Relationship between perinatal appearance of cellular retinol-binding protein, type II and retinal reductase activity in chick liver

To explore a role of the transiently appearing cellular retinol-binding protein, type II (CRBP(II)) in perinatal chick liver, we have examined whether the relationships exist among the perinatal changes in hepatic CRBP(II) protein and mRNA levels, retinal reductase activity and beta-carotene levels in liver and serum. Northern blot analysis for hepatic CRBP(II) revealed a transient expression of CRBP(II) mRNA around hatching. The protein of CRBP(II) was also expressed transiently and the highest levels of CRBP(II) were found in the livers 1-3 days after birth. The retinal reductase activity was very low at embryonic age, but its activity rapidly rose at hatching, peaking at 1 day after birth, followed by a gradual decrease to a lower level in 7-day-old chicks. This perinatal pattern of the retinal reductase activities was similar to the pattern of transient appearance of the hepatic CRBP(II), and was also paralleled to the developmental changes in serum and liver beta-carotene concentrations. These findings suggest that hepatic CRBP(II) transiently appearing during the perinatal period may involve in metabolizing hepatic beta-carotene, directing the retinal to the retinal reductase and leading further to the subsequent esterification of the converted retinol.

[Meningeal seeding of spinal cord glioblastoma multiforme without any signs of myelopathy]

An autopsy case of meningeal spreading of glioblastoma multiforme (GBM) probably originating in the cervical cord was reported. In contrast to autopsy findings, main symptoms were similar to subacute meningitis, and any signs of myelopathy could not be detected during the clinical course. The patient was a 22-year-old man who was hospitalized because of a 2-week history of progressive headache following cough and slight fever. Vomiting and somnolence, developing 5 days before admission, were improved the day after a lumbar puncture performed at another hospital. On admission, meningeal signs, mild right abducens palsy, and depressed deep tendon reflexes were detected. There was no muscle weakness, sensory loss, or Babinski sign. Lumbar puncture yielded CSF with an opening pressure of 280 mmH2O, 21 mononuclear cells/mm3, a protein level of 645 mg/dl, and a glucose level of 7 mg/dl. Cytology for malignancy and multiple cultures were negative. Brain CT scan showed mild hydrocephalus and swelling of the brainstem and cerebellum. Intravenous administration of antimicrobial drugs was started and ventriculoperitoneal shunt surgery was performed. During the third hospital week, however, meningeal signs progressed and somnolence reappeared, followed by progressive multiple cranial neuropathy and polyradiculopathy characterized by flaccid tetraparesis, muscle atrophy, and sensory impairment without a level. Babinski sign could not be detected. MRI revealed an intramedullary lesion in the lower cervical cord, swelling of the brainstem, cerebellum, spinal cord and nerve roots, and a diffuse or nodular thickning of leptomeninges. Repeated CSF cytology disclosed atypical cells. Examinations for extraneural malignancies were negative. During the 9th hospital week, flaccid tetraplegia progressed and stupor developed, and the patient died 2 weeks later. The pathological study was limited to the brain. The brain showed a diffuse opalescent thickening of the leptomeninges, especially over the ventral aspect of the brainstem and cerebellum, where the blood vesseles and cranial nerves were obscured. Histological examination revealed the appearance of GBM. The malignant cells filled the subarachnoid space, and to a variable extent penetrated the brainstem and cerebellum along perivascular spaces. Hypertrophied optic tracts and trigeminal nerves were also infiltrated by the cells. However, there were no mass lesions assumed to be primary ones anywhere in the cerebral parenchyma. Therefore, it was thought that GBM primarily growing in cervical cord metastasized to intracranial subarachnoid space by way of the cerebrospinal fluid pathway. Spinal cord GBM usually presents signs of myelopathy from the early stage. The present case was characterized by no signs of myelopathy during the clinical course. It is speculated that the intramedullary GBM, originating near the surface of cervical cord, had been rapidly disseminated into the subarachnoid space up to the intracranial cavity before myelopathy appeared, and caused cranial and spinal nerve roots dysfunction, which covered signs of myelopathy. Cord GBM should be always considered as a differential diagnesis in a case of subacute meningitis.

Dietary maltitol increases calcium content and breaking force of femoral bone in ovariectomized rats

Maltitol is a disaccharide alcohol generated by hydrogenation of maltose and exhibiting resistance to intestinal disaccharidases. We demonstrated previously that maltitol stimulates transepithelial transport of calcium in the ileum, accompanied by an elevation of intestinal calcium absorption as well as calcium retention in the body. In this study, we examined whether the maltitol-induced increase in intestinal calcium absorption leads to an alteration of the physical properties of bones in rats subjected to ovariectomy. We used this study as a simulation model for postmenopausal females who are at risk for osteoporosis. Following the intake of a low-calcium diet for 28 d ovariectomized rats were fed diets containing either 10% maltose (control) or 10% maltitol, together with increased amounts of calcium (0.3% in Experiment 1 and 1.2% in Experiment 2) for 21 d. Balance studies performed during the final 5-d (Experiment 1) or 2-d (Experiment 2) period of the experiments showed that maltitol increased intestinal calcium absorption and retention. The breaking force of femoral bones was significantly elevated (by 5-7%) in animals fed the maltitol diet compared with that in rats fed the maltose diet. The calcium content in the femoral bones as well as the mineral bone density of the tibial metaphysis was also elevated in rats fed the maltitol diet. These results indicate that maltitol stimulates the intestinal absorption of dietary calcium leading to an increase in calcium content in the bone, and coinciding with the elevation of the breaking strength of the bone in ovariectomized rats.

[Cerebellin in the cerebellum in spinocerebellar degeneration]

To clarify the possible pathophysiological role of cerebellin in spinocerebellar degeneration, immunoreactive cerebellin was measured in the postmortem brain of 4 patients with spinocerebellar degeneration and 4 controls. Three other representative neuropeptides, corticotropin releasing hormone (CRH), neuropeptide Y and somatostatin, were also measured. Significant decreases in the concentration of immunoreactive cerebellin and immunoreactive CRH were found in the cerebellar hemisphere in spinocerebellar degeneration, suggesting an important pathophysiological role of cerebellin and CRH in this group of diseases. No such decreases were found in neuropeptide Y or somatostatin.

