A Secondary Metabolic Enzyme Functioned as an Evolutionary Seed of a Primary Metabolic Enzyme.

The antibiotic alaremycin has a structure that resembles that of 5-aminolevulinic acid (ALA), a universal precursor of porphyrins, and inhibits porphyrin biosynthesis. Genome sequencing of the alaremycin-producing bacterial strain and enzymatic analysis revealed that the first step of alaremcyin biosynthesis is catalysed by the enzyme, AlmA, which exhibits a high degree of similarity to 5-aminolevulinate synthase (ALAS) expressed by animals, protozoa, fungi, and α-proteobacteria. Site-directed mutagenesis of AlmA revealed that the substitution of two amino acids residues around the substrate binding pocket transformed its substrate specificity from that of alaremycin precursor synthesis to ALA synthesis. To estimate the evolutionary trajectory of AlmA and ALAS, we performed an ancestral sequence reconstitution analysis based on a phylogenetic tree of AlmA and ALAS. The reconstructed common ancestral enzyme of AlmA and ALAS exhibited alaremycin precursor synthetic activity, rather than ALA synthetic activity. These results suggest that ALAS evolved from an AlmA-like enzyme. We propose a new evolutionary hypothesis in which a non-essential secondary metabolic enzyme acts as an 'evolutionary seed' to generate an essential primary metabolic enzyme.

Predicative factors of the effect of Body Weight Support Treadmill Training in stroke hemiparesis patients.

[Purpose] The aim of this study was to determine if gait index predicts the efficacy of weight-support treadmill training (BWSTT) in hemiplegic stroke patients. [Participants and Methods] In total, 21 patients who had sustained a hemiplegic stroke, on an average 71 days prior, and could walk independently on level ground were included in the study. BWSTT was performed under 20% of bodyweight unloading at the maximum speed possible for each participant to a perceived level of fatigue of 15 on the 20-point Borg scale. The immediate effects of BWSTT were evaluated as the change in the following variables, calculated from 5 level ground gait cycles; walking speed and rate, root mean square, coefficient of variability, auto-correlation coefficient, and single leg stance time ratio. All indices were calculated from the triaxial accelerometer attached to the waist of the participant. Linear regression was used to identify predictive variables of BWSTT effectiveness. [Results] Only single leg stance time ratio on level ground was extracted as a predictor of BWSTT effectiveness. [Conclusion] Single leg stance time ratio was a predictive factor of improved gait symmetry after BWSTT and therefore, could be used as a factor to select patients who might benefit from BWSTT as a component of stroke rehabilitation.

Relationship between walking ability of patients with stroke and effect of body weight-supported treadmill training.

[Purpose] Reports on the amount of unloading maximizing walking ability in patients with stroke are limited. The effect of body weight-supported treadmill training (BWSTT) in patients with stroke has not been clarified. We aimed to investigate the effects of unloading rate during BWSTT on the gait of patients with stroke and the relationship between BWSTT and walking ability on flat ground. [Participants and Methods] We performed BWSTT in 17 patients at three unloading rates: 0%, 20%, and 40%. Then, we examined the walking speed and rate, number of steps, single-leg support time ratio, and root mean square before and after unloading. Furthermore, we examined the relationship between walking ability on flat ground and immediate effects of BWSTT at each unloading rate. [Results] We observed no significant improvement under all conditions. However, walking ability improved at unloading rates of 20% and 40%, with poor temporal symmetry while walking on flat ground. [Conclusion] Our results revealed that BWSTT has diverse effects depending on the unloading rate and the ability to walk on flat ground. In particular, it tends to be highly effective for those who have poor sway and symmetry, which may serve as an index for prescribing BWSTT.

Isolated torsion of the fallopian tube in a menopausal woman and a pre-pubertal girl: two case reports.

INTRODUCTION: Isolated torsion of the fallopian tube without an ovarian abnormality is an uncommon event, with an incidence of approximately 1 in 1,500,000 females. Isolated torsion of the fallopian tube occurs mostly in reproductive-aged women, and is thus extremely rare in menopausal women and pre-pubertal girls. CASE PRESENTATIONS: In case 1, 63-year-old Japanese woman presented with a 2-day history of acute lower abdominal pain. Menopause occurred at 53 years of age. Pelvic ultrasonography showed an enlarged mass (73 × 47 mm) on the right side of her uterus. An urgent laparoscopy was performed based on a presumptive diagnosis of right ovarian tumor torsion. During the laparoscopy, we noted a black, necrotic, solid tumor arising from the distal end of her right fimbria. Her right fallopian tube was twisted with the tumor, but her right ovary was normal and not involved. A laparoscopic tumorectomy with a right salpingectomy was performed. Her post-operative course was uneventful. In case 2, a 10-year-old Japanese girl presented with a 1-day history of lower abdominal pain associated with nausea and vomiting. Menarche had occurred 2 months earlier. A computed tomography and magnetic resonance imaging examination demonstrated a dilated tubal cystic mass with a normal uterus and bilateral ovaries. An urgent laparoscopy was performed based on a presumptive diagnosis of right fallopian tube torsion. During laparoscopy, her right fallopian tube was noted to be dark red, dilated, and twisted several times. Her right fimbria was necrotic-appearing and could not be preserved. Therefore, a laparoscopic right salpingectomy was performed. A histologic examination revealed ischemic changes with congestion of her right fallopian tube, which was consistent with tubal torsion. She had an uncomplicated post-operative course. CONCLUSION: We have presented two very rare cases of isolated fallopian tubal torsion. Radiologic interventions, such as computed tomography and magnetic resonance imaging, in addition to ultrasonography, are helpful diagnostic tools. Isolated torsion of the fallopian tube should be considered in the differential diagnosis of lower abdominal pain with a cystic mass and a normal ipsilateral ovary in all female patients, regardless of age.