Ethylene production by strains of the plant-pathogenic bacterium Pseudomonas syringae depends upon the presence of indigenous plasmids carrying homologous genes for the ethylene-forming enzyme

The molecular characteristics of the ethylene-forming enzymes of strains of Pseudomonas syringae were tested. The ethylene-producing activities of the nine strains as measured in vivo and in vitro were similar, except for that of P. syringae pv. mori M5. A polyclonal antibody and a DNA probe for the ethylene-forming enzyme from P. syringae pv. phaseolicola PK2 were prepared to investigate homologies among the proteins and genes for the ethylene-forming enzymes. With the exception of P. syringae pv. mori M5, eight strains tested expressed the same antigen as the ethylene-forming enzyme from P. syringae pv. phaseolicola PK2 and were homologous to DNA sequences on indigenous plasmids. Molecular masses of antigenic proteins from all ethylene-producing strains were 40 kDa. The N-terminal amino acid sequence of the purified ethylene-forming enzyme from P. syringae pv. glycinea KN130 was identical to that of the enzyme from P. syringae pv. phaseolicola PK2. These results show that the ethylene-forming enzymes encoded by the indigenous plasmid(s) in the pathogenic bacteria examined were similar.

Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma

BACKGROUND

The authors have used percutaneous microwave coagulation therapy (PMCT) as a new percutaneous local treatment for single unresectable hepatocellular carcinoma (HCC) measuring 2 cm or less in greatest dimension (small HCC). PMCT was used to attempt a cure of the disease. In this study, the efficacy of this treatment was assessed.

METHODS

PMCT was performed on 18 patients with single small HCC. A microwave electrode (custom-made, 30-cm long by 1.6-mm thick) was inserted percutaneously into the tumor area under ultrasonic guidance. Microwaves at 60 W for 120 seconds were used to irradiate the tumor and surrounding area.

RESULTS

After PMCT was administered, various image findings were correlated with tissue necrosis. At the tumor and surrounding area, ultrasonography showed echogenic change, contrast enhancement disappeared on contrast enhanced computed tomography, and magnetic resonance imaging (T2-weighted image) showed decreased intensity in all cases after treatment. Complete necrosis of the tumor area in a specimen obtained from one patient who underwent hepatectomy after PMCT also was confirmed. The treatment reduced levels of the tumor marker, alpha-fetoprotein, which had been high in some patients. Although the follow-up period was short (11-33 months), 17 patients remain alive. Local recurrence in the treated area has not been detected, and no serious side effects or complications have been encountered.

CONCLUSIONS

PMCT may be an effective and safe treatment for small HCCs.

Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma

BACKGROUND

The authors have used percutaneous microwave coagulation therapy (PMCT) as a new percutaneous local treatment for single unresectable hepatocellular carcinoma (HCC) measuring 2 cm or less in greatest dimension (small HCC). PMCT was used to attempt a cure of the disease. In this study, the efficacy of this treatment was assessed.

METHODS

PMCT was performed on 18 patients with single small HCC. A microwave electrode (custom-made, 30-cm long by 1.6-mm thick) was inserted percutaneously into the tumor area under ultrasonic guidance. Microwaves at 60 W for 120 seconds were used to irradiate the tumor and surrounding area.

RESULTS

After PMCT was administered, various image findings were correlated with tissue necrosis. At the tumor and surrounding area, ultrasonography showed echogenic change, contrast enhancement disappeared on contrast enhanced computed tomography, and magnetic resonance imaging (T2-weighted image) showed decreased intensity in all cases after treatment. Complete necrosis of the tumor area in a specimen obtained from one patient who underwent hepatectomy after PMCT also was confirmed. The treatment reduced levels of the tumor marker, alpha-fetoprotein, which had been high in some patients. Although the follow-up period was short (11-33 months), 17 patients remain alive. Local recurrence in the treated area has not been detected, and no serious side effects or complications have been encountered.

CONCLUSIONS

PMCT may be an effective and safe treatment for small HCCs.

