Gene polymorphism and frequencies of the NPC1L1 gene (rs2072183, rs217434 and rs217428) in Japanese patients with dyslipidemia.

WHAT IS KNOWN AND OBJECTIVE: Niemann-Pick C1-Like 1 (NPC1L1) plays a pivotal role in intestinal cholesterol absorption. Ezetimibe is known as an inhibitor for NPC1L1 and decreases concentration of low-density lipoprotein cholesterol (LDL-C) in blood. Responses of the decrease of serum LDL-C levels to ezetimibe have been reported to be different among NPC1L1 variants. However, there are still limited data concerning the genetic variation in the NPC1L1 gene, specifically, in Japanese patients with dyslipidemia. The purpose of this study is to elucidate genotype and allele frequencies of the NPC1L1 gene in Japanese patients with dyslipidemia. METHODS: Written informed consent was obtained from all participants. All patients were administered ezetimibe at the dose of 10 mg for once a day either alone or coadministered with statins. Patient's data were retrospectively obtained from their medical records. Genomic DNA was extracted from whole blood samples and analysed three NPC1L1 SNPs (rs2072183, rs217428 and rs217434) by the direct sequencing method. RESULTS AND DISCUSSION: We found that there is a significant difference of genotype frequencies between healthy Japanese and dyslipidemic subjects in rs2072183. No significant differences were observed in rs217428 and rs217434; however, comparison of our data with literature reports suggests that there are significant differences in the frequencies of rs217428 and rs217434 between Canadian and Japanese dyslipidemic patients. WHAT IS NEW AND CONCLUSION: Our study is the first report concerning the genotype and allele frequencies of the gene coding for NPC1L1 in Japanese patients with dyslipidemia. The most notable result was to demonstrate that there exists a significant difference in rs2072183 variant between healthy Japanese and dyslipidemic subjects and also found that there exists genetic variation of rs2072183 between Japanese and Canadian patients with dyslipidemia. Our results are expected to facilitate research in the proper use of ezetimibe-based mono- or combination therapies. Further studies will be required to evaluate the effects of rs2072183 on the efficacy of LDL cholesterol reduction by ezetimibe.

Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment: a retrospective study of 95 patients.

AIM: Acute haemorrhagic rectal ulcer (AHRU) is characterized by sudden onset of painless and massive rectal bleeding in elderly bedridden patients who have serious illness. Endoscopic diagnosis and management of AHRU is, however, still controversial. We retrospectively investigated 95 AHRU patients to elucidate the clinical characteristics, endoscopic findings and haemostatic strategies. METHOD: Between January 1999 and March 2007, 95 patients were diagnosed with AHRU in our hospital. Medical records and colonoscopy files were reviewed. Clinical features, colonoscopic findings, haemostatic treatment and outcome of the patients were evaluated. RESULTS: Eighty per cent of the patients were bedridden at the onset. The most frequent underlying disorder was cerebrovascular disease (36.8%). Hypoalbuminaemia (< 3.5 g/dl) was seen in 92.6% of the patients. Endoscopic findings of AHRU were classified as circumferential ulcer (41.1%), linear or nearly round small ulcer(s) (44.2%), circumferential and small ulcer(s) (7.4%) and Dieulafoy-like ulcer (7.4%). Primary endoscopic haemostatic treatment was performed in 45.3% of cases. Recurrent bleeding occurred in 24.2% of patients. Permanent haemostasis was achieved by secondary endoscopic treatment in 82.6% of re-bleeding patients. CONCLUSION: Understanding the typical clinical and endoscopic findings and careful endoscopic examination are important for the accurate diagnosis of AHRU, and endoscopic haemostatic therapy may be effective for bleeding patients.

Purification and properties of a membrane-bound phospholipase B from Mycobacterium lepraemurium.

