[Advances in functional assessment and bowel rehabilitation following intersphincteric resection for low rectal cancer]

Intersphincteric resection (ISR) has been performed as an ultimate sphincter-sparing strategy in selected patients with low rectal cancer. Accumulating evidence suggests that ISR may be an interesting alternative to abdominoperineal resection to avoid a permanent stoma without compromising oncological outcomes. However, bowel dysfunction is a most common consequence of ISR not to be neglected. To date, limited clinical research has reported functional and quality of life outcomes according to patient-reported outcome measures. Also, data concerning management of low anterior resection syndrome are scarce due to lack of quality evidence. Therefore, this review provides an up-to-date summary of systematic assessment (including function, quality of life, manometry and morphology) and bowel rehabilitation for ISR patients. Postoperative anal function is often assessed by a combination of scales, including the Incontinence Assessment Scale, the Gastrointestinal Function Questionnaire, the Specific LARS Assessment Scale and the Faecal Diary. The condition-specific Quality of Life Scale is more appropriate for Quality-of-life measures in fecal incontinence after ISR. Patients' physiological function after ISR can be assessed using water- or high-resolution solid-state anorectal manometry. Anatomical and morphological changes can be assessed using defecography and 3D endorectal ultrasound. Electrical stimulation and biofeedback, pelvic floor exercises, rectal balloon training, transanal irrigation and sacral neuromodulation are all options for post-operative rehabilitation.

A new dimeric (-)-5-methylmellein from cultures of the basidiomycete Inonotus sinensis

(-)-5-Methylmellein (1) and its new dimer (2) were isolated from cultures of the basidiomycete Inonotus sinensis. Their structures were elucidated on the basis of extensive spectroscopic methods including UV, IR, HR-EI-MS, 1D NMR and 2D NMR. The structure of Compound 2 was determined by single-crystal X-ray crystallographic analysis. Compound 2 was tested for the cytotoxicities against five human cancer cell lines.

Two new sesquiterpenes from cultures of the fungus Irpex lacteus

Two new tremulane-type sesquiterpenes, irlactin L (1) and irlactin M (2) were isolated from cultures of the fungus Irpex lacteus, together with one known compound, 6-hydroxy-2,6-dimethyloct-7-enoic acid (3). Their structures were elucidated by spectroscopic data analysis. Compounds 1-2 were tested for their cytotoxicities against five human cancer cell lines and for their inhibitory activities against isozymes of 11β-hydroxysteroid dehydrogenases (11β-HSD).[Formula: see text].

Two new compounds from cultures of the basidiomycete Daedaleopsis tricolor

Two new compounds, daedatrin K (1) and 2-hydroxy-1-(5-(hydroxymethyl)furan-2-yl)propan-1-one (2), were isolated from cultures of the basidiomycetes Daedaleopsis tricolor. The new structures were elucidated on the basis of extensive spectroscopic methods. At the same time, two compounds were tested for their cytotoxicities against five human cancer cell lines. [Formula: see text].

Phenylspirodrimane Derivatives From Cultures of the Fungus Stachybotrys chartarum YIM DT 10079

A new phenylspirodrimane derivative, stachartin F (1), and 2 known secondary metabolites stachybonoid E (2) and stachybonoid F (3) were isolated from cultures of the tin mine tailings-associated fungus Stachybotrys chartarum YIM DT 10079. Their structures were determined with the help of extensive spectroscopic analyses and absolute configuration of compound 1 was rationalized by quantum chemical calculations of the electronic circular dichroism spectra.

[Risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection for low rectal cancer]

