Bioactivity-guided fractionation for anti-inflammatory and analgesic properties and constituents of Xanthium strumarium L

The aim of this study was to fractionate an extract of Xanthium strumarium L. (EXS) and to investigate the anti-inflammatory and analgesic properties of the extract and its fractions. The ethanol extract of X. strumarium (EXS) was fractionated on the basis of polarity. Among the different fractions, the n-butanol fraction showed the highest anti-inflammatory activity in the croton-oil-induced ear edema test and furthermore reduced the number of writhings induced by acetic acid in mice in a dose-dependent manner. This indicates that the n-butanol fraction of X. strumarium possesses potent analgesic effects which are likely to be mediated by its anti-inflammatory activity. Bioassay-guided fractionation of EXS led to the isolation and identification of ten caffeoylquinic acids and three heterocyclics by HPLC-DAD-MS(n) from the active n-butanol fraction, implying that the active compounds are polar in nature. The isolated caffeoylquinic acids could partially explain the antinociceptive effect of X. strumarium polar extract.

Elevated Bmi-1 expression is associated with dysplastic cell transformation during oral carcinogenesis and is required for cancer cell replication and survival

Bmi-1 is a polycomb group protein that was identified as c-myc cooperating oncogene in murine lymphomagenesis. The current study was undertaken to determine the role of Bmi-1 in human oral carcinogenesis. Bmi-1 protein and RNA expression levels were markedly enhanced in the cells of oral squamous cell carcinomas (OSCC) compared with that of normal human oral keratinocytes (NHOK). Enhanced-Bmi-1 expression was also detected in situ in the archived oral mucosal tissues with cancerous and precancerous histopathology, including that of mild epithelial dysplasia. Thus, Bmi-1 expression occurs at a very early stage in oral carcinogenesis. To determine the biological role of Bmi-1 in cell proliferation, endogenous Bmi-1 was knocked down in actively proliferating SCC4 cells and NHOK by RNA interference. After Bmi-1 knockdown, cell replication was severely retarded. However, the expression of p16^INK4A, a known cellular target of Bmi-1, was not changed in cells with or without Bmi-1 knockdown. Furthermore, Bmi-1 knockdown in HOK-16B-BaP-T cells, in which the p16^INK4A/pRb pathway was abrogated, led to immediate arrest of replication and loss of viable cells. Thus, our data suggest that Bmi-1 may act through p16^INK4A-independent pathways to regulate cellular proliferation during oral cancer progression.

Directing adenovirus across the blood–brain barrier via melanotransferrin (P97) transcytosis pathway in an in vitro model

Adenovirus serotype 5 (Ad5) is widely used in the development of gene therapy protocols. However, current gene therapy strategies involving brain are mostly based on intra-cranial injection. A major obstacle for systemically administered vectors to infect brain tissue is the blood-brain barrier (BBB). One strategy to cross the BBB is transcytosis, a transcellular transport process that shuttles a molecule from one side of the cell to the other side. Recently, melanotransferrin (MTf)/P97 was found to be able to cross the BBB and accumulate in brain. We thus hypothesize that re-directing Ad5 vectors to the MTf transcytosis pathway may facilitate Ad5 vectors to cross the BBB. To test this hypothesis, we constructed a bi-specific adaptor protein containing the extracellular domain of the coxsackie-adenovirus receptor (CAR) and the full-length melanotransferrin (sCAR-MTf), and investigated its ability to re-direct Ad5 vectors to the MTf transcytosis pathway. We found this adaptor protein could re-direct Ad5 to the MTf transcytosis pathway in an in vitro BBB model, and the transcytosed Ad5 viral particles retained their native infectivity. The sCAR-MTf-mediated Ad5 transcytosis was temperature- and dose dependent. In addition, we examined the directionality of sCAR-MTf-mediated Ad5 transcytosis, and found the efficiency of apical-to-basal transcytosis was much higher than that of basal-to-apical direction, supporting a role of this strategy in transporting Ad5 vectors towards the brain. Taken together, our study demonstrated that re-directing Ad5 to the MTf transcytosis pathway could facilitate gene delivery across the BBB.

