Formation of the three C–C bridges between the two naphthol monomers for elsinochrome (1) involves three distinct classes of oxidases.

Parastagonospora nodorum is an important pathogen of wheat. The contribution of secondary metabolites to this pathosystem is poorly understood. A biosynthetic gene cluster (SNOG_08608-08616) has been shown to be upregulated during the late stage of P. nodorum wheat leaf infection. The gene cluster shares several homologues with the Cercospora nicotianae CTB gene cluster encoding the biosynthesis of cercosporin. Activation of the gene cluster by overexpression (OE) of the transcription factor gene (SNOG_08609) in P. nodorum resulted in the production of elsinochrome C, a perelyenequinone phytotoxin structurally similar to cercosporin. Heterologous expression of the polyketide synthase gene elcA from the gene cluster in Aspergillus nidulans resulted in the production of the polyketide precursor nortoralactone common to the cercosporin pathway. Elsinochrome C could be detected on wheat leaves infected with P. nodorum, but not in the elcA disruption mutant. The compound was shown to exhibit necrotic activity on wheat leaves in a light-dependent manner. Wheat seedling infection assays showed that ΔelcA exhibited reduced virulence compared with wild type, while infection by an OE strain overproducing elsinochrome C resulted in larger lesions on leaves. These data provided evidence that elsinochrome C contributes to the virulence of P. nodorum against wheat.

Radiculopathy and spinal pain are debilitating conditions affecting millions of people worldwide each year. While most cases can be managed conservatively with physiotherapy and nonsteroidal anti-inflammatory medications, minimally invasive corticosteroid injections are the mainstay intervention for those not responsive to conservative treatment. Historically, spinal injections were performed in the absence of imaging guidance; however, imaging modalities, in particular fluoroscopy and computer tomography (CT), have become the standard of care in performing most of these procedures. Under imaging guidance, operators can accurately confirm needle placement and safely target localised pathologies.

Radiologically inserted gastrostomy (RIG) is performed in patients who cannot safely or sufficiently receive oral nutrition; however, postoperative complications are not uncommon. The risk of major complications such as peritonitis, migration, infection, malposition, and bleeding is small but appreciable, although mortality as a direct consequence of gastrostomy placement is rare. In this case series, we describe the major gastrostomy complications (arterial haemorrhage, gastric fluid leak, peritonitis, RIG site infection, ileus and colon perforation) that occurred in four patients at our hospital over a 27-month period in which 152 RIG procedures were performed (an incidence rate of 2.6%). Herein, we describe the gastrostomy procedures, clinical course, and surgical corrections required for these patients before discussing the complication risks for common gastrostomy procedures and potential methods to reduce and prevent such complications.