Improving the antinutritional profiles of common beans (Phaseolus vulgaris L.) moderately impacts carotenoid bioaccessibility but not mineral solubility

Common beans are a common staple food with valuable nutritional qualities, but their high contents in antinutritional factors (ANFs) can decrease the bioavailability of (i) fat-soluble micronutrients including carotenoids and (ii) minerals. Our objective was to select ANF-poor bean lines that would not interfere with carotenoid and mineral bioavailability. To achieve this objective, seeds of commercial and experimental Phaseolus vulgaris L. bean lines were produced for 2 years and the bean's content in ANFs (saponins, phytates, tannins, total polyphenols) was assessed. We then measured carotenoid bioaccessibility and mineral solubility (i.e. the fraction of carotenoid and mineral that transfer into the aqueous phase of the digesta and is therefore absorbable) from prepared beans using in vitro digestion. All beans contained at least 200 mg/100 g of saponins and 2.44 mg/100 g tannins. The low phytic acid (lpa) lines, lpa1 and lpa12 exhibited lower phytate levels (≈ - 80%, p = 0.007 and p = 0.02) than their control BAT-93. However, this decrease had no significant impact on mineral solubility. HP5/1 (lpa + phaseolin and lectin PHA-E free) bean line, induced an improvement in carotenoid bioaccessibility (i.e., + 38%, p = 0.02, and + 32%, p = 0.005, for phytofluene bioaccessibility in 2021 and 2022, respectively). We conclude that decrease in the phytate bean content should thus likely be associated to decreases in other ANFs such as tannins or polyphenols to lead to significant improvement of micronutrient bioaccessibility.

Legumes and common beans in sustainable diets: nutritional quality, environmental benefits, spread and use in food preparations

In recent decades, scarcity of available resources, population growth and the widening in the consumption of processed foods and of animal origin have made the current food system unsustainable. High-income countries have shifted towards food consumption patterns which is causing an increasingly process of environmental degradation and depletion of natural resources, with the increased incidence of malnutrition due to excess (obesity and non-communicable disease) and due to chronic food deprivation. An urgent challenge is, therefore, to move towards more healthy and sustainable eating choices and reorientating food production and distribution to obtain a human and planetary health benefit. In this regard, legumes represent a less expensive source of nutrients for low-income countries, and a sustainable healthier option than animal-based proteins in developed countries. Although legumes are the basis of many traditional dishes worldwide, and in recent years they have also been used in the formulation of new food products, their consumption is still scarce. Common beans, which are among the most consumed pulses worldwide, have been the focus of many studies to boost their nutritional properties, to find strategies to facilitate cultivation under biotic/abiotic stress, to increase yield, reduce antinutrients contents and rise the micronutrient level. The versatility of beans could be the key for the increase of their consumption, as it allows to include them in a vast range of food preparations, to create new formulations and to reinvent traditional legume-based recipes with optimal nutritional healthy characteristics.

In order to lower the antinutritional activity of serine protease inhibitors, we need to understand their role in seed development

Proteases, including serine proteases, are involved in the entire life cycle of plants. Proteases are controlled by protease inhibitors (PI) to limit any uncontrolled or harmful protease activity. The role of PIs in biotic and abiotic stress tolerance is well documented, however their role in various other plant processes has not been fully elucidated. Seed development is one such area that lack detailed work on the function of PIs despite the fact that this is a key process in the life cycle of the plant. Serine protease inhibitors (SPI) such as the Bowman-Birk inhibitors and Kunitz-type inhibitors, are abundant in legume seeds and act as antinutrients in humans and animals. Their role in seed development is not fully understood and present an interesting research target. Whether lowering the levels and activity of PIs, in order to lower the anti-nutrient levels in seed will affect the development of viable seed, remains an important question. Studies on the function of SPI in seed development are therefore required. In this Perspective paper, we provide an overview on the current knowledge of seed storage proteins, their degradation as well as on the serine protease-SPI system in seeds and what is known about the consequences when this system is modified. We discuss areas that require investigation. This includes the identification of seed specific SPIs; screening of germplasms, to identify plants with low seed inhibitor content, establishing serine protease-SPI ratios and lastly a focus on molecular techniques that can be used to modify seed SPI activity.

Genome-wide analysis of genetic diversity in a germplasm collection including wild relatives and interspecific clones of garden asparagus

The Asparagus genus includes approximately 240 species, the most important of which is garden asparagus (Asparagus officinalis L.), as this is a vegetable crop cultivated worldwide for its edible spear. Along with garden asparagus, other species are also cultivated (e.g., Asparagus maritimus L.) or have been proposed as untapped sources of variability in breeding programs (e.g., Asparagus acutifolius L.). In the present work, we applied reduced-representation sequencing to examine a panel of 378 diverse asparagus genotypes, including commercial hybrids, interspecific lines, wild relatives of garden asparagus, and doubled haploids currently used in breeding programs, which enabled the identification of more than 200K single-nucleotide polymorphisms (SNPs). These SNPs were used to assess the extent of linkage disequilibrium in the diploid gene pool of asparagus and combined with preliminary phenotypic information to conduct genome-wide association studies for sex and traits tied to spear quality and production. Moreover, using the same phenotypic and genotypic information, we fitted and cross-validated genome-enabled prediction models for the same set of traits. Overall, our analyses demonstrated that, unlike the diversity detected in wild species related to garden asparagus and in interspecific crosses, cultivated and wild genotypes of A. officinalis L. show a narrow genetic basis, which is a contributing factor hampering the genetic improvement of this crop. Estimating the extent of linkage disequilibrium and providing the first example of genome-wide association study and genome-enabled prediction in this species, we concluded that the asparagus panel examined in the present study can lay the foundation for determination of the genetic bases of agronomically important traits and for the implementation of predictive breeding tools to sustain breeding.

Antinutritional factors, nutritional improvement, and future food use of common beans: A perspective

Common bean seeds are an excellent source of protein as well as of carbohydrates, minerals, vitamins, and bioactive compounds reducing, when in the diet, the risks of diseases. The presence of bioactive compounds with antinutritional properties (e.g., phytic acid, lectins, raffinosaccharides, protease inhibitors) limits, however, the bean's nutritional value and its wider use in food preparations. In the last decades, concerted efforts have been, therefore, made to develop new common bean genotypes with reduced antinutritional compounds by exploiting the natural genetic variability of common bean and also applying induced mutagenesis. However, possible negative, or positive, pleiotropic effects due to these modifications, in terms of plant performance in response to stresses or in the resulting technological properties of the developed mutant genotypes, have yet not been thoroughly investigated. The purpose of the perspective paper is to first highlight the current advances, which have been already made in mutant bean characterization. A view will be further provided on future research directions to specifically explore further advantages and disadvantages of these bean mutants, their potential use in innovative foods and representing a valuable genetic reservoir of combinations to assess the true functional role of specific seed bioactive components directly in the food matrix.

