Development of somatic hybrids Solanum × michoacanum Bitter. (Rydb.) (+) S. tuberosum L. and autofused 4x S. × michoacanum plants as potential sources of late blight resistance for potato breeding.

KEY MESSAGE: Phytophthora infestans resistant somatic hybrids of S. × michoacanum (+) S. tuberosum and autofused 4 x S. × michoacanum were obtained. Our material is promising to introgress resistance from S. × michoacanum into cultivated potato background. Solanum × michoacanum (Bitter.) Rydb. (mch) is a wild diploid (2n = 2x = 24) potato species derived from spontaneous cross of S. bulbocastanum and S. pinnatisectum. This hybrid is a 1 EBN (endosperm balance number) species and can cross effectively only with other 1 EBN species. Plants of mch are resistant to Phytophthora infestans (Mont) de Bary. To introgress late blight resistance genes from mch into S. tuberosum (tbr), genepool somatic hybridization between mch and susceptible diploid potato clones (2n = 2x = 24) or potato cultivar Rywal (2n = 4x = 48) was performed. In total 18,775 calli were obtained from postfusion products from which 1,482 formed shoots. The Simple Sequence Repeat (SSR), Cleaved Amplified Polymorphic Sequences (CAPS) and Random Amplified Polymorphic DNA (RAPD) analyses confirmed hybrid nature of 228 plants and 116 autofused 4x mch. After evaluation of morphological features, flowering, pollen stainability, tuberization and ploidy level, 118 somatic hybrids and 116 autofused 4x mch were tested for late blight resistance using the detached leaf assay. After two seasons of testing three somatic hybrids and 109 4x mch were resistant. Resistant forms have adequate pollen stainability for use in crossing programme and are a promising material useful for introgression resistance from mch into the cultivated potato background.

[Penile implants]. / Penile Implantate.

Many patients presenting with erectile dysfunction have been successfully treated with techniques mentioned earlier in this issue. However patients with an insufficient response are still candidates for the treatment with penile implants. For this reason it is mandatory to know about the indications, the systems and the operative techniques of penile implants. In a time of decreasing numbers of implant surgery this method still remains a valuable tool for the therapy of erectile dysfunction.

Clinical, cytogenetic and molecular analysis of three 46,XX males.

Cytogenetic analysis, fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR) were applied to characterize the Y-chromosomal breakpoints of three XX male patients. Two of these patients show a breakpoint within a protein kinase gene, PRKY, previously described as a hotspot of ectopic recombination between homologous regions on X and Y chromosomes during male meiosis. The slightly different clinical phenotypes of the three patients cannot be correlated with the localization of the breakpoints.

The effect of leukemia inhibitory factor (LIF) on trophoblast differentiation: a potential role in human implantation.

Leukemia inhibitory factor (LIF) is a multifunctional glycoprotein strongly associated with normal implantation in the mouse. We have recently determined that LIF is expressed in the human endometrium in a menstrual cycle dependent manner. Maximal expression is observed between days 19 and 25 of the menstrual cycle, coinciding with the time of human implantation. In this study we have utilized purified cultures of human cytotrophoblasts to examine the effects of LIF on several morphologic and biochemical markers of the trophoblastic differentiation. We purified human cytotrophoblasts from term placentae and cultured them with and without LIF (10 ng/mL). The secretion of human CG, oncofetal fibronectin, and progesterone were measured at 24, 48, 72, and 96 h. Northern blot analysis was used to assess messenger RNA (mRNA) expression of beta hCG and oncofetal fibronectin. We found that LIF markedly decreased trophoblast production of hCG protein at 72 and 96 h, as well as expression of beta hCG mRNA. LIF also significantly increased the expression of oncofetal fibronectin mRNA and secretion of the protein. LIF did not affect steroidogenic activity of cultured trophoblasts, as determined by progesterone production. These biochemical changes are characteristic of cytotrophoblast differentiation toward an anchoring extravillous phenotype. Thus, LIF appears to be an important regulator of human embryonic implantation by directly modulating trophoblast differentiation.

Intracervical placement of catheter balloon at hysterosalpingography.

