Discovery of New Isotopes ^{160}Os and ^{156}W: Revealing Enhanced Stability of the N=82 Shell Closure on the Neutron-Deficient Side

Using the fusion-evaporation reaction ^{106}Cd(^{58}Ni,4n)^{160}Os and the gas-filled recoil separator SHANS, two new isotopes _{76}^{160}Os and _{74}^{156}W have been identified. The α decay of ^{160}Os, measured with an α-particle energy of 7080(26) keV and a half-life of 201_{-37}^{+58}  μs, is assigned to originate from the ground state. The daughter nucleus ^{156}W is a β^{+} emitter with a half-life of 291_{-61}^{+86}  ms. The newly measured α-decay data allow us to derive α-decay reduced widths (δ^{2}) for the N=84 isotones up to osmium (Z=76), which are found to decrease with increasing atomic number above Z=68. The reduction of δ^{2} is interpreted as evidence for the strengthening of the N=82 shell closure toward the proton drip line, supported by the increase of the neutron-shell gaps predicted in theoretical models.

Efficacy and Safety of Sacubitril/Valsartan Compared With ACEI/ARB on Health-Related Quality of Life in Heart Failure Patients: A Meta-Analysis

BACKGROUND

Data on the effects of sacubitril/valsartan compared with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) on health-related quality of life (HRQoL) are limited.

OBJECTIVE

To evaluate the comparative effects between sacubitril/valsartan and ACEI/ARB on HRQoL, a systematic review and meta-analysis were performed.

METHODS

PubMed, EMBASE, Web of Science, and ClinicalTrials.gov were searched from inception to March 2, 2022 for randomized controlled trials that compared the HRQoL scores, including Kansas City Cardiomyopathy Questionnaire (KCCQ), Minnesota Living with Heart Failure Questionnaire (MLHFQ), or Medical Outcomes Study Short-Form Health Survey 12 or 36 (SF-12/36), between sacubitril/valsartan and ACEI/ARB. After screening, studies that met the inclusion criteria were eventually included and analyzed.

RESULTS

A total of 8 studies with 17 390 patients (8693 patients used sacubitril/valsartan, and 8697 patients used ACEI/ARB) were included in this study. Five of these studies used KCCQ, 1 used SF-12/36, 1 used MLHFQ, and 1 used both KCCQ and SF-12/36. The KCCQ overall summary score and its subscales were significantly higher in sacubitril/valsartan compared with ACEI/ARB in heart failure patients with reduced ejection fraction, but were similar in heart failure patients with preserved ejection fraction. Sacubitril/valsartan conferred similar HRQoL scores in MLHFQ and SF-12/36 to ACEI/ARB. The most frequently reported adverse event for sacubitril/valsartan is hypotension and the risk is higher than for ACEI/ARB.

CONCLUSIONS

Sacubitril/valsartan may have the potential to improve HRQoL in heart failure patients with reduced ejection fraction compared with ACEI/ARB. Hypotension is the most common adverse event with sacubitril/valsartan compared with ACEI/ARB. The results of this study may contribute to the rational use of sacubitril/valsartan.

Rationally designed carboxymethylcellulose-based sorbents crosslinked by targeted ions for static and dynamic capture of heavy metals: Easy recovery and affinity mechanism

A separable spherical bio-adsorbent (CMC-Cr) was prepared for capturing heavy metal ions by simple coordination and cross-linking between targeted ions of Cr³⁺ and carboxymethyl cellulose (CMC). A simple alternation of the CMC incorporation allowed the interconnected networks within the microspheres of preformed solid CMC to be adjusted. The excellent network structure could achieve the maximum collision between the adsorbent and the heavy metal cations in the wastewater. Through investigations, CMC-Cr-2 beads were determined as the optimal adsorbent. The adsorption performance of novel materials was evaluated by examining their adsorption behavior on Pb(II) and Co(II) under both static and dynamic conditions. The results showed that the adsorption behavior of CMC-Cr-2 beads on both two heavy metal cations could be fully reflected by the Freundlich model. Under the theoretical conditions, the maximum adsorption capacities were 97.26 and 144.74 mg/g. The kinetic results for the adsorption of two heavy metal cations on CMC-Cr-2 beads were consistent with the Pseudo-second-order kinetic model. Moreover, the correlation coefficient of the Thomas model was significant in the dynamic adsorption performance tests. Five regeneration cycle studies were successfully carried out on CMC-Cr-2 beads to evaluate reusability and stability. The applicability of CMC-Cr-2 beads in authentic aqueous solutions (both the single and binary pollutant systems) was also studied, and the results indicated that CMC-Cr-2 beads had a high potential for practical implementation. Furthermore, by analyzing the surface interactions of two heavy metal cations with the CMC-Cr-2 beads based on FTIR and XPS characterization, a basic understanding of the interaction between bio-sorbents and pollutants in wastewater can be obtained.

