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Examines the expression of a circular DNA clone in Craterostigma plantagineum using Northern blot analysis. Effect of abscisic acid treatment on transcript accumulation; Mechanism for adaptation to cellular dehydration; Transduction of extracellular signals to intracellular responses.

The article presents a study which examines the early diagnosis of colorectal cancer with faecal occult blood test (FOBT). An overview of the methodology used for the study is provided, along with information on the FOBT screening programme in Finland. Results showed that FOBT screening increased the rate of diagnosing early colorectal cancer at the initial first screening round.

Summary: The ability of combined step aerobic- and circuit-training to prevent bone loss after breast cancer treatments was related to skeletal site and patients' menopausal status. Among premenopausal breast cancer survivors, a 12-month exercise intervention completely prevented bone loss at the femoral neck, whereas no exercise effect was seen at lumbar spine or at neither site in postmenopausal women. Introduction: The primary objective of this randomised clinical trial was to determine the preventive effect of supervised weight-bearing jumping exercises and circuit training on bone loss among breast cancer patients. Methods: Of 573 breast cancer survivors aged 35-68 years randomly allocated into exercise or control group after adjuvant treatments, 498 (87%) were included in the final analysis. The 12-month exercise intervention comprised weekly supervised step aerobic- and circuit-exercises and similar home training. Bone mineral density (BMD) at lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical performance was assessed by 2-km walking and figure-8 running tests, and the amount of physical activity was estimated in metabolic equivalent-hours/week. Results: In premenopausal women, bone loss at the femoral neck was prevented by exercise, the mean BMD changes being −0.2% among the trainees vs. −1.4% among the controls ( p = 0.01). Lumbar bone loss could not be prevented (−1.9% vs. −2.2%). In postmenopausal women, no significant exercise-effect on BMD was found either at the lumbar spine (−1.6% vs. −2.1%) or femoral neck (−1.1% vs. −1.1%). Conclusions: This 12-month aerobic jumping and circuit training intervention completely prevented femoral neck bone loss in premenopausal breast cancer patients, whereas no effect on BMD was seen in postmenopausal women. [ABSTRACT FROM AUTHOR]

Background: Screening for colorectal cancer (CRC) with guaiac-based faecal occult-blood test (FOBT) has been reported to reduce CRC mortality in randomised trials in the 1990s, but not in routine screening, so far. In Finland, a large randomised study on biennial FOB screening for CRC was gradually nested as part of the routine health services from 2004. We evaluate the effectiveness of screening as a public health policy in the largest population so far reported., Methods: We randomly allocated (1:1) men and women aged 60-69 years to those invited for screening and those not invited (controls), between 2004 and 2012. This resulted in 180 210 subjects in the screening arm and 180 282 in the control arm. In 2012, the programme covered 43% of the target age population in Finland., Results: The median follow-up time was 4.5 years (maximum 8.3 years), with a total of 1.6 million person-years. The CRC incidence rate ratio between the screening and control arm was 1.11 (95% CI 1.01 to 1.23). The mortality rate ratio from CRC between the screening and control arm was 1.04 (0.84 to 1.28), respectively. The CRC mortality risk ratio was 0.88 (0.66 to 1.16) and 1.33 (0.94 to 1.87) in males and females, respectively., Conclusions: We did not find any effect in a randomised health services study of FOBT screening on CRC mortality. The substantial effect difference between males and females is inconsistent with the evidence from randomised clinical trials and with the recommendations of several international organisations. Even if our findings are still inconclusive, they highlight the importance of randomised evaluation when new health policies are implemented., Trial Registration: 002_2010_august.

Background: Aromatase inhibitors effectively prevent breast cancer recurrence and development of new contralateral tumours in postmenopausal women. We assessed the efficacy and safety of the aromatase inhibitor anastrozole for prevention of breast cancer in postmenopausal women who are at high risk of the disease., Methods: Between Feb 2, 2003, and Jan 31, 2012, we recruited postmenopausal women aged 40-70 years from 18 countries into an international, double-blind, randomised placebo-controlled trial. To be eligible, women had to be at increased risk of breast cancer (judged on the basis of specific criteria). Eligible women were randomly assigned (1:1) by central computer allocation to receive 1 mg oral anastrozole or matching placebo every day for 5 years. Randomisation was stratified by country and was done with blocks (size six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation; only the trial statistician was unmasked. The primary endpoint was histologically confirmed breast cancer (invasive cancers or non-invasive ductal carcinoma in situ). Analyses were done by intention to treat. This trial is registered, number ISRCTN31488319., Findings: 1920 women were randomly assigned to receive anastrozole and 1944 to placebo. After a median follow-up of 5·0 years (IQR 3·0-7·1), 40 women in the anastrozole group (2%) and 85 in the placebo group (4%) had developed breast cancer (hazard ratio 0·47, 95% CI 0·32-0·68, p<0·0001). The predicted cumulative incidence of all breast cancers after 7 years was 5·6% in the placebo group and 2·8% in the anastrozole group. 18 deaths were reported in the anastrozole group and 17 in the placebo group, and no specific causes were more common in one group than the other (p=0·836)., Interpretation: Anastrozole effectively reduces incidence of breast cancer in high-risk postmenopausal women. This finding, along with the fact that most of the side-effects associated with oestrogen deprivation were not attributable to treatment, provides support for the use of anastrozole in postmenopausal women at high risk of breast cancer., Funding: Cancer Research UK, the National Health and Medical Research Council Australia, Sanofi-Aventis, and AstraZeneca., (Copyright © 2014 Cuzick et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd. All rights reserved.)

