[Survival rates in patients with systemic lupus erythematosus]

To assess the impact of demographic and clinical factors on prognosis in patients with systemic lupus erythematosus (SLE), we examined the survival rate by lifetable analysis in 566 patients. All patients were Shanghai citizens who were diagnosed as having SLE in Huashan Hospital between 1959 and 1992. According to American Rheumatism Association's preliminary criteria. The survival rate from the time of SLE onset was 93% at 1 year, 73% at 5 years and 60% at 10 years. On univariate analysis, we found that the following factors worsened the probability of survival; male, neuropsychiatric manifestation, pleurisy-pericarditis, anemia, thrombocytopenia, lymphocytopenia, proteinuria, hematuria, urinary cast, azotemia, decreased endogenous creatinine clearance, increased cholesterol in serum, hypocomplementemia, abnormal electrocardiograph and high corticosteroid dose of treatment. On multivariate analysis, we found the four independent risk factors were male, azotemia, hypocomplementemia and high corticosteroid dose of treatment.

Structure-function analysis of SH3 domains: SH3 binding specificity altered by single amino acid substitutions

SH3 domains mediate intracellular protein-protein interactions through the recognition of proline-rich sequence motifs on cellular proteins. Structural analysis of the Src SH3 domain (Src SH3) complexed with proline-rich peptide ligands revealed three binding sites involved in this interaction: two hydrophobic interactions (between aliphatic proline dipeptides in the SH3 ligand and highly conserved aromatic residues on the surface of the SH3 domain), and one salt bridge (between Asp-99 of Src and an Arg three residues upstream of the conserved Pro-X-X-Pro motif in the ligand). We examined the importance of the arginine binding site of SH3 domains by comparing the binding properties of wild-type Src SH3 and Abl SH3 with those of a Src SH3 mutant containing a mutated arginine binding site (D99N) and Abl SH3 mutant constructs engineered to contain an arginine binding site (T98D and T98D/F91Y). We found that the D99N mutation diminished binding to most Src SH3-binding proteins in whole cell extracts; however, there was only a moderate reduction in binding to a small subset of Src SH3-binding proteins (including the Src substrate p68). p68 was shown to contain two Arg-containing Asp-99-dependent binding sites and one Asp-99-independent binding site which lacks an Arg. Moreover, substitution of Asp for Thr-98 in Abl SH3 changed the binding specificity of this domain and conferred the ability to recognize Arg-containing ligands. These results indicate that Asp-99 is important for Src SH3 binding specificity and that Asp-99-dependent binding interactions play a dominant role in Src SH3 recognition of cellular binding proteins, and they suggest the existence of two Src SH3 binding mechanisms, one requiring Asp-99 and the other independent of this residue.

A 55-kilodalton antigen encoded by a gene on a Borrelia burgdorferi 49-kilobase plasmid is recognized by antibodies in sera from patients with Lyme disease

We have identified a 55-kDa antigen encoded by a gene on a 49-kb plasmid of Borrelia burgdorferi. The screening of a B. burgdorferi DNA expression library (N40 strain) with rabbit anti-B. burgdorferi serum and then with serum from a patient with Lyme disease arthritis revealed a clone that synthesized an antigen that was reactive with both sera. DNA sequence analysis identified an operon with two genes, s1 and s2 (1,254 and 780 nucleotides), that expressed antigens with the predicted molecular masses of 55 and 29 kDa, respectively. Pulsed-field gel electrophoresis showed that the s1-s2 operon was located on the 49-kb plasmid. Recombinant S1 was synthesized as a glutathione S-transferase fusion protein in Escherichia coli. Antibodies to recombinant S1 bound to a 55-kDa protein in lysates of B. burgdorferi, indicating that cultured spirochetes synthesized S1. Thirty-one of 100 Lyme disease patients had immunoglobulin G (IgG) and/or IgM antibodies to S1. IgG antibodies to S1 were detected by enzyme-linked immunosorbent assay and immunoblots in the sera of 21 (21%) of 100 patients with Lyme disease; 11 (27.5%) of the S1-positive samples were from patients (40) with early-stage Lyme disease, and 10 (16.7%) were from patients (60) with late-stage Lyme disease. Fifteen (38.5%) of 40 serum samples from patients with early-stage Lyme disease had IgM antibodies to S1. These data suggest that the S1 antigen encoded by a gene on the 49-kb plasmid is recognized serologically by a subset of patients with early- or late-stage Lyme disease.