OBJECTIVE -- To describe the technique of hysterosalpingography with endocervical placement of the balloon of the catheter rather than endometrial placement. PATIENTS -- 48 consecutive patients undergoing hysterosalpingography in the course of infertility work-up at a university hospital. METHOD -- With the patient in the lithotomy position, the cervix is visualized and cleansed. The catheter and balloon are inserted in the cervical canal and inflated with the contrast agent. The contrast agent is injected slowly at low pressure, and three to six spot films are obtained. Only gentle traction can be applied by this method, so oblique views are obtained early in the examination. RESULTS -- Balloon placement was atraumatic. Although good views were obtained more frequently than with traditional techniques, about one-quarter of the studies were unsatisfactory. CONCLUSION -- This method is easy, atraumatic, and allows excellent visualization of the entire endometrial cavity and upper intracervical canal.

Hormone replacement therapy.

Although hormone replacement therapy (HRT) has been available for almost 100 years, conflicting opinions still exist about its efficacy and safety. There is uniform agreement that vasomotor instability and vaginal atrophy are totally reversible with HRT. Effective treatment of bone loss with HRT depends on the number of years of estrogen deprivation, peak bone mass, and rapidity of bone loss. Oral, transdermal, and pellet estrogens are equality effective. Mortality from coronary heart disease decreased 20% to 40% in women on HRT, yet the mechanism has not yet been ascertained. The increased risk of endometrial cancer has been confirmed, but better diagnostic techniques for detection in the precancerous state have been developed. The relationship of breast cancer to estrogen use has not been conclusive. Meta-analysis of 13 studies results in a relative risk of 1.06, whereas a large case-control study reveals a relative risk of 0.9. However, it is clear that in the average, healthy woman, low-dose estrogen replacement for less than 10 years does not increase the risk of breast cancer. Physicians are encouraged to help patients weigh the risks and benefits of HRT.

Incidence of breast cancer in a 22-year study of women receiving estrogen-progestin replacement therapy.

OBJECTIVE: To review the incidence of breast cancer in a continuous 22-year study of conjugated estrogen-medroxyprogesterone acetate hormone replacement therapy. METHODS: Eighty-four pairs of continuously hospitalized postmenopausal women who were matched for age, smoking history, and medical diagnosis were treated with estrogen-progestin hormone replacement therapy or placebo in a prospective and double-blind manner for 10 years. In the subsequent 12 years, the women were offered the choice of starting, stopping, or continuing hormone replacement therapy. RESULTS: After the initial 10 years, the incidence of breast cancer in the placebo group was 4.8%, whereas no cancers were found in the hormone replacement therapy group (P = .12). After an additional 12 years of follow-up, the overall incidence of breast cancer in the women who had never taken hormone replacement therapy was 11.5%, whereas no breast cancers had developed in the women who had ever taken hormone replacement therapy (P < .01). CONCLUSIONS: These data suggest that the 22-year administration of estrogen-progestin hormone replacement therapy did not increase the incidence of breast cancer in a small group of continuously hospitalized postmenopausal women.

[The in vitro fertilization program in Klagenfurt]. / In-vitro-Fertilisationsprogramm in Klagenfurt.

690 infertile patients have been treated with IVF since 1984 in Klagenfurt. All patients who asked for IVF/ET treatment are included in this study without any selection. The data therefore show the effective chance to become pregnant. The majority of the patients was infertile due to tubal-factor, underwent two treatment cycles only and was stimulated with a simple clomid-scheme. Oocyte retrieval has been performed via laparoscope only in the beginning; for three years already it is done transvaginally under ultrasound control. Depending on the number of transferred embryos the pregnancy rate varies and reaches 35% in triple-transfers. Until now 140 clinical pregnancies could be achieved and 72 women gave birth to 78 healthy children. Therefore our patients can count on an average pregnancy rate of 20.3% and an 10.4 baby-take-home rate.

Endometrial assessment by vaginal ultrasonography before endometrial sampling in patients with postmenopausal bleeding.

