a natural horseradish peroxidase (HRP) and low concentrations of H2O2 (approximately 40 microM) at 4 degrees C over 12 weeks under static conditions, we show the increased degradation of nanotube structure. This reaction was monitored via multiple characterization methods, including transmission electron microscopy (TEM), dynamic light scattering (DLS), gel electrophoresis, mass spectrometry, and ultraviolet-visible-near-infrared (UV-vis-NIR) spectroscopy. These results mark a promising possibility for carbon nanotubes to be degraded by HRP in environmentally relevant settings. This is also tempting for future studies involving biotechnological and natural (plant peroxidases) ways for degradation of carbon nanotubes in the environment.

Synthesis, characterization, and manipulation of nitrogen-doped carbon nanotube cups

Isolated, carbon nanotube cups with diameters of 12-40 nm have been synthesized by chemical vapor deposition through incorporation of nitrogen atoms into graphitic carbon structure and subsequent mechanical separation. Incorporation of nitrogen affords carbon nanotube cups with a unique composition comprising multiwalled, graphitic lattice with nitrogen groups on the exterior rim and hollow interior cavities. These nanostructures demonstrate the ability to participate in hydrogen bonding because of nitrogen functionalities on their open edges. Furthermore, reaction with these nitrogen functionalities results in the coupling of gold nanoparticles (GNPs) to the open rim of carbon nanotube cups. Through atomic force microscopy manipulation and adhesion force measurements, we compare the mobility of these structures on a hydrophilic surface before and after GNP coupling. Understanding of these forces will aid in useful nanostructure assembly for energy and biomedical applications.

Effect of liquid swine manure rate, incorporation, and timing of rainfall on phosphorus loss with surface runoff

Excessive manure phosphorus (P) application increases risk of P loss from fields. This study assessed total runoff P (TPR), bioavailable P (BAP), and dissolved reactive P (DRP) concentrations and loads in surface runoff after liquid swine (Sus scrofa domesticus) manure application with or without incorporation into soil and different timing of rainfall. Four replicated manure P treatments were applied in 2002 and in 2003 to two Iowa soils testing low in P managed with corn (Zea mays L.)-soybean [Glycine max (L.) Merr.] rotations. Total P applied each time was 0 to 80 kg P ha(-1) at one site and 0 to 108 kg P ha(-1) at the other. Simulated rainfall was applied within 24 h of P application or after 10 to 16 d and 5 to 6 mo. Nonincorporated manure P increased DRP, BAP, and TPR concentrations and loads linearly or exponentially for 24-h and 10- to 16-d runoff events. On average for the 24-h events, DRP, BAP, and TPR concentrations were 5.4, 4.7, and 2.2 times higher, respectively, for nonincorporated manure than for incorporated manure; P loads were 3.8, 7.7, and 3.6 times higher; and DRP and BAP concentrations were 54% of TPR for nonincorporated manure and 22 to 25% for incorporated manure. A 10- to 16-d rainfall delay resulted in DRP, BAP, and TPR concentrations that were 3.1, 2.7, and 1.1 times lower, respectively, than for 24-h events across all nonincorporated P rates, sites, and years, whereas runoff P loads were 3.8, 3.6, and 1.6 times lower, respectively. A 5- to 6-mo simulated rainfall delay reduced runoff P to levels similar to control plots. Incorporating swine manure when the probability of immediate rainfall is high reduces the risk of P loss in surface runoff; however, this benefit sharply decreases with time.

Pulmonary edema due to Plasmodium vivax malaria in an American missionary

Pulmonary edema is a recognized complication of Plasmodium falciparum malaria but is uncommon with Plasmodium vivax infection. We report the case of a non-immune adult with imported P. vivax malaria who developed pulmonary edema during treatment. The case was further complicated by a recurrent malaria episode after failure of acute quinine and doxycycline treatment followed by terminal primaquine therapy. Prompt recognition and appropriate management of pulmonary edema is needed for optimal outcomes of P. vivax infection, as well as awareness of the potential failure of terminal therapy for liver hypnozoites.