Neurotensin transcription is oppositely regulated during development and regeneration

Our previous work demonstrated that neurotensin mRNA expression was transiently up-regulated during development in the hypoglossal motoneurone. The present study was carried out to examine how neurotensin mRNA expression changes during nerve regeneration. Following either unilateral resection or crushing of the hypoglossal nerve, mRNA expression was detected by non-radioactive in situ hybridization histochemistry using an alkaline phosphatase-labelled oligonucleotide probe. A reduction in neurotensin mRNA was observed on the operated side after the nerve injury. It took around 2 months for NT mRNA levels to return to normal. Similar down-regulation was observed following crushing, but recovery was more rapid than that observed with sectioning, probably due to the extent of nerve damage. This finding indicates that neurotensin transcription is up-regulated during development but, on the contrary, down-regulated during regeneration.

Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma

BACKGROUND

The authors have used percutaneous microwave coagulation therapy (PMCT) as a new percutaneous local treatment for single unresectable hepatocellular carcinoma (HCC) measuring 2 cm or less in greatest dimension (small HCC). PMCT was used to attempt a cure of the disease. In this study, the efficacy of this treatment was assessed.

METHODS

PMCT was performed on 18 patients with single small HCC. A microwave electrode (custom-made, 30-cm long by 1.6-mm thick) was inserted percutaneously into the tumor area under ultrasonic guidance. Microwaves at 60 W for 120 seconds were used to irradiate the tumor and surrounding area.

RESULTS

After PMCT was administered, various image findings were correlated with tissue necrosis. At the tumor and surrounding area, ultrasonography showed echogenic change, contrast enhancement disappeared on contrast enhanced computed tomography, and magnetic resonance imaging (T2-weighted image) showed decreased intensity in all cases after treatment. Complete necrosis of the tumor area in a specimen obtained from one patient who underwent hepatectomy after PMCT also was confirmed. The treatment reduced levels of the tumor marker, alpha-fetoprotein, which had been high in some patients. Although the follow-up period was short (11-33 months), 17 patients remain alive. Local recurrence in the treated area has not been detected, and no serious side effects or complications have been encountered.

CONCLUSIONS

PMCT may be an effective and safe treatment for small HCCs.

[Follow-up study of MRI imaging in a case of traumatic pulmonary hematoma]

A 29-year-old male was suffered from traumatic pulmonary hematoma by blunt chest trauma. We examined chest roentogenograms, chest CT, and MR imaging of the thorax periodically. Those revealed that: 1) Traumatic pulmonary hematoma produce an intense signal and is not influenced by blood stream in the MR imaging. 2) Like other methods, in MRI, pulmonary hematoma gradually decreased its volume. However, as hematoma is visualized solitarily in MRI, small hematoma can be distinguished easily.

Enzymatic sulfation of glycosides and their corresponding aglycones by arylsulfate sulfotransferase from a human intestinal bacterium

A novel type of arylsulfate sulfotransferase (ASST) from a predominant human intestinal bacterium catalyzes the stoichiometric transfer of a sulfate group from phenolic sulfate esters to phenols. We clarified that polyphenols were better substrates of this enzyme than the corresponding glycosides. Additionally, a coumarin derivative, esculetin, was sulfated by ASST at the 6-position to give 6-monosulfate. Therefore, ASST is more useful for the preparation of sulfated polyphenols at their specific hydroxyl groups and would play an important role in the metabolism of phenolic compounds in vegetable food and traditional medicines.

[Influence of age on long-term memory]

Memory for past public events having occurred between 1950-1989 was examined in Japanese subjects with average education aged forty to seventy-nine years. We compiled a public events test battery consisting of 80 multiple-choice questions regarding events, persons, or places that were prominent in the news during the four decades 1950 to 1989. With increasing age, performances of a public event test declined equivalently each decade. The effect of both age and decade was significant by three-way analysis of variance. The interaction term (age x decade) was not significant, which indicates that performance on questions relating to each decade was affected about equally by age. Performance on this test was clearly age-dependent across the time period sampled. Considering the results obtained in this study, we could conclude that aging influences very old memories as well as recent memories.

