Probucol inhibits lipid peroxidation of macrophage and affects its secretory properties

AIM

To investigate the mechanisms of anti-atherogenic actions of probucol.

METHODS

Human peripheral blood monocytes were cultured, and treated by copper ion (10 mumol/L) and/or probucol (PBC). Lipid peroxidation was measured by assaying malondialdehyde (MDA). The cytokine interleukin-1 beta (IL-1 beta) and apolipoprotein E (apo E) secreted by monocyte were assayed by enzyme linked immunoassay (ELISA).

RESULTS

PBC 10-80 mumol/L inhibited copper ion-induced cellular lipid peroxidation from 15.30 to 7.74 mumol MDA/g cell protein. PBC 40 mumol/L inhibited oxidized macrophage-mediated oxidation of LDL from 5.18 to 1.65 mumol MDA/g cell protein, and attenuated secretory properties of monocytes induced by copper ion. The release of apo E, which is involved in reverse cholesterol transport, increased by 65%. And the release of IL-1 beta, which was shown to enhance vascular smooth muscle cell proliferation, decreased by 45%.

CONCLUSION

Probucol inhibits lipid peroxidation of macrophages and affects their secretory properties.

Applicability of BSID-II in diagnosing developmental delay at Kaohsiung area

The purpose of this study was to investigate the applicability of BSID-II in diagnosing children with developmental delay in Kaohsuing area. Five hundred and forty-four children, all who were patients of Developmental Delay Clinic of Kaohsuing Medical University, participated in this study. The instrument of this study was the Bayley Scales of Infant Development--second edition (BSID-II), the primary value of which was in diagnosing developmental delay and planning intervention strategies. The standardization and statistical properties of BSID-II made it one of the best measures of infant development available. The findings as follows: (1) the alpha coefficients were between .95 and .99, which were higher than data on manual of BSID-II; (2) the reproducibilities, which were different with each examiner, were between .9503 and .9633, that were good enough to be a developmental scale; (3) Standard Errors of Measurement were between 2.8589 and 3.8206. It was a restricted sample so that these also were lower than the data on manual of BSID-II. This evidence shows BSID-II is a highly reliable instrument of developmental assessment at Kaohsuing area. A special norm for developmentally delayed children and quality control of examiners are suggested.

The regulator of the yeast proline utilization pathway is differentially phosphorylated in response to the quality of the nitrogen source

The proline utilization pathway in Saccharomyces cerevisiae is regulated by the Put3p transcriptional activator in response to the presence of the inducer proline and the quality of the nitrogen source in the growth medium. Put3p is constitutively bound to the promoters of its target genes, PUT1 and PUT2, under all conditions studied but activates transcription to the maximum extent only in the absence of rich nitrogen sources and in the presence of proline (i.e., when proline serves as the sole source of nitrogen). Changes in target gene expression therefore occur through changes in the activity of the DNA-bound regulator. In this report, we demonstrate by phosphatase treatment of immunoprecipitates of extracts metabolically labeled with (32)P or (35)S that Put3p is a phosphoprotein. Examination of Put3p isolated from cells grown on a variety of nitrogen sources showed that it was differentially phosphorylated as a function of the quality of the nitrogen source: the poorer the nitrogen source, the slower the gel migration of the phosphoforms. The presence of the inducer does not detectably alter the phosphorylation profile. Activator-defective and activator-constitutive Put3p mutants have been analyzed. One activator-defective mutant appears to be phosphorylated in a pattern similar to that of the wild type, thus separating its ability to be phosphorylated from its ability to activate transcription. Three activator-constitutive mutant proteins from cells grown on an ammonia-containing medium have a phosphorylation profile similar to that of the wild-type protein in cells grown on proline. These results demonstrate a correlation between the phosphorylation status of Put3p and its ability to activate its target genes and suggest that there are two signals, proline induction and quality of nitrogen source, impinging on Put3p that act synergistically for maximum expression of the proline utilization pathway.

