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1.  Two new pathogenic ascomycetes in Guignardia and Rosenscheldiella on New Zealand's pygmy mistletoes (Korthalsella: Viscaceae) 
Studies in Mycology  2011;68:237-247.
Two new pathogens, Guignardia korthalsellae and Rosenscheldiella korthalsellae, are described from New Zealand's pygmy mistletoes (Korthalsella, Viscaceae). Both form ascomata on living phylloclades with minimal disruption of the tissue. Fungal hyphae within the phylloclade are primarily intercellular. Guignardia korthalsellae disrupts a limited number of epidermal cells immediately around the erumpent ascoma, while the ascomata of Rosenscheldiella korthalsellae develop externally on small patches of stromatic tissue that form above stomatal cavities. Rosenscheldiella is applied in a purely morphological sense. LSU sequences show that R. korthalsellae as well as another New Zealand species, Rosenscheldiella brachyglottidis, are members of the Mycosphaerellaceae sensu stricto. Genetically, Rosenscheldiella, in the sense we are using it, is polyphyletic; LSU and ITS sequences place the two New Zealand species in different clades within the Mycosphaerellaceae. Rosenscheldiella is retained for these fungi until generic relationships within the family are resolved. Whether or not the type species of Rosenscheldiella, R. styracis, is also a member of the Mycosphaerellaceae is not known, but it has a similar morphology and relationship to its host as the two New Zealand species.
PMCID: PMC3065993  PMID: 21523197
ITS; LSU; Mycosphaerellaceae; Phaeocryptopus; phylogeny
2.  Clinical investigation of an outbreak of alveolitis and asthma in a car engine manufacturing plant 
Thorax  2007;62(11):981-990.
Exposure to metal working fluid (MWF) has been associated with outbreaks of extrinsic allergic alveolitis (EAA) in the USA, with bacterial contamination of MWF being a possible cause, but is uncommon in the UK. Twelve workers developed EAA in a car engine manufacturing plant in the UK, presenting clinically between December 2003 and May 2004. This paper reports the subsequent epidemiological investigation of the whole workforce. The study had three aims: (1) to measure the extent of the outbreak by identifying other workers who may have developed EAA or other work‐related respiratory diseases; (2) to provide case detection so that those affected could be treated; and (3) to provide epidemiological data to identify the cause of the outbreak.
The outbreak was investigated in a three‐phase cross‐sectional survey of the workforce. In phase I a respiratory screening questionnaire was completed by 808/836 workers (96.7%) in May 2004. In phase II 481 employees with at least one respiratory symptom on screening and 50 asymptomatic controls were invited for investigation at the factory in June 2004. This included a questionnaire, spirometry and clinical opinion. 454/481 (94.4%) responded and 48/50 (96%) controls. Workers were identified who needed further investigation and serial measurements of peak expiratory flow (PEF). In phase III 162 employees were seen at the Birmingham Occupational Lung Disease clinic. 198 employees returned PEF records, including 141 of the 162 who attended for clinical investigation. Case definitions for diagnoses were agreed.
87 workers (10.4% of the workforce) met case definitions for occupational lung disease, comprising EAA (n = 19), occupational asthma (n = 74) and humidifier fever (n = 7). 12 workers had more than one diagnosis. The peak onset of work‐related breathlessness was Spring 2003. The proportion of workers affected was higher for those using MWF from a large sump (27.3%) than for those working all over the manufacturing area (7.9%) (OR = 4.39, p<0.001). Two workers had positive specific provocation tests to the used but not the unused MWF solution.
Extensive investigation of the outbreak of EAA detected a large number of affected workers, not only with EAA but also occupational asthma. This is the largest reported outbreak in Europe. Mist from used MWF is the likely cause. In workplaces using MWF there is a need to carry out risk assessments, to monitor and maintain fluid quality, to control mist and to carry out respiratory health surveillance.
PMCID: PMC2117138  PMID: 17504818
3.  Comparison of the expression of p53, p21, Bax and the induction of apoptosis between patients with basal cell carcinoma and normal controls in response to ultraviolet irradiation 
Journal of Clinical Pathology  2002;55(11):829-833.