[Preliminary clinical experience of the novel transcatheter aortic valve system Prizvalve® for the treatment of severe aortic stenosis]

Objective: To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) with the novel Prizvalve^® system in treating severe aortic stenosis. Methods: This is a single-center, prospective, single-arm, observational study. A total of 11 patients with severe aortic stenosis with high risk or inappropriate for conventional surgical aortic valve replacement (SAVR) were included, and TAVI was achieved with the Prizvalve^® system between March 2021 and May 2021 in West China Hospital. Transthoracic echocardiography (TTE) was performed immediately after prosthesis implantation to evaluate mean transaortic gradient and maximal transaortic velocity. The device success rate was calculated, which was defined as (1) the device being delivered via the access, deployed, implanted and withdrawn, (2) mean transaortic gradient<20 mmHg (1 mmHg=0.133 kPa) or a maximal transaortic velocity<3 m/s post TAVI, and without severe aortic regurgitation or paravalvular leak post TAVI. TTE was performed at 30 days after the surgery, and all-cause mortality as well as the major cardiovascular adverse events (including acute myocardial infarction, disabling hemorrhagic or ischemic stroke) up to 30 days post TAVI were analyzed. Results: The age of 11 included patients were (78.1±6.3) years, with 8 males. A total of 10 patients were with NYHA functional class Ⅲ or Ⅳ. Devices were delivered via the access, deployed, implanted and withdrawn successfully in all patients. Post-implant mean transaortic gradient was (7.55±4.08) mmHg and maximal transaortic velocity was (1.78±0.44) m/s, and both decreased significantly as compared to baseline levels (both P<0.05). No severe aortic regurgitation or paravalvular leak was observed post TAVI. Device success was achieved in all the 11 patients. No patient died or experienced major cardiovascular adverse events up to 30 days post TAVI. Mean transaortic gradient was (9.45±5.07) mmHg and maximal transaortic velocity was (2.05±0.42) m/s at 30 days post TAVI, which were similar as the values measured immediately post TAVI (both P>0.05). Conclusions: TAVI with the Prizvalve^® system is a feasible and relatively safe procedure for patients with severe aortic stenosis and at high risk or inappropriate for SAVR. Further clinical studies could be launched to obtain more clinical experience with Prizvalve^® system.

Facile transformation of carboxymethyl cellulose beads into hollow composites for dye adsorption

Novel millimeter hollow microspheres were fabricated from carboxymethyl cellulose microspheres and polyethyleneimine using glutaraldehyde as a crosslinking agent. The hollow microspheres prepared with different polyethyleneimine usages and different polyethyleneimine treatment time were investigated deeply and characterized via SEM-EDX, FT-IR, and BET surface area analysis. It was shown that polyethyleneimine could break the coordination bonds between the carboxyl and Al (III) in carboxymethyl cellulose microspheres, leading to the formation of hollow structures. Most importantly, the usage and treatment time of polyethyleneimine can distinctly tailor the structure of the carboxymethyl cellulose microspheres, resulting in the formation of different hollow microspheres with varied shell thickness and size. Most importantly, we found that the prepared hollow microspheres have excellent adsorption performance toward targeted methyl blue under testing conditions. By virtue of the large accessible amount of -NH₂ groups and its unique hollow structure, this type of millimeter hollow microspheres have broad application prospects in the treatment of emerging contaminants in wastewater.

Bi-layered hollow amphoteric composites: Rational construction and ultra-efficient sorption performance for anionic Cr(VI) and cationic Cu(II) ions

Here, we have developed a novel bilayer hollow amphiphilic biosorbent (BHAB-3) with large adsorption capacity, rapid adsorption kinetics, and cost-effective for the removal of Cr(VI) and Cu(II) from aqueous solutions. The synthesis was based on the clever use of freeze-drying to fix the structure, secondary modification of the carboxymethyl cellulose microspheres with polyethyleneimine and cross-linking by glutaraldehyde. The consequences of pH, initial concentration, contact time and temperature on adsorption were investigated. The Langmuir model fits showed that the maximum adsorption capacities of the two target heavy metal ions reached 835.91 and 294.79 mg/g, respectively. Moreover, BHAB-3 was characterized by SEM, FT-IR, TGA, and XPS synergistically, showing that it exhibits a strong complexation ability for Cu(II) and a strong electrostatic effect for Cr(VI). Adsorption and desorption experiments showed only a slight decrease in the adsorption capacity of the BHAB-3 for Cr(VI) and Cu(II) ions after 5 and 26 cycles, respectively. Given the excellent properties of this adsorbent, it is a promising candidate for heavy metal ion removal.