An Eggplant Recombinant Inbred Population Allows the Discovery of Metabolic QTLs Controlling Fruit Nutritional Quality

Eggplant (Solanum melongena L.) represents the third most important crop of the Solanaceae family and is an important component of our daily diet. A population of 164 F6 recombinant inbred lines (RILs), derived from two eggplant lines differing with respect to several key agronomic traits, "305E40" and "67/3," was grown to the commercial maturation stage, and fruits were harvested, separated into peel and flesh, and subjected to liquid chromatography Liquid Chromatography/Mass Spectrometry (LC/MS) analysis. Through a combination of untargeted and targeted metabolomics approaches, a number of metabolites belonging to the glycoalkaloid, anthocyanin, and polyamine classes and showing a differential accumulation in the two parental lines and F1 hybrid were identified. Through metabolic profiling of the RILs, we identified several metabolomic quantitative trait loci (mQTLs) associated with the accumulation of those metabolites. Each of the metabolic traits proved to be controlled by one or more quantitative trait loci (QTLs); for most of the traits, one major mQTL (phenotypic variation explained [PVE] ≥ 10%) was identified. Data on mQTL mapping and dominance-recessivity relationships of measured compounds in the parental lines and F1 hybrid, as well as an analysis of the candidate genes underlying the QTLs and of their sequence differences in the two parental lines, suggested a series of candidate genes underlying the traits under study.

A chromosome-anchored eggplant genome sequence reveals key events in Solanaceae evolution

With approximately 450 species, spiny Solanum species constitute the largest monophyletic group in the Solanaceae family, but a high-quality genome assembly from this group is presently missing. We obtained a chromosome-anchored genome assembly of eggplant (Solanum melongena), containing 34,916 genes, confirming that the diploid gene number in the Solanaceae is around 35,000. Comparative genomic studies with tomato (S. lycopersicum), potato (S. tuberosum) and pepper (Capsicum annuum) highlighted the rapid evolution of miRNA:mRNA regulatory pairs and R-type defense genes in the Solanaceae, and provided a genomic basis for the lack of steroidal glycoalkaloid compounds in the Capsicum genus. Using parsimony methods, we reconstructed the putative chromosomal complements of the key founders of the main Solanaceae clades and the rearrangements that led to the karyotypes of extant species and their ancestors. From 10% to 15% of the genes present in the four genomes were syntenic paralogs (ohnologs) generated by the pre-γ, γ and T paleopolyploidy events, and were enriched in transcription factors. Our data suggest that the basic gene network controlling fruit ripening is conserved in different Solanaceae clades, and that climacteric fruit ripening involves a differential regulation of relatively few components of this network, including CNR and ethylene biosynthetic genes.

Two metallocarboxypeptidase inhibitors are implicated in tomato fruit development and regulated by the Inner No Outer transcription factor

The TCMP-1 and TCMP-2 genes of tomato code for metallocarboxypeptidase inhibitors and show sequential, tightly regulated expression patterns during flower and fruit development. In particular, TCMP-1 is highly expressed in flower buds before anthesis, while TCMP-2 in ripe fruits. Their expression pattern suggests that they might play a role in fruit development. Here, to investigate their function, we altered their endogenous levels by generating transgenic plants harbouring a chimeric gene expressing the TCMP-1 coding sequence under the control of the TCMP-2 promoter. The expression of the transgene caused an earlier fruit setting with no visible phenotypic effects on plant and fruit growth. The altered TCMP-1 regulation determines an increased level of TCMP-1 in the fruit and unexpected changes in the levels of both TCMPs in flower buds before anthesis, suggesting a mechanism of transcriptional cross-regulation. We in silico analysed TCMPs promoter regions for the presence of common cis acting elements related to ovary/fruit development and we found that both promoters contain putative binding sites for INNER NO OUTER (INO), a transcription factor implicated in ovule development. By chromatin immunoprecipitation, we proved that INO binds to TCMP-1 and TCMP-2 promoters, thereby representing a candidate regulatory factor for coordinated control of TCMPs.

A spiking strategy facilitates housekeeping selection for RT-qPCR analysis under different biotic stresses in eggplant

Endogenous housekeeping genes are traditionally employed to normalize the expression of target genes in RT-qPCR studies. Assuming that a perfect housekeeping suitable for every condition does not exist, expression stability of the chosen reference gene should be evaluated at every new experiment. The housekeeping selection process reveals furthermore complicated and time-consuming when different conditions have to be compared in the same experimental dataset. As an alternative strategy, we spiked an external reference transcript (ERT) into all RNA samples of our dataset (eggplant roots subjected to different biotic stresses), and used it to normalize the expression levels of native candidate housekeeping. ERT expression resulted highly stable across all samples and enabled to indicate glyceraldehyde 3-phosphate dehydrogenase (GAPDH) as the most stable endogenous housekeeping. This result was confirmed by the use of GeNorm, Normfinder, and BestKeeper algorithms. This method might be generally applied to expedite the selection process of the best reference gene.

Mapping Quantitative Trait Loci Affecting Biochemical and Morphological Fruit Properties in Eggplant (Solanum melongena L.)

Eggplant berries are a source of health-promoting metabolites including antioxidant and nutraceutical compounds, mainly anthocyanins and chlorogenic acid; however, they also contain some anti-nutritional compounds such as steroidal glycoalkaloids (SGA) and saponins, which are responsible for the bitter taste of the flesh and with potential toxic effects on humans. Up to now, Quantitative Trait Loci (QTL) for the metabolic content are far from being characterized in eggplant, thus hampering the application of breeding programs aimed at improving its fruit quality. Here we report on the identification of some QTL for the fruit metabolic content in an F2 intraspecific mapping population of 156 individuals, obtained by crossing the eggplant breeding lines "305E40" × "67/3." The same population was previously employed for the development of a RAD-tag based linkage map and the identification of QTL associated to morphological and physiological traits. The mapping population was biochemically characterized for both fruit basic qualitative data, like dry matter, °Brix, sugars, and organic acids, as well as for health-related compounds such chlorogenic acid, (the main flesh monomeric phenol), the two peel anthocyanins [i.e., delphinidin-3-rutinoside (D3R) and delphinidin-3-(p- coumaroylrutinoside)-5-glucoside (nasunin)] and the two main steroidal glycoalkaloids, solasonine, and solamargine. For most of the traits, one major QTL (PVE ≥10%) was spotted and putative orthologies with other Solanaceae crops are discussed. The present results supply valuable information to eggplant breeders on the inheritance of key fruit quality traits, thus providing potential tools to assist future breeding programs.