Objective: To evaluate the risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection (Lap-ISR) for patients with low rectal cancer. Methods: A retrospective case-control study was performed to collect clinicopathological data from a prospective database (registration number: ChiCTR-ONC-15007506) at the Department of Colorectal Surgery, the Characteristic Medical center of PLA Rocket Force. From June 2011 to August 2018, a total of 144 consecutive patients with low rectal cancer who underwent Lap-ISR were enrolled in the study. Inclusion criteria: (1) reconstruction of digestive tract by end-to-end hand-made coloanal anastomosis (HCAA); (2) distance from lower tumor margin to anorected sphincter ring < 1 cm and distance from lower tumor margin to intersphincteric groove ≥ 1 cm; (3) T1-3 stage tumor with expected negative circumferential resection margin evaluated by preoperative MRI or 3D endoanal ultrasound; (4) rectal cancer confirmed as well- or moderately-differentiated adenocarcinoma; (5) preoperative Wexner incontinence score >10 points. Exclusion criteria: (1) follow-up period less than 3 months; (2) multiple primary cancers; (3) undergoing colonic J-pouch, coloplasty or reconstruction of end-to-side coloanal anastomosis; (4) death within perioperative period (within 3 months after surgery). Coloanal anastomotic stricture was diagnosed if the index finger or 12 mm electronic colonoscope had obvious resistance through the anastomosis or new rectum, or could not pass, accompanied by clinical symptoms such as difficult defecation and anal incontinence. Degree of anastomotic stricture was divided into 3 grades: grade A required anal enlargement, laxative or enema to assist defecation without active surgical treatment; grade B required surgery or endoscopic intervention; grade C required definitive ostomy, including unreducible preventive ileostomy or permanent colostomy. Univariate and multivariate analysis were used to evaluate the effects of 28 variables, including baseline data (age, gender, body mass index, neoadjuvant therapy, etc.), tumor-related factors (distance between tumor low margin and anal edge, maximum diameter of tumor, TNM staging, etc.), surgery-related factors (operation time, intraoperative blood loss, ISR procedure, anastomotic height, etc.) and anastomotic leakage, on the postoperative coloanal anastomotic stricture. Univariate analysis used χ(2) test or Fisher's exact test, then factors with P<0.05 were further included in multivariate analysis using logistic regression. Results: A total of 144 patients were enrolled in the study, including 90 males and 54 females with a median age of 59 years and median BMI of 24.88 kg/m(2). R0 resection rate was 96.5% (139/144). Median tumor distal resection margin was 1.5 (0.5 to 3.0) cm. Median follow-up was 31.5 (4 to 86) months. Coloanal anastomotic stricture was observed in 19 patients (13.2%), including 3 cases (2.1%) of grade A, 9 cases (6.2%) of grade B, and 7 cases (4.9%) of grade C. The median interval from the initial surgery to diagnosis of anastomotic stricture was 7 (1 to 31) months. Univariate analysis showed that male (χ(2)=6.795, P=0.009), radiotherapy (χ(2)=13.330, P=0.001), operation type of ISR (χ(2)=7.996, P=0.013), and anastomotic leakage (χ(2)=10.198, P=0.004) were associated with the postoperative coloanal anastomotic stricture. Multivariate analysis further indicated that male (OR=5.975, 95% CI: 1.209-29.534, P=0.028), postoperative radiotherapy (OR=8.748, 95% CI: 2.397-31.929, P=0.001), and anastomotic leakage (OR=6.313, 95% CI: 1.834-21.734, P=0.003) were independent risk factor of postoperative coloanal anastomotic stricture. Conclusion: For male patients, or patients with postoperative radiotherapy or anastomotic leakage, close follow-up should be carried out to prevent postoperative coloanal anastomotic stricture following Lap-ISR.

[Expand pedicle forehead flap in the repair of whole nasal defect]

Objective:To observed the application of expanded pedicle forehead flap in nasal defect. Method:Totally 11 whole nasal defect cases in our department from June 2010 to March 2016 were treated with the expanded pedicle forehead flap. Regular follow-up was performed after operation to observe the survival condition of flaps, shape, color, texture and scar in donor site after nasal repair. Result:The expanded pedicle forehead flap and transplantation of autologous costal cartilage nasal stents were all survived, the reconstruction nasal shape was satisfied. After 1-5 years follow up, the repair using expanded forehead flap had a good color with enough blood supply, and the nasal ventilation function is well. There was only one linear scar leaved in donor site. Conclusion:Application of the expanded pedicle forehead flap is a good mothed for the treatment of whole nasal defect.

A new tremulane sesquiterpenoid from the fungus Irpex lacteus

A new tremulane sesquiterpenoid, named irlactam A (1), was isolated from cultures of the fungus Irpex lacteus. The new structure was elucidated by spectroscopic data analysis. The compound was tested for its cytotoxicities on HL-60, SMMC-7721, A-549, MCF-7, and SW480 cells and for its inhibitory activity against isozymes of 11 β-hydroxysteroid dehydrogenases (11 β-HSD).