Effect of excitatory amino acid receptor agonists on secretion of growth hormone as assessed by the reverse hemolytic plaque assay

Recent findings indicate that excitatory amino acids (EAAs) can modulate growth hormone (GH) secretion in several mammalian species in vivo and in vitro. In this study, we examined the effects of EAA receptor antagonists [N-methyl-D,L-aspartate (NMDA), kainic acid, L-glutamate] on GH secretion by the reverse hemolytic plaque assay (RHPA). Anterior pituitary cells of adult male Sprague-Dawley rats were enzymatically dispersed and subjected to RHPA. EAA receptor agonists increased the mean plaque area in a dose-dependent manner: the maximal increase was observed at 10 microM and increased the fraction of somatotrophs forming large plaques. NMDA (10 microM) did not increase the mean plaque area in the presence of the NMDA receptor antagonists 10 microM AP-7 and 10 microM MK-801. Coincubation of kainic acid with the non-NMDA receptor antagonist CNQX blocked the kainic-acid-stimulated increase in GH secretion. The addition of MK-801, AP-7 or CNQX to glutamate caused a partial reduction of the mean plaque area. Ten micromoles per liter glutamate with 10 nM GH-releasing hormone (GHRH) produced an additive effect on GHRH-induced GH release. Somatostatin suppressed the stimulatory action of glutamate. We speculate that glutamate plays a role in the regulation of GH secretion.

Development of Theileria sergenti schizonts in the lymph node of experimentally infected cattle

Schizogony of Japanese Theileria sergenti of cattle was studied by light and electron microscopy. Schizonts were detected in the draining lymph node between 4 and 8 days after sporozoite inoculation. Macroschizonts (the phase of nuclear division having invaginations) were formed 6 days after inoculation. Subsequently, microschizonts (the phase of merozoite formation displaying rosette-like appearance) were observed 8 days after inoculation. Multiple infections of a host cell with sporozoites were suggested to occur since different stages of schizonts were simultaneously detected in the same cell. Host cells of schizonts were considerably enlarged by parasitism. However, morphological characteristics of the developmental stages of T. sergenti schizonts resembled those of malignant Theileria species (e.g. T. parva). Schizogony of T. sergenti observed in this study seems to be the primary generation.

Effects of nicardipine, nitroglycerin, and nitroprusside on left ventricular diastolic function during enflurane anesthesia

The purpose of this study was to evaluate the effects of nicardipine (NCR), nitroglycerin (NTG), or nitroprusside (SNP) on left ventricular diastolic function during enflurane anesthesia in acutely instrumented dogs. Using echocardiography, time constants for the decline in isovolumic left ventricular pressure (T), stiffness constant (K), diastolic time intervals, and left ventricular filling rates were measured in 21 mongrel dogs during the following conditions: (1) 0% enflurane (control), (2) 3.3% enflurane, (3) intravenous infusion of NCR, 1 microgram/kg/min, NTG, 2 micrograms/kg/min, or SNP, 2 micrograms/kg/min, during 3.3% enflurane, and (4) intravenous infusion of NCR, 2 micrograms/kg/min, NTG, 4 micrograms/kg/min, or SNP, 4 micrograms/kg/min, during 3.3% enflurane. During 3.3% enflurane anesthesia, T and K increased significantly, and left ventricular filling rates decreased. The administration of NCR, NTG, or SNP returned T and K to control levels. Left ventricular rapid filling rate returned toward the control level only with NCR (P < 0.05, NCR v NTG, SNP). It is concluded that the depression of diastolic function during enflurane anesthesia was improved by NCR or other vasodilators. The extent and mechanism of action of these vasodilators might differ, however.

Mutations in ras genes in cells cultured from mouse skin tumors induced by ultraviolet irradiation

Mutations in ras oncogenes were detected in cultured cells of mouse skin tumors induced by near-UV irradiation. DNA extracted from the UV-induced tumor cells was transfected to golden hamster embryo cells, and focus-forming ability was confirmed in 22 of 26 cell strains, 15 of which had the repetitive mouse sequence. Mouse ras genes were detected in 10 of these 22 cell strains. Point mutations in the ras genes were at Ha-ras codon 13 (GGC-->GTC in two strains, GGC-->AGC in one strain), Ki-ras codon 61 (CAA-->GAA in two strains), and N-ras codon 61 (CAA-->CAT in two strains, CAA-->AAA in two strains). In one tumor cell strain no base change was directed. Most mutations occurred at dipyrimidine sites. Pyrimidine dimers or pyrimidine(6-4)pyrimidone photoproducts are the likely cause of the skin cancers. The base change occurred preferentially at G.C base pairs, and transversions predominated.

