TRANSPARENT TESTA 16 and 15 act through different mechanisms to control proanthocyanidin accumulation in Arabidopsis testa.

Flavonoids are secondary metabolites that fulfil a multitude of functions during the plant life cycle. In Arabidopsis proanthocyanidins (PAs) are flavonoids that specifically accumulate in the innermost integuments of the seed testa (i.e. endothelium), as well as in the chalaza and micropyle areas, and play a vital role in protecting the embryo against various biotic and abiotic stresses. PAs accumulation in the endothelium requires the activity of the MADS box transcription factor TRANSPARENT TESTA (TT) 16 (ARABIDOPSIS B-SISTER/AGAMOUS-LIKE 32) and the UDP-glycosyltransferase TT15 (UGT80B1). Interestingly tt16 and tt15 mutants display a very similar flavonoid profiles and patterns of PA accumulation. By using a combination of genetic, molecular, biochemical, and histochemical methods, we showed that both TT16 and TT15 act upstream the PA biosynthetic pathway, but through two distinct genetic routes. We also demonstrated that the activity of TT16 in regulating cell fate determination and PA accumulation in the endothelium is required in the chalaza prior to the globular stage of embryo development. Finally this study provides new insight showing that TT16 and TT15 functions extend beyond PA biosynthesis in the inner integuments of the Arabidopsis seed coat.

A new system for fast and quantitative analysis of heterologous gene expression in plants.

• Large-scale analysis of transcription factor-cis-acting element interactions in plants, or the dissection of complex transcriptional regulatory mechanisms, requires rapid, robust and reliable systems for the quantification of gene expression. • Here, we describe a new system for transient expression analysis of transcription factors, which takes advantage of the fast and easy production and transfection of Physcomitrella patens protoplasts, coupled to flow cytometry quantification of a fluorescent protein (green fluorescent protein). Two small-sized and high-copy Gateway® vectors were specifically designed, although standard binary vectors can also be employed. • As a proof of concept, the regulation of BANYULS (BAN), a key structural gene involved in proanthocyanidin biosynthesis in Arabidopsis thaliana seeds, was used. In P. patens, BAN expression is activated by a complex composed of three proteins (TT2/AtMYB123, TT8/bHLH042 and TTG1), and is inhibited by MYBL2, a transcriptional repressor, as in Arabidopsis. Using this approach, two new regulatory sequences that are necessary and sufficient for specific BAN expression in proanthocyanidin-accumulating cells were identified. • This one hybrid-like plant system was successfully employed to quantitatively assess the transcriptional activity of four regulatory proteins, and to identify their target recognition sites on the BAN promoter.

[Ureteroureterostomy following Coffey operation (author's transl)]. / Termino-Laterale Ureteroureterostomie nach Coffey-Operation.

Ipsilateral end-to-side uretero-ureterostomy of a duplicated ureter was carried out following a Coffey operation for bladder contracture. The advantages of this procedure over an additional uretero-intestinal anastomosis are outlined.

Repair of traumatic urethral fistula and huge tissue defect with Lehoczky's island flap.

A 20-years-old male patient suffered pelvic bone fracture and a penetrating urethral injury through the perineum due to a car accident. The injury and the unsuccessful reconstruction resulted in a large perineal tissue defect, urethral fistula, and dislocation of the anus close to the fistula. The authors performed a successful reconstruction; closure of the urethral fistula, sinking of the anus to its proper place, and substitution of the missing skin and subcutaneous tissue with Lehoczky's flap. The flap with its good blood supply and mass of tissue repaired the defect and promoted the rapid, functionally and cosmetically excellent result.

Our experience with the Mainz pouch II: 40 patients; follow-up and complications.

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible.

Gastrocystoplasty, a wrong choice in an adult case.

A 28-year-old woman presented a huge vesico-vagino-rectal fistula after radiotherapy because of a gynecological tumour. Reconstruction consisted of a colostomy, closure of the rectal hole with a pedicled perineal skin graft, a bivalve opening of the bladder and, with the two valves coverage of the vaginal suture line, and augmentation gastrocystoplasty. The fistulas healed but the patient suffered from an intolerable burning sensation, that is why the stomach wall was removed and uretero-ileo-cutaneostomy was created. The colostomy was closed, and the patient now has a well functioning urine stoma.

[Incidence of osteoporosis in Heves County]. / Az osteoporosis gyakorisága Heves megyében.

The socio-economic importance of osteoporosis is in the increase. The costs of the effects of reduced working capability and treatment of fractures are estimated costs only. The authors report on 146 osteoporotic patients between 1986-89, suffering from fractures. Among the patients there is a female dominance. The number of osteoporotic fractures is in the increase in the recent years. The authors pointed out the importance of early diagnosis and prevention, to solve the great social problems caused by morbidity, reduced working capability and lower life standard.

[Mainz pouch II, a modified method of ureterosigmoidostomy]. / Mainz pouch II, a módosított ureterosigmoidostomia.

The authors applied a new method, the low pressure ureterosigmoidostomy, namely the Mainz pouch II. The essence of the operation was a reverse "U" shape opening of the sigma, detubularization, then suturing together, so a diverticulum like cavity was created, and the ureters were implanted here. The detubularization broke the peristaltic pressure wave in the bowel and protected the kidneys from reflux, inflammation and stone formation. From early complications the suture insufficiency and sterile disruption of the abdominal wall emerged. The former was solved with conversion to rectal bladder, the latter with special stitches. Hyperchloraemic acidosis manifested in every case and it was compensated with medicines. For the 23 tumour free patients the operation brought daytime continency, a good quality of life, and as a palliation diminished the complaints. There were no inflammatory complications and only one ureter stricture and one fistula developed. The operation technically was simple and united the advantages of the ureterosigmoidostomy and the low pressure reservoir.

[Severe necrotic processes of the penis and scrotum]. / A hímvesszó és a herezacskó súlyos szövetelhalásos folyamatai.

Authors summarise the two-decade experience of their department in severe tissue necrosis of penis and scrotum. Presented cases represent a shared field of urology with dermatology, infectology, nephrology and andrology. Tissue necrosis extended to different depth of the penis, from superficial skin and subcutaneous tissues, fascias to the entire organ. Underlying diseases are acute and chronic inflammations, metabolic diseases, vascular lesions. Diagnostic difficulties and therapeutic choices, both conservative and operative, are discussed.

Abdominal symptoms of hereditary angioedema and early weaning.

Hereditary angioedema (HAE), a condition caused by deficiency of C1 inhibitor that results in acute and painful swelling in locations that can include the face, neck, abdomen, extremities and genitals, is a potentially life-threatening disorder. Many factors may contribute to phenotype development. A case report prompted us to investigate the potential influence of early weaning on HAE gastrointestinal symptoms. Retrospective analysis was performed based on clinical data from 89 patients registered with our HAE center, including duration of breast-feeding, timing of cow's milk introduction, age at symptom onset and localization of the attacks. We did not find any relationship between these factors. Although breastfeeding is known to confer protection against numerous diseases, it showed no efficacy against the manifestations of HAE in our patient population.