Aim: Ultraviolet light (UV) is known to cause DNA damage in the epidermis. The damaged DNA is repaired or deleted by apoptosis to prevent the generation of cancer. It has been suggested that a deficient apoptotic mechanism may predispose individuals to skin cancer. Therefore, the response of normal controls and patients with basal cell carcinoma (BCC) to UV irradiation was investigated.
Methods: The buttock skin from normal volunteers and patients with BCC was irradiated using solar simulated radiation (SSR). SSR mimics the effect of natural sunlight. Skin biopsies were excised and examined for p53, p21, and Bax protein expression and for the induction of apoptosis.
Results: At 33 hours after UV irradiation, the induction of apoptosis was significantly higher (p = 0.04) in patients with BCC than in normal volunteers (Mann Whitney test). A trend towards higher p21 expression was found at 33 hours in patients with BCC (mean, 18.69 positive cells/field) than in normal volunteers (mean, 9.89), although this difference was not significant (p = 0.05 positive cells/field).
Conclusion: These results may imply that patients with BCC have enhanced sensitivity to UV irradiation or that there is some defect in the cell arrest or repair pathways, which results in damaged cells been pushed into apoptosis rather than repair.
PMCID: PMC1769808  PMID: 12401820
solar simulated radiation; basal cell carcinoma; p53 pathway
4.  Telomerase activity detected in oral lichen planus by RNA in situ hybridisation: not a marker for malignant transformation 
Journal of Clinical Pathology  2002;55(8):602-607.
Background: Oral lichen planus (OLP) is a chronic inflammatory condition. Clinically, it is characterised by the presence of a white lace-like lesion on the buccal mucosa, tongue, and gingivae, with erosions and ulceration. The World Health Organisation considers OLP to be a premalignant condition.
Aims: To investigate expression of the telomerase RNA component (hTR) in OLP compared with normal control buccal mucosa and to assess the possibility of using hTR expression as a marker for malignant transformation in OLP.
Methods: hTR expression was analysed in 40 cases of OLP and 18 normal control buccal mucosa samples using an RNA in situ hybridisation approach.
Results: Strong hTR RNA expression was seen in the basal, suprabasal, and to a lesser extent in the upper epithelial layers in 36 of the 40 OLP lesions examined. Infiltrating subepithelial lymphocytes in OLP were also shown to express hTR RNA. Weak hTR RNA expression was seen in seven of the 18 normal control buccal mucosa specimens, with expression confined exclusively to the basal layer of the epithelium and absent in the suprabasal and upper layers.
Conclusion: The telomerase RNA component hTR is found to be highly expressed in the epithelium of non-dysplastic OLP lesions. It is possible that this high expression is related to the increased cellular proliferation seen in OLP lesions rather than being an indicator of susceptibility to malignancy. Thus, hTR RNA expression may not be a suitable marker for predicting malignant transformation in OLP.
PMCID: PMC1769712  PMID: 12147655
oral lichen planus; RNA in situ hybridisation; telomerase; malignant transformation
6.  Hospital preparedness for hazardous materials incidents and treatment of contaminated patients. 
Western Journal of Medicine  1997;167(6):387-391.
Hospital-based facilities providing emergency care in the state of Washington were surveyed to determine their level of preparedness for hazardous materials incidents including the treatment of contaminated patients. Responses to a faxed questionnaire were received from 95 (94%) of the 101 emergency care facilities in Washington State. Only 42 (44%) of the facilities reported the ability to receive any chemically exposed patient. Of the 95 responding emergency care facilities, 39 (41%) had no designated decontamination facilities; 67 (70%) had protocols for handling chemical contamination and possible evacuation from hazardous materials spills, and 52 (55%) had protocols for handling medical facility contamination and possible evacuation from treating chemically contaminated patients. Twelve (13%) facilities had evacuated their emergency department or other part of the hospital for contamination incidents in the past 5 years. Despite the frequent occurrence of hazardous materials incidents, most emergency care facilities in Washington State are not fully prepared to handle contaminated patients and chemical spills. This may have important implications for the care of persons with exposure to hazardous materials and for implementing Joint Commission on Accreditation of Healthcare Organizations standards and federal Occupational Safety and Health Administration regulations.
