The diageotropica gene differentially affects auxin and cytokinin responses throughout development in tomato.

The interactions between the plant hormones auxin and cytokinin throughout plant development are complex, and genetic investigations of the interdependency of auxin and cytokinin signaling have been limited. We have characterized the cytokinin sensitivity of the auxin-resistant diageotropica (dgt) mutant of tomato (Lycopersicon esculentum Mill.) in a range of auxin- and cytokinin-regulated responses. Intact, etiolated dgt seedlings showed cross-resistance to cytokinin with respect to root elongation, but cytokinin effects on hypocotyl growth and ethylene synthesis in these seedlings were not impaired by the dgt mutation. Seven-week-old, green wild-type and dgt plants were also equally sensitive to cytokinin with respect to shoot growth and hypocotyl and internode elongation. The effects of cytokinin and the dgt mutation on these processes appeared additive. In tissue culture organ regeneration from dgt hypocotyl explants showed reduced sensitivity to auxin but normal sensitivity to cytokinin, and the effects of cytokinin and the mutation were again additive. However, although callus induction from dgt hypocotyl explants required auxin and cytokinin, dgt calli did not show the typical concentration-dependent stimulation of growth by either auxin or cytokinin observed in wild-type cells. Cross-resistance of the dgt mutant to cytokinin thus was found to be limited to a small subset of auxin- and cytokinin-regulated growth processes affected by the dgt mutation, indicating that auxin and cytokinin regulate plant growth through both shared and separate signaling pathways.

Auxin-cytokinin interactions in higher plants: old problems and new tools.

The plant hormones auxin and cytokinin interact in a complex manner to control many aspects of growth and differentiation. Recent advances in understanding their metabolism and the cell cycle are now helping to clarify the mechanisms by which these hormones act together to control various physiological and developmental responses. Molecular and genetic tools are being used to reveal interactions between auxin and cytokinin at multiple levels, including mutual regulation of active hormone availability, input into multiple signal transduction pathways, alteration of gene expression, post-translational modifications and direct modulation of enzyme activity.

The effects of a low-dose gestodene-containing oral contraceptive on endometrial histology in healthy women.

OBJECTIVE: In women who use oral contraceptives with low estrogen doses, a quiescent endometrium is frequently produced. Further reduction of the estrogen dose would not be expected to alter this effect. In this open-label study, the effects on the endometrium of a monophasic oral contraceptive containing 75 micrograms gestodene and 20 micrograms ethinylestradiol were assessed. METHOD: Biopsies were performed on 25 women on therapy. The biopsies were performed during the late luteal phase (last 7 days) in the pretreatment cycle and during days 15-21 in cycle 6 for 13 subjects (Group A) and during days 15-21 in cycle 3 and during the late luteal phase (last 7 days) in the post-treatment cycle for 12 subjects (Group B). RESULTS: All subjects completed six cycles of treatment. Nine of 13 subjects pretreatment and nine of 12 subjects at cycle 3 were characterized by the pathologist as having a secretory endometrium. Four of 13 subjects at cycle 6 and ten of 11 subjects post-treatment also demonstrated a secretory endometrium. Pre-decidual changes were seen in one, two, two and zero subjects at pretreatment, after three cycles, six cycles, and post-treatment, respectively. Six subjects had an atrophic endometrium at cycle 6. CONCLUSIONS: With monophasic gestodene/ethinylestradiol 75 micrograms/20 micrograms, a secretory or inactive endometrium was present in most subjects. Thus, the effects on the endometrium of this oral contraceptive containing a reduced estrogen dose are consistent with those produced by other low-estrogen-dose combination oral contraceptives.

Changes in androgens during treatment with four low-dose contraceptives.

