Species identification of mycobacteria by PCR-restriction fragment length polymorphism of the rpoB gene

PCR-restriction fragment length polymorphism analysis (PRA) using the novel region of the rpoB gene was developed for rapid and precise identification of mycobacteria to the species level. A total of 50 mycobacterial reference strains and 3 related bacterial strains were used to amplify the 360-bp region of rpoB, and the amplified DNAs were subsequently digested with restriction enzymes such as MspI and HaeIII. The results from this study clearly show that most of the mycobacterial species were easily differentiated at the species level by this PRA method. In addition, species with several subtypes, such as Mycobacterium gordonae, M. kansasii, M. celatum, and M. fortuitum, were also differentiated by this PRA method. Subsequently, an algorithm was constructed based on the results, and a blinded test was carried out with more than 260 clinical isolates that had been identified on the basis of conventional tests. Comparison of these two sets of results clearly indicates that this new PRA method based on the rpoB gene is more simple, more rapid, and more accurate than conventional procedures for differentiating mycobacterial species.

Trends in the prevalence of infection with mycobacterium tuberculosis in Korea from 1965 to 1995: an analysis of seven surveys by mixture models

SETTING

Korea.

OBJECTIVE

Estimation of the prevalence of tuberculous infection from tuberculin skin test surveys can be difficult if cross-reactions resulting from infection with environmental mycobacteria outweigh reactions resulting from tuberculous infection. Mixture analysis was thus chosen as a novel approach for estimating the prevalence of tuberculous infection in Korea.

DESIGN

Seven tuberculin skin test surveys conducted between 1965 and 1995 were analyzed by mixture models, a statistical methodology used either to estimate a prevalence or to classify individuals into predefined homogeneous sub-populations. A Bayesian approach including prior information on component distributions was taken. The final model was selected based on the fit to observed values, and the analysis was therefore stratified by sex and year of survey and included age as a covariate.

RESULTS

The results showed a large decrease in tuberculous infection in the population below 30 years of age: among 10- to 14-year-old boys (girls), infection prevalence decreased from 74.5% (67.9%) in 1965 to 16.5% (16.9%) in 1995. Additionally, the mean induration for individuals with tuberculous infection decreased by 2mm between 1965 and 1995, indicating a changing sensitivity of tuberculin over time.

CONCLUSIONS

Mixture analysis is a promising approach for determining the prevalence of tuberculous infection in the presence of substantial interference from infection with environmental mycobacteria and changing tuberculin reaction sizes over time.

Voltage-dependent K(+) currents in spiral prominence epithelial cells of rat cochlea

It has been suggested that spiral prominence is associated with ion transport, but the characterization of ion channels has not been explored so far. We studied the electrical properties and ion conductances of the spiral prominence epithelial cells (SPECs), which are epithelial cells covering the luminal side of spiral prominence, in the upper turn of neonatal rat cochlea using a whole-cell variant patch clamp technique. The cell capacitance was 16.3+/-2.1 pF (n=33) and the resting membrane potential was -68. 9+/-2.5 mV (n=14) in perilymph-like bath solution. It was found that those SPECs possess a large voltage-activated, outwardly rectifying K(+) current and a small inwardly rectifying K(+) current. The outward K(+) current was activated by depolarizing pulses more positive than -30 mV, and sensitive to tetraethylammonium chloride (20 mM), 4-aminopyridine (10 mM), but not to Ba(2+) (0.5 mM). Tail current analysis revealed that it was primarily K(+)-selective. The time course of activation was well fitted by an exponential function raised to second power. The small inwardly rectifying K(+) current was sensitive to Ba(2+) (0.5 mM), and the Ba(2+)-sensitive current was K(+)-selective. In cell-attached or inside-out patch recordings, no discernible K(+) channel currents were found in the apical membrane of SPECs. Based on these results, we conclude that SPECs have two types of voltage-dependent K(+) currents, which are most likely located in the basolateral membrane.

A micromachined silicon depth probe for multichannel neural recording

A process of making a new type of silicon depth-probe microelectrode array is described using a combination of plasma and wet etch. The plasma etch, which is done using a low temperature oxide (LTO) mask, enables probe thickness to be controlled over a range from 5 to 90 mu. Bending tests show that the probe's mechanical strength depends largely on shank thickness. More force can be applied to thicker shanks while thinner shanks are more flexible. One can then choose a thickness and corresponding mechanical strength using the process developed. The entire probe shaping process is performed only at low temperature, and thus is consistent with the standard CMOS fabrication. Using the probe in recording from rat's somatosensory cortex, we obtained four channel simultaneous recordings which showed clear independence among channels with a signal-to-noise ratio performance comparable with that obtained using other devices.

