Morphology of Puccinia horiana, Causal Agent of Chrysanthemum White Rust, Sampled From Naturally Infected Plants

Chrysanthemum white rust (CWR), caused by Puccinia horiana, is pathogenic on many Chrysanthemum spp. and close relatives, and infects commercially important florist chrysanthemum cultivars (Chrysanthemum × morifolium) throughout the world. Due to regulations, most research and observations with CWR are done in vitro with symptomatic plants. In contrast, research presented herein is based on microscopic examination of symptomatic and asymptomatic plants collected from natural outbreaks in the field. We observed scattered (not in a linear pattern) telial sori on infected chrysanthemum leaves, stems, and flowers that coalesced at high infection levels. Teliospores were mainly two-celled but occasionally one- or three-celled. Promycelia arose from the apical teliospore cell, the basal cell, or both. The number of basidiospores on promycelia varied from one to four. Germ tubes, arising from P. horiana basidiospores, penetrated the host epidermis directly without appressoria. A mucilaginous exudate formed at the site of attachment and penetration of leaf and stem tissue, as well as on internal cell walls. P. horiana colonization was systemic, with intercellular mycelium and intracellular M-haustoria in both symptomatic and asymptomatic infected host tissue. Hyphal anastomosis was observed within infected plants, suggesting that asexual fusion between different P. horiana pathotypes or genotypes might occur.

First Confirmed Report that Puccinia horiana, Causal Agent of Chrysanthemum White Rust, Can Overwinter in Pennsylvania

Chrysanthemum white rust (CWR) is a quarantine-significant pest in the United States (Title 7, Code of Federal Regulations, Part 319.37-2). The causal agent of CWR, Puccinia horiana Henn., is an autoecious, microcyclic rust that is pathogenic on chrysanthemum species (Chrysanthemum spp.) and close relatives within the family Asteraceae. CWR is indigenous to Japan, where it was first reported in 1895 (4). By the 1960s, CWR was found throughout Europe and later spread to Africa, Oceana, South America, and other parts of Asia. In North America, CWR was reported in Mexico and in the United States (New Jersey and Pennsylvania [1977], Oregon and Washington [1990], and California [1991]). Additional detections of CWR were later reported in 22 Pennsylvania counties (2004, 2006 to 2010) (3). These later Pennsylvania reports stated that eradication was attempted at some sites, but unconfirmed observations suggested that the rust pathogen might overwinter in volunteer plants (3). Since "CWR is known to overwinter in Europe where chrysanthemums overwinter (average minimum temperatures ranging from -10°F to 10°F)" (2), the unconfirmed Pennsylvania observations prompted us to determine if P. horiana can overwinter in Pennsylvania. During October 2010, we identified CWR on perennial mums planted at six outdoor garden locations in University Park, PA. Symptomatic plants were quarantined and eradication attempted. Eradicated sites were routinely surveyed and CWR confirmed in July 2011 on volunteer plants at two of the originally infested sites. An additional outdoor garden site with CWR was observed in State College, PA, during October 2011 and eradication attempted. The three infested sites were surveyed throughout the fall and winter of 2011 to 2012. During February 2012, two asymptomatic volunteer plants arising from root pieces were collected from each of the three sites. Each sample was washed with tap water to remove excess soil, examined morphologically, surface sterilized with 10% bleach, and divided into two subsamples. One subsample from each site was divided into crown and root portions and DNA extracted using a Qiagen DNeasy Plant Mini Kit. Molecular analysis was performed using modifications of published primers ITS 5 and Rust1 (1,4). Puccinia horiana was detected in plant roots from one site and in plant crowns from two sites. The remaining two subsamples from each site were transplanted into sterilized potting soil and placed in a clean controlled environment chamber at 18°C and 85% relative humidity (RH). After 6 weeks, six actively growing plants were transferred to a second clean controlled environment chamber at 17°C and 90 to 100% RH. On 6 April 2012, CWR symptoms and signs were confirmed morphologically on two plants that had been removed from one site. On 19 April 2012, CWR signs and symptoms were confirmed morphologically and by molecular analysis on leaves of volunteer plants at one University Park site. DNA extractions were sequenced and shared a 100% maximum identity to a known P. horiana accession (EU816920.1) in GenBank. To our knowledge, this is the first confirmed report of P. horiana overwintering in Pennsylvania. References: (1) H. Alaei et al. Mycol. Res. 113:668, 2009. (2) Anon. Chrysanthemum White Rust Bulletin, Syngenta Flowers Inc., Gilroy, CA, 2010. (3) S. Kim et al. Phytopathology 101:S91, 2011. (4) K. Pedley. Plant Dis. 93:1252, 2009.