WS75624 A and B, new endothelin converting enzyme inhibitors isolated from Saccharothrix sp. No. 75624. I. Taxonomy, fermentation, isolation, physico-chemical properties and biological activities

Novel endothelin converting enzyme (ECE) inhibitors, WS75624 A and B, have been isolated from the fermentation broth of Saccharothrix sp. No. 75624. These inhibitors were purified from an acetone extract of whole culture broth followed by HP-20 column chromatography, silica gel column chromatography and HPLC. WS75624 A and B showed highly potent ECE inhibitory activity, and both had IC50 values of 0.03 microgram/ml. WS75624 A and B also showed other metalloprotease (collagenase and neutral endopeptidase) inhibitory activity with IC50 values of 1 microgram/ml. Since large amount of WS75624 B was isolated, we tried in vivo evaluation using WS75624 B. WS75624 B inhibited big endothelin-induced pressor effect when administered to SD rat intravenously with big ET-1.

WS75624 A and B, new endothelin converting enzyme inhibitors isolated from Saccharothrix sp. No. 75624. II. Structure elucidation of WS75624 A and B

The structures of WS75624 A and B, novel endothelin converting enzyme inhibitors, were determined to be 1 and 2A, respectively, by a combination of chemical evidence and a series of 2D NMR spectral analyses.

Tau in cerebrospinal fluid: a potential diagnostic marker in Alzheimer's disease

Cerebrospinal fluid from 70 patients with Alzheimer's disease (AD) and 96 patients with non-AD neurological diseases as well as 19 normal control subjects was surveyed by sandwich enzyme-linked immunosorbent assay to quantitate levels of the microtubule-associated protein tau in cerebrospinal fluid. The tau level was significantly increased in AD patients as compared with that in patients with non-AD neurological diseases and control subjects. Increased tau levels were found irrespective of age at onset, apolipoprotein E genotype, and clinical stage. Western blots of AD cerebrospinal fluid proteins revealed two to three tau-immunoreactive bands with an apparent molecular mass between 50 and 65 kd consistent with phosphorylated cerebrospinal fluid tau. Taken together, our results suggest that cerebrospinal fluid tau might reflect the progressive accumulation of altered tau due to the progressive death of neurons in the AD brain, and that the enzyme-linked immunosorbent assay of cerebrospinal fluid tau may prove to be a reliable and early diagnostic test for AD.

A new aromatase inhibitor, FR901537. I. Taxonomy, fermentation, isolation, physiochemical characteristics and biological activities

FR901537 is a new aromatase inhibitor produced by a bacterium Bacillus sp. No. 3072. Structural studies of FR901537 suggested that it was a novel naphthol derivative having pantetheine in its structure. FR901537 showed a potent inhibitory activity against aromatase from human placenta or rat ovary, but did not inhibit the activity of 11 beta-hydroxylase from bovine adrenal cortex. Lineweaver-Burk plot analysis revealed that FR901537 is a competitive inhibitor.

Unsaturated fatty acids regulate gene expression of cellular retinol-binding protein, type II in rat jejunum

We have shown that cellular retinol-binding protein, type II (CRBP II) mRNA and its protein levels are elevated in the jejunum of rats fed a diet rich in long-chain triacylglycerols. In the present study, we explored which types of fatty acids modulate CRBP II gene expression. Rats previously fed a low fat, high starch diet were force-fed a basal fat-free diet or the diet supplemented with 0.21 mol/L of various fatty acids (i.e., caprylic, palmitic, stearic, oleic, linoleic and alpha-linolenic acids). Force-feeding a diet containing linoleic acid produced an elevation of CRBP II mRNA levels in rats in both a dose-dependent (0.053-0.21 mol/L) and time-dependent (up to 6 h) manner. Among fatty acids tested, all unsaturated fatty acids (oleic, linoleic and alpha-linolenic acids) were able to enhance CRBP II mRNA levels by 54-63% within 6 h, whereas a medium-chain fatty acid (caprylic acid) and a saturated fatty acid (stearic acid) elicited little effect on the CRBP II mRNA levels; palmitic acid produced only a small elevation (16%) of the CRBP II mRNA level. Transcripts of both retinoid X receptor alpha and peroxisome proliferator-activated receptor (PPAR), which are thought to interact as a heterodimer with the cis-element located in the CRBP II promoter and to be activated by 9-cis retinoic acid and long-chain fatty acids, respectively, were constitutively expressed in the rat jejunum.(ABSTRACT TRUNCATED AT 250 WORDS)

Consumption of excess vitamin A, but not excess beta-carotene, causes accumulation of retinol that exceeds the binding capacity of cellular retinol-binding protein, type II in rat intestine

We assessed the effects of excess dietary vitamin A or beta-carotene on the cellular retinol-binding protein, type II [CRBP(II)] level and activities of lecithin: retinol acyltransferase (LRAT) and acyl-CoA:retinol acyltransferase (ARAT) in rat intestine. Male rats were fed for 7 d diets containing amounts of retinyl acetate or beta-carotene that were 1 (control), 10, 100 and 1000 times the NRC recommended requirement. No responses of the jejunal CRBP(II) level to an intake of excess vitamin A or beta-carotene were observed. The unesterified retinol and retinyl palmitate concentrations in the jejunum were small in rats fed 10 times the vitamin A requirement but they were significantly greater in rats fed 100 and 1000 times the vitamin A requirement than in controls. The molar ratio of unesterified retinol/CRBP(II) was < 1 for the controls and the group fed 10 times the vitamin A requirement, but > 3 for the group fed 100 times the requirement and > 19 for the group fed 1000 times the requirement. The LRAT activity was significantly greater in rats fed 1000 times the vitamin A requirement compared with all other groups, but ARAT activity was unaffected. Consumption of excess beta-carotene did not alter LRAT or ARAT activity, and led to a very small deposition of unesterified retinol and retinyl palmitate in the jejunum. Because CRBP(II) may play an important role in preventing the toxic effect of unbound retinol in the small intestine, consumption of excess vitamin A in amounts < 10 times the NRC recommended requirement may not cause a disturbance of the absorptive cell function.(ABSTRACT TRUNCATED AT 250 WORDS)

Decrease in cerebellin and corticotropin-releasing hormone in the cerebellum of olivopontocerebellar atrophy and Shy-Drager syndrome

Four neuropeptides; cerebellin, corticotropin-releasing hormone (CRH), neuropeptide Y and somatostatin were studied by radioimmunoassay in the postmortem human brains obtained from three patients with olivopontocerebellar atrophy (OPCA) and one with Shy-Drager syndrome. Significant decreases in cerebellin and CRH concentrations were found in the cerebellar hemisphere of these diseases compared with controls. These findings suggest important pathophysiological roles of cerebellin and CRH in these cerebellar diseases. Such significant decreases were not found in neuropeptide Y and somatostatin.