A cystine-knot miniprotein from tomato fruit inhibits endothelial cell migration and angiogenesis by affecting vascular endothelial growth factor receptor (VEGFR) activation and nitric oxide production

SCOPE

Cystine-knot miniproteins are bioactive molecules with a broad range of potential therapeutic applications. Recently, it was demonstrated that two tomato cystine-knot miniproteins (TCMPs) exhibit in vitro antiangiogenic activity on human umbilical vein cells. The aim of the present study was to investigate the effects of a fruit-specific cystine-knot miniprotein of tomato on in vitro endothelial cell migration and in vivo angiogenesis using a zebrafish model.

METHODS AND RESULTS

The cystine-knot protein purified from tomato fruits using gel filtration LC and RP-HPLC inhibited cell migration when tested at 200 nM using the wound healing assay, and reduced nitric oxide formation probed by 4-amino-5-methylamino-27-difluorofluoscescin diacetate. RT-PCR and Western blot analyses demonstrated that vascular endothelium growth factor A dependent signaling was the target of TCMP bioactivity. Angiogenesis was inhibited in vivo in zebrafish embryos treated with 500 nM TCMP.

CONCLUSION

Our results demonstrate that cystine-knot miniproteins present in mature tomato fruits are endowed with antiangiogenic activity in vitro and in vivo. These molecules may confer beneficial effects to tomato dietary intake, along with lycopene and other antioxidants. Further investigation is warranted to explore the potential of these compounds as model scaffolds for the development of new drugs.

Association Mapping for Fruit, Plant and Leaf Morphology Traits in Eggplant

An eggplant (Solanum melongena) association panel of 191 accessions, comprising a mixture of breeding lines, old varieties and landrace selections was SNP genotyped and phenotyped for key breeding fruit and plant traits at two locations over two seasons. A genome-wide association (GWA) analysis was performed using the mixed linear model, which takes into account both a kinship matrix and the sub-population membership of the accessions. Overall, 194 phenotype/genotype associations were uncovered, relating to 30 of the 33 measured traits. These associations involved 79 SNP loci mapping to 39 distinct chromosomal regions distributed over all 12 eggplant chromosomes. A comparison of the map positions of these SNPs with those of loci derived from conventional linkage mapping showed that GWA analysis both validated many of the known controlling loci and detected a large number of new marker/trait associations. Exploiting established syntenic relationships between eggplant chromosomes and those of tomato and pepper recognized orthologous regions in ten eggplant chromosomes harbouring genes influencing breeders’ traits.

Association Mapping for Fruit, Plant and Leaf Morphology Traits in Eggplant

An eggplant (Solanum melongena) association panel of 191 accessions, comprising a mixture of breeding lines, old varieties and landrace selections was SNP genotyped and phenotyped for key breeding fruit and plant traits at two locations over two seasons. A genome-wide association (GWA) analysis was performed using the mixed linear model, which takes into account both a kinship matrix and the sub-population membership of the accessions. Overall, 194 phenotype/genotype associations were uncovered, relating to 30 of the 33 measured traits. These associations involved 79 SNP loci mapping to 39 distinct chromosomal regions distributed over all 12 eggplant chromosomes. A comparison of the map positions of these SNPs with those of loci derived from conventional linkage mapping showed that GWA analysis both validated many of the known controlling loci and detected a large number of new marker/trait associations. Exploiting established syntenic relationships between eggplant chromosomes and those of tomato and pepper recognized orthologous regions in ten eggplant chromosomes harbouring genes influencing breeders' traits.

Linkage disequilibrium and genome-wide association analysis for anthocyanin pigmentation and fruit color in eggplant

Background

The genome-wide association (GWA) approach represents an alternative to biparental linkage mapping for determining the genetic basis of trait variation. Both approaches rely on recombination to re-arrange the genome, and seek to establish correlations between phenotype and genotype. The major advantages of GWA lie in being able to sample a much wider range of the phenotypic and genotypic variation present, in being able to exploit multiple rounds of historical recombination in many different lineages and to include multiple accessions of direct relevance to crop improvement.

Results

A 191 accessions eggplant (Solanum melongena L.) association panel, comprising a mixture of breeding lines, old varieties and landrace selections originating from Asia and the Mediterranean Basin, was SNP genotyped and scored for anthocyanin pigmentation and fruit color at two locations over two years. The panel formed two major clusters, reflecting geographical provenance and fruit type. The global level of linkage disequilibrium was 3.4 cM. A mixed linear model appeared to be the most appropriate for GWA. A set of 56 SNP locus/phenotype associations was identified and the genomic regions harboring these loci were distributed over nine of the 12 eggplant chromosomes. The associations were compared with the location of known QTL for the same traits.

Conclusion

The GWA mapping approach was effective in validating a number of established QTL and, thanks to the wide diversity captured by the panel, was able to detect a series of novel marker/trait associations.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-896) contains supplementary material, which is available to authorized users.

The population structure and diversity of eggplant from Asia and the Mediterranean Basin

A collection of 238 eggplant breeding lines, heritage varieties and selections within local landraces provenanced from Asia and the Mediterranean Basin was phenotyped with respect to key plant and fruit traits, and genotyped using 24 microsatellite loci distributed uniformly throughout the genome. STRUCTURE analysis based on the genotypic data identified two major sub-groups, which to a large extent mirrored the provenance of the entries. With the goal to identify true-breeding types, 38 of the entries were discarded on the basis of microsatellite-based residual heterozygosity, along with a further nine which were not phenotypically uniform. The remaining 191 entries were scored for a set of 19 fruit and plant traits in a replicated experimental field trial. The phenotypic data were subjected to principal component and hierarchical principal component analyses, allowing three major morphological groups to be identified. All three morphological groups were represented in both the “Occidental” and the “Oriental” germplasm, so the correlation between the phenotypic and the genotypic data sets was quite weak. The relevance of these results for evolutionary studies and the further improvement of eggplant are discussed. The population structure of the core set of germplasm shows that it can be used as a basis for an association mapping approach.