The phospholipid deacylating enzyme was solubilized from the particulate (membrane) fraction of Mycobacterium lepraemurium with Triton X-100 and sodium cholate, and purified 1100-fold to homogeneous state by 5 steps of column chromatography: DE-52, PL-Sepharose (phosphatidylserine-attached sepharose), Mono P, heparin-Agarose and Mono Q column chromatography. The purified enzyme was composed of single polypeptide chain and molecular mass of 37 kDa was estimated for the protein by SDS-PAGE. The isoelectric point was determined about pH 4.6 and the protein was highly resistant to various kinds of proteolytic enzymes. The purified enzyme hydrolyzed both diacyl and monoacyl phospholipids showing that this enzyme was classified to phospholipase B (phospholipase A1/lysophospholipase). This phospholipase B had acidic pH optima and hydrolyzed both neutral phospholipids such as phosphatidylcholine (PC), phosphatidylethanolamine (PE) and acidic phospholipids such as phosphatidylserine (PS), phosphatidylinositol (PI) and phosphatidylglycerol (PG). Various fatty acids such as 12:0, 14:0, 16:0, 18:0 and 18:1 at sn-1 position, and 18:1, 18:2, 18:3 and 16:0 at sn-2 position were liberated from PC, suggesting no strict specificity toward the fatty acyl groups of phospholipids. From the comparison of degradation patterns of phosphatidylcholine with sn-1-[1-14C]- and sn-2-[1-14C]fatty acids, this enzyme was suggested to hydrolyze sn-1 position of phospholipid first and then sn-2 position, as the phospholipase B of M. phlei. This enzyme also attacked 1-acyl- and 2-acyl-lyso-PC at about same rates. The Km values for 1-acyl-2-oleoyl-PC and 2-oleoyl-lyso-PC were estimated 1.6 and 0.75 mM, respectively.

Phospholipid deacylating activities in murine leprosy bacilli.

1) The particulate fraction of cultivated murine leprosy bacilli (Mycobacterium lepraemurium, rough colonies of the Hawaiian-Ogawa strain) contained phospholipid deacylating activities with acidic pH optima. It hydrolyzed phosphatidylcholine and phosphatidylethanolamine at similar rates, and phosphatidylinositol oligomannosides more slowly. It also hydrolyzed 1-acyl- and 2-acyl-GPCs (sn-glycerol 3-phosphocholine) more rapidly than phosphatidylcholine. 2) Ca2+ did not stimulate either diacyl- or monoacyl-hydrolase activity. Triton X-100 and Emulgen 913 had little influence on the hydrolysis of phosphatidylcholine, but at rather high concentrations inhibited the hydrolyses of 1-acyl- and 2-acyl-GPCs. Iron ions strongly inhibited the hydrolysis of phosphatidylcholine, but caused little or no inhibition of the deacylations of 1-acyl- and 2-acyl-GPCs. 3) With 1-[stearoyl-14C]phosphatidylcholine and 2-[oleoyl-14C]phosphatidylcholine as substrates, both labeled fatty acid and lysophosphatidylcholine were produced. Labeled fatty acid appeared more rapidly from 2-[oleoyl-14C]phosphatidylcholine than labeled lysophosphatidylcholine, while labeled lysophosphatidylcholine was produced more than labeled fatty acid from 1-[stearoyl-14C]phosphatidylcholine in the early stage of incubation.

Metabolism of triacylglycerol in Mycobacterium smegmatis.

Mycobacterium smegmatis cells incorporated [1-14C]oleic acid into triacylglycerols (TG) from the medium more rapidly than shorter chain fatty acids, caprilic and butyric acids. This incorporation was inhibited more strongly by 10(-3) M N-ethylmaleimide than by 10(-3) M KCN. [14C]TG in the bacterial cells was utilized when the cells were in poor nutritional conditions, such as phosphate buffer (pH 7.0) containing oleic acid. Accumulation of TG was observed in the cells at late stages of growth. Diglyceride acyltransferase [EC 2.3.1.20] activity was detected in a cell-free extract from this bacterium. The pH optimum of this enzyme was between pH 7 and 9. F- and Tween 20 showed remarkable enhancing and inhibitory effects, respectively.

Cloning and sequence determination of the gene coding for the elongation factor Tu of Mycobacterium leprae.

Elongation factor Tu (EF-Tu) plays an important role in protein biosynthesis and is susceptible to antibiotics in prokaryotes like Escherichia coli. In order to understand the primary structure of EF-Tu in the intracellular pathogenic bacterium Mycobacterium leprae, the gene (tuf gene) coding for this protein was cloned and sequenced. The gene contains a coding region of 1,188 bp with GUG as start codon. The deduced amino acid sequence has 396 amino acids with a molecular weight of 43.6 kDa. Putative GTP-binding sites are located at amino acid positions 19-24, 83-87, and 138-141. Comparison of M. leprae EF-Tu amino acid sequence with those of M. tuberculosis, Micrococcus luteus, E. coli, and Salmonella typhimurium reveals 74-95% homology. Mitochondrial EF-Tu of Saccharomyces cerevisiae (62%) and chloroplast EF-Tu of Arabidopsis thalina (65.6%) also show strong homology with that of M. leprae. In contrast, the EF-Tu of the archaebacterium Halobacterium marismoruti exhibits relatively less homology (36.7%). Southern hybridization of M. leprae tuf gene with genomic DNA of slow growing and fast growing mycobacteria and related species like Corynebacterium fascians and Nocardia asteroides suggests that the gene is highly conserved in these organisms.

