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Arthritis and arthralgia are the most common extra-intestinal manifestations of Inflammatory Bowel Disease (IBD), occurring in up to a third of patients. These may affect the peripheral or axial skeletal system and may or may not reflect disease activity. As a result, it is challenging to identify an alternative diagnosis to account for joint manifestations in the setting of IBD. We describe a case of a 30 year old woman with quiescent Crohn's colitis who presented with 2 weeks of fever, flitting arthralgia, a sore throat and a nocturnal rash on her thighs. She denied any gastrointestinal symptoms to suggest a flare up of IBD. Investigations revealed a neutrophilia and a markedly elevated serum ferritin. The patient met all four major and several minor Yamaguchi criteria for Adult Onset Still's Disease (AOSD). She was treated with corticosteroids and analgesia with resolution of her symptoms and normalisation of her biochemical markers. While joint manifestations are the most common extra-intestinal symptoms of Inflammatory Bowel Disease, atypical presentations should raise the concern of an additional diagnosis. This case represents a rare presentation of Crohn's disease complicated by AOSD.

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BACKGROUND: The rapid urease test (RUT) is used at Groote Schuur Hospital for diagnosing Helicobacter pylori infection. This is an in-house method, which has not been validated. OBJECTIVE: To validate our practice of reading the RUT immediately after endoscopy (RUT(0)), by comparing this with a reading at 24 hours (RUT(24)) and with histological analysis. DESIGN: Ninety consecutive patients undergoing upper endoscopy over a 6-week period from October 2005 to November 2005, and in whom rapid urease testing was indicated, were included in the study. Patients with recent exposure (within 2 weeks of endoscopy) to proton pump inhibitors (PPIs), histamine receptor antagonists (H2RAs) and antibiotics (confounders) were noted and included in the cohort. Two antral and two body biopsies were taken for histological examination and a third antral biopsy was placed in the RUT bottle. Both haematoxylin and eosin and modified Giemsa staining methods were used to identify H. pylori. The RUT was read immediately (within 5 minutes of upper endoscopy) (RUT(0)), as per our current practice, and each specimen was re-read at 24 hours (RUT(24)). Sensitivity, specificity, positive and negative predictive values and the impact of confounders were calculated. RESULTS: Of the 90 patients undergoing rapid urease testing, 39% were male and 61% were female, with a mean age of 55 years (range 22-79 years). Histological examination revealed H. pylori in 67.8% (N=61) of the biopsy specimens. In the 65 patients without confounders, the sensitivity and specificity of the RUT(0) were 65.9% and 100% respectively, and 90.9% and 100% for RUT(24). After including the 25 patients with confounders, the sensitivity and specificity were 68.8% and 100% for RUT(0), and 90.1% and 100% for RUT(24) respectively. Thirteen RUT(0) specimens (30.9%) that were initially negative became positive at the RUT(24) reading. There were 6 (9.8%) RUT(0)- and RUT(24)-negative but histology-positive specimens. Four of these 6 false-negative RUT(24) results could be accounted for by a low H. pylori density on histological analysis (2 patients were taking PPIs). Confounders did not alter the sensitivity and specificity outcomes or impact on the number of false-negative RUTs. CONCLUSIONS: Our locally prepared RUT is a specific test for the detection of H. pylori infection. The sensitivity is greatly enhanced by reading the test at 24 hours. The use of PPIs, H(2)RAs and antibiotics preceding endoscopy did not impact significantly on the results.