Descending facilitatory modulation of a behavioral nociceptive response by stimulation in the adult rat anterior cingulate cortex

It is well documented that the descending endogenous analgesia system, including the periaqueductal gray (PAG) and the rostral ventral medulla (RVM), play an important role in modulation of nociceptive transmission and morphine- and cannabinoid-produced analgesia. Neurons in the PAG receive inputs from different nuclei of higher structures, including the anterior cingulate cortex (ACC). However, it is unclear if stimulation of neurons in the ACC modulates spinal nociceptive transmission. The present study has examined the effects of electrical stimulation and chemical activation of metabotropic glutamate receptors (mGluRs) in the ACC on a spinal nociceptive tail-flick (TF) reflex induced by noxious heating. Activation of the ACC at high intensities (up to 500 microA) of electrical stimulation did not produce any antinociceptive effect. Instead, at most sites within the ACC (n = 36 of 41 sites), electrical stimulation produced significant facilitation of the TF reflex (i.e. decreases in TF latency). Chemical activation of mGluRs within the ACC also produced a facilitatory effect. Descending facilitation from the ACC apparently relays at the RVM. Electrical stimulation in the RVM produces a biphasic modulatory effect, showing facilitation at low intensities and inhibition at higher intensities. The present study provides evidence that activation of mGluRs within the ACC can facilitate spinal nociception.

The role of RhoA in the germinal vesicle breakdown of mouse oocytes

We have investigated a new role of RhoA in the germinal vesicle breakdown (GVBD) of mouse oocytes. First, RhoA was identified by immunostaining and ADP-ribosylation in germinal vesicle (GV) stage-oocytes. RhoA was mainly localized in the ooplasmic area, but rarely detected in germinal vesicle. Incubation of oocyte extract with C3 transferase induced a strong ADP-ribosylation at about 25 kDa. Incubation of GV-stage oocytes in culture medium induced the spontaneous maturation to GVBD by about 78 and 87% of total oocytes at 1 and 3 h, respectively. However, microinjection of C3 transferase into GV-stage oocytes significantly inhibited GVBD at 1 (GVBD = 29%) and 3 h (GVBD = 49%). To study the role of reactive oxygen species (ROS) in the oocyte maturation, the level of intra-oocyte ROS was measured using a ROS-specific fluorescent dye H(2)DCFDA during the oocyte maturation. Spontaneous maturation of GV-stage oocytes induced a significant increase of ROS at 3 h by about twofold over the control level and then the increased level was maintained until 6 h. However, microinjection of C3 transferase inhibited the production of intra-oocyte ROS. Incubation with ROS scavengers, N-acetyl-l-cysteine and catalase, blocked the ROS increase. The ROS scavengers also significantly inhibited GVBD, as did C3 transferase. Thus, it was proposed that RhoA was involved in the GVBD, possibly by the production of ROS in mouse oocytes.

Transcriptional induction of Nur77 by indomethacin that results in apoptosis of colon cancer cells

Non-steroidal anti-inflammatory drugs (NSAIDs) have cancer preventive and tumor regressive effects in the human colon, perhaps due to their capability to induce apoptosis of the colon cancer cells. Here, we report that indomethacin induced the expression of Nur77 which has been implicated in activation-induced apoptosis of T-lymphocytes, in a colon cancer cell line, HCT-15. The transcript- and protein-level, the transcriptional activity of Nur77 promoter, and the DNA binding of Nur77 were significantly induced following indomethacin treatment. Among the two potential trans-acting factors that activate Nur77-promoter, indomethacin induced DNA binding and reporter gene activity of AP-1, but not that of related serum response factor (RSRF), suggesting that the transcriptional induction of Nur77 may be mediated through activation of AP-I. Further, we showed that all trans-RA repressed the induction of Nur77 as well as the apoptosis-induced by indomethacin, providing evidence that transcriptional induction of Nur77 may be an important mechanism by which indomethacin induces apoptosis in colon cancer cells.