PMCID: PMC1304716  PMID: 9426476
7.  Public debate on private medicine. 
PMCID: PMC1335476  PMID: 8976323
8.  Avoiding medication mixups. Identifiable imprint codes. 
Western Journal of Medicine  1996;165(6):352-354.
This study was done to determine if current imprinting of solid medication forms permits health care professionals to identify the manufacturers involved so as to be able to activate the hierarchic identification system mandated by the Food and Drug Administration. We tested 15 representatives of 6 groups of health professionals for their ability to identify the manufacturer after having examined 30 solid-dosage forms drawn from a pseudo-random sample of stock hospital formulary products. The correct identification of the manufacturer was the sole criterion. Of the 2,700 opportunities, the manufacturer was able to be identified for only 43%. Nurses and medical students had a 35% success rate, pharmacists and poison center specialists a 55% success rate, and residents and attending physicians a 40% rate. None approached 95% accuracy. Currently employed imprints fail in their objective to permit health care professionals--or the general public--to rapidly identify prescription drugs. The manufacturers' logotypes need to be modified if this identification system is to be implemented. We propose a simple voluntary collaborative effort by the pharmaceutical industry to solve the problem.
PMCID: PMC1303871  PMID: 9000855
9.  Prevalence of Giardia cysts and Cryptosporidium oocysts and characterization of Giardia spp. isolated from drinking water in Canada. 
This study was carried out to estimate the prevalence and potential for human infectivity of Giardia cysts in Canadian drinking water supplies. The presence of Cryptosporidium oocysts was also noted, but isolates were not collected for further study. A total of 1,760 raw water samples, treated water samples, and raw sewage samples were collected from 72 municipalities across Canada for analysis, 58 of which treat their water by chlorination alone. Giardia cysts were found in 73% of raw sewage samples, 21% of raw water samples, and 18.2% of treated water samples. There was a trend to higher concentration and more frequent incidence of Giardia cysts in the spring and fall, but positive samples were found in all seasons. Cryptosporidium oocysts were found in 6.1% of raw sewage samples, 4.5% of raw water samples, and 3.5% of treated water samples. Giardia cyst viability was assessed by infecting Mongolian gerbils (Meriones unguiculatus) and by use of a modified propidium iodide dye exclusion test, and the results were not always in agreement. No Cryptosporidium isolates were recovered from gerbils, but 8 of 276 (3%) water samples and 19 of 113 (17%) sewage samples resulted in positive Giardia infections. Most of the water samples contained a low number of cysts, and 12 Giardia isolates were successfully recovered from gerbils and cultured. Biotyping of these isolates by isoenzyme analysis and karyotyping by pulsed-field gel electrophoresis separated the isolates into the same three discrete groups. Karyotyping revealed four or five chromosomal bands ranging in size from 0.9 to 2 Mb, and four of the isolates had the same banding pattern as that of the WB strain. Analysis of the nucleotide sequences of the 16S DNA coding for rRNA divided the isolates into two distinct groups corresponding to the Polish and Belgian designations found by other investigators. The occurrence of these biotypes and karyotypes appeared to be random and was not related to geographic or other factors (e.g., different types were found in both drinking water and sewage from the same community). Biotyping and karyotyping showed that isolates from this study were genetically and biochemically similar to those found elsewhere, including well-described human source strains such as WB. We conclude that potentially human-infective Giardia cysts are commonly found in raw surface waters and sewage in Canada, although cyst viability is frequently low. Cryptosporidium oocysts are less common in Canada. An action level of three to five Giardia cysts per 100 liters in treated drinking water is proposed on the basis of the monitoring data from outbreak situations. This action level is lower than that proposed by Haas and Rose (C. N. Haas and J. B. Rose, J. Am. Water Works Assoc. 87(9):81-84, 1995) for Cryptosporidium spp. (10 to 30 oocysts per 100 liters).
PMCID: PMC168064  PMID: 8702271
12.  Health care abuse. 
PMCID: PMC1486664  PMID: 8167997
13.  Assessing CME needs assessment. 
Western Journal of Medicine  1993;158(5):535-536.
PMCID: PMC1022149  PMID: 8342281
14.  Playing the cost-containment game. 
Western Journal of Medicine  1992;157(1):77-78.