Synthesis and biological evaluation of 1β-methylcarbapenems having cyclic thiourea moieties and their related compounds

The synthesis of a new series of 1beta-methylcarbapenems having cyclic thiourea moieties is described. Their in vitro antibacterial activities against both Gram-positive and Gram-negative bacteria were tested and the effect of substituent on the pyrrolidine ring was investigated. A particular compound (IIId) having piperazine thiourea moiety showed the most potent antibacterial activity.

Preimplantation genetic diagnosis and screening

Preimplantation genetic diagnosis (PGD) identifies genetic abnormalities in preimplantation embryos prior to embryo transfer. PGD is an exciting technology that may improve the likelihood of a successful pregnancy and birth for five distinct patient groups: (1) those with infertility related to recurrent miscarriages or unsuccessful in vitro fertilization (IVF) cycles, (2) those with unexplained infertility, (3) advanced maternal age, (4) severe male factor infertility, and (5) couples at risk for transmitting a hereditary disease to their offspring. PGD is always performed following an IVF cycle where multiple oocytes are retrieved and fertilized. Sophisticated techniques such as multiprobe, multicolor fluorescence in situ hybridization are used to test single cells for structural or numerical chromosome abnormalities, whereas the polymerase chain reaction, linkage analysis, and DNA sequencing are used to analyze single cells for disease-specific DNA mutations. PGD allows one to transfer only those embryos identified as being free of genetic abnormalities, thus potentially increasing the implantation rate and decreasing the miscarriage rate. These technologies identify embryos free of specific genetic abnormalities and may increase the likelihood of achieving the patient's goal: the birth of a healthy infant.

Differential regulation of ceramide in lipid-rich microdomains (rafts): Antagonistic role of palmitoyl:protein thioesterase and neutral sphingomyelinase 2

Cell differentiation and myelination involve a fine balance between stasis and programmed cell death, yet the genes that regulate this have not been clearly defined. We therefore studied two key gene products involved in oligodendrocyte plasma membrane lipid metabolism and their antagonistic role in ceramide-mediated cell death signaling. Overexpression of palmitoyl:protein thioesterase (PPT1; verified by Western blot of the V5-tagged protein and increased enzyme activity) resulted in decreased ceramide in the detergent-resistant microdomain (DRM, or raft) relative to cholesterol and sphingomyelin (SM). This PPT1 overexpression also resulted in protection against cell death induced by either staurosporine or C(2)-ceramide. In contrast, overexpression of neutral sphingomyelinase 2 (NSMase2; verified by Western blot of the FLAG-tagged protein and increased enzyme activity) resulted in increased membrane NSMase and increased ceramide in rafts relative to cholesterol and SM. The difference in SM and ceramide turnover was quantitated by [(3)H]palmitate pulse-chase labeling. Furthermore, when NBD-SM was added to cells, it was hydrolyzed by NSMase-transfected cells at more than twofold the rate in untransfected cells. NSMase2 overexpression enhanced cell death induced by staurosporine or C(2)-ceramide, in contrast to the protective effect of PPT1 overexpression. The presence of a fraction of both PPT1 and NSMase2 in rafts together with their substrates (palmitoylated proteins and SM, respectively) suggests a mechanism for dynamic palmitoylation/depalmitoylation of certain proteins in controlling cell death via NSMase activation.

Preclinical evaluation of a class of infectivity-enhanced adenoviral vectors in ovarian cancer gene therapy