Aim: The aim of the present study was to examine the impact of obesity and physical activity on the health and wellbeing of patients with breast cancer shortly after the adjuvant treatments., Patients and Methods: A total of 537 women aged 35 to 68 years with newly-diagnosed breast cancer were enrolled into the exercise intervention study. The physical activity, physical performance (2-km walking test), cardiovascular risk factors, quality of life (EORTC-QoL-C30), co-morbidities and body-mass index (BMI) were measured after the adjuvant treatments., Results: Overall, 191 (39%) patients were overweight (BMI=25-30) and 85 (17%) obese (BMI ≥ 30). Physical activity and performance (p<0.001 and p<0.001), QoL (p<0.001) and high density lipoprotein (HDL)-cholesterol decreased (p<0.001) whereas age (p=0.009), co-morbidities (p<0.001), hypertension (p=0.011), metabolic syndrome (p<0.001), low density lipoprotein (LDL)-cholesterol (p=0.0043), triglycerides (p<0.001), glucose (p<0.001) and insulin (p<0.001) increased linearly with BMI. Higher waist circumference (p=0.0011), triglyceride (p=0.020), insulin (p=0.0098), rate of metabolic syndrome (p=0.028), and lower HDL-cholesterol (p=0.012) and QoL (p<0.001) were associated with low physical activity. Physical activity and BMI were the most important determinants of physical performance (p<0.001 and p<0.001, respectively)., Conclusion: Obesity and a sedentary lifestyle are related to poor physical performance, increased risk of cardiovascular diseases and impaired QoL, leading to a vicious circle, which impairs patients' physical health and QoL.

Aims of the Study: This prospective study was performed to investigate the effects of 5-year's use of tamoxifen in preventive setting on endometrium and gynaecological symptoms., Material and Methods: Altogether 96 women were treated either with tamoxifen (TAM, n=45) or placebo (PLA, n=51) for up to 5 years in a randomised, double-blind IBIS I breast cancer prevention trial, clinically followed-up for an additional year and for the occurrence of malignancies at least 9 years between 2/1995 and 7/2009 in Finland. The gynaecological follow-up with trans-vaginal ultrasound and endometrial biopsies were performed at baseline, at 2.5 and 5 years and at the 6 years follow-up visit., Results: Women in the TAM group discontinued the treatment significantly more often (44% versus 22%; p=0.017) and earlier (at 15 versus 30 months; p=0.044), than those in the PLA group. In postmenopausal women the median endometrial thickness was significantly increased at five years in the TAM group (median 4.3 versus 2.0mm, p=0.011), but there was no difference between the groups at one year after the treatment. There were also statistically significantly more referrals to hospitals due to gynaecological findings in the TAM group (risk rates (RR) 3.15; 95% confidence intervals (CI) 1.12-10.10), but no differences in hysterectomy rates or other serious adverse event rates were observed., Conclusions: The discontinuation rate in the TAM group was high, and the discontinuations also occurred early. Even though there were significantly more non-serious gynaecological events during the TAM treatment, routine gynaecological follow-up cannot be recommended., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

We report the complete and annotated genome sequence of the plant-pathogenic enterobacterium Pectobacterium sp. strain SCC3193, a model strain isolated from potato in Finland. The Pectobacterium sp. SCC3193 genome consists of a 5,164,411-bp [corrected] chromosome, with no plasmids.

Aim: The study aimed at determining whether physical exercise training improves the quality of life (QoL) and physical fitness of breast cancer survivors., Patients and Methods: A total of 573 breast cancer survivors were randomized into an exercise or a control group, 12-months after adjuvant treatments. EORTC QLQ-C30 and BR-23 questionnaires were used for evaluation of QoL, FACIT-F for fatigue and the Finnish modified version of Beck's 13-item depression scale (RBDI) for depression. Physical fitness was assessed by a 2-km walking test, and a figure-8 running test and physical activity (PA) by metabolic equivalent (MET) hours per week (MET-h/wk)., Results: Figure-8 running time improved significantly among the patients of the intervention group compared with the controls (p<0.001). No significant between-group differences were observed in 2-km walking time, in PA, EORTC-QLQ-C30, BR-23, FACIT-F or BDI. However, there was a linear relationship between increased PA and improved QoL (p=0.006), irrespective of the intervention., Conclusion: Increase in physical activity was associated with improved QoL, but no effect of the exercise intervention was observed.