Solanum torvum responses to the root-knot nematode Meloidogyne incognita

BACKGROUND

Solanum torvum Sw is worldwide employed as rootstock for eggplant cultivation because of its vigour and resistance/tolerance to the most serious soil-borne diseases as bacterial, fungal wilts and root-knot nematodes. The little information on Solanum torvum (hereafter Torvum) resistance mechanisms, is mostly attributable to the lack of genomic tools (e.g. dedicated microarray) as well as to the paucity of database information limiting high-throughput expression studies in Torvum.

RESULTS

As a first step towards transcriptome profiling of Torvum inoculated with the nematode M. incognita, we built a Torvum 3' transcript catalogue. One-quarter of a 454 full run resulted in 205,591 quality-filtered reads. De novo assembly yielded 24,922 contigs and 11,875 singletons. Similarity searches of the S. torvum transcript tags catalogue produced 12,344 annotations. A 30,0000 features custom combimatrix chip was then designed and microarray hybridizations were conducted for both control and 14 dpi (day post inoculation) with Meloidogyne incognita-infected roots samples resulting in 390 differentially expressed genes (DEG). We also tested the chip with samples from the phylogenetically-related nematode-susceptible eggplant species Solanum melongena. An in-silico validation strategy was developed based on assessment of sequence similarity among Torvum probes and eggplant expressed sequences available in public repositories. GO term enrichment analyses with the 390 Torvum DEG revealed enhancement of several processes as chitin catabolism and sesquiterpenoids biosynthesis, while no GO term enrichment was found with eggplant DEG.The genes identified from S. torvum catalogue, bearing high similarity to known nematode resistance genes, were further investigated in view of their potential role in the nematode resistance mechanism.

CONCLUSIONS

By combining 454 pyrosequencing and microarray technology we were able to conduct a cost-effective global transcriptome profiling in a non-model species. In addition, the development of an in silico validation strategy allowed to further extend the use of the custom chip to a related species and to assess by comparison the expression of selected genes without major concerns of artifacts. The expression profiling of S. torvum responses to nematode infection points to sesquiterpenoids and chitinases as major effectors of nematode resistance. The availability of the long sequence tags in S. torvum catalogue will allow precise identification of active nematocide/nematostatic compounds and associated enzymes posing the basis for exploitation of these resistance mechanisms in other species.

The population structure and diversity of eggplant from Asia and the Mediterranean Basin

A collection of 238 eggplant breeding lines, heritage varieties and selections within local landraces provenanced from Asia and the Mediterranean Basin was phenotyped with respect to key plant and fruit traits, and genotyped using 24 microsatellite loci distributed uniformly throughout the genome. STRUCTURE analysis based on the genotypic data identified two major sub-groups, which to a large extent mirrored the provenance of the entries. With the goal to identify true-breeding types, 38 of the entries were discarded on the basis of microsatellite-based residual heterozygosity, along with a further nine which were not phenotypically uniform. The remaining 191 entries were scored for a set of 19 fruit and plant traits in a replicated experimental field trial. The phenotypic data were subjected to principal component and hierarchical principal component analyses, allowing three major morphological groups to be identified. All three morphological groups were represented in both the "Occidental" and the "Oriental" germplasm, so the correlation between the phenotypic and the genotypic data sets was quite weak. The relevance of these results for evolutionary studies and the further improvement of eggplant are discussed. The population structure of the core set of germplasm shows that it can be used as a basis for an association mapping approach.

Wide-bandwidth phase lock between a CW laser and a frequency comb based on a feed-forward configuration

Wide-bandwidth phase lock between the tooth of a frequency comb and a CW extended-cavity diode laser at 1.55 μm is achieved by the use of an acousto-optical frequency shifter in a feed-forward configuration. The coherence properties of the comb are efficiently transferred to the CW laser, whose linewidth is narrowed down to the ∼10 KHz comb level. A maximum control bandwidth of ∼0.6 MHz has been experimentally achieved, limited by the transit time of the acoustic wave inside the frequency shifter.

Variation among endoscopy units in the achievement of the standards of colonoscopic performance indicators

BACKGROUND/AIMS

To assess the achievement of quality standards of colonoscopy at six endoscopy units.

METHODOLOGY

Three indicators were used to assess the quality of 1056 colonoscopies performed at six hospitals: cecal intubation; adequate colon cleansing; and removal and recovery of all detected polyps. Analyses were performed on the total number of colonoscopies and on colonoscopies in which polyps were actually detected. The accomplishment of each indicator and a global compound index of all three indicators, named the Problem Rate, were analyzed. Results from each endoscopy unit were compared to previously established standards.

RESULTS

Adequate colon cleansing was the most frequent problem for quality in all centers; adequate colon preparation was 67% (range 50 to 84%). The cecum was reached in 84% of all colonoscopies (range 76 to 90%). 75% of all patients (range 28. 79%) had all polyps excised and recovered. All centers had rates below standard for one or several indicators (p<0.01, all cases). Two of the participant hospitals had an overall problem rate above the estimated standard (p<0.01).

CONCLUSIONS

There is a significant variation in the achievement of quality standards of colonoscopy between endoscopy units. Colon cleansing is the most frequent quality problem for colonoscopy.

Over-expression of the Arabidopsis AtMYB41 gene alters cell expansion and leaf surface permeability

The Arabidopsis AtMYB41 gene encodes an R2R3-MYB transcription factor whose expression is not detectable under normal growth conditions in any organ or at any developmental stage analysed. It is expressed at high levels in response to drought, ABA and salt treatments, suggesting a possible role in stress responses. Transgenic lines over-expressing this transcription factor showed a pleiotropic phenotype similar to that exhibited by some mutants that affect cuticle biosynthesis. This includes a dwarf appearance, dependent on smaller cells with abnormal morphology, enhanced sensitivity to desiccation, and enhanced permeability of leaf surfaces, suggesting discontinuity in the cuticle. The expression of genes involved in lipid metabolism and transport, in cell-wall modifications and cell expansion, genes coding for membrane-associated proteins and genes specifically involved in cuticle metabolism was differentially modulated between wild-type and transgenic plants, suggesting a direct or indirect role of AtMYB41 in the regulation of their transcription. Taken together, our results suggest that AtMYB41 is part of a complex network of transcription factors controlling cell expansion and cuticle deposition in response to abiotic stress.

