Yap regulates skeletal muscle fatty acid oxidation and adiposity in metabolic disease

Obesity is a major risk factor underlying the development of metabolic disease and a growing public health concern globally. Strategies to promote skeletal muscle metabolism can be effective to limit the progression of metabolic disease. Here, we demonstrate that the levels of the Hippo pathway transcriptional co-activator YAP are decreased in muscle biopsies from obese, insulin-resistant humans and mice. Targeted disruption of Yap in adult skeletal muscle resulted in incomplete oxidation of fatty acids and lipotoxicity. Integrated 'omics analysis from isolated adult muscle nuclei revealed that Yap regulates a transcriptional profile associated with metabolic substrate utilisation. In line with these findings, increasing Yap abundance in the striated muscle of obese (db/db) mice enhanced energy expenditure and attenuated adiposity. Our results demonstrate a vital role for Yap as a mediator of skeletal muscle metabolism. Strategies to enhance Yap activity in skeletal muscle warrant consideration as part of comprehensive approaches to treat metabolic disease.

Release and clinical significance of soluble CD83 in chronic lymphocytic leukemia

Soluble CD83 (sCD83), a potent immunosuppressive agent, circulates at elevated levels in some chronic lymphocytic leukemia (CLL) patients. We report that CLL patients with elevated plasma sCD83 levels had significantly shorter (P=0.038) treatment free survival. Culture of CLL cells with solid phase CD83 mAb+IL-4 significantly increases sCD83 release (23-117-fold, P=0.013) and ligation of normal donor PBMC with solid phase CD83 mAb alone induces similar significant increases in sCD83 release (P=0.003). RT-PCR analysis detected the presence of a transcript for sCD83 in 2/3 CLL samples. These results suggest sCD83 release may play a regulatory role in CLL progression.

Chromium, cobalt and titanium metallosis involving a Nottingham shoulder replacement

Metallosis after shoulder replacement has not previously been described in the literature. We report a patient who developed extensive metallosis after implantation of an uncemented Nottingham shoulder replacement. He underwent a revision procedure. Examination of the retrieved prosthesis showed that the titanium porous coating was separating from the humeral stem and becoming embedded in the ultra-high-molecular-weight polyethylene glenoid component, resulting in abrasive wear of the humeral component. There was metallosis despite exchange of the modular humeral head. Both components had to be exchanged to resolve the problem.

The effect of hydrogen peroxide concentration on metal ion release from dental casting alloys

There are concerns that tooth bleaching agents may adversely affect dental materials. The aim of this study was to test the hypothesis that increasing concentrations of hydrogen peroxide (HP) are more effective than water at increasing metal ion release from two typical dental casting alloys during bleaching. Discs (n = 28 for each alloy) were prepared by casting and heat treated to simulate a typical porcelain-firing cycle. Discs (n = 7) of each alloy were immersed in either 0%, 3%, 10% or 30% (w/v) HP solutions for 24 h at 37 degrees C. Samples were taken for metal ion release determination using inductively coupled plasma-mass spectrometry and the data analysed using a two-way anova followed by a one-way anova. The surface roughness of each disc was measured using a Talysurf contact profilometer before and after bleaching and the data analysed using a paired t-test. With the exception of gold, the differences in metal ion concentration after treatment with 0% (control) and each of 3%, 10% and 30% HP (w/v) were statistically significant (P < 0.05). Metal ion release from the two alloys increased with increasing HP concentrations (over 3000% increase in Ni and 1400% increase in Pd ions were recorded when HP concentration increased from 0% to 30%). Surface roughness values of the samples before and after bleaching were not significantly different (P > 0.05) Exposure of the two dental casting alloys to HP solutions increased metal ion release of all the elements except gold.

The effect of hydrogen peroxide concentration on metal ion release from dental amalgam

OBJECTIVES

The aim of this study was to investigate the effect of hydrogen peroxide (HP) concentration on metal ion release from dental amalgam.

METHODS

Dental amalgam discs (n=25) were prepared by packing amalgam into cylindrical plastic moulds (10 mm diameter and 2 mm height). The discs were divided into five equal groups and each group was immersed in 20 ml of either 0%, 1%, 3%, 10% or 30% HP solution for 24 h at 37 degrees C. Samples were taken for metal ion release determination (Hg, Ag, Sn and Cu) using inductively coupled plasma mass spectrometry (ICP-MS). The surface roughness of each disc was measured before and after bleaching.

RESULTS

The differences in concentration of metal ions released after treatment with 0% (control) and each of 1%, 3%, 10% and 30% HP were statistically significant (p<0.05). Metal ion release for the elements (Hg, Ag, Sn and Cu) increased with exposure to increasing concentrations of HP. Surface roughness measurements of the samples before and after treatments with HP solutions were not significantly different (p>0.05).