Noise characteristic design of CMOS source follower and voltage amplifier for active semiconductor micro-electrodes for neural signal recording

A noise performance design method for the pre-amplifiers of an active neural probe is given. The on-chip circuitry of the active neural probe consists of CMOS devices that show high-/low-frequency noise, so that the device noise can become dominant. Analysis of the signal-to-device-noise ratio (SDNR) for the CMOS source follower buffer and two-stage differential voltage amplifier is given. Closed-form expressions for the output noise power are derived and exploited to tailor the parameters that are controllable during circuit design. The output SDNR is calculated considering the real extracellular action potentials, the electrode-electrolyte interface and the noise spectrum of CMOS devices from typical foundries. It is shown that the output device noise power can be much higher than the output signal power if the devices at the input stage of the pre-amplifier are made as small as given fabrication technology permits. Quantitative information of the circuit parameters to achieve an SDNR higher than 5 for neural spikes with 60 microV amplitude are provided for both pre-amplifier types.

Polyphasic assignment of an aromatic-degrading Pseudomonas sp., strain DJ77, in the genus Sphingomonas as Sphingomonas chungbukensis sp. nov

Pseudomonas sp. strain DJ77, which was described as an aromatic-degrading bacterium, was investigated to clarify its taxonomic position. Phylogenetic analysis based on 16S rDNA sequences indicated that the strain belonged to the genus Sphingomonas and formed a monophyletic clade with the type strains of Sphingomonas chlorophenolica, Sphingomonas herbicidovorans and Sphingomonas yanoikuyae with sequence similarity values of 98.1, 96.1 and 95.6%, respectively. Genomic relatedness based on DNA-DNA hybridization of strain DJ77 to these strains is 7-14%. Strain DJ77 contained ubiquinone 10 as the main respiratory quinone, and the G+C content of DNA was 63 mol%. The organism contained octadecenoic acid (67%) as major cellular fatty acid. Strain DJ77 can be readily differentiated from representative members of the genus Sphingomonas using a battery of biochemical tests. On the basis of polyphasic evidence, it is proposed that strain DJ77, previously known as Pseudomonas sp., be reclassified in the genus Sphingomonas as Sphingomonas chungbukensis sp. nov. The type strain is strain DJ77T (= KCTC 2955T = IMSNU 11152T).

Heavy contamination of a subsurface aquifer and a stream by livestock wastewater in a stock farming area, Wonju, Korea

A survey of groundwater and stream water quality was undertaken in a stock farming area where livestock wastewater infiltrates into sandy unsaturated zones and saturated bedrock aquifers containing fractures. To determine the degree of contamination and track the effect of livestock wastewater on groundwater and stream water quality, the population of indicator bacteria (total coliforms, fecal coliforms, fecal streptococci, Staphylococcus spp., and sulfite-reducing clostridia) together with relevant physicochemical parameters were monitored along the wastewater flow-pathways over a 19-month period. The stream water was severely contaminated with livestock wastewater. Nearly all physicochemical and bacteriological parameters in the stream water were much greater than those in the groundwater. Nitrate-N concentrations ranged from 10.0 to 20.0 mg l(-1) in boreholes located downstream (site C) from the livestock waste disposal site, while those in the background borehole (W2) were below 1.0 mg l(-1). Densities of indicator bacteria in boreholes at site C were two or three orders of magnitude higher than those in W2 borehole. In boreholes located downstream from the livestock waste disposal site, the concentration of ammonium-N, nitrate-N, and pollution indicator bacteria increased as groundwater level rose due to infiltration of rainwater. In W2 borehole, however, physicochemical parameters and the number of pollution indicator bacteria had no correlation with the groundwater level. Collectively, these results suggest that the deep aquifers were heavily contaminated with infiltrated livestock wastewater, which consequently must be adequately treated to minimize groundwater pollution.