In this 12-month RCT, we examined whether aerobic impact exercise training (3x/week) could facilitate breast cancer survivors' recovery by enhancing their bone structural strength, physical performance and body composition. After the adjuvant chemo- and/ or radiotherapy, 86 patients were randomly assigned into the training or control group. Structural bone traits were assessed with pQCT at the tibia and with DXA at the femoral neck. Agility (figure-8 running), jump force and power (force platform), grip strength and cardiovascular fitness (2-km walk test) were also assessed. Training effects on outcome variables were estimated by two-way factorial ANCOVA using the study group and menopausal status as fixed factors. Bone structural strength was better maintained among the trainees. At the femoral neck, there was a small but significant 2% training effect in the bone mass distribution (p=0.05). At the tibial diaphysis, slight 1% to 2% training effects (p=0.03) in total cross-sectional area and bone structural strength were observed (p=0.03) among the postmenopausal trainees. Also, 3% to 4% training effects were observed in the figure-8 running time (p=0.03) and grip strength (p=0.01). In conclusion, vigorous aerobic impact exercise training has potential to maintain bone structural strength and improve physical performance among breast cancer survivors.

Introduction: Mortality from colorectal cancer has been shown to decrease by repeated screening using faecal occult blood (FOB) testing in randomized screening trials. This report presents coverage and performance of organized screening among the general population in Finland., Methods: In 2004-2007, people aged 60-69 years were randomized into biennial screening and control arms. The screening test was a guaiac-based FOB test (Hemoccult) with dietary restriction and three test cards for six consecutive samples. Test positives were referred for full colonoscopy. The programme was launched in 2004 and subsequently it expanded over regions and age-cohorts., Results: In 2007, the programme covered one-third of the target population and 74,592 people had been invited for screening, of them 26,866 for the second round. Uptakes for the first and second rounds, respectively, were 62% and 68% in men and 77% and 80% in women. The proportion of test positives increased from 2.4% to 2.9% from the first to the second round and the positive predictive value for cancers decreased from 7.5% to 4.3%., Conclusions: By 2007, organized colorectal cancer screening covered one-third of the target population in Finland. Implementation of screening measured with response rate was successful and met the criteria for a public health programme, but performance in terms of positive predictive value needs monitoring.

Chitinases are hydrolytic enzymes that have been employed in biotechnology in attempts to increase plants' resistance against fungal pathogens. Genetically modified plants have given rise to concerns of the spreading of transgenes into the environment through vertical or horizontal gene transfer (HGT). In this study, chitinase-like sequences from silver birch (Betula pendula) EST-libraries were identified and their phylogenetic relationships to other chitinases were studied. Phylogenetic analyses were used to estimate the frequency of historical gene transfer events of chitinase genes between plants and other organisms, and the usefulness of phylogenetic analyses as a source of information for the risk assessment of transgenic silver birch carrying a sugar beet chitinase IV gene was evaluated. Thirteen partial chitinase-like sequences, with an approximate length of 600 bp, were obtained from the EST-libraries. The sequences belonged to five chitinase classes. Some bacterial chitinases from Streptomyces and Burkholderia, as well as a chitinase from an oomycete, Phytophthora infestans, grouped together with the class IV chitinases of plants, supporting the hypothesis that some class IV chitinases in bacteria have evolved from eukaryotic chitinases via horizontal gene transfer. According to our analyses, HGT of a chitinase IV gene from eukaryotes to bacteria has presumably occurred only once. Based on this, the likelihood for the HGT of chitinase IV gene from transgenic birch to other organisms is extremely low. However, as risk is a function of both the likelihood and consequences of an event, the effects of rare HGT event(s) will finally determine the level of the risk.

Hypothesis: This study's aim was to find out how well various microdissection approaches reveal the basic anatomy of the epitympanum, especially the pathways of aeration to Prussak's space, without the help of serial sections, which many find difficult to interpret., Background: The basic studies where made during the latter half of the 19th and the first half of the 20th century. Conflicting concepts have later been published, and doubtful information has been included even in textbooks., Methods: We have studied 145 temporal bones via microdissection to record the state of the soft tissue structures of the epitympanum, particularly upon Prussak's space with its boundaries. A normal surgical otomicroscope was used in the evaluation, and the findings were recorded via black and white and/or color photography; for recent cases, a digital video camera was used., Results: The epitympanic diaphragm separates the large upper floor compartments from the small, laterally placed lower floor unit. The latter consists of Prussak's space and the posterior pouch, at times also of the lower lateral attic. The tympanic isthmus connects the upper unit to the medial tympanum. Defects in the diaphragm create additional airways to the upper unit, in 29% via the tensor fold and in 19% via the lateral incudomalleal fold. In only 7% was there a small opening in the roof of Prussak's space connecting it to the upper unit. Effective aeration of Prussak's space was independent of the upper floor compartments., Conclusion: Microdissection is a reliable and sufficient method for teaching epitympanic anatomy. All important structures can be identified and defects in the epitympanic diaphragm verified. Data obtained via serial sections are invaluable in research but not essential in the training of ear surgeons. The two-floor structure of the epitympanum with an independent aeration of the two units should be the starting point for all anatomy teaching.