CONCLUSIONS

Exposure to HP bleaching agent was associated with increased metal ion released from dental amalgams compared to treatment with a control solution. Ion release was in proportion to the peroxide concentration tested, with the highest concentration associated with the greatest metal ion release for all elements investigated.

The 1.2 A structure of a novel quorum-sensing protein, Bacillus subtilis LuxS

In bacteria, the regulation of gene expression in response to changes in cell density is called quorum sensing. The autoinducer-2 production protein LuxS, is involved in a novel quorum-sensing system and is thought to catalyse the degradation of S-ribosylhomocysteine to homocysteine and the autoinducer molecule 4,5-dihydroxy-2,3-pentadione. The crystal structure of Bacillus subtilis LuxS has been determined at 1.2 A resolution, together with the binary complexes of LuxS with S-ribosylhomocysteine and homocysteine to 2.2 and 2.3 A resolution, respectively. These structures show that LuxS is a homodimer with an apparently novel fold based on an eight-stranded beta-barrel, flanked by six alpha-helices. Each active site contains a zinc ion coordinated by the conserved residues His54, His58 and Cys126, and includes residues from both subunits. S-ribosylhomocysteine binds in a deep pocket with the ribose moiety adjacent to the enzyme-bound zinc ion. Access to the active site appears to be restricted and possibly requires conformational changes in the protein involving the movement of residues 125-129 and those at the N terminus. The structure contains an oxidised cysteine residue in the active site whose role in the biological process of LuxS has not been determined. The autoinducer-2 signalling pathway has been linked to aspects of bacterial virulence and pathogenicity. The structural data on LuxS will provide opportunities for targeting this enzyme for the rational design of new antibiotics.

Nutrition, HIV, and drug abuse: the molecular basis of a unique role for selenium

HIV-infected injection drug users (IDUs) often suffer from serious nutritional deficiencies. This is a concern because plasma levels of micronutrients such as vitamin B12, zinc, and selenium have been correlated with mortality risk in HIV-positive populations. Injection drug use also increases lipid peroxidation and other indicators of oxidative stress, which, combined with antioxidant deficiencies, can stimulate HIV-1 replication through activation of NF-kappaB transcription factors, while weakening immune defenses. As detailed herein, these prooxidant stimuli can also increase the pathogenic effects of HIV-1 by another mechanism, involving viral selenoproteins. Overlapping the envelope coding region, HIV-1 encodes a truncated glutathione peroxidase (GPx) gene (see #6 in reference list). Sequence analysis and molecular modeling show that this viral GPx (vGPx) module has highly significant structural similarity to known mammalian GPx, with conservation of the catalytic triad of selenocysteine (Sec), glutamine, and tryptophan. In addition to other functions, HIV-1 vGPx may serve as a negative regulator of proviral transcription, by acting as an NF-kappaB inhibitor (a known property of cellular GPx). Another potential selenoprotein coding function of HIV-1 is associated with the 3' end of the nef gene, which terminates in a conserved UGA (potential Sec) codon in the context of a sequence (Cys-Sec) identical to the C-terminal redox center of thioredoxin reductase, another cellular regulator of NF-kappaB. Thus, in combination with known cellular mechanisms involving Se, viral selenoproteins may represent a unique mechanism by which HIV-1 monitors and exploits an essential micronutrient to optimize its replication relative to the host.

Molecular modeling and in vitro activity of an HIV-1-encoded glutathione peroxidase

Based on theoretical evidence, it has been proposed that HIV-1 may encode several selenoprotein modules, one of which (overlapping the env gp41-coding region) has highly significant sequence similarity to the mammalian selenoprotein glutathione peroxidase (GPx; EC ). The similarity score of the putative HIV-1 viral GPx homolog relative to an aligned set of known GPx is 6.3 SD higher than expected for random sequences of similar composition. Based on that alignment, a molecular model of the HIV-1 GPx was constructed by homology modeling from the bovine GPx crystal structure. Despite extensive truncation relative to the cellular GPx gene, the structural core and the geometry of the catalytic triad of selenocysteine, glutamine, and tryptophan are well conserved in the viral GPx. All of the insertions and deletions predicted by the alignment proved to be structurally feasible. The model is energetically favorable, with a computed molecular mechanics strain energy close to that of the bovine GPx structure, when normalized on a per-residue basis. However, considering the remote homology, this model is intended only to provide a working hypothesis allowing for a similar active site and structural core. To validate the theoretical predictions, we cloned the hypothetical HIV-1 gene and found it to encode functional GPx activity when expressed as a selenoprotein in mammalian cells. In transfected canine kidney cells, the increase in GPx activity ranged from 21% to 43% relative to controls (average 30%, n = 9, P < 0.0001), whereas, in transfected MCF7 cells, which have low endogenous GPx activity, a near 100% increase was observed (average 99%, n = 3, P < 0.05).