Soil and surface runoff phosphorus relationships for five typical USA midwest soils

Excessively high soil P can increase P loss with surface runoff. This study used indoor rainfall simulations to characterize soil and runoff P relationships for five Midwest soils (Argiudoll, Calciaquaoll, Hapludalf, and two Hapludolls). Topsoil (15-cm depth, 241-289 g clay kg(-1) and pH 6.0-8.0) was incubated with five NH4H2PO4 rates (0-600 mg P kg(-1)) for 30 d. Total soil P (TPS) and soil-test P (STP) measured with Bray-P1 (BP), Mehlich-3 (M3P), Olsen (OP), Fe-oxide-impregnated paper (FeP), and water (WP) tests were 370 to 1360, 3 to 530, 10 to 675, 4 to 640, 7 to 507, and 2 to 568 mg P kg(-1), respectively. Degree of soil P saturation (DPS) was estimated by indices based on P sorption index (PSI) and STP (DPSSTP) and P, Fe, and Al extracted by ammonium oxalate (DPSox) or Mehlich-3 (DPSM3). Soil was packed to 1.1 g cm(-3) bulk density in triplicate boxes set at 4% slope. Surface runoff was collected during 75 min of 6.5 cm h(-1) rain. Runoff bioavailable P (BAP) and dissolved reactive P (DRP) increased linearly with increased P rate, STP, DPSox, and DPSM3 but curvilinearly with DPSSTP. Correlations between DRP or BAP and soil tests or saturation indices across soils were greatest (r > or = 0.95) for FeP, OP, and WP and poorest for BP and TPS (r = 0.83-0.88). Excluding the calcareous soil (Calciaquoll) significantly improved correlations only for BP. Differences in relationships between runoff P and the soil tests were small or nonexistent among the noncalcareous soils. Routine soil P tests can estimate relationships between runoff P concentration and P application or soil P, although estimates would be improved by separate calibrations for calcareous and noncalcareous soils.

Failure of trimethoprim/sulfamethoxazole prophylaxis for Pneumocystis carinii pneumonia with concurrent leucovorin use

Pneumocystis carinii is a common cause of pneumonia in patients with AIDS, however, the incidence has dropped with the availability of effective prophylactic regimens. First-line treatment for both acute Pneumocystis pneumonia and chronic prophylaxis is trimethoprim/sulfamethoxazole (TMP/SMX). This combination can cause hypersensitivity reactions as well as myelosuppression. The simultaneous administration of leucovorin during acute treatment has been shown to reduce the incidence of neutropenia, but may interfere with the efficacy of TMP/SMX. We report a case of P. carinii pneumonia in a patient with AIDS who failed TMP/SMX prophylaxis while taking leucovorin.

Role of heparan sulfate as a tissue-specific regulator of FGF-4 and FGF receptor recognition

FGF signaling uses receptor tyrosine kinases that form high-affinity complexes with FGFs and heparan sulfate (HS) proteoglycans at the cell surface. It is hypothesized that assembly of these complexes requires simultaneous recognition of distinct sulfation patterns within the HS chain by FGF and the FGF receptor (FR), suggesting that tissue-specific HS synthesis may regulate FGF signaling. To address this, FGF-2 and FGF-4, and extracellular domain constructs of FR1-IIIc (FR1c) and FR2-IIIc (FR2c), were used to probe for tissue-specific HS in embryonic day 18 mouse embryos. Whereas FGF-2 binds HS ubiquitously, FGF-4 exhibits a restricted pattern, failing to bind HS in the heart and blood vessels and failing to activate signaling in mouse aortic endothelial cells. This suggests that FGF-4 seeks a specific HS sulfation pattern, distinct from that of FGF-2, which is not expressed in most vascular tissues. Additionally, whereas FR2c binds all FGF-4-HS complexes, FR1c fails to bind FGF-4-HS in most tissues, as well as in Raji-S1 cells expressing syndecan-1. Proliferation assays using BaF3 cells expressing either FR1c or FR2c support these results. This suggests that FGF and FR recognition of specific HS sulfation patterns is critical for the activation of FGF signaling, and that synthesis of these patterns is regulated during embryonic development.

