Phylogenetic relationships of Cheju horses to other horse breeds as determined by mtDNA D-loop sequence polymorphism

Historical records suggest that horses inhabiting the island of Cheju in Korea are descendants of Mongolian horses introduced in 1276. Other studies, however, suggest that horses may have been present on the island prior to the Mongolian introduction. To determine the origin of the Cheju horses we used a phylogenetic analysis of sequences of the mitochondrial DNA (mtDNA) D-loop region, including tRNA Pro and parts of tRNA thr and tRNA Phe sequences (1102-bp excluding the tandem repeat region). Maximum parsimony and neighbor-joining trees were constructed using sequences determined for seven Cheju, four Mongolian, one Przewalskii and two Chinese Yunnan horses, and published sequences for one Swedish and three Thoroughbred horses. Donkey mtDNA was used as an outgroup. We found that the mtDNA D-loop sequence varies considerably within Mongolian, Cheju and Thoroughbred horse breeds, and that Cheju horses clustered with Mongolian horses as well as with horses from other distantly related breeds. On the basis of these findings we propose that horses on Cheju Island are of mixed origin in their maternal lineage, and that horses may have existed and been traded on the island before the Mongolian introduction.

Clinical observations of erythema multiforme in children

Erythema multiforme (EM), a cutaneous or mucocutaneous disorder, occurs primarily in young adults. To evaluate the precipitating factors, clinical courses, and treatment of this disease in children, 30 cases aged from 1 month old to 15 years of age were studied retrospectively from Jan 1988 to Aug 1998. Twenty-three cases were diagnosed as minor type; the other 7 were of major type (Stevens-Johnson syndrome). Mycoplasma infection was identified in 4 patients, and adenovirus in one patient with EM minor. Cytomegalovirus was found in one EM major patient. Anticonvulsant administration before the skin lesions were recorded in 5 EM major patients and 2 EM minor patients. All cases received supportive treatment during admission. Besides, 6 of 7 patients with EM major, and 11 of 23 EM minor (Group A) received systemic corticosteroid at a dose equal to prednisolone 1-2 mg/kg/day for 3-14 days. One EM major patient and 11 patients with EM minor (Group B) received supportive care only. One EM minor patient with acute idiopathic thrombocytopenia purpura was treated with intravenous immunoglobulin. The mean duration of course of EM minor was 11.8 +/- 2.9 days, and it was 25.1 +/- 9.8 days for EM major. No mortality and no sequelae were noted. The average disease course and hospitalization time were not significantly different between Group A and B: (11.4 +/- 3.1 days vs 12.4 +/- 2.9 days, p = 0.45); (5.4 +/- 2.0 days vs 6.3 +/- 3.1 days, p = 0.47). This study demonstrated that infections, especially mycoplasma, and anticonvulsants play important roles in childhood EM. The skin lesions of EM minor subsided within 2 weeks, and EM major recovered completely within 6 weeks. Systemic corticosteroid may be beneficial to EM major, but probably is unnecessary for patients with EM minor.

Cloning, sequencing, and tissue expression of CYP3A27, a new member of the CYP3A subfamily from embryonic and adult rainbow trout livers

Screening of lambdagt11 and lambdagt22A cDNA libraries of livers from adult females and embryos of rainbow trout (Oncorhynchus mykiss), respectively, using rabbit anti-rainbow trout cytochrome P450 LMC5 polyclonal antibodies showed that there were identical cDNAs of 1802-bp nucleotides with open reading frames coding for proteins containing 518 amino acids (59,206 Da, pI = 6.39). The cDNA was assigned CYP3A27 by the P450 Nomenclature Committee to represent the first CYP3A subfamily member reported for aquatic species. The deduced N-terminal sequence of CYP3A27 was in agreement with 8 of the first 12 confirmed amino acid residues from Edman degradation of LMC5, a P450 previously isolated from juvenile trout liver. In similarity comparisons between species by positional alignment, the deduced amino acid sequence of rainbow trout CYP3A27 was 56.4% identical with dog CYP3A12, 56.0% with monkey CYP3A8, 54.9% with human CYP3A4, 54.7% with rat CYP3A9, and 54.2% with sheep CYP3A24. Marked differences in sex, age, and tissue expression of CYP3A27 in rainbow trout were observed at the mRNA level as shown by Northern blots. The major extrahepatic expression site for CYP3A27 was upper small intestine. Females expressed considerably more CYP3A27 mRNA than male in the fish examined. Southern blot analysis of restriction enzyme-digested rainbow trout genomic DNA demonstrated that multiple CYP3A27-related genes exist in rainbow trout.

Rapid prenatal diagnosis of trisomy 21 by polymerase chain reaction- associated analysis of small tandem repeats and S100B in chromosome 21

OBJECTIVES

The incidence of Down syndrome increases with maternal age and a rapid and accurate method for prenatal diagnosis is a necessity. This study was devised to evaluate and compare the methods for detecting trisomy 21 by polymerase chain reaction (PCR)-associated analysis of small tandem repeats (STR) of D21S11 and semiquantitative analysis of S100B of chromosome 21.

METHODS

PCR was performed with DNA template obtained from 20 normal samples (10 blood, 10 amniotic fluid) and 12 Down syndrome samples (10 blood, 2 amniotic fluid). 32P-labelled primers for D21S11 and S100B were used. PCR products for D21S11 were subjected to polyacrylamide urea gel (6%) electrophoresis, followed by exposure to X-ray film, and then the densities of signals were recorded by densitometer. PCR products for S100B and insulin-like growth factor-I (IGF-I) as an internal control were subjected to agarose gel (2%) electrophoresis and the relative amounts of radioactivity in their products were measured to assess the quantitation of template DNA.

RESULTS

Analysis of D21S11 STR showed equivalent triplets in 4 cases and unequivalent doublets (1:2) in 8 Down syndrome samples. The normal control group showed singlets in 5 cases and equivalent doublets in 15 cases. In the analysis of S100B, the ratios of S100B to IGF-I was 1.4-1.6 in 7 of 12 Down syndrome samples, while the ratios of S100B in all normal samples were close to 1.0. All the results were obtained within 24 h. The D21S11 STR analysis managed to distinguish more clearly between normal and trisomy 21, while semiquantitative PCR analysis of S100B was less able to assess trisomy 21.

CONCLUSION

Prenatal diagnosis of trisomy 21 by PCR-associated STR analysis of D21S11 and semiquantitative analysis of S100B are useful, innovative, accurate and rapid diagnostic methods, while D21S11 STR analysis is more discriminating in detecting trisomy 21 and also may be employed in preimplantation diagnosis of Down syndrome.

