Immunoregulatory role of acid sphingomyelinase in allergic asthma

Acid sphingomyelinase (ASM) is one of the enzymes that catalyzes the breakdown of sphingomyelin to ceramide and phosphorylcholine. In this study, we aimed at elucidating the role of ASM in allergic asthma. We used an ovalbumin-induced murine model of asthma where we compared wild-type and ASM-deficient mice. In wild-type mice, secretory ASM activity in the bronchoalveolar lavage fluid was increased in the acute ovalbumin model, but not in a tolerogenic model. Furthermore, in the absence of ASM, the serum IgE level was reduced, compared with wild-type mice, while an accumulation of interstitial macrophages and foreign antigen-induced regulatory T cells along with exhausted CD4⁺ PD1⁺ T cells was observed in the lungs of ASM^−/− mice. In conclusion, in the absence of ASM, we observed an accumulation of immunosuppressive antigen-induced regulatory T cells expressing Foxp3 and CTLA4 in the lung as well as multinucleated interstitial macrophages and exhausted CD4⁺ PD1⁺ T cells associated with inhibition of serum IgE in asthma.     

Zur Frage der Ausgleichsextraktion bei Nichtanlage oder traumatischem Verlust von Frontzähnen im Unterkiefer

Zusammenfassung Es wird über eigene Erfahrungen bei der kieferorthopädischen Behandlung der Nichtanlage bzw. des traumatischen Verlustes von Frontzähnen im Unterkiefer berichtet. Speziell wird auf die Problematik der Ausgleichsextraktion eingegangen. An Hand kasuistischer Beispiele werden die Behandlungsmöglichkeiten bei Fehlen eines, zweier bzw. dreier Frontzähne im Unterkiefer demonstriert.

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Summary The authors report on experiences with the orthodontic treatment of a missing anlage or of the traumatic loss, respectively, of frontal teeth in the lower jaw. In particular the problem of compensating extractions is dealt with. Cases are demonstrated to show the therapeutical possibilities with the absence of one, two or three frontal teeth of the lower jaw.

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Mit 7 Abbildungen

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Herrn Prof. Dr. Dr. Dr. h. c. mult. E. Reichenbach zum 75. Geburtstag     

InEOS--new system component in Cerec 3D

A new device for digitizing model surfaces for dental CAD/CAM applications is available with the inEOS scanner. It works according to the principle of stripe light projection. Both rotational scan mode of single prepared teeth and overview scan mode in which a complete model of the jaw can be acquired are possible. Detailed scans can be token in addition to improve the data quality. The software basis is the proven Cerec inLab 3D program. The virtually produced restorations can be milled either with the inLab milling unit or transferred to the Infinident milling center for central production. A clinical case which was treated by using the inEOS scanner is presented.     

The “speed” of acuity in scotopic vs. photopic vision

Graefe's Archive for Clinical and Experimental Ophthalmology - The effect of duration of optotype presentation on visual acuity measures has been extensively studied under photopic conditions....     

Analysis of failure and clinical outcome after unsuccessful medial patellofemoral ligament reconstruction in young patients

Purpose

Reconstruction of the medial patellofemoral ligament (MPFL) has become a popular procedure for patients with patellofemoral instability. Nevertheless, complication rates of up to 26 % have been reported. This study presents the analysis of failure and clinical outcome of subsequent revision surgery in young patients following unsuccessful medial patellofemoral ligament reconstruction.

Methods

Nineteen consecutive patients with unsuccessful MPFL reconstruction underwent revision surgery. Pre-operative assessment included physical examination, radiographs and magnetic resonance imaging to assess the MPFL graft, trochlear dysplasia, tibial tubercle–trochlear groove (TT-TG) distance, patella alta and femoral tunnel positioning. Evaluation also included the detection of cartilage injuries as well as visual analog scale (VAS), knee function scores and patient satisfaction. Each complication was analysed and an appropriate revision procedure was performed according to the identified technical or untreated anatomical risk factor.

Results

The average age at the time of the index operation was 20.2 years (range, 16–27 years). The average age at the time of the primary MPFL reconstruction was 18.4 years (range, 15–25). Three main reasons for failure after MPFL reconstruction could be identified: failure to consider additional risk factors, intra-operative technical errors and inappropriate patient selection. In five patients severe trochlear dysplasia and in two patients concomitant excessive femoral anteversion as additional risk factors were detected. Seven patients experienced medial retinacular pain with limited flexion due to technical errors caused in three patients by anterior placement of the femoral tunnel and in four others by overtensioning of the MPFL graft. Four patients with patellofemoral pain were found to have ICRS grade III or IV cartilage injuries. The median postoperative Kujala scores improved from 57 (34 – 73) pre-operatively to 83 (49 – 94), the median knee function improved from 5 (range, 2 – 6) pre-operatively to 8 (range, 3 – 10). Median VAS scores improved from 4 (2 – 7) to 2 (0 – 5). A total of 78.9 % of patients were satisfied or very satisfied, 15.8 % were partially satisfied and one patient (5.3 %) was not satisfied with the result after revision surgery.

Conclusion

Failure to consider additional risk factors, technical intra-operative errors and inappropriate patient selection were identified as reasons for revision surgery after MPFL reconstruction. Identifying the potential causes of failure can help to treat and possibly prevent future complications.