A high-level and regulatable production system for recombinant glycoproteins using a human interferon-alpha promoter-based expression vector

A novel expression vector for human cells, pIFP, which expresses a cloned gene under the control of the human interferon-alpha-encoding gene (IFN-alpha) promoter (pIFN) was constructed. As a model of glycoprotein production, a human erythropoietin-encoding cDNA (EPO) inserted downstream from pIFN in pIFP was introduced into human B-cell leukemia-derived BALL-1 cells, and EPO-producing cells were established. Upon stimulation with Sendai virus, the cells produced human EPO at high levels. The highest production level and the highest inducibility were 872 IU/ml and 67-fold, respectively. Simultaneously, the transformed cells also produced IFN-alpha and tumor necrosis factor-alpha (TNF-alpha), as the parental BALL-1 cells did. Comparing the amounts of the substances produced, activity of the exogenous pIFN introduced seemed much higher than that of the endogenous one. Further, the transformed cells could be obtained in a large quantity by being applied to the 'in vivo cell proliferation method (hamster method)'. Human EPO produced by the transformed cells had a molecular mass range of 35 to 42 kDa, similar to that of EPO produced by CHO cells. The processing of EPO seemed to occur properly. The combination of the human pIFN, BALL-1 cells and the hamster method provides us with a useful production system for bioactive glycoproteins of human origin.

Difference in response to colony-stimulating factors and involvement of protein kinase C signal transduction system in three subclones from the ME-1 cell line and two sublines

We previously established a cell line from a patient with acute myelomonocytic leukemia with eosinophilia (M4E0), ME-1. ME-1 cells are responsive to colony-stimulating factors (CSFs) such as interleukin-3 (IL-3), IL-4, and granulocyte-macrophage CSF (GM-CSF), and exhibit monocyte-macrophage differentiation. We isolated three subclones, ME-F1 from ME-1, and ME-F2 and ME-F3 from two sublines of ME-1. These subclones had different morphologic, cytochemical, phenotypic, and cytogenetic features. They represented different monocytic-lineage differentiation stages and exhibited different responses to IL-3, GM-CSF, and especially IL-4. IL-3, GM-CSF, and IL-4 enhanced proliferation and differentiation to macrophage-like cells in the ME-F1 subclone. However, they enhanced only proliferation of ME-F2 cells and only differentiation to macrophage-like cells in the ME-F3 subclone. To elucidate possible differences in signal transduction mechanisms in ME-F1, ME-F2, and ME-F3 cells following stimulation by CSFs, we studied the effects of IL-3 and IL-4 on protein kinase C (PKC) activity. Both IL-3 and IL-4 induced a rapid, transient decrease of cytosolic PKC in ME-F1 cells, but did not affect PKC activity in ME-F2 and ME-F3 cells. The PKC inhibitors, 1-(5-isoquinolinyl-sulfonyl)-2-methylpiperazine (H-7) and calphostin C inhibited IL-3-induced enhancement of proliferation and differentiation of ME-F1 cells, but did not inhibit enhancement of proliferation of ME-F2 cells and differentiation of ME-F3 cells. Our data suggest that PKC-dependent signal transduction is considerably related to IL-3-induced proliferation and differentiation of ME-F1 cells. In addition, it was demonstrated that the two subclones, ME-F2 and ME-F3, lost one of the two responses of ME-F1 cells to CSFs, either proliferation or differentiation, and simultaneously lost PKC-dependent response to CSFs.

Pigments from the cultured lichen mycobionts of Graphis scripta and G. Desquamescens

Two new pigments, named grapheone and graphisquinone, were identified in the cultures of the spore-derived mycobionts of the lichens Graphis scripta and Graphis desquamescens, respectively.

Time course of augmentation and depression of hypoxic ventilatory responses at altitude