Amyloid load in Parkinson's disease dementia and Lewy body dementia measured with [11C]PIB positron emission tomography

BACKGROUND

Neuropathological studies have reported varying amounts of amyloid pathology in dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). [11C]PIB positron emission tomography (PET) is a marker of brain amyloid deposition. The aim of this study was to quantify in vivo amyloid load in DLB and PDD compared with control subjects and subjects with Parkinson's disease (PD) without dementia.

METHODS

13 DLB, 12 PDD, 10 PD subjects and 41 age matched controls (55-82 years) were recruited. Each subject underwent clinical evaluation, neuropsychological assessment, T1 and T2 MRI, and [11C]PIB PET. The amyloid load was estimated from 60-90' target region:cerebellar [11C]PIB uptake ratios. Object maps were created by segmenting individual MRIs and convolving them with a probabilistic atlas. Cortical [11C]PIB uptake was assessed by region of interest analysis.

RESULTS

The DLB cohort showed a significant increase in mean brain [11C]PIB uptake and individually 11 of the 13 subjects with DLB had a significantly increased amyloid load. In contrast, mean [11C]PIB uptake was normal for the PDD group although two of 12 patients with PDD individually showed a raised amyloid load. Where significant increases in [11C]PIB uptake were found, it was increased in cortical association areas, cingulate and striatum. None of the subjects with PD showed significantly raised cortical [11C]PIB uptake.

CONCLUSION

This study suggests that amyloid load is significantly raised in over 80% of subjects with DLB, while amyloid pathology is infrequent in PDD. These in vivo PET findings suggest that the presence of amyloid in DLB could contribute to the rapid progression of dementia in this condition and that anti-amyloid strategies may be relevant.

Abeta deposits in older non-demented individuals with cognitive decline are indicative of preclinical Alzheimer's disease

Approximately 30% of healthy persons aged over 75 years show Abeta deposition at autopsy. It is postulated that this represents preclinical Alzheimer's disease (AD). We evaluated the relationship between Abeta burden as assessed by PiB PET and cognitive decline in a well-characterized, non-demented, elderly cohort. PiB PET studies and cognitive tests were performed on 34 elderly participants (age 73+/-6) from the longitudinal Melbourne Healthy Aging Study (MHAS). Subjects were classified as being cognitively 'stable' or 'declining' by an independent behavioural neurologist based on clinical assessment and serial word-list recall scores from the preceding 6-10 years. Decline was calculated from the slope of the word-list recall scores. Abeta burden was quantified using Standardized Uptake Value normalized to cerebellar cortex. Ten subjects were clinically classified as declining. At the time of the PET scans, three of the declining subjects had mild cognitive impairment, one had AD, and six were declining but remained within the normal range for age on cognitive tests. Declining subjects were much more likely to show cortical PiB binding than stable subjects (70% vs. 17%, respectively). Neocortical Abeta burden correlated with word-list recall slopes (r=-0.78) and memory function (r=-0.85) in the declining group. No correlations were observed in the stable group. Abeta burden correlated with incident memory impairment and the rate of memory decline in the non-demented ageing population. These observations suggest that neither memory decline nor Abeta deposition are part of normal ageing and likely represent preclinical AD. Further longitudinal observations are required to confirm this hypothesis.