Fusion expression of human pro-urokinase with E. coli thioredoxin

Human pro-urokinase (pro-UK) was cloned into plasmid pET32b and fused to the E. coli thioredoxin (trxA). When expressed in E. coli AD494(DE3), the fusion protein Trx-pro-UK accumulated as insoluble inclusion bodies and amounted to 35% of total cellular proteins. When co-expressed with molecular chaperones human protein disulfide isomerase (PDI) and E. coli GroESL, all the expressed products still existed in the form of insoluble inclusion bodies.

Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes

OBJECTIVES

Nutritional status in the acute stage of stroke has not been properly evaluated in different stroke subtypes. The objective of this study was to investigate the nutritional status of different subtypes of stroke patients.

SUBJECTS AND METHODS

We studied 88 female patients with first-ever strokes. Strokes were divided into cerebral infarction (CI, n=67) and intracerebral hemorrhage (ICH, n=21). We measured the nutritional status of the patients in the acute stage of stroke with the use of 8 parameters including 3 biochemical and 5 anthropometric ones. These variables were assessed in stroke patients and 120 age-matched controls, and were compared with each other.

RESULTS

In the acute stage of stroke, undernourishment was significantly (P=0.000) more prevalent in the ICH group (62%) than in the CI group (25%) or controls (13%). On the other hand obesity was present in 10%, 24% and 17% in patients with ICH, those with CI, and controls, respectively, which was not significantly different (P=0.461). Only abdominal skinfold thickness was significantly greater in patients with CI than in those with ICH or controls. Conclusions - Our results illustrate that undernourishment is prevalent in acute stroke patients, significantly more so in patients with ICH than in those with CI. Stroke patients, especially those with ICH, should receive special nutritional intervention starting immediately after admission.

[Studies on late replication bands of giant panda (Ailuropoda melanoleuca) chromosomes]

Using the cultured giant panda (Ailuropoda melanoleuca) lymphocytes as experimental material, we carried out the terminal marking on the chromosomes which were in replication by adding BrdU (a final concentration: 10 micrograms/ml) about four hours before harvesting the cells. The chromosomes marked by BrdU were proceeded by staining with acridine orange solution (0.05%), irradiated by ultraviolet and counter-stained by Giemsa, we obtained clear chromosomes replication patterns. According to the different replication bands, every chromosome's characteristics in late replication behavior could be identified. In the two X chromosomes of female individual, one X chromosome is obviously much later than the other one. Especially in the large area near centromere on the long arm of late replicating X chromosome. In the male individual, there is also a large area on the long arm of chromosome Y which replicates very late, but the end of long arm of chromosome Y replicates much earlier.

CYP2M1: cloning, sequencing, and expression of a new cytochrome P450 from rainbow trout liver with fatty acid (omega-6)-hydroxylation activity

A cDNA clone was isolated from a female rainbow trout liver lambda g tau 11 library using polyclonal antibodies raised against rainbow trout cytochrome P450 LMC1. This 2149-nucleotide clone contained an open reading frame encoding a protein of 499 amino acids with a calculated M(r) of 56,850 Da. On the basis of cytochrome P450 (P450) amino acid sequence comparisons, this rainbow trout P450 was assigned by the P450 Nomenclature Committee to a new P450 subfamily designated as CYP2M1. Northern blot results suggest that the expression of CYP2M1 at the transcriptional level was generally sex, tissue, and age specific. By use of a full-length CYP2M1 cDNA probe, it was observed that this cDNA hybridized strongly to a single 2.2-kb transcript in juvenile female rainbow trout trunk kidney and in liver from juvenile and sexually mature trout from both sexes. Negligible amounts of mRNA hybridizable to CYP2M1 cDNA were found in the juvenile and sexually mature male trunk kidney. cDNA-directed expression in COS-7 cells and of recombinant baculovirus in insect cells produced a protein that was reactive with rabbit anti-trout P450 LMC1 polyclonal antibody and exhibited the unique (omega-6)-hydroxylation toward lauric acid previously observed with rainbow trout P450 LMC1.

Expression of CYP2M1, CYP2K1, and CYP3A27 in brain, blood, small intestine, and other tissues of rainbow trout

Expression of five constitutive forms of cytochrome P450 [(LMC1 (CYP2M1), LMC2 (CYP2K1), LMC3, LMC4, and LMC5 (CYP3A27)] in selected tissues from sexually immature 2-year old female and male rainbow trout (Oncorhynchus mykiss) were examined at the translational level by Western blot using polyclonal antibodies raised in rabbits against those purified trout hepatic P450s. Tissues examined were from brain, liver, muscle, blood, head kidney, trunk kidney, upper intestine, stomach, heart, and gonad (ovary or testis). The results showed that the liver was the major organ for expression of all the trout P450s studied. Trunk kidney was the secondary expression site except for LMC5. Selective translational expression of these P450 isoforms or similar proteins was observed for LCM1 and LMC5 in brain; for LMC2 and LMC5 in female upper intestine; and for LMC2 in blood plasma of the fish studied under the experimental and sampling conditions.

Severe colonic complications in acute pancreatitis

BACKGROUND

Colonic complications in patients with acute pancreatitis may be very severe and have rarely been analyzed in Chinese patients.

METHODS

We retrospectively evaluated 1,637 patients with acute pancreatitis who were admitted to the Veterans General Hospital-Taipei from January 1986 to December 1995 in order to identify those with severe colonic complications. The clinical, radiologic and pathologic features and surgical findings in these patients are reviewed.

RESULTS

Eight of 1,637 patients with acute pancreatitis had severe colonic complications. Six of them were diagnosed between two and eight weeks after the onset of clinical pancreatitis. All had a Ranson's score of at least 3. Four patients, including one with hematochezia, had a strong positive reaction for occult blood in stool specimens. Computed tomography (CT) revealed necrotizing pancreatitis and colonic wall swelling in all eight patients. Colonic involvement was discovered by CT in two patients prior to surgery, one with colocutancous fistula and the other with colonic perforation. The other six patients were found to have colonic involvement incidentally at the time of laparotomy. All of the colonic involvements were located near the splenic flexure. In addition to necrosectomy, three patients underwent segmental hemicolectomy and the remaining five patients had simple closure of the perforation. Diverting loop ileostomy or colostomy was also carried out in all patients. Three patients (34%) died of overwhelming sepsis superimposed on the subsequent multiple organ failure between 44 and 122 days after the onset of pancreatitis.