The aim of the present study was to compare changes in the endogenous androgen environment in healthy women while on low-dose oral contraceptives (OCs). One-hundred healthy women were randomized to receive one of four OCs during six months: 21 tablets of Cilest, Femodeen, Marvelon, or Mercilon. During the luteal phase of the pretreatment cycle, body weight and blood pressure were recorded and the following parameters were measured: sex hormone-binding globulin (SHBG), corticosteroid-binding globulin (CBG), testosterone (T), free testosterone (FT), 5 alpha-dihydrotestosterone (DHT), androstenedione (A), dehydroepiandrosterone-sulphate (DHEA-S) and 17 alpha-hydroxyprogesterone (170HP) while also the free androgen index (FAI) was calculated. Measurements were repeated during the 3rd week of pill intake in the 4th and the 6th pill month. There were no differences on body mass and blood pressure with the use of the four OCs. The mean serum DHEA-S decreased significantly in all groups though less in the Mercilon group when compared to Cilest and Marvelon (approximately 20% vs 45%). Mean serum SHBG and CBG increased significantly in all four groups approximately 250% and 100%, respectively. In each group CBG also increased significantly but less in women taking Mercilon (-75%) as compared to the others (-100%). Current low-dose OCs were found to have similar impact on the endogenous androgen metabolism with significant decreases of serum testosterone, DHT, A, and DHEA-S. They may be equally beneficial in women with androgen related syndromes such as acne and hirsutism.

PIP: Health researchers randomly assigned 100 healthy women aged 18-38 from the Netherlands and Saudi Arabia to one of four various oral contraceptive (OC) groups to undergo six cycles of OC therapy so they could evaluate changes in plasma concentrations of sex hormone binding globulin (SHBG), corticosteroid-binding globulin (CBG), albumin (Alb), testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), androstenedione (A), dehydro-epiandrosterone-sulphate (DHEA-S), and 17 alpha-hydroxyprogesterone (17OHP). The four monophasic OCs were Cilest (35 mcg ethinyl estradiol [E2] and 250 mcg norgestimate), Femodeen (30 mcg E2 and 75 mcg gestodene), Marvelon (30 mcg E2 and 150 mcg desogestrel), and Mercilon (20 mcg E2 and 150 mcg desogestrel). There were 12 dropouts. Neither body weight nor blood pressure changed significantly during the study. All steroidal serum parameters (T, FT, DHT, A, DHEA-S, 17OHP, Alb) fell significantly during the six cycles of OC treatment (ratio of decrease, 1.3-3), regardless of OC type. These changes had appeared after cycle 4. The only significant difference between the OC groups was that the mean decrease of DHEA-S for Mercilon was lower than that for the other OC groups (21% vs. 43% for Cilest, 44% for Marvelon, and 34% for Femodeen; p 0.05). SHBG and CBG rose greatly during OC use in all four OC groups (mean increase = 263% and 94%, respectively; p 0.05). The increase in CBG was significantly less in the Mercilon group than in the other OC groups (74% vs. 96% for Cilest, 101% for Femodeen, and 102% for Marvelon; p 0.05). These findings show that OC use changed the endogenous androgen environment in the direction of hypoandrogenism. Thus, all four OCs can equally treat androgen-related syndromes (e.g., acne and hirsutism).

Comparative evaluation of the androgenicity of four low-dose, fixed-combination oral contraceptives.

Changes in endogenous androgen metabolism were compared in healthy women taking one of four low-dose modern oral contraceptives (OCs). One hundred women were randomized to (1) 35 micrograms ethinyl estradiol (EE) + 250 micrograms norgestimate (Cilest); (2) 20 micrograms EE + 150 micrograms desogestrel (Mercilon); (3) 30 micrograms EE + 150 micrograms desogestrel (Marvelon); or (4) 30 micrograms EE + 75 micrograms gestodene (Femodene). During the luteal phase of the pretreatment cycle, body weight and blood pressure were recorded, and plasma levels of the following variables were recorded: sex-hormone-binding globulin (SHBG), cortisol-binding globulin (CBG), testosterone, free testosterone, dihydrotestosterone, androstenedione, dihydroepiandrosterone sulfate (DHEAS), and hydroxyprogesterone. The free androgen index was also calculated. These variables were remeasured during the third week of OC intake and during the fourth and sixth cycles. There were no statistically significant differences in androgenic variables among the four OCs. The DHEAS concentration decreased less with the 20 micrograms EE + desogestrel formulation compared with either 30 micrograms EE + desogesterel or norgestimate-containing formulations (20% vs. 45%). Concentrations of SHBG and CBG increased significantly in all four groups (average 263 +/- 119% and 94 +/- 26%, respectively); CBG increased less in women taking 20 micrograms EE + desogestrel (about 75%) than in the other formulations (about 100%). The four modern, low-dose OCs tested had similar impacts on endogenous androgen metabolism, yielding significant decreases in testosterone, dihydrotestosterone, androstenedione, and DHEAS. All of these formulations may be beneficial in women with androgen-related syndromes such as acne and hirsutism. Large studies are under way to establish which of the third-generation OCs is the least androgenic. In vitro studies suggest that norgestimate has the least androgenic profile.