Hypoxic ventilatory response (HVR) and hypoxic ventilatory depression (HVD) were measured in six subjects before, during, and after 12 days at 3,810-m altitude (barometric pressure approximately 488 Torr) with and without 15 min of preoxygenation. HVR was tested by 5-min isocapnic steps to 75% arterial O2 saturation measured by pulse oximetry (Spo2) at an isocapnic PCO2 (P*CO2) chosen to set hyperoxic resting ventilation to 140 ml.kg-1.min-1. Hypercapnic ventilatory response (HCVR, 1.min-1.Torr-1) was tested at ambient and high SPO2 6-8 min after a 6- to 10-Torr step increase of end-tidal PCO2 (PETCO2) above P*CO2. HCVR was independent of preoxygenation and was not significantly increased at altitude (when corrected to delta logPCO2). Preoxygenated HVR rose from -1.13 +/- 0.23 (SE) l.min-1.%SPO2(-1) at sea level to -2.17 +/- 0.13 by altitude day 12, without reaching a plateau, and returned to control after return to sea level for 4 days. Ambient HVR was measured at P*CO2 by step reduction of SPO2 from its ambient value (86-91%) to approximately 75%. Ambient HVR slope was not significantly less, but ventilation at equal levels of SPO2 and PCO2 was lower by 13.3 +/- 2.4 l/min on day 2 (SPO2 = 86.2 +/- 2.3) and by 5.9 +/- 3.5 l/min on day 12 (SPO2 = 91.0 +/- 1.5; P < 0.05). This lower ventilation was estimated (from HCVR) to be equivalent to an elevation of the central chemoreceptor PCO2 set point of 9.2 +/- 2.1 Torr on day 2 and 4.5 +/- 1.3 on day 12.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of ethyl all-cis-5,8,11,14,17-icosapentaenoate (EPA-E) on elasticity and endothelium-dependent relaxation of the aorta in high cholesterol diet-fed rabbits]

We studied the elasticity and endothelium-dependent relaxation (EDR) of the aorta in 1% cholesterol diet (HCD)-fed rabbits. Furthermore, the effects of ethyl all-cis-5,8,11,14, 17-icosapentaenoate (EPA-E) were examined in this model of atherosclerosis. After 12 weeks of feeding with HCD, the animals showed increase in plasma total cholesterol level, formation of atherosclerotic plaque, decrease in aortic elasticity and impairment of EDR to acetylcholine (ACh). The levels of aortic elasticity in HCD-fed rabbits administered orally with EPA-E (300 mg/kg for 12 weeks) were almost the same as those of rabbits fed a normal diet, although EPA-E showed no effects on the plasma total cholesterol level and formation of atherosclerotic plaque in HCD-fed rabbits. On EDR in response to ACh and cyclic GMP formation in the HCD-fed rabbit aorta, EPA-E improved the impairment of these parameters, but not significantly. Therefore, EPA-E had little effect on the endothelium in this model of atherosclerosis, although EPA-E improved the decrease in the aortic elasticity. Because the levels of aortic elasticity showed no significant correlation with the magnitude of EDR to ACh or the size of atherosclerotic plaque, the decrease of aortic elasticity in this model of atherosclerosis was thought to have little relation to the dysfunction of the endothelium.

Primary cutaneous B-cell lymphomas in Japan. A report of three cases and a comparison of Japanese and white patients

BACKGROUND

In contrast to cutaneous T-cell lymphoma, primary cutaneous B-cell lymphomas (pCBCL) are rare in Japan. Thus there have been no reports in the English literature that analyze Japanese pCBCL cases in detail.

OBJECTIVE

We describe three additional Japanese cases of pCBCL and review the Japanese literature to compare their clinical features and prognoses with those in cases that involve white persons.

METHODS

In our three cases, we performed immunohistochemical and flow cytometric analyses to determine the phenotypes of tumor cells. Genotypic analysis was also conducted by Southern blotting. In addition, we reviewed 43 cases of pCBCL reported in Japan.

RESULTS

In our three cases of pCBCL, the lack of systemic involvement indicated that they were primary cutaneous tumors. One of our cases, which had a poor prognosis, lacked both HLA-DR and CD44 phenotypes, which are usually observed in the diffuse large-cell type of pCBCL. We found three major differences between the reported Japanese cases including ours and the cases that involved white persons: (1) histologically, the diffuse type was presented in 79% of lesions of less than 12 months' duration in the Japanese cases but in only 9% of lesions in white persons; (2) chemotherapy was more frequently selected in the Japanese cases (51%), whereas radiotherapy was used more frequently in white cases (71%); and (3) the death rate from pCBCL was much higher in Japanese (16%) than in white (2%) persons.

CONCLUSION

pCBCL in Japanese persons seems to be different from that in white persons in frequency, in histoarchitectural growth pattern, and in prognosis.