CONCLUSIONS

Severe colonic complications of acute pancreatitis are rare. Although preoperative diagnosis is difficult, CT may be helpful to make an early diagnosis. These complications should be suspected in patients with severe acute pancreatitis when acute lower gastrointestinal hemorrhage or positive stool occult blood is found two to eight weeks after the onset of pancreatitis or when CT reveals necrotizing pancreatitis and colonic wall swelling; this will allow early surgical intervention.

Ki-1 lymphoma in two children

Childhood Ki-1 lymphoma is rarely reported in Taiwan. We present two 8-year-old girls with Ki-1 lymphoma diagnosed and treated at the National Taiwan University Hospital. The first patient presented with a neck mass with hepatosplenomegaly. The second patient initially presented with joint pain and pathologic fracture; she was later found to have bone marrow involvement. Histologic studies of both tumors revealed bizarre large cells with pleomorphic nuclei and prominent nucleoli. All these cells were immunolabeled with monoclonal antibody Ki-1. The two patients received different polyregime chemotherapy protocols followed by bone marrow transplantation (BMT); patient 1 had autologous BMT and patient 2 had allogeneic BMT. In addition, local radiotherapy and retinoic acid were tried for patient 1 but she responded poorly and died 2 years after presentation. In patient 2, although bone marrow was initially involved, allogeneic BMT was performed smoothly after tumor loading was reduced and the patient was in remission at last follow-up, 26 months after presentation. Ki-1 lymphoma in children is characterized by clinical presentations, and histologic and immunologic findings. Aggressive polyregime chemotherapy and bone marrow transplantation are treatments for this disease.

Sexual knowledge, behaviors, and attitudes of medical students in Kunming, China

422 medical students at a conservative campus in Yunnan reported their sexual knowledge, behaviors, and attitudes of reproductive health service to help students acquire necessary sexual knowledge and avoid unwanted pregnancy, abortion, and sexually transmitted diseases.

Absolute ethanol embolotherapy for hemangioma with Kasabach-Merritt syndrome

This report describes a female baby having a hemangioma over the right thigh that had appeared as an irregular bruise since two days old. Severe thrombocytopenia, consumptive coagulopathy, anemia, and heart failure developed at three months old. With a diagnosis of Kasabach-Merritt syndrome, systemic corticosteroid, vincristine, subcutaneous alpha-interferon, and massive plate transfusion were given. However, the platelet count remained low and the skin lesion enlarged gradually. Trans-feeding-arterial embolotherapy with a 5 ml pure ethanol (1 ml/kg) injection was performed at four months of age. Thirty days later, her platelet count recovered and the hemangioma shrunk in size. This case illustrates that absolute ethanol embolotherapy is an effective treatment for hemangioma with Kasabach-Merritt syndrome and may be life-saving for those with lesions refractory to medical therapy.

Glucocorticoid inhibition of adjuvant arthritis synovial macrophage nitric oxide production: role of lipocortin 1

Nitric oxide (NO) is a mediator of inflammatory injury which is inhibited by glucocorticoids and is implicated in rheumatoid (RA) and adjuvant arthritis (AA). The glucocorticoid-induced anti-inflammatory molecule lipocortin 1 is expressed in RA synovium, but the effects of lipocortin 1 on synovial inflammation have been little studied. We investigated the effects of glucocorticoids and lipocortin 1 on inducible NO synthase (iNOS) and glucocorticoids on the induction of lipocortin 1 in AA synovial macrophages. NO production was measured by Griess assay in supernatants of day 14 AA rat synovial explants and of synovial macrophages purified from enzyme-digested synovium and treated with lipopolysaccharide (LPS) 1 microg/ml, dexamethasone (DEX) 10(-7) M, and anti-lipocortin 1 MoAb. iNOS and lipocortin 1 expression were detected by flow cytometry using specific MoAb. Cell surface lipocortin was determined by Western blot. NO was produced by all AA synovial explants and NO was released by cultured synovial macrophages (14.5 +/- 2.1 micromol/24 h). iNOS was detected in synovial macrophages (ED-1+) by permeabilization flow cytometry. LPS increased synovial macrophage NO release (P < 0.0001) and iNOS expression (P = 0.04). DEX inhibited constitutive (P = 0.002) and LPS-induced (P < 0.001) NO release and iNOS expression (P = 0.03). DEX inhibition of synovial macrophage NO was associated with induction of cell surface and intracellular lipocortin 1. Anti-lipocortin 1 MoAb treatment reduced the inhibition of NO release by DEX (P = 0.002), but had no effect on iNOS expression. These findings demonstrate a role for lipocortin I in the inhibition by glucocorticoids of AA synovial macrophage iNOS activity.

Etiology and outcome of hydrops fetalis

Hydrops fetalis is a morbid condition caused by a wide variety of diseases. Although treatment for some underlying pathologies is becoming available, the prognosis remains poor. To analyze the etiology and outcome of hydrops fetalis, we reviewed the records of 79 fetuses encountered at the National Taiwan University Hospital between January 1993 and October 1996. The mean +/- standard deviation gestational age at presentation was 24.9 +/- 6.3 weeks. One case was due to RhE incompatibility. Seventy-eight fetuses were diagnosed as having nonimmune hydrops fetalis; this was idiopathic in 20 fetuses. In the other 58, the causes and associated conditions were classified into eight groups: hematologic (25), cardiovascular (15), chromosomal (5), gastrointestinal (4), cystic hygroma (3), pulmonary (2), infection (2), and miscellaneous (3). One fetus with cystic hygroma also had a chromosomal abnormality (Turner's syndrome). The most common cause of nonimmune hydrops fetalis was homozygous alpha-thalassemia (31%). Twenty-nine fetuses were lost to follow-up after initial evaluation and 50 fetuses were delivered at our hospital. Of these, there were eight cases of antepartum death, 24 cases of intrapartum death, and 18 live births. Seventeen of the live-born infants were treated at our neonatal intensive care unit, of whom only seven survived.

Three-dimensional surface reconstruction using optical flow for medical imaging

The recovery of a three-dimensional (3-D) model from a sequence of two-dimensional (2-D) images is very useful in medical image analysis. Image sequences obtained from the relative motion between the object and the camera or the scanner contain more 3-D information than a single image. Methods to visualize the computed tomograms can be divided into two approaches: the surface rendering approach and the volume rendering approach. In this paper, a new surface rendering method using optical flow is proposed. Optical flow is the apparent motion in the image plane produced by the projection of the real 3-D motion onto 2-D image. The 3-D motion of an object can be recovered from the optical-flow field using additional constraints. By extracting the surface information from 3-D motion, it is possible to get an accurate 3-D model of the object. Both synthetic and real image sequences have been used to illustrate the feasibility of the proposed method. The experimental results suggest that the proposed method is suitable for the reconstruction of 3-D models from ultrasound medical images as well as other computed tomograms.

