Objective Several trials have reported early superior patency of stenting over isolated angioplasty (plain old balloon angioplasty POBA) for infra-inguinal occlusive disease, yet long-term data are ...sparse. The purpose of this study was to contrast long-term clinical outcomes and costs of angioplasty alone vs angioplasty with selective stenting in the treatment of femoropopliteal occlusive disease. Methods Patients undergoing primary endovascular treatments of the native femoropopliteal arteries from 2002 to 2009 were divided into two groups, POBA alone or stenting based on final treatment received at their index procedure. Study end points included actuarial 5-year primary patency (using strict criteria of any hemodynamic deterioration or return of symptoms), 5-year limb salvage, and 5-year survival and hospital costs. Results Eight hundred twenty-four primary procedures were performed during the study interval; 517 (63%) were POBA and 307 (37%) were stenting. The mean follow-up duration was 33 months (range, 0-98 months). The indication for intervention in the stenting group was claudication in 71% of the patients, whereas the remaining 29% had critical limb ischemia (CLI). In the POBA cohort, the indication for treatment was claudication in 59% of the patients and CLI in the remaining 41%. A higher percentage of POBA lesions were TransAtlantic Inter-Society Consensus (TASC) II A & B when compared to stenting (91% POBA vs 73% stenting; P < .001). There was no difference in overall 5-year primary patency (POBA 36% ± 3%; stenting 41% ± 4%; P = .31), nor was there a difference in patients with claudication (POBA 42% ± 4%; stenting 45% ± 4%; P = .8). In patients with CLI, the 4-year primary patency was 27% ± 5% (POBA) vs 36% ± 8% (stenting), P = .22; the 4-year limb salvage was 80% ± 4% (POBA) vs 90% ± 5% (stenting), P = .18. There was no difference in survival between the two groups (claudication: 83% ± 3% POBA vs 84% ± 4% stenting at 5 years ( P = .65), CLI: 44% ± 4% POBA vs 49% ± 6% stenting at 4 years ( P = .40). Subgroup analysis by lesion anatomy showed similar primary patency between POBA and stenting for TASC II A & B lesions, while the primary patency was significantly higher at 5 years after stenting of TASC II C & D lesions (34% ± 6% vs 12% ± 9%; P < .05). Stenting increased the procedural cost by 57% when compared to POBA ( P < .001) regardless of treatment indication. In addition, stenting added 45% ( P < .001) to the overall hospital cost of patients treated for claudication. Conclusion Stenting resulted in equivalent long-term outcomes compared to POBA when stratified by indications. However, stenting yielded statistically better primary patency in patients with TASC II C & D lesions. The lack of improved clinical outcomes and significantly higher cost of stenting supports a posture of selective use of stents (especially in TASC II A & B) in the endovascular treatment of femoropopliteal occlusive disease.
We examined production of reactive oxygen species (ROS) and induction of cell death in tissue-cultured tobacco cells undergoing different disease resistance responses. A superoxide-dependent ...hypersensitive response occurs during both the race-specific resistance response of tobacco cells challenged with incompatible zoospores of Phytophthora nicotianae and during non-specific elicitation of tobacco cells challenged with Phytophthora glucan elicitors extracted from the fungal cell wall. Inhibition studies are consistent with dependence upon endogenous Ca2+ levels, and with involvement of NAD(P)H oxidase and peroxidases in production of ROS during both specific and non-specific elicitation. The patterns of resistance expression during non-host resistance or field resistance responses appear to be similar to race-specific resistance expression with regard to the timing and order of events. However, the intensity of the response is very much reduced. In contrast, during non-specific elicitation, these temporal patterns are significantly altered. The differences in timing, intensity and extent of responses during different modes of disease resistance expression indicate that stimulation of cultured plant cells with non-specific soluble fractions in order to model in planta events during plant / Oomycete and, by implication, plant / fungal interactions, has significant limitations.