[Brain abscess ruptured into the lateral ventricle: the usefulness of treatment by intraventricular irrigation with antibiotics. A case report]

A case is reported of a brain abscess, which ruptured into the lateral ventricle and was treated using intraventricular irrigation with antibiotics. A 37-year-old man was suffering from a headache and high fever. Precontrast CT scan revealed a heterogeneous low density area in the left temporal lobe, and postcontrast CT scan showed a multilobular ring-like enhanced mass. Diagnosed as a brain abscess, intravenous administration of antibiotics was performed. On the sixth day the patient suddenly became drowsy. Postcontrast CT scan revealed an enhanced effect in the left lateral ventricular wall. Drowsiness was attributed to increased intracranial pressure and severe ventriculitis. Bilateral continuous ventricular drainage via the anterior horn of the lateral ventricle was performed. The drainage fluid from the left lateral ventricle was just like pus. Intraventricular irrigation with antibiotics between the bilateral anterior horns of the lateral ventricle, was performed in order to save the patient. The infusion fluid, Lactate Ringer's solution containing Cefazolin sodium, was infused into the right ventricle and CSF-like pus was drained from the left ventricle. The CSF reading gradually improved, and on the 14th day postoperatively irrigation was terminated. The postoperative course was uneventful. The diagnosis, treatment, and prognosis of patients with brain abscesses have improved dramatically as a result of more reliable methods of identifying infecting organisms, more effective antibiotic regimens, the development of microsurgical techniques and CT scan. However, despite these advances, the prognosis for brain abscess ruptured into the ventricle is usually very pessimistic.(ABSTRACT TRUNCATED AT 250 WORDS)

An artificial esophagus consisting of cultured human esophageal epithelial cells, polyglycolic acid mesh, and collagen

Previously, the authors successfully grafted collagen sheets covered with cultured human esophageal epithelial cells onto latissimus dorsi muscles of athymic mice. To make a tubular artificial esophagus they developed a polyglycolic acid mesh-collagen complex tube whose inner side was epithelialized in vitro by cultured human esophageal epithelial cells. Human esophageal epithelial cells were isolated from normal mucosa resected from specimens of esophageal cancer patients and cultured on the surface of the collagen gel in which polyglycolic acid mesh was embedded. After the culture reached confluence, polyglycolic acid mesh was sutured to create a tubular form lined with cultured cell layers (restructured mucosal tube). Such tubes were wrapped in the latissimus dorsi muscle flaps of athymic rats using a fibrin glue. The animals were killed 4, 8, 20, and 28 days after grafting and the grafted tubes were studied histologically. Up to 28 days after grafting, the luminal structure was maintained without structure. Eight days after grafting, rat fibroblasts infiltrated from the muscle and neovascularization appeared in the collagen layer. The grafted epithelium remained healthy and grew to 15 cell layers by 20 days, much like normal human esophageal epithelium. Staining by anti-laminin monoclonal antibody confirmed a basement membrane.

Combined therapy with arbekacin and fosfomycin for methicillin-resistant Staphylococcus aureus infections

We examined the clinical efficacy of a combination of arbekacin and fosfomycin in the treatment of various methicillin-resistant Staphylococcus aureus (MRSA) infections. The combination of arbekacin plus fosfomycin displayed 65.4% (17/26) clinical efficacy and 65.4% (17/26) bacteriological efficacy. This combination thus appeared to be an effective regimen for the treatment of MRSA infections. However, its bacteriological efficacy against concomitant Pseudomonas aeruginosa strains was only 16.7% (1/6). In addition, in 4 episodes of superinfection involving P. aeruginosa strains developed during the combination therapy.

Benign recurrent intrahepatic cholestasis: a long-term follow-up

We report on a case with a 50-year history of benign recurrent intrahepatic cholestasis, including 33 years of follow-up at our hospital. The attacks of jaundice began at the age of 1 year and have been repeated more than 14 times to date. During the follow-up period at our hospital, the patient has suffered 6 attacks of cholestasis. During the episodes of cholestasis, a dissociation between the serum level of bilirubin and that of bile acids was observed. The analysis of serum bile acids during cholestasis showed that cholic acid and chenodeoxycholic acid were the main bile acids, and no appreciable amounts of the secondary bile acids were detected. Between episodes the liver function tests, including serum bile acids, were normal. Despite multiple attacks of cholestasis over many years, no permanent liver damage has occurred. This case reaffirms the essentially benign nature of this disease.