Structure-based design of a bispecific receptor mimic that inhibits T cell responses to a superantigen

Key surface proteins of pathogens and their toxins bind to the host cell receptors in a manner that is quite different from the way the natural ligands bind to the same receptors and direct normal cellular responses. Here we describe a novel strategy for "non-antibody-based" pathogen countermeasure by targeting the very same "alternative mode of host receptor binding" that the pathogen proteins exploit to cause infection and disease. We have chosen the Staphylococcus enterotoxin B (SEB) superantigen as a model pathogen protein to illustrate the principle and application of our strategy. SEB bypasses the normal route of antigen processing by binding as an intact protein to the complex formed by the MHC class II receptor on the antigen-presenting cell and the T cell receptor. This alternative mode of binding causes massive IL-2 release and T cell proliferation. A normally processed antigen requires all the domains of the receptor complex for its binding, whereas SEB requires only the alpha1 subunit (DRalpha) of the MHC class II receptor and the variable beta subunit (TCRVbeta) of the T cell receptor. This prompted us to design a bispecific chimera, DRalpha-linker-TCRVbeta, that acts as a receptor mimic and prevents the interaction of SEB with its host cell receptors. We have adopted (GSTAPPA)(2) as the linker sequence because it supports synergistic binding of DRalpha and TCRVbeta to SEB and thereby makes DRalpha-(GSTAPPA)(2)-TCRVbeta as effective an SEB binder as the native MHC class II-T cell receptor complex. Finally, we show that DRalpha-(GSTAPPA)(2)-TCRVbeta inhibits SEB-induced IL-2 release and T cell proliferation at nanomolar concentrations.

Graphic analysis of femoral growth in young children with Perthes' disease

A cohort of 20 children, younger than 5.5 years at the time of onset of unilateral Perthes' disease, were studied by computer graphic analysis. Graphic outlines derived from each child's series of anterior posterior radiographs of the pelvis and hips were aligned on layers in a computer application such that changes over time could be directly visualized and measured. In these young children, injury to the cartilaginous growth mechanisms accounted for almost all of the abnormal change in the shape of the proximal femur; growth abnormalities had been established by the time of initial radiographs and persisted both as constant growth-rate change and growth-direction change until skeletal maturity. Despite the similar degree of radiographic bone necrosis, outcomes differed, and the specific growth aberrations were highly unique to the individual. At the time of the most recent radiographs, among the diseased hips 7 had spherical femoral heads larger than the normal side, eight had elliptical femoral heads congruent with the acetabulum, and five had elliptical femoral heads with a flat area congruent with the acetabulum. The study did not provide evidence to support a logic for brace or surgical treatment of young children with Perthes' disease.

Surgical management of ankle valgus in children: use of a transphyseal medial malleolar screw

Valgus deformity of the ankle in children is associated with a wide variety of clinical conditions. A retrospective review was performed of 17 children (29 involved extremities) with ankle valgus deformity who had been managed by use of a percutaneously placed, transphyseal medial malleolar screw. Median age at the time of surgery was 11 years, 2 months. Median postoperative follow-up was 2 years, 2 months. Tibiotalar axis and ankle mechanical axis were the best radiographic indicators of ankle valgus deformity. Fibular station and epiphyseal wedging were poor predictors of ankle alignment. Significant improvement in the tibiotalar axis (median, 12 degrees) was noted at follow-up, and the median rate of correction was 0.59 degree/month. Resumption of physeal growth and recurrence of deformity (rate of 0.60 degree/month) was seen when the screws were removed before skeletal maturity. The transphyseal medial malleolar screw is a minimally invasive, minimally morbid, technically simple method of reversible partial epiphysiodesis at the ankle and is an effective technique for the correction of ankle valgus deformity associated with a wide variety of clinical conditions in children.

Same-day versus staged anterior-posterior spinal surgery in a neuromuscular scoliosis population: the evaluation of medical complications

The medical complications occurring in 29 patients with neuromuscular spinal deformity undergoing two-stage anterior-posterior spinal fusion ("staged") were compared with 16 neuromuscular patients undergoing single-stage anterior-posterior spinal fusion ("same day"). Thirty-six (124%) major and minor medical complications occurred postoperatively in the staged patients, whereas 14 (88%) major or minor complication were present in same-day surgery patients. Thirty-five percent of staged patients had no complications, whereas 63% of same-day patients were without complications. Associated findings comparing the two-stage procedure to the single-stage surgery included operative and anesthesia time increase, increased blood-volume loss, increased blood transfusion, decreased nutritional parameters, and longer hospital stays. With either approach, there is the risk of significant complications in this vulnerable population.