Objective: Histological studies show that amniotic fluid cellular content (AFCC) causes in the middle ear a foreign body reaction, the extent and severity of which depends upon the massiveness of contamination. We studied how factors related to birth and environment affect proneness to acute otitis media (AOM) in infants born through meconium contaminated amniotic fluid., Methods: From the birth records of infants born from 1996 to 2000 a list was made of those born through meconium contaminated amniotic fluid with pulmonary aspiration and tracheal suctioning, followed by treatment in a neonatal intensive care unit. Thirty-seven such children formed the study group, 43 children matching the study cases but born through clear fluids formed the control group. Birth and environmental factors together with the frequency and number of episodes of AOM were analyzed in all, based on a verified questionnaire. In addition, 27 children in the study group and 21 in the control group received a specialist ENT examination, hearing tests and tympanometry., Results: The events at delivery were highly significantly different between the two groups, manifested by the lower Apgar points in the study group (p<0.001) while other birth and environmental factors appeared equalized. The first episode of AOM in the study group came earlier than in the control group and their frequency was significantly higher during the 1st and 2nd year of life and during the entire observation period (p<0.001). Tympanostomy was performed more often in the study group. Tympanometry showed more cases of reduced static admittance and negative pressure than in the control group and hearing was poorer., Conclusions: Cases with compromised delivery through meconium contaminated fluids, resulting in pulmonary aspiration and in need of intensive care treatment, form a risk group, which should be closely followed. Early nasopharyngeal suctioning of AFCC may reduce its entry into the middle ear. A prolonged episode of AOM suggests mucosal involvement of several middle ear compartments, shown by histological studies to occur in all cases of massive contamination. Placement of a ventilation tube after the first prolonged AOM allows regression of the granulation tissue in the air spaces together with the secretory elements in the mucosa.

Apoptosis was studied using temporal bones from three fetuses representing different times of gestation and from three neonates. Paraffin-embedded sections 20-microm thick were studied using the terminal deoxynucleotide transferase-mediated dUTP nick-end labeling method based on 3'-end-labeling of fragmented DNA. Phenotyping of the immune cells was performed using regular monoclonal antibodies. In the bone marrow the granulocyte series dominated and the number of cells in the macrophage series was noticeably fewer, with apoptotic cells occurring in both. In the embryonic mesenchyme, solitary apoptotic cells occurred in all locations in both the fetuses and neonates. Apoptosis is a basic factor in the regression of embryonal mesenchyme, but may not be preprogrammed. Basic scientific data obtained from modified tissue cultures show that mechanical forces cause cells to switch between different genetic programs. It is suggested that the act of swallowing causes periodic changes in the amniotic fluid pressure and provides the necessary force for regression of the mesenchyme by apoptosis.

Hypothesis: This study's aim was to find histologic data that would indicate the mode of disappearance of the embryonal mesenchyme., Background: The basic studies made during the first half of the 20th century concluded that mesenchyme disappears by regression and resorption. Recently, it was suggested that mesenchyme disappears by receding, spreading, and thinning to match the enlarging bony spaces., Methods: We studied 11 serially sectioned temporal bones from newborns to adults and describe detailed findings in a 9-day-old newborn and in a 1.5-year-old infant. The temporal bones were sectioned to 20 mum and stained by hematoxylin and eosin., Results: Histologic evidence of regression was found in the form of degenerating mesenchymal cells and fibers, in areas free of cells, and with empty spaces of varying size between the fibers. Vacuoles differing much in size appeared, and phagocytic cells were frequent. A rich capillary network allowed resorption of hemopoietic cells dispersed from the marrow spaces into the mesenchyme. From the lower lateral attic, from Prussak's space, and from the mastoid air cells, mesenchyme can disappear only by regression-there is no space where it could recede., Conclusion: Pneumatization of the middle ear spaces occurs by regression and resorption with an individual speed under genetic guidance. The osteoclastic activity of the periosteum, intertwined with the nearest mesenchyme, is decisive in the mastoid air cell formation. Dispersion and reabsorption of hemopoietic cells is a normal phenomenon in this process. Underpressure in the middle ear spaces, caused either by a meconium-related foreign body otitis media in infancy or by chronic otitis media in childhood, are factors that may lead to a partial or full arrest of pneumatization.

Hypothesis: An influx of amniotic fluid cellular content (AFCC) into the middle ears during birth may lead to the development of a chronic inflammatory process in the form of varying amounts of granulation tissue even if signs of otitis media are absent. This foreign body neonatal otitis media may predispose the child to recurrent otitis media., Background: Foreign body neonatal otitis media caused by AFCC was described by Aschoff and elaborated by Wittmaack 100 years ago. Recent studies have shown how AFCC spreads to various middle ear compartments and causes histologic changes, the severity of which is related to the amount of AFCC. Specific elements become phagocytized after the first months of life but have caused the formation of inflammatory polyps and granulation tissue with round cell secretions in the meantime., Methods: Ten temporal bones from the Temporal Bone Foundation, derived from infants aged 5 months to 1 year 11 months, were serially sectioned at 20 microm, saved at 0.2-mm intervals, numbered, and stained with hematoxylin and eosin. Every slide was studied for the presence, nature, and stage of pathologic tissue changes of the middle ear and the mastoid antrum., Results: Pseudocystic granulation tissue was massive in the temporal bone of the 8-month-old child born through thick meconium. Severe changes were present in the temporal bones of two infants aged 5 months, one of which showed traces of AFCC. In the temporal bones of two older children, long-standing changes were minor, one of them still showed traces of AFCC. Fresh acute changes and long-standing histologic changes occurred side by side., Conclusions: Neonatal otitis media caused by AFCC can give rise to extensive granulation tissue and round cell secretion, which is likely to make the ear susceptible to infectious otitis media. Cumulative development of granulation tissue as a result of infection may lead to blockage of attic aeration and drainage pathways, causing irreversible adhesive otitis media. A data base should be formed of all neonates born through meconium-stained amniotic fluid to allow a comparison with those born through clear fluids. Surgery with the creation of auxiliary aeration pathways becomes advisable in the treatment of ears with massive development of granulation tissue.