Imaging beta-amyloid burden in aging and dementia

OBJECTIVE

To compare brain beta-amyloid (Abeta) burden measured with [(11)C]Pittsburgh Compound B (PIB) PET in normal aging, Alzheimer disease (AD), and other dementias.

METHODS

Thirty-three subjects with dementia (17 AD, 10 dementia with Lewy bodies [DLB], 6 frontotemporal dementia [FTD]), 9 subjects with mild cognitive impairment (MCI), and 27 age-matched healthy control subjects (HCs) were studied. Abeta burden was quantified using PIB distribution volume ratio.

RESULTS

Cortical PIB binding was markedly elevated in every AD subject regardless of disease severity, generally lower and more variable in DLB, and absent in FTD, whereas subjects with MCI presented either an "AD-like" (60%) or normal pattern. Binding was greatest in the precuneus/posterior cingulate, frontal cortex, and caudate nuclei, followed by lateral temporal and parietal cortex. Six HCs (22%) showed cortical uptake despite normal neuropsychological scores. PIB binding did not correlate with dementia severity in AD or DLB but was higher in subjects with an APOE-epsilon4 allele. In DLB, binding correlated inversely with the interval from onset of cognitive impairment to diagnosis.

CONCLUSIONS

Pittsburgh Compound B PET findings match histopathologic reports of beta-amyloid (Abeta) distribution in aging and dementia. Noninvasive longitudinal studies to better understand the role of amyloid deposition in the course of neurodegeneration and to determine if Abeta deposition in nondemented subjects is preclinical AD are now feasible. Our findings also suggest that Abeta may influence the development of dementia with Lewy bodies, and therefore strategies to reduce Abeta may benefit this condition.

Stereotactic radiosurgery planning with ictal SPECT images

This paper is motivated by a clinical requirement to utilise ictal SPECT images for target localisation in stereotactic radiosurgery treatment planning using the xknife system which only supports CT and MRI images. To achieve this, the SPECT images were converted from raw (pixel data only) format into a part 10 compliant DICOM CT fileset. The minimum requirements for the recasting of a raw format image as DICOM CT or MRI data set are described in detail. The method can be applied to the importation of raw format images into any radiotherapy treatment planning system that supports CT or MRI import. It is demonstrated that the combination of the low spatial resolution SPECT images, depicting functional information, with high spatial resolution MRI images, which show the structural information, is suitable for stereotactic radiosurgery treatment planning.

Association of alcohol use and other high-risk behaviors among trauma patients

BACKGROUND

Risk behaviors and psychological problems may limit recovery after trauma, may be related to injury recidivism, and may limit the effectiveness of alcohol interventions in trauma patients. The aim of the current study was to evaluate the prevalence of behaviors associated with injury and their relationship with alcohol use in adult trauma patients.

METHODS

A prospective cohort of 301 adult patients admitted to a single Level I trauma center were interviewed regarding risk behaviors and alcohol use.

RESULTS

There was evidence of acute and/or chronic alcohol use in 48.2% of cases. Over three fourths of patients (77%) engaged in one or more high-risk driving practices, 40% engaged in one or more violence-related behaviors, and 19% reported suicidal ideation in the last year. These risk behaviors were more common in patients who evidenced acute and/or chronic alcohol use.

CONCLUSION

Behaviors that place an individual at greater risk for traumatic injury are common among seriously injured adult patients admitted to an urban Level I trauma center and frequently coexist with alcohol use. Their importance to injury, injury recidivism, and recovery after trauma requires further investigation.