Endoscopic carpal tunnel release in patients receiving long-term hemodialysis

This study evaluated the clinical results of endoscopic carpal tunnel release in carpal tunnel syndrome caused by long-term hemodialysis and compared the results with that of idiopathic carpal tunnel syndrome. Operations were done in 32 patients (60 hands) with idiopathic carpal tunnel syndrome and in eight patients (15 hands) with carpal tunnel syndrome resulting from long-term hemodialysis. There was no significant difference in findings of preoperative evaluations and postoperative clinical results between the two groups, except for a difference with the patient satisfaction score with surgery on a visual analogue scale. The mean satisfaction score was 9.0 at 6 months, 9.3 at 1 year, and 9.5 at the 2-year followup in the group of patients with idiopathic carpal tunnel syndrome. However, in the group of patients with carpal tunnel syndrome resulting from long-term hemodialysis, the mean satisfaction score was 8.5 at 6 months, 8.2 at 1 year, and 6.5 at the 2-year followup. The score began to decrease at an average of 17.2 months after surgery. Long-term hemodialysis related carpal tunnel syndrome showed satisfactory short-term clinical results until approximately 1.5 years after the operation. After that time, the symptoms tended to deteriorate in 50% of the patients who received hemodialysis continuously.

The ethanol-soluble part of a hot-water extract from Artemisia iwayomogi inhibits liver fibrosis induced by carbon tetrachloride in rats

This study was carried out to investigate the protective effects of the hot-water extract from Artemisia iwayomogi (Compositae) on carbon tetrachloride-induced liver fibrosis in rats. Liver injury was induced by oral administration of carbon tetrachloride (1 mL kg(-1)) twice a week during 4 weeks of A. iwayomogi treatment. Extracts from A. iwayomogi were prepared and administered to rats orally (2 g kg(-1) as A. iwayomogi for 4 weeks) as follows: group 1, hot-water extract; group 2, ethanol-soluble part of hot-water extract; group 3, ethanol-insoluble part of hot-water extract; and group 4, methanol extract. In rats treated with the ethanol-soluble part of the hot-water extract, liver hydroxyproline content was reduced to 74% that of carbon tetrachloride control rats (P < 0.05). Protein expression of alpha smooth muscle cell like actin was also decreased in rats treated with the ethanol-soluble part of the hot-water extract, which indicates inhibition of hepatic stellate cell activation. Liver malondialdehyde levels were significantly lowered in rats treated with the ethanol-soluble part of hot-water extract (P < 0.05). Serum cholesterol levels in rats treated with hot-water extract, ethanol-soluble or -insoluble parts of hot-water extract or methanol extract were significantly reduced when compared with those of carbon tetrachloride control rats (P < 0.05). The ethanol-soluble part of the hot-water extract from A. iwayomogi inhibited fibrosis and lipid peroxidation in rats with liver fibrosis induced by carbon tetrachloride. Both hot-water extract (either ethanol-soluble or -insoluble) and methanol extract of A. iwayomogi also lowered serum cholesterol levels in fibrotic rats.

Radiographic knee dimensions in discoid lateral meniscus: comparison with normal control

We reviewed the knee radiographs of 68 cases of arthroscopically proven discoid lateral meniscus, including 42 cases of complete type and 26 cases of incomplete type discoid lateral meniscus. Knee radiographs of 70 cases that had no arthroscopic evidence of pathology of the meniscus were used as controls. We excluded patients who had significant trauma history and who were under 16 years of age or over 60 years to avoid measuring radiographs of skeletally immature or degenerative knees. The absolute values and relative normalized values of specific knee dimensions, such as a squared-off appearance of the lateral femoral condyle, widened femorotibial joint space, cupping of the lateral tibial plateau, obliquity of the lateral tibial plateau articular surface, high fibular head, and hypoplasia of the lateral intercondylar spine, were compared between the patients with discoid lateral meniscus and the normal controls. Among those dimensions, high fibular head and widened lateral tibiofemoral joint space showed statistically significant differences between the discoid lateral meniscus group and normal control group. We suggest that these findings would be useful in screening lateral discoid meniscus on plain radiography.

Sequence analysis of the hemagglutinin gene of H9N2 Korean avian influenza viruses and assessment of the pathogenic potential of isolate MS96