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A retrospective chart review was conducted to examine risk factors associated with the occurrence of choreoathetosis, a rare but significant complication of open-heart surgery in children. Ten children were identified as having developed choreoathetosis after cardiac surgery. Their charts were reviewed and compared with 33 age- and diagnosis-matched controls who underwent open-heart surgery during the same time period. Children with choreoathetosis reached lower rectal and esophageal temperatures (p = 0.0018 for both) and spent a greater portion of total bypass time at lower rectal and esophageal temperatures (p < 0.001 for both). Duration of cooling below 20 degrees C esophageal temperature and PaCO2 at the end of the cooling period were significant predictors of choreoathetosis (p = 0.023 and p = 0.0497, respectively) in a logistic regression model, and a greater fraction of choreoathetosis patients had prior developmental delays (p = 0.017). No difference was found in the age at surgery, duration of bypass, aortic cross-clamp time, arterial pH, PaCO2 or mean arterial pressure. The combination of extended exposure to profound hypothermia and alpha-stat pH management strategy and preexisting developmental delay are associated with the development of choreoathetosis following open-heart surgery 61 in children.

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Quantitative characters are often said to evolve rather slowly, taking many generations to exhibit appreciable differences among populations. We tested this notion experimentally by performing bi-directional selection on corolla diameter of plants from a wild population of Phlox drummondii for three generations. By monitoring flower size, tube length and stigma-anther proximity of flowers, we obtained the direct and indirect responses to selection, and calculated genetic correlations, realized and narrow sense heritabilities using offspring-mother regression. Realized heritability of flower size was high (0.83), whereas genetic correlations among traits were weak or not significant. The per-generation average of the response in corolla diameter was about 5%. We found that P. drummondii has a great capacity to respond rapidly to selection, and this capacity may be in part responsible for the observed high degree of differentiation within the species. We also concluded that rapid evolution of morphological floral traits is possible.

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The fitness effects due to initial flowering date in Phlox drummondii were determined for three populations in central Texas (USA) over 3 yr (1990-1992). Mean fitness (seed set) always decreased with the later initiation of flowering. The likelihood of a plant fruiting differed with flowering date in five of the six instances (population by year combinations). Though plants that initiated flowering later tended to have spent more time in the vegetative stage and tended to die later in the year than did earlier flowering plants, this was not sufficient to overcome the reproductive penalties of flowering late. Plants that initiated flowering later in the season spent less time in the adult phase and were smaller. The mean number of flowers, fruits, and seeds per flowering plant always decreased with later flowering. Fruit set was negatively correlated with flowering date in four of the six population by year combinations. Nonparametric fitness functions were used to summarize predicted fitness among different initial flowering dates for each population on a yearly basis. Predicted mean fitness always declined nonlinearly with later flowering; the earliest flowering plants always had the highest predicted fitness. These fitness functions describe directional selection for the early initiation of flowering.

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The effect of beta-adrenergic receptor blockade on retention in a mildly aversive passive-avoidance procedure was investigated. Rats were given passive-avoidance training--1 trial per day for 4 days-and were administered saline, the centrally and peripherally acting beta-adrenergic blocker propranolol (4 or 10 mg/kg ip), or the peripherally acting beta-adrenergic blocker sotalol (4 or 10 mg/kg ip) immediately or 2 hr after the 1st trial. Enhanced retention occurred only with the higher dose (10 mg/kg) of propranolol and only when it was administered immediately after training. The enhanced retention produced by propranolol is discussed in terms of opposing, regionally specific actions of beta-adrenergic receptor-mediated neural circuits on modulation of memory.

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Migrants between plant populations may represent a random sample of the donor population or may be related, being identical in the extreme. There is considerable potential for kin-structured migration in many plant species through the co-dispersal of seeds from single individuals. Through simulation experiments we have shown that the greater the level of relatedness of migrants, the less a given level of migration counterbalances the effect of genetic drift among populations.

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Most plant populations show a "skewedrd distribution of fecundity amongst their members, in contrast to the poisson distribution assumed by most population genetical theory. We examine by simulation the consequences of skewed fecundity for plant evolution when combined with sieve selection. In comparison with poisson-based theory, plant populations are likely to show a faster response to selection, especially when the favoured allele is at a low frequency. Selection against a deleterious immigrant allele will also be more effective, reducing its equilibrium frequency in a population. In the special case of heterozygote disadvantage traits will evolve that could not under poisson theory. However, random variation is also higher, giving a 10-plant population an effective population size of about 6.4 under poisson theory. The conclusions are not qualitatively changed by different assumptions on the exact shape of the fecundity distribution, or on heritability, or on reproduction by the smallest plants of the population.

