Synergistic Effect of Different Plant Cell Wall-Degrading Enzymes Is Important for Virulence of Fusarium graminearum

Endo-polygalacturonases (PGs) and xylanases have been shown to play an important role during pathogenesis of some fungal pathogens of dicot plants, while their role in monocot pathogens is less defined. Pg1 and xyr1 genes of the wheat pathogen Fusarium graminearum encode the main PG and the major regulator of xylanase production, respectively. Single- and double-disrupted mutants for these genes were obtained to assess their contribution to fungal infection. Compared with wild-type strain, the ∆pg mutant showed a nearly abolished PG activity, slight reduced virulence on soybean seedlings, but no significant difference in disease symptoms on wheat spikes; the ∆xyr mutant was strongly reduced in xylanase activity and moderately reduced in cellulase activity but was as virulent as wild type on both soybean and wheat plants. Consequently, the ΔpgΔxyr double mutant was impaired in xylanase, PG, and cellulase activities but, differently from single mutants, was significantly reduced in virulence on both plants. These findings demonstrate that the concurrent presence of PG, xylanase, and cellulase activities is necessary for full virulence. The observation that the uronides released from wheat cell wall after a F. graminearum PG treatment were largely increased by the fungal xylanases suggests that these enzymes act synergistically in deconstructing the plant cell wall.

Italian validation of the Belastungsfragebogen Parkinson kurzversion (BELA-P-k): a disease-specific questionnaire for evaluation of the subjective perception of quality of life in parkinson's disease

BACKGROUND

Quality of life (QoL) is the sense of well-being perceived by people. The improvement of parkinsonian patient's QoL is a crucial goal for clinicians involved in rehabilitative care. In order to provide an appropriate endpoint for the assessment of the effectiveness of rehabilitation treatments on QoL of patients with Parkinson's Disease (PD), in this study we have first translated and then validated the Belastungsfragebogen Parkinson kurzversion (BELA-P-k). This tool allows evaluating separately two crucial aspects: i) the loss of personal autonomy in activities of daily life and ii) the psychological and psychosocial impact of the disease.

METHODS

The BELA-P-k was translated from Dutch into Italian. Subsequently 202 PD patients filled out the questionnaire. Patients were also evaluated by using the Parkinson Disease Questionnaire -39 (PDQ39), the Unified Parkinson's Disease Rating Scale (UPDRS), the Mini Mental State Examination (MMSE) and the Frontal Assessment Battery (FAB).

RESULTS

The internal consistency for total of two different scores Bothered by (Bb) and Need for Help (NfH) was excellent (p = 0.91) for both categories. The correlation between Bb and NfH categories was significant and strong, very-strong, ranging from 0.78 to 0.88 (all p < 0.0001). Finally, the value of Spearman r for the relationship between Bb and NfH items and PDQ 39 values were significant (p ≤ 0.003).

CONCLUSIONS

In conclusion, we validated the BELA-P-k and demonstrated that it is an appropriate and potentially useful tool for assessing QoL in the management of PD.

TRIALS REGISTRATION

This trial was retrospectively registered with ClinicalTrials.gov, NCT03073044.

Impaired human ovarian follicular fluid complement function in hereditary angioedema

We sought and detected functionally active complement in human ovarian follicular fluid obtained during the peri-ovulatory period. All the functional complement activities tested, including total haemolytic complement, classical pathway activity, alternative pathway activity and C1 inhibitor function were present with values within the normal serum range. Active complement in follicular fluid is relevant for the function of the enzymatic multifactorial mechanism of ovulation. The presence in hereditary angioedema patients of both complement (C1 inhibitor deficiency and chronically consumed complement) and ovarian abnormalities (cystic ovaries), led us to study complement function in the follicular fluid of women of reproductive age affected with hereditary angioedema. In contrast to healthy women, hereditary angioedema patients showed dramatically reduced classical pathway activity and undetectable functional and antigenic C1 inhibitor. C4 was very low, while C3 and B were slightly reduced or within the normal serum range. This complement profile was also detected in patients' sera. Since hereditary angioedema patients often show cystic ovaries (polycystic or multifollicular), the presence of multifollicular ovaries in the two patients studied, along with complement dysfunction, may be relevant. These findings, as well as the normalisation of the ovaries found by us in hereditary angioedema patients and in the patients reported here who were undergoing danazol treatment, and the increase in C1 inhibitor and the improvement of clinical symptoms, suggest a further link between complement and ovarian function.