Two related protein phosphatases 2C, ABI1 and AtPP2CA have been implicated as negative regulators of ABA signalling. In this study we characterized the role of AtPP2CA in cold acclimation. The pattern of expression of AtPP2CA and ABI1 was studied in different tissues and in response to abiotic stresses. The expression of both AtPP2CA and ABI1 was induced by low temperature, drought, high salt and ABA. The cold and drought-induced expression of these genes was ABA-dependent, but divergent in various ABA signalling mutants. In addition, the two PP2C genes exhibited differences in their tissue-specific expression as well as in temporal induction in response to low temperature. To elucidate the function of AtPP2CA in cold acclimation further, the corresponding gene was silenced by antisense inhibition. Transgenic antisense plants exhibited clearly accelerated development of freezing tolerance. Both exposure to low temperature and application of ABA resulted in enhanced freezing tolerance in antisense plants. These plants displayed increased sensitivity to ABA both during development of frost tolerance and during seed germination, but not in their drought responses. Furthermore, the expression of cold-and ABA-induced genes was enhanced in transgenic antisense plants. Our results suggest that AtPP2CA is a negative regulator of ABA responses during cold acclimation.

In this study, 24 temporal bones with an age range from neonates to 23-month-old infants were serially sectioned and studied for the spread and fate of amniotic fluid cellular content (AFCC) in the middle ear and mastoid. Most children had had either a moderate or massive contamination. AFCC clusters were found to spread to all compartments, with the sites of predilection being the stapes region, the lower lateral attic and the tympanic isthmus. AFCC created an intensive foreign body giant cell reaction and the foreign material practically dissolved in 5 months as a result of the organization process. Tiny remnants of AFCC appeared as late as 15 months after birth. It seems likely that AFCC contamination predisposes the ears to recurring otitis media. The sequalae of the massive granulation tissue development involves obliteration of Prussak's space and its aeration routes, as well as blockage of the tympanic isthmus, leading to extensive disease in the major attic compartments.

Hypothesis: Blockage of the aeration pathways to the attic may cause circumscribed or widespread alterations that are difficult to diagnose clinically. The narrow route via the posterior pouch to Prussak's space is especially vulnerable to obstruction in recurring otitis media., Background: Recent studies of the epitympanic diaphragm and compartments have clarified the anatomy of the attic aeration and drainage pathways and emphasized the role of their patency in the healing process of middle ear infections. In neonatal otitis media, the amniotic fluid cellular content (AFCC) has proved to be a good indicator in outlining the areas where inflammation products concentrate, possibly causing early blockage of ventilation., Methods: Twenty-eight temporal bones from 14 children were studied; 4 of these children had experienced bilateral recurring otitis media. In the latter group, 1 ear was studied by microdissection and the other by serial sectioning., Results: Prussak's space was involved in all 4 pairs of bones and either contained thick mucus, contained secretion in the process of organization, or was obliterated. The tympanic isthmus was fully obstructed in 1, partially blocked in 2, and open in 5 specimens., Conclusions: If a thick mature connective tissue mass develops under the epidermal layer of Shrapnell's membrane during an obliteration process of Prussak's space, the condition may stay stable and benign. Severe retraction of Shrapnell's membrane represents a likely forerunner of a retraction pocket cholesteatoma. Systematic otomicroscopy allows early detection, and cure can be achieved by minor surgery. In some children, despite the treatment of recurring otitis media with ventilation tubes, the attic and mastoid can be extensively involved, necessitating atticomastoidectomy and the creation of new pathways for attic aeration.

Glycine betaine is an osmoprotectant found in many organisms, including bacteria and higher plants. The bacterium Escherichia coli produces glycine betaine by a two-step pathway where choline dehydrogenase (CDH), encoded by betA, oxidizes choline to betaine aldehyde which is further oxidized to glycine betaine by the same enzyme. The second step, conversion of betaine aldehyde into glycine betaine, can also be performed by the second enzyme in the pathway, betaine aldehyde dehydrogenase (BADH), encoded by betB. Transformation of tobacco (Nicotiana tabacum), a species not accumulating glycine betaine, with the E. coli genes for glycine betaine biosynthesis, resulted in transgenic plants accumulating glycine betaine. Plants producing CDH were found to accumulate glycine betaine as did F1 progeny from crosses between CDH- and BADH-producing lines. Plants producing both CDH and BADH generally accumulated higher amounts of glycine betaine than plants producing CDH alone, as determined by 1H NMR analysis. Transgenic tobacco lines accumulating glycine betaine exhibited increased tolerance to salt stress as measured by biomass production of greenhouse-grown intact plants. Furthermore, experiments conducted with leaf discs from glycine betaine-accumulating plants indicated enhanced recovery from photoinhibition caused by high light and salt stress as well as improved tolerance to photoinhibition under low temperature conditions. In conclusion, introduction of glycine betaine production into tobacco is associated with increased stress tolerance probably partly due to improved protection of the photosynthetic apparatus.