Photon migration in the presence of a single defect: a perturbation analysis

We present an analytical perturbation analysis for studying the sensitivity of diffusive photon flux to the addition of a small spherical defect object in multiple-scattering media such as human tissues. As a first simple application of our perturbation method, we derive analytically the photon migration path distributions and the shapes of the so-called banana regions in which the photon migration paths are concentrated. We then derive analytically the sensitivity of detected photon flux densities to the inclusion of small spherical defects in the multiple-scattering medium for both single-source and two-source configurations, at both steady-state (dc) and frequency-modulation conditions, and compare the results with Monte Carlo simulations.

Lyme disease in human DR4Dw4-transgenic mice

The evolution of Lyme arthritis in DR4-transgenic mice infected with Borrelia burgdorferi was studied because chronic Lyme arthritis in humans is associated with an increased frequency of the HLA-DR4 allele. B10 nontransgenic and DR4-transgenic mice expressing chimeric human-mouse major histocompatibility complex class II genes in which the human alpha 1 and beta 1 domains of DR4Dw4 replaced the corresponding domains of the mouse I-E(d) were inoculated with B. burgdorferi and examined at up to 180 days for infection and disease. All mice were infected throughout the 180 days, and arthritis evolved to equal severity in transgenic and control mice within 30 days and resolved by day 120. Both groups of mice developed high antibody titers to B. burgdorferi, but antibodies to outer surface proteins A and B were not readily detectable. The DR4Dw4 transgene did not predispose mice to the development of chronic Lyme arthritis.

Two binding orientations for peptides to the Src SH3 domain: development of a general model for SH3-ligand interactions

Solution structures of two Src homology 3 (SH3) domain-ligand complexes have been determined by nuclear magnetic resonance. Each complex consists of the SH3 domain and a nine-residue proline-rich peptide selected from a large library of ligands prepared by combinatorial synthesis. The bound ligands adopt a left-handed polyproline type II (PPII) helix, although the amino to carboxyl directionalities of their helices are opposite. The peptide orientation is determined by a salt bridge formed by the terminal arginine residues of the ligands and the conserved aspartate-99 of the SH3 domain. Residues at positions 3, 4, 6, and 7 of both peptides also intercalate into the ligand-binding site; however, the respective proline and nonproline residues show exchanged binding positions in the two complexes. These structural results led to a model for the interactions of SH3 domains with proline-rich peptides that can be used to predict critical residues in complexes of unknown structure. The model was used to identify correctly both the binding orientation and the contact and noncontact residues of a peptide derived from the nucleotide exchange factor Sos in association with the amino-terminal SH3 domain of the adaptor protein Grb2.

Effect of 24-h blood pressure levels and circadian blood pressure rhythm on left ventricular structure and function in isolated systolic hypertension