Ovarian steroids regulate 24p3 expression in mouse uterus during the natural estrous cycle and the preimplantation period

We examined 24p3 expression in the mouse uterus at various stages of the natural estrous cycle and during the preimplantation period. The level of 24p3 mRNA appeared intensively in proestrus and estrus, then declined sharply from metestrus to diestrus. Consistent with this observation, 24p3 protein was abundant in proestrus, decreased from estrus to metestrus and declined to a very low level in diestrus. The uterine 24p3 expression closely overlapped with the estradiol (E2) surge in proestrus and estrus but it was suppressed when progesterone (P4) rose to a high level during the reproductive cycle. Neither the protein nor its message was detected in the uteri of immature mice or ovariectomized adult animals. While an injection of P4 to these animals was unable to initiate uterine 24p3 expression, administration of estrogenic steroids to these animals markedly stimulated the gene expression. Treatment of these animals with E2 together with P4, on the other hand, did not stimulate the gene expression. In pregnant animals (day 1 (D1)=day of vaginal plug), 24p3 mRNA remained at a high level on D1 and D2 but dropped to an almost undetectable level on D3 and D4. This was accompanied by a decrease in 24p3 protein from D1 to D2 and a decline in the protein to undetectable levels from D3 to D4. The staining patterns of both the immunohistochemical localization of 24p3 protein and in situ hybridization for the detection of 24p3 mRNA in the uterine sections showed that 24p3 expression took place mainly in the luminal and glandular epithelial cells of the endometrium. This together with our previous observation that 24p3 protein is found in uterine luminal fluid indicates that the protein is secreted primarily from these cells to their respective luminal surfaces during proestrus and estrus.

[Construction of expressing vector for phage display scFv and a mouse unspecified antibody library]

The display of antibody gene library on the surface of E. coli filamentous phage offers a new method of obtaining antibodies against specific antigens. In the paper, it is reported that a phagemid for phage display antibody, named after pFUW80, characterized expressing scFv either secretly or stickily. With a series of designed PCR primers, heavy-chain and light-chain variable region genes of mice antibodies were amplified and a mouse unspecified single-chain antibody library with the size of 1.2 x 10(6) clones was constructed. From this library, phage was selected out against antigen human IgG and detected by ELISA and partial sequence analysis. These primary results established the foundation for future research using this system.

Hemolytic anemia in native valve infective endocarditis: a case report and literature review

Hemolytic anemia is a rare manifestation of infective endocarditis. A 19-year-old man with a small ventricular septal defect developed right-sided infective endocarditis with huge vegetations involving the tricuspid valve, the ventricular septal defect, and the pulmonary valve. Intravascular hemolysis was suggested by the presence of numerous fragmented erythrocytes, giant platelets and polychromasia of the red blood cells. The direct Coombs test was positive, and there were spherocytes and splenomegaly, findings that suggested an immune-mediated mechanism also played a role in the hemolysis. The hematological picture persisted despite antibiotic therapy and recovered only after surgical removal of the vegetations, tricuspid and pulmonary valvectomy, and patch closure of the ventricular septal defect.

Retrieval of atmospheric profiles from satellite sounder measurements by use of the discrepancy principle

It is known that an infrared or a microwave remote-sensing equation is an integral equation of the first kind. As a result, it is ill-posed, the solution is unstable, and difficulties arise in its retrieval. To make the solution stable, either an a priori error covariance matrix or a smoothing factor gamma is necessary as a constraint. However, if the error covariance matrix is not known or if it is estimated incorrectly, the solution will be suboptimal. The smoothing factor gamma depends greatly on the observations, the observation error, the spectral coverage of channels, and the initial state or the first guess of the atmospheric profile. It is difficult to determine this factor properly during the retrieval procedure, so the factor is usually chosen empirically. We have developed a discrepancy principle (DP) to determine the gamma in an objective way. An approach is formulated for achieving an optimal solution for the atmospheric profile together with the gamma from satellite sounder observations. The DP method was applied to actual Geostationary Operational Environment Satellite (GOES-8) sounder data at the Southern Great Plains Cloud and Radiation Testbed site. Results show that the DP method yields a 21.7% improvement for low-level temperature and a 23.9% improvement for total precipitable water (TPW) retrievals compared with the traditional minimum-information method. The DP method is also compared with the Marquardt-Levenberg algorithm used in current operational GOES data processing. Results of the comparison show significant improvement, 6.5% for TPW and 11% for low-level water-vapor retrievals, in results obtained with the DP method compared with the Marquardt-Levenberg approach.

