Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care

OBJECTIVE

The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis.

METHODS

We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded.

RESULTS

We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers.

CONCLUSION

In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BACKGROUND

Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.

METHODS

In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.

RESULTS

One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.

CONCLUSION

High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Quantification of classical HLA class I mRNA by allele-specific, real-time polymerase chain reaction for most Han individuals

Recent studies have shown that expression levels of different alleles at the same HLA class I locus can vary dramatically, which might have a broad influence on human disease. However, precise quantification of the relative expression level of each HLA allele is challenging, because distinguishing different alleles on the same locus is difficult. Here, we developed a series of allele-specific, real-time polymerase chain reaction assays for quantifying HLA class I allele mRNA in most Han individuals. The alleles of almost all heterozygous genotypes with a frequency higher than 0.5% in our population (78 alleles on HLA-A locus, 124 alleles on HLA-B locus, and 74 alleles on HLA-C locus) were specifically amplified. The specificity of the amplification was strictly validated by setting the corresponding negative control for each allele of each genotype. The amplification efficiency of each reaction was determined, and the slopes of the reactions were compared. This study provides a tool for detecting the comprehensive expression profile of HLA class I alleles and will be useful not only for the investigation of the molecular mechanism underlying HLA allele expression regulation but also for exploration of immunological mechanisms involving HLA expression in the fields of tumour immune evasion, viral infection, auto-immune disorders, and graft vs host disease after haematopoietic stem cell transplantation.

Antioxidant action of acteoside and its analogs on lipid peroxidation

We have investigated antioxidant actions of acteoside (ACT) and another natural phenylpropanoid glycoside, cistanoside F (CIS-F) on lipid peroxidation in rat liver mitochondria (RLM) and rat liver mitochondrial lipid (RLML) liposomes induced by Fe(2+)/ADP. A synthetic ACT analogue, TX-1847, was also examined. Oxygen consumption, the formation of thiobarbituric acid reactive substances (TBARs) and glutathione concentration were determined simultaneously during lipid peroxidation. The radical scavenging activity of the compounds was evaluated by using 1,1-diphenyl-2-picrylhydrazyl. ACT and its analogs produced dose-dependent inhibitions of mitochondrial and liposomal lipid peroxidation (ACT ≈ CIS-F > TX-1847). Their radical scavenging activities were ranked as follows: TX-1847 > ACT > CIS-F. ACT, CIS-F, and TX-1847 spared reduced glutathione (GSH) during mitochondrial lipid peroxidation. The radical scavenging activities of the compounds did not parallel their anti-peroxidative activities. The data are consistent with the idea that the inhibitory activities of phenylpropanoids were primarily due to a radical chain-breaking mechanism. The sugar moieties in ACT and CIS-F, and/or the conformational structure of the compounds, also seem to play an important role in their inhibitory effects on lipid peroxidation.

The impact of disease activity and tumour necrosis factor-α inhibitor therapy on cytokine levels in juvenile idiopathic arthritis

The aim of this study was to evaluate prospectively cytokine levels and disease activity in juvenile idiopathic arthritis (JIA) patients treated with and without tumour necrosis factor (TNF)-α inhibitors. TNF-α inhibitor-naive JIA subjects were followed prospectively for 6 months. Cytokine levels of TNF-α, interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-17 were measured at baseline for JIA subjects and healthy controls (HCs). Cytokine levels were then measured at four time-points after initiation of TNF-α inhibition for anti-TNF-α-treated (anti-TNF) JIA subjects, and at two subsequent time-points for other JIA (non-TNF) subjects. JIA disease activity by Childhood Health Assessment Questionnaire (CHAQ) disability index/pain score and physician joint count/global assessment was recorded. Sixteen anti-TNF, 31 non-TNF and 16 HCs were analysed. Among JIA subjects, those with higher baseline disease activity (subsequent anti-TNFs) had higher baseline TNF-α, IL-6 and IL-8 than those with lower disease activity (non-TNFs) (P < 0·05). TNF-α and IL-10 increased, and IL-6 and IL-8 no longer remained significantly higher after TNF-α inhibitor initiation in anti-TNF subjects. Subgroup analysis of etanercept versus adalimumab-treated subjects showed that TNF-α and IL-17 increased significantly in etanercept but not adalimumab-treated subjects, despite clinical improvement in both groups of subjects. JIA subjects with increased disease activity at baseline had higher serum proinflammatory cytokines. TNF-α inhibition resulted in suppression of IL-6 and IL-8 in parallel with clinical improvement in all anti-TNF-treated subjects, but was also associated with elevated TNF-α and IL-17 in etanercept-treated subjects.