[Severe backache in clinically inactive ulcerative colitis]. / Schwere Lumbalgie bei klinisch inaktiver Colitis ulcerosa.

A 22-year-old man with a history of ulcerative colitis complained of progressive lower back pain that had persisted for more than one year and which finally confined him to bed. X-ray examination revealed sclerosis of the right sacroiliac joint, and of the 6th lumbar vertebra. An NMR examination revealed a diffuse signal loss in the region of the 6th lumbar vertebra. On account of the progressive increase in liver transaminases in the serum, an ERCP was carried out, which confirmed the suspected primary sclerosing cholangitis (PSC). Severe axial arthritis and PSC with underlying clinically inactive ulcerative colitis was diagnosed, and treatment with salazosulfapyridine and ursodeoxycholic acid initiated. This led to freedom from pain within a matter of weeks and an appreciable reduction in serum cholestasis parameters.

[Cholecystectomy and colorectal cancer. Does cholecystectomy increase the risk of developing colon cancer?]. / Cholezystektomie und kolorektales Karzinom. Erhöht eine Cholezystektomie das Risiko, an einem Kolonkarzinom zu erkranken?

PROBLEM: Within the course of the last ten years, a possible association between carcinoma of the colon and prior cholecystectomy has been discussed. METHODOLOGY: In 342 patients with colorectal carcinoma, and in a control group of 182 patients with gastric carcinoma, the rate of prior cholecystectomy was investigated. RESULTS: The cholecystectomy rate in the case of colon carcinoma patients was 7.9, and thus differed non-significantly from that of the control group (5.5%). At least in our case material, no relationship was found between cholecystectomy and carcinoma of the colon. The results reported in other studies are compared and discussed.

[Recording of data and immediate interpretation of myoelectric activity of the stomach--electrogastrography]. / Anordnung zur Aufzeichnung und sofortigen Interpretation der myoelektrischen Aktivität des Magens--Elektrogastrographie.

Unlike other electrophysiological measurements such as electrocardiography (ECG) and electroencephalography (EEG), the cutaneous measurement of the electrical activity of the stomach (electrogastrography, EGG) is not an established clinical diagnostic procedure. To overcome common problems in acquiring very-low-frequency signals in the presence of large and unstable voltages we developed a real time data acquisition and analysis system based on linear-phase digital signal processing instead of analog filtering. FFT's computed on line from highly overlapping time sets are displayed as pseudo-3D or grey-scale graphic plots.

Does physical exercise influence bowel transit time in healthy young men?

An examination was performed on 20 healthy men, who had a specific diet, to test the influence of moderate physical activity on bowel transit. During a 3-day pause and a 3-day phase of easy sports activity (jogging), oro-anal transit was measured with the help of radiopaque markers (Hinton method). While the subject was under exertion, the entire weight of stool rose significantly (743 vs. 600 g), whereas we found no significant influence on the oro-anal transit time (39 vs. 48 h) or on stool frequency (1.3 vs. 1.3 per day). Moderate physical activity had no effect on bowel transit time of healthy men under a constant diet. The effect of the so often recommended increase of physical activity on constipation remains to be elucidated.

Effects of age and gender on fat-induced gallbladder contraction and gastric emptying of a caloric liquid meal: a sonographic study.

In this study, the gastric emptying of a liquid fatty meal and the consecutive gallbladder contraction were simultaneously measured by ultrasound in four different age- and sex-related groups of normal subjects: group A, 15 women less than 50 yr (premenopausal); group B, 15 women greater than 50 yr (postmenopausal); group C, 15 men less than 50 yr; and group D, 15 men greater than 50 yr. Apart from a significantly delayed gastric emptying in the premenopausal women, no significant differences in the postprandial relative gallbladder emptying rates were observed between the four study groups. Ninety-five percent of all study subjects had a gallbladder volume reduction of more than 50% after a liquid fatty meal. It is therefore concluded, that 1) endogenous or contraceptive female sex hormones may have a delaying effect on gastric emptying of caloric liquids in the premenopausal state, 2) aging or gender do not significantly influence the fat-induced gallbladder contraction in man, and 3) a 50% residual volume of the gallbladder after a fatty meal should be considered as the upper limit of normal gallbladder contractility (95 percentile of a normal collective).