A new cyclohexenone from the tin mine tailings-derived fungus Aspergillus flavus YIM DT 10012

A new cyclohexenone, named phomaligol D (1), together with two known compounds, kojic acid (2) and phomaligol A (3) were isolated from the tin mine tailings-derived fungus Aspergillus flavus YIM DT 10012. Their structures were elucidated by detailed analysis of spectroscopic data.

Tremulane sesquiterpenes from cultures of the basidiomycete Irpex lacteus

Five new tremulane sesquiterpenes, named irlactins F-J (1-5), were isolated from cultures of the basidiomycete Irpex lacteus together with two known analogues (6 and 7). Structures and relative configurations of compounds 1-5 were elucidated by spectroscopic data analysis. Compund 4 exhibited moderate cytotoxicities on HL-60, SMMC-7721, A-549, MCF-7, and SW480 cells with IC₅₀ values of 16.23, 20.40, 25.55, 19.05, and 18.58μM, respectively.

A new cyclic dipeptide from cultures of Coprinus plicatilis

Three cyclic dipeptides (1-3), including one new compound (1) were isolated from cultures of the basidiomycetes Coprinus plicatilis. Their structures were elucidated by spectroscopic methods, including extensive 2D NMR techniques. At the same time, all compounds were tested for their cytotoxicities against five human cancer cell lines.

Three new drimane sesquiterpenoids from cultures of the fungus Penicillium sp

Three new drimane sesquiterpenoids, 12-hydroxyalbrassitriol (1), drim-8(12)-en-6β,7α, 9α,11-tetraol (2), and drim-68(12)-dien-9α,11-diol (3), along with one known analog albrassitriol (4), were isolated from cultures of the tin mine tailings-associated fungus Penicillium sp. The new structures were determined on the basis of extensive spectroscopic analyses. All compounds were tested for their cytotoxicities against five human cancer cell lines.

[Distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015: results from a multicenter, retrospective study]

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions: Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

[The expression of serum hepatocyte growth factor in OSAHS]

Objective:To investigate the clinical significance of detecting peripheral blood hepatocyte growth factor（HGF） in OSAHS patients.Method:Ninety-six cases of OSAHS patients in our hospital were selected as OSAHS group,and were divided into 3 subgroups according to the PSG results：mild,medium and severe. Each group included 32 cases,Thirty-five cases of healthy persons were selected as control group. ELISA method was utilized to detect the HGF level of peripheral blood. HGF concentration was measured in 32 patients with severe OSAHS after 3 months of comprehensive treatment. The relationship between serum HGF and sleep respiration events was further analyzed.Result: The HGF concentration of peripheral blood increased with the severity of OSAHS.The serum levels of HGF in the control,mild,medium and severe group were（487.75±46.74）pg/ml，（519.44±50.77）pg/ml，（753.52±58.91） pg/ml and（829.49±61.74）pg/ml,respectively. There were significant differences among groups（F=117．733,P<0.01). HGF concentration in peripheral blood of OSAHS patients was unrelated to sex,age,and BMI（P>0.05）,and positively correlated with AHI,negatively correlated with LSaO₂（P<0.01）. After comprehensive treatment,the serum HGF concentration and AHI in severe OSAHS group were significantly decreased,while LSaO₂ was significantly increased.Conclusion:The level of HGF was increased in OSAHS patients and was positively correlated with the severity of OSAHS. Determining the level of HGF in peripheral blood is important for evaluating the severity of OSAHS and the degree of vascular endothelial dysfunction,and assessing the risk of cardiovascular disease.

Two new sesquiterpenoids from cultures of the basidiomycete Tremella foliacea

Two new sesquiterpenoids, trefoliol B (1) and trefoliol C (2), together with known echinocidin A (3), were isolated from cultures of the basidiomycetes Tremella foliacea. The new structures were elucidated on the basis of extensive spectroscopic methods. At the same time, trefoliol B (1) and echinocidin A (3) were tested for their cytotoxicities against five human cancer cell lines and for their inhibitory activities against isozymes of 11β-hydroxysteroid dehydrogenases (11β-HSD). No compound showed significant activity (IC50 > 40 μM). Compound 1 showed moderate inhibitory activities against 11β-HSD1 (human IC50 = 13.1 μM; mouse IC50 = 91.8 μM).