A surge in anti-dsDNA titer predicts a severe lupus flare within six months

OBJECTIVE

Rising anti-double-stranded (ds) DNA titers have been shown by some, but not all, studies to be predictive of disease flares in systemic lupus erythematosus (SLE). We hypothesized that a rapid and substantial rise in anti-dsDNA titer (anti-dsDNA surge) would be a good predictor of a clinically important SLE flare.

METHODS

A matched case-control study was conducted in an academic rheumatology practice setting. Our primary endpoint was the occurrence of a severe SELENA-SLEDAI (SS) flare within six months of an anti-dsDNA surge, and secondary endpoints were mild/moderate SS flares, as well as BILAG A and B renal flares. Cases were identified as those patients whose disease course included a surge of anti-dsDNA, defined as an increase of anti-dsDNA titer by the Crithidia luciliae immunofluorescence (CLIF) assay from 0 to 3+/4+, or from 1+ to 4+, within a period of less than 12 months. The date of the anti-dsDNA surge was defined as Day 0. Two control SLE patients were identified for each case and were matched for age, sex, race, and visit date closest to case Day 0, but without an anti-dsDNA surge. Logistic regression models were used to detect associations between anti-dsDNA surges and severe SS flares.

RESULT

A higher proportion of cases, compared to controls, experienced a severe SS flare within six months of Day 0 (OR 6.3 (95% confidence intervals 2.0-19.9), p = 0.02). Associations with all flares and hospitalizations for flares were also observed. However, an anti-dsDNA surge was not predictive of a renal flare.

CONCLUSION

An anti-dsDNA surge predicts the subsequent development of a severe SS flare within six months. Physicians should closely monitor such patients and treat promptly at the first sign of clinical activity.

Two novel HLA class I alleles, HLA-B*40:122 and HLA-B*40:127

The new alleles human leukocyte antigen (HLA)-B*40:122 and HLA-B*40:127 differs from B*40:02:01 and B*40:06:01:01 by a single nucleotide, respectively.

Expression of the nonclassical HLA class I and MICA/B molecules in human hepatocellular carcinoma

HLA-G and HLA-E are nonclassical human MHC class I molecules, which promote tolerance to NK cytotoxicity. MICA and MICB are known to enhance the functions of NK and T cells. However, the expression of these molecules has never been investigated in liver cancer. Using RT-PCR and western blot, we aimed to identify the expression of HLA-G, HLA-E, MICA and MICB in a panel of 41 tissues dissecting from liver cancer patients in China. HLA-G mRNA was expressed in 8 of 41 Human Hepatocellular Carcinoma (HCC) specimens and in 1 adjacent normal hepatocellular tissue. The expression of HLA-G protein was found in 7 of the 8 HLA-G mRNA-positive HCC tissues. HLA-E mRNA was up-regulated in 56% HCC specimens but the expression of HLA-E protein was only upregulated in 29% HCC tissues in comparison with their adjacent normal counterpart. MICA and MICB mRNA was decreased in 5% and 8% HCC specimens, while the expression of their proteins decreased in 21% and 24% HCC tissues. These results suggested that the expressions of HLA-G, HLA-E, MICA and MICB were differently up-regulated in HCC tissues. Furthermore, HLA-E and MICA/B genes showed obviously distinctive expression pattern at transcription and translation level.

Identification of a novel HLA-C allele, C*12:10:02, in a Chinese individual

The new human leukocyte antigen (HLA) class I allele C*12:10:02 differs from C*12:02:03 by a non-synonymous mutation at codon 99 (TAT to TTT).

Identification of a novel HLA class I allele, HLA-Cw*0134 in a Chinese individual

The new human leukocyte antigen (HLA) class I allele, HLA-Cw*0134, was identified in a Chinese individual. HLA-Cw*0134 differs from HLA-Cw*0124 by one nonsynonymous nucleotide change at the codon 99 (TGT to TAT) and one synonymous nucleotide change at the codon 127 (AAC to AAT).