Forty-one participants (mean age 69 +/- 5.6 years) were examined by fully automatic blood pressure monitor and Doppler echocardiography to gain information on the ambulatory blood pressure and the left ventricular structure and function in isolated systolic hypertension. Cumulative sum (cusum)-derived statistics was used to quantify circadian blood pressure rhythm and 24-h blood pressure levels were defined as mean blood pressure values during 24 h, waking (06:00-22:00 h) and sleeping (22:00-06:00 h) periods, respectively. Most of the derivatives of ambulatory blood pressure, including cusum-derived statistics and 24-h blood pressure levels, were significantly related with the left ventricular structural (left ventricular posterior wall and interventricular septum thickness) and functional (acceleration time in the left ventricular outflow tract and early diastolic deceleration time) indexes. Among the left ventricular structural and functional indexes, interventricular septum thickness at end diastole had the strongest correlation with sleeping diastolic mean blood pressure (r = 0.41, P < 0.01), left ventricular posterior wall at end diastole, the best with 24-h systolic mean blood pressure (r = 0.41, P < 0.01), acceleration time the strongest with systolic cusum-derived circadian alteration magnitude (r = 0.49, P < 0.01) and early diastolic deceleration time the greatest with diastolic cusum-derived trough blood pressure (r = 0.45, P < 0.01). We conclude that left ventricular structural changes rely on 24-h systolic and diastolic blood pressure levels, whereas left ventricular functional variations may be more dependent upon circadian blood pressure rhythm in elderly patients with isolated systolic hypertension.

Vertical Aluminophosphate Molecular Sieve Crystals Grown at Inorganic-Organic Interfaces

Tubular aluminophosphate molecular sieve crystals were grown at an organic interface with their channels (7 angstroms in cross section) vertical to the substrate. To induce surface nucleation and oriented growth of AIPO(4)-5 crystals, organophosphonate layers cross-linked with Zr(IV) were assembled on a gold substrate and the modified substrate was immersed in a hydrothermal bath containing reagents for the synthesis of the molecular sieve. Reflection-absorption infrared studies demonstrated the stability of the phosphonate layers under these conditions. Drastic changes in the morphology of the surface-grown crystals from spherical agglomerates to vertical needles to thin tilted needles could be achieved by adjusting the water content of the synthesis bath. Nitrogen sorption in these structures on a piezoelectric device confirmed the presence of zeolitic microporosity.

[Surgical treatment of orbital fracture]

In last six years, 51 cases (34 males, 17 females) of orbital deformities caused by fracture were treated. According to careful examinations, x-ray and CT scan, the operation plan was made. The coronal incision or plus lower eyelid incision were employed. Subperiosteal dissection began from the upper margin of the orbit to release input soft tissue and reposition the eyeball. Rib bone was grafted for orbital defects. Canthoplasty was used if necessary. The surgical results were satisfactory.

[Mandibular advancement for the treatment of micrognathia with obstructive sleep apnea]

Fifteen patients with micrognathia and obstructive sleep apnea syndrome (OSAS) are presented. All patients were evaluated before and after surgery by physical examinations, cephalometric, fibroptic pharyngoscopy and oxygen saturation (SaO2). A method that allows isolated advancement of the genial tubercle and genioglossus muscle is described. The operation could enlarge the pharyngeal airway space at the base of the tongue (P < 0.05), increase SaO2 and decrease MP-H (P < 0.05) so that the symptoms of OSAS improved or disappeared. The facial symmetry and chin prominence also improved significantly. This method is simple and effective for the treatment of OSAS due to micrognathia and obviates the need for intermaxillary fixation. But it is not indicated for patients with severe malocclusion or airway obstruction on more than one sites.

Structural basis for the binding of proline-rich peptides to SH3 domains

A common RXL motif was found in proline-rich ligands that were selected from a biased combinatorial peptide library on the basis of their ability to bind specifically to the SH3 domains from phosphatidylinositol 3-kinase (PI3K) or c-Src. The solution structure of the PI3K SH3 domain complexed to one of these ligands, RKLPPRPSK (RLP1), was determined. Structure-based mutations were introduced into the PI3K SH3 domain and the RLP1 ligand, and the influence of these mutations on binding was evaluated. We conclude that SH3 domains recognize proline-rich motifs possessing the left-handed type II polyproline (PPII) helix conformation. Two proline residues directly contact the receptor. Other prolines in the ligands appear to function as a molecular scaffold, promoting the formation of the PPII helix. Three nonproline residues consisting of combinations of arginine and leucine interact extensively with the SH3 domain and appear to confer ligand specificity.