Chemical constituents from cultures of the basidiomycete Trichaptum pargamenum

Four cadinane-type sesquiterpenes and four 13-carbon γ-lactones, together with three known compounds, were isolated from cultures of the basidiomycete Trichaptum pargamenum. Their structures were elucidated on the basis of extensive spectroscopic methods. The absolute configurations of two of the cadinene type sesquiterpenes 1 and 3 were confirmed by single crystal X-ray diffractions.

Three new compounds from the cultures of basidiomycete Boreostereum vibrans

Three new compounds, vibranether (1), myrrhlalkyldiol (2), vibralactone H (3), together with three known compounds, 2-methyl-6-p-tolylheptane-2,3-diol (4), 2-hydroxy-2-methyl-6-p-tolylheptan-3-one (5), and vibralactone (6), were isolated from the cultures of the basidiomycete Boreostereum vibrans. Their structures were determined on the basis of spectroscopic evidences (1D and 2D NMR, HRMS, UV, and IR data), chemical methods, and the literature data. The new compounds displayed no significant cytotoxicities against five human cancer cell lines (IC50>40 μM).

Two new drimane sesquiterpenoids from cultures of the basidiomycete Trichaptum biforme

Two new drimane sesquiterpenoids (1 and 2), as well as five known compounds (3–7), were isolated from the basidiomycete Trichaptum biforme. The structures of new compounds were elucidated by extensive spectroscopic methods, and the known compounds were identified by comparing their spectroscopic data with those reported in the literature. The cytotoxicities results against five human cancer cell lines of compounds 1 and 2 were negligible.

Four new sesquiterpenoids from cultures of the fungus Funalia trogii

Four new drimane sesquiterpenoids, named as funatrols A-D, together with isodrimenediol, were isolated from cultures of the fungus Funalia trogii. The new structures were elucidated by means of spectroscopic methods. All compounds were tested for their cytotoxicities against five human cancer cell lines.

Five new 5,6-seco-tremulane sesquiterpenoids from the basidiomycete Conocybe siliginea

Five new 5,6-seco-tremulane sesquiterpenoids (1–5), as well as three known analogues (6–8), were isolated from the basidiomycete Conocybe siliginea. The structures of new compounds were elucidated by extensive spectroscopic methods. The known compounds were identified by comparing their spectroscopic data with those reported in the literature.

Three new phenyl-ethanediols from the fruiting bodies of the mushroom Fomes fomentarius

Three new phenyl-ethanediols, (1R)-(3-ethenylphenyl)-1,2-ethanediol (1), (1R)-(3-formylphenyl)-1,2-ethanediol (2), and (1R)-(3-acetophenyl)-1,2-ethanediol (3), were isolated from the fruiting bodies of the mushroom Fomes fomentarius, together with two related known compounds, (3-ethylphenyl)-1,2-ethanediol (4) and (4-acetophenyl)-1,2-ethanediol (5). Their structures were elucidated by spectroscopic methods including extensive 2D NMR techniques. Compounds 1-3 showed weak antimicrobial activity.

Two new sesquiterpenes from cultures of the basidiomycete Agaricus arvensis

Two new drimane sesquiterpenoids, 11,12-dihydroxy-15-drimeneoic acid (1) and 3α,11,15-trihydroxydrimene (2), were isolated from cultures of the basidiomycete Agaricus arvensis, together with one known compound 3β,11,12-trihydroxydrimene (3). Their structures were established by means of spectroscopic analysis.

Cerebellar ataxia with elevated cerebrospinal free sialic acid (CAFSA)

In order to identify new metabolic abnormalities in patients with complex neurodegenerative disorders of unknown aetiology, we performed high resolution in vitro proton nuclear magnetic resonance spectroscopy on patient cerebrospinal fluid (CSF) samples. We identified five adult patients, including two sisters, with significantly elevated free sialic acid in the CSF compared to both the cohort of patients with diseases of unknown aetiology (n = 144; P < 0.001) and a control group of patients with well-defined diseases (n = 91; P < 0.001). All five patients displayed cerebellar ataxia, with peripheral neuropathy and cognitive decline or noteworthy behavioural changes. Cerebral MRI showed mild to moderate cerebellar atrophy (5/5) as well as white matter abnormalities in the cerebellum including the peridentate region (4/5), and at the periventricular level (3/5). Two-dimensional gel analyses revealed significant hyposialylation of transferrin in CSF of all patients compared to age-matched controls (P < 0.001)--a finding not present in the CSF of patients with Salla disease, the most common free sialic acid storage disorder. Free sialic acid content was normal in patients' urine and cultured fibroblasts as were plasma glycosylation patterns of transferrin. Analysis of the ganglioside profile in peripheral nerve biopsies of two out of five patients was also normal. Sequencing of four candidate genes in the free sialic acid biosynthetic pathway did not reveal any mutation. We therefore identified a new free sialic acid syndrome in which cerebellar ataxia is the leading symptom. The term CAFSA is suggested (cerebellar ataxia with free sialic acid).

Dietary protective and risk factors for esophageal and stomach cancers in a low-epidemic area for stomach cancer in Jiangsu Province, China: comparison with those in a high-epidemic area

Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area.

Carnitine/acylcarnitine translocase deficiency (neonatal phenotype): successful prenatal and postmortem diagnosis associated with a novel mutation in a single family

The neonatal phenotype of carnitine-acylcarnitine translocase (CACT) deficiency is one of the most severe and usually lethal mitochondrial fat oxidation disorders characterized by hypoketotic hypoglycemia, hyperammonemia, cardiac abnormalities, and early death. In this study, the proband was the daughter of consanguineous Hispanic parents. At 36 h of life, she had bradycardia and died at 4 days of age without a specific diagnosis. In a subsequent pregnancy, prenatal counseling and amniocentesis were provided. Incubation of the amniocytes from this pregnancy and fibroblasts (from the dead proband) with [16-(2)H(3)]palmitic acid and analysis by tandem mass spectrometry revealed an increasedconcentration of [16-(2)H(3)]palmitoylcarnitine, suggesting the diagnoses of either CACT or carnitine palmitoyltransferase II (CPT-II) deficiency. CACT enzyme activity was absent in both cell lines. Molecular investigation of cDNA from the dead proband and her affected sibling revealed aberrant CACT cDNA species, including exon 3 skipping, both exon 3 and 4 skipping, and a 13-bp insertion at cDNA position 388. Investigation of these cell lines for mutations affecting CACT RNA processing by analysis of CACT gene sequences, including intron and exon boundaries, revealed a single nucleotide G deletion at the donor site in intron 3 which resulted in exon skipping and a 13-bp insertion. The proband and her affected sibling were homozygous for this deletion.

SC35 plays a role in T cell development and alternative splicing of CD45

Molecular diversity via alternative splicing is important for cellular function and development. SR proteins are strong candidate regulators of alternative splicing because they can modulate splice site selection. However, endogenous substrates for SR proteins are largely unknown, and their roles as splicing regulators in vertebrate development are unclear. Here we report that Cre-mediated conditional deletion of the prototypical SR protein SC35 in the thymus causes a defect in T cell maturation. Deletion of SC35 alters alternative splicing of CD45, a receptor tyrosine phosphatase known to be regulated by differential splicing during thymocyte development and activation. This study establishes a model to address the function of SR proteins in physiological settings and reveals a critical role of SC35 in a T cell-specific regulated splicing pathway.

Identification of a novel mutation in patients with medium-chain acyl-CoA dehydrogenase deficiency

A novel mutation was identified in two unrelated patients with medium-chain acyl-CoA dehydrogenase deficiency. First, a 19-year-old Caucasian female presented with a devastating illness, resulting in sudden death in adulthood which is unusual. The second patient, now a 3.5-year-old male, presented at 17 months of age with a hypoglycemic seizure and dehydration. Sequence analysis revealed a novel mutation G617T in exon 8 resulting in an arginine to leucine substitution at codon 206 (R206L). Both patients were compound heterozygous for this G617T and the common mutation A985G.

Comparative study of lifestyles of residents in high and low risk areas for gastric cancer in Jiangsu Province, China; with special reference to allium vegetables

There is a low risk area for gastric cancer in Jiangsu Province, China, where people frequently consume raw allium vegetables. As a first step epidemiological study to clarify the factors involved in the low incidence of gastric cancer, we conducted a comparative study of the ecological factors in a high risk area (HRA), Yangzhong, and a low risk area (LRA), Pizhou, using a questionnaire. Subjects were selected from the general population according to age and sex, and comprised 414 residents of the HRA and 425 residents of the LRA. Ecological factors were compared for the two areas by Cochran-Mantel-Haenszel method, age-adjusted. Smoking and drinking habits were found to be more common in the LRA. On the other hand, allium vegetables were consumed in the LRA much more frequently, with high consumption of raw vegetables fruit, tomatoes, kidney beans and soybean products. People who consumed garlic en masse 3 times or more per week were 82% of men and 75% of women in the LRA, and 1% of men and women in the HRA. The results of the survey suggest that frequent consumption of allium vegetables, in addition to other anticancer foods, may be a factor in low mortality for gastric cancer.

Identification of two novel mutations in the hypoglycemic phenotype of very long chain acyl-CoA dehydrogenase deficiency

Very long chain acyl-CoA dehydrogenase (VLCAD) catalyzes the initial step of long chain fatty acid oxidation in the mitochondria. Patients with VLCAD deficiency have recently been observed with two clinical phenotypes. The cardiac form presents with an early onset cardiomyopathy and a high incidence of infant death, while the hypoglycemic form resembles medium chain acyl-CoA dehydrogenase (MCAD) manifesting with hypoketotic hypoglycemia. In our investigation on the molecular basis for these phenotypes, we identified two novel mutations in one VLCAD patient with the hypoglycemic form, a C953T (Pro318Leu) mutation in exon 10 resulting in a substitution of proline 318 by leucine on one allele, and a C1194A (Tyr398Stop) mutation in exon 12 which created a premature stop codon TAA on another allele. The Tyr398Stop mutation may result in a truncated protein or instable messenger RNA.

Protective effect of allium vegetables against both esophageal and stomach cancer: a simultaneous case-referent study of a high-epidemic area in Jiangsu Province, China

To study the relation between allium vegetable intake and cancer of the esophagus (EC) and stomach (SC) in Yangzhong city, which is one of the highest-risk areas for these cancers in Jiangsu province, China, a simultaneous case-referent study was conducted using histopathologically confirmed cases (EC: n = 81, SC: n = 153) and population-based referents (n = 234). A questionnaire was used to collect information on the general status of subjects, their dietary habits, frequency intake of allium vegetables and other foods, tea consumption, smoking and alcohol drinking. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a multiple logistic regression model. The results showed that frequent intake of allium vegetables (including garlic, onion, Welsh onion and Chinese chives), raw vegetables, tomatoes and snap beans, and tea consumption were inversely associated with the risk for EC and SC. In the highest consumption category (> or = 1 time/week) of garlic, onion, Welsh onion and Chinese chives, the adjusted ORs compared with the lowest category (< 1 time/month) were 0.30 (CI = 0.19-0.47), 0.25 (CI = 0.11-0.54), 0.15 (CI = 0.08-0.26), and 0.57 (CI = 0.23-1.42) for EC, and 0.31 (CI = 0.22-0.44), 0.17 (CI = 0.08-0.36), 0.22 (CI = 0.15-0.31) and 0.40 (CI = 0.17-0.94) for SC, respectively. The main results in the present study suggested that allium vegetables, like raw vegetables, may have an important protecting effect against not only stomach cancer, but also esophageal cancer.

Identification of four novel mutations in patients with carnitine palmitoyltransferase II (CPT II) deficiency

Carnitine palmitoyltransferase II (CPT II) deficiency, an autosomal recessive disorder of fatty-acid oxidation, presents as three distinct phenotypes (neonatal, infantile, and adult onset). In order to investigate the molecular basis of these three phenotypes, six patients with CPT II deficiency have been studied. All six unrelated patients in this study experienced the clinical symptoms of CPT II deficiency. Three patients had the neonatal form, one had the milder infantile form, and the remaining two had the adult-onset form with "muscular" symptoms only. Their diagnoses were based upon in vitro analysis of the mitochondrial beta-oxidation pathway in fibroblasts and standard enzyme assays. We devised a method to screen the entire coding sequence and flanking splice junction of the CPT II gene. A total of six different mutations have been identified, including four novel mutations. Among them, the previously reported common mutation, S113L, was only found in 3 of 12 variant alleles. Three of the six mutations have been identified in a few unrelated patients, while the remaining three have been found in single families. This study, as well as those by others, indicates genetic heterogeneity in this disease. In addition to tabulating the mutations, the correlation of mutant genotype to clinical phenotype is briefly discussed.