Identification of a novel HLA-A allele, HLA-A*9216

The new human leukocyte antigen (HLA)-A*9216 differs from A*02010101 by a nonsynonymous nucleotide change at condon 76 (GTG>CTG).

Molecular cloning and functional analysis of a novel type of Bowman-Birk inhibitor gene family in rice

Bowman-Birk inhibitor (BBI) genes encode serine protease inhibitors that have repetitive cysteine-rich domains with reactive sites for the trypsin or chymotrypsin family. We have identified seven BBI genes from japonica rice (Oryza sativa subsp. japonica var Teqing). All of the genes identified were found in a single cluster on the southern end of the long arm of rice chromosome 1. Four of the seven BBI genes have two repetitive cysteine-rich domains, whereas one has a truncated domain with only one reactive site. We have also identified three novel BBI genes, each of which possesses three repetitive domains instead of two. In situ hybridization analyses indicated that the accumulation of rice BBI transcripts was differentially regulated in germinating embryos and also in the leaves, roots, and flower organs at later developmental stages. Different members of the rice BBI gene family displayed different expression patterns during rice seed germination, and wounding induced the expression of rice BBI transcripts. The three-domain BBIs had higher expression levels than the two-domain BBIs. It was also found that the mRNA of rice BBI genes was present in abundant amounts in scutellar epithelium and aleurone layer cells. RBBI3-1, one of the three-domain RBBI, exhibited in vitro trypsin-inhibiting activity but no chymotrypsin-inhibiting activity. Overexpression of RBBI2-3 in transgenic rice plants resulted in resistance to the fungal pathogen Pyricularia oryzae, indicating that proteinase inhibitors confer resistance against the fungal pathogen in vivo and that they might play a role in the defense system of the rice plant.

Safety assessment for genetically modified sweet pepper and tomato

The coat protein (CP) gene of cucumber mosaic virus (CMV) was cloned from a Chinese CMV isolate, the CaMV promoter and NOS terminator added and the gene construct was transformed into both sweet pepper and tomato plants to confer resistance to CMV. Safety assessments of these genetically modified (GM) plants were conducted. It was found that these two GM products showed no genotoxicity either in vitro or in vivo by the micronucleus test, sperm aberration test and Ames test. Animal feeding studies showed no significant differences in growth, body weight gain, food consumption, hematology, blood biochemical indices, organ weights and histopathology between rats or mice of either sex fed with either GM sweet pepper or tomato diets compared with those with non-GM diets. These results demonstrate that the CMV-resistant sweet pepper and tomato are comparable to the non-GM counterparts in terms of food safety.

Infrared Spectra of Phthalocyanine and Naphthalocyanine in Sandwich-Type (Na)phthalocyaninato and Porphyrinato Rare-Earth Complexes. II. The Effects of Rare-Earth Ionic Size on the IR Characteristics of Naphthalocyaninein Bis(naphthalocyaninato) Rare-Earth Complexes

The infra-red (IR) spectroscopic data for a series of 28 homoleptic substituted bis(naphthalocyaninato) rare-earth complexes M(2,3-Nc*)2 [M = Y, La–Lu except Pm; H2Nc* = 3(4),12(13),21(22),30(31)-tetra(tert-butyl)-2,3- naphthalocyanine (H2TBNc) and 3,4,12,13,21,22,30,31-octa(dodecylthio)-2,3-naphthalocyanine (H2ODTNc)] have been collected with a resolution of 2 cm–1. These neutral sandwich complexes are radicals due to their composition (Nc*)2–MIII(Nc*)–, wherein the unpaired electron is delocalized over both macrocycles on the vibrational time scale. Compared to spectra obtained with low resolution, such as 4 cm–1, a larger number of vibrational modes could be distinguished. The IR spectra for M(ODTNc)2 are much simpler than those of M(TBNc)2, revealing the relatively higher symmetry of the former molecules. By analogy with bis(phthalocyaninato) rare-earth counterparts, the pyrrole stretching absorptions at 1314–1317 and 1323–1330�cm–1 for M(TBNc)2 and at 1316–1327 cm–1 for M(ODTNc)2 are assigned to the IR marker bands of the respective naphthalocyanine mono-anion radicals. These marker bands, together with those at 746–753 cm–1 assigned to C–H wagging, 1350–1355 cm–1 attributed to pyrrole stretchings, and 1389–1394 cm–1 due to naphthalene stretchings, have been found to shift slightly to higher energy along with the rare-earth contraction, clearly demonstrating the effect of rare-earth ionic radius.