Diet-induced changes in gene expression of lactase in rat jejunum

To explore the mechanisms by which jejunal lactase activity is modified by carbohydrate and/or fat intake, mRNA levels and the absolute synthesis rate of lactase-phlorizin hydrolase (LPH) were determined in 6-wk-old rats that were fed either low-starch diets containing long-chain triacylglycerol (LCT, 73% energy as corn oil) or medium-chain triacylglycerol (MCT, 66% energy as MCT, 7% energy as corn oil), or a high-starch diet (70% energy as cornstarch) for 7 days. LPH mRNA levels in the jejunum were similar between LCT-fed and MCT-fed rats, but animals fed the high-starch diet exhibited a greater (2x) LPH mRNA level than other groups. The absolute synthesis rate of LPH, estimated by the flooding dose technique using [3H]phenylalanine, was greater (2.4x) in rats fed the high-starch diet than in other groups. A short-term force-feeding experiment revealed that sucrose was able to evoke LPH mRNA levels within 12 h but that a nonmetabolizable sugar (alpha-methylglucoside) was unable to enhance it. By contrast, animals fed the high-LCT diet showed a lower (by 30%) lactase activity than rats fed the low-starch, high-MCT diet, which was accompanied by not only a reduction of immunoreactive LPH in brush-border membranes but also a reduction in lactase activity per unit weight of immunoreactive LPH. These results suggest that both gene expression and posttranslational events of LPH might be influenced by dietary manipulations; carbohydrate intake primarily increases LPH mRNA levels, and LCT accelerates inactivation and/or degradation of lactase.

[Retrospective analysis of postoperative chemotherapy with UFT against pancreatic cancer]

The retrospective study was carried out to evaluate the effect of UFT given orally in patients with histologically proven pancreatic cancer in our institutions for 6 years. The study regimen was designed as follows: 400 or 600 mg/body UFT per day after the patients having something solid evidences of tumor. For 6 years, 78 patients were entered in this protocol. Further details of the patients characteristics were as follows: head 47 (60.3%) cases, tail & body 31; resection cases 26 (33.3%), palliative 52; Stage IV 62 (79.5%) cases. Resection, P (peritoneal dissemination). H (liver metastasis) and T (tumor size) were statistically proven to be significant prognostic factors. The median survival time of UFT group was 204 days and that of non UFT group was 123 days. According to the retrospective analysis, there was a significant difference in the cumulative survival rate between UFT group and non UFT group with 1.98 of Hazard's proportional ratio (p = 0.009). However, further clinical investigations-prospective study are necessary to confirm these data.

Dietary regulation of sucrase-isomaltase gene expression in rat jejunum

We have previously demonstrated that intake of fat as well as carbohydrate affects the activity and immunoreactive amount of sucrase-isomaltase (S-I) in rat jejunum. To examine whether diet-related changes in sucrase and isomaltase activities are accompanied by the variations of sucrase-isomaltase mRNA levels, 7-week-old rats were fed either a high-long-chain triacylglycerols diet (73 energy% as corn oil), a high-medium-chain triacylglycerols (MCT) diet (66 energy% as MCT, 7 energy% as corn oil) or a high-carbohydrate diet (70 energy% as corn starch) for 7 days. Northern blot analysis revealed that S-I mRNA levels were abundant in the jejunum of rats fed the high-MCT diet; the levels were similar to those in the rats fed the high-carbohydrate diet. Force-feeding a high-sucrose diet (40 energy% as sucrose) brought about a parallel rise in both S-I mRNA and sodium/D-glucose cotransporter (SGLT1) mRNA levels within 12 h. Force-feeding the high-MCT diet also produced an elevation of S-I mRNA and SGLT1 mRNA. However, force-feeding a diet containing alpha-methylglucoside, a non-metabolizable but actively transported sugar, did not increase S-I mRNA or SGLT1 mRNA level; sucrase activity was nevertheless elevated by feeding alpha-methylglucoside diet. These results suggest that not only carbohydrate intake but also MCT intake might influence S-I mRNA and SGLT1 mRNA levels in the jejunum, presumably through common metabolite(s) of carbohydrates and MCT, and that carbohydrate may play another role in enhancement of the sucrase activity through modulation of translation and/or posttranslational modifications of the sucrase-isomaltase complex.

FR901451, a novel inhibitor of human leukocyte elastase from Flexibacter sp. I. Producing organism, fermentation, isolation, physico-chemical and biological properties

A novel human leukocyte elastase (HLE) inhibitor, FR901451 was discovered in the fermentation broth of a bacteria. The bacteria was identified as Flexibacter sp. No. 758. FR901451 has a molecular weight of 1269 and a molecular formula of C60H79N13O18. The mode of inhibition against HLE is competitive, with a Ki value of 9.8 x 10(-9) M.

Dietary carbohydrate and fat independently modulate disaccharidase activities in rat jejunum

The role of carbohydrate and fat in diet-induced modifications of jejunal disaccharidase activities was evaluated with an isoenergic diet containing a nonmetabolizable sugar, alpha-methylglucoside. Rats previously fed a high fat, low starch diet or a high starch low fat diet were force-fed three times over 12 h isoenergic high fat diets with or without alpha-methylglucoside, or a low fat diet containing alpha-methylglucoside. Regardless of the previous diet fed, force-feeding the high fat, alpha-methylglucoside diet produced significantly greater sucrase and lactase activities in the upper jejunum than force-feeding the high fat diet without alpha-methylglucoside; comparable or only slightly greater sucrase and lactase activities were seen in the lower jejunum. The animals fed the low fat, alpha-methylglucoside diet exhibited significantly greater sucrase and lactase activities in the lower jejunum than did the rats fed the high fat, alpha-methylglucoside diet; a less marked difference (< 30%) was observed between these two groups for disaccharidase activities in the upper jejunum. The lower sucrase and lactase activities observed in the jejunum of animals force-fed the high fat diet after consuming the high starch, low fat diet were accompanied by greater trypsin activity in the lumen of the upper and lower jejunum, suggesting that proteolytic degradation of sucrase and lactase might be stimulated in rats fed the high fat diets. These results suggest that both dietary carbohydrate and dietary fat independently and by different mechanisms modulate jejunal disaccharidase activities.