Exacerbation of adjuvant arthritis by adrenalectomy is associated with reduced leukocyte lipocortin 1

OBJECTIVE

Lipocortin 1 is a mediator of the antiinflammatory actions of therapeutic glucocorticoids. ENdogenous glucocorticoids modulate inflammatory arthritides including rheumatoid and adjuvant arthritis (AA), but the role of lipocortin 1 in this phenomenon is not known. We studied the effects of endogenous glucocorticoids on adjuvant arthritis and leukocyte lipocortin 1 content.

METHODS

Adrenalectomy of sham adrenalectomy was performed 2 days before adjuvant injection in 170 g inbred Sprague-Dawley rats. Peripheral blood was obtained and disease severity assessed by delta paw volume and clinical score 14 days later. Leukocyte subset lipocortin 1 content was determined by double labeling permeabilization flow cytometry using specific monoclonal antibodies.

RESULTS

Lipocortin 1 fluorescence was readily detected in control rat peripheral blood cells labeled with OX-1 (pan-leukocyte), OX-19 (CD5), W3/25 (CD4), and OX-8 (CD8). Lipocortin 1 fluorescence was significantly greater in polymorphonuclear leukocytes (PMN) (RP3; p < 0.01). Induction of AA was accompanied by significant increases in lipocortin 1 (p < 0.001) in all subsets. Sham adrenalectomy induced no significant change in AA rat leukocyte lipocortin 1. Adrenalectomy induced significant exacerbation of AA disease severity compared to sham operation (delta paw volume 1.43 +/- 0.1 vs 1.13 +/- 0 ml; p < 0.05). Adrenalectomy was also associated with significant reduction in lipocortin 1 content in all leukocyte subsets except PMN. Leukocyte lipocortin 1 content exhibited significant negative correlation with clinical disease severity (R2 = -0.55; p < 0.05).

CONCLUSION

Endogenous glucocorticoids modulate leukocyte expression of lipocortin 1 in inflammatory disease, and reduced lipocortin 1 may be involved in the exacerbation of AA by adrenalectomy.

Rapid polymerase chain reaction analysis of St14 (DXS52) VNTR: carrier detection of hemophilia A

OBJECTIVE

To determine the frequency of St14 VNTR allele in Koreans as a marker of the hemophilia A and to evaluate the efficacy of this marker for carrier detection of hemophilia A METHODS: PCR amplified RFLP analysis of St14 VNTR was done in 312 X-chromosomes of 122 unrelated Korean males and 95 females and the same method was applied to carrier detection in the 2 hemophilia A families.

RESULTS

There were 13 alleles of different sizes of St14 VNTR locus appeared in 312 X-chromosomes of unrelated Koreans. For carrier detection of hemophilia A, in the family A, the mother showed 1390/ 1330 bp alleles and the father showed 700 bp allele. The affected son has inherited 1390 bp allele from his mother. The daughter at risk showed 1330/700 bp alleles. In family B, the mother showed 1280/700 bp alleles and the stepfather showed 1390 bp allele. The affected son has inherited 1280 bp allele. The daughter at risk showed 1390/700 bp alleles. And so the daughters of the 2 families were not carriers for hemophilia A.

CONCLUSION

PCR analysis of St14 VNTR was a useful tool for carrier detection of hemophilia A.

A retrospective drug utilization evaluation of antihyperlipidaemic agents in a medical centre in Taiwan

OBJECTIVE

The purpose of this study was to retrospectively evaluate the prescribing of antihyperlipidaemic agents in an 800-bed medical centre in southern Taiwan.

METHODS

A retrospective study based on reviewing medical records was conducted using a computerized database. We randomly selected 344 patients (age range 5-85 years) who received an antihyperlipidaemic agent between 1 April 1994 and 30 September 1994 and reviewed their medical records. All the related data from the date when the antihyperlipidaemic agent was first prescribed to 31 December 1994 was assessed. Usage guidelines for antihyperlipidaemic agents were defined by referring to the literature and specialist opinion.

RESULTS

Two hundred and twenty-two patients (64.5%) were treated with antihyperlipidaemic agents in accordance with the usage guidelines. In addition, most of the treatments complied with the regulations laid down by related health insurance programmes. The other 122 cases (35.5%) failed to meet any of the indications of the usage guidelines. Only 102 patients (29.7%) had their baseline lipid profiles examined and 117 patients (34%) had their baseline liver function tested. Over all, very few cases had lipid profiles and liver function tests every 3 months while taking antihyperlipidaemic agents. Patients who had been prescribed antihyperlipidaemic agents for more than 1 year were evaluated to assess the effectiveness of their pharmacological therapy. The prescribed doses were found to be lower than recommended in the general literature except for patients who received lovastatin and pravastatin.

CONCLUSIONS

There are many treatment guidelines for hypercholesterolaemia in north America and Europe. This study revealed that a large proportion of antihyperlipidaemic agents used in our patient population did not comply with these general recommendations. Although the reasons for not complying with usage guidelines need to be further investigated, our study findings may well serve as the basis for further quality management and pharmacoeconomic analysis.

Prolactin regulation of mitochondrial aspartate aminotransferase and protein kinase C in human prostate cancer cells

Citrate production is a major physiological function of the prostate that is regulated by testosterone and prolactin. Mitochondrial aspartate aminotransferase (mAAT) is a key enzyme in the metabolic pathway of prostate citrate production. In addition, prolactin stimulates expression of mAAT in the rat lateral prostate. In this report we establish the role of prolactin in the regulation of mAAT in two prostate cancer cell lines, LNCaP and PC-3. LNCaP cells respond to hormonal stimulation with increased secretion of prostate specific products. PC-3 cells, on the other hand, are testosterone independent and apparently do not respond to other growth factors either. Results showed that both LNCaP and PC-3 cells responded to prolactin with increased mAAT activity and an increased steady state level of mAAT mRNA. Prolactin also increased protein kinase C (PKC) activity in both these cell lines. Treatment of LNCaP and PC-3 cells with the phorbol ester 12-O-tetradecanoylphorbol (TPA) caused the same effect on mAAT activity and mRNA level as prolactin. The results suggest that the diacylglycerol-PKC signal transduction system mediates the prolactin effect on mAAT. In addition, these results also show that the prolactin effect on mAAT is independent of androgens since PC-3 cells reportedly lack androgen receptor expression. Thus, these results provide evidence that prolactin is a physiological regulator of prostate function in human as well as rat prostate. In addition, the results also show that though prostate cancer cells are androgen independent, they remain responsive to prolactin. This could have important implications for the treatment and management of prostate cancer.

Identification and characterization of acoK, a regulatory gene of the Klebsiella pneumoniae acoABCD operon

By using transposon insertional mutagenesis and deletion analyses, a recombinant clone containing the region upstream of the acoABCD operon of Klebsiella pneumoniae was found to be required for acetoin-inducible expression of the operon in Escherichia coli. The nucleotide sequence of the region was determined, and it displayed an open reading frame of 2,763 bp that is transcribed divergently to the acoABCD operon. This gene, designated acoK, is capable of encoding a protein with an overall 58.4% amino acid identity with MalT, the transcriptional activator of the E. coli maltose regulon. A conserved sequence for nucleotide binding at the N-terminal region, as well as a helix-turn-helix motif belonging to the LuxR family of transcriptional regulators at the C terminus, was also identified. Primer extension analysis identified two transcription initiation sites, S1 and S2, located 319 and 267 bp, respectively, upstream of the putative start codon of acoK. Several copies of NtrC recognition sequence [CAC-(N11 to N18)-GTG] were found in the promoter regions of both the acoK gene and the acoABCD operon. Acetoin-dependent expression of the acoABCD operon could be restored in the E. coli acoK mutants by supplying a plasmid carrying an intact acoK, suggesting a transactivating function of the gene product. The AcoK protein overproduced in E. coli was approximately 100 kDa, which is in good agreement with the molecular mass deduced from the nucleotide sequence. A specific DNA binding property and an ATPase activity of the purified AcoK were also demonstrated.

The genomic structure of a mouse seminal vesicle autoantigen

The genomic structure of an androgen-stimulated mouse seminal vesicle autoantigen was determined. Analysis of the nucleotide sequence established 2135 bp of the 5'-flanking region, four exons of 123, 136, 112, 227 bp, three introns of 1555, 1931, 316 bp, and 185 bp of the 3'-flanking region of this gene. Ten DNA segments, five in the 5'-flanking region, two in the first intron, and three in the second intron were identified to have more than 50% homology with the consensus sequence of the androgen response element (ARE). Two sets of adjacent DNA segments, one including -213 to -199 bp and -124 to -110 bp in the 5'-flanking region and the other including 2532 to 2546 bp and 2582 to 2596 bp in the second intron, are noticeable for their high degree of homology with ARE.

Heterogeneity of the human H blood group alpha(1,2)fucosyltransferase gene among para-Bombay individuals

BACKGROUND AND OBJECTIVES

The para-Bombay phenotype has a relatively high frequency of about 1 in 8,000 Taiwanese. Studies were carried out on eight healthy and unrelated Taiwanese with the para-Bombay phenotype to cast light on its immunogenetic basis.

MATERIALS AND METHODS

Blood and saliva samples were tested with standard hemagglutination techniques. Salivary ABH substances were determined by hemagglutination inhibition. PCR techniques were used to amplify the coding region of the H genes.

RESULTS

Five different h alleles, designated as h1, h2, h3, h4 and h5, were identified in the Taiwanese with the para-Bombay phenotype. The h1 allele loses one of the three AG repeats located at the nucleotides 547-552 of the H gene, whereas two of the three T repeats located at the nucleotides 880-882 are deleted in the h2 allele. The h3 allele contains a C658 to T missense mutation, whereas two missense mutations, C35 to T and A980 to C were identified in the h4 allele. A T460 to C missense is present in the h5 allele. The h5 allele was identified in an individual whose red blood cells contain blood group A antigen but not H antigen, and thus may be considered a weak variant of the H gene.

CONCLUSIONS

So far no biologic relevance of the H antigen has been discovered, and its deficiency does not seem to produce any deleterious effects. There may be better understanding of the evolutionary basis for the polymorphisms at these loci after systematic study of different ethnic populations.

Identification and characterization of the acoD gene encoding a dihydrolipoamide dehydrogenase of the Klebsiella pneumoniae acetoin dehydrogenase system

The acoD gene, which encodes a dihydrolipoamide dehydrogenase component of the acetoin dehydrogenase enzyme system of Klebsiella pneumoniae was isolated and the nucleotide sequence determined. The gene is capable of encoding a protein of 465 amino acid residues with conserved binding domains for NAD and FAD, and two redox-active cysteine residues. The acoD gene product exhibited a Michaelis constant of 170 microM for NAD, while NADP can not be used as a substrate. The purified enzyme appeared to be a dimer of the acoD gene product. It did not associate tightly with the E1 and E2 components of either acetoin dehydrogenase or 2-oxoglutarate dehydrogenase to form an active multi-enzyme complex.

Heterogeneity of the human Secretor alpha(1,2)fucosyltransferase gene among Lewis(a+b-) non-secretors

The human Secretor alpha (1,2)fucosyltransferase gene determines the ABH secretor status and influences the Lewis phenotype of an individual. Two different se alleles with point mutations, C571 to T and G849 to A respectively, in the coding region were identified in Le(a+b-) non-secretors from one of the Taiwanese indigenous groups. The base substitutions predict the alteration of Arg191 and Trp283 to stop codons respectively, resulting in deletion of the Secretor enzyme's C-terminal segment. Both alleles of the Secretor locus in all Le(a+b-) non-secretors, but not in Le(a+b-) secretors, were further demonstrated to be either one of these two se alleles with nonsense mutations. These results suggest two new molecular bases for the null se allele responsible for the formation of the non-secretor phenotype.

Chorionic villus sampling: clinical experience of the initial 750 cases

OBJECTIVE

To assess the factors that might influence the success rate, safety and reliability of chorionic villus sampling (CVS) and to evaluate the relationship between CVS and other congenital anomalies.

DESIGN

Analysis of the outcome of 750 cases of CVS (730 cases with transcervical and 20 cases with transabdominal).

SETTING

The outpatient prenatal genetic clinic of a university tertiary care center.

SUBJECT

Seven hundred and fifty pregnant women that underwent CVS for prenatal genetic diagnosis from 7 to 12 weeks of gestation.