Ovarian carcinoma cells are often infected inefficiently by adenoviruses (Ad) due to low expression of coxsackie-adenovirus receptors (CAR), hindering the application of adenovirus-mediated gene therapy in ovarian cancer. In this study, we explored a class of infectivity-enhanced Ad vectors, which contain CAR-independent targeting motifs RGD (Ad5.RGD), polylysine (Ad5.pK7), or both (Ad5.RGD.pK7), for their utility in ovarian cancer gene therapy using in vitro and in vivo model systems. We found that these vectors infected established ovarian carcinoma cell lines and primary ovarian cancer cells with significantly enhanced infectivity. Among them, Ad5.RGD.pK7 appeared to be most efficient. Further, we evaluated their gene delivery efficiency using two different ovarian cancer mouse models--subcutaneous and intraperitoneal human ovarian cancer xenografts. All of the modified vectors appeared to be more efficient than the unmodified Ad5 vector in both models, although some of the differences are not statistically significant. Of these, Ad5.RGD.pK7 exhibited the highest efficacy in the subcutaneous tumor model, while Ad5.pK7 worked most efficiently in the intraperitoneal tumor model. These preclinical results suggest that Ad5.RGD.pK7 and Ad5.pK7 may be very useful in ovarian cancer gene therapy.

Opioids in cancer and non-cancer pain management in Korea: the past, present and future

Opiate consumption in Korea has risen exponentially, mainly due to the improved awareness of patients as well as the medical community of the need for pain control. As education grows and the numbers of oncology patients increase, this trend is expected to continue in the area of cancer pain management. It will, however, take some time before it reaches further into the chronic non-cancer population. The current situation and problems of analgesic use in Korea are discussed in detail in this article. For the medical community, a lack of proper education appears to be the main issue. The stigma attached when using narcotic medication seems to be a psychological burden for patients. Bureaucracy in the legal and administrative systems hampers the adequate supply of drugs. The importance of proper education for everyone in these areas cannot be overemphasized. As many new health care systems are introduced in the future, change will be imposed upon the medical field.

Phenomenology of high-energy neutrinos in low-scale quantum-gravity models

We show that neutrino telescopes, optimized for detecting neutrinos of TeV to PeV energy, can reveal threshold effects associated with TeV-scale gravity. The signature is an increase with energy of the cross section beyond what is predicted by the standard model. The advantage of the method is that the neutrino cross section is measured in an energy region where (i) the models are characteristically distinguishable and (ii) the standard model neutrino cross section can be reliably calculated so that any deviation can be conclusively identified.

[The development of a full-automated blood coagulation analyzer]

This paper introduces the electronic principles and systematic construction functions of a full-automated blood coagulation analyzer, which can measure the blood coagulation rightly and effectively in the clinic. by using the scattered light turbidmetry. This analyzer overcomes some shortcomings existing in other analyzers such as high price, low resolution and no quality control function.

h --> mutau at Hadron colliders

We study the observability for a lepton flavor-changing decay of a Higgs boson h--> mutau at Hadron colliders. Flavor-changing couplings of a Higgs boson exist at tree level in models with multiple Higgs doublets. The hmutau coupling is particularly motivated by the favorable interpretation of nu(mu)-nu(tau) oscillation. We find that at the Tevatron run II the unique mutau signature could serve as the Higgs discovery channel, surpassing expectations for Higgs boson searches in the SM and in a large parameter region of the MSSM. The sensitivity will be greatly improved at the LHC, beyond the coverage at a muon collider Higgs factory.

Reduced cellular transport and activation of fluoropyrimidine nucleosides and resistance in human lymphocytic cell lines selected for arabinosylcytosine resistance

Arabinofuranosylcytosine (araC) resistant H9-araC0.05 and H9-araC0.5 sublines were obtained following in vitro exposure of H9 cells to 0. 05 and 0.5 microM araC, respectively. These cell lines were 83.3- and 266.7-fold, 21- and 80-fold, and 2.4- and 4.0-fold more resistant to 5-fluorouridine (FUR), 5-fluoro-2'-deoxyuridine (FdUR), and 5-fluorouracil (FU), respectively. Compared with H9 cells, the cellular accumulation of FUR was 2.2 and 0.2%, FdUR 15.6 and 0.9%, and FU 56.9 and 66.5% in H9-araC0.05 and H9-araC0.5 cells, respectively. An araC resistant HL60 cell line (promyelocytic cell line) was 5.0- and 1.7-fold resistant to FUR and FdUR, respectively, but displayed no resistance to FU. The lower FUR and FdUR nucleotide levels in the resistant cells were a result of reduced cellular transport and uridine kinase (UR kinase) and thymidine kinase (TK) activities. Compared with the parental cell line, the p-nitrobenzyl thioinosine (an inhibitor of nucleoside transport) binding sites also were lower in the araC resistant cells. There was no difference in the expression of multidrug-resistant protein and thymidylate synthase mRNA in the parental and the resistant cell lines. Data presented here suggest that araC exposure of H9 cells, in addition to araC resistance, induced/selected cells that were resistant to FUR and FdUR. These cells had altered cellular drug transport and lower TK and UR kinase activities. Further studies to understand molecular mechanisms of this phenomenon are warranted.