New α-Emitting Isotope ^{214}U and Abnormal Enhancement of α-Particle Clustering in Lightest Uranium Isotopes

A new α-emitting isotope ^{214}U, produced by the fusion-evaporation reaction ^{182}W(^{36}Ar,4n)^{214}U, was identified by employing the gas-filled recoil separator SHANS and the recoil-α correlation technique. More precise α-decay properties of even-even nuclei ^{216,218}U were also measured in the reactions of ^{40}Ar, ^{40}Ca beams with ^{180,182,184}W targets. By combining the experimental data, improved α-decay reduced widths δ^{2} for the even-even Po-Pu nuclei in the vicinity of the magic neutron number N=126 are deduced. Their systematic trends are discussed in terms of the N_{p}N_{n} scheme in order to study the influence of proton-neutron interaction on α decay in this region of nuclei. It is strikingly found that the reduced widths of ^{214,216}U are significantly enhanced by a factor of two as compared with the N_{p}N_{n} systematics for the 84≤Z≤90 and N<126 even-even nuclei. The abnormal enhancement is interpreted by the strong monopole interaction between the valence protons and neutrons occupying the π1f_{7/2} and ν1f_{5/2} spin-orbit partner orbits, which is supported by the large-scale shell model calculation.

Effect of rifampicin on anticoagulation of warfarin: A case report

BACKGROUND

The drug interaction between warfarin and rifampicin is widely known, but there are still some difficulties in managing the combination of the two drugs.

CASE SUMMARY

A patient with brucellosis received strict monitoring from a Chinese pharmacist team during combination of warfarin and rifampicin. The dose of warfarin was increased to 350% in 3 mo before reaching the lower international normalized ratio treatment window. No obvious adverse reaction occurred during the drug-adjustment period. This is the first case report of long-term combined use of rifampicin and warfarin in patients with brucellosis and valve replacement in China based on the Chinese lower warfarin dose and international normalized ratio range.

CONCLUSION

Anticoagulation for valve replacement in Chinese patients differs from that in other races. Establishment of a pharmacist clinic provides vital assistance in warfarin dose adjustment.

Modifying alginate beads using polycarboxyl component for enhanced metal ions removal

Designing desirable adsorbent for highly efficient removal of heavy metal ions is of practical significance, given the cost-effectiveness, environmental benign, natural abundance and easy-handling collection features. Herein, a bead-like adsorbent with high adsorption capacity was prepared by modifying alginate beads using polyacrylate with high density of carboxyl groups. The developed alginate/polyacrylate beads were collaboratively characterized by FT-IR, TGA, SEM, XPS, etc., and various adsorption conditions were tested including the pH of the solution, contact time and the initial concentration. The experimental data were fitted well by the Freundlich isotherm model, and the maximum adsorption capacity was obtained from the Langmuir model was 611.0 mg/g, and adsorption process followed the Pseudo-second-order kinetic model. The adsorption mechanisms conformed to multi-layer adsorption, and mainly dominated by chemical interactions. The bead-like adsorbent exhibited excellent reusability after eight sequential cycles and displayed higher adsorption capacity towards lead ions. This type of adsorbent might possess promising role in treating heavy metals from water by virtue of degradable, cost-effective component and high adsorption efficiency.

[Comparison of age-based clinical and abnormal immune parameters in patients with Henoch-Schönlein purpura]