[Study of enzyme immunosensor immobilized by regenerated silk fibroin]

The author studies the enzyme immunosensor made up of graphite electrode and protein film of regenerated silk fibroin which is employed to immobilized antigen (rabbit IgG). IgG will be recognized and combined by antibody (goat-anti-rabbit IgG-HRP). After enlarging the signal of the combination of antigen and antibody by H2O2, the concentration of IgG is able to be measured by testing the electrode potential directly. The Enzyme Immunosensor is sensitive when measuring IgG and the detection limit of 1.2 x 10(-10) mol/L is found. It shows linear response over the concentration range of 4.1 x 10(-7)-1.2 x 10(-10) mol/L. Electrophoresis cuts down the time of antibody-antigen interaction from 90 min to 30 min. The response time is 15 s. Enzyme immunosensor with better stability and higher sensitivity can be used extensively in clinical diagnosis, medical and environmental studies, HLA molecular diagnosis and so on.

How does oxygen inhibit central metabolism in the obligate anaerobe Bacteroides thetaiotaomicron

The molecular basis of obligate anaerobiosis is not well established. Bacteroides thetaiotaomicron is an opportunistic pathogen that cannot grow in fully aerobic habitats. Because microbial niches reflect features of energy-producing strategies, we suspected that aeration would interfere with its central metabolism. In anaerobic medium, this bacterium fermented carbohydrates to a mixture of succinate, propionate and acetate. When cultures were exposed to air, the formation of succinate and propionate ceased abruptly. In vitro analysis demonstrated that the fumarase of the succinate-propionate pathway contains an iron-sulphur cluster that is sensitive to superoxide. In vivo, fumarase activity fell to < 5% when cells were aerated; virtually all activity was recovered after extracts were chemically treated to rebuild iron-sulphur clusters. Aeration minimally affected the remainder of this pathway. However, aeration reduced pyruvate:ferredoxin oxidoreductase (PFOR), the first enzyme in the acetate fermentation branch, to 3% of its anaerobic activity. This cluster-containing enzyme was damaged in vitro by molecular oxygen but not by superoxide. Thus, aerobic growth is precluded by the vulnerability of these iron-sulphur cluster enzymes to oxidation. Importantly, both enzymes were maintained in a stable, inactive form for long periods in aerobic cells; they were then rapidly repaired when the bacterium was returned to anaerobic medium. This result explains how this pathogen can easily recover from occasional exposure to oxygen.

[Change of NOS activity in hypoxia and cold-induced blood vessels damage and its biological significance]

OBJECTIVES

To explore the therapeutic methods for hypoxia and cold induced blood vessel damage by observing the changes of NO synthase (NOS) activity in hypoxia and development of coldm induced blood vessels damage, and studying the effects of SOD and vitamin C on the changes of NOS activity.

METHODS

The main artery was isolated from Wistar rats and exposed to hypoxia and/or cold environment in vitro. LDH activity was measured using an automatic biochemical analyzer and NOS and SOD activities in blood vessels were analyzed respectively by Griess assay and adrenaline autoxidantion method.

RESULTS

NOS activity in hypoxia, cold and hypoxia-cold damaged vessels decreased by 18.2%, 19.1% and 25.9% respectively after exposure as compared with the control vessels. The changes of NOS activity were time dependent. The NOS activity in damaged vessels was negatively correlated with LDH activity in the culture medium of the respective vessels. The SOD activity in hypoxia and/or cold damaged vessels also decreased significantly. Giving SOD (200 u/ml) or vitamin C (50 mg/ml) immediately after hypoxia and/or cold exposure increased the NOS activity and SOD activity in the damaged vessels significantly, as compared with the non-treatment controls.