A novel mutation identified in carnitine palmitoyltransferase II deficiency

Carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal recessive disorder of mitochondrial fatty-acid oxidation which presents as three distinct phenotypes (neonatal, infantile, and adult onset). CPT II exons from an adult-onset CPT II-deficient patient were amplified and directly sequenced to further investigate the molecular basis of this disorder. A novel mutation, C471T, in exon 4 of the carnitine palmitoyltransferase II gene was found which created a stop codon, TGA, at residue 124 of the protein (R124Stop). This mutation would result in severe protein truncation. This unique mutation was found on one allele while the S113L mutation, previously reported, was present on the other allele.

Generalized glycogen storage and cardiomegaly in a knockout mouse model of Pompe disease

Glycogen storage disease type II (GSDII; Pompe disease), caused by inherited deficiency of acid alpha-glucosidase, is a lysosomal disorder affecting heart and skeletal muscles. A mouse model of this disease was obtained by targeted disruption of the murine acid alpha-glucosidase gene (Gaa) in embryonic stem cells. Homozygous knockout mice (Gaa -/-) lack Gaa mRNA and have a virtually complete acid alpha-glucosidase deficiency. Glycogen-containing lysosomes are detected soon after birth in liver, heart and skeletal muscle cells. By 13 weeks of age, large focal deposits of glycogen have formed. Vacuolar spaces stain positive for acid phosphatase as a sign of lysosomal pathology. Both male and female knockout mice are fertile and can be intercrossed to produce progeny. The first born knockout mice are at present 9 months old. Overt clinical symptoms are still absent, but the heart is typically enlarged and the electrocardiogram is abnormal. The mouse model will help greatly to understand the pathogenic mechanism of GSDII and is a valuable instrument to explore the efficacy of different therapeutic interventions.

Potential misconceptions in dopamine transporter assays arising from the binding of [125I]RTI-121 to filters: effect of ions and cocaine

Binding of the cocaine analog 3 beta-(4-[125I]iodophenyl)tropane-2 beta-carboxylic acid isopropyl ester ([125I]RTI-121) to filters was studied in order to assess its contribution to labeling dopamine transporters on rat striatal synaptosomal membranes in filtration assays. Filter binding (FB) decreased with increasing Na+. Cocaine (30 and 100 microM) substantially reduced the FB at low Na+ with much less of an effect at higher Na+. Similar results were observed with K+. At 10 mM Na+, RTI-121 (1 microM) displaced the FB to the same degree as cocaine (100 microM); mazindol (10 microM), BTCP (1 microM), and dopamine (1 mM) did so to a lesser degree; and GBR12935 (1 microM) did not. If the specific binding was calculated without deducting the FB displaced with cocaine (DFB), the DFB accounted for 15-19% of the 'specific binding' at 10 mM Na+ in the assay. This additional binding population resulted in an upward curvilinear Scatchard plot and incorrect estimation of equilibrium binding parameters and ion potencies. At 10 mM Na+, without deduction of DFB, the high-affinity component had a Kd of 3.4 nM and Bmax of 2.4 pmol/mg protein, and the respective values for the low-affinity component were 84 nM and 16 pmol/mg protein; when DFB was deducted, one component was observed with a Kd of 4.4 nM and Bmax of 3.3 pmol/mg protein. The presence of higher Na+ in the assay diminished these artifacts. Thus, at 150 mM Na+, without deduction of DFB, there was one binding component with a Kd of 3.9 nM and Bmax of 4.6 pmol/mg protein; these values became 3.3 nM and 3.8 pmol/mg protein when DFB was deducted.

Modeling of the interaction of Na+ and K+ with the binding of the cocaine analogue 3beta-(4-[125I]iodophenyl)tropane-2beta-carboxylic acid isopropyl ester to the dopamine transporter

The present study examines the interaction of Na+ and K+ with the binding of the cocaine analogue 3beta-(4-[125I]iodophenyl)tropane-2beta-carboxylic acid isopropyl ester to dopamine transporters (DATs) in rat striatal synaptosomal membranes at 37 degrees C. The binding increases with [Na+] from 10 to 100 mM and decreases with higher [Na+]. The presence of K+ reduces the maximal stimulatory effect of Na+ and causes a nonlinear EC50 shift for Na+. K+ strongly inhibits the binding at low [Na+]. Increasing [Na+] produces a linear IC50 shift for K+. Saturation analysis indicates a single binding site changing its affinity for the radioligand depending on [K+]/[Na+] ratio in the assay buffer. A reduced Bmax was observed in the presence of 10 mM Na+ and 30 mM K+. Both high [Na+] and high [K+] accelerate the dissociation of the binding, and K+-induced acceleration was abolished by increasing [Na+]. Least squares model fitting of equilibrium data and kinetic analysis of dissociation rates reveal competitive interactions between Na+ and K+ at two sites allosterically linked on the DAT: One site mediates the stimulatory effect of Na+, and the other site involves the radioligand binding and the inhibitory effect of cations on the binding. Various uptake blockers and substrates, dopamine in particular, display reduced potency in inhibiting the binding at a higher [K+]/[Na+] ratio.