Gastrointestinal transit of solid-liquid meal in chronic alcoholics.

Gastric emptying, mouth-to-cecum transit, and whole-gut transit of a solid-liquid meal were measured in 46 chronic alcoholics and in 30 control subjects by using scintigraphic techniques, hydrogen breath test, and stool markers. In the alcoholics various parameters such as ethanol consumption, gastrointestinal symptoms, and alcoholic neuropathy were determined and related to gastrointestinal transit times. Although there was no significant overall difference of gastric emptying, abnormally delayed gastric emptying was detected in 23.9% of the alcoholics but no control subject (P less than 0.005). Mouth-to-cecum transit was significantly prolonged in the alcoholics (P less than 0.001) with 14 alcoholics (37.8%) disclosing delayed mouth-to-cecum transit. No significant differences between both groups were detected concerning whole gut transit. In the alcoholics there was a significant correlation of dyspeptic symptoms with delayed gastric emptying (P less than 0.006), and alcoholics with diarrhea had an accelerated mouth-to-cecum transit as compared to those without diarrhea (P less than 0.05). Neither the presence of autonomic or peripheral neuropathy nor the presence of liver cirrhosis or ascites was significantly related to gastrointestinal transit times. However, the daily ethanol ingestion significantly correlated with gastric emptying (P less than 0.005). It is concluded, therefore, that in chronic alcoholics the small intestine and the stomach are most likely to be affected by gastrointestinal transit disorders and that these transit abnormalities are potentially related to toxic damage of gastrointestinal smooth muscle.

Sonographic evaluation of gallbladder kinetics: in vitro and in vivo comparison of different methods to assess gallbladder emptying.

In an in vitro study, 10 gallbladders of adult pigs and 6 gallbladders of lambs, all removed immediately after slaughtering, were stimulated in a water bath by electric means to induce active contraction. Gallbladder emptying was followed by ultrasonography employing five measurement procedures: (1) gallbladder width, (2) longitudinal planimetry, (3) transverse planimetry, (4) ellipsoid method, and (5) sum of cylinders method. In an in vivo investigation, gallbladder emptying of 30 volunteers (12 healthy subjects, 18 diabetics) was evaluated in the same way after ingestion of a fatty meal. Gallbladder width was found to be unsuitable to estimate the decrease in gallbladder volume due to a nonlinear relation of the parameters. Longitudinal planimetry tended to be less valid than transverse planimetry in assessing gallbladder volume reduction. The most valid estimation of gallbladder volume decreases was obtained by the two three-dimensional procedures. However, in neither in vitro nor in vivo could a significant difference between the sum of cylinders method and the ellipsoid method in determining relative volume reduction be established. We conclude that a three-dimensional measurement procedure should be used for valid assessments of gallbladder motility. However, according to our data there is no advantage in using the time-consuming sum of cylinders method compared to the simple ellipsoid method.

[Carcinoembryonic antigen (CEA) in ascites]. / Karzinoembryonales Antigen (CEA) im Aszites.

The diagnostic value of carcinoembryonic antigen (CEA) was studied prospectively in 18 patients with ascites of malignant and 28 patients with ascites of benign genesis. Both sensitivity and specificity reached 83%. With a prevalence of malignant disease of 38%, the positive and negative predictive values were 75% and 89%, respectively. In contrast to frequent false-positive CEA values in the serum of liver cirrhotics (48.3%), false-positive CEA values in the ascites of the same patients were observed in only 17.3%. It is thus recommended that if CEA determination is to be employed, it should be done in the ascites itself.

[Sonographic assessment of gastric emptying. Reliability and validity of the antrum sagittal surface method for fluids]. / Sonographische Erfassung der Magenentleerung. Reliabilität und Validität der Antrumflächenmethode für Flüssigkeiten.