Sequence analysis of the hemagglutinin (HA) gene of five Korean H9N2 avian influenza virus (AIV) isolates showed that these viruses were closely related and possibly came from the same source. Phylogenetic analysis of the HA1 subunit of H9 subtype isolates revealed that Korean AIV isolates were different from isolates from the poultry markets in Hong Kong in 1997. None of the Korean AIVs had multiple basic amino acids at the HA cleavage site that confer high pathogenicity to some H5 and H7 AIVs. Phylogenetic analysis of the nucleoprotein and matrix gene demonstrated that Korean isolates cluster with Eurasian origin AIVs. The pathogenic potential of one of the isolates (MS96) was assessed after several passages in 14-day-old embryonated chicken eggs (ECE). Fourteen-day-old ECE derivatives of MS96 showed increased HA titer and embryo mortality in eggs; this was apparent after the third passage in 14-day-old ECE. Sequence analysis of the cleavage site of MS96 after the third and tenth passages in 14-day-old ECE revealed no changes in the amino acid sequence. The pathogenicity of MS96 after the tenth passage in 14-day-old eggs (MS96p10(ECE14)) was tested with 4-wk-old specific-pathogen-free chickens. The 14-day-old derivative, MS96p10(ECE14), showed wider tissue tropism and induced more severe clinical signs than the parent virus. Furthermore, after intranasal inoculation of 86-wk-old broiler breeders and 30-wk-old layers, the MS96p10(ECE14) derivative induced more severe signs of depression than the parent virus as well as a transient drop in egg production.

Nitric oxide, an important regulator of perfusion-contraction matching in conscious pigs

We examined whether nitric oxide (NO) inhibition during moderate reduction in coronary blood flow (CBF) would affect perfusion-contraction matching. Coronary stenosis (CS) was induced in conscious pigs, which resulted in a stable 39 +/- 1% reduction in CBF for 1.5 h. Ischemic zone wall thickening (IZWT) decreased by an average of 56 +/- 2% during CS from 2.7 +/- 0.2 mm. After reperfusion, myocardial stunning was observed, but this recovered without evidence of necrosis. After recovery and subsequent administration of systemic NO synthase inhibition (N(omega)-nitro-L-arginine, 25 mg. kg(-1). day(-1) x 3 days), CS for 1.5 h reduced CBF similarly but decreased IZWT significantly more, P < 0.05, by 89 +/- 5%. Myocardial stunning, i.e., the decrease in IZWT at 12 h post-CS, was more severe (-65 +/- 5% vs. -21 +/- 3%), P < 0.05. Furthermore, CS during NO synthase inhibition resulted in multifocal subendocardial areas of necrosis in the area at risk. These data suggest that in the intact, conscious pig, NO inhibition prevents perfusion-contraction matching, resulting in intensification of post-ischemic stunning and development of subendocardial necrosis.

Differentiation of Borrelia burgdorferi sensu lato on the basis of RNA polymerase gene (rpoB) sequences

We determined the nucleotide sequences (329 bp) of the rpoB DNAs from 22 reference strains of Borrelia. No insertions or deletions were observed. Deduced amino acid sequences of amplified rpoB DNA comprised 109 amino acid residues (N(450) to M(558) [Escherichia coli numbering]). All amino acid sequences were identical with the exception of those of Borrelia lusitaniae PotiB2 (T(461)-->A) and B. bissettii DN127 (I(498)-->V). Each species of B. burgdorferi sensu lato was differentiated as a distinct entity in the phylogenetic tree constructed by a neighbor-joining method. B. burgdorferi sensu lato could be distinguished from B. turicatae and B. hermsii, which are associated with relapsing fever. Seventeen Korean isolates could be identified by PCR-linked direct sequencing and restriction analysis of the rpoB DNA. These results suggest that rpoB DNA is useful for identification and characterization of Borrelia. In addition, we developed the rapid species identification method using the species-specific primer sets based on rpoB gene sequences.

3'UTR polymorphisms in the NRAMP1 gene are associated with susceptibility to tuberculosis in Koreans

SETTING

Korea University and the Korean Institute of Tuberculosis, Seoul, Korea.

OBJECTIVE

To determine whether polymorphisms in the 3' untranslated region (UTR) of the NRAMP1 gene are associated with susceptibility to tuberculosis in Koreans.

DESIGN

A case-control study design was used to compare the frequency of 3'UTR of NRAMP1 among 192 tuberculosis patients and 192 healthy individuals. All of the samples were diagnosed by X-ray, smear and culture tests between 1998 and 1999 in the Cross of Lorraine Clinic at the Korean Institute of Tuberculosis.

RESULTS

A significant association was found between the Korean tuberculosis patients and polymorphisms in the 3'UTR of the NRAMP1 gene (odds ratio [OR] 1.845; 95% confidence interval [CI] 1.097-3.104; chi2 = 5.424; P = 0.020).