Dietary fat regulates cellular retinol-binding protein II gene expression in rat jejunum

Cellular retinol-binding protein II (CRBP II) is an abundant cytosolic protein of intestinal absorptive cells. In this study, we examined whether dietary fat modulates the expression of CRBP II in the small intestine. In the rats fed a diet rich in long-chain triacylglycerols (LCT), both CRBP II mRNA and CRBP II protein levels in the jejunum were more than two-fold greater than in the rats fed a low fat diet and a diet rich in medium-chain triacylglycerols (MCT). The mRNA abundance of a retinoid X receptor (RXR alpha), which is thought to interact with the cis-element located in the CRBP II promoter, was elevated in the jejunum of rats fed high-LCT and high-MCT diets as compared with that of animals fed a low-fat diet, but the levels of RXR alpha mRNA of the LCT diet group was similar to that of MCT diet group. These results suggest that the expression level of the CRBP II gene is not directly related to the RXR alpha expression, and that it might be modulated by long-chain fatty acids or their metabolites.

[A national surveillance study on alcoholic liver disease in Japan (1986-1991)]

National surveillance studies on alcoholic liver disease (ALD) in Japan were performed in 1978 and 1985, by a previous Japanese study group for ALD (Takeuchi group). In the present study, a subsequent nationwide surveillance study was performed from 1986 to 1991 and the results were compared with the previous two studies. In order to clarify the etiological relationships between hepatitis C virus (HCV) infection and ALD, an analysis was also done according to the new diagnostic criteria of ALD which was proposed by this group (Takada group). By the criteria of the Takeuchi group, the incidence of ALD was not significantly different during 1986 to 1991. However, the incidence of hepatocellular carcinoma (HCC) in alcoholic cirrhosis (AL-LC) clearly increased during this period. The analysis including the results of the previous study indicate that incidence of ALD reached a plateau in 1980 and then features of ALD in Japan entered a stable stage. However, HCC in AL-LC continued to show a linear increase from 1976 to 1991. Analysis with the new criteria of the Takada group was done in cases of 1990 and 1991. Approximately 2 out of 3 cases of ALD were caused by alcohol alone, and the remaining cases were caused by a combination of alcohol and HCV. Cases caused only by HCV were very rare. The main etiology in patients with alcoholic hepatitis and fibrosis was alcohol alone and that in chronic hepatitis of heavy drinkers was a combination of alcohol and HCV. In half of the patients with AL-LC, the etiology was alcohol alone and in the other half patients, it was a combination of both factors. In most patients with HCC, the etiology was a combination of alcohol and HCV, indicating that HCV infection may be important for the development of HCC in alcoholics.

Effect of dietary fat content on microvillus in rat jejunum

To examine whether dietary manipulation of isoenergic diets might affect microvillar structure of small intestinal epithelial cells, morphological parameters of enterocytes and microvilli in the mid-villus portion of jejunum were determined in the rats fed either high-starch (70 energy %), low-fat (7 energy %) diet or high-fat (73 energy %), low-starch (5 energy %) diet for 7 days. Feeding the high-fat diet produced an increase in the height of villus, in accordance with the elevated jejunal mucosal weight and total protein contents as compared with the high-starch diet. No appreciable change in crypt depth occurred. Scanning electron microscopy of jejunal epithelial cells revealed that the morphometrical parameters of the villus cells were unchanged by the diets, but the microvillar structure of each villus cell was influenced by the diets; the animals fed the high-fat diet exhibited a reduced length (28%) of microvillus with a slight increase (12%) in diameter, showing a significantly reduced surface area of microvilli per enterocyte. The reduction in microvillar surface area of animals fed the high-fat diet was accompanied by the decrease in total proteins of the brush border membranes as well as the decrease in the activities of microvillar stalked disaccharidases, i.e., sucrase-isomaltase and lactase. These results provide an evidence that dietary manipulation, even when diets are "complete" in terms of the content of energy, protein, and other micronutrients, can modify the microvillar structure of small intestinal epithelial cells, leading to alterations in the digestive/absorptive surface area of villus cells.

Monostearoylglycerol-starch complex: its digestibility and effects on glycemic and lipogenic responses

We examined whether a modification of a starch into an alpha-amylase resistant form can lead to a reduction of postprandial glucose and insulin responses, and consequently to a change of lipid metabolism in liver and adipose tissue. For this purpose, a processed starch was prepared using a cornstarch (70% amylose and 30% amylopectin) and monoacylglycerol (monostearate; MS), forming monostearate-starch complex (MS-treated cornstarch). When we determined in vitro hydrolysis of MS-treated cornstarch using alpha-amylase and intestinal microvillar alpha-glucosidases, the glucose production rate of the MS-treated cornstarch was slower than the non-treated cornstarch. Measurement of a transmural potential difference (delta PD) evoked by the MS-treated cornstarch in everted rat jejunum showed that the absorption rate of glucose released from the MS-treated cornstarch was also remarkably slower than that from the non-treated cornstarch. The postprandial plasma insulin response to the MS-treated cornstarch was reduced, although plasma glucose response was unchanged. In a feeding study, two groups of five or six male Wistar-strain rats were fed defined diets containing 61.1% MS-treated cornstarch or 58.2% non-treated cornstarch ad libitum for 14 days. Food intakes during the period were similar between the two groups. Feeding the MS-treated cornstarch resulted in a significantly lower maltase activity in upper jejunum than did the non-treated cornstarch feeding. The activities of lipogenic enzymes--fatty acid synthetase (FAS), malic enzyme (ME), and glucose-6-phosphate dehydrogenase (G-6-PDH)--significantly decreased in epididymal adipose tissue of rats fed the MS-treated cornstarch. In the liver, FAS activity was lower in the MS-treated cornstarch group. The results indicated that MS-treated cornstarch was digested less rapidly, and lowered blood insulin response, consequently leading to a declined lipogenesis of adipose tissue and liver. This study suggests that the rate of intestinal hydrolysis of starch is an important determinant of metabolic responses such as glycemic and lipogenic responses to diets.