A guard-cell-specific MYB transcription factor regulates stomatal movements and plant drought tolerance

Stomatal pores located on the plant epidermis regulate CO(2) uptake for photosynthesis and the loss of water by transpiration. The opening and closing of the pore is mediated by turgor-driven volume changes of two surrounding guard cells. These highly specialized cells integrate internal signals and environmental stimuli to modulate stomatal aperture for plant survival under diverse conditions. Modulation of transcription and mRNA processing play important roles in controlling guard-cell activity, although the details of these levels of regulation remain mostly unknown. Here we report the characterization of AtMYB60, a R2R3-MYB gene of Arabidopsis, as the first transcription factor involved in the regulation of stomatal movements. AtMYB60 is specifically expressed in guard cells, and its expression is negatively modulated during drought. A null mutation in AtMYB60 results in the constitutive reduction of stomatal opening and in decreased wilting under water stress conditions. Transcript levels of a limited number of genes are altered in the mutant, and many of these genes are involved in the plant response to stress. Our data indicate that AtMYB60 is a transcriptional modulator of physiological responses in guard cells and open new possibilities to engineering stomatal activity to help plants survive desiccation.

Diagnostic value of symptoms in patients with suspected upper digestive tract disease

OBJECTIVE

to develop a predictive model based on clinical data for patients with suspected upper digestive tract disease.

PATIENTS AND METHODS

forty-seven clinical data were obtained before endoscopy from 283 patients with suspected upper digestive disease (153 men; mean age 55 years, limits 17-92 years). A clinical prediction of diagnosis was made before endoscopy. On the basis of the endoscopic findings, the patients were divided into three diagnostic groups: absence of significant disease (group I), significant benign disease (group II) and malignant disease (group III). The probability rate of belonging to each one of the three groups was obtained for each patient by using Bayes' theorem.

RESULTS

the endoscopic findings were classified according to their clinical importance: 121 patients (43%) belonged to group I, 137 (48%) were included in group II; and 25 (9%) in group III. The clinical prediction correctly classified 61% of the patients (group I: 56%, group II: 62% and group III: 76%) The coincidence between prediction obtained using Bayes' theorem and the actual diagnosis was 61% (group I: 65%, group II: 51%, group III: 92%). The predictive model was useful to confirm or not the clinical prediction.

CONCLUSION

objective analysis of clinical data can be useful to support clinical judgment, mainly in patients with neoplasia. However, the model is not adequate to improve indication of upper endoscopy since many patients are misclassified.

Menière's disease and gentamicin: preliminary results using the minimum effective dose and integrated therapy

Treatment of Menière's disease is aimed at restoring a normal quality of life and preserving residual hearing, in view of the increasing frequency with which the contralateral ear is affected. Conventional medical treatment (diuretics + vasoactive drugs) leads to cure in a large percentage of patients (75-95%). In intractable cases, transtympanic (intratympanic) aminoglycoside therapy, associated with various techniques, is becoming widespread as an alternative to surgery. Progressive reduction of the dose introduced into the middle ear did not prevent the onset of anacusis in several patients; the variable, unpredictable permeability of the round window membrane, the object of fundamental studies in the past, explains this complication. The Author has used gentamicin transtympanically in Menierians since 1978, and has treated a total of 105 patients. He first prescribed transtympanic gentamicin therapy that did not follow, but was integrated with conventional medical treatment in 22 intractable Menierians, by instilling the minimum effective dose, to reduce the risk of hearing impairment. Preliminary results, related to stage of disease, may be summarised as follows: improvement in the quality of life, as evaluated by the American Academy of Ophthalmology & Otolaryngology Committee on Hearing and Equilibrium questionnaire (14 patients--63.63%--at point 1 and 8-36.36%--at point 2); disappearance of vertigo in 15 patients (68.18%); a minor vertigo attack in 3 and two minor attacks in 3 others not affecting quality of life; persistence of occasional unsteadiness in one patient. Hearing remained unchanged in 15 patients, improved slightly in 3 cases and worsened slightly in 2; decreased sensitivity to high tones was observed in 2 patients at the first insertion of gentamicin. According to the Author, employing integrated therapy and using the minimum effective dose of gentamicin, the risk of damage to the cochlear structures may be reduced, although not excluded, while restoring a good quality of life, even when repeat instillation is necessary.

[Endoscopic treatment of pancreatitis and its complications]

OBJECTIVES

To study the long- and short-term safety and efficacy of endoscopic treatment of pancreatitis and its complications in our environment.

PATIENTS AND METHODS

We performed a retrospective analysis of 43 patients with chronic pancreatitis, acute pancreatitis complicated with pseudocyst, and pancreatic fistula diagnosed by endoscopic retrograde cholangiopancreatography who were suitable for endoscopic treatment.

RESULTS

Endoscopic treatment was attempted in 35 patients. The indication for treatment was pain in 17 patients (48.5%), jaundice in 7 (20%), pseudocyst in 10 (28.5%) and suspected external fistula in 1 (3%). The technique was successfully performed in 28 (80%). Of the patients with pain, pancreatic prosthesis was inserted in 13 and extracorporeal lithotripsy was applied in 6. Sixty-five percent of the patients improved. Of the 7 patients with jaundice, all had secondary stenosis of the biliary tract. Treatment was applied in 2, who showed partial improvement. Of the 15 patients with pseudocyst, endoscopic treatment was indicated in 10; the technique was successfully performed in 8 and complete resolution was achieved in 7 (87.5%). The patient with external fistula was treated with transpapillary prosthesis and complete resolution of disruption of Wirsung's duct was achieved. Overall improvement in successfully treated patients was: complete in 19 (68%), partial in 3 (18%), no improvement in 4 (14%) and 2 patients were lost to treatment. There were 4 short-term complications. There were 4 deaths and one was related to the technique.

CONCLUSIONS

Endoscopic treatment of chronic pain in chronic pancreatitis, pseudocysts and fistulas was effective in our environment with a low rate of complications.

[Endoscopic treatment combined with extracorporeal shock wave lithotripsy of difficult bile duct stones]

OBJECTIVES

The aim of this study was to determine the safety and effectiveness of extracorporeal shock wave lithotripsy (ESWL) in difficult bile duct stones resistant to endoscopic extraction.

PATIENTS AND METHOD

From January 1997 to February 2002, combined treatment with endoscopy and ESWL was used in 19 patients who had undergone unsuccessful endoscopic bile duct stone extraction after sphincterotomy. The procedure was carried out using analgesic and sedative drugs or deep sedation, prophylactic antibiotic therapy, and monitoring of vital signs. Bile duct stone localization was performed by contrast injection through nasobiliary drainage and fluoroscopy. After each ESWL session, lavage was performed through drainage and stone fragments were extracted endoscopically.

RESULTS

The 19 patients presented high surgical risk due to advanced aged and/or concomitant diseases. All presented jaundice and pain and nine (47.3%) presented associated cholangitis. Thirty ESWL sessions were performed (1.57 sessions per patient), with a mean of 2,120 shock waves per session. In 16 of the 19 patients (84.2%), combined treatment with ESWL and subsequent instrumental endoscopic extraction achieved complete clearance of the biliary tract. The treatment failed in 3 patients who were referred for surgical treatment. No early or late complications were observed, except in one patient who presented a self-limiting febrile syndrome.