CONCLUSION

This study showed that genetic variations in the human NRAMP1 gene are associated with susceptibility to smear-positive tuberculosis in Korean patients. The 3'UTR variant allele associated with susceptibility to tuberculosis is very uncommon in Caucasians, but is present in Koreans and West Africans. These observations may explain in part why African Americans and Koreans have greater susceptibility to tuberculosis than Caucasians.

Production of biologically active human granulocyte colony stimulating factor in the milk of transgenic goat

We have developed a transgenic female goat harboring goat beta-casein promoter/human granulocyte colony stimulating factor (G-CSF) fusion gene by microinjection into fertilized one-cell goat zygotes. Human G-CSF was produced at levels of up to 50 microg/ml in transgenic goat milk. Its biological activity was equivalent to recombinant human G-CSF expressed from Chinese hamster ovary (CHO) cell when assayed using in vitro HL-60 cell proliferation. Human G-CSF from transgenic goat milk increased the total number of white blood cells in C57BL/6N mice with leucopenia induced by cyclophosphamide (CPA). The secreted human G-CSF was glycosylated although the degree of O-glycosylation was lower compared to CHO cell-derived human G-CSF.

Deletion polymorphism in the coding region of the human NESP55 alternative transcript of GNAS1

NESP55, a novel member of the chromogranins, was originally implicated as a precursor of a peptide LSAL with 5-HT1B receptor antagonist activity. In humans, NESP55 (MIM 139320) is encoded by an alternative transcript of GNAS1, the gene encoding the guanine nucleotide-binding alpha subunit of G(S). As a result of the potential relevance of NESP55 to serotoninergic neurotransmission, we screened its sequence using genomic DNA pools from autistic disorder, obsessive-compulsive disorder (OCD) probands and control subjects. Six single nucleotide polymorphisms (SNPs) were identified and the allele frequencies of those SNPs were determined. In addition, a 24-bp in-frame deletion in the coding region was found in one of the OCD probands. To further investigate its pattern of inheritance and the relevance to studied phenotypes, we genotyped 123 total subjects from autism, OCD and attention deficit hyperactivity disorder (ADHD) families. The deletion was detected only in one OCD family and followed Mendelian inheritance. All subjects with the deletion were heterozygous. However, there are no specific behavioural or physical alterations in the subjects with this deletion variant. The physiological role of NESP55 in serotoninergic neurotransmission as well as the effect of the deletion on its function should be evaluated in future studies.

Serum ferritin in healthy subjects and type 2 diabetic patients

In order to study the relationship between the serum ferritin level and the components of the insulin resistance syndrome in type 2 diabetic patients, we evaluated fifty type 2 diabetic patients who were selected according to NDDG/WHO criteria from those patients attending Korea University Hospital from 1997 to 1998. Twenty-five healthy non-diabetic subjects of comparable age and sex distribution acted as a control group. The results showed that the value of log ferritin was higher in the type 2 diabetes patients than the control subjects, but not at a statistically significant level (p = 0.09). Log ferritin was correlated with fasting blood sugar level (r = 0.235, p = 0.048) and body mass index (BMI) (r = 0.285, p = 0.05). In the type 2 diabetic patients, log ferritin was correlated with fasting C-peptide (r = 0.478, p = 0.009). In the control subjects, log ferritin was correlated only with BMI (r = 0.477, p = 0.012). In a stepwise multiple regression analysis, the diabetic group showed a significant correlation between fasting C-peptide and log ferritin (p = 0.001). In the control group, the fasting sugar level was significantly correlated with log ferritin (p = 0.034). These results suggest that serum ferritin can be employed as a marker of not only glucose homeostasis but also insulin resistance both in type 2 diabetic and control subjects.

Transcriptional inactivation of the tissue inhibitor of metalloproteinase-3 gene by dna hypermethylation of the 5'-CpG island in human gastric cancer cell lines