Radiographic evaluation of bowed legs in children

Radiographic screening is widely used to distinguish between Blount disease (infantile tibia vara) and physiologic bowing. Thirteen children with Blount disease, evaluated before 3 years of age, with initial radiographs showing no sign of Langenskiold changes, were compared with 50 children with physiologic bowing, also evaluated before 3 years of age with similar radiographic studies. Screening test accuracy was determined retrospectively for measurement of the mechanical axis, the tibial metaphyseal-diaphyseal angle (TDMA), and the epiphyseal-metaphyseal angle (EMA). A radiographic screening method combining the TMDA and the EMA, using cutoff values of 10 degrees and 20 degrees respectively, exhibited the best combination of sensitivity, specificity, and positive predictive value, correctly identifying all cases of Blount disease and 40 of 50 cases of physiologic bowing. Our data suggest that children between 1 and 3 years of age with TMDA <10 degrees, or TMDA > or =10 degrees and EMA < or =20 degrees, are at less risk for development of Blount disease. Children with TMDA > or =10 degrees and EMA >20 degrees are at greater risk for development of Blount disease and should be followed closely.

Epiphyseal changes after proximal femoral osteotomy

This study was conducted to evaluate the risk factors for epiphyseal changes suggestive of osteonecrosis after proximal femoral osteotomy for hip subluxation associated with cerebral palsy. Forty-eight children with 94 hips were reviewed. Two observers rated the radiographs using a written protocol on two occasions each so that reproducibility of these observations could be assured. Concomitant pelvic osteotomy proved to have the greatest association with risk of epiphyseal changes. These findings, suggestive of osteonecrosis, were present in 7 of 68 (10%) hips that had isolated femoral osteotomy, and in 12 of 26 (46%) hips that had concomitant pelvic osteotomy.

Clinical evaluation of bowed legs in children

Early radiographic screening and/or referral to a clinical specialist are often used to distinguish between physiologic bow leg deformity and infantile tibia vara disease in young children. These practices are a consequence of the clinician's inability (based upon the clinical examination) to distinguish between the deformities associated with physiologic and pathologic bow legs. Because the great majority of these children have physiologic bowing, routine radiographic screening and referral are not cost effective and expose children to unnecessary radiation. This study describes and evaluates the efficacy of a simple clinical examination technique, the 'cover up' test, to identify young children with bow legs who are at high risk for having infantile tibia vara. The 'cover up' test qualitatively assesses the alignment of the proximal portion of the shank or lower leg relative to the thigh or upper leg. Obvious valgus alignment is considered a negative test and is indicative of physiologic bowing. Neutral or varus alignment is considered a positive test and suggests that the child is at greater risk for having infantile tibia vara. Eighteen children with infantile tibia vara, evaluated initially prior to 3 years of age, and followed to the time of surgical correction, were compared with 50 children with physiologic bowing, also evaluated initially prior to 3 years of age and followed to resolution (mean follow-up 3 years and 10 months). All of the children with infantile tibia vara had a positive 'cover up' test (sensitivity = 1.00). Eighteen of 25 children with a positive 'cover up' test actually had or developed infantile tibia vara (positive predictive value = 0.72). Forty-three of 50 children with physiologic bowing had a negative 'cover up' test (specificity = 0.86). All of the children with a negative 'cover up' test actually had physiologic bowing (negative predictive value = 1.00). We conclude that the 'cover up' test is an effective screening tool for the assessment of bow legs in children between 1 and 3 years of age. Children with a negative 'cover up' test do not require radiographic evaluation and should be followed clinically for resolution of the bowing. Children with a positive 'cover up' test should have radiographic evaluation of the lower extremities or be referred to a specialist for further evaluation and treatment.