Hypothesis: The tissue-fixed amniotic fluid cellular content (AFCC) in the middle ear and mastoid antrum causes foreign body type reactions that may later severely restrict the aeration pathways to the main attic and to Prussak's space., Background: It was shown by Aschoff 100 years ago that AFCC remained in the neonate ears and caused sterile otitis media. Recent data show that children born through thick meconium are at risk for large quantities of AFCC entering the middle ear cleft, the ensuing inflammatory reaction being related to the amount of AFCC. Spread of AFCC in the neonate occurred along the aeration pathways with corresponding tissue fixation but further systematic data in young infants are lacking., Methods: Five temporal bones of three infants aged 2 to 4 months were embedded in celloidin, serially sectioned at 20 microns, and every 10th section stained with Hematoxylin and eosin and mounted on slides. All slides were studied and relevant details of aeration pathways and all compartments photographed., Results: The histologic changes were characterized by the development of masses of pseudocystic granulation tissue, with some remnants of the original AFCC, mainly in the form of fragments of hair. The tympanic isthmus was involved to varying extent, maximally to half of its size. Posterior tympanum and the stapes region had masses of fresh granulation tissue, the maturing of which might cause marked indrawing of the posterior pars tensa and further reduction of the tympanic isthmus. Aeration of Prussak's space was severely involved in two bones, favored by the narrow pathway through the posterior pouch. Features of recent acute or secretory otitis media were associated with the early changes caused by AFCC., Conclusions: The granulation tissue in this age group is immature and its final fate is decided by the nature of the future ear disease. If the AFCC contamination is slight, the granulation tissue after maturing may appear only in the form of thin cords and sheets, a frequent chance finding in ear surgery. Large amount of AFCC may lead to chronic inflammation, which may predispose the child to recurring middle ear infections during infancy. Further histologic and clinical studies in older infants and young children are needed to find out the final outcome after a massive AFCC contamination of the new-born middle ear.

The atmospheric air pollutant ozone (O3) is one of the environmental stresses that induce formation of reactive oxygen species (ROS) in plants. Previously, the toxicity of O3 has been believed to be a result of ROS formation from O3-degradation. Recently, however, it has been shown that O3 induces active ROS production, which suggests that O3-responses may be mechanistically similar to pathogen-induced responses and that O3-damage could be a result of deleterious firing by the ROS of pathways normally associated with the HR. The subcellular localization of O3-induced H2O2 production was studied in birch (Betula pendula). O3 induced H2O2 accumulation first on the plasma membrane and cell wall. Experiments with inhibitors of possible sources for H2O2 in the cell wall suggested that both NADPH-dependent superoxide synthase and the cell wall peroxidases are involved in this H2O2 production. The H2O2 production continued in the cytoplasm, mitochondria and peroxisomes when the O3-exposure was over, but not in chloroplasts. The timing of mitochondrial H2O2 accumulation coincided with the first symptoms of visible damage and, at the same time, the mitochondria showed disintegration of the matrix. These responses may not be directly connected with defense against oxidative stress, but may rather indicate changes in oxidative balance within the cells that affect mitochondrial metabolism and the homeostasis of the whole cell, possibly leading into induction of programmed cell death.

The long-term results of pediatric cholesteatoma are dispersed and there is no consensus on operation methods and on factors affecting outcome of surgery. We analyzed the independently evaluated long-term results and possible reasons for recholesteatoma. Eighty-four consecutive pediatric (age < 16 years) cholesteatoma operations were undertaken in the Helsinki University Central Hospital ENT Department. The operations were not staged; all mastoids were obliterated and bony ear canals reconstructed without open cavities. The pre- and perioperative and annual control data were recorded in a database. The last control was independently performed (J.S.) with an average follow-up of 4.8 years and 87% attendance. The total recholesteatoma rate was 29% (24/84), and it was not dependent on the size of cholesteatoma, mastoid status, cholesteatoma in the window niches or stapedial erosion. A retraction process developed in 25% (21/84) of the ears and 42% (9/21) of these turned into retraction pocket cholesteatomas as late as 13 years postoperatively. Retractions and postoperative discharge, especially in combination, predisposed to recholesteatoma. Of the healed ears, 37% became atelectatic. Hearing was maintained on the preoperative level. Reduced middle ear and attic ventilation led to retractions, and atelectasis and a tendency to discharge accelerated the process. Pitfalls in mastoid obliteration and attic reconstruction and the failure to create new ventilation routes were important reasons for recholesteatoma.