RESULTS

Advanced maternal age was the most common indication for CVS (32.8%). The overall sampling success rate was 98.0% (735/750), representing 93.9% at 7 to 8 weeks, 98.1% at 9 to 10 weeks, and 98.3% at 11 to 12 weeks of gestation. The majority of cases (93.1%) required one or two aspirations. Cytogenetic analysis routinely included direct overnight and long-term culture methods which revealed 16 abnormalities (2.2%). Of 735 cases in which CVS was successful, 700 advanced to normal offspring, 17 had therapeutic termination, and 18 resulted in spontaneous abortions; there was an overall fetal loss rate of 2.4% (18/750).

CONCLUSION

CVS in early pregnancy is a relatively safe and reliable method of prenatal genetic diagnosis capable of replacing genetic amniocentesis. However, it must be done by experienced personnel. No congenital anomalies were found to be related to CVS in this series.

[Vaginal colonization of group B Streptococcus: a study in 267 cases of factory women]

An epidemiologic study on vaginal colonization of group B streptococcus (GBS) from non-pregnancy women was carried out. Two hundred sixty seven female workers were studied. The carrier rate of GBS in vaginal specimens was 10.86%. Women aged 45 years old and above had more cases with genital tract GBS colonization. Women with vaginal colonization had more history of miscarriage and using IUD. We did not find the positive correlations between vaginal colonization and oral contraceptive, ovarian cyst, hysteromyoma in our study group. Women with gynecologic inflammation had more cases with vaginal GBS colonization. There is a significant increase for women with vaginitis and cervicitis. Serotyping study showed that types III and II were the most frequent GBS types isolated from the carriers. Antibiotic sensitivity test showed that more than half GBS strains were resistant to oxcillin and amikacin.

Correlation of a missense mutation in the human Secretor alpha 1,2-fucosyltransferase gene with the Lewis(a+b+) phenotype: a potential molecular basis for the weak Secretor allele (Sew)

A missense mutation (A385 to T), predicting an Ile129 to Phe substitution, in the human Secretor alpha 1,2-fucosyltransferase gene was present in double dose in Lewis(a+b+) individuals, but not in Lewis(a-b+) individuals. Co-segregation of the Lewis(a+b+) phenotype with homozygosity for the mutation was also verified. These results yield a potential molecular basis for the weak Secretor allele (Sew) accounting for the Lewis(a+b+) phenotype.

Cytogenetic study employing chorionic villi in ectopic pregnancy

Maternal factors such as salpingitis and peritubal adhesion are known to be associated with ectopic pregnancy; however, a few studies have considered the chromosomal complements of ectopic conceptuses. We studied 16 ectopic conceptuses obtained by surgical resection. The karyotyping of chorionic villi was performed using direct and culture technique. Among 16 studied cases, 14 cases showed normal karyotype (nine with 46, XY; five with 46, XX). One case showed trisomy 16(47, XY, + 16) and another showed variation from normal chromosomal complement (46, XY, 14s+), resulting in 6.3% incidence of the structural abnormalities of the chromosome. On the basis of our study, we determined the possibility of chorionic villi karyotyping in ectopic pregnancy. This ectopic conceptuses are no more likely to show chromosomal abnormalities than in utero conceptuses of comparable gestational age. Therefore, maternal factors such as salpingitis and peritubal adhesion are the most likely explanations for ectopic pregnancy.

Rapid chromosome analysis and prenatal diagnosis using fluid from the cystic hygroma, hydrothorax and isolated ascites: new source for chromosome analysis

OBJECTIVE

To determine whether abnormally collected fetal body fluid could be used as alternative cell sources for cytogenetic assessment.

METHOD

Using modified lymphocyte culture, the abnormal fetal body fluids obtained from the five fetal anomaly cases (3 cystic hygromas, 1 hydrothorax, and 1 isolated ascites) were analyzed in order to determine their karyotypes.

RESULTS

Two cases showed 45, X and 46, XX/45, X and the other three showed a normal karyotype.

CONCLUSION

The cytogenetic analysis from body fluid aspiration yields a rapid and accurate result within 96 hours. This method could be helpful when cordocentesis or placental biopsy is not feasible or when time requirement for amniotic fluid cell culture is burdensome to patient management.

Prenatal fetal sex determination from maternal peripheral blood using polymerase chain reaction

We have investigated the use of a nested polymerase chain reaction(PCR) assay with Y-specific sequence from the DYS 14 locus on the short arm of Y-chromosome for prenatal sex determination in the peripheral blood of 22 pregnant women who participated in the antenatal genetic diagnosis program. The sensitivity and specificity of the nested PCR using DYS 14 locus primers(Y1.5,Y1.6, and Y1.7,Y1.8) were 76.4% and 55.5%, respectively. In terms of gestational age, positive predictive values of 66.6%, 66.6%, and 80% were obtained for the first, second, and third trimester respectively. The corresponding negative predictive values were 50%, 50%, and 100% respectively. Male specific band was positive in three of the six cases of female bearing women and male specific band was negative in three of the seven cases of male bearing women during 9-16 gestational weeks showing low sensitivity. But all cases except one show the male specific band during the male fetus and all female fetuses did not show the male specific 198 base pair band during 18 approximately 40 gestational weeks. This study suggests that prenatal sex determination by PCR employing maternal peripheral blood was usually possible in late pregnancy but less reliable in early pregnancy. It seems that if we used a method separating fetal cells from maternal blood and then run PCR on these cells with DYS 14 locus primers we could make a fairly accurate fetal sex determination.

[Perinatal colonization of group B streptococcus: a study in 600 cases in Beijing Tiantan Hospital]

An epidemiologic study of perinatal colonization of group B streptococcus (GBS) was carried out. Six hundred mother-infant pairs were studied at Beijing Tiantan Hospital. Maternal carriage rate of GBS was 8% with a neonatal colonization rate of 6.7%. Overall perinatal carriage rate was 13%. Women with perinatal colonization showed prone to have more premature and low birth weight babies. We did not find that perinatal colonization was associated with prolonged rupture of membranes and IUGR in our study group. Serotypical study showed that most frequent GBS type isolated from the carriers was III, followed by I a. Antibiotic sensitivity study showed that more than half of the GBS strains were resistant to the antibiotics a severe problem which might have caused by abuse in this country.