Effect of metal ions in the culture medium on the stearoyl-coenzyme A desaturase activity of Mycobacterium phlei.

A particulate fraction prepared from Mycobacterium phlei grown in a metal-deficient medium exhibited a greatly reduced activity of stearoyl-CoA desaturase compared to that from normally grown cells. Metal deficiency, however, had no effect on the FAD-dependent NADPH-cytochrome C reductase activity, which has been suggested to participate in the desaturation process. When the cells were grown in the deficient medium supplemented with both Fe2+ and Mg2+, the desaturase activity was restored to the normal level. Supplementation with Mg2+ alone promoted growth but did not restore the desaturase activity, whereas Fe2+ alone did cause a significant restoration. Among the various metal ions tested, only Fe2+ and Fe3+ enhanced the formation of desaturase activity in the deficient medium. When added to the assay medium in vitro, Fe2+ and Fe3+ did not stimulate the desaturase activity of the particulate fraction from the deficient cells. Cultivation in the metal-deficient medium had essentially no effect on the levels of cytochromes in the particulate fraction, but dramatically decreased the non-heme iron content and the amount of a high-spin ferric species exhibiting an ESR signal at g=4.3. No labile sulfur could be detected in the normal or metal-deficient particulate fractions. It is concluded that the presence of iron ions in the culture medium is necessary for the synthesis and/or assembly of the terminal portion of the desaturase system.

Substrate specificity of endo-polyguluronide lyases from Pseudomonas sp. on the basis of their kinetic properties.

Two endo-alginate lyases [EC 4.2.2.3] differing in their mode of degradation of substrates and practically free of polymannuronide lyase activity were partially purified from Pseudomonas sp. cells. Their substrate specificities were investigated for two different kinds of alginate fragments; a polyguluronide (SG) and a polyuronide consisting of mannuronic (M) and guluronic (G) acid residues (SMG). The effects of various salts and some organic compounds such as EDTA and p-chloromercuribenzoate on the degradation of the two substrates were similar. High concentrations of the substrates similarly inhibited the action ofthe lyases, giving a bell-shaped plot. A polymannuronide alginate fragment (SM) which was a substrate for polymannuronide lyase but was not attacked by these guluronide lyases also inhibited the degradation of SG and SMG. The overall degradation velocities of a mixture of SG and SMG by both lyases coincided with those calculated from the Michaelis-Menten formula. Based on the above results, it was concluded that SG and SMG are attacked by the same endo-polyguluronide lyase.

Multiple components of endo-polyguluronide lyase of Pseudomonas sp.

A lyophilized alginate lyase preparation obtained from dialyzed extract of sonicated Pseudomonas sp. cells was fractionated by gell filtration on a Sephadex G-150 column, and three alginate lyase [EC4.2.2.3] fractions, peaks I, II, and III, were obtained. They were remarkably thermolabile. The lyase fractions degraded two kinds of alginate fragments, a polygluuronide (SG), and a polyuronide consisting of both mannuronic and guluronic acid residues (SMG), as well as commerical alginate, but were virtually inactive toward polymannuronide fragment (SM). The modes of degradation of these substrates by the lyase fractions were endowise with different degrees of randomness. Attack by the peak I fraction was more random than those by peaks II and III. The main lysis products formed from SG and SMG by these layses were identified as mixtures of unsaturated tri- and monouronides. The unsaturated triuronide from SG was deltatugg and SMG yielded a mixture of deltaUGG and a poorly characterized unsaturated trimer, possibly deltaUMG. However, the patterns of monomer and trimer production by theselyase fractions changed in different ways during incubation.

Fine structure of SMG alginate fragment in the light of its degradation by alginate lyases of Pseudomonas sp.