PMCID: PMC1021917  PMID: 1413755
17.  Wheat Germ Agglutinin Binding to the Outer Cuticle of the Plant-parasitic Nematode Anguina tritici 
Journal of Nematology  1988;20(3):499-501.
PMCID: PMC2618836  PMID: 19290245
Anguina tritici; lectin; wheat germ agglutinin
18.  Mechanisms leading to hypogonadism in men with burns injuries. 
A profound and persistent depression of serum testosterone concentrations was found in 19 men with burns injuries. This could not be explained by changes in sex hormone binding globulin capacity, hyperprolactinaemia, classical primary testicular failure, or a hypogonadotrophic state. Pulsatile release of luteinising hormone was found in control subjects but was absent or diminished in burnt patients with low serum testosterone concentrations. In addition, these patients showed reduced biological activity of luteinising hormone as measured by bioassay even though normal concentrations of luteinising hormone were detected by radioimmunoassay. The temporary hypogonadism after burns injury and possibly in other clinical states may be related to hypothalamic dysfunction, which leads to abnormal generation of luteinising hormone releasing hormone and non-pulsatile secretion of luteinising hormone of reduced biological activity.
PMCID: PMC1247271  PMID: 3115476
19.  Distribution of Field Corn Roots and Parasitic Nematodes in Subsoiled and Nonsubsoiled Soil 
Journal of Nematology  1986;18(2):203-207.
A field trial was conducted for 2 years in an Arredondo fine sand containing a tillage pan at 15-20 cm deep to determine the influence of subsoiling on the distribution of corn roots and plant-parasitic nematodes. Soil samples were taken at various depths and row positions at 30, 60, and 90 days after planting in field corn subsoiled under the row with two chisels and in non-subsoiled corn. At 30 and 60 days, in-row nematode population densities to 60 cm deep were not affected by subsoiling compared with population densities in nonsubsoiled plots. After 90 days, subsoiling had not affected total root length or root weight at the 20 depth-row position sampling combinations, but population densities of Meloidogyne incognita and Criconemella spp. had increased in subsoiled corn. Numbers of Pratylenchus zeae were not affected. Subsoiling generally resulted in a change in distribution of corn roots and nematodes in the soil profile but caused little total increase in either roots or numbers of nematodes. Corn yield was increased by subsoiling.
PMCID: PMC2618515  PMID: 19294167
subsoiling; field corn; Zea mays L.; cultural practices; Meloidogyne incognita; Pratylenchus zeae; Criconemella spp.; root-knot nematode; lesion nematode; ring nematode; nematode ecology
20.  Characterization and Localization of Saccharides on the Head Region of Four Populations of the Potato Cyst Nematode Globodera rostochiensis and G. pallida 
Journal of Nematology  1986;18(1):23-25.
N-acetylglucosamine, galactose, N-acetylgalactosamine and mannose and (or) glucose were present on specimens of two populations of Globodera rostochiensis and two of G. pallida representing four different pathotypes. Individuals within the pathotypes varied in the amounts of some of the saccharides present. The Pa₁ population differed from the other populations in the presence on all individuals of N-acetylgalactosamine and the absence of extensive residues of mannose/glucose. TEM studies showed that N-acetylglucosamine and mannose/glucose were present on the exudate from the amphids of juveniles from the Ro₁ population.
PMCID: PMC2618504  PMID: 19294133
amphidial exudate; N-acetylglucosamine; galactose; N-acetylgalactosamine; mannose; glucose; fluorescence; microscopy; electron microscopy; rhodamine; ferritin; pathotypes; potato cyst nematode
21.  Morphological and Histochemical Changes Occurring during the Life-span of Root-tip Galls on Lolium perenne Induced by Longidorus elongatus 
Journal of Nematology  1984;16(3):223-229.
The RNA and protein content of perennial ryegrass root-tip galls induced by Longidorus elongatus were measured from transverse sections and the morphology described. Galls progressed through five distinct stages and were viable for only 10-12 days at 18 C, after which they collapsed and became necrotic. In the initial stage hypertrophy occurred and cells contained enlarged nuclei and nucleoli, a greater proportion of cytoplasm, and increased concentrations of protein. This was followed by hyperplasia; cells divided to give two or four daughter cells, accompanied by a proportionate reduction in volumes of cytoplasm, nuclei, and nucleoli and reduced concentrations of RNA and protein. The third stage was secondary hypertrophy with enlarged, amoeboid nuclei and nucleoli and a significant increase in concentration of RNA and protein. In the final two stages, as feeding by L. elongatus progressively removed cell contents, most cells were devoid of inclusions and galls collapsed and were invaded by soil bacteria. This ordered development and exploitation of galls suggests that L. elongatus may have two phases in its feeding.
