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Objective: To clarify the clinical, pathologic, and genetic features of neonatal Dubin-Johnson syndrome., Study Design: Ten patients with neonatal Dubin-Johnson syndrome were recruited from 6 pediatric centers in Japan between September 2013 and October 2016. Clinical and laboratory course, macroscopic and microscopic liver findings, and molecular genetic findings concerning ATP-binding cassette subfamily C member 2 (ABCC2) were retrospectively and prospectively examined., Results: All neonates exhibited cholestasis, evident as prolonged jaundice with or without acholic stools and elevations of serum direct bilirubin as well as γ-glutamyltransferase or total bile acids. Only 38% (3 of 8) of patients who underwent liver biopsy showed a grossly black liver or melanin-like pigment deposits in hepatocytes; their biopsies were performed in early infancy. Immunohistochemically, all liver specimens showed no expression of multidrug resistance-associated protein 2 but increased expression of the bile salt export pump protein. Homozygous or compound heterozygous pathogenic variants of ABCC2 were identified in all patients, representing 11 distinct pathogenic variants including 2 not previously reported., Conclusions: Immunohistochemical staining of the liver for multidrug resistance-associated protein 2 and molecular genetic analysis of ABCC2 are crucial for accurate diagnosis of neonatal Dubin-Johnson syndrome., (Copyright © 2017 Elsevier Inc. All rights reserved.)

In order to increase the discriminating power of DNA analysis in personal identification, we evaluated the forensic utility of the microsatellite locus D14S299 (wg1c5) in the Japanese population and also in the Chinese and Caucasian populations. Twelve different alleles were identified in length by gel electrophoresis with silver staining. The major alleles in Japanese were sequenced and designated as the numbers of the variable repeats (GGAT or GGAA). There were five variable regions and extensive homoplasy was found. However, the allele fragment lengths were in 4 bp increments and no "interalleles" were found. The estimated heterozygosity and the polymorphism information content (PIC) were 0.726 and 0.689, respectively in Japanese. Those in Chinese (0.743 and 0.704) were similar to those in Japanese, while those in Caucasians (0.812 and 0.781) were much higher. After adjacent alleles were combined to yield at least five entries, statistical analysis was performed. The power of discrimination (PD) was 0.887 in Japanese, 0.895 in Chinese and 0.935 in Caucasians and no significant deviations from the Hardy-Weinberg equilibrium were found in the three populations. We retyped all apparently homozygous samples using an alternative pair of flanking primers and found them to be true homozygotes. D14S299 appears to be a useful STR locus for forensic practice.

Cyanobacterial toxins, microcystins, have a potent tumor-promoting activity. We investigated the level of microcystins in drinking water collected from 1992 to 1994 in Haimen City, China, where people who drink pond ditch water usually incurred a high incidence rate of hepatocellular carcinoma compared with those who drink well water. High-performance liquid chromatography, liquid chromatography/mass spectrometry (LC/MS), and protein phosphatase inhibition assay (pp assay) were used to identify and quantify the microcystins. Microcystin LR and [D-Asp3]microcystin LR were detected in 2 of 50 samples at a concentration less than 100 ng/L by LC/MS in 1992. Although no microcystins were found by the chemical method in 1993, 6 of 7 samples except for 3 tap water samples showed an approximate amount of 100 ng/L by using the pp assay in 1994. The obtained results supported the epidemiological results reported by Yu.