CONCLUSIONS

The decrease of NOS activity is closely related to the development of damage induced by hypoxia and/or cold injury. SOD and vitamin C could protect the blood vessels exposed to hypoxia and/or cold from damage, possibly by increasing NOS activity.

General dental practitioners' perceptions of removable prosthodontics in the undergraduate curriculum

The undergraduate dental curriculum is undergoing rapid change and revision in dental schools worldwide. Decreasing edentulism, the advent of the clinical dental technician, and advances in technology (such as dental implantology) have led to changes in patient management and treatment options for general dental practitioners in New Zealand. The current undergraduate removable prosthodontic curriculum has seen very little change in past years at the School of Dentistry, University of Otago, and is under review to facilitate the teaching of general dental practice in the Final Year. A questionnaire-based survey of 150 general dental practitioners (response rate 74.6 percent) supported modification of the existing removable prosthodontics curriculum to improve its relevance to modern general dental practice. Integration of fixed and removable prosthodontic teaching was recommended.

Adaptation of Haemophilus influenzae to acquired and innate humoral immunity based on phase variation of lipopolysaccharide

Phase variation in colony morphology has been associated with the pathogenesis of infection caused by Haemophilus influenzae. This study shows that differences in colony opacity in non-typeable H. influenzae (NTHi) strain H233 involve phase changes in the lipopolysaccharide (LPS) and depend on the expression of licl and lic2, which contain translational switches based on intragenic tandem repeats of 5'-CAAT-3'. Genetic analysis showed that opaque organisms have an out-of-frame number of repeats in both licl, required for the expression of phosphorylcholine (ChoP), and lic2, a putative galactosyl transferase that adds the terminal galactose on Galalpha1-4Gal. Defined variants in these loci were used to examine the contribution of individual LPS structures to resistance to serum bactericidal activity mediated by antibody and C-reactive protein (CRP). The addition of ChoP by licl was the only factor in serum killing involving CRP and complement. The terminal galactose moiety, in contrast, conferred resistance to killing by naturally acquired antibody and complement present in human serum. As Galalpha1-4Gal is also found on human glycolipids, it appears that decoration of the cell surface with this host-like antigen blocks antibody-mediated serum bactericidal activity. Genetic analysis of NTHi within the human respiratory tract demonstrated that Galalpha1-4Gal may not be expressed during carriage but may be advantageous for the organism in inflammatory states such as pneumonia.

The phosphorylcholine epitope undergoes phase variation on a 43-kilodalton protein in Pseudomonas aeruginosa and on pili of Neisseria meningitidis and Neisseria gonorrhoeae

Phosphorylcholine (ChoP) is a component of the teichoic acids of Streptococcus pneumoniae and has been recently identified on the lipopolysaccharide of Haemophilus influenzae, also a major pathogen of the human respiratory tract. Other gram-negative pathogens that frequently infect the human respiratory tract were surveyed for the presence of the ChoP epitope as indicated by binding to monoclonal antibodies (MAbs) recognizing this structure. The ChoP epitope was found on a 43-kDa protein on all clinical isolates of Pseudomonas aeruginosa examined and on several class I and II pili of Neisseria meningitidis. The specificity of the anti-ChoP MAb was demonstrated by the inhibition of binding in the presence of ChoP but not structural analogs. As in the case of H. influenzae, the expression of this epitope was phase variable on these species. In P. aeruginosa, this epitope was expressed at detectable levels only at lower growth temperatures. Expression of the ChoP epitope on piliated neisseriae displayed phase variation, both linked to pilus expression and independently of fully piliated bacteria.