Selenium-dependent glutathione peroxidase modules encoded by RNA viruses

Glutathione peroxidase (GPx) is the prototypical eukaryotic selenoprotein, with the rare amino acid selenocysteine (Sec) at the enzyme active site, encoded by the UGA codon in RNA. A DNA virus, Molluscum contagiosum, has now been shown to encode a functional selenium-dependent GPx enzyme. Using modifications of conventional sequence database searching techniques to locate potential viral GPx modules, combined with structurally guided comparative sequence analysis, we provide compelling evidence that Se-dependent GPx modules are encoded in a number of RNA viruses, including potentially serious human pathogens like HIV-1 and hepatitis C virus, coxsackievirus B3, HIV-2, and measles virus. Analysis of the sequences of multiple viral isolates reveals conservation of the putative GPx-related features, at least within viral subtypes or genotypes, supporting the hypothesis that these are functional GPx modules.

Hepatitis C virus encodes a selenium-dependent glutathione peroxidase gene. Implications for oxidative stress as a risk factor in progression to hepatocellular carcinoma

AIM

Using structural bioinformatics methods, the aim is to assess the hypothesis that hepatitis C virus (HCV) encodes a glutathione peroxidase (GPx) gene in an overlapping reading frame, linking HCV expression and pathogenesis to the Se status and dietary oxidant/Antioxidant balance of the host.

METHODS

The putative HCV GPx gene was identified by searching viral sequence databases, using conserved GPx active site sequences as probes, giving particular weight to the UGA (selenocysteine) codon. Multiple sequence alignments were generated and analyzed to validate the sequence similarity, and to establish the degree of conservation of the identified genomic features in HCV. Molecular modeling was used to assess the structural feasibility of the proposed homology.

RESULTS

The GPx homology region overlaps the NS4 gene, and is well conserved in HCV. The sequence similarity of the conserved active site regions to a set of known GPx is high (4 to 6 SD greater than expected for similar random sequences). The computed strain energy of a molecular model of the HCV GPx is energetically favorable, comparable to the bovine GPx structure.

CONCLUSIONS

By linking HCV replication and pathogenesis to the Se status and dietary oxidant/antioxidant balance of the host, the existence of a viral GPx gene could help to explain why HCV disease progression is accelerated by oxidant stresses such as alcoholism and iron overload.

The fate of the EEA stapled anastomosis: a clinico-radiological study of 38 patients

Despite the widespread use of the EEA stapling device, little is known about the eventual fate of the stapled anastomosis. In a study of 38 stapled colonic anastomoses the staples were found to have passed out rectally in 11 patients (29%) within 6 months of surgery. Staple loss occurred only when the small or medium sized cartridges were used (P less than 0.02). Anastomotic stenosis developed in 5 patients (13.2%) and was also related to the use of the smaller size cartridges. In order to minimise these problems every effort should be made to use the large EEA cartridge.

Should cholecystography or ultrasound be the primary investigation for gallbladder disease?

The conclusions drawn from a prospective survey of 500 patients examined by cholecystography (OCG) and ultrasound (UCG) are presented. First, both procedures were found to be highly accurate in detecting calculi, with false-negative rates of 1%. Secondly, if OCG is abandoned in favour of UCG, most acalculous adenomyomatosis (and many polyps) will not be diagnosed. If acalculous as well as calculous disease is regarded as clinically important, fluoroscopic OCG is the examination of choice. However, if a clinician wishes solely to find or exclude stones the investigations are equally accurate. Thirdly, since some calculi and some acalculous disease will be missed by either technique, serious consideration should be given to the further investigation of all gallbladders considered normal by either examination. A protocol is described which, though unorthodox, enables a decision on the status of the gallbladder to be made on a single visit to the radiology department.