[Spontaneous heterotopic pregnancy with live embryos: an insidious echographic problem in the first trimester. Therapeutic problems. A clinical case and review of the literature]

A case of spontaneous heterotopic pregnancy (simultaneous intra- and extrauterine) with living embryos is described. A 26 year old primigravida, affected by threatened abortion at 7 weeks gestation with right pelvic pain underwent a transvaginal sonography which allowed a certain diagnosis. A minilaparotomy with right salpingectomy was performed at the 8th week of gestation. Intrauterine pregnancy was uneventful and a healthy female infant was delivered at term weighting 3200 g. The international literature concerning heterotopic pregnancy is reviewed. Diagnostic and therapeutic aspects are discussed in the light of this case. Heterotopic pregnancy is an insidious pathology with a constant increase of incidence that should be considered as a diagnostic possibility in all cases at risk. Minilaparotomic salpingectomy in general anesthesia is probably the safest treatment for the patient and the least traumatic for a good outcome of her intrauterine pregnancy.

Role of antepartum computerized fetal heart rate analysis in the prediction of fetal distress during labor

OBJECTIVE

To ascertain the diagnostic ability of a computerized fetal heart rate (FHR) analysis system in the identification of patients at risk of fetal distress in labor.

STUDY DESIGN

Five-hundred and seventy-seven healthy term pregnancies were enrolled in a prospective, cross-sectional study and subdivided into two groups, with (n = 90) or without (n = 487) fetal distress in labor. Computerized FHR recordings were performed periodically and regression analysis was performed in a univariate and multivariate way to assess the ability of the last FHR recordings in the prediction of subsequent fetal distress.

RESULTS

The two groups showed a significant difference in almost all of the FHR parameters studied. The multivariate analysis showed that only the FHR baseline and the percentage of small acceleration were independently and significantly related to the labor outcome. The combination of these two parameters reaches a sensitivity of 45%, specificity of 91%, positive predictive value of 48% and negative predictive value of 90%, with an overall accuracy of 84%.

CONCLUSIONS

The increase in FHR baseline and in small FHR accelerations can be major factors in the prediction of subsequent fetal distress in healthy term fetuses.

[Serum beta hCG levels and transvaginal echography in the early phases of pregnancy]

One hundred thirty two patients at an early gestational age were monitored every other day to establish beta hCG levels at which the gestational sac, the yolk sac and fetal heart motion can be sonographically detected. These structures were observed at significantly lower beta hCG levels by means of the vaginal probe in comparison with the abdominal one. In normal pregnancy a gestational sac of 1-3 mm was detected at a mean hCG level of 1150 UI/l (range 800-1500); the yolk sac was detected at a mean hCG level of 6000 UI/l (range 4500-7500); fetal hart motion was visible at a mean hCG level of 10,425 UI/l (range 8650-12,200). The yolk sac and fetal heart motion were always detected when the gestational sac was greater than 11 and 17 mm respectively. A practical method to evaluate early first trimester pregnancy is suggested.

[Umbilical flowmetry: effect of measurement sites on the results]

Pulsed Doppler duplex sonography was performed longitudinally on 11 uncomplicated singleton pregnancies from 20 to 41 week's gestation (87 measurements). Blood flow velocities were recorded at 3 locations: abdominal insertion site (O), in the free floating part (C), placental insertion site (PL). The objective of the study was to determine whether the C site S/D ratio, the quickest and easiest to perform, relates to the other sites. The S/D ratio measurements fell from the near abdomen (O) to the free floating part (C) to the placental insertion site (PL) between 25-35 week's gestation. Statistical analysis, including analysis of variance for repeated measures and student t test, showed no significant difference in S/D ratio among the locations before 25 and after 35 week's gestation. The S/D ratio at the O site was significantly higher than at the PL site between 25-35 week's gestation; the C site was not significantly different from the PL site.