Predictive value of intraoperative clubfoot radiographs on revision rates

The predictive value of intraoperative radiographic assessment and its correlation with short term revision rates is presented for surgical correction of resistant clubfoot. Seventy-three children (115 feet) who underwent a primary procedure at one institution for idiopathic clubfoot between January 1991 and December 1994 were reviewed. A strategy using sequential release guided by intraoperative radiographs was employed in all cases. The intraoperative radiographic findings correlated with the need for early revision surgery, with residual radiographic evidence of cavus deformity associated with the greatest risk for revision. The sequential release strategy resulted in fewer overcorrections compared with historical controls of more complete subtalar release.

Caps on malpractice awards: update

Tort reform for professional liability is in the best interests of not only all physicians, but for industry and the citizenry as a whole. The enormous sums of money donated by the Trial Lawyers Association, whose livelihood is at stake, makes initial passage of tort reform difficult and, once passed, brings it under constant attack. Even if a well-disposed legislature passes a professional liability law, state supreme courts are ever ready to invalidate such laws. Thus, once tort reform has been passed, the next battleground is the state supreme court. ACS chapters should be preparing their membership for educating the public as well as themselves as to the danger of a state supreme court comprised of members opposed to tort reform, and be prepared to help the election of those individuals who are more sympathetic to tort reform.

DNA recognition properties of the N-terminal DNA binding domain within the large subunit of replication factor C

Replication Factor C (RFC) is a five-subunit protein complex required for eukaryotic DNA replication and repair. The large subunit within this complex contains a C-terminal DNA binding domain which provides specificity for PCNA loading at a primer-template and a second, N-terminal DNA binding domain of unknown function. We isolated the N-terminal DNA binding domain from Drosophila melanogaster and defined the region within this polypeptide required for DNA binding. The DNA determinants most efficiently recognized by both the Drosophila minimal DNA binding domain and the N-terminal half of the human large subunit consist of a double-stranded DNA containing a recessed 5' phosphate. DNA containing a recessed 5' phosphate was preferred 5-fold over hairpined DNA containing a recessed 3' hydroxyl. Combined with existing data, these DNA binding properties suggest a role for the N-terminal DNA binding domain in the recognition of phosphorylated DNA ends.

A modified Harrington technique for scoliosis

Post-Harrington techniques for adolescent idiopathic scoliosis have increased the complexity of scoliosis surgery while contributing only biomechanically more secure fixation and sagittal contour preservation. On the the basis of principles defined by Harrington, the authors developed a simplified technique that accomplishes equivalent outcomes.

Distraction instrumentation outcomes in scoliosis

The short-term outcomes of a new distraction technique using a small rod spinal instrumentation system (WRIGHTLOCK) are reported for adolescent idiopathic scoliosis. No caudally directed thoracic hooks were used. Seventy-four children aged 11.7 to 17.5 years who underwent consecutive posterior instrumentations are reviewed. Their curves improved from a mean of 55.6 degrees to 22.7 degrees (average of 59.2% correction). At 2.7 years mean follow-up, coronal curves lost an average of 4.2 degrees correction. Overall, there was a mean increase of 4.4 degrees in kyphosis. Children with the most preoperative hypokyphosis were afforded the greatest gains in kyphosis. Instrumentation resulted in a mean loss of 8.2 degrees lumbar lordosis. These results compare favorably with published results for other multihook systems.

Surgical corrections in scoliosis: a meta-analysis

A meta-analysis of the acute correction outcomes in adolescent idiopathic scoliosis is reported. Posterior instrumentation systems generally gave similar coronal plane corrections with average corrections for differing systems ranging from 48% to 67%. There was significant overlap of corrections reported for each of the systems. Anterior instrumentation gave better results with average corrections ranging from 71% to 93%. No instrumentation demonstrated a consistent ability to restore a normal thoracic kyphosis, but all seemed to maintain preoperative kyphosis measures. All systems, including newer multihook systems, showed a small loss of lumbar lordosis postoperatively. The available data demonstrates that no posterior implant produces vertebral derotation.

Plantar-advancement skin flap for central ray resections in the foot: description of a technique

A surgical technique using an advancement plantar skin flap to maintain the resection gap closure when performing central ray resections is described and illustrated. The concept, applicable to central polydactyly or polysyndactyly of the foot, was developed with goals of providing a skin tether to maintain a normally narrow foot as well as to improve the appearance of the surgical scar.