The hydrophobic pocket of 24p3 protein from mouse uterine luminal fluid: fatty acid and retinol binding activity and predicted structural similarity to lipocalins

The conformation of 24p3 protein purified from mouse uterine luminal fluid was studied by circular dichroism spectroscopy in 200-300 nm. At pH 7.4, the spectrum in the UV region appears as one negative band with a minimum mean residue ellipticity of -3,600 deg.cm2.dmole(-1) at 217 nm, suggesting a very low or no helical content, but a considerable amount of beta-form, beta-turn, and unordered form in the protein molecule. This agrees with the predicted secondary structures consisting of only one a-helical segment of residues 150-163 and nine segments of residues 28-35, 50-60, 67-72, 78-86, 94-97, 106-114, 119-125, 136-140 and 166-172 in beta-forms, which would construct two orthonormal beta-sheets to form a less polar beta-barrel. The environments around Trp-31 and Trp-81 of this protein were studied by intrinsic fluorescence and solute quenching. They give an emission peak at 332 nm, and only about 21% of them are accessible to quenching by acrylamide. This together with their low accessibility to either CsCI or KI suggests that they are located in the less polar beta-barrel. Hydrophobic compounds such as fatty acids, retinoids, and cholesteryl oleate in the protein solution diminish the protein fluorescence. Analysis of the fluorescence data suggests that the protein has a binding site for hydrophobic ligand. The association constants for the complex formation are 1.03 x 10(6) MM(-1), 1.92 x 10(5) M(-1), 2.38 x 10(5) M(-1) or 1.25 x 10(5) M(-1) for cholesteryl oleate, oleic acid, retinol, or retinoic acid at pH 7.4. Analysis of the equilibrium binding data from binding assay using [H3]-retinol and [H3]-retinoic acid reveals a singular type of retinoid-binding site in the protein with the association constant of 4.92 x 10(5) M(-1) and 1.17 x 10(5) M(-1) for retinol and retinoic acid, respectively. Trp-31 or/ and Trp-81 is in or very near the binding site and the gross conformation of protein changes considerably as the formation of protein-ligand complex.

Involvement of heat shock elements and basal transcription elements in the differential induction of the 70-kDa heat shock protein and its cognate by cadmium chloride in 9L rat brain tumor cells

Exposure of 9L rat brain tumor cells to 40-100 microM CdCl2 for 2 h leads to an induction of a wide spectrum of heat shock proteins (HSPs). We have demonstrated that induction of the 70-kDa HSP (HSP70) and enhanced expression of its cognate (HSC70) by cadmium are concentration dependent and that the induction kinetics of these HSP70s are different. The increased synthesis of the HSP70s is accompanied by the increase in hsp70 and hsc70 mRNA levels, indicative of transcriptional regulation of the heat shock genes. Electrophoretic mobility shift assay (EMSA) using probes encompassing heat shock element (HSE), TATA, GC, and CCAAT boxes derived from the promoter regions of the heat shock genes shows distinguished binding patterns between hsp70 and hsc70 genes in both control and cadmium-treated cells. The results indicate that, in addition to the HSEs, the basal transcription elements are important in the regulation of the heat shock genes. The binding patterns of the corresponding transcription factors of these elements are examined by EMSA by using extended promoter fragments from respective heat shock genes with sequential addition of excess oligonucleotides encompassing individual transcription elements. Taken together, our results show that the differential induction of hsp70 and hsc70 involves multiple transcription factors that interact with HSE, TATA, GC, and CCAAT boxes.

Protective effects of Ginkgo biloba extract against lysophosphatidylcholine-induced vascular endothelial cell damage

AIM

To study the protective effects of Ginkgo biloba extract (GbE) against endothelial cell damage induced by lysophosphatidylcholine (LPC).

METHODS

The vasorelaxation response to acetylcholine (ACh) were investigated in the isolated rabbit thoracic aorta. Lipid peroxidation products were determined by measuring thiobarbituric acid reactive substance.

RESULTS

GbE attenuated the inhibition of vasorelaxation response to ACh and prevented the LPC-induced increase of malondialdehyde (MDA) content both in thoracic aortae. GbE prevented the leakage of LDH and the increase of MDA content in cultured endothelial cells in a concentration-dependent manner. GbE also markedly increased epoprostenol level in cultured endothelial cells treated with LPC.

CONCLUSION

GbE protected endothelial cells against LPC-induced damage due to reduction in lipid peroxidation and facilitation of synthesis and/or release of epoprostenol.