Objective: To explore age-based clinical and immune parameters in Henoch-Schönlein purpura (HSP) to determine clinically useful markers reflecting disease characteristic. Methods: A cohort of 502 patients with HSP were enrolled into this retrospective study to evaluate their clinical and immune data. Results: Majority HSP cases occurred at age ≤14 years and showed significant immune imbalances of ESR, CD3(+) cells, CD4(+) cells, CD3(-)CD16(+)CD56(+) cells, CD4(+)/CD8(+) cells, IgG, IgA, IgM, IgE, complements C3/C4 and ASO in the acute phase. Compared to patients aged >14 years, symptoms of joint were more frequent at disease onset in patients aged ≤14 years (20.8% vs 7.6%, χ(2)=13.547, P<0.001) , and involvement of digestive tract and joint were also more frequent (57.4% vs 33.8%, χ(2)=24.106, P<0.001; 55.9% vs 32.5%, χ(2)=23.768, P<0.001, respectively) , but not for involvement of kidney (21.4% vs 51.3%, χ(2)=42.440, P<0.001) . The patients aged ≤14 years had distinct immune state, reductions of CD3(+) cells, CD4(+) cells and IgG were more frequent than patients aged >14 years, also increase of ASO (33.1% vs 20.0%, χ(2)=6.656, P=0.010) , but not increase of IgA (2.6% vs 39.4%, χ(2)=15.582, P<0.001) . In addition, reduction of IgG and increase of IgE were positively associated with digestive tract involvement (P<0.001, P=0.001, respectively) , reduction of CD3(+)CD4(+) cells and normal IgM were positively associated with joint involvement (P=0.004, P=0.003, respectively) , increase of CD3(+)CD8(+) cells and normal CD3(+) cells were positively associated with kidney involvement (P=0.032, P=0.014, respectively) . Conclusion: HSP showed significant immune imbalance in the acute phase, patients between aged ≤14 and >14 years had distinct clinical and immune characteristic, and abnormal immune parameters were significantly associated with organ involvements.

Graphene-clad microfibre saturable absorber for ultrafast fibre lasers

Graphene, whose absorbance is approximately independent of wavelength, allows broadband light–matter interactions with ultrafast responses. The interband optical absorption of graphene can be saturated readily under strong excitation, thereby enabling scientists to exploit the photonic properties of graphene to realize ultrafast lasers. The evanescent field interaction scheme of the propagating light with graphene covered on a D-shaped fibre or microfibre has been employed extensively because of the nonblocking configuration. Obviously, most of the fibre surface is unused in these techniques. Here, we exploit a graphene-clad microfibre (GCM) saturable absorber in a mode-locked fibre laser for the generation of ultrafast pulses. The proposed all-surface technique can guarantee a higher efficiency of light–graphene interactions than the aforementioned techniques. Our GCM-based saturable absorber can generate ultrafast optical pulses within 1.5 μm. This saturable absorber is compatible with current fibre lasers and has many merits such as low saturation intensities, ultrafast recovery times, and wide wavelength ranges. The proposed saturable absorber will pave the way for graphene-based wideband photonics.

Diversity and antimicrobial activity of endophytic fungi isolated from Cephalotaxus hainanensis Li, a well-known medicinal plant in China

About 1051 endophytic fungi were isolated from leaves, branches, barks and stems of Cephalotaxus hainanensis Li from four sites in Hainan, China. The fungi were identified as 21 genera by morphology and ITS sequences. One dominant species was Phomopsis quercella in Hainan Tropical Botanical Garden and Bawangling Nature Reserve, with relative frequency of 42·06 and 34·88% respectively. Another dominant species was Colletotrichum boninense in Wuzhishan and Jianfengling Nature Reserves, with relative frequency of 36·84 and 46·97% respectively. Among the selected 21 endophytic fungi, 17 strains (80·95%) had activity against at least one pathogenic bacteria, and 14 strains (66·67%) exhibited activity against at least one fungal pathogens. Neonectria macroconidialis showed strong inhibition against Staphylococcus aureus (inhibition zone being 20 mm), Bacillus subtilis (14 mm) and Streptococcus agalactiae (28 mm). Xylaria sp. showed strong inhibition against Escherichia coli (20 mm), Rhizoctonia solani (20 mm) and Sclerotinia sclerotiorum (17 mm). Verticillium bulbillosum showed great activity against Strep. agalactiae (32 mm) and Fusarium oxysporum (22 mm). These endophytic fungi showed potentials in medicine development.

SIGNIFICANCE AND IMPACT OF THE STUDY

Endophytic fungi from medicinal plants are an important source of novel and viable drugs. Cephalotaxus hainanensis Li is well known for leukaemia treatment and its endophytic fungi were isolated to investigate the diversity and antimicrobial activity. It was found that Ce. hainanensis Li had rich endophytic fungi, and some fungi showed strong antimicrobial activity against certain pathogens. These fungi can be used in medicine development.

Effect of team support training on rehabilitation of stoma patients with rectal cancer

AIM: To investigate the effect of team support training on rehabilitation in stoma patients with rectal cancer.

