Search for a command to run...
evacuation be properly related to symptoms and outcome. In the interim the ejection fraction ascertained by quantitative cholescintigraphy is a reasonable tool for identifying disordered gallbladder motility and relating this to biliary symptoms. Even pain relief soon after surgery is an imperfect endpoint because of placebo effect. The advent of laparoscopic cholecystectomy will be a temptingly easy solution to difficult cases. Before becoming too haphazard, a more complete, careful evaluation of gallbladder function and contents is essential. The once elusive testb) to diagnose acalculous biliary pain are being clarified. Cholescintigraphy may yet provide the best bet. ABSTRACT The nucleotide sequence of the RNA genome of the human hepatitis C virus (HCV) has been determined from overlapping cDNA clones. The sequence (9379 nucleotides) has a single large open reading frame that could encode a viral polyprotein precursor of 3011 amino acids. While there is little overall amino acid and nucleotide sequence homology with other viruses, the 5' HCV nucleotide sequence upstream of this large open reading frame has substantial similarity to the 5' termini of pestiviral genomes. The polyprotein also has significant sequence similarity to helicases encoded by animal pestiviruses, plant potyviruses, and human flaviviruses, and it contains sequence motifs widely conserved among viral replicases and trypsin-like pro- teases. ABSTRACT The nucleotide sequences of cDNAs (275 base-pairs) in the non-structural protein 5 regions of Japanese isolates of hepatitis C virus (HCV-J) from the plasma of 11 patients with non-A, non-B hepatitis and the livers of five patients with hepatocellular carcinoma were analyzed. Approximately 14 to 17% of nucleotide se- quences of the HCV-Js examined differed from that of the original isolate in the United States (HCV-US). Furthermore, 2.5 to 11% sequence diversity was found among the HCV-Js. The nucleotide sequences of the HCV- Js showed characteristic common differences from that of HCV-US, although they also showed some random substitutions. Plural HCV- J genomes were found in two of the cDNAs derived from liver spec- imens, and a deletion of 102 nucleotides was found in the cDNA derived from one plasma specimen. These results suggest that HCV-J is a strain different from the HCV-US and that mutation of the viral genome occurs at as high a frequency as in that of the human immunodeficiency virus. COMMENTS