Hypothesis: The attic compartments, except for Prussak's space, are aerated through the tympanic isthmus. The aim of this study was to develop aeration pathways that would bypass the isthmus in surgery for chronic inflammatory ear disease and cholesteatoma., Background: Microdissection of the epitympanum has shown that the anterior attic and the supratubal recess are separated by the tensor fold, the excision of which creates a large new aeration pathway., Methods: Earlier surgical experience was reexamined as to the access to the tensor fold. Twenty temporal bones were dissected to create clinically useful new surgical routes for tensor fold removal in the presence of an intact ossicular chain., Results: An endaural atticotomy, extended to the supratubal recess, allows excision of the tensor fold; however, the excision must be performed blindly. Cutting the neck of the malleus to allow lateral lifting of the manubrium exposes the tensor tendon and allows rapid excision of the fold. The elasticity of the tendon assists in approximation of the cut edges. In canal wall up surgery, removal of the lateral attic bone until the root of the zygoma exposes the anterior surface of the head of the malleus and the lateral portion of the transverse crest. Drill-out of the crest leads directly to the posterior side of the tensor fold, allowing its excision under direct vision. Thinning of the attic bone lateral to the body and short process of the incus allows simultaneous removal of the lateral incudomalleal fold., Conclusions: When the ossicular chain is discontinuous, tensor fold resection can be made under direct vision. With an intact chain, cutting of the neck of the malleus used in tympanic glomus tumors causes no hearing changes, allows complete fold excision, and is adaptable to chronic ear surgery. The frontolateral attic route for removal of tensor fold, together with the lateral incudomalleal fold, can be used in the canal wall up surgery to improve attic aeration.

Hypothesis: The aim of this study was to find suitable methods for basic anatomic evaluation of the supratubal recess and the anterior surface of the tensor fold., Background: The current method of superior microdissection via the middle fossa floor provides a good picture of the anatomy and pathology of the epitympanum, but the supratubal recess can be evaluated only after excision of the tensor fold. Postinflammation changes cannot be examined accurately because destruction of the tensor fold necessarily alters the anatomic details., Methods: Eight temporal bones were studied via a lateral and 14 via an anterior approach, both complemented by the superior microdissection. Data on 51 earlier superior dissections were reevaluated as to the state of the supratubal recess. Histology was documented from eight biopsy specimens and of four serially sectioned temporal bones, two normal and two infected., Results: The lateral route offered a good view to the tensor tendon and lower portion of the tensor fold, but the anterior malleal ligament obstructed the view to the fold's upper portion. The anterior route offered excellent visibility to the anterior pouch, mesotympanum, tensor fold, and the whole supratubal recess. The tensor fold was mostly fixed superiorly to the bony roof with a narrow or broad soft band of composite tissue, infrequently to the transverse crest directly. Inflammatory changes spread from the tympanic isthmus region to the supratubal space over the fold and, if extensive, formed broad inflammatory and scar tissue bands between the fold and the anterior bony wall., Conclusions: The supratubal recess and the mesotympanum can best be evaluated via the anterior approach, which should be added to the temporal bone microdissection program. It serves well as the starting route, followed by the conventional superior dissection of the epitympanum. The knowledge gained is indispensable in surgery for chronic otitis media for creation of a large common middle ear air space and functioning aeration pathways.

Plant calcium can modulate a particular plant-pathogen interaction and have a decisive role in disease development. Enhanced resistance to the phytopathogenic enterobacterium Erwinia carotovora, the causal agent of bacterial soft rot disease, is observed in high-calcium plants. One of the main virulence determinants of E. carotovora, the PehA endopolygalacturonase, is specifically required in the early stages of the infection. Production of PehA was found to be dependent on the calcium concentration in the bacterial environment. An increase in extracellular calcium to mM concentrations repressed pehA gene expression without reducing or even enhancing expression of other extracellular enzyme-encoding genes of this pathogen. An increase in plant calcium levels could be correlated to enhanced resistance to E. carotovora infection and to an inhibition of in planta production of PehA. Ectopic expression of pehA from a calcium-insensitive promoter allowed E. carotovora to overcome this calcium-induced resistance. The results imply that plant calcium can constitute an important signal molecule in plant-pathogen interaction, which acts by modulating the expression of virulence genes of the pathogen.

Hypothesis: The aim of this study was to investigate the anatomy and pathology of the anterior epitympanum and of the tensor fold., Background: Early studies reported data that are primarily still relevant, but contemporary reports present conflicting data, including several erroneous concepts., Methods: Fifty-one temporal bones were dissected, and the anatomic details were photographed in 42 normal and nine infected bones. Histology was documented from seven serially sectioned bones, five normal and two infected., Results: The tensor fold formed the frontal wall of the anterior epitympanum between tensor tendon and attic bony wall, the anterior insertion consisting of composite connective and fatty tissue with some bone trabeculae. The transverse crest was posterior to it and extended from the anterior tympanic spine to the facial canal. The tensor fold angle in 78% of the specimens was between 45 degrees and 80 degrees, seldom horizontal, and the size of the supratubal recess (or space) increased as the fold angle increased. In 14 ears (27%) the fold had a membrane defect connecting the two spaces. Blockade of the tympanic isthmus caused inflammatory obliteration of the anterior epitympanum when the tensor fold was intact., Conclusions: The anterior epitympanum, a closed space around the anterior half of the head of the malleus, is normally closed by an intact tensor fold, but about one fourth of ears may show membrane defects. Aeration occurs via the tympanic isthmus through a constriction formed by the head of the malleus with the medial attic wall. In surgery for ears with epitympanal pathology, incus transposition should be combined with resection of the thin portion of the tensor fold for safeguarding permanent attic aeration.