PMCID: PMC2618383  PMID: 19294015
morphology; stereology; RNA; protein; host-parasite relationship
22.  Electron Microscope Characterization of Carbohydrate Residues on the Body Wall of Xiphinema index 
Journal of Nematology  1983;15(4):528-534.
The location of carbohydrate moieties on the outer cuticle of Xiphinema index was examined by electron microcopy using several different reagents: a) The periodic acid-thiosemicarbazide-silver proteinate reaction was used as a general stain for carbohydrates. In sectioned material it stained the canal system and deeper layers of the cuticle as well as the outer surface, b) Cationized ferritin at pH 2.5, which identifies carboxyl and sulfate groups, was used to identify sialic acid residues and also labelled parts of the canal system, c) Ferritin-goat anti rabbit IgG coupled to a DNP ligand was used to label either sialyl or galactosyl/N-acetyl-D-galactosaminyl residues, d) Ferritin hydrazide, a new reagent, was used for the ultrastructural localization of glyco-conjugates. Reagents c) (with appropriate antisera) and d) were applied only to the outer surfaces of the cuticle; they showed that sialic acid residues were concentrated mainly on the outer body wall of the head, the lips, oral opening, amphid apertures, and outer surface of protruded odontostyles. Ferritin distribution was not altered by pretreatment with neurantinidase. Galactose oxidase treatments revealed galactose/N-acetyl-D-galactosamine residues along the entire body wall. These results confirmed earlier findings obtained by fluorescence microscopy.
PMCID: PMC2618312  PMID: 19295842
outer cuticle surface; cuticular canal system; sialic acid; galactose; electron microscopy; cryoultramicrotomy; cationized ferritin; ferritin hydrazide
23.  Control of hypertension in out-patients. Experience of the Glasgow Blood Pressure Clinic. 
Postgraduate Medical Journal  1980;56(659):633-637.
Five hundred and sixty-two patients who had attended the Glasgow Blood Pressure Clinic regularly for 3 years between 1969 and 1978 were studied. The mean BPs for the group were 187/115 mmHg initially, 157/100 mmHg after 6 months, and 153/98 mmHg after 3 years. Twenty-eight per cent had 'normal' systolic pressure and 22% 'normal' diastolic pressure at 3 years. Thirty-seven per cent with mild, 83% with moderate, and 89% with severe systolic pressure elevation had moved into less severe categories by 3 years, as had 30% with mild, 60% with moderate and 84% with severe diastolic evaluation. Those patients with severe hypertension, who did not attain a less grade, had a statistically significant drop in pressure. Four per cent of all patients, however, had moved into a more severe severe grade of systolic pressure evaluation and 6% into a more more severe diastolic pressure grade at 3 years. These results suggest that the hospital Hypertension Clinic can play a useful part in the lowering of BP in out-patients. It is clear, however, that 'normal' BP levels are not achieved in a significant proportion of patients.
PMCID: PMC2425945  PMID: 7465471
24.  Religion, science and faith 
PMCID: PMC1875231  PMID: 20313873
25.  Primary orbital schwannomas. 
Seven histologically proved cases of primary orbital schwannoma have been seen at the University of British Columbia Orbital Clinic between September 1976 and December 1980. We describe here their varied clinical presentations, preoperative investigations, operative findings, and appearances on light and electron microscopy. Although no single feature is pathognomonic, a multiplicity of clinical, radiographic, and surgical features point to this lesion. Of preoperative investigations the computed tomography scan was the most helpful, especially in localising the lesion. Of the 7, 4 were intraconal and 3 were extraconal. The surgical approach was dictated by tumour site and included anterior, lateral, and panoramic orbitotomies. At surgery the nerve of origin of 4 of the tumours was identified. All tumours were excised totally or subtotally. There has been no recurrence to date.
PMCID: PMC1039752  PMID: 7066273

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