The tissue inhibitor of metalloproteinase-3 (TIMP-3), a recently cloned member of TIMP gene family, has been implicated in the negative regulation of tumor cell invasion and tumor growth. Down-regulation of this gene has been shown to occur in a mouse carcinogenesis model, suggesting that it might play a role in the tumor progression of some cancers. In this study, we used human gastric cancer cell lines to investigate whether TIMP-3 gene expression is suppressed in human gastric cancer. We examined whether aberrant DNA methylation of the 5'-CpG island of the TIMP-3 gene is involved in this cancer. Nine of 10 human gastric cancer cell lines completely lost TIMP-3 gene expression compared with normal samples. Southern blot analysis and bisulfite genomic sequencing revealed aberrant hypermethylation near the transcription-start site of the TIMP-3 gene in all cell lines lacking TIMP-3 expression. Treatment of these cell lines with the demethylating agent 5-aza-2'-deoxycytidine restored TIMP-3 gene expression. Our results suggest that the TIMP-3 gene is another early target of tumor-associated aberrant DNA methylation in human gastric carcinogenesis. Consequently, genetic silencing of TIMP-3 may lead to a more malignant and invasive phenotype in these cancer cells.

Arthroscopic treatment for limitation of motion of the elbow

This study describes the long-term clinical results and serial changes of postoperative range of motion after arthroscopic treatment for limitation of motion of the elbow. Sixty-three patients with limitation of motion of the elbow were treated with arthroscopic procedures. The total range of motion was 79 degrees before surgery. The range of motion showed a progressive increase until 1 year after surgery (mean, 121 degrees). However, after 1 year, the range of motion showed little additional increase. The range of motion acquired during surgery (mean, 122 degrees) usually was the same range that patients achieved during the rehabilitation period (mean, 122 degrees at an average 42.5 months of followup). Extension improved an average of 21 degrees, and flexion increased an average of 23 degrees. The range of motion showed more improvement in patients whose duration of symptoms was less than 1 year (49 degrees) than in those whose duration of symptoms was longer than 1 year (30 degrees). Patients with posttraumatic stiffness had more marked limitation of extension and decreased total range of motion (73 degrees) than did those with degenerative stiffness (86 degrees) before surgery. However, no significant difference existed in the postoperative total range of motion (posttraumatic stiffness, 123 degrees; and degenerative stiffness, 121 degrees). Based on the authors' experience, 92% of patients obtained significant improvement in range of motion after arthroscopic procedures. The minimally invasive nature of elbow arthroscopy is a reproducible and effective procedure for limitation of motion of the elbow with minimal morbidity.

Small nucleolar RNP scleroderma autoantigens associate with phosphorylated serine/arginine splicing factors during apoptosis

OBJECTIVE

Proteins that are phosphorylated during apoptosis are commonly precipitated by autoantibodies found in the sera of patients with systemic lupus erythematosus. We sought to determine whether scleroderma autoantigens such as small nucleolar RNPs (snoRNP) also associate with phosphoproteins in response to various cellular stressors.

METHODS

We screened a panel of monoclonal antibodies derived from mice exposed to mercury, a well-characterized murine model of the anti-snoRNP autoimmune response, for the ability to selectively precipitate phosphoproteins from radiolabeled lysates prepared from Jurkat T cells subjected to stressful stimuli.

RESULTS

Monoclonal antibodies reactive with snoRNPs precipitated a phosphoprotein complex (pp42, pp34, and pp23) from lysates prepared from apoptotic cells. Several novel phosphoproteins (pp62 and pp18) were also observed. The phosphorylation and/or recruitment of these proteins to the snoRNP complex is induced by multiple apoptotic stimuli (e.g., Fas ligation, anisomycin, or ultraviolet irradiation), an effect that is blocked by overexpression of Bcl-2. We were unable to demonstrate an association of the phosphoprotein complex with snoRNPs in cells treated with the xenobiotic agent mercury. The snoRNP-associated phosphoprotein complex is composed of serine/arginine (SR) splicing factors, including SRp40.

CONCLUSION

The association of phosphorylated SR proteins with snoRNPs in cells undergoing apoptosis suggests that the immune response to fibrillarin that characterizes a subset of patients with scleroderma may be related to cell death induced by apoptotic stimuli (e.g., Fas ligation, irradiation, or chemical toxins), or by exposure to mercury.

Active properties of the urinary bladder: in vitro comparative studies between adult and neonatal rats

OBJECTIVE

To determine, using in vitro comparative studies, developmental aspects associated with the active properties of the urinary bladder in neonatal and adult rats.

MATERIALS AND METHODS

Urinary bladders were removed from neonatal (1-3 days old) and adult (15 weeks old) male Sprague-Dawley rats. Anterior longitudinal muscle strips were obtained from each group and isometric tensions recorded. Nerve-mediated contractions elicited by electrical field stimulation (0.8 ms pulse) or carbachol-induced contractile responses in neonatal and adult bladder strips were compared. Contractile tensions were normalized using the wet weight of the bladder strip or by using the percentage contraction induced by 60 mmol/L KCl.