Hepatic messenger RNA contents of cytochrome P4502E1 in patients with different P4502E1 genotypes

Since heavy drinkers do not always develop alcoholic liver disease (ALD), genetic factors may be involved. Cytochrome P4502E1 (P4502E1) is the main enzyme that oxidizes ethanol in the non-alcohol dehydrogenase pathway. Recently, the presence of genetic polymorphisms at the 5'-flanking region of this enzyme was confirmed. We recently detected the c2 gene of P4502E1 in most patients with ALD, suggesting that development of ALD may be genetically controlled. Although high transcriptional activity of the c2 gene was confirmed in studies using the Hep G2 cell, little is known about transcriptional activity in humans with the c2 gene. Therefore, messenger RNA (mRNA) contents of P4502E1 in livers of patients with different P4502E1 genotypes were measured. Hepatic mRNA contents in type B were three times higher than in type A, suggesting that transcriptional activity of the c2 gene of P4502E1 is stronger than that of the c1 gene, even in human liver. The results of the present study are compatible with those in the Hep G2 cells. These results suggest that polymorphisms of the P4502E1 gene may be linked to the development of ALD through enhancement of ethanol metabolism in the non-alcohol dehydrogenase pathway.

Is apoptosis involved in alcoholic hepatitis?

Apoptosis is a type of cell death which is clearly distinguishable from necrosis in its morphological and biochemical features. To clarify the role of apoptosis in alcoholic liver injury, we investigated the expression of apoptosis-related Lewis(Le)(y) antigen by immunohistochemistry in liver samples from patients suffering from alcoholic liver disease. Liver biopsy samples were taken from 20 patients who drank more than 80 g of ethanol per day on average. Indirect immunohistochemical staining was carried out using anti-cytokeratin and anti-Le(y) antibodies. To examine the relationship between Mallory bodies and apoptosis, double staining was performed using both antibodies. In alcoholic hepatitis, many Mallory bodies were stained with anti-cytokeratin antibody in hepatocytes of the centrilobular area. Le(y) antigen was also detected in hepatocytes in the same area. Immunohistochemical double staining showed that some of the hepatocytes containing Mallory bodies were stained with anti-Le(y) antibody. Few hepatocytes expressing Le(y) antigens, however, were observed in other types of alcoholic liver disease, including steatosis, fibrosis and cirrhosis. From these results, it is suggested that apoptosis may also be involved in alcoholic hepatitis and that hepatocytes containing Mallory bodies can be eliminated by apoptosis.

Maltitol-induced increase of transepithelial transport of calcium in rat small intestine

To gain an insight into a mechanism whereby maltitol increases intestinal absorption of calcium, we evaluated transepithelial calcium transport of everted segments of rat small intestine by comparing the values in the presence of maltitol with the values in the presence of maltose. In jejunal segments, no significant difference in the rate of calcium transport was seen between the incubations in the medium containing 100 mM maltitol and in the medium containing 100 mM maltose, regardless of the calcium concentrations in the mucosal-side medium. By contrast, the everted ileal segments incubated in the presence of maltitol exhibited two-fold greater transepithelial calcium transport than did the segments incubated in the presence of maltose at a high (10 mM) concentration of calcium, whereas at a low (0.5 mM) concentration of calcium, maltitol did not produce a significant effect. With the conditions in which intestinal alpha-glucosidases were inhibited using the medium containing Tris or acarbose, a slight (40%) but significant increase of calcium transport was again observed in the segments incubated in the medium containing maltitol as compared with the medium containing maltose. The results suggest that maltitol enhances the rate of transepithelial calcium transport in the lower part of small intestine by modulating the passive diffusion of calcium, and that not only the nature of low digestibility, but also some other nature(s) of maltitol might be responsible for the maltitol-induced increase of ileal calcium transport.

Improvement of left ventricular function after renal transplantation in a patient with uremic cardiomyopathy: report of a case

The improvement of heart function in a patient on hemodialysis with dilated cardiomyopathy by renal transplantation is herein reported. The patient was a 35-year-old woman. Hemodialysis had been initiated 3 months before, but she experienced difficulty with hemodialysis maintenance and exhibited congestive heart failure. The ejection fraction (EF) was decreased to 36.6% in the echocardiogram, and an intracardiac biopsy of the right ventricle showed myofiber degeneration and interstitial edema upon examination by light microscopy. She then underwent renal transplantation, and the postoperative recovery was almost uneventful. The cardiothoracic ratio decreased rapidly to around 40% after 1 month, although her body weight increased. The ejection fraction increased to 50% in the echocardiogram. An intracardiac biopsy of the right ventricle revealed disoriented myofibers, but myofiber degeneration improved, and no interstitial edema was present upon examination by light microscope. The electron microscopy showed that the intracellular edema had disappeared and other degenerative changes had also improved. The patient was discharged on the 44th postoperative day, with a serum creatinine of 1.3 mg/dl.

[Genetic and epidemiologic studies on alcoholic liver diseases]

Polymorphic alleles of several genes such as ADH2, ALDH2, ApoB100, GST1, GST3 and ALAD were investigated from the aspect of the relationship with alcohol related diseases. DNAs were prepared from whole blood samples of 84 healthy controls (male), 70 patients (male) with alcohol related diseases and 87 patients (male) with non-alcoholic diseases. PCR technique was used for the detection of GST1 showed a good correlation to alcoholic liver diseases. The patients with alcoholic liver diseases had a higher frequency of ALDH2*1 than the healthy controls (p < 0.005). The frequencies of GST1 gene deletion in the samples were as follows: Healthy controls; 47.6%, alcoholic liver diseases (fibrosis: 75%, cirrhosis: 65.5%, hepatoma: 75%) and non-alcoholic liver diseases: 54%. The data indicated that the patients with alcoholic liver diseases had a significantly higher frequency of gene deletion than the healthy controls (p < 0.005). In addition, homozygote of ALAD1 allele detected by MpsI-RFLP showed a good correlation to alcoholic liver diseases. Thus, the genetic polymorphism of ALDH2, GST1 gene deletion and ALAD can be applied widely for the study of genetic association with alcoholic liver diseases.

WB2838 [3-chloro-4-(2-amino-3-chlorophenyl)-pyrrole]: non-steroidal androgen-receptor antagonist produced by a Pseudomonas

In the course of our search for non-steroidal androgen-receptor antagonists of microbial origin, Pseudomonas sp. No. 2838 was found to produce an inhibitor of androgen binding to its receptor. This compound, named WB2838, was isolated and identified as 3-chloro-4-(2-amino-3-chlorophenyl)-pyrrole. The IC50 value of WB2838 for partially purified rat prostate cytosol receptor was 8.0 x 10(-7) M. However, the IC50 value of WB2838 against estrogen-receptor binding was about 90-fold greater than that against androgen-receptor binding. WB2838 inhibited the growth of androgen-responsive mouse mammary carcinoma SC-3 cells in the presence of 10(-8) M testosterone at IC50 value of 4.1 x 10(-7) M. This inhibition was reversed by adding 10(-5) M testosterone to the culture medium. WB2838 also showed the inhibitory activity against the growth of the ventral prostate induced by testosterone propionate in castrated immature rats. Therefore, it was concluded that WB2838 was a non-steroidal androgen-receptor antagonist.