Comparison of neurologic deficits with atlanto-dens intervals in patients with Down syndrome

Eighty-four patients with Down syndrome had flexion-extension lateral roentgenograms of the C1-C2 articulation for the purpose of dividing the group into subluxators (> or = 4 mm atlanto-dens interval and 2 mm translation) and nonsubluxators (those who did not meet these criteria). Neurologic examinations and chart review were carried out on all patients to ascertain those with a positive neurologic finding or history. Seventeen (20%) were defined as subluxators and 67 (80%) as nonsubluxators. Five (29%) of the subluxators were found to have positive neurologic findings and 18 (27%) of the nonsubluxators had similar types of positive neurologic findings. These percentages are not significantly different. This led us to conclude that positive neurologic findings and an abnormal atlanto-dens interval are not alone adequate criteria to judge need for surgical stabilization of the C1-C2 articulation in patients with Down syndrome.

Replication factor C interacts with the C-terminal side of proliferating cell nuclear antigen

Replication factor C (RF-C) is a heteropentameric protein essential for DNA replication and repair. It is a molecular matchmaker required for loading of proliferating cell nuclear antigen (PCNA) onto double-stranded DNA and, thus, for PCNA-dependent DNA elongation by DNA polymerases delta and epsilon. To elucidate the mode of RF-C binding to the PCNA clamp, modified forms of human PCNA were used that could be 32P-labeled in vitro either at the C or the N terminus. Using a kinase protection assay, we show that the heteropentameric calf thymus RF-C was able to protect the C-terminal region but not the N-terminal region of human PCNA from phosphorylation, suggesting that RF-C interacts with the PCNA face at which the C termini are located (C-side). A similar protection profile was obtained with the recently identified PCNA binding region (residues 478-712), but not with the DNA binding region (residues 366-477), of the human RF-C large subunit (Fotedar, R., Mossi, R., Fitzgerald, P., Rousselle, T., Maga, G., Brickner, H., Messner, H., Khastilba, S., Hübscher, U., and Fotedar, A., (1996) EMBO J., 15, 4423-4433). Furthermore, we show that the RF-C 36 kDa subunit of human RF-C could interact independently with the C-side of PCNA. The RF-C large subunit from a third species, namely Drosophila melanogaster, interacted similarly with the modified human PCNA, indicating that the interaction between RF-C and PCNA is conserved through eukaryotic evolution.

Growth profiles and articular cartilage characterization in a goat model of Legg-Calve-Perthes disease

Numerous animal species, including the goat, have been evaluated as potential models for human Legg-Calve-Perthes disease (LCPD). These models disrupt the vasculature of the femoral head, causing it to collapse, and therefore do not mimic all the clinical patterns of the human disease. Baseline data regarding the weight and femoral length in the growing goat are not available. This study characterized the goat's normal growth for comparison with that of humans. The growth aberrations in the proximal femur created by surgically ablating the capital physis were described and compared with the aberrations observed in human LCPD cases. Age, weight, and femoral length (test and control) data were obtained for goats approximately 1 to 14 months of age. At 4 months of age, a craniolateral surgical approach was used to expose the cranial lateral capital physis so that it could be cauterized. Postoperative radiographs were evaluated by graphic analysis to assess the resultant changes in the morphology of the proximal femur. The articular cartilage of the femoral head and acetabulum was evaluated mechanically, using indentation testing, to determine the apparent modulus of elasticity, and histopathologically regarding its thickness and proteoglycan content. The proximal femurs of goats and humans exhibit similar morphology and growth patterns. There was a positive correlation between age, weight, and femoral lengths in the goat. The surgical procedure was effective in ablating the capital femoral physis as indicated by shorter femoral lengths and fragmented, flattened, and mushroomed femoral heads. The histopathological data revealed that the articular cartilage was significantly thicker in the operated hip joints at the ventrocaudal and cranial acetabula and the dorsal and ventral femoral heads. The test cartilage exhibited significantly less positive staining for proteoglycans in the dorsocaudal and the cranial acetabula as well as the ventral femoral head. The apparent modulus of elasticity, of the test cartilage was significantly lower than the control value at the dorsocaudal acetabulum. These data show that the surgical procedure produced morphological changes that mimic those in human LCPD. The increased thickness of the articular cartilage of the LCPD femoral head may account for the articular degeneration observed in older patients with LCPD, as increased cartilage thickness is associated with decreased tissue quality.