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Inbreeding is known to increase developmental instability in outbreeding plants, and it has been argued that phenotypic plasticity in response to environmental variation might be similarly affected. To investigate whether phenotypic plasticity is altered by inbreeding, an outcrossed group and three successive generations of inbred cultivated Phlox drummondii were grown in six different treatments (Control, Low Water, Low Nutrient, Early and Late Leaf Removal, and Small Pots). Twelve plant characters were measured to determine the effects of the treatments and inbreeding. For those characters where inbreeding level by treatment interaction was indicated, the amounts and patterns of plasticity were examined to determine the source of the interaction. Despite substantial evidence for inbreeding depression of plant vigor and fecundity, there was no indication of an increase in the amount of phenotypic plasticity with progressive inbreeding. There was also no evidence that inbreeding systematically disrupts the pattern of plastic response to the environment.

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Two varieties of the annual plant Phlox drummondii were grown in pots in the greenhouse. Pots differed in the mixture of varieties, total number of plants, spatial clustering of plants, and soil treatment.The shoot biomass of centrally located target plants was significantly influenced by the varietal composition within a pot, and the pattern of this genetic effect varied with both plant density and soil treatment. Density and soil treatment interacted strongly, with the negative effect of neighbors on shoot growth being significantly greater when soil nutrient concentrations were lower.The varieties differed significantly in their relative allocation of biomass to roots. Relative root allocation was increased in response to both the presence of neighbors and a decrease in soil nutrient availability. These factors did not interact significantly in their effects.Although both plant size and relative allocation to roots were influenced by varietal composition, these genetic effects were small relative to the effects of density and soil treatment.The strong interactions between plant location, plant identity, and soil treatment suggest that relations between neighbors will be very complex in natural populations occupying microgeographically heterogeneous habitats. A more complete understanding of these interactions will be required before realistic dynamic models of natural populations can be constructed.

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Survivorship and growth of individuals of the annual plant Phlox drummondii were examined in artificial, density-stressed populations composed of five genetically differentiated varieties sown in monocultures and in five pairwise mixtures. All experiments were replicated under two treatments of nutrient availability.Varieties differed significantly in competitive ability, and relative competitive success was shown to be highly habitat (treatment) dependent. In 19 of 20 mixed populations, the relative rankings of pairs of competitors were consistent with a priori expectations based on the morphological and/or historical differences between seed sources, but were not predictable from relative tolerances to density stress in monoculture.Estimated selection coefficients based on relative competitive abilities ranged from 0.04 to 0.94. Despite these large fitness differences among competing varieties, most of the variance in the absolute fitness of individuals resided within varieties. This variation may be mostly environmental.In the high nutrient treatment, where competition for light was most intense, variation in individual plant size was lower in mixed culture as compared to monocultures. Genetic variation for competitive ability may actually lead to greater size uniformity among survivors by promoting an early initiation of thinning, thereby reducing the density stress on survivors.

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The species concept is a central tenet of biological diversity. Attempts to describe diversity have led to empirical concepts of species based on assumptions found wanting for plants. Plant species lack reality, cohesion, independence, and simple evolutionary or ecological roles. The concept of species for plant taxonomists and evolutionists can only serve as a tool for characterizing diversity in a mentally satisfying way. Diversity is idiosyncratic. ft is impossible to reconcile idiosyncrasy with preconceived ideas of diversity. The search for hidden likenesses is unlikely to yield a unifying species concept. The concept that is most operational and utilitarian for plants is a mental abstraction which orders clusters of diversity in multidimensional character space.

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The effect of polyploidy on the activity of alcohol dehydrogenase was examined in a series of diploid and synthetic autotetraploid Phlox drummondii. In most cases autotetraploids had about twice as much activity as the corresponding diploids, in two cases autotetraploids had about 1.5 times more activity, and in one wild seed pair the activity of the tetraploid was somewhat lower.