CONCLUSIONS

Therapeutic endoscopy combined with ESWL is safe and effective in patients with difficult bile duct stones. It represents a therapeutic alternative in patients at high surgical risk.

A randomized comparison of low-dose ketamine and lignocaine infiltration with ketamine-diazepam anaesthesia for post partum tubal ligation in Vanuatu

Ketamine remains one of the most commonly used anaesthetic agents around the world. Despite it being the anaesthetic agent of choice in many developing nations, there is a paucity of literature describing ketamine in the developing world. In what we believe is the first randomized controlled trial to be performed in Vanuatu (formerly the New Hebrides) we compared the use of ketamine 0.9 mg/kg and diazepam 0.07 mg/kg with ketamine 0.3 mg/kg and 2% lignocaine infiltration in 50 Melanesian women undergoing post partum tubal ligation. All women received 0.5 mg/kg intramuscular pethidine. Visual analog pain scores and verbal numeric satisfaction scores were similar between the groups. However the time to obeyed command was significantly faster in the 0.3 mg/kg ketamine group (7.0+/-4.9 vs 13.0+/-9.2 min). The incidence of dreaming was similar and the content rated as pleasant by both groups. In institutions where post-anaesthesia care resources are limited, 0.3 mg/kg ketamine with local anaesthesia provides for earlier self-care of patients after tubal ligation, without compromise of analgesia, emergence or satisfaction. The implications of these findings extend to other procedures that require short general anaesthesia, which can be adequately performed with low-dose ketamine and local anaesthesia. The latter technique allows more rapid awakening.

[Comparison of the efficacy of cleaning and disinfection of videoscopes: mechanized versus manual]

AIM

a) To analyze the effectiveness of the automated cleaning and disinfection of endoscopies (Olympus miniETD, not previously tested) versus the manual method; b) To evaluate the drying and storage procedures used in our unit.

MATERIAL AND METHODS

Prospective 10-day study. The endoscopies were randomized for automated or manual cleaning and disinfection. Endoscopic samples were collected for microbiology studies at three points during the process: a) after endoscopy (after manual cleaning with water), b) after cleaning with enzymatic detergent and disinfection (automated or manual) and c) at the first hour in the morning.

RESULTS

Sixty-five samples were collected after endoscopy: 26 from gastroscopy, 26 from colonoscopy and 13 from duodenoscopy (positive cultures were found in 22, 25 and 10, respectively). The 35 samples collected after automated disinfection were negative, as were 29 of the 30 collected after manual disinfection (p = 0.46). Sixty-four of the 65 samples were negative for hepatitis B and hepatitis C. The only sample positive for hepatitis C became negative after manual disinfection. Positive culture was found in 15% of the samples collected before beginning the session.

CONCLUSIONS

a) Automated cleaning and disinfection (Olympus miniETD) are as effective as manual cleaning. b) Drying and storage procedures should be improved and/or disinfection should be carried out again before the first endoscopy of each session.

Transtympanic gentamicin in the treatment of Meniére's disease

Aminoglycosides enable a pharmacological approach, before resorting to surgery, to the treatment of Menière's disease (MD) proving unamenable to routine medical treatment. The staging of MD is an essential preliminary step in the implementation of a specific and personalized treatment with transtympanic gentamicin. The ideal condition is the presence of endolymphatic hydrops with little or no damage to the cochlear and vestibular hair cells. The technical aspects of the method are discussed. In 21 patients with unilateral Menière's disease in various stages, this treatment achieved the regression of vertigo in 86% of cases; hearing was better in 19% of cases, preserved in 62% and worse in 19%; tinnitus regressed totally or partially in 62% of cases; aural fullness also regressed totally or partially in 57% of cases.

[Hepatoporto-appendicostomy. Our experience in 3 cases of biliary cystic disease]

This report details our preliminary experience with hepaticoporto-appendicostomy in three patients with biliary cystic disease. The surgical procedure was total resection of choledochal cyst and vascularized appendix interposition between biliary tree and duodenum. The children have been followed by clinical, ultrasonography and endoscopic (ECPR) during a period between 1-4 years. There was no episodes of ascending colangitis. All the patients remain free of jaundice and the biochemical abnormalities have become normal three months after interposition. Our results suggest that this procedure is more physiologic than the standard bilioenteric derivation Roux-in-Y, because allow bile to enter freely to duodenum and prevent reflux, stasis and ascending cholangitis. This procedure allows postoperative endoscopic valoration, not possible in another kind of bilioenteric derivations.

Individual prediction of response to pneumatic dilation in patients with achalasia

During nine years, 157 consecutive patients with achalasia have been dilated in our unit. First, the long-term effect of dilation on clinical status was evaluated. The probability of being in clinical remission eight years after first dilation was 51%. The pressure of the LES measured after dilation was highly predictive of the long-term clinical evolution. Second, a predictive model of the individual response to pneumatic dilation was developed and simplified. Therapy was effective in 80% of the patients, after one to four dilations. Younger age was the only factor significantly associated with ineffective therapy. Depending on the prognosis of the outcome calculated with the predictive model, patients were classified in groups of risk that showed a different rate of ineffective, therapy. In the simplified model, age < or = 20 years, male gender, esophageal body diameter < or = 3 cm, esophageal body basal pressure > 15 mm Hg, and pressure of the lower esophageal sphincter > 30 mm Hg were predictors of a poor response to dilation. We conclude that pneumatic dilation is an effective therapy for achalasia. A predictive model was useful to classify the patients in groups with a different risk for ineffective dilation. A simplification of this model could be used to predict the response to dilation.

[Primary carcinoma of the thyroglossal duct. 2 case reports]

AA. present two cases of carcinoma arising on thyroglossal duct's cystic. Those carcinomas are a rare event and will be suspected in the patients that present an irregular tumefaction of medial neck's district. Etiology is unknown; is possible that a preceding irradiation on the neck will represent a factor risk. AA. retained that in case of medial neck's district tumefactions is necessary executed a total examination of neck's and head's district, an echography, a thyroid scintigraphy, a thoracic radiography, a panendoscopy and a FNAB. When we found a squamous carcinoma on residual thyroglossal duct the therapy is chirurgical in function of dimension of T and N with following radiotherapy in function of stage (possible lymph node metastasis). When we found a different adenoma is necessary chirurgical removal of tumefactions with hyoid bone's a body resection (Sistrunk's operation) with total thyroidectomy and following Pochin's test for seeking eventual residual with radiometabolic and suppressive therapy.