A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part IV: Comparisons of dietary intake

STATEMENT OF PROBLEM

It is unclear whether the replacement of conventional mandibular dentures with implant-supported overdentures alters the diet and thus improves the nutritional intake of edentulous persons.

PURPOSE

The purpose of this study was to compare the pretreatment and posttreatment diets of edentulous diabetic patients who received new dentures with either a conventional complete mandibular denture (CD) or a mandibular implant-supported overdenture (IOD).

MATERIAL AND METHODS

New dentures were made for 89 edentulous diabetic patients with acceptable metabolic control without insulin (NIT) or with insulin (IT). A randomized approach was used to assign 37 patients a mandibular CD and 52 patients a mandibular IOD supported by 2 cylindrical implants. Of the 89 patients, 58 submitted a dietary log for 7 consecutive days before treatment (PT) and 6 months after treatment completion (PTC). An average daily intake of 28 essential nutrients was determined for each patient at each time interval. Separate 2 x 2 x 2 repeated analysis of variance (ANOVA) tests were performed for each nutrient to compare the means of the 2 denture groups (CD and IOD), 2 diabetic groups (NIT and IT), and 2 time intervals (PT and PTC). The intakes were also compared with the recommended daily allowance (RDA).

RESULTS

ANOVAs for all 28 nutritional variables showed no main effect for either denture type or diabetic treatment. Time effects were seen for magnesium, potassium, copper, and monounsaturated fats. The PTC mean intake of the total sample (N = 58) decreased for all 3 minerals and increased for monounsaturated fats with study dentures. Post hoc tests showed the differences between PT and PTC means to be statistically significant for only magnesium (P=.043) and potassium (P=.015). The percentage of patients with PT intake 25% or more below the RDA ranged from 33% to 85% in the CD group and from 24% to 100% in the IOD group for the same 11 nutrients. PTC fiber intake deficiency was noted in almost all participants. Carbohydrate consumption was markedly lower than that recommended by the American Diabetic Association.

CONCLUSION

As is often the case with elderly groups, this group of edentulous diabetic patients showed highly comprised nutritional intakes of fiber, vitamins, and minerals. The replacement of old dentures with new dentures that included either a mandibular CD or IOD did not alter patient diets such that the patients improved their nutritional intakes of essential micronutrients and macronutrients.

Prevalence of HTLV-I-associated T-cell lymphoma

In order to assess the prevalence rate of HTLV-1-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials.

[CT guided percutaneous fine needle aspiration for early diagnosis of pancreatic infection after acute necrotizing pancreatitis]

OBJECTIVE

To assess CT-guided percutaneous fine needle aspiration (FNA) for early diagnosis of pancreatic infection after acute necrotizing pancreatitis.

METHODS

CT-guided percutaneous FNA was employed to diagnose pancreatic infection after acute necrotizing pancreatitis in 14 patients. The aspirates were smeared, cultured and subjected polymerase to chain reaction (PCR) for detecting bacteria.

RESULTS

Ten patients were diagnosed as having pancreatic infection and 4 non-pancreatic infection. FNA was totally performed for 15 times: left retroperitoneal route for 12 times, left and right retroperitoneal route for one time, and transperitoneal route for two times. The sensitivity of smear, PCR, culture to diagnose pancreatic infection was 7/10, 9/10, 10/10, respectively. Their specificity was 4/4, and the time for obtaining the results was 30 minutes, 4 hours, 3 days respectively.