METHODS: Two hundred and ten rectal carcinoma patients who underwent stoma creation at Luqiao Traditional Chinese Medicine Hospital of Taizhou City from January 2011 to December 2013 were randomly divided into either an observation group (n = 105) or a control group (n = 105). Patients in the control group were followed by telephone and given conventional health guidance. Patients in the observation group joined team support training once a week (at least 8 wk) and were followed by telephone every week. Compliance behavior, the city of hope-quality of life-ostomy questionnaire (COH-QOL-OQ) score, the general self-efficacy scale (GSES) score and rehabilitation were compared between the two groups 6 mo later.

RESULTS: The rates of compliance behavior including correct stoma nursing, timely replacement and cleaning of ostomy bag, daily regular defecation training, keeping optimistic attitude, actively integrating into society, bland diet, appropriate outdoor rehabilitation exercise, active consultation, and regular reexamination in the observation group were significantly superior to those in the control group (93.3% vs 77.1%, 95.2% vs 81.0%, 85.7% vs 65.7%, 94.3% vs 79.0%, 91.4% vs 73.3%, 89.5% vs 75.2%, 87.6% vs 71.4%, 90.5% vs 67.6%, 88.6% vs 69.5%, P < 0.01). The scores of physiological, psychological, social, spiritual dimensions and total score of COH-QOL-OQ in the observation group were significantly superior to those in the control group (7.15 ± 3.01 vs 6.12 ± 2.56, 6.55 ± 2.95 vs 5.49 ± 2.62, 6.20 ± 3.14 vs 5.02 ± 2.95, 6.87 ± 3.08 vs 5.76 ± 2.71, 6.65 ± 3.17 vs 5.52 ± 2.91, P < 0.01). The total score and rate of high level GSES in the observation group were significantly superior to those in the control group (0.91 ± 0.81 vs 2.55 ± 0.86, 61.9% vs 41.9%, P < 0.01). The incidences of complications including peristomal infection, stoma stenosis, parastomal hernia, stomal injury, and stoma prolapse in the observation group were significantly lower than those in the control group (3.81% vs 16.19%, 6.67% vs 25.71%, 2.86% vs 15.24%, 0.01% vs 13.33%, P < 0.01). The rates of regular defecation, defecation intention, and normal stool character in the observation group were significantly superior to those in the control group (81.9% vs 61.0%, 87.8% vs 62.9%, 82.9% vs 61.0%, P < 0.01).

CONCLUSION: Team support training could improve self-care ability, self-efficacy and quality of life in stoma patients with rectal cancer.

A new ditopic ratiometric receptor for detecting zinc and fluoride ions in living cells

The synthesis, characterization and ion binding properties of a new ditopic ratiometric receptor (1), based on 2-(4,5-dihydro-1H-imidazol-2-yl)phenol and crown ether moieties, have been described. The ditopic ratiometric receptor has been studied in sensing both F(-) and Zn(2+) ions, exhibiting different fluorescent colour changes from cyan green to blue/black observable by the naked eye under UV-light. The addition of Zn(2+) to the solution of 1 induced the formation of a 2 : 2 ligand-metal complex 1-Zn(2+), which displays a remarkable blue shift of the emission maxima of 1 from 455 nm to 400 nm due to the inhibition of excited-state intramolecular proton transfer (ESIPT) mechanism. The sensing processes were monitored by fluorescence/absorption titrations, and further confirmed by Job's plot and (1)H NMR titrations. The crystal structure of 1-Zn(2+) reveals that 1 binds Zn(2+) in four-coordinated modes. Furthermore, 1 is cell permeable and may be applied to detect trace Zn(2+) and F(-) during the development of a living organism.

First Report of Stem Canker Disease of Pitaya (Hylocereus undatus and H. polyrhizus) Caused by Neoscytalidium dimidiatum in Taiwan