In vitro activity of a new antibacterial drug, trospectomycin sulphate (U-63,366F), against Bacteroides strains isolated from the vagina

The antibacterial activity of trospectomycin, clindamycin, metronidazole, imipenem, cefoxitin, and piperacillin was tested against 72 Bacteroides spp. strains isolated from the vagina of women with vaginitis by determining the minimal inhibitory concentration using the agar dilution method. Trospectomycin shows a good activity which is comparable to that of imipenem and metronidazole. Its expanded spectrum of activity makes trospectomycin suitable for the use in single-drug therapy of pelvic infections in women.

[Hysteroscopic evaluation of endometrial ultrasonic anomalies in asymptomatic postmenopausal patients. Preliminary results]

A group of 248 asymptomatic postmenopausal patients was evaluated using transvaginal echography. Thirty-five patients with endometrial echopatterns which were larger than 8 mm and/or irregular then underwent hysteroscopy and endometrial biopsy. Results show that 31.4% of cases in which there was a thickening of the endometrial echopattern correspond to the presence of polyp, myoma, synechia with atrophic endometrium. In conclusion, the Authors affirm the inappropriateness of the term "endometrial echopattern" in menopause, since this term should be reserved to describe the typical appearance of the endometrium during the reproductive phase. They stress that ultrasonography can reveal anomalies of the internal echostructure of the womb but that further tests (e.g. hysteroscopy, biopsy) are required to diagnose their nature.

[Doppler flowmetry in a case of single umbilical artery]

A case of sonographic diagnosis of single umbilical artery associated with hypoplastic left heart syndrome and left renal agenesis is reported. Umbilical artery Doppler waveforms are presented and discussed for the first time.

[Neoplasms with unknown primary location]

Neoplasms with unknown primary location (U.P.L.N.) represent an important chapter of oncological pathology which has not yet been completely defined regarding diagnostics, therapy and prognosis. U.P.L.N. recur in clinical practice in 0.5%-10% of cases and show equal sharing in both sexes: still mortality is high. This is in agreement with the biological behavior of U.P.L.N. which is that of a neoplastic illness, systemic from the onset and therefore immediately aggressive. Treatments commonly used only slightly alter the course of the disease. If the general state of the patients allows it, treatment must include every available therapeutical remedy (CHR, RDT, CHM) conveniently evaluated in every single case and preferably under the guidance of the apparent histotype and of the onset seat. The histotype of an U.P.L.N. sensibly affects the prognosis of the patient: there is an improvement in well differentiated and lodged forms and conversely, there is a sharp impairment with fast evolution in the less differentiated and variably metastasized forms. In our case-report, the U.P.L.N. rate has been 5.37% on 1786 cancer diagnoses from February 1980 until January 1988. In 65% of these cases, the histotype sustaining the pathology was represented by adenocarcinoma, in 21% by epidermoid carcinoma and in the remaining 14% by undifferentiated carcinoma. The clinical onset most frequently observed has involved the lymph nodes, followed by involvement of the serosa, bones, lungs and liver. Complex therapeutic treatments have not provided clear results, but the use of anthracyclines and cyclophosphamide seems promising. Finally, we suggest the use of immunomodulators (such as interferons, thymus hormone, lymphokines) in association with the classic chemotherapeutics.

[Dynamic ultrasonic hysteroscopy]

An attempt was made to establish Dynamic Echohysteroscopy (DEHS) diagnostic criteria for the study of female genital apparatus, as recently proposed. DEHS consists of a pelvic ultrasonography during and following an injection of physiological solution in the uterine cavity. Since this technique does not use X-rays, it has been proven useful to study female infertility. The authors have studied the normal and pathological aspects of 33 patients who underwent both DEHS and hysterosalpingography (HSG) (comparison diagnostic test). The results lead to the following conclusions: 1) DEHS can be considered a useful alternative to HSG, in the evaluation of uterine pathology; 2) in the evaluation of tubal pathology, DEHS has fewer diagnostic possibilities than HSG. Nevertheless, DEHS indirectly allows the patency of at least one tube.

Sinusoidal-like fetal heart-rate pattern. Real-time ultrasound may help in differential diagnosis

Cases of benign sinusoidal-like fetal heart-rate pattern, associated with rhythmic movements of the fetal mouth, are reported as probably physiological. The importance of fetal behavior observation during prepartum fetal heart-rate monitoring is stressed as a quick way to improve diagnostic accuracy in similar cases.