Endoscopic sclerotherapy versus oesophageal transection in the prevention of variceal rebleeding

OBJECTIVE

To compare sclerotherapy with oesophageal transection in the prevention of rebleeding in patients with oesophageal varices.

DESIGN

A prospective trial.

PATIENTS

Forty-one patients with cirrhosis and variceal bleeding.

METHODS

After recovering from an acute episode of oesophageal variceal bleeding patients were randomized into two groups. One patient was excluded. Twenty-two patients were treated with sclerotherapy (group 1) and 18 underwent an oesophageal transection (group 2), with a shorter elapsed time from randomization to treatment in group 1. Both groups were similar with regard to clinical and biochemical features and variceal size. Failure, defined in group 1 as rebleeding or incomplete eradication after four sclerotherapy sessions, occurred in five (22.7%) patients; in group 2, rebleeding occurred in two (11.1%) patients (no statistically significant difference).

CONCLUSION

Although the survival rate was similar in both groups, sclerotherapy is preferable to oesophageal transection because it requires a shorter duration of hospitalization and has fewer complications.

[Candida esophagitis and cytomegalovirus gastritis: optic and immunohistochemical diagnosis in an HIV+ patient]

Esophageal candidiasis, along with gastritis caused by cytomegalovirus--CMV--, is a common opportunistic infection in immunodepressed patients. A clinico-pathological description is made of a human immunodeficiency virus-positive female (group IV-C-2) with a history of odynophagia and dysphagia resistant to treatment. The light microscopy and immunohistochemical study of an endoscopic esophago-gastric biopsy allowed the diagnosis of moniliasic esophagitis associated with CMV-induced gastritis. Emphasis is placed on the efficacy of immunohistochemical techniques over other methods in diagnosing CMV infection.

[Combined endoscopic treatment with extracorporeal lithotripsy in chronic calcifying pancreatitis]

In the management of severe chronic pancreatitis, a variety of new endoscopic methods have been proposed as an alternative to traditional surgery. The main goal of these procedures is the remission of pain. They include pancreatic endoscopic sphincterotomy with subsequent endoscopic extraction, which can be associated to extracorporeal shock-wave lithotripsy for stone desintegration before removal of large calculi, and to the insertion of a pancreatic stent in case of a pancreatic duct stricture. We present two cases of severe chronic pancreatitis managed successfully with this endoscopic treatment.

[Results of endoscopic dilatation treatment of benign esophageal stenosis]

The management of benign esophageal stenoses is based on endoscopic dilatation of the tight segment for the remission of dysphagia. Five hundred and twenty sessions of dilatation with Savary-Guilliard bougies have been performed in one hundred and twenty-nine patients with benign esophageal stenoses. Patients with peptic stenoses (n = 59) needed a lesser number of sessions (mean: 2.47) than patients with postsurgical (n = 44; mean: 4.86) or caustic (n = 18; mean: 7.77) stenoses. The treatment failed in 4 patients (3.2%) and severe complications were observed in 3 patients (2.4%). These results support the efficacy and safety of this technique.

[Endoscopic prosthesis insertion in the palliative treatment of malignant esophageal stenosis. (Endoscopic esophageal prosthesis)]

We report our experience with endoscopic esophageal prosthesis in the treatment of 82 patients with advanced malignant oesophageal stenosis. The cause of the stenosis was an esophageal or esophagogastric cancer in 75 cases and a bronchogenic cancer in 7 patients. In 18 cases a tracheobronchial fistula was also present. A silicone tube (Atkinson) was used in 58 patients, a polyvinyl tube (Wilson-Cook) in 22 cases and a self-expanding tube in the remaining 2 patients. There was no technical failure in the insertion of the prosthesis. A normal feeding was possible in 71 of the 82 patients (86%) within 48 after the intubation. Major complications occurred in 8 cases (9.7%), 4 patients with esophageal perforation and 4 cases with aspiration bronchopneumonia. Postoperative mortality rate was 7.3%, one patient with perforation, 3 cases with aspiration bronchopneumonia and 2 patients with sepsis. The prosthesis partially displaced in 9 cases, but could be endoscopically replaced in all of them. The displacement of the prosthesis was complete in 3 patients, one of which needed a surgical procedure to remove the tube. The prosthesis was bunged up by a solid meal bolus in 4 cases, but an endoscopic procedure was successful in removing the bolus. Therapy with laser was necessary in two cases with self-expanding prosthesis obstructed by tumoral growth. We conclude that, in malignant esophageal stenosis, the endoscopic implantation of esophageal endoprosthesis is an effective, cheap and relatively safe palliative therapeutic alternative with a low postoperative mortality rate.

[Prevalence of gastroesophageal reflux in patients with primary motor disorder of the esophagus treated with endoscopic pneumatic dilatation]

The prevalence of gastroesophageal reflux after successful pneumatic dilatation was investigated in 30 patients with primary esophageal motor disorder. After a median follow-up period of 377 days, three patients presented symptoms of acid reflux and five patients had endoscopic esophagitis (grade I, 3 patients; grade II, one patient; and grade III, one patient). Ambulatory 24 hr. esophageal pH monitoring was positive in 20% and 30% of the patients compared to our normal values and to those from other series from the literature, respectively. The concordance between pH results and symptoms and/or endoscopic esophagitis was very low. It is concluded that 24 hr. esophageal pH monitoring is frequently abnormal after pneumatic dilatation, but its clinical significance is low, because very few patients have symptoms and/or severe esophagitis.

Does endoscopy improve prediction of the prognosis in upper gastrointestinal bleeding?

To evaluate the prognostic value of the endoscopic examination, we included 189 consecutive patients with upper gastrointestinal bleeding, in a prospective study. Rebleeding was more frequent in patients with endoscopic stigmata of hemorrhage. The prognostic prediction given by the physician was slightly, but not significantly, improved after the result of the endoscopy was available. However, when the clinical data were evaluated by computer, using the Bayes' theorem, the endoscopic findings provided no additional prognostic value. We conclude that the endoscopic findings have intrinsic prognostic value, but add little to clinical data obtained on admission.