Somatic embryo formation and germination from immature embryo-derived suspension-cultured cells of Angelica sinensis (Oliv.) Diels

Embryogenic callus was induced from immature embryos of Angelica sinensis cultured on Murashige and Skoog (MS) basal medium. Embryogenic callus growth was more rapid on MS basal medium than on B5 or White medium. Embryogenic callus was used to establish a suspension culture and somatic embryos and germinating embryos developed during the culture. A shaking speed of 80 rpm was found to be optimal for establishing suspension cultures, while 100 rpm produced more somatic embryos and germinating embryos with an initiation cell density of 0.2 ml packed cell volume/25 ml medium. Adding 0.3% agar to the liquid medium also stimulated the formation of somatic and germinating embryos. While no plant growth regulators were needed for culture initiation and plant regeneration, the addition of 0.5-1 mg/l 2,4-dichlorophenoxyacetic acid was needed to maintain the embryogenic suspension culture by preventing embryo germination. Forty percent of the germinating embryos survived after culturing on filter paper moistened with liquid half-strength MS medium containing 3% sucrose. The plants were successfully transferred into soil.

Involvement of p38 mitogen-activated protein kinase signaling pathway in the rapid induction of the 78-kDa glucose-regulated protein in 9L rat brain tumor cells

We have previously shown that treatment with okadaic acid (OA) followed by heat shock (HS) (termed OA --> HS treatment) leads to rapid transactivation of the 78-kDa glucose-regulated protein gene (grp78) in 9L rat brain tumor cells. A cAMP-responsive element-like (CRE-like, TGACGTGA) promoter sequence and a protein kinase A signaling pathway are involved in this induction, and activation of both CRE binding protein (CREB) and activating transcription factor-2 (ATF-2) is required in the above process. Herein, we report that transactivation of grp78, as well as phosphorylation/activation of ATF-2, can be completely annihilated by SB203580, a highly specific inhibitor of p38 mitogen-activated protein kinase (p38(MAPK)). Activation of p38(MAPK) by OA --> HS is also substantiated by its own phosphorylation as well as the phosphorylation and activation of MAPK activating protein kinase-2 in cells subjected to this treatment. The involvement of p38(MAPK) in the activation of ATF-2, which leads to the transactivation of rat grp78, is confirmed by electrophoretic mobility shift assay using a probe containing the CRE-like sequence as well as by transient transfection assays with a plasmid containing a 710-base pair stretch of the grp78 promoter. Together with our previous studies, these results led us to conclude that phosphorylation/activation of CREB upon OA --> HS treatment is mediated by cAMP-dependent protein kinase, whereas that of ATF-2 is mediated by p38(MAPK). The transcription factors may bind to each other to form heterodimers that in turn transactivate grp78 by binding to the CRE-like element. This suggests that distinct signaling pathways converge on CREB-ATF-2, where each subunit is individually activated by a specific class of protein kinases. This may allow modulation of grp78 transactivation by diverse external stimuli.

Rapid induction of the Grp78 gene by cooperative actions of okadaic acid and heat-shock in 9L rat brain tumor cells--involvement of a cAMP responsive element-like promoter sequence and a protein kinase A signaling pathway

We have demonstrated that treatment with 200 nM okadaic acid (OA) for 1 h followed by a 15-min heat shock (HS) at 45 degrees C (termed OA-->HS treatment) leads to a rapid transactivation of grp78, the gene for the 78-kDa glucose-regulated protein, in 9L rat brain tumor cells. The level of Grp78 mRNA rose 15-fold in 60 min after the combined treatment. Nuclear extracts from cells subjected to OA-->HS treatment, compared to those of treatment with OA or HS alone, exhibited an increased binding activity toward an oligonucleotide probe containing the cAMP-responsive element-like (CRE-like, TGACGTGA) regulatory element in electrophoretic mobility shift assays (EMSA). The binding resulted in the formation of two protein-EMSA probe complexes exhibiting different association and dissociation rates in kinetic studies. The protein factors in the upper band (complex I) and lower band (complex II) were identified as the activating transcription factor-2 (ATF-2) and the CRE binding factor 1 (CREB-1), respectively, by antibody interference assays. In addition, the identity of CREB-1 was confirmed by supershift analysis. The binding activity, as well as the transactivation of the grp78 gene, can be abolished by a 1-h treatment with the cAMP-dependent protein kinase (PKA) inhibitor but not with protein kinase C or Ca2+/calmodulin-dependent protein kinase II inhibitors. Accumulation of steady-state level of ATF-2 was observed and was also modulated by treatment with H-89, a PKA inhibitor. From these results, we conclude that the CRE-like element plays an important role in the rapid transactivation of the grp78 gene and that the PKA signaling pathway is involved. In addition, PKA-mediated transcriptional regulation of grp78 in OA-->HS treatment is through regulation of protein phosphorylation as well as de novo synthesis of ATF-2.