MSCRAMM-mediated adherence of microorganisms to host tissues

Microbial adhesion to host tissue is the initial critical event in the pathogenesis of most infections and, as such, is an attractive target for the development of new antimicrobial therapeutics. Specific microbial components (adhesins) mediate adherence to host tissues by participating in amazingly sophisticated interactions with host molecules. This review focuses on a class of cell surface adhesins that specifically interact with extracellular matrix components and which we have designated MSCRAMMs (microbial surface components recognizing adhesive matrix molecules). MSCRAMMs recognizing fibronectin-, fibrinogen-, collagen-, and heparin-related polysaccharides are discussed in terms of structural organization, ligand-binding structures, importance in host tissue colonization and invasion, and role as virulence factors.

The immature goat as an animal model for Legg-Calvé-Perthes disease

Legg-Calvé-Perthes disease (LCPD) results from avascular necrosis of the capital femoral epiphysis in growing children. This disease often yields a significant deformity of the proximal femur, which may result in osteoarthritis. Its cause is unknown, although extensive radiographic, clinical, and histologic evaluations have been performed. Attempts at developing an animal model for LCPD have been unsuccessful. Previous models have been based predominantly on determining the vascular etiology of the disease. There is a need for an animal model that mimics the growth pattern of the proximal femur seen in LCPD. Such a model would allow for the development and testing of new treatments. Thus far, no treatment strategy has been completely successful. A study involving graphic analysis of radiographs found that arrested anterolateral physeal growth with continued or accelerated perichondrial ring and posteromedial epiphyseal growth would account for the most severe morphologic changes observed in the femoral heads of patients with LCPD. A surgical procedure was performed to ablate the capital femoral physis in goat kids in an attempt to mimic the changes noted in this study. The procedure was evaluated with radiographs, gross specimens, and histopathologic slides. Graphic analysis of the radiographs revealed changes in the shape of the operated femoral head compared with the unoperated femoral head. While bone, fibrous, and fibrocartilaginous bridges were histologically observed across the physis, the resultant deformities did not mimic the changes identified in the graphic analysis study, perhaps because of inconsistencies in the surgical ablative techniques, which will require further modification. This study provides the basis for further research to develop a successful model.

Fimbriation, capsulation, and iron-scavenging systems of Klebsiella strains associated with human urinary tract infection

Thirty-two strains of Klebsiella pneumoniae and seven strains of Klebsiella oxytoca isolated from urinary tract infections in elderly adults were analyzed for capsular antigens, iron-scavenging systems, and fimbriation. All strains were capsulated. Twenty-seven different K antigens were identified among the strains, with no particular antigen dominating. All strains produced the iron-scavenging system enterochelin as analyzed by bioassay and DNA hybridization. In contrast, the aerobactin iron-sequestering system was not detected in any of the strains. All strains caused hemagglutination of tannin-treated human erythrocytes and reacted with an anti-type 3 fimbriae antiserum as well as in DNA hybridization with a type 3 fimbria-specific probe, indicating that the Klebsiella strains possessed this fimbrial type. Possession of type 1 fimbriae was analyzed by agglutination tests and by hybridization with DNA probes from two distinct Klebsiella type 1 fimbria gene clusters. Phenotypic expression of the type 1 fimbriae was found in 29 of 32 K. pneumoniae strains, whereas 30 strains reacted with either of the two type 1 fimbrial cluster DNA probes. In K. oxytoca, however, only three of seven strains expressed type 1 fimbriae and reacted with the DNA probes. The type 3 fimbriae were found to bind to a fraction of epithelial cells exfoliated in normal human urine, whereas the type 1 fimbriae bound strongly to urinary slime. No inhibitors of type 3 fimbrial binding were detected in human urine.

