Search

We often encounter complications from biliary stents used as a treatment for obstructive jaundice and acute cholangitis. Early complications after stent placement include pancreatitis, bleeding, and duodenal perforation [1]. Stent deviation is also a complication. This is particularly prominent for plastic stents, where stent deviation is observed in 6-18.7 % of cases [2]. Stent deviation is more common among patients who have undergone endoscopic sphincterotomy (Figure 1). Most deviated biliary plastic stents are excreted in stool or collected endoscopically, but, very rarely, complications causing gastrointestinal perforation have been reported. We have described deviated biliary plastic stents causing sigmoid colon diverticulum perforation and even uterine appendage penetration (Figure 2). Diagnosis can be made from clinical symptoms and abdominal computed tomography. Treatment is basically surgery. Biliary stent-related complications are inevitable, and sometimes become serious. On suspicion of such complications, the most important issue is to accurately and rapidly diagnose complications and conduct appropriate management.

International audience; Here we report the new features and improvements in our latest release of the H-Invitational Database (H-InvDB; http://www.h-invitational.jp/), a comprehensive annotation resource for human genes and transcripts. H-InvDB, originally developed as an integrated database of the human transcriptome based on extensive annotation of large sets of full-length cDNA (FLcDNA) clones, now provides annotation for 120 558 human mRNAs extracted from the International Nucleotide Sequence Databases (INSD), in addition to 54 978 human FLcDNAs, in the latest release H-InvDB_4.6. We mapped those human transcripts onto the human genome sequences (NCBI build 36.1) and determined 34 699 human gene clusters, which could define 34 057 (98.1%) protein-coding and 642 (1.9%) non-protein-coding loci; 858 (2.5%) transcribed loci overlapped with predicted pseudogenes. For all these transcripts and genes, we provide comprehensive annotation including gene structures, gene functions, alternative splicing variants, functional non-protein-coding RNAs, functional domains, predicted sub cellular localizations, metabolic pathways, predictions of protein 3D structure, mapping of SNPs and microsatellite repeat motifs, co-localization with orphan diseases, gene expression profiles, orthologous genes, protein-protein interactions (PPI) and annotation for gene families. The current H-InvDB annotation resources consist of two main views: Transcript view and Locus view and eight sub-databases: the DiseaseInfo Viewer, H-ANGEL, the Clustering Viewer, G-integra, the TOPO Viewer, Evola, the PPI view and the Gene family/group.

The human genome sequence defines our inherent biological potential; the realization of the biology encoded therein\ud requires knowledge of the function of each gene. Currently, our knowledge in this area is still limited. Several lines of\ud investigation have been used to elucidate the structure and function of the genes in the human genome. Even so, gene\ud prediction remains a difficult task, as the varieties of transcripts of a gene may vary to a great extent. We thus\ud performed an exhaustive integrative characterization of 41,118 full-length cDNAs that capture the gene transcripts as\ud complete functional cassettes, providing an unequivocal report of structural and functional diversity at the gene level.\ud Our international collaboration has validated 21,037 human gene candidates by analysis of high-quality full-length\ud cDNA clones through curation using unified criteria. This led to the identification of 5,155 new gene candidates. It also\ud manifested the most reliable way to control the quality of the cDNA clones. We have developed a human gene\ud database, called the H-Invitational Database (H-InvDB; http://www.h-invitational.jp/). It provides the following:\ud integrative annotation of human genes, description of gene structures, details of novel alternative splicing isoforms,\ud non-protein-coding RNAs, functional domains, subcellular localizations, metabolic pathways, predictions of protein\ud three-dimensional structure, mapping of known single nucleotide polymorphisms (SNPs), identification of polymorphic\ud microsatellite repeats within human genes, and comparative results with mouse full-length cDNAs. The H-InvDB\ud analysis has shown that up to 4% of the human genome sequence (National Center for Biotechnology Information\ud build 34 assembly) may contain misassembled or missing regions. We found that 6.5% of the human gene candidates\ud (1,377 loci) did not have a good protein-coding open reading frame, of which 296 loci are strong candidates for nonprotein-coding\ud RNA genes. In addition, among 72,027 uniquely mapped SNPs and insertions/deletions localized within\ud human genes, 13,215 nonsynonymous SNPs, 315 nonsense SNPs, and 452 indels occurred in coding regions. Together\ud with 25 polymorphic microsatellite repeats present in coding regions, they may alter protein structure, causing\ud phenotypic effects or resulting in disease. The H-InvDB platform represents a substantial contribution to resources\ud needed for the exploration of human biology and pathology

BACKGROUND—It was recently reported that A to G transition mutations at positions 2143 and 2144 in the 23S rRNA gene are associated with clarithromycin resistance in Helicobacter pylori. AIMS—To study the incidence and mechanism of development of clarithromycin resistance by analysing these mutations. SUBJECTS—Eighty two H pylori positive patients who had an endoscopic examination and no history of treatment with macrolide antibiotics. METHODS—Clarithromycin resistance was screened for by polymerase chain reaction-restriction fragment length polymorphism of the 23S rRNA gene coupled with antibiotic susceptibility testing. In clinical isolates with mutations or resistance, mutations in individual colonies were analysed by direct sequencing. RESULTS—Of the 79 amplicons (DNA fragments amplified by polymerase chain reaction), Alw26I and MboII digestion disclosed the mutation in four (5%) and one (1%) respectively. However, the Alw26I cleavage was incomplete in two of the four amplicons, as was the MboII cleavage. Individual colony analysis of the isolates with incomplete cleavage patterns showed the presence of both wild type and mutated strains in the 23S rRNA genes. CONCLUSIONS—Both clarithromycin sensitive and resistant strains colonised in some patients with no history of exposure to macrolides. The results suggest that resistant strains may not be formed but selected by clarithromycin administration. Keywords: Helicobacter pylori; clarithromycin resistance; 23S rRNA gene; point mutation; mixed strain colonisation