The colon as oesophageal substitute in non-malignant disease. Long-term clinical results and functional studies

Between 1974 and 1987, we performed 18 left colonic interpositions for benign oesophageal disease: caustic lesions in 6 patients, undilatable reflux stenosis in 5, reoperative peptic strictures in 5, penetrating wound in 1 and iatrogenic stricture following oesophagogastric transection for bleeding in 1. Four patients were women. The mean age was 40 +/- 19 years. In 10 patients a left thoracotomy was used; in the other 8 a cervico-abdominal approach was employed. One patient died postoperatively from liver failure. The mean follow-up was 11 +/- 4 years. Clinical results were excellent or good in 12 of the remaining 17 patients (71%). These results varied according to the length of colon interposition; in patients with long colonic interposition, poorer results were achieved. The motor activity of the colonic transplant was evaluated by manometric studies. After intraluminal injection of 30 ml of liquid, the colon responded uniformly with sequential peristaltic waves. Transmission of the oesophageal waves through the oesophagocolic anastomosis was studied in 2 patients. After wet swallows, the oesophageal contractile waves were followed by colonic waves. Solid radionuclide colonic transit studies were carried out in 18 control subjects and in 18 patients with colon interposition. In subjects with a normal oesophagus, the general pattern was rapid emptying of the bolus through the oesophagus. Findings in patients with a short transplant were similar to those observed in normal oesophagi. In most patients with long transplants the transit was abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)

[Carcinoma of the esophagus. Palliative treatment with endoscopic prosthesis]

The efficacy and safety of endoscopically inserted esophageal prosthesis was evaluated in 33 patients with non-operable carcinoma involving the esophagus. In 30 cases, the origin of the tumor was esophageal, and in 3 cases, bronchopulmonary. Esophago-pulmonary fistula was present in 9 patients. Histologic exam of the tumors revealed 11 adenocarcinomas and 22 epidermoid carcinomas. In every case, Atkinson prosthesis was used and previous esophageal dilatation was needed in 21 patients. Normal oral feeding was achieved in 29 patients. Mean hospital stay after insertion of the prosthesis was 5 days. Survival rate was 84.8% at one month, 63.6% at 4-6 months, 42.4% survived more than 6 months, and 21.2% were still alive one year after the procedure. Complications occurred in 3 patients (9%) -esophageal perforation in two cases, and pneumonia in one case. One patient died. In conclusion, in patients with advanced carcinoma involving the esophagus, palliative therapy with endoscopically inserted esophageal prosthesis is effective, relatively safe and cheap.

Motor pattern of the sphincter of Oddi in patients with juxtapapillary diverticula

In 15 patients with duodenal diverticula close to the papilla of Vater we evaluated the motor activity of the sphincter of Oddi by endoscopic biliary manometry. Both basal pressure and phasic activity were similar to those in nine patients without biliopancreatic disease and in 60 patients with common bile duct stones. The anatomical relationship between the papilla and diverticula did not lead to any change in the motor pattern. If juxtapapillary diverticula are associated with a higher prevalence of biliopancreatic disease, dysfunction of the sphincter of Oddi does not seem to play a pathogenic role.

[Early complications of pneumatic dilatation in the treatment of primary motility disorders of the esophagus]

We analyze the incidence and evolution of the early complications of 96 consecutive patients with primary esophagus motor disorders, treated with pneumatic dilatation under endoscopic control (1.4 sessions per patient). In 4 (0.042/patient, 0.029/dilatation) patients the esophagus was perforated; the diagnosis was made in the first 24 hours; pneumomediastinum was a constant finding in the radiological exploration. In three cases the complication was suspected because of the apparition of sustained thoracic pain after the dilatation maneuver and in one case the presentation symptom was bleeding of cardial mucosa, larger than usual, at the end of the dilatation. The four patients evolved favorably with conservative treatment (avoidance of oral food intake, gastroesophageal aspiration, antibiotic therapy and parenteral nutrition).

Endoscopic biliary manometry in patients with suspected sphincter of Oddi dysfunction and in patients with cystic dilatation of the bile ducts

We studied the motility of the sphincter of Oddi in 12 patients with suspected sphincter of Oddi dysfunction, in four patients with cystic dilatation of the bile ducts (two Caroli's cases and two fusiform choledochal cyst cases), and in 33 patients with retained common duct stones. In these last 33 patients, the motor activity of the sphincter of Oddi was similar to that recorded in nine control subjects without pancreatic or biliary diseases. In the suspected Oddi dysfunction cases, both the basal sphincteric pressure and the frequency of the phasic contractions were significantly elevated (P less than 0.001). Patients with biliary cystic dilatation showed an increased basal pressure, but the frequency of the contractions was elevated in only those with choledochal cysts and the amplitude in only one of the two patients with Caroli's disease. Motor disorders of the sphincter of Oddi provide a basis for an alternative etiopathogenesis of cystic disease of the biliary system and a possible explanation for pain and dilatation of the bile duct in patients with suspected sphincter of Oddi dysfunction.

Effect of intravenous glucagon and glucagon-(1-21)-peptide on motor activity of sphincter of Oddi in humans

Glucagon-(1-21)-peptide, the peptide containing the amino acid sequence (1-21) of glucagon, has the same spasmolytic effect as the complete molecule, without its metabolic action. The effect of glucagon and glucagon-(1-21)-peptide on sphincter of Oddi motor activity was evaluated in 20 patients undergoing ERCP and endoscopic biliary manometry. Glucagon produced a nonsignificant decrease in basal pressure, but significantly reduced both frequency and amplitude of phasic activity of the sphincter of Oddi. Glucagon-(1-21)-peptide showed no effect on basal pressure and amplitude of phasic activity, but provoked a significant reduction of frequency of phasic contraction.

Transtympanic administration of aminoglycosides in patients with Menière's disease

Transtympanic administration of gentamicin was used to treat patients with unilateral Menière's disease and was stopped at the first signs of damage to cochlear and/or vestibular function. Twenty-eight patients were treated between 1974 and 1981 and 34 patients were managed between 1981 and 1987. In the two groups of patients, objective vertigo disappeared in 85%, hearing improved in 26%, aural fullness disappeared in 78%, while tinnitus ceased altogether in 51% and became less intense in 24%. Our findings show that this kind of treatment can be used after unsuccessful medical therapy and prior to any labyrinthine or endolymphatic sac surgery.

Motor pattern of the sphincter of Oddi in patients with bilioenteric shunt: a manometric study

An endoscopic biliary manometry was performed on 11 patients with a surgical bilioenteric shunt--choledochoduodenostomy--and no pressure gradient between common bile duct and duodenum. Basal pressure and frequency of the phasic waves of the sphincter of Oddi were significantly higher in these patients than in controls or in patients with retained common bile duct stones. These results suggest a functional adaptation of the sphincter of Oddi in an attempt to recover the normal pressure in the biliary tract.