An alginate fragment named SMG, consisting of mannuronic (M) and guluronic acid residues (G)(DP=25), was prepared from the partial acid hydrolysate of a commercial alginate. Two subfractions, SMG-ppt (DP=52) and SMG-sup (DP=18) were obtained from SMG by fractionation with MgC12 and CaC12. The M/G ratios of these alginate fragment were 1.4-1.9. Their lysis products by a pseudomonad alginate lyase [EC 4.2.2.3] preparation were fractionated by gel filtration, giving similar patterns. The major products in their digests were unsaturated monouronides (53-50%) and triuronides (30-35%). The former was identified as a delta4,5-hexuronic acid (deltaU) and the latter was identified as a mixture of delta4,5-hexuronosyl-(1 leads to 4)-beta-D-mannuronosyl-(1 leads to 4)-L-guluronic acid (deltaUMG) and delta4,5-hexuronosyl-(1 leads to 4)-alpha-L-guluronosyl-(1 leads to 4))L-guluronic acid (deltaUGG). The two unsaturated triuronides were present in roughly equal amounts. The presence of 4-O-alpha-L-guluronosyl-L-guluronic acid (GG) and 4-O-beta-D-mannuronosyl-L-guluronic acid (MG) or 4-O-beta-L-guluronosyl-D-mannuronic acid (GM) was also demonstrated inthe digest. Moreover, indirect evidence suggested nonreducing terminal deltaU residue and free deltaU in the digest to be derived more from M than G of the original SMG. Thus, it was concluded that more than one-third of uronic acid residues of SMG molecules may be composed of almost equal amounts of MG and GG sequences, most of which may be connected by M to form MMG and MGG sequences, respectively.

Diaminodiphenylsulfone resistance of Mycobacterium leprae due to mutations in the dihydropteroate synthase gene.

The nucleotide sequence analysis of the dihydropteroate synthase (DHPS) gene of six diaminodiphenylsulfone-resistant Mycobacterium leprae strains revealed that the mutation was limited at highly conserved amino acid residues 53 or 55. Though the mutation at amino acid residue 55 or its homologous site has been reported in other bacteria, the mutation at residue 53 is the first case in bacteria. This is the first paper which links the mutations in DHPS and sulfonamide resistance in M. leprae. This finding is medically and socially relevant, since leprosy is still a big problem in certain regions.

A new method for measurement of surfactant specific apoprotein in amniotic fluid.

A simple and rapid method for the quantitative measurement of surfactant specific apoprotein concentration in amniotic fluid was developed using the measurement of immunological reactions by the nephelometric technique. Use of this method made it possible to measure 0.5-8.0 micrograms apoproteins per ml within approximately 70 min. Surfactant specific apoproteins in 54 samples of amniotic fluid were measured using the method. The surfactant specific apoprotein concentration in amniotic fluid increased from 1.03 +/- 0.51 micrograms/ml (mean +/- S.D.) at 26-30 weeks of gestation to 4.45 +/- 2.08 micrograms/ml at 36 weeks of gestation or more. Among premature infants, who were delivered within 24 h afer amniocentesis, surfactant specific apoprotein concentration was less than 1.5 micrograms/ml in three infants with respiratory distress syndrome (RDS), and more than 2.1 micrograms/ml in six without RDS. The results indicated that the quantitative measurement of surfactant specific apoprotein in amniotic fluid is effective in predicting the fetal lung maturity, and that simplicity and rapidity make our method useful for clinical application.

Detection of Mycobacterium leprae by Polymerase Chain Reaction.

The improved procedure based on Polymerase Chain Reaction (PCR) for detection of M. leprae has been developed. The sensitivity and specificity of this method were tested using different concentration of genomic DNA of M. leprae Thai 53 and genomic DNAs from mycobacterial species and related microorganisms respectively. Application of this method to biopsy samples obtained from Bangladesh was conducted and detected M. leprae DNA in 7 of the 10 clinical specimens. Acid fast bacilli were not detected in four of the seven positive cases under the microscopic observation. It was concluded that this method was sensitive and specific for detection of M. leprae in clinical specimens and also simple to detect in only one step of PCR.

[Rapid detection of acid-fast bacilli with Mycobacteria Growth Indicator Tube (MGIT)].