RESULTS

Nerve-mediated contractile responses showed that the muscarinic component predominated in the neonatal rat bladder, which contrasted with the predominant purinergic components in adult bladder. The pattern of spontaneous activity and carbachol-induced contraction differed in the two groups. Small spontaneous contractions in the basal state occurred in adult bladder strips, while short-lived large spontaneous contractions were present in neonatal strips. The amplitude of carbachol-induced contractions generated in the neonatal bladder was larger than that in the adult bladder. In addition, the time to achieve peak contraction elicited by carbachol (5 micromol/L) was shorter in the neonatal bladder. Repetitive carbachol applications induced an attenuation of the contractile response (desensitization), but the neonatal bladder was more resistant to desensitization than the adult bladder.

CONCLUSIONS

These results show that nerve-mediated or agonist-induced contractile patterns, and spontaneous activity, in the neonatal bladder differ from those of the adult bladder in rats. The results suggest that in addition to neural immaturity, there are functional differences between the bladders of adult and neonatal rats.

Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries

CONTEXT

No large-scale study has investigated the impact of multidrug-resistant tuberculosis (TB) on the outcome of standard short-course chemotherapy under routine countrywide TB control program conditions in the World Health Organization's (WHO) directly observed treatment short-course strategy for TB control.

OBJECTIVE

To assess the results of treatment with first-line drugs for patients enrolled in the WHO and the International Union Against Tuberculosis and Lung Disease's global project on drug-resistance surveillance.

DESIGN AND SETTING

Retrospective cohort study of patients with TB in the Dominican Republic, Hong Kong Special Administrative Region (People's Republic of China), Italy, Ivanovo Oblast (Russian Federation), the Republic of Korea, and Peru.

PATIENTS

New and retreatment TB cases who received short-course chemotherapy with isoniazid, rifampicin, pyrazinamide, and either ethambutol or streptomycin between 1994 and 1996.

MAIN OUTCOME MEASURE

Treatment response according to WHO treatment outcome categories (cured; died; completed, defaulted, or failed treatment; or transferred).

RESULTS

Of the 6402 culture-positive TB cases evaluated, 5526 (86%) were new cases and 876 (14%) were retreatment cases. A total of 1148 (20.8%) new cases and 390 (44.5%) retreatment cases were drug resistant, including 184 and 169 cases of multidrug-resistant TB, respectively. Of the new cases 4585 (83%) were treated successfully, 138 (2%) died, and 151 (3%) experienced short-course chemotherapy failure. Overall, treatment failure (relative risk [RR], 15.4; 95% confidence interval [CI], 10.6-22.4; P<.001) and mortality (RR, 3.73; 95% CI, 2.13-6.53; P<.001) were higher among new multidrug-resistant TB cases than among new susceptible cases. Even in settings using 100% direct observation, cases with multidrug resistance had a significantly higher failure rate than those who were susceptible (9/94 [10%] vs 8/1410 [0.7%]; RR, 16.9; 95% CI, 6.6-42.7; P<.001). Treatment failure was also higher among patients with any rifampicin resistance (n=115) other than multidrug resistance (RR, 5.48; 95% CI, 3.04-9.87; P<.001), any isoniazid resistance (n=457) other than multidrug resistance (RR, 3. 06; 95% CI, 1.85-5.05; P<.001), and among patients with TB resistant to rifampicin only (n=76) (RR, 5.47; 95% CI, 2.68-11.2; P<.001). Of the retreatment cases, 497 (57%) were treated successfully, 51 (6%) died, and 124 (14%) failed short-course chemotherapy treatment. Failure rates among retreatment cases were higher in those with multidrug-resistant TB, with any isoniazid resistance other than multidrug resistance, and in cases with TB resistant to isoniazid only.

CONCLUSIONS

These data suggest that standard short-course chemotherapy, based on first-line drugs, is an inadequate treatment for some patients with drug-resistant TB. Although the directly observed treatment short-course strategy is the basis of good TB control, the strategy should be modified in some settings to identify drug-resistant cases sooner, and to make use of second-line drugs in appropriate treatment regimens. JAMA. 2000;283:2537-2545