Purpose: This retrospective study investigates the general outcome and subjective impression of patients who have undergone surgery for otosclerosis. Postoperative complaints and complications, as well as hearing results, are also reported., Materials and Methods: Questionnaire and audiomeric results of 246 stapes surgery patients (270 operations) were studied., Results: Hearing results showed a mean improvement in pure-tone average of 26 dB and air-bone gap closure to within 10 dB in 214 cases (79%). No serious complications or profound sensorineural hearing loss occurred. Patients were generally pleased with surgery, and subjective evaluation of benefit corresponded with objective audiometric result. However, a variety of complaints, such as vertigo, tinnitus, loud noise intolerance, pain, chorda tympani symptoms, and sound distortion problems, were reported. Most of these symptoms correlated significantly with the patients' subjective opinion of the surgical outcome., Conclusion: Patients as well as surgeons consider hearing improvement as the main indicator of success in surgery for otosclerosis. However, postoperative symptoms and complaints can be expected in a certain percentage of patients. Because these can influence the general outcome of surgery, the ear surgeon should try to painstakingly refine his technique in an effort to minimize their sources. They should also be discussed in preoperative patient counseling.

Thirty-seven temporal bones were dissected, and the posterior tympanic and epitympanic folds recorded and photographed. Histologic details were documented from four serially sectioned temporal bones, two normal and two inflamed. Of these 41 specimens, 31 were normal, and 10 showed signs of inflammation. The type for the lateral fold was incudomalleal in 16 and incudal in 25 ears. Incus intercrural and incudostapedial folds appeared only exceptionally. Medial and superior incudal folds were not present in normal ears. The anterior tympanic isthmus was a constant, large aeration pathway. In chronically inflamed ears, its partial or total block was caused by polypoid or large sheet-like folds. Inactive sequelae appeared as mature, simple, one-layer or extensive multilayer networks of webs, connected with a deeply indrawn incudomalleal fold. The small posterior isthmus was open to the incudal fossa in 13 ears, and in 28, it was sealed off by a posterior incudal fold. The mastoid air cell tracks were (in ten of 37 dissected ears) open to the incudal fossa, or directly, to the posterior tympanum. Auxiliary pathways due to membrane defects were found in both the horizontal and descending portions of the incudomalleal fold. Excepting the chordal, incudomalleal, and posterior incudal folds, fold-like webs in the posterior tympanum and epitympanum are of inflammatory origin.

Thirty temporal bones were dissected under the operating microscope, and four whole temporal bone specimens were studied by light microscopy for evaluation of the lateral malleal space and Prussak's space. In all specimens Prussak's space showed a blind end toward the anterior pouch and communicated with the posterior pouch. Its roof consisted of the lateral malleal ligamental fold, which was always strongest in its anterior half and as a rule had a thin area in its posterior portion. In four ears there was a membrane defect connecting Prussak's space to the lateral malleal space. The latter did not contain additional folds and communicated freely with the upper attic. The pathways for spread of an acquired primary cholesteatoma from Prussak's space are outlined.

The results of surgery in a series of 452 ears having either myringoplasty (281 ears) or tympanoplasty (171 ears) were studied in relation to the experience of the surgeons. The trainees received an annual course in temporal bone dissection and were given daily surgical instruction in the operating theatre. The 142 ears operated by them showed less disease than those operated upon by the programme chairman (114 ears) and by the faculty (196 ears). The performance of the trainees was safe, and as to healed tympanic membrane and hearing results all studied parameters were statistically equal to those of the faculty. Repair of anterior perforations proved to be the most difficult and the overall results of both the faculty and trainees left place for improvement. On-line recording of surgical data and annual evaluation of an individual surgeon's results is suggested as a necessary means for continuous post-graduate training.

The epitympanic compartments and the anatomy of the atticotympanic diaphragm were examined in a pair of serially sectioned temporal bones with secretory otitis media and chronic otitis media, respectively. Findings confirmed reports of 19th century scientists in that Prussak's space has a wide connection to the mesotympanum through the posterior pouch of Tröltsch and may have an additional narrow passage in its roof to the lateral malleal space. The lateral incudomalleal fold regularly separates the upper lateral attic from the lower lateral attic and the mesotympanum. The medial incudal fold as a rule is atrophic already at birth. The anterior tympanic isthmus thus extends from the tensor tympani tendon to the posterior incudal ligament and is the main passage for epitympanic and mastoid aeration. Opening(s) in the tensor fold, when present, are also important. In some ears, the posterior tympanic isthmus may form an auxiliary narrow route for aeration via the incudal fossa. The isthmi may be blocked by middle ear infection, which can lead to chronic mastoid and attic disease. Pathways for cholesteatoma spread in the epitympanum are discussed.

The authors compared the long-term recovery of sutured facial nerves after the removal of 8 neurofibromatosis-2 (NF2)-associated and 22 non-NF2 acoustic neuromas. The patients were from a series of 270 patients operated on for an acoustic neuroma between 1979 and 1989. The assessment was done with a modified House and Brackmann scale from video recordings. At least some facial movement or tone was achieved (Grade 5 or better) in all but three patients, but in none was the recovery excellent. The facial function, judged by the overall appearance in movement, recovered less in patients with NF2 (P = 0.048); a moderately good recovery (Grade 3 or better) was seen in one patient of eight with NF2, as compared with 13 of 22 with non-NF2. In conclusion, if the tumor cannot be peeled off easily from the facial nerve in patients with NF2, leaving a fragment of tumor behind is preferable to cutting and suturing the facial nerve.