Endometrial sampling is the mainstay of management of the postmenopausal patient with uterine bleeding. Thirty women with postmenopausal bleeding were studied prospectively. Before endometrial sampling, a vaginal probe ultrasonographic examination was performed. Eleven patients demonstrated a thin "pencil line" endometrial echo in which the maximum anteroposterior thickness on the long axis view was less than or equal to 5 mm. All eleven patients had minimal tissue obtained on biopsy and a pathology report of "tissue insufficient for diagnosis." Seventeen patients had an echogenic endometrium greater than or equal to 6 mm. Pathology reports of their samples revealed tissue insufficient for diagnosis (two cases), proliferative endometrium (six), secretory endometrium (three), hyperplastic endometrium (three), polyp (two), and endometrial cancer (one case). Two additional patients had no endometrial echo visualized because of associated myomas. These findings suggest (1) that the absence of significant endometrial tissue (echo less than or equal to 5 mm) on vaginal ultrasonography in cases with postmenopausal bleeding is uniformly associated with tissue insufficient for diagnosis, and (2) when endometrial thickness is greater than or equal to 6 mm the histologic diagnosis should be determined in the pathology laboratory.

Estrogen regulation of agonistic and proceptive responses in the golden hamster.

The role of estrogen in modulation of agonistic (attack-chase) and proceptive (vaginal-marking) responses of the female hamster toward a male was examined in relation to time course of induction and duration of response. In addition, the sex-specific nature of the vaginal-marking response was examined. Cycling females showed a significantly higher frequency of attack-chase when endogenous estrogen levels were minimal in comparison to that at peak estrogen levels during the estrous cycle. Removal of estrogen (ovariectomy) resulted in a significant increase in attack-chase scores compared to high endogenous estrogen. Addition of exogenous estrogen (Silastic capsule) resulted in a significant decrease in attack-chase scores compared to ovariectomized animals. The inverse effect was found for vaginal marking with the lowest frequency of vaginal marking at low endogenous estrogen levels or following ovariectomy. During high endogenous estrogen levels or following treatment with exogenous estrogen vaginal-marking scores were maximal. Maximal induction of vaginal-marking responses and reduction of attack-chase were found between 6 and 48 hr of estrogen treatment. Both behaviors then returned to the prehormonal treatment level. Failure to detect effects beyond 48 hr was not due to repeated testing, as animals lacking hormone, or animals first tested at 96 hr of estrogen exposure, showed no effect of the treatment. Males gonadectomized as adults never showed vaginal marking, whereas males gonadectomized neonatally showed a low level of vaginal marking which was increased significantly following estrogen treatment. Thus both attack-chase and vaginal marking in the presence of a male are modulated by estrogen. Further, since vaginal marking is estrogen sensitive in the neonatally gonadectomized male, expression of vaginal marking is determined by the hormonal environment during the neonatal period. However, peripheral feedback may be important for frequency of occurrence.

Long-term results of deep dorsal penile vein transsection in venous impotence.

29 individuals with venous impotence underwent transsection of the deep dorsal penile vein, of the superficial and ectopic veins, if any. 19 patients responded initially with either spontaneous erections or increased sensitivity of the cavernous bodies to intracorporeal papaverine. 1 patient developed postoperative priapism. The majority of patients who failed to respond had major leakage into the cavernous veins or abnormal connections between the spongious and cavernous bodies. An intraoperative decrease of flow rates to induce and maintain erection was found to be indicative for response. 10 individuals developed secondary erectile dysfunction 4-24 months after the initial response. A more extensive surgical approach should be considered to improve long-term success rates.

Comparative evaluation of New York City and modified Thayer-Martin media for isolation of Neisseria gonorrhoeae.

Commercially manufactured New York City (NYC) medium and modified Thayer-Martin (MTM) medium were compared for their ability to isolate Neisseria gonorrhoeae from clinical specimens. Twenty-seven public health laboratories throughout California evaluated 4,802 specimens collected from patients attending either sexually transmitted disease or family planning clinics. Total of 726 and 737 N. gonorrhoeae isolates were recovered from NYC and MTM medium, respectively. Although less contamination was noted on NYC medium, MTM medium was equivalent to commercially prepared NYC medium for the isolation of N. gonorrhoeae from clinical specimens.