The reliability and validity of sonographic measurements of gastric emptying employing sagittal antral planimetry were investigated. The intraindividual reproducibility of this procedure was examined in 15 healthy volunteers, who ingested 400 ml of water on two separate study days. Simultaneous studies of gastric emptying by ultrasound and scintigraphy were performed on 17 of 20 patients with suspected gastroparesis (16 diabetics and one patient with disseminated encephalomyelitis), using a caloric liquid test meal (20 g Biloptin-fatty meal in 300 ml water at 37 degrees C, radiolabeled with 0.5 mCi 99mTc-colloid). The expansion of the antral area with increasing amounts of ingested fluid and the emptying times showed a good intraindividual reproducibility from day to day (r = 0.94 vs. r = 0.81). There was a significant correlation between the relative residual volumes calculated by scintigraphy and by ultrasound (r = 0.82). These results imply that the ultrasonic sagittal antral area method is reliable and valid in the assessment of gastric emptying rates in humans.

[Dermatomyositis as a paraneoplastic syndrome. A case report]. / Dermatomyositis als paraneoplastisches Syndrom. Eine Fallbeschreibung.

A female patient with dermatomyositis with the typical clinical findings of this disease, corresponding histological muscular changes and neurological findings is described. Since in the further course of the disease, recurrent gastric carcinoma was diagnosed, this case again emphasizes the significance of dermatomyositis as a paraneoplastic syndrome, and the need for tumor screening when dermatomyositis is diagnosed in advanced adulthood.

[The prognostic relevance of tumor localization in colorectal cancer. A multivariate analysis]. / Prognostische Relevanz der Tumorlokalisation beim kolorektalen Karzinom. Eine multivariate Analyse.

Records of 292 patients with colorectal cancer, operated at St.-Josef-Hospital between 1973 and 1984 were studied using Cox regression model to elucidate the prognostic influence of tumor site. Neither in univariate nor in multivariate analysis any significant independent influence of tumor site on prognosis could be detected. Male sex, older age and more advanced tumor stage were independently associated with poorer prognosis.

Effect of cholecystectomy on common bile duct diameters: a longitudinal prospective ultrasonographic study.

The medium-term effect of cholecystectomy on common bile duct diameters (CBD) was investigated prospectively in 64 patients with gallstone disease examined by ultrasonography immediately before and 27 months to 39 months after the operation. In 32 patients with chronic cholecystitis and patent cystic ducts, CBD diameters increased slightly (median 4.6 mm pre- and 5.3 mm postoperatively; p less than 0.05). A group of 19 patients with acute cholecystitis or cystic duct occlusion showed a significant decrease (median 7.7 mm pre- and 5.5 mm postoperatively; p less than 0.05). In 13 patients with common bile duct stones, the CBD diameters also decreased significantly after surgical intervention (median 7.5 mm pre- and 5.0 mm postoperatively; p less than 0.05). The widest CBD diameter after cholecystectomy observed in this study was 10 mm. We conclude that either increases or decreases of the CBD diameters may occur after cholecystectomy in patients with calculous gallbladder disease, and that the postoperative evolution is governed by the exact nature of the underlying biliary disease at the time of the index operation.

Oral inflammatory changes as an initial manifestation of Crohn's disease antedating abdominal diagnosis. Report of a case.

The case of a 14-year-old boy who had oral ulcers with histologic proof of granulomatous disease nine months before the diagnosis of intestinal Crohn's disease is presented. Additional extraintestinal manifestations of this case were cheilitis, anal fissures, and "metastatic" disease to the umbilicus. The diagnosis was established after the onset of abdominal symptoms. All manifestations responded rapidly to systemic prednisone, sulfasalazine, and metronidazole.

[Rate of complications in acute treatment of stomach ulcer: modification of the incidence by active therapy in placebo-controlled studies]. / Komplikationsrate während der Akutbehandlung des Magenulkus: Beeinflussung der Inzidenz durch Verumtherapie in plazebokontrollierten Studien.

We evaluated 32 randomized placebo-controlled trials in gastric ulcer patients to determine the ulcer-related complication rate (bleeding, perforation) during short-term therapy. Patients treated with placebo had a significantly greater risk to drop out for ulcer-related complications than patients treated with active drugs (1,2% vs 0%; p less than 0,01), while the number of patients dropping out for other reasons did not differ significantly (8,4% vs 7,3%, p greater than 0,1). Thus, the efficiency of active drug therapy in gastric ulcer episodes is not only reflected by a significantly higher healing rate in 4 to 8 weeks (64,7% vs 41,4%, p less than 0,01) but also by a much lower risk for ulcer-related complications.