Construction and expression of single-chain Fv antibody against human bladder carcinoma

We designed two sets of oligonucleotide primers to amplify the immunoglobulin heavy- and light-chain variable-region genes from genomic DNA by polymerase chain reaction (PCR). The genomic DNA was extracted from hybridoma BDI-1 cells, which secreted a monoclonal antibody (mAb) against human bladder carcinoma. The primers contained special restriction sites that allowed the variable-region genes to be easily cloned for sequencing and expression. The recombinants were sequenced by Sanger's method. It was proved that the full lengths of the VH and VK genes were 366 and 324 bp, respectively. Compared with other published sequences, the VH gene was a member of mouse heavy-chain VH subgroup II and originated from the rearrangement of VH, Dsp2.2 and JH4. The VK gene was VK subgroup IV and from VK and JK4. The VH and VK genes was inserted expression vector pWAI80. By inducement, the ScFv antibodies were expressed and secreted from Escherichia coli. Binding activities against the bladder carcinoma cells were detected. We suggest that ScFv antibody recognized the antigen specifically.

Demonstration of a glycoprotein derived from the 24p3 gene in mouse uterine luminal fluid

A glycoprotein in mouse uterine luminal fluid was purified to homogeneity via a series of purification steps involving Sephadex G-100 chromatography, Sephadex G-50 chromatography and HPLC on a reverse-phase C18 column, in that order. Automated Edman degradation was unable to determine the N-terminal residue of the glycoprotein and the partial sequences determined from its trypsin digests were found to be identical with the protein sequence deduced from 24p3 cDNA. The core protein and the total amount of carbohydrate together gave a molecular mass of 25.8 kDa. Results from the characterization of the glycopeptide bond indicated the presence of N-linked carbohydrate but no O-linked carbohydrate in the protein, which has two potential sites for N-linked carbohydrate at Asn81 and Asn85, as deduced from analysis of the primary structure. The core protein was shown to have a molecular mass equal to that of the putative protein deduced from cDNA, suggesting that this protein may contain no signal peptide. Results of Northern-blot analysis for various tissues of adult mice revealed that the 24p3 gene was expressed in lung, spleen, uterus, vagina and epididymis.

CPEO and carnitine deficiency overlapping in MELAS syndrome

Mitochondrial myopathy, encephalopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is one of the mitochondrial encephalomyopathies that has distinct clinical features including stroke-like episodes with migraine-like headache, nausea, vomiting, encephalopathy and lactic acidosis. We report a 27-year-old woman who presented with partial seizure, stroke-like episodes including hemiparesis, hemianopia and hemihypethesia, sensorineural hearing loss, migraine-like headache, and lactic acidosis. Brain computed tomographic scan showed encephalomalacia in the right parieto-occipital area and recent hypodensity in the left temporoparieto-occipital area with cortical atrophy. Muscle biopsy revealed ragged-red fibers and paracrystaline inclusions in the mitochondria. Genetic study revealed an A to G point mutation at nucleotide position (np) 3243 of mitochondrial DNA. External ophthalmoplegia and ptosis were also found during two exaggerated episodes in this patient. Therefore, the overlapping syndrome of chronic progressive external ophthalmoplegia in the MELAS syndrome is considered in this case. Furthermore, we also found carnitine deficiency in this patient and she was responsive well to steroid therapy. Muscle biopsy also revealed excessive lipid droplets deposits. Therefore, the carnitine deficiency may occur in MELAS syndrome with the A to G point mutation at np 3243. We recommend the steroid or carnitine supplement therapy be applied to the MELAS syndrome with carnitine deficiency.

[Outcome of HCV infection in intravenous drug addicts and influential factors]

A total of 154 intravenous drug addicts with antibody to hepatitis C virus (Anti-HCV) were followed up for 6 and 15 months, respectively. The corresponding negative conversion rates of anti-HCV were 11.0% (17/154) and 33.3% (29/87), respectively. The data were analysed by logistic curve fitting. Results showed that marriage and income status have significant influence on negative conversion rate of anti-HCV.