Scene disposition and mode of transport following rural trauma: a prospective cohort study comparing patient costs

This prospective cohort study was performed from 1994 to 1996 to compare the impact of scene disposition on prehospital and hospital costs incurred by rural trauma patients transported to a trauma center by helicopter or ground ambulance. The study included all rural adult injury victims who arrived at the tertiary trauma center by ambulance within 24 h of injury. Inclusion criteria consisted of inpatient admission or death in the emergency department, and any traumatic injury except burns. Data collected included mortality, mode of transport, Injury Severity Score (ISS), and costs from impact to discharge or death. Of 105 study patients, 52 initially went to a rural hospital, while 53 went directly to the trauma center. There was no significant difference in survival in the two groups. The ISS was significantly higher for patients taken directly to the trauma center from the scene. The ISS of trauma patients transported from the rural hospital was highest for patients sent by ground transport. The prehospital transport costs were significantly more for patients transported to a rural hospital first. The costs incurred at the trauma center were highest for those patients transported directly from the scene. Many severely injured patients were initially transported to a rural hospital rather than directly to the trauma center. At both the scene and rural hospital, consistent use of triage criteria appeared to be lacking in determining the severity of injury, appropriate destination, and mode of transport for trauma patients. Since no significant difference in prehospital helicopter and ground transport costs was demonstrated, the decision on mode of transport should be in the best interest of patient care.

A PCR method for typing B-L beta II family (class II MHC) alleles in broiler chickens

Certain haplotypes of the major histocompatibility (B) complex are strongly associated with resistance or susceptibility to several infectious diseases in Leghorn chickens. Identification of chicken haplotypes based on the nucleotide sequence of B complex loci could provide more precise identification of haplotypes than traditional serological methods. We report the development and application of polymerase chain reaction with sequence specific primers (PCR-SSP) to type broiler chicken B haplotypes based on the DNA sequence of B-L beta II family genes. Five well-defined standard B haplotypes from White Leghorns and 12 recently characterized B haplotypes from a broiler breeder line were used to develop the test system. The B-L beta II family loci were amplified from genomic DNA by B-L beta II family specific primers and then characterized by PCR-SSP. In total, ten pairs of primers, derived from the sequences of expressed B-L beta II family alleles, were used in the PCR typing test to discriminate the chicken B haplotypes identified previously by serological means. The PCR-SSP showed that each haplotype had a different amplification pattern, except those haplotypes known or suspected to have the same B-L beta alleles. Cloning and sequencing of the family specific PCR products indicated that two loci in the B-L beta II family, presumably B-L beta I and B-L beta II, were amplified. Finally, B-L beta PCR-SSP typing was used in combination with B-G RFLP analyses to characterize unusual (variant) B serotypes; the results indicate that some of these are natural recombinants within the B complex.

Open pelvic fracture and fecal diversion

BACKGROUND

Mandatory fecal diversion has been advocated as an appropriate measure to prevent infection in the clinical setting of an open pelvic fracture. However, the efficacy of this practice has not been verified by prospective investigation and has received only inconsistent support from retrospective analyses.

OBJECTIVE

To determine whether fecal diversion is associated with a substantially lower incidence of abdominopelvic infectious complications in patients with open pelvic fractures.

DESIGN

Case-control study.

SETTING

University-based tertiary care, level I trauma center.

METHODS

The current study reviews our experience with 60 cases admitted from 1987 to 1993 to Harborview Medical Center, a regional level I trauma center. Data collected on each patient included age, sex, Injury Severity Score, Glasgow Coma Scale, initial heart rate and systolic blood pressure, location and severity of wound, fracture pattern, pelvic stability, time to open reduction internal fixation or external fixation, mortality, use of fecal diversion, and incidence and location of infection. Review of the literature produced an additional 186 patients amenable to analysis.

RESULTS

Fecal diversion was performed in 19 patients, 5 (26%) of whom experienced subsequent abdominopelvic infectious morbidity. Of the remaining 41 patients, 7 patients (17%) experienced infectious complications. The 2 groups (diversion vs no diversion) were comparable with regard to relevant demographic and clinical characteristics of injury severity. Combining the present series with those reported by others gave a composite series of 246 patients. For the composite series, diversion was performed in 70% of patients. Infection developed in 27% of patients who underwent diversion vs 29% in patients who did not. In the present series, only mechanical instability was determined by stepwise logistic regression to be significantly associated with pelvic infection. This association was not altered by diversion status.