Characterization of [125I]RTI-121 binding to dopamine transporter in vitro

AIM

To characterize the binding of [125I]3 beta-(4-iodophenyl) tropane-2 beta-carboxylic acid isopropyl ester (RTI-121) to the dopamine transporter (DAT) under physiologically relevant conditions.

METHODS

[125I]RTI-121 was used to label the DAT on fresh rat striatum synaptosomal membranes in artificial cerebrospinal fluid (ACSF) at 37 degrees C.

RESULTS

[125I]RTI-121 binding reached equilibrium within 3 min and remained at its plateau value for at least 9 min. The data from kinetic, saturation, and competition studies supported a one-site model for the binding of [125I]RTI-121 to the DAT. Various DAT blockers (oocaine, GBR12935, and BTCP) and substrates (dopamine and d-amphetamine) competitively inhibited the binding of [125I]RTI-121. Compared with NaPhos-KCl-NaCl assay buffer, ACSF containing Ca2+ and Mg2+ markedly increased the IC50 of DAT blockers for inhibiting [125I]RTI-121 binding with less effect on that of substrates. Various D2 receptor ligands (pergolide, quinirole, sulpiride, and l-stepholidine) had no direct effect on the binding of [125I]RTI-121.

CONCLUSION

[125I]RTI-121 binding under physiologically relevant conditions fulfills the basic criteria for DAT binding assay.

Improved detection of the G1528C mutation in LCHAD deficiency

Long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency, an autosomal recessive disorder of fatty-acid oxidation, is clinically characterized by skeletal myopathy, Reye-like syndrome, or sudden unexplained infant death. A common mutation, G1528C, has recently been reported. To avoid nonspecific amplification from a "pseudogene" and potential complications, we have developed a nested PCR/PstI digestion method. Here, we report mutation studies in 11 additional unrelated patients with LCHAD deficiency. Genomic DNA fragments (117 bp) were amplified by the nested PCR, digested with PstI, and subjected to electrophoresis on 12% polyacrylamide gel. Four patients were found to be homozygous for the G1528C mutation; 7 patients were compound heterozygous, indicating significant genetic heterogeneity. The G1528C mutation has been found on at least one allele in all patients with isolated LCHAD deficiency, suggesting that it is an excellent marker for this disease. This DNA test combined with tandem mass-spectrometric in vitro probe analysis easily identifies affected individuals and carriers in families which are compound heterozygous for G1528C.

Prenatal diagnosis of mitochondrial fatty acid oxidation defects

Amniocytes isolated from two pregnancies at risk for fatty acid oxidation defects were incubated with stable isotopically labelled palmitate, in the presence of L-carnitine, to probe that pathway. The labelled acylcarnitines were then quantitated using tandem mass spectrometry. Amniocytes from a pregnancy at risk for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency produced a characteristic acylcarnitine profile with increased levels of octanoylcarnitine and decanoylcarnitine, indicative of MCAD deficiency. DNA analysis confirmed that the fetus was homozygous for the MCAD A985G mutation. Acylcarnitine and DNA analysis of the infant's blood obtained post-partum confirmed MCAD deficiency. Amniocytes from a pregnancy at risk for an unspecified fat oxidation defect produced increased levels of long-chain acylcarnitines consistent with a deficiency in very-long-chain acyl-CoA dehydrogenase (VLCAD). Measurements of the enzymatic activity confirmed VLCAD deficiency in amniocytes. Acylcarnitine profiles of the infant's blood obtained post-partum in addition to enzyme activities measured in fibroblasts confirmed VLCAD deficiency. The successful prenatal diagnosis of VLCAD and MCAD deficiencies using in vitro probes of fatty acid oxidation in fibroblasts suggests that this approach can potentially recognize many mitochondrial fatty acid oxidation defects even if no prior diagnosis is determined in the family at risk.