CONCLUSIONS

Retroperitoneal approach can be used for most patients with acute necrotizing pancreatitis when performing CT guided-percutaneous FNA. PCR of aspirates is a rapid and accurate method to diagnose pancreatic infection.

[Detection of K-ras gene mutations in DNA extracted from the plasma of patients with pancreatic cancer]

OBJECTIVES

To detect mutations of the K-ras codon 12 in DNA extracted from the plasma of patients with pancreatic cancer, and to explore the possibility of using this method in early diagnosis of pancreatic cancer.

METHODS

Plasma DNA was isolated from the blood of 22 patients with pancreatic cancer and from 20 normal controls. K-ras codon 12 mutations were detected by mutant enriched polymerase chain reaction-restriction fragment length polymorphism technique and subsequent product sequencing. The relation of K-ras mutations in plasma to clinical features in pancreatic cancer patients was analyzed.

RESULTS

Seventeen (77.3%) of 22 patients with pancreatic cancer had a codon 12 K-ras mutation in their plasma DNA. In two patients, the PCR products were sequenced and the mutations were confirmed. The occurrence of K-ras mutations in the plasma DNA was not related to tumor location, tumor size, and TNM stage. No K-ras mutation was detected in the plasma specimen of any of the normal controls.

CONCLUSIONS

K-ras mutations are frequently found in the plasma DNA of patients with pancreatic cancer. Analysis of K-ras mutation in the plasma DNA may be useful in the early detection of pancreatic cancer.

Day 3 morphology is a poor predictor of blastocyst quality in extended culture

OBJECTIVE

To determine how the quality of blastocysts formed on day 5/6 of extended culture compares with their morphology on day 3.

DESIGN

Retrospective observational study of IVF laboratory records.

SETTING

Private assisted reproduction clinic.

PATIENT(S)

101 IVF cycles in which 5 to 25 embryos were produced. The average maternal age was 33.1 years.

INTERVENTION(S)

Embryos were individually cultured in vitro in sequential media for an extended time to enable use of blastocysts for fresh transfer or cryopreservation.

MAIN OUTCOME MEASURE(S)

Comparison of embryo quality for putative ET or cryopreservation on day 3 with quality of embryos used for actual ET and cryopreservation on day 5/6.

RESULT(S)

Of 1,263 cleaving embryos, 559 were judged to have been suitable for use on day 3; 355 would have been used for ET (average per ET, 3.5) and 204 would have been frozen (equivalent to 44% utilization). In actuality, 471 blastocysts were used on day 5/6, of which 234 were transferred (average per ET, 2.3), and 237 were frozen (equivalent to 37% utilization). Only 48% embryos that would have been chosen for ET and/or cryopreservation on day 3 were eventually used in such a manner at the blastocyst stage. Historically, the rate of viable pregnancy from day 3 transfers was 30.5% per transfer; this rate increased to 45% with routine day 5/6 transfers.

CONCLUSION(S)

Extended culture of human embryos seems to increase discrimination of potential embryonic viability. Criteria for embryo selection on day 3 seem to be inadequate. Extended in vitro culture may therefore be an effective means of optimizing IVF clinical success.

Dietary olive oil enhances murine lymphocyte calcium uptake

BACKGROUND

Dietary lipids enhance immune function and improve outcome from injury or infection in animal models. We tested the hypothesis that amount, type, or both, of dietary lipid increases intracellular calcium concentration, a surrogate for lymphocyte activation.

METHODS

Mice were fed 2 weeks on semipurified diets with 5% (by weight [w/w]), 10% (w/w), or 20% (w/w) dietary fat consisting of coconut, olive, safflower, or linseed oil. Changes in intracellular calcium concentration after mitogen stimulation of splenic lymphocytes was estimated by using flow cytometry.