CDEBP, a site-specific DNA-binding protein of the ‘APP-like’ family, is required during the early development of the mouse

A murine protein, termed CDEBP, was previously shown to bind the double-stranded DNA motif GTCACATG, identical to the yeast centromeric element CDEI. The cDNA sequence showed three domains with extensive similarities to the amyloid beta precursor protein (APP). The protein is homologous over its entire length to the human protein designated APPH. In situ immunofluorescence assays using antibodies raised against distinct parts of CDEBP detected discrete sites of accumulation inside the interphase nucleus, and the bulk of the protein was not associated with mitotic chromosomes. One of the complexes with double-stranded CDEI oligonucleotides detected by gel shift assay was not present when the protein had been selectively removed from nuclear extracts by immunoprecipitation. We reported previously that microinjection into one-cell mouse embryos of DNA fragments including the CDEI sequence results in an early arrest of development with abnormal nuclei containing variable amounts of DNA. The same characteristic figures were observed when embryos were treated with antisense oligonucleotides complementary to parts of the CDEBP coding region. Complexes between the CDEBP protein and CDEI sites in the mouse genome thus appear to play a critical role in the replication/segregation of the embryonic genome.

Antibody Fc functional activity of intravenous immunoglobulin preparations treated with solvent-detergent for virus inactivation

We report here results of in vitro comparisons of the Fc functional activity of a second-generation intravenous immunoglobulin (IGIV) preparation (Venoglobulin-I) and a third-generation IGIV product that includes a deliberate virus-inactivation step (Venoglobulin-S). Both formulations showed equivalent Fc-mediated function against viral antigens (rubella, influenza A, and influenza B) by single-radial hemolysis test, and against group B Streptococcus, Staphylococcus aureus and Escherichia coli by opsonophagocytosis assay. In addition, we showed by three different immunochemical reactions and by HPLC analysis that both preparations consisted of mostly monomeric IgG and contained very low levels of complement-fixing IgG aggregates. However, IgG aggregation induced by heating at 63 degrees C markedly enhanced fixation of Clq and C3 and binding to Raji cells, indicating that the IgG molecules retained their complement-fixing capacity. Thus, the incorporation of a virus inactivation step in the manufacture of our third-generation IGIV did not alter the Fc functional activities of the IgG, as measured by these in vitro assay systems.

Inactivation and elimination of viruses during preparation of human intravenous immunoglobulin

We report here the results of our evaluation of virus inactivation during the manufacturing steps of two intravenous immunoglobulin (IGIV) preparations. Virus inactivation and/or removal by processing steps, such as ethanol fractionation and polyethylene glycol precipitation, and deliberate virucidal steps, such as solvent/detergent treatment and pasteurization, were tested on a variety of human pathogenic and experimental model viruses, including human immunodeficiency, Hepatitis C, Mumps, Vaccinia, Chikungunya, Vesicular Stomatitis, Sindbis, and ECHO viruses. All viruses were successfully inactivated and/or eliminated by the processing steps studied. In some cases, however, multiple steps were required. We conclude that the incorporation of steps deliberately designed to inactivate or remove viruses during the production of IGIV provides an extra measure of viral safety.

Cloning and sequencing of the major rainbow trout constitutive cytochrome P450 (CYP2K1): identification of a new cytochrome P450 gene subfamily and its expression in mature rainbow trout liver and trunk kidney

We have cloned and sequenced a full-length cDNA encoding the major constitutive rainbow trout liver cytochrome P450 that we had earlier designated as cytochrome P450 LMC2 (Arch. Biochem. Biophys. 268, 227, 1989). The 1859-bp cDNA was isolated from a male rainbow trout liver cDNA library and contained an open reading frame encoding for a protein of 504 amino acids and having a calculated molecular weight of 56,795. From nucleotide and amino acid sequence comparisons, the trout P450 LMC2 has been assigned to a new cytochrome P450 gene subfamily designated P4502K1 or CYP2K1. Marked differences in the sex- and tissue-specific expression of this gene were found at both the transcriptional and translational level in sexually mature rainbow trout liver and trunk kidney. Transcriptional expression investigated by Northern analysis of total RNA using a 440-bp 3'-terminal cDNA probe (2K1,7c) showed sexual and organ differences. Mature male trunk kidney expressed 2K1,7c-hybridizable mRNA to a substantially greater extent than did female trunk kidney, with multiple mRNA bands appearing in approximately the 2.8- and 1.9-kb region. While the livers of some males displayed separate 2.8-kb hybridizable bands, such bands were generally undetectable in female liver samples. By contrast, 1.9-kb mRNA bands were found at generally similar concentrations in the livers of both sexes. Taking into consideration the individual biological variabilities, it was apparent that mature male trout expressed the 2.8-kb mRNA much more strongly in trunk kidney than in liver. Translational expression, analyzed by Western blotting of microsomes separated on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and probed with rabbit polyclonal antibody and two different monoclonal antibodies prepared against P450 LMC2, demonstrated corresponding sex- and organ-related differences in P450 protein expression. Southern analysis of sexually mature male trout genomic DNA suggested that CYP2K1 is not a single copy gene, thus providing additional evidence for the complexity of the CYP2K1 system in rainbow trout.

Flow cytometric detection of anti-neutrophil cytoplasmic autoantibodies

An intracytoplasmic immunofluorescence staining technique which allows the detection and quantification of anti-neutrophil cytoplasmic autoantibodies (ANCA) by flow cytometry is described. A polymorph neutrophil population from human peripheral blood was used in this study as indicator cells. These were fixed and permeabilized by paraformaldehyde, Tween 20 and saponin, to allow ANCA in the patients sera to reach their intracellular antigen targets. The numbers of indicator cells remained unaltered by the permeabilization protocol and no cell aggregation or loss of intracellular antigenicity was observed. An excellent agreement (91% (207/228)) between ANCA detection by immunofluorescence microscopy (IF) and flow cytometry was noted. Compared with IF assay, the flow cytometric method has a sensitivity of 93% (42/45) and a specificity of 90% (165/183). Although not able to discriminate between P-ANCA or C-ANCA, this flow cytometric method has the advantage of providing an objective, reproducible and quantitative measure of ANCA, which makes it an ideal technique for screening of patients sera for ANCA reactivities.

[The hemodynamic and oxygen dynamic effects of mechanical ventilation in chronic cor pulmonale]

Observation by using Swan-Ganz catheter on hemodynamic and oxygen dynamic changes before and after assisted volume controlled mechanical ventilation (MV) was carried out in 11 cases of chronic cor pulmonale complicated with pulmonary encephalopathy. Pulmonary vascular resistance and pulmonary artery pressure were significantly decreased by the relief of hypoxia pulmonary vasoconstriction after MV. Because of the relax of sympathetic tension, the heart rate, arterial blood pressure, pulmonary capillary wedge pressure and central venous pressure reduced simultaneously. Left and right ventricular stroke work decreased after MV, without significant change in cardiac output. Venous admixture (Qs/Qt) was markedly reduced by MV and oxygen supply-demand ratio raised. It is thus shown that marked improvement of hemodynamic and oxygen dynamic status can be induced by mechanical ventilation at an opportune moment.