The BBL MGIT Mycobacteria Growth Indicator Tube is a novel broth based culture system for the detection of mycobacteria from clinical specimens. The tubes consist of a fluorescent indicator embedded in silicone on the bottom of a 16x100 mm round-bottom tube, filled with 4ml of an enriched BBL Middlebrook 7H9 broth base, with 0.25% glycerol. Actively growing mycobacteria consume the oxygen dissolved in the medium and fluorescence will occur when the tubes are observed with a 365nm transilluminator. The purpose of this study is to evaluate comparatively MGIT with 1% Ogawa egg medium by using two hundred and forty-five clinical specimens. The samples were digested, decontaminated and concentrated for culture using N-acetyl-L-cysteine-sodium hydroxide method. Fifty-nine of 245 (24%) clinical samples were culture positive for mycobacteria (43 M. tuberculosis complex, 12 M. avium complex and 4 other species) by one or both test systems. The MGIT detected 4 isolates of M. tuberculosis complex and 6 isolates of M. avium complex not recovered by the Ogawa egg medium, respectively. The mean time of detection of M. tuberculosis complex was 13 days (range: 2-26 days) and 19 days (range: 8-31 days) for MGIT and Ogawa egg medium, respectively, and that of M. avium complex was 5 days (range: 2-8 days) and 16 days (range: 6-22 days) for the MGIT and Ogawa egg medium, respectively. Overall, the MGIT is a sensitive culture system for the detection of mycobacteria from clinical specimens, is easy to use and may be applicable to clinical laboratories.

Comparison of two dentin adhesives to primary vs. permanent bovine dentin.

The purpose of this study was to compare the shear bond strengths of two adhesive systems to the primary and permanent dentin. Labial surfaces of extracted and frozen bovine mandibular primary incisors and permanent incisors were ground with #600 grit SiC paper to expose dentin. Bisco Dental Products All Bond 2 (Group AB2) or Sunmedical Co. Superbond D Liner (Group SDL) tooth surface conditioner and adhesive were applied and bonded with resin composite. A shear bond strength (SBS) test was performed and the data were analyzed by an ANOVA (P < 0.05). After the SBS test, the test surfaces of the dentin and the resin were observed using SEM. SBS on the primary dentin were significantly higher than those on the permanent dentin, both in the nonthermal cycled groups and the thermal cycled groups with the exception of the thermal cycled group of Group SDL. In the thermal cycled group of Group SDL, there was no significant difference between SBS on the primary dentin and SBS on the permanent dentin. Bond strengths on the primary dentin were found to be significantly higher than those on the permanent dentin, when using All Bond 2 or Superbond D Liner adhesive systems.

Comparison of polymerase chain reaction, immunohistochemistry and conventional histopathology in the diagnosis of early leprosy in Sichuan Province of China.

46 formalin-fixed, paraffin-embedded skin biopsy specimens, which were clinically suspected or diagnosed as early leprosy, were retrieved from the files of Sichuan, China from 1997 to 1999. All of them were examined by polymerase chain reaction (PCR) using the primers amplifying the 130 base-pair fragment of the gene from the 16S ribosomal RNA of Mycobacterium leprae, hematoxylin and eosin (H&E) staining, modified Fite-Faraco technique for M. leprae and immunostaining with the antiserum against the PGL-1, LAM-B, S-100 protein using ABC method. PCR was positive for 27 (58.7%) of 46 specimens. In 13 (28.3%) among them, only PCR signals were positive for M. leprae and all other test were negative. AFB was positive for 7 (15.2%) of 46, PGL-1 was positive for 17 (36.9%) of 46, LAM-B was positive for 10 (21.7%) of 46. Early epithelioid cells granuloma was detected in 4 (8.7%) patients (TT 3, BT 1), macrophage granuloma was detected in 1 (2.2%) patient (BL), S-100 protein staining showed early nerve granuloma for 4 (8.7%) of 46, peripheral nerve inflammatory infiltration for 11 (23.9%) of 46. Comparison PCR with other method showed statistically significant difference. PCR have an advantage over microscopic examination in detecting M. leprae in biopsy specimens negative for acid-fast bacilli.

Pathological investigation of armadillos infected with Mycobacterium leprae.

An infection experiment with M. leprae was carried out using 20 nine-banded armadillos. As a result, the development of leprous lesions and a marked multiplication of AFB were confirmed in a high rate of 13 out of 15 cases (86.8%) in the inoculated groups. These changes were found to be progressing at post mortem of one case even with the shortest life period for 7.5 months and were very serious in one case with the longest life period for 33 months, suggesting the continuation of symptoms, though it is an expression neglecting the individual difference in susceptibility to leprosy. Among infected viscera with AFB, the most conspicuous lesions were found in the liver and spleen. The developed lesions were found in the lung, stomach and kidney which had been never seen in HD in human cases, and so, which may characterize armadillos' leprosy. The change in the peripheral nerve was not so severe when compared with that in HD in human cases. This difference will remain as a future pathological problem to be solved.