CONCLUSIONS

Diversion of the fecal stream to protect open pelvic fractures is not associated with a lower incidence of abdominopelvic infectious complications. Diversion may offer protection to a select group of patients with extensive soft tissue injury or posterior wounds. Mechanical instability was independently associated with infection.

Characterization of dynamic 3-D PET imaging for functional brain mapping

Methods for optimizing the acquisition, reconstruction and analysis of positron emission tomography (PET) images for functional brain mapping have been investigated. The scatter fraction and noise-equivalent count rate characteristics were measured for the ECAT 951/31R PET scanner operating in septa-extended two-dimensional (2-D) and septa-retracted three-dimensional (3-D) modes. The 3-D mode is shown to provide higher signal-to-noise images than the 2-D mode at specific activities less than 30 kBq/ml. To enable increased temporal resolution in dynamic 3-D PET activation studies, a parallel version of the 3-D reconstruction algorithm was developed. Implementation of the reprojection algorithm on an 88 processor 1860 supercomputer resulted in a more than tenfold increase in reconstruction speed compared to a single 1860 processor system. An investigation of the optimal duration for imaging brain activations was undertaken in 12 normal subjects using repeated H2(15)O slow infusions and a visually presented lexical decision task. The significance of change in regional cerebral blood flow (CBF) was determined using statistical parametric maps for images acquired during stimulation, immediately after stimulation, and commencing 1 min after cessation of the stimulus. Regions of CBF change were detected in all three images. Dynamic 3-D, or four-dimensional (4-D), PET activation scanning is shown to be practical and likely to further improve the sensitivity of PET for detection of subtle regional CBF changes in functional brain mapping research.

Diagnosis of injuries after stab wounds to the back and flank

BACKGROUND

Historically, patients with deep posterior wounds underwent a formal celiotomy to rule out injury. Currently, we use a policy of selective management. The purpose of this review is to evaluate our experience with selective management to identify potential areas of further improvement.

METHODS AND RESULTS

This study includes 203 patients over a 10-year period. By changing from a policy of mandatory exploration to selective management the total celiotomy rate decreased from 100 to 24% and the therapeutic celiotomy rate increased from 15 to 80%.

CONCLUSIONS

In stable patients, a diagnostic peritoneal lavage should be performed as the initial diagnostic study. When diagnostic peritoneal lavage is negative, triple contrast computed tomography should be performed to evaluate the remaining retroperitoneal structures. Any suggestion of pericolonic extravasation of contrast or air, edema, or hemorrhage must be interpreted as a positive study and prompt consideration for operative exploration.

The effect of neuroleptic and antiparkinsonian medication on the gag reflex

A polygraph assessment of medicated psychiatric patients suggests anticholinergic effects are the primary cause of a diminished gag reflex. Sex differences indicate that females are relatively protected.

Doctor-initiated consultations: a study of communication between general practitioners and patients about the need for reattendance

It has been suggested that general practitioners have the potential to regulate a large percentage of their workload through their control of 'doctor-initiated' consultations. A survey was made of 300 consecutive consultations in a group practice. After their consultation patients completed a questionnaire asking what advice the doctor had given them on the need to reattend. At the same time the general practitioner completed a similar questionnaire about the need for reattendance and the advice given. The general practitioners judged that 74% of patients definitely or possibly needed to reattend, and only 26% definitely did not need to reattend. The coefficient of agreement between patients' and doctors' views on whether reattendance had been recommended was only 0.41. Thus the room for control of doctor-initiated consultations is limited by both clinical considerations and the apparent difficulty of accurately communicating the doctor's advice on reattendance to the patient.