RESULTS

Olive oil diets increase intracellular calcium concentration after concanavalin A, lipopolysaccharide, and CD3 stimulation. On the other hand, linseed oil (which is high in omega-3 fatty acids, which have been shown in other studies to enhance immune function) depresses intracellular calcium levels. The amount of dietary fat had no effect on intracellular calcium.

CONCLUSION

Olive oil merits further study in the application of nutritional pharmacology to immunomodulation of the critically injured, because it may enhance lymphocyte function.

The effects of plasma fentanyl concentrations on propofol requirement, emergence from anesthesia, and postoperative analgesia in propofol-nitrous oxide anesthesia

To determine the effects of plasma fentanyl concentrations on intraoperative propofol requirements, emergence from anesthesia, and relief of postoperative pain, we studied 60 ASA physical status I and II patients undergoing spine fusion. The patients were randomly assigned to four study groups according to the expected intraoperative plasma fentanyl concentrations. Group I received an infusion of saline, and Groups II, III, and IV received fentanyl infusions to maintain the blood levels at 1.5, 3.0, and 4.5 ng/mL, respectively. An infusion rate of propofol was adjusted to keep the mean arterial pressure within 15% of the control value. Inspired nitrous oxide concentrations were maintained at 67%. The following were investigated in each group: 1) an average propofol infusion rate, 2) time to spontaneous eye opening and recovery of orientation (name, date, and place), and 3) total dose of fentanyl used for 24 h after admission to the postanesthetic care unit. Average propofol infusion rates were 10.1 +/- 2.5 (mean +/- SD), 7.5 +/- 1.2, 5.7 +/- 1.1, and 4.9 +/- 1.2 mg. kg(-1). h(-1), in Groups I, II, III, and IV, respectively. Groups receiving fentanyl infusion had significantly smaller infusion rates of propofol (P < 0.01) than the group receiving saline. Among the three fentanyl infusion groups, Group II (P < 0.01) had more than Groups III and IV. The time to spontaneous eye opening and the recovery of orientation were directly related to plasma fentanyl concentrations. The plasma fentanyl levels between Groups III and IV were the same. The total amount of IV patient-controlled analgesia fentanyl during postoperative 24 h increased significantly when the order of plasma fentanyl concentrations was reversed, 913.1 +/- 58.4, 553.4 +/- 129, 222.7 +/- 73.4, and 135.1 +/- 69.5 microg in Groups I, II, III, and IV, respectively. These results suggest that the addition of fentanyl infusions had ceiling effects that reduce the intraoperative propofol requirements according to the plasma fentanyl concentrations. The ceiling effect was demonstrated in the recovery of consciousness but not in the fentanyl requirements for postoperative analgesia.

IMPLICATIONS

The addition of fentanyl, a potent opioid, reduced the intraoperative requirement of propofol, an IV anesthetic, in the order of the plasma fentanyl concentrations. The ceiling effects of fentanyl were demonstrated in the reduction of propofol requirements and recovery of consciousness but not in the fentanyl requirements for postoperative analgesia.

Apolipoprotein B-100 gene Xba I polymorphism and cholesterol gallstone disease

The apolipoprotein (apo) B gene Xba I polymorphism is associated with alterations in serum lipids. Disturbances in serum lipids may be a risk factor for cholesterol gallstone disease. However, the relation between the Xba I polymorphism and cholesterol gallstones is unknown. This study was aimed at characterizing the polymorphism of the apo B gene Xba I in patients with gallbladder stones and the association of Xba I polymorphism with serum lipids. Xba I genotypes were measured by PCR-RFLP, and serum lipids assayed in 190 patients with gallbladder stones and 441 control subjects. The frequency of the X+/- genotype (20.63 vs. 7.94%) and X+ allele (10.79 vs. 3.97%) was significantly higher in the patient group than in the control group. Patients with the X+/- genotype had a significantly higher concentration of total cholesterol, low-density lipoprotein (LDL)-cholesterol, and apo B in serum than patients with the X-/- genotype. The X+ allele of the apo B gene is characterized by a higher cholesterol concentration and a higher LDL-cholesterol concentration in serum, and it may be a marker for increased risk of cholesterol gallstone disease.