Pitaya (Hylocereus undatus and H. polyrhizus Britt. & Rose), a perennial succulent plant grown in the tropics, is becoming an emerging and important fruit plant in Taiwan. In September of 2009 and 2010, a number of pitaya plants were found to have a distinctive canker on stems. The disease expanded quickly to most commercial planting areas in Taiwan (e.g., Pintung, Chiayi, and Chunghua). Symptoms on the stem were small, circular, sunken, orange spots that developed into cankers. Pycnidia were erumpent from the surface of the cankers and the stems subsequently rotted. After surface disinfestation with 0.1% sodium hypochloride, tissues adjacent to cankers were placed on acidified potato dextrose agar (PDA) and incubated at room temperature for 1 week, after which colonies with dark gray-to-black aerial mycelium grew. Hyphae were branched, septate, and brown and disarticulated into 0- to 1-septate arthrospores. Sporulation was induced by culturing on sterile horsetail tree (Casuarina equisetifolia) leaves. Conidia (12.79 ± 0.72 × 5.14 ± 0.30 μm) from pycnidia were one-celled, hyaline, and ovate. The internal transcribed spacer (ITS) region of ribosomal DNA was PCR amplified with primers ITS1 and ITS4 (2) and sequenced. The sequence (GenBank Accession No. HQ439174) showed 99% identity to Neoscytalidium dimidiatum (Penz.) Crous & Slippers (GenBank Accession No. GQ330903). On the basis of morphology and nucleotide-sequence identity, the isolates were identified as N. dimidiatum (1). Pathogenicity tests were conducted in two replicates by inoculating six surface-sterilized detached stems of pitaya with either mycelium or conidia. Mycelial plugs from 2-day-old cultures (incubated at 25°C under near UV) were inoculated to the detached stems after wounding with a sterile needle. Conidial suspensions (10³ conidia/ml in 200 μl) were inoculated to nonwounded stems. Noninoculated controls were treated with sterile medium or water. Stems were then incubated in a plastic box at 100% relative humidity and darkness at 30°C for 2 days. The symptoms described above were observed on inoculated stems at 6 to 14 days postinoculation, whereas control stems did not develop any symptoms. N. dimidiatum was reisolated from symptomatic tissues. To our knowledge, this is the first report of N. dimidiatum causing stem canker of pitaya. References: (1) P. W. Crous et al. Stud. Mycol. 55:235, 2006. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, New York, 1990.

First Report of Fruit Rot Disease of Mango Caused by Botryosphaeria dothidea and Neofusicoccum mangiferae in Taiwan

Mango (Mangifera indica L.) is an economically important fruit crop in the tropical and subtropical areas of the world. In southern Taiwan, mango is grown on 18,000 ha of hilly land mainly located in Tainan, Kaohsiung, and Pingtung. Tons (180,000) of mango with a value of NT$6.6 billion (US$206 million) are produced annually. In 2008, mango fruit rot disease was observed 1 week after harvest on 30 to 72% of stored mangoes collected from seven orchards in southern Taiwan. The initial symptom was a small, brown lesion and rot symptoms advanced progressively. Two predominant fungi were isolated from the margin of lesions on acidified potato dextrose agar (PDA with lactic acid, pH 3.8). Isolates of each fungal type were transferred to 2% water agar containing sterilized pine needles and exposed to near UV light to induce sporulation. For the first fungus, conidia obtained from pycnidia were ovate, one-celled, and hyaline, with an average length and width of 12.93 ± 0.93 × 6.98 ± 0.40 μm and an average length/width ratio of 1.85. To confirm the identity of the fungus, PCR amplification by universal primers, ITS1/ITS4, and DNA sequencing of the internal transcribed spacer (ITS1-5.8S-ITS2 rRNA gene cluster) were conducted. The internal transcribed spacer (ITS) sequence of ribosomal DNA of this fungus was analyzed and submitted to GenBank (Accession No. GQ421486). It showed a sequence identity of 100% with Neofusicoccum mangiferae (Syd. & P. Syd.) Crous, Slippers & A. J. L. Phillips) (GenBank Accession No. AY615185). For the second fungus, conidia obtained from pycnidia were fusiform, one-celled, and hyaline, with an average length and width of 22.87 ± 1.32 × 6.42 ± 0.46 μm and a length/width ratio of 3.53. The ITS sequence of ribosomal DNA of this fungus was analyzed and submitted to GenBank (Accession No. GQ421485). It showed a sequence identity of 100% with Botryosphaeria dothidea (Moug.: Fr.) Ces & De Not.) (GenBank Accession No. AY 786321). To test pathogenicity, four mango fruits were wounded with a sterile needle, inoculated with mycelium agar plugs (0.5 mm in diameter) excised from separate monoconidial cultures, and incubated in a plastic box with a 100% relative humidity for 2 days at room temperature. Brown lesions appeared on all wounded sites of each fungus 2 days postinoculation. In control experiments, sterile agar plugs were placed on the wounded mango fruits. These fruits remained completely free from symptoms throughout the experiment. The pathogen was reisolated from the lesions of inoculated fruits and identified as N. mangiferae and B. dothidea, thus fulfilling Koch's postulates. N. mangiferae and B. dothidea have been reported on mango trees in Australia and South Africa (1). To our knowledge, this is the first report of these fungi causing fruit rot of mango in Taiwan. References: (1) B. Slippers et al. Mycologia 97:99, 2005.