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An approach was made to the problem of estimating rates of chromosomal evolution in plants. This was done by considering variability in chromosome number within genera whose ages are known approximately from fossil and biogeographic evidence. The relative increases in chromosome number diversity per lineage per unit time were as follows: herbaceous angiosperms, 100; woody angiosperms, 14; conifers, 2; and cycads, 0. Rates of increase in species diversity were estimated in an analogous way. These rates were strongly correlated with the karyotypic rates.These evolutionary rate differences between major groups of seed plants are largely explicable in terms of the breeding structures of populations. Herbs usually have small to moderate effective population sizes, and relatively high dispersability. By contrast, woody angiosperms and gymnosperms are usually obligate outbreeders with large effective population sizes and low dispersability. Thus the probability of fixing and dispersing new karyotypes or novel character ensembles is higher in herbs than in other seed plants.

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Allozyme inheritance and transmission genetics of 11 enzyme systems were determined in the permanent translocation heterozygotes Oenothera biennis, Oe. strigosa, and Oe. parviflora. Electrophoretic variation was examined first among 164 strains of structural heterozygotes. Allelic configurations were then judged from inheritance patterns in reciprocal F1 hybrids between each of 22 ring-forming strains and tester strains of the related bivalent-formers, Oe. hookeri and Oe. grandiflora. Allozymes are inherited as codominant markers, and, as dictated by the genetic system, within a strain individual allelic variants are generally transmitted through only one germ line. Of the 20 loci resolved, only eight are polymorphic in any species, and, within species, generally only two alleles are present at each polymorphic locus. Despite the relatively meager allelic array, each of the 22 strains whose chromosome complexes were characterized is genotypically unique. Generally, within taxa, alpha (egg) and beta (sperm) complexes differ in allele frequency at several polymorphic loci. Such variability is correlated with differences in the phylogenetic origins of complexes and not with differences in segmental arrangement within a group of related complexes.

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The species richness of fungi associated with British trees is described by a significant species/area curve (r = 0.53, 0.01 > P > 0.001). Introduced tree species cannot be shown to have fewer fungal species than natives, per unit distributional range about Britain. Also, among natives and among introductions, older host taxa do not have more fungal species than do younger ones. This indicates the species richness of fungi to rapidly reach the limit set by host range, within ecological time. The slope of the species/area relationship for fungi is one-fourth that for insects; we propose that this is due to the inherently greater dispersability of fungi. Finally, the species/area regression residuals for fungi are correlated with those for insects (r = 0.65, 0.001 > P), suggesting plant defense mechanisms may be generally effective to plant parasites, be they insects or fungi.

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Twenty enzyme loci were studied in 44 Illinois populations of Oenothera biennis; four were polymorphic. Most of the variation was distributed between populations. Fifty-nine percent of the populations had one genotype, 27% two genotypes and the remaining 16% from three to five genotypes; the average was 1.50. The proportion of genetic diversity present in single populations is.38 of that present in the state. Members of single populations were uniformly heterozygous for 1 to 4 loci. The mean heterozygosity per population ranged from 0 to 20%. For Illinois populations collectively, heterozygosity averaged 4.5%. There was much gene frequency heterogeneity between populations. The true standardized genetic variance among populations for alleles at polymorphic loci varied from.40 to.78. Populations from Cook County were much more similar inter se than those downstate, had fewer genotypes and polymorphic loci, and had less heterozygosity than downstate populations. The mean normalized genetic identity among Cook County populations was.987 versus.947 for downstate populations. The mean number of genotypes per population in Cook County was 1.06 versus 2.40 in downstate populations. There was only one polymorphic locus in Cook County, VLP. The genetic structure of Oe. biennis suggests that single populations are colonized by one, or at best a few individuals. Cook County populations are judged to be less variable than downstate populations because the mean age of the populations probably is less than that of those downstate.