Abuse of antibiotics in China and its potential interference in determining the etiology of pediatric bacterial diseases

There is scant information about the etiology and epidemiology of bacterial diseases of infants and children in China because of very little success with bacterial culture. This study describes the severity of abuse of antibiotics among Chinese pediatricians and this abuse's potential interference in determining the etiology of bacterial diseases. According to a survey in Beijing Children's Hospital more than 98% of the patients in the Outpatient Department who were diagnosed with common cold were given antibiotics by physicians. More than one-third of the patients had been taking antibiotics before coming to the hospital. Using a sensitive Staphylococcus aureus assay we found that 70% of blood samples and 43% of cerebrospinal fluid samples from the patients with bacterial meningitis and pneumonia contained antibacterial activity. Bacteria were recovered significantly less often from the samples with antibacterial activity than from those who did not from which antibiotic was not recovered, both in blood (5.3% vs. 12.5%) and in cerebrospinal fluid (2.5% vs. 14.8%). This study indicates that antibiotic abuse is a severe problem in China and that judicious use of antibiotics is urgently needed.

The prevalence study on restriction fragment length polymorphism analysis for the detection of hemophilia A carrier

We have analyzed two (BclI and XbaI) intragenic restriction fragment length polymorphisms (RFLPs) and St14 (DXS52) variable number of tandem repeats (VNTR) by rapid PCR method in 97 unrelated normal subjects. The incidences for positive Bc1I and XbaI polymorphic sites in the Koreans were 81% and 72%, respectively, which were higher than other ethnic groups but similar to that reported in the Chinese or Japanese, giving the heterozygosity rate of 0.32 and 0.40, respectively. The amplified allele size was 880 bp with no other polymorphism in the analysis of St14 (DXS52) VNTR. This finding should be taken into account in the planning of a prenatal diagnosis program for ethnic Koreans.

Countercurrent immunoelectrophoresis for diagnosis of acute bacterial pneumonia in Chinese children

Countercurrent immunoelectrophoresis (CIE) with H. influenzal type b(Hib) and Pneumococci Omni antisera was performed on serum and concentrated urine and pleural fluid samples from 100 patients with acute pneumonia in Beijing Children's Hospital. Thirty-one patients were investigated by bacteriologic techniques (blood culture and pleural fluid culture). CIE was positive in 29/100 (29%) of cases of Hib, 13/100 (13%) of cases for pneumococci. Overall, bacterial causes of pneumonia were diagnosed by CIE in 41/100 (41%) cases. Antigens were detected in 5/90 (5.6%) serum samples, in 36/87 (41.5%) concentrated urine samples, and in 1/2 (50%) samples of pleural fluid. Only one Hib strain was found by pleural fluid culture. The contamination rate of bacterial culture in this group was high (5/31 cases, 16.1%). Therefore, traditional bacteriologic techniques are of very limited value for diagnosing pneumonia in Chinese children. The results showed that bacterial pathogen, especially Hib and Pneumococci, are very common and important causes of pediatric pneumonia in China.

Comparison of sublingual captopril, nifedipine and prazosin in hypertensive emergencies during hemodialysis

Hypertensive emergencies in hemodialysis require immediate therapy, usually by parenteral drug administration; however, sublingual medications may have potential in this special condition. Sublingual captopril (25 mg), nifedipine (10 mg) and prazosin (2 mg) were prescribed to determine the effectiveness and safety of each medication in the treatment of hypertensive emergencies during hemodialysis. Blood pressure and heart rate were measured continuously up to 120 min postdose. The response rates were 83% for captopril, 90% for nifedipine and 11% for prazosin. The significant hypotensive effects of both sublingual captopril and nifedipine occurred at 10 min and continued up to 120 min. The reduction of systolic blood pressure occurred earlier in nifedipine than captopril (10 vs. 15 min). No significant difference in heart rate between them was noted. There were no side effects in the captopril group but flushing, tachycardia and headache were observed in 4 patients of the nifedipine group. We concluded that sublingual captopril and nifedipine were effective but captopril seemed to have less side effects than nifedipine and may be an excellent alternative to sublingual nifedipine in the urgent treatment of hypertensive emergencies in hemodialysis. Prazosin was not recommended because of its low response rate.

Multiresolution texture segmentation with application to diagnostic ultrasound images

A multiresolution texture segmentation (MTS) approach to image segmentation that addresses the issues of texture characterization, image resolution, and time to complete the segmentation is presented. The approach generalizes the conventional simulated annealing method to a multiresolution framework and minimizes an energy function that is dependent on the resolution of the size of the texture blocks in an image. A rigorous experimental procedure is also proposed to demonstrate the advantages of the proposed MTS approach on the accuracy of the segmentation, the efficiency of the algorithm, and the use of varying features at different resolution. Semireal images, created by sampling a series of diagnostic ultrasound images of an ovary in vitro, were tested to produce statistical measures on the performance of the approach. The ultrasound images themselves were then segmented to determine if the approach can achieve accurate results for the intended ultrasound application. Experimental results suggest that the MTS approach converges faster and produces better segmentation results than the single-level approach.

Transient immunoglobulin M antibody response to hepatitis C virus capsid antigen in posttransfusion hepatitis C: putative serological marker for acute viral infection

The development of serological assays for hepatitis C virus (HCV) has made specific diagnosis possible. However, markers useful in indicating acute-phase HCV infection have not been identified. By an immunoblotting method, we characterized the IgM and IgG antibody response against HCV capsid antigen in patients with HCV infection. Among 88% of patients with acute posttransfusion hepatitis C recruited in a prospective study, there was a transient IgM antibody response. The IgM antibody appeared shortly after onset of hepatitis (average 3.7 weeks), persisted for several months (average 18 weeks), and then disappeared. In contrast, the IgG antibody persisted long-term once it appeared. Among patients with chronic hepatitis C with milder disease activities (serum aminotransferase increase above normal levels of less than 4-fold), the IgM antibody was negative in the majority (72%). In those with acute exacerbations (aminotransferase increase of greater than 10-fold), about 55% were negative for the IgM antibody. The reactivity of the IgM antibody in the rest was weaker or became negative upon further dilution of serum. The results suggest that IgM anti-capsid antibody may serve as a marker indicating acute or active HCV infection.