Examination of the MSX1 gene in patients with Parkinson's disease

BACKGROUND

Several genetic variants in transcription factor genes have been reported to be associated with Parkinson's disease (PD). The muscle segment homeobox drosophila homolog of 1 gene (MSX1) is a major upstream regulator of the dopaminergic neuronal subtype specification.

AIMS OF THE STUDY

To determine whether genetic variation in the coding region of the MSX1 gene plays a role in the etiology of PD.

METHODS

We searched for genetic variations in the coding region of the MSX1 gene in 202 patients with PD and 200 normal controls by PCR-single-strand conformation polymorphism (PCR-SSCP) and sequencing.

RESULTS

No mutation in the MSX1 gene was identified in our cohort.

CONCLUSIONS

Mutations in the coding region of the MSX1 gene play little or no role in the development of PD.

First Report of a Fruit Rot Disease of Avocado Caused by Neofusicoccum mangiferae

Production of avocado (Persea americana) has increased significantly during the last 10 years in Taiwan and the area of cultivation is approximately 500 ha. The most important postharvest disease of avocado is anthracnose caused by Colletotrichum gloeosporioides (Penz.) in Taiwan (1). In 2008, a new disease was found to be infecting avocado fruit at some orchards in Tainan County of southern Taiwan. Infected avocados developed smooth, brown, circular spots first on the surface of harvested fruits. A fungus was always isolated from the margin of lesions and could also be found from symptomless fruit pedicles and stems. Fungal colonies cultured on acidified potato dextrose agar (PDA with lactic acid; pH 3.8) were initially colorless, turned dark gradually, and ultimately became gray to dark gray. After 4 days under fluorescent light at 25°C, pycnidia formed on PDA. Conidia obtained from fruiting bodies were ovate, one celled, and hyaline, with an average length and width of 12.9 (9.9 to 15.6) × 6.4 (5.2 to 7.2) μm. The internal transcribed spacer (ITS) sequence of ribosomal DNA of this fungus was analyzed and submitted to GenBank (No. EU847427). It showed a sequence identity of 99% with Neofusicoccum mangiferae ((Syd. & P. Syd.) Crous, Slippers & A.J.L. Phillips) (GenBank No. AY615185). Thus, both morphological and molecular results confirmed the isolated fungus as N. mangiferae. Five avocado fruits were used to test the pathogenicity with three different treatment inoculation sites on each fruit. Wounded and unwounded sites on fruit were inoculated with mycelia agar plugs (0.5 mm in diameter) excised from a monoconidial culture and the fruit was kept in a plastic box with high humidity for 2 days at room temperature. Brown lesions appeared on all wounded sites 2 days postinoculation (dpi) and on unwounded sites at 4 dpi. The pathogen was reisolated from the lesions of inoculated fruits and found to be N. mangiferae, thus fulfilling Koch's postulates. In control experiments, sterile agar plugs were placed on the wounded avocado fruits. These fruits remained completely free from symptoms throughout the experiment. Several species of Botryosphaeria have been reported on avocado, including N. parvum (anamorph of B. parva), Fusicoccum aesculi (anamorph of B. dothidea), and Dothiorella aromatica (= F. luteum). To our knowledge, this is the first report of N. mangiferae causing fruit rot of avocado in Taiwan. Previously, N. mangiferae has been reported on mango trees worldwide, especially in Australia and Thailand (2). The presence of N. mangiferae in the subtropical area presents a serious disease problem not only to avocado but also to mango. References: (1) Y. P. Tsai, ed. List of Plant Diseases in Taiwan. 4th ed. Taiwan Phytopathological Society, 2002. (2) B. Slippers et al. Mycologia 97:99, 2005.