Gastric perforation in the neonate: clinical analysis of 12 cases

Gastric perforation is a rare abdominal catastrophe which associated with high mortality in newborn infants. From June 1978 to July 1991, twelve cases of neonatal gastric perforation presented at Chang Gung Memorial Hospital. Male to female ratio was 9:3. The most common presenting signs were abdominal distension (100%), feeding intolerance (92%), respiratory distress (67%) and poor activity (58%). All cases had significant symptoms between two and five days of age. All of the abdominal plain film showed pneumoperitonium. The most common site of perforation was the great curvature of the stomach (83%). Among the 10 pathological reports available, 8 cases had ischemic change and 2 cases had hemorrhage and inflammatory cell infiltration. There was a high mortality rate of 58% in this series. Male, hyponatremia (serum sodium < 130 meq/l) and metabolic acidosis (pH < 7.3) were poor prognostic factors. This report suggests that early diagnosis and early management before clinical deterioration of the metabolic status may improve prognosis for neonatal gastric perforation patients.

[The performances of attention deficit/hyperactivity disorder on neuropsychological tests of children]

The purpose of this study was to investigate the Attention Deficit/Hyperactivity Disorder (ADHD) by neuropsychological tests of children. There were two groups of subjects; one group was 23 ADHD children, the other group was 33 normal children. All of the subjects were 5 to 8 years old (mean = 7.05). The social economic status differences were nonsignificant between the two groups (chi-square = 0.52, p > 0.05). The instruments were WISC-R, Tests of Psycholinguistic Abilities, Diagnostic Arithmetic Test, and Reitan-Indiana Neuropsychological test for yound children. The findings were: (1) For all IQs (verbal, performance, full), the ADHD group was significantly lower than the normal group, and there were 8 (34.8%) ADHD children who were mental retards, 3 (13.0%) ADHD children were borderline mental retards, and there was just one (3.0%) normal child who was a borderline mental retard. (2) For academic abilities (Tests of Psycholinguistic Abilities, and Diagnostic Arithmetic Tests), the ADHD group was significantly (p < 0.05) lower than the normal group, and the higher the grade, the larger the difference. (3) For neuropsychological tests, if cut-off points of performance level (0, 1, 2, 3) were percentile 5, 10, and 25 for all of the subjects, then there 12 variable criteria were lower than the Reitan's, 3 variable criteria were higher than the Reitan's, 29 variable criteria were similar with Reitan's, and 8 variables were indiscriminate between individuals. (4) The motor functions and higher cognitive abilities of the ADHD group were worse than those of the normal group.

[Histamine release from mast cell induced by main pathogenic bacteria of respiratory infections in Guangzhou area]

The methodology for isolating rat peritoneal mast cell was established. The main pathogenic bacterial ultrasonicates of respiratory infection in GuangZhou area have been examined for their ability to release histamine from purified rat peritoneal mast cells. The results were as following: (1) 7 pathogenic bacteria can cause direct release of histamine from rat mast cells. The most effective histamine releasers were P. mira (histamine release percent is 26.89% +/- 6.70%), Strep. Pneu (24.16% +/- 3.71%), E. Coli (20.40% +/- 4.83%) and K. Pneu (17.91% +/- 4.60%). (2) Histamine release initiated by bacterial ultrasonicates was completed within 30 minutes E. Coli differed from K. Pneu induced histamine release was independent of its dose. (3) The products of K. Pneu did not induce histamine release directly and bacterial hemolysin may play a potent role in bacteria-induced release of histamine. Our findings provide some evidence for mechanism by which respiratory bacterial infection can precipitate or exacerbate attacks of bronchial asthma.

Adenomyoma of the papilla of Vater: a case report

Adenomyoma of the papilla of Vater is exceedingly rare. Histologically, the adenomyoma is characterized by locules of ducts with interlacing bundles of smooth muscle. A 63-year-old male patient is presented who had developed abdominal pain, progressively darker urine and light color stool, jaundice and dyspepsia over the past two-month period. Impression from radiologic study was neoplasm of the papilla of Vater, pathologic findings proved adenomyoma. This case, and review of the literature, suggest that local excision is the treatment-of-choice.