A calendar of fungal spore seasons for Melbourne during 1993 was established using a 7-day volumetric Burkard trap. Twenty-nine genera and five spore groups were identified. The dominant spore types ...detected were Cladosporium (41.7%), Leptosphaeria (14.9%), Coprinus (14.6%), 'Ascospore 1' (5.5%), Ganoderma (2.1%) and Alternaria (1.4%). Seasonally, spore levels of Cladosporium and Alternaria peaked in spring and summer, Leptosphaeria and Ganoderma peaked toward summer and autumn, 'Ascospore 1' peaked in winter, whilst spore levels of the basidiomycete Coprinus fluctuated year round. In conclusion, a range of allergenic fungal spores were present in the air of Melbourne throughout the year.
Papua New Guinea and Bougainville produce 42,000 tonnes of dry cocoa beans annually, supplying 2% of the total world cocoa market and 9% of the world's fine flavour cocoa. More than 80% of production ...comes from an estimated 70,000 smallholder farmers scattered across the country, producing mean yields of 300-400 kg/ha. At the 2003 National Cocoa Summit, the industry set a production target of 100,000 tonnes by 2012. Typically, smallholder farmers invest little time or money in farm management and the current low yields reflect high levels of disease losses (estimated 40% yield loss), due mainly to pod rots and canker (Phytophthora palmivora), Vascular-streak dieback (Oncobasidium theobromae) and Pink disease (Erythricium salmonicola). Recognising the need for change in management practices we developed a series of low, medium and high-input Integrated Disease Management (IDM) options which underpin new farmer participation-based approaches in the delivery of extension information. We are documenting disease losses and smallholder knowledge, skills and attitudes to disease management, fostering adoption of IDM strategies by cocoa farmers and improving cocoa yield. The goal is to transform the cocoa industry from 90% low management input to 50% medium management input, thereby increasing cocoa production and improving farmer incomes. Yields in farmer trials of up to 2,000 kg beans/ha have been realised.
We isolated bacteria and fungi from composted chicken, sheep, cow and horse manure and screened each isolate for their ability to suppress P. dnnamomi in dual-culture in vitro assays. Of the 180 ...isolates, including 31 actinomycetes, 64 fungi, 44 fluorescent pseudomonads and 41 endospore-forming bacteria, 45 isolates significantly inhibited the growth of P. dnnamomi on plates. The inhibitory microbes included 24 fungi (including Trichoderma sp., Gliodadium penicillioldes and Fusarium sp.), 0 actinomycetes (all Streptomyces sp.), 7 fluorescent pseudomonads (Pseudomonas sp.) and 4 endospore-forming bacteria (Bacillus sp.). The most common mode of action observed was antibiosis, although mycoparasitism, indicated by parallel hyphal growth, hyphal coiling, appressorium formation and direct penetration, was also observed with one isolate of Trichoderma. These results help to explain the role of microbes in the suppression and biological control of P. cinnamomi by composted manures.
Phytophthora cinnamomi infects the roots of and causes dieback of Pinus radiata, Banksia integrifolia and Isopogon cuneatus. Foliar sprays of potassium phosphonate (0.1 g a.i./L or 1.0 g a.i./L) and ...Bion 500 WG (500 g/kg acibenzolar-S-methyl; 1.0 μ a.i./L or 2.5 μ a.i./L), separately and in combinations, were applied to these plants immediately after transplanting into potting mix infested with P? cinnamomi. After 14 weeks the incidence of root infection by P cinnamomi was assessed and plant growth measured. The incidence of root infection was reduced by sprays of potassium phosphonate or Bion. Combinations of phosphonate and Bion additively reduced the incidence of root infection, but no treatment eradicated the pathogen from roots or soil. Phytotoxicity was not observed in any treatment, demonstrating that effective control of Phytophthora root rot can be achieved on phosphorus-sensitive plants using low rates of phosphonate in combination with Bion. Additional keywords: Activon, benzol,2,3thiadiazole-7-carbothioica cid-S-methyl ester, BTH, phosphitePUBLICATION ABSTRACT
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