First Report of Lasiodiplodia Fruit Rot of Jackfruit in Taiwan

Jackfruit (Artocarpus heterophyllus Lam.) is a tropical fruit that is native to India. Five diseases, including Rhizopus fruit rot and anthracnose fruit rot, have been recorded in Taiwan (2). In 2003, brown lesions were observed on mature or harvested fruits at the Chiayi Agricultural Experiment Branch. The disease caused fruits to collapse and was easily distinguished from anthracnose and Rhizopus fruit rot. In the field, Rhizopus fruit rot was characterized by black flocci sporangia and mycelia covering the flowers and young fruits. Lasiodiplodia fruit rot often occurred on mature or wounded fruit and diseased fruit were covered with gray or black flat mycelia under humid conditions. In the early stage of Lasiodiplodia fruit rot, tiny yellow-brown lesions appeared on the peel. The lesions could rapidly expand to 10 cm in diameter within 5 days and became dark brown with a light margin. The rot symptoms progressed quickly from the peel surface into the sarcocarps that eventually turned black and soft. A fungus was isolated from the margin of the lesions and cultured on acidified potato dextrose agar (PDA) (pH 3.8). The morphology of the fungus was similar to Lasiodiplodia theobromae (Pat.) Griff. & Maubl. (synonym Botryodiplodia theobromae Pat.), which causes the stem-end rot of mango, papaya, and banana in Taiwan. The fungus grew well and produced pycnidia and conidia on PDA. Young conidia were ovate, hyaline, and thin walled without septa. Mature conidia (20 to 28 × 12 to 15 μm) were dark brown and thick walled with one median septum and longitudinal striations. The internal transcribed spacer (ITS) sequence of ribosomal DNA of this fungus was submitted to GenBank (Accession No. EU 407235) and showed 100% sequence identity with that of Botryosphaeria rhodina (anamorph Lasiodiplodia theobromae; GenBank Accession No. DQ458890). On the basis of morphological and molecular criteria, the fungus was identified as L. theobromae (1). Three healthy jackfruit fruits were wounded and inoculated with 2 × 2 mm mycelial agar plugs of the fungus from a monoconidial culture. A sterile agar plug was placed on the wounded site as a control. The fruits were kept in a box to maintain high humidity for 2 days at room temperature. Brown lesions were observed on all inoculated sites 6 days post infection. The pathogen was reisolated from the lesions of inoculated fruits, fulfilling Koch's postulate. The experiment was repeated twice. To our knowledge, this is the first report of L. theobromae causing fruit rot of jackfruit in Taiwan. References: (1) B. C. Sutton. The Coelomycetes. Commonwealth Mycological Institute, Kew, UK, 1980. (2) Y. P. Tsai, ed. List of Plant Diseases in Taiwan. 4th ed. Taiwan Phytopathological Society, 2002.

Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients

BACKGROUND AND PURPOSE

There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.

MATERIALS AND METHODS

We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis < 50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (> 50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] > or = 4) within 2 days before stent placement.

RESULTS

The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale < or = 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933-34.500; P = .004).

CONCLUSION

BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.

Concomitant multiple revascularizations in supra-aortic arteries: short-term results in 50 patients

BACKGROUND AND PURPOSE

The outcome for simultaneous revascularization of more than 1 supra-aortic arterial stenosis has not been evaluated because of concerns regarding the increased risk of additional procedures. We evaluated the feasibility and safety of concomitant multiple supra-aortic arterial revascularizations (CMSAR).

MATERIALS AND METHODS

We retrospectively evaluated 50 consecutive patients who underwent CMSARs with angioplasty and stent placement. The study included a separate lesion group (LG) (n = 28), ipsilateral LG (n = 17) including adjacent (n = 6) and remote (n = 11) tandem lesions, and triple LG (n = 5). We assessed the procedural success (defined as residual stenosis <30%) and periprocedural event rate (ER) (minor or major stroke, and death). We compared the ERs in the lesion (ipsilateral vs separate) and symptom (unstable vs stable) pattern groups with the Fisher exact test.

RESULTS

Procedural success was achieved in all patients (50/50). Periprocedural events within 30 days were noted in 5 (10%). ER within 2 days after the procedure was higher in the ipsilateral LG (4/17) than in the separate LG (0/28) (P = .016). Major events consisting of a major stroke and a death occurred in 2 patients in the unstable group (4%) and was more common in the unstable (2 of 7) than in the stable group (0/38) (P = .029). During the mean 11-month follow-up period, there was 1 symptomatic recurrence.

CONCLUSION

CMSARs are feasible with a high procedural success rate resulting in a favorable short-term outcome. However, they must be carefully performed in ipsilateral LG, especially in patients in the unstable group.

Pulmonary nocardiosis manifested as miliary nodules in a neonate--a case report

A case of pulmonary nocardiosis in a 18-day-old neonate is presented. The chest roentgenograms demonstrated the widespread nodularities, mimicking miliary tuberculosis. Nocardiosis is rare in childhood but should be included in the differential diagnosis of the disseminated nodularities seen in the chest roentgenogram.