[External valvuloplasty under preoperative angioscopic control]

Intraoperative angioscopy was applied to evaluate the venous valvular incompetence and perform external valvuloplasty in case of venous reflux. Sixty-seven limbs, 43 cases of primary varicose veins were examined using intraoperative angioscopy and the angioscopic findings of the incompetent venous valves were classified into three types as follows: valves with elongated and atrophic cusps 43 (50%)--type I, values with expanded and depressed commissures 36 (42%)--type II, and valves with perforated cusps or other changes 7 (8%)--type III, according to the angioscopie findings, external valvuloplasty was done in 31 subterminal valves of the long saphenous veins and 7 highest valves of the superficial femoral vein. Our external valvuloplasty consisted of two techniques. The first was the total plication technique for valvular annulus by a running suture of prolene and the second was by the venocuff sleeve of the autogenetic femorofascial band. The degree of plication was decided by angioscopic observation. Postoperative observation periods were from 2 to 28 months. There was no recurrence of varicose veins or prominent venous reflux. The application of intraoperative angioscopy is therefore useful for the choosing appropriate surgical procedures and for the evaluation of venous valvuloplasty.

R1128 substances, novel non-steroidal estrogen-receptor antagonists produced by a Streptomyces. II. Physico-chemical properties and structure determination

R1128 A, B, C and D, new non-steroidal estrogen-receptor antagonists, were isolated from the cultured broth of Streptomyces sp. No. 1128. Their structures were elucidated to be 1,3,6-trihydroxy-8-alkylanthraquinones on the basis of their physico-chemical properties and spectroscopic data.

Detection of precore/core-mutant hepatitis B virus genome in patients with acute or fulminant hepatitis without serological markers for recent HBV infection

To confirm the possibility that some hepatitis B virus (HBV) variants do not induce HB s antigen (HBsAg), anti-HB core antibody (anti-HBc) and anti-HBc IgM in a transient infection, polymerase chain reaction (PCR) was performed in 20 patients with acute hepatitis and 7 patients with fulminant hepatitis. Patients were diagnosed with non-A, non-B hepatitis by serological markers at admission. PCR successfully amplified the precore/core gene in 5 (25%) of the patients with acute hepatitis and 2 (29%) of the patients with fulminant hepatitis. Subsequent sequencing revealed frequent mutations including precore-defects in the precore/core gene.

Dietary vitamin A modulates lecithin-retinol acyltransferase activity in developing chick intestine

Retinol absorbed and generated from beta-carotene requires to be esterified by lecithin-retinol acyltransferase (LRAT) in intestinal absorptive cells. To characterize developmental changes in retinol absorptive capability in intestine, we determined LRAT activity and the amount of its retinol donor, cellular retinol-binding protein, type two (CRBP(II)) in the duodenum of developing chicks. The LRAT activity in duodenal microsomes was very low at 18- and 20-day chick embryo, but exhibited a rapid (15-fold) increase during 48 h around hatching, which occurred in parallel with the abrupt elevation of the content of CRBP(II) in chick duodenum. To examine whether dietary vitamin A affects the developmental change in LRAT activity and CRBP(II) content, 1-day-old chicks were pair-fed vitamin A-depleted or vitamin A-supplemented diet for 14 days. The chicks fed vitamin A-depleted diet showed significantly reduced LRAT activity and CRBP(II) in duodenum as early as 3 days after the start of the vitamin A-depleted diet. Changing the diet from vitamin A-depleted to vitamin A-supplemented diet led to an increase in duodenal LRAT activity within 24 h, while serum retinol concentration remained unchanged. These results suggest that duodenal LRAT activity and CRBP(II) are modulated by dietary vitamin A during the perinatal period.

Feeding medium-chain triglycerides to rats decreases degradation of sucrase-isomaltase complex in the jejunum

We demonstrated previously that feeding a diet containing medium-chain triglycerides (MCT) to rats causes an increase in the sucrase activity in jejunum relative to diets containing long-chain triglycerides (LCT). To explore the mechanism whereby MCT affect jejunal sucrase activity, 7-wk-old rats were fed a high LCT diet for 7 d, and then they were force-fed either the high LCT diet, a high MCT diet or a high carbohydrate (alpha-methylglucoside) diet for the subsequent 12 h. Feeding the high carbohydrate diet produced significantly greater sucrase and isomaltase activities in both upper and lower jejunum than feeding the LCT diet. Feeding the high MCT diet led to significantly greater sucrase activity in the lower jejunum, but isomaltase activity was not elevated. Rocket immunoelectrophoresis revealed that in the lower jejunum of the rats fed the high MCT diet the proportion of sucrase-isomaltase complex to its degradation product (i.e., isomaltase monomer) was elevated, suggesting that dietary MCT affects sucrase activity by retardation of degradation of sucrase-isomaltase. Because the amounts of total bile acids in the upper jejunum were 50% lower in rats fed the high MCT diet relative to animals fed the high LCT diet, it is likely that MCT feeding decreases secretion of bile into the lumen, which in turn decreases degradation of the sucrase subunit of the sucrase-isomaltase complex.

