Successful implantation after reducing matrix metalloproteinase activity in the uterine cavity

BACKGROUND: Recently, the concept of recurrent implantation failure (RIF) in assisted reproductive technology has been enlarged. Chronic uterine inflammation is a known cause of implantation failure and is associated with high matrix metalloproteinase (MMP) activity in uterine cavity flushing. MMP activity of women with RIF has been reported to be higher than that of fertile women. In the present retrospective study we evaluated the efficacy of treatment for high MMP activity in the uterine cavity of patients with RIF. METHODS: Of the 597 patients recruited to the study, 360 patients underwent MMP measurements and 237 patients did not (control group). All patients had failed to become pregnant, despite at least two transfers of good-quality embryos. Gelatinase MMP-2 and MMP-9 activity in uterine flushing fluid was detected by enzymology (MMP test). All samples were classified into two groups (positive or negative) based on the intensity of the bands on the enzyme zymogram, which represents the degree of MMP activity. Patients who tested positive on the initial test were treated for 2 weeks with a quinolone antibiotic and a corticosteroid, and subsequently underwent a second MMP test. Negative results on the second MMP tests after treatment and subsequent rates of pregnancy and miscarriage were used to evaluate the efficacy of treatment. Data were analyzed by the Mann–Whitney U-test and the chi-square test. RESULTS: Of the patients who underwent the MMP test, 15.6% had positive results (high MMP activity). After treatment, 89.3% of patients had negative results on the second MMP test. These patients had a significantly better pregnancy rate (42.0%) than the control group (26.6%), as well as a lower miscarriage rate (28.5% vs 36.5%, respectively). CONCLUSIONS: A 2-week course of antibiotics and corticosteroids effectively improves the uterine environment underlying RIF by reducing MMP activity

Cloning of the Extracellular Acid Esterase Gene from Acidophilic Bacterium, Acidocella facilis

An acidophilic heterotrophic bacterium, Acidocella facilis sp. AIU409 produces an extracellular acid esterase when grown in a medium containing sorbitan mono ester, Tween 80. The estA gene encoding for the acid esterase was isolated from the genomic library of A. facilis AIU409, cloned into Escherichia coli MV1184, and the nucleotide sequence of the gene was determined. The structural gene of estA was found to be 1881bp. The open reading frame of estA encodes 627 amino acid residues (calculated molecular mass, 64,140 daltons). A rho-independent terminator was present just downstream of the termination codon, TGA. The deduced N-terminal amino acid showed that the presursor of the acid esterase had a signal peptide composed of 23 amino acids and a consensus sequence of lipase, G-X-S-X-S. The molecular mass excluding the signal peptide calculated from the deduced amino acid sequence if the acid esterase is 61,846. This is lower than the molecular mass, 64kDa estimated by gel electrophoresis. The predicated amino acid sequence of the acid esterase has high similarity to the acyltransferase from Aeromonas hydrophila and the lipase from Xenorhadbus luminescens.好酸性従属栄養細菌AcidocellafacilisAIU409株は，基質としてソルビタンモノエステルであるTweenを含む培地中で培養された時に，菌体外に熱安定性の高い酸性エステラーゼを生産する．エステラーゼをコードする遺伝子（estA）をA.facilisAIU409株のゲノムライブラリーから単離し，大腸菌MV1184にクローニングし，その遺伝子の全塩基配列を決定した．その結果，estAの構造遺伝子が，1881塩基対であることが明らかになった．酸性エステラーゼ遺伝子のオープンリーディングフレーム（ORF）は，627アミノ酸残基（計算された分子量は64,140ダルトン）をコードしていた．ロー因子非依存性の転写終結シグナルが終止コドンであるTGAのすぐ下流に存在していた．そのＮ末端予想アミノ酸配列より，酸性エステラーゼの前駆体は，Ｎ末端に23個のアミノ酸残基から成るシグナルペプチドを有していた．また，リパーゼのコンセンサス配列であるG-X-S-X-Sの配列が存在することが明らかとなった．酸性エステラーゼの予想アミノ酸配列から計算された分子量は61,486であり，これはSDS-PAGEによって予想されていた分子量より，やや低い値であった．また，Acidocellafacilis酸性エステラーゼの予想アミノ酸配列は，Aeromonashydrophila由来のacyltrans-feraseやXenorhabdusluminescens由来のリパーゼと高い相同性を示した

Mucin-hypersecreting bile duct neoplasm characterized by clinicopathological resemblance to intraductal papillary mucinous neoplasm (IPMN) of the pancreas

<p>Abstract</p> <p>Background</p> <p>Although intraductal papillary mucinous neoplasm (IPMN) of the pancreas is acceptable as a distinct disease entity, the concept of mucin-secreting biliary tumors has not been fully established.</p> <p>Case presentation</p> <p>We describe herein a case of mucin secreting biliary neoplasm. Imaging revealed a cystic lesion 2 cm in diameter at the left lateral segment of the liver. Duodenal endoscopy revealed mucin secretion through an enlarged papilla of Vater. On the cholangiogram, the cystic lesion communicated with bile duct, and large filling defects caused by mucin were observed in the dilated common bile duct. This lesion was diagnosed as a mucin-secreting bile duct tumor. Left and caudate lobectomy of the liver with extrahepatic bile duct resection and reconstruction was performed according to the possibility of the tumor's malignant behavior. Histological examination of the specimen revealed biliary cystic wall was covered by micropapillary neoplastic epithelium with mucin secretion lacking stromal invasion nor ovarian-like stroma. The patient has remained well with no evidence of recurrence for 38 months since her operation.</p> <p>Conclusion</p> <p>It is only recently that the term "intraductal papillary mucinous neoplasm (IPMN)," which is accepted as a distinct disease entity of the pancreas, has begun to be used for mucin-secreting bile duct tumor. This case also seemed to be intraductal papillary neoplasm with prominent cystic dilatation of the bile duct.</p