Zonal variation of HLA expression on human cornea epithelium

Seven human corneas were studied, using the enzyme-linked immunosorbent assay (ELISA) technique, for expression of human leukocyte antigens (HLA) class-I and class-II antigens on the epithelial cells of the central 8-mm corneal button and the remaining corneal periphery and limbus. The antigenicity was compared with that of Raji and Daudi cell lines, which served as controls. It was demonstrated that the epithelium of the two corneal parts shows a high expression of HLA class-I antigens, albeit not as strong as that found in the control cell lines. On the other hand, HLA class-II antigens were found only in the limbal-peripheral area. Expression of the HLA class-I antigens was weaker in the central portion of the cornea. It is proposed that the absence of HLA class-II antigens expression in the central portion of the cornea offers an additional explanation for the greater success of small corneal grafts, since the recognition step necessary for the immunological response is lacking.     

Changes in the maxillary and mandibular tooth size-arch length relationship from early adolescence to early adulthood. A longitudinal study

The purpose of this study was to determine the association between the changes in maxillary and mandibular tooth size-arch length discrepancies (TSALD) and various dentofacial variables for 18 male and 14 female subjects with normal occlusion. All subjects were participants in the Iowa Longitudinal Growth Study and records were evaluated at two stages of dental development: stage I, when the permanent second molars initially erupted into occlusion (X age = 13.3 years); and stage II, at early adulthood (X age = 26.0 years). The following sets of variables were evaluated: mesiodistal crown diameters of single and groups of permanent teeth, dental arch widths and lengths, curve of Spee, maxillary and mandibular anterior and total crowding or spacing, anterior tooth rotations, and various cephalometric dentofacial parameters. Student's t test were used to compare subjects with the most and least changes. Regression analyses also were used to assess the relationships between these parameters and the changes in the maxillary and mandibular tooth size-arch length relationship. The most consistent finding from the t test comparisons is the significantly greater reduction in the available arch length in the group with the most TSALD at early adulthood. No other variables were found to be consistently different in the comparisons between the two groups. The results of the regression analysis indicated that a number of dentofacial variables are associated with the changes in the maxillary and mandibular TSALD--for example, the mesiodistal diameter of different teeth and the changes in anterior and posterior facial heights. The clinical implications of the present findings are discussed.     

The value of perioperative Doppler ankle systolic pressure measurements in reconstructive arterial surgery

This study evaluates the use of ankle systolic Doppler indices for the detection of technical errors during reconstructive surgery. Measurements taken peroperatively, following declamping, are expressed as a ratio of brachial systolic pressure and compared with preoperative and postoperative readings. A study has been made of 377 limbs in 272 patients, including patients undergoing surgery for aneurysm, claudication and limb salvage. In the majority of patients the peroperative ratios were similar to, or improved on, pre-operative levels. No technical errors or primary failures were apparent in those patients in which this was the case. In contrast, in the 27 limbs in which a pre-operative ratio had been measurable, but no peroperative signal obtained, 21 technical errors were identified and corrected immediately. There were 16 limbs with severe ischaemia, and neither pre-operative nor peroperative signals, in which the outcome was less certain. In ten, major amputation subsequently became necessary because of inadequate run-off which was demonstrated radiologically. Finally, there were four limbs in which failure occurred postoperatively in spite of a restored peroperative signal. It is concluded that this simple technique is useful and sensitive.     

Outbreak of carbapenem-resistant Klebsiella pneumoniae producing KPC-3 in a tertiary medical centre in Israel

This report describes an outbreak of carbapenem-resistant KPC-3-producing Klebsiella pneumoniae outside the USA. Ninety patients from different departments of a tertiary medical centre were diagnosed with carbapenem-resistant, extended-spectrum β-lactamase (ESBL)-negative Klebsiella pneumoniae infection by standard methods over a 10-month period in 2006. Fifteen randomly selected outbreak isolates were subjected to randomly amplified polymorphic DNA (RAPD) polymerase chain reaction (PCR) as well as PCR amplification and sequencing of the KