Evaluation of a novel automated non-invasive pulse pressure variation algorithm

In mechanically ventilated patients, Pulse Pressure Variation (PPV) has been shown to be a useful parameter to guide fluid management. We evaluated a real-time automated PPV-algorithm by comparing it to manually calculated PPV-values. In 10 critically ill patients, blood pressure was measured invasively (IBP) and non-invasively (CNAP^® Monitor, CNSystems Medizintechnik, Austria). PPV was determined manually and compared to automated PPV values: PPV_manIBP vs. PPV_autoIBP was ?0.19±1.65% (mean bias±standard deviation), PPV_manCNAP vs. PPV_autoCNAP was ?1.02±2.03% and PPV_autoCNAP vs. PPV_manIBP was ?2.10±3.14%, suggesting that the automated CNAP^® PPV-algorithm works well on both blood pressure waveforms but needs further clinical evaluation.     

Peripheral blood CD4+CD8+ lymphocytes in cynomolgus monkeys are of resting memory T lineage

In this study, we analyzed peripheral blood CD4+CD8+ double-positive (DP) lymphocytes in adult cynomolgus monkeys (Macaca fascicularis). Forty of 55 monkeys had > 5% of the peripheral blood DP subpopulation (9.3 +/- 5.9%; mean +/- SD) in peripheral blood lymphocytes (PBL) in contrast to a low percentage of peripheral blood DP cells in humans and mice. In a cross-sectional study, the peripheral blood DP cells were found to increase in proportion with age. To clarify whether peripheral blood DP lymphocytes were immature precursors released from thymus without prior differentiation, the expressions of CD8 chains and CD1b on peripheral blood DP lymphocytes were compared with those on thymocytes. The peripheral blood DP lymphocytes were CD8 alpha + beta- and CD1b-, while thymic DP lymphocytes were CD8 alpha + beta + and CD1b +, suggesting that the peripheral blood DP cells are extrathymic T lymphocytes. Furthermore, the peripheral blood DP lymphocytes exhibited a resting memory T cell phenotype with CD2hiCD3+CD28-CD29hiCD49dhiCD69- CD80lo. Taken together, adult cynomolgus monkeys possess a unique peripheral blood DP T cell subpopulation which expresses a resting memory T cell phenotype. In addition, similar phenotypic properties of DP lymphocytes were distributed in the spleen and lymph nodes, although the proportion was less in the spleen and much less in lymph nodes than in PBL.      

Identification of Candida species in the clinical laboratory: a review of conventional,commercial, and molecular techniques

In healthy individuals, Candida species are considered commensal yeasts of the oral cavity. However, these microorganisms can also act as opportunist pathogens, particularly the so‐called non‐albicans Candida species that are increasingly recognized as important agents of human infection. Several surveys have documented increased rates of C. glabrata, C. tropicalis, C. guilliermondii, C. dubliniensis, C. parapsilosis, and C. krusei in local and systemic fungal infections. Some of these species are resistant to antifungal agents. Consequently, rapid and correct identification of species can play an important role in the management of candidiasis. Conventional methods for identification of Candida species are based on morphological and physiological attributes. However, accurate identification of all isolates from clinical samples is often complex and time‐consuming. Hence, several manual and automated rapid commercial systems for identifying these organisms have been developed, some of which may have significant sensitivity issues. To overcome these limitations, newer molecular typing techniques have been developed that allow accurate and rapid identification of Candida species. This study reviewed the current state of identification methods for yeasts, particularly Candida species.     

The influence of epigenetics in relation to oral health

The immune response is influenced by genetic and epigenetic factors, as well as disease and environmental factors. The term ‘epigenetics’ describes changes in the genome that influence the gene expression without altering the DNA sequence. In contrast to genetic changes in the DNA, epigenetic changes are reversible and are influenced by environmental factors. The aim of this study is to review the literature on epigenetic modifications with respect to oral health and inflammatory conditions in the oral cavity and to discuss the potential use of this new research field for the dental hygienists' and/or dentists' clinical work. Relevant publications were identified using the PubMed database without limits. The searches were conducted during January to March 2012 and resulted in articles published between 1912 and 2012. Key factors such as environment, diet, smoking, bacteria and inflammation were identified to be relevant to oral health. The result of this review article shows that there is a void in the research on epigenetics in relation to oral health. Identification of epigenetic modifications correlating with oral health may not only present a link between the influence of genetics and that of the environment on oral diseases but also provide new treatment models and tools for the dental professionals.     

Langerhans cell density in epithelial skin tumors correlates with epithelial differentiation but not with the peritumoral infiltrate

We investigated the intraepithelial density of Langerhans cells in 17 epithelial skin tumors by immunohistologic and morphometric methods. There was a significant difference between seborrheic keratosis (Langerhans cell density 431 +/- 31/mm2; normal epidermis: 378 +/- 20/mm2), basal cell carcinoma (28 +/- 6/mm2), and squamous cell carcinoma (100 +/- 21/mm2). No correlation was found between the Langerhans cell density and the number of intraepithelial T lymphocytes or the extent of the peritumoral inflammatory infiltrate. A significant inverse correlation was demonstrated between mean nuclear area of the epithelial tissue and the Langerhans cell density (r = -0.7; p less than 0.05). These data indicate that the number of Langerhans cells does not influence the extent of the antitumoral immune response. The correlation with the level of epithelial differentiation may be due to different homing conditions.     

Feasibility of using interpolated contours of targets and organs at risk in intensity‐modulated radiation therapy treatment planning for advanced‐stage nasopharyngeal carcinoma

To assess the dosimetric effect of using interpolated contours in planning intensity‐modulated radiation therapy (IMRT) for advanced T‐stage nasopharyngeal carcinoma. The present study focused on T3–T4 tumours where the proximity of targets to neurological organs poses a stringent test on the feasibility of such an approach. Contours of targets and organs were delineated on CT images of 2.5‐mm interval and a reference IMRT plan was generated. An investigative (INV) IMRT plan was then generated with the same planning protocol, but based on interpolated contours that replaced deleted contours on alternate slices. The reference and INV plans were compared. Regarding target coverage, all targets in the INV plans met the acceptance criteria except for the PTV in one case. Regarding organs, the mean dose to 1% volume of the brainstem and spinal cord in the INV plans were kept below their dose limits. No significant differences in the mean doses to others organs were found. Satisfactory target coverage and protection of critical organs to a degree similar to full‐scale contouring could be achieved with use of interpolated contours. The saving in manpower time for contouring is expected to significantly improve the throughput of the IMRT planning process.