Adherence to respiratory epithelia by recombinant Escherichia coli expressing Klebsiella pneumoniae type 3 fimbrial gene products

We examined the role of Klebsiella fimbrial types 1 and 3 in mediating adherence to human buccal and tracheal cells and to lung tissue sections. We found that clinical isolates of Klebsiella pneumoniae producing type 3 fimbriae and Escherichia coli HB101 containing a recombinant plasmid encoding expression of Klebsiella type 3 fimbriae (pFK10) demonstrated increased adherence to tracheal cells, trypsinized buccal cells, and lung tissue sections, in contrast to nonfimbriate and to type 1 fimbriate bacteria. Adherence by type 3 fimbriate bacteria was inhibited by purified type 3 fimbriae and Fab fragments derived from type 3 fimbrial-specific polyclonal immunoglobulin G. Type 3 fimbriae mediated attachment to the basolateral surface of tracheal cells and to the basal epithelial cells and the basement membrane regions of bronchial epithelia. Using an E. coli transformant (pDC17/pFK52), which expresses nonadherent P fimbrial filaments, along with the type 3 fimbrial adhesin (MrkD), we demonstrated that type 3 fimbrial attachment to respiratory cells was attributable to the MrkD adhesin subunit. Subsequent experiments demonstrated that the epithelial target of the type 3 fimbrial adhesin was most likely a peptide molecule rather than a carbohydrate. The results of this study demonstrate that, in vitro, the Klebsiella type 3 fimbrial adhesin mediates adherence to human respiratory tissue.

Fimbrial types among respiratory isolates belonging to the family Enterobacteriaceae

Bacterial attachment is believed to be an early step in gram-negative nosocomial pneumonia. The frequency of fimbria-associated adhesins among respiratory pathogens has not been studied in detail. In this study isolates belonging to the family Enterobacteriaceae, prospectively obtained from intensive care unit patients who were suspected of having nosocomial pneumonia, were examined for fimbria-associated adhesins. Type 3, P, type 1, and other fimbrial phenotypes were identified by specific hemagglutination and electron microscopy. The Klebsiella type 3 fimbrial phenotype was further characterized by using a monoclonal antibody. Also, both type 3 and Escherichia coli P fimbrial genotypes were detected by using DNA colony blot assays. The frequencies of genera or species isolated were as follows: Enterobacter (38.6%), Klebsiella (26.8%), Serratia (17.7%), E. coli (13%), and Proteus (5.2%). Isolates of Klebsiella oxytoca, K. pneumoniae, and Enterobacter cloacae most commonly possessed the type 3 fimbrial phenotype and genotype. The phenotype and genotype for E. coli P fimbriae (46.2 and 50%, respectively), a known pathogenic determinant in the urinary tract, were detected more frequently than expected. In addition, a previously unspecified hemagglutinin that was specific for porcine erythrocytes was almost uniformly expressed among isolates of Enterobacter aerogenes. Finally, the expression of the type 1 fimbrial phenotype was widely detected among the isolates tested but notably absent among K. oxytoca and Proteus mirabilis isolates. The frequency of the various fimbrial types identified suggests a role for these bacterial organelles in adherence to respiratory epithelia.

Design and evaluation of a posterior laminar clamp spinal fixation system

A new spinal instrumentation system for posterior applications was designed with the intent of minimizing intrusion of hardware into the neural canal during and postinsertion. Basic biomechanical measurements of posterior pullout strength led to the establishment of a clamp as an effective mechanism for gaining purchase on the vertebral lamina. These experiments defined the appropriate instrumentation size, as well as establishing that there was no loss of strength with the spinous process removed and the posterior laminar cortex compromised. There was no statistically significant difference between the maximum pullout strength achievable, using a band around the lamina as a control, and that produced by the implant system, in the thoracic spine. Comparative testing of a prototype system in flexion, extension, lateral bending, and torsion showed that the system, in general, had stiffness greater than segmental wiring and less than or equal to Cotrel-Dubousset fixation.

Nucleotide sequence and functions of mrk determinants necessary for expression of type 3 fimbriae in Klebsiella pneumoniae

The nucleotide sequence of six genes involved in the expression of type 3 fimbriae of Klebsiella pneumoniae was determined. In addition to the genes that encode the fimbrial subunit (mrkA) and adhesion (mrkD), the mrkB, mrkC, and mrkE genes appear to be involved in assembly of the fimbrial filament and regulation of type 3 fimbrial expression. The mrkF gene product is required to maintain the stability of the fimbrial filament on the cell surface.