Changes in type IV collagen content in livers of patients with alcoholic liver disease

An increase of serum type IV collagen levels in patients with liver disease has been reported; however, the mechanisms of this increase are not yet well known. We recently developed an assay system for type IV collagen content in liver biopsy specimens. In this study, type IV collagen content in the livers and sera of patients with alcoholic liver disease and nonalcoholic liver disease was determined. Serum and hepatic type IV collagen contents were measured with a one-step sandwich enzyme immunoassay system using monoclonal antibodies for human type IV collagen. Hepatic type IV collagen content increased significantly in liver disease. In alcoholic liver disease, type IV collagen content in patients with mild fibrosis was lower than that in advanced types of alcoholic liver disease. In nonalcoholic liver disease, hepatic type IV collagen content tended to increase with the progression of fibrosis. Type IV collagen content in alcoholic liver disease was significantly higher than that in the corresponding type of nonalcoholic liver disease. Hepatic total collagen content increased significantly in parallel with the progression of fibrosis in both alcoholic liver disease and nonalcoholic liver disease. The total collagen content in each type of alcoholic liver disease was significantly lower than that in the corresponding type of nonalcoholic liver disease. The ratio of type IV collagen to total collagen content was the highest in livers showing mild fibrosis, both in alcoholic liver disease and nonalcoholic liver disease, and decreased in parallel with the progression of fibrosis. The ratio in patients with alcoholic liver disease was significantly higher than that in those with the corresponding nonalcoholic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of genotypes of hepatitis C virus on interferon treatment for chronic type C hepatitis

Interferon is commonly used for treatment of type C hepatitis, but the effects are variable and many factors may be responsible. Hepatitis C virus (HCV) can be classified into 4 types, PT, K1, K2a and K2b. Therefore, the responses to interferon treatment in patients with the different HCV genotypes were analyzed. Twenty-four patients with type C hepatitis were treated with 3 to 10 million units of various types of interferon for more than 8 weeks. HCV-RNA encoding the NS5 region (HCV-NS5) was positive in these 24 patients, 16 of which were classified with the K1 type and 8 with the K2 type of HCV. In all patients except for 2, HCV-NS5 became negative within 3 weeks of treatment without relation to the HCV genotypes. Serum alanine aminotransferase levels were normalized in 7 out of 8 patients in the K2 group and in 4 out of 16 patients in the K1 group at the end of 8 weeks. At the 24th week, ALT levels were normalized in 5 out of 6 patients in the K2 group, and in one out of 9 patients in the K1 group. The percentage of patients exhibiting a good response was significantly higher in the K2 group than in the K1 group at both observation periods. During the post-treatment periods, relapse following complete response was found in 3 patients in the K2 group and in one patient in the K1 group. The final effects of interferon were significantly better in the K2 group than in the K1 group.(ABSTRACT TRUNCATED AT 250 WORDS)

Differences in the hepatitis C virus genotypes in different countries

We recently classified the hepatitis C virus (HCV) into 4 types (HCV-PT, -K1, -K2a and -K2b) according to differences in nucleotide sequences. It was found that HCV-PT, the prototype reported from the U.S.A., was rare in Japan, suggesting that distribution of HCV genotypes may be different in various countries. The prevalence of HCV genotypes was therefore compared in different countries. Genotyping of HCV was performed by slot-blot hybridization analysis using cDNA probes specific to each type of HCV or by restriction fragment length polymorphism analysis. In 121 Japanese non-cancer patients, the prevalence of HCV genotypes was 77.7% for HCV-K1, 16.5% for HCV-K2a and 5.0% for HCV-K2b. HCV-PT was detected in only 1 patient (0.8%). The prevalence in 43 Japanese hepatocellular carcinoma (HCC) patients was 74.4% for HCV-K1, 18.6% for HCV-K2a and 4.7% for HCV-K2b. HCV-PT was found in only 1 sample. In 19 European non-cancer patients, HCV-PT was found in 42.1% and HCV-K1 was found in 52.6%. HCV-K2 was not found. All 7 samples from European HCC patients were HCV-K1, indicating a significantly higher prevalence than in non-cancer patients. In 13 Brazilian non-cancer patients, the distribution pattern was similar to that of the Europeans. In 10 samples from the U.S.A., HCV-PT was found in 70% and HCV-K2 was found in 1 sample. In 18 Chinese non-cancer patients, HCV-K1 was found in 44.4%, HCV-K2a in 50.0% and HCV-K2b in 5.6% HCV-PT was not found. Two samples from Chinese HCC patients were HCV-K1.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of chorea-acanthocytosis associated with low glycohemoglobin A1c]

We reported the first case of chorea-acanthocytosis associated with low glycohemoglobin A1c. Fasting blood sugar, daily profile of blood sugar, serum fructosamine and 75 g glucose tolerance test were all within normal limits. While abnormal hemoglobins were not detected, red blood cell half-life was sharply reduced to 13.4 days. These findings suggest that the low glycohemoglobin A1c in this case is highly ascribable to the reduction of red blood cell half-life rather than to continuous hypoglycemia. However, we can not rule out that the abnormalities of red blood cell membrane, suggested factors in this disease, may be related to the low glycohemoglobin A1c value. Further investigations on chorea-acanthocytosis cases with normal red blood cell half-life are necessary in order to elucidate whether an abnormal glycohemoglobin A1c value is a specific indication regarding this disease.

Adaptive changes of intestinal cellular retinol-binding protein, type II following jejunum-bypass operation in the rat

To examine whether the amount of intestinal cellular retinol-binding protein, type II (CRBP(II)) exhibits an adaptive change in a shortened jejunum, the distal end of 5-cm proximal-jejunal segment of 2-mth-old rats was joined to the proximal end of the ileum by an end-to-end anastomosis (jejunum-bypass operation). Three weeks after the operation, the amounts of CRBP(II) in proximal jejunum, proximal ileum and distal ileum were determined using a monospecific antiserum by enzyme-linked immunosorbent assay. The jejunum-bypass operation led to a 2-fold increase in the total amounts of CRBP(II) in proximal ileum where hyperplasia occurred; this elevation was in parallel to the increase of total proteins and DNA contents. in the proximal jejunum preceding the bypassed segment, the CRBP(II) level per unit DNA increased by 80%. The jejunum-bypass operation changed neither hepatic total retinol content, nor serum concentrations of retinol and retinol binding protein as compared with the sham-operation, suggesting that retinol absorption was elevated in the shortened small intestine. These results suggest that the increase in CRBP(II) content following jejunum-bypass might be an adaptive response to an enhancement of retinol absorption.

Characteristic features of alcoholic liver disease in Japan: a review

The characteristics of alcoholic liver disease (ALD) in Japanese patients were reviewed and compared with those in Western countries. From the study in Japanese cases, it became clear that alcoholic fibrosis and chronic hepatitis induced by alcohol were types of ALD other than the traditional 3 types. Liver injury in Japanese cases was clearly milder than that in American cases. In American cases, the injury may be fully developed, because of greater alcohol and fat intake. This may be one reason why the two above types of ALD have not been mentioned in the literature of Western countries. In Japanese patients, hepatitis C virus (HCV) infection is not related to alcoholic fibrosis and alcoholic hepatitis. On the other hand, the prevalence of HCV markers was high in chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) patients. Alcoholic hepatitis and chronic hepatitis are the high risk groups for the development of cirrhosis and the chronic hepatitis group is at high risk for the development of HCC. Although the risk is low in alcoholic fibrosis, some patients also develop cirrhosis. About half of the cases of cirrhosis may develop from alcoholic hepatitis and alcoholic fibrosis, and the remaining half cases may develop from chronic hepatitis. Over 80% of HCC cases may develop from chronic hepatitis in Japan. Chronic alcoholism enhanced the development of HCV-related HCC. Recent increase of HCC in alcoholic cirrhosis in Japan may be related to the increase of alcohol consumption, the increase of blood transfusions, and longer survival of cirrhosis patients.