Phosphorylcholine on the lipopolysaccharide of Haemophilus influenzae contributes to persistence in the respiratory tract and sensitivity to serum killing mediated by C-reactive protein

Haemophilus influenzae undergoes phase variation in expression of the phosphorylcholine (ChoP) epitope, a structure present on several invasive pathogens residing in the human respiratory tract. In this study, structural analysis comparing organisms with and without this epitope confirmed that variants differ in the presence of ChoP on the cell surface-exposed outer core of the lipopolysaccharide. During nasopharyngeal carriage in infant rats, there was a gradual selection for H. influenzae variants that express ChoP. In addition, genotypic analysis of the molecular switch that controls phase variation predicted that the ChoP+ phenotype was predominant in H. influenzae in human respiratory tract secretions. However, ChoP+ variants of nontypable H. influenzae were more sensitive to the bactericidal activity of human serum unrelated to the presence of naturally acquired antibody to ChoP. Serum bactericidal activity required the binding of C-reactive protein (CRP) with subsequent activation of complement through the classical pathway. Results of this study suggested that the ability of H. influenzae to vary expression of this unusual bacterial structure may correlate with its ability both to persist on the mucosal surface (ChoP+ phenotype) and to cause invasive infection by evading innate immunity mediated by CRP (ChoP- phenotype).

[Three kinds of standing-materials for concha in reconstruction of ear]

In the reconstruction of the concha, standing support was necessary. From 1984 to 1996, 33 cases of aurical defects were admitted. Three standing-materials were chosen, and they included carved autogenous cartilage, heterogenous concha cartilage and steel wire work silicon-wires with silastic rubber tube. After expansion of the postauricular skin by tinsion expander, the standing-material was enveloped and total ear reconstruction or repair was performed. After followed up for average of 3.5 years, of the twenty-two cases, 16 had a satisfactory result, unsatisfied in 3 and failure in 3. It was concluded that the outcome of autogenous concha cartilage as a standing-material was good. The other two materials if used should be very carefully.

190-fs passively mode-locked thulium fiber laser with a low threshold

We report a self-starting passively mode-locked thulium-doped silica fiber laser capable of 190-fs pulses. This practical, compact package is driven by a single 50-mW passively cooled diode laser, has a launched pumppower threshold of 18 mW for mode locking, and produces a 50-MHz train of mode-locked 20-pJ pulses at a wavelength near 1.9 microm.

Immunodetection of beet necrotic yellow vein virus RNA3-encoded protein in different host plants and tissues

The protein p25 open reading frame (ORF) of beet necrotic yellow vein virus-BNYVV RNA3 was cloned into bacterial expression vector downstream of the 5-'terminus part of beta-galactosidase ORF and the expressed p25 fusion protein was used to produce an antiserum. The latter was employed to detect the subcellular location of p25 in mechanically inoculated Tetragonia expansa, Chenopodium quinoa and sugarbeet leaves by Western blot assay. The results showed that p25 was present as a soluble protein only in the S30 fraction of T. expansa, C. quinoa and sugarbeet leaves infected with BNYVV.

Cell-specific expression of estrogen receptor in the human pituitary and its adenomas

Estrogen affects the synthesis and release of several pituitary hormones. The estrogen receptor (ER), a member of the steroid hormone receptor family, is thought to mediate transcriptional effects in a cell-specific fashion. We investigated whether ER is expressed in specific hormone-producing cell types in the human pituitary and its adenomas. Pituitary adenomas (n = 34) were collected at the time of surgery, and normal glands were obtained from autopsy. Expression of ER messenger ribonucleic acid (mRNA) was determined by reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization. ER was also localized with immunohistochemistry and protein extraction. By RT-PCR, ER mRNA was found in the nontumorous pituitary and in pituitary adenomas expressing only PRL, in those producing GH and PRL, and in adenomas expressing the gonadotropic hormones. No ER mRNA was detected in adenomas expressing only GH without PRL or gonadotropins, nor in tumors producing ACTH without PRL or gonadotropins. In situ hybridization was not as sensitive or specific as RT-PCR. Biochemical analysis performed on seven tumors that were positive for ER mRNA by RT-PCR detected ER protein in only one PRL adenoma and one oncocytoma and yielded negative or equivocal results in one PRL adenoma, three GH-PRL adenomas, and one null cell adenoma. ER protein was localized by immunohistochemistry in scattered cells of the nontumorous adenohypophysis and in a few PRL and gonadotroph adenomas. We conclude that ER expression, as determined by RT-PCR, correlates with the expression of PRL or gonadotropins; in contrast, ER mRNA was not detected in adenomas that express only GH or ACTH. These findings implicate ER as a cell-specific transcription factor that may regulate cytodifferentiation in the pituitary.