[Surgical correction of Crouzon syndrome using LeFort III advancement osteotomy]

Crouzon syndrome is one of craniosynostosis syndromes (or craniofacial dysostosis). It consists of multiple craniofacial deformities including severe midface retrusion, exorbitism and close bite. In 11 cases LeFort III advancement osteotomy to move the midface segments was performed in past eight years. We evaluate the result of reconstructive and postoperative aesthetic improvement using measurements of lateral cephalograms and exophthalmetry. Changes in midface horizontal view are obvious postoperatively, and SNA is increased from 70.9 degree to 74.5 degree, SNB decrease from 85.1 degree to 80.8 degree, and ANB increase from -14.2 degree to -6.3 degree. Midface segment is brought forward (average 10mm) and downward (average 2mm) postoperatively. The distance from the posterior nasal spine to the posterior pharyngeal wall on cephalograms is increased from 9.1mm to 19mm. Complications are discussed.

[The humoral immune response of different strains of mice after intragastrointestinal immunization with human sperm antigens]

The inbred Balb/c and C57 mice, and the outbred Swiss Webster mice were intragastrointestinally immunized with human sperm antigens. The lymphocytes from the spleen, mesenteric lymph node (MLN), Peyer's patch (PP) and uterus or epididymis were isolated and cultured. The lymphocyte-secreting antisperm IgG and IgA and the antisperm antibodies in the gut wash and serum were determined with enzyme-linked immunosorbent assay (ELISA). In the Balb/c and Swiss Webster mice, the immune responses to sperm have shown to be stronger than that in C57, stronger in female than in male. The antigenicity of sperm membrane extracts seems to be higher than that of whole sperm. Antisperm antibodies secreted by lymphocytes from the epididymis and uterus have demonstrated to be detectable. For stimulation of the local immune response, the intra-PP and intralumina immunizations are more effective than others.

Mesoscopic Conductors and Correlations in Laser Speckle Patterns

Submicrometer disordered metallic systems at low temperatures display interesting conductance fluctuation effects, owing to the interference of coherent electron wave transmission through the system. This quantum interference phenomenon also gives rise to the striking experimental observation that the 1/f noise power (where f is frequency) in disordered conductors increases as the temperature is decreased, contrary to common intuition. The theoretical techniques developed for this problem can be applied to the transmission of light through a random medium, and this yields novel predictions for the correlations in the laser speckle patterns and the possibility of studying the positions and motions of scatterers in a medium which multiply scatter the probing light.

[Estrogen receptor content of peripheral blood lymphocytes in patients with systemic lupus erythematosus]

ER content in lymphocytes of peripheral blood from 27 SLE patients and 20 healthy controls were determined by dextran-coated charcoal assay. ER content in lymphocytes of each sample was expressed by both fmol/mg of lymphocyte cytosolic protein and fmol/micrograms of lymphocyte DNA. The results showed that there was no significant difference between the ER content of lymphocytes from the controls and that from patients with SLE. But the logarithmic mean of ER content in lymphocytes, expressed by fmol/mg of cytosolic protein, in 14 patients with active SLE (0.9356 +/- 0.31) was significantly higher than that in 13 patients with inactive SLE (0.2979 +/- 0.23, P less than 0.001) and in the controls (0.6204 +/- 0.52, P less than 0.001). The normal upper limit of ER content in lymphocytes, expressed by fmol/micrograms of DNA, was 0.136. The elevated rate of ER content in lymphocytes in 14 active SLE (92.9%) was also higher than that in quieiescent patients (23.1%, P less than 0.001) and in the controls (10%, P less than 0.001). Moreover, the elevated level of ER content was found to be related to the positive antidsDNA antibody and hypocomplementemia.