Induction and distribution of cellular retinol-binding protein, type two during villus-crypt development in the chick duodenum

Between day 18 of embryogenesis and 1 day posthatch, a rapid and remarkable (over 10-fold) increase in cellular retinol-binding protein, type two (CRBP(II)) levels occurred in the lower portion of duodenal villi of the chick. With further postnatal growth and concomitant with initiation of food intake, CRBP(II) levels increased over 2-fold in the mid-villus enterocytes. The results suggest that a first induction of CRBP(II) occurs in differentiating lower villus enterocytes during the perinatal period and is followed by marked increases in mid-villus cells. These quantitative change in the distribution and levels of CRBP(II) are probably related to the appearance of retinol in the duodenal lumen.

The relationship between the development of alcoholic liver and pancreatic diseases and the induction of gamma glutamyl transferase

It is well known that the responses of serum gamma glutamyl transferase (GGT) to chronic alcohol drinking are different depending on the individual. In order to clarify the genetic backgrounds in the development of alcoholic liver and pancreatic diseases, the relationships between serum GGT response and alcoholic liver and pancreatic diseases in heavy drinkers were studied. The responses of GGT to alcohol drinking were classified into three groups: non-response, mild-response and hyperresponse. In alcoholic liver disease, non-responders were scarcely found and the response of GGT tended to increase in parallel with the progression of liver disease, when the hepatitis C virus (HCV) marker-positive patients were excluded. The differences in GGT levels between just after and at 4 weeks after abstinence in the HCV marker-negative patients were significantly higher than those in the HCV marker-positive patients. The rate of decrease in GGT activities during 4 weeks following abstinence was significantly higher in the HCV marker-negative patients than in the HCV marker-positive patients, indicating higher GGT induction in the HCV marker-positive patients. All patients with alcoholic pancreatitis, but without liver disease, were non-responders. All patients, except one, with severe pancreatitis were also non-responders. In alcoholic pancreatic disease, GGT induction correlated negatively with the development of pancreatitis. These results suggested that genetic polymorphism of GGT may link with the induction of GGT by alcohol drinking, and consequently link with the development of alcoholic liver and pancreatic diseases.

Analysis of the characteristics of microheterogeneity of various serum glycoproteins in chronic alcoholics

It has been reported that microheterogeneity of serum glycoproteins including transferrin is found in alcoholic liver disease. In the present study, microheterogeneity of serum glycoproteins in alcoholic liver disease patients was analysed using the Western blotting technique after isoelectric focusing. Microheterogeneity was found for serum alpha 1-antitrypsin, alpha 2-macroglobulin, caeruloplasmin, alpha 1-acid glycoprotein and hemopexin as well as transferrin. Microheterogeneity disappeared following treatment with sialidase in some but not all glycoproteins. In hemopexin, microheterogeneity was recognized only after treatment with sialidase. These results suggest that mechanisms of microheterogeneity of serum glycoproteins in alcoholic liver disease may vary. One mechanism may be the interference of glycosylation of glycoproteins in the Golgi apparatus, and another may be the decrease of asialo-protein receptors in hepatocytes.

Effects of alcohol on the replication of hepatitis C virus

We have reported that hepatitis C virus (HCV) RNA encoding the NS5 region (HCV-NS5) became negative following abstinence in some patients with alcoholic liver disease (ALD). In order to clarify the relationship between alcohol misuse (abuse) and the replication of HCV, serial changes of HCV-NS5 and the titer of HCV (HCV-titer) in blood after abstinence were studied in 11 male patients with ALD. Disappearance of HCV-NS5 after abstinence was found in five out of 11 patients (45%) and HCV-titer in blood decreased in all of these cases. In one patient, HCV-NS5 became positive and HCV-titers increased again following resumption of alcohol misuse. The etiology of liver disease in heavy drinkers was subdivided into three categories: alcohol alone, alcohol and HCV, and HCV alone, according to the diagnostic criteria of the Japanese research group for ALD. The etiology in four patients was a combination of alcohol and HCV, and was HCV alone in the remaining seven patients. In all four patients of the alcohol and HCV group, and one out of seven patients in the HCV alone group, HCV-NS5 became negative and HCV-titer decreased after abstinence. The decrease in HCV-titer was not related to the HCV genotypes. These results suggest that alcohol misuse may enhance the replication of HCV.

Relationship between alcoholic liver disease and HCV infection

The high prevalence of hepatitis C virus (HCV) markers in alcoholic liver cirrhosis (AL-LC) and hepatocellular carcinoma (HCC) suggests a close aetiopathogenic relationship between alcoholic liver disease (ALD) and HCV infection. In the present study, HCV markers in ALD were measured by the highly sensitive methods, and the changes of sequential HCV markers after abstinence in ALD patients were analysed in order to elucidate the effect of alcohol on HCV. Antibodies to HCV-related antigen were determined using the first or second generation test kit. HCV-RNA genomes encoding the NS-5 region were detected using the RT-PCR method. In the HCV-NS5 negative serum, HCV genomes of the 5'-noncoding region were detected using the two-stage PCR method. Titres of HCV-RNA were measured by multiple cyclic PCR and cDNA dot blotting. Typing of HCV genomes was carried out on the PCR product from the NS-5 region by slot blot hybridization using type-specific cDNA probes, or by restriction fragment length polymorphisms analysis. In alcoholic fibrosis and alcoholic hepatitis, the prevalence of HCV markers was low, suggesting that the main aetiological factor is alcohol but not HCV in these types of ALD. HCV markers were positive in the half of the patients with AL-LC, and in more than 80% of patients with AL-CH and AL-HCC, indicating that HCV infection closely relates to these types of ALD. The ratio of the K1 type to the K2 type of HCV genomes was 4:1 in all types of NANB liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)