Haemostatic changes following surgery

Changes in factors V, VII and VIII and in fibrinogen were studied in 32 patients undergoing major abdominal surgery. Mean levels of factors V and VII were similar to population-based values preoperatively. Factor V fell following elective surgery and then rose above the mean pre-operative level before returning to it by the tenth post-operative day. Factor VII fell following both elective and emergency surgery and tended to remain depressed throughout the post-operative period. Pre-operative values of factor VIII and fibrinogen were higher than population-based values and higher in the emergency than in waiting-list patients. Both factor VIII and fibrinogen rose following elective surgery but no statistically significant change was seen following emergency surgery. The uncomplicated conditions leading to elective surgery, the acute complications leading to emergency surgery, and surgery itself may each have contributed to increases in factor VIII and fibrinogen levels, whereas the fall in factors V and VII was largely related to surgery itself. The findings may help in the interpretation of associations between clotting factors and thrombotic disease, particularly in the case of factor VII.

Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial

Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation's obsession with the need for regular frequent defecation.

Subcellular localization of serotonin and motilin in the human jejunum

1. Analytical subcellular fractionation techniques have been applied to human jejunal homogenates to study the localization of serotonin and motilin. 2. Serotonin, detected by a fluorimetric assay, showed two distinct particulate distributions in the density gradients with modal densities of 1.14 and 1.20. Motilin, whether detected by N-terminal or C-terminal specific antibodies showed similar density distributions with a modal density of 1.20, coinciding with the denser peak of serotonin. 3. These results lend support to the histochemical suggestions that motilin is located in a a serotonin-containing granule.

Hypertrophic scarring: Dexon suture in a randomized trial

In a randomized prospective trial of three methods of skin suture an increased incidence of hypertrophic scarring in paramedian and inguinal wounds has been found to be associated with the use of 2/0 Dexon suture subcuticularly. However, the variance associated with the type of suture was less than that associated with the sex of the patient. The patient's opinion of the appearance of the scar was the same for all three suture methods used in skin closure.

"Right" stay in hospital after sugery: randomised controlled trial

A randomised controlled trial was carried out on 100 patients to compare the effects of discharge after certain pre-specified clinical criteria had been fulfilled--"right" stay--with those of discharge at an arbitrary 10 days after surgery--"fixed" stay. The operations concerned (cholecystectomy and vagotomy) were more hazardous than those previously included in studies of early discharge. Patients in the right-stay group were discharged, on average, 7-6 days after operation--that is, two days earlier than those in the fixed-stay group. In terms of clinical progress, social factors such as return to work, and the acceptability to patients and relatives of the implications of right stay, patients in this group fared as well as those in the fixed-stay group, and in some respects slightly better. Right stay entailed the transfer of some work from hospital to community medical and nursing staff, but this also was acceptable. The concept and use of the right-stay principle is of value in planning the postoperative discharge of suitable patients.

Comparative study of short-term recovery of mental efficiency after anaesthesia

Two common general anaesthetic techniques were compared to evaluate the time taken for the patient's mental efficiency to recover sufficiently for him to be escorted home after inguinal herniorrhaphy. Recovery in performance efficiency to at least 60% of the patient's own maximum is suggested as a criterion for discharge, and this needs a stay in hospital of seven to nine hours.

Biliary excretion of diazepam in man

In a study of diazepam metabolism, diazepam 10 mg was administered i.m. to four patients who had biliary T-tube drainage. Blood and bile diazepam metabolite concentrations were measured for 12 hr. The expected fluctuations in blood diazepam concentrations were seen, and conjugated diazepam metabolites were present in human bile. Bile diazepam concentrations were insufficient to account for an enterohepatic circulation.

Faecal bile-acids and clostridia in patients with cancer of the large bowel

Of 44 patients with cancer of the large bowel, 36 ( 82%) had high faecal bile-acid concentrations compared with only 15 (17%) out of 90 patients with other diseases. 31 (70%) of the 44 patients with large-bowel cancer had high faecal bile-acid concentrations in the presence of faecal clostridia able to dehydrogenate the bile-acid nucleus, compared with only 8 (9%) out of 90 patients with other diseases. Thes findings support the hypothesis that cancer of the large bowel is caused by high concentrations of bile-acid derivatives produced by certain anaerobic bacteria.

Tuberculosis, Crohn's disease and villous papilloma of the rectum

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Gastric emptying of solid meals after truncal vagotomy and pyloroplasty in human subjects

Gastric emptying of isotopically labelled solid meals was studied in normal human subjects and in patients at different intervals after truncal vagotomy and Heineke-Mikulicz pyloroplasty. One to four weeks after vagotomy and pyloroplasty gastric emptying was delayed grossly in some patients regardless of the completeness of vagotomy. Patients with gross delay had symptoms of gastric retention. Eight weeks later emptying had returned towards normal and one or more years after vagotomy and pyloroplasty emptying was within the normal range.A subthreshold dose of carbachol injected during the course of emptying of a meal in some of the postvagotomy patients had no detectable influence on the rate of emptying of the meal.