Clonality of thyroid nodules in sporadic goiter

Clonality studies have suggested that neoplasms are monoclonal and hyperplasias are polyclonal. To investigate this question in thyroid, we analyzed the clonality of 26 morphologically characterized hyperplastic nodules from 19 patients with sporadic goiters. For comparison we studied six thyroid carcinomas. We used the highly informative M27 beta probe that maps to the X-chromosome DXS255 locus (X cen-p11.22). Material was obtained from 52 nodules; tissue from nine nodules was rejected because of contamination with normal elements, five patients (eight nodules) were homozygous at Pst I sites in nonnodular thyroid tissue, and three nodules were excluded for technical reasons. Methylation patterns after Hpa II digestion confirmed polyclonality in all nontumorous thyroids of informative patients. Seven hyperplastic nodules were polyclonal, and 18 were monoclonal; one showed loss of heterozygosity. One nodule exhibited aberrant methylation. Multiple nodules were obtained from four patients; in three, all were monoclonal with activation of the same allele. Three papillary carcinomas were monoclonal; two exhibited aberrant methylation. One follicular carcinoma showed loss of heterozygosity. Our data indicate that morphologically indistinguishable hyperplastic thyroid nodules may be monoclonal or polyclonal. These findings suggest that variable molecular mechanisms are involved in the pathogenesis of nodules in sporadic goiter. Future studies will need to explore the biological significance of nodules of variable clonal origin.

Ca2+ ATPase activity in essential and renal hypertension

In 15 patients with essential hypertension, 16 patients with renal hypertension and in 12 healthy subjects Ca2+ ATPase activity was determined in red blood cells both in the basal state and after maximal stimulation with calmodulin. Normal subjects showed a basal and maximal activity of 7.1 +/- 3.6 and 16.0 +/- 2.3 pmol phosphate/min.10(6) RBC, respectively. Renal hypertensives had a similar basal Ca2+ ATPase activity (5.4 +/- 4.1 pmol phosphate/min.10(6) RBC) and a lowered maximal Ca2+ ATPase activity (9.8 +/- 5.4 pmol phosphate/min.10(6) RBC, p < 0.05). In essential hypertensives basal and maximal Ca2+ ATPase activity was 9.0 +/- 5.3 and 35.4 +/- 14.4 pmol phosphate/min.10(6) RBC, respectively, the latter being significantly increased (p < 0.01). This finding, which is in contrast to earlier results indicating a lowered Ca2+ ATPase activity in essential hypertension, may be explained as a consequence of an increased Ca2+ influx in essential hypertension. A lowered Ca2+ ATPase activity does not seem to be involved in the pathogenesis of essential hypertension.

[GC-MS analysis of essential oils in needles of Pinus in northeastern China]

The essential oils of five species of Pinus (P. densiflora, P. sylvestris var. mongolica, P. sylvestris var. sylvestriformis, P. tabulaeformis and P. takahasii) have been analysed by GC-MS. Fifty compounds have been identified.

Autoantibodies to serum proteins in women with recurrent spontaneous abortion: subsequent pregnancy outcome

Sera from 130 first trimester pregnant women were tested for their serum antibody level against a naturally occurring serum antigen purified from non-pregnancy sera. IgG and IgM antibody level was measured using enzyme linked immunosorbent assay. Results indicate that patients with multiple abortion (n = 26) have significantly (p = 0.0029) lower level of IgG antibody and significantly (p = 0.0001) higher level of IgM antibodies against the serum antigen as compared to the patients with successful pregnancies with no history of miscarriage (n = 63). Western blot analysis identified the serum antigen recognized by the IgM antibody as a 24 kDa molecular mass component. These IgG and IgM antibodies may play an important role in the outcome of pregnancy.

[Analysis of essential oils in roots and fruits of Angelica in Northeast China]

The essential oils of roots and fruits of five species of Angelica have been examined and analysed by GC-MS-DS; 59 chemical compounds are reported, of which alpha-pinene, myrcene and p-cymene are common to all five species. This paper provides a scientific basis for developing the resources of this genus in the Northeast.

Remnants of the Venous Valves in the Adult Heart

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Retroperitoneal Hernia

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Some Variations in the Musculature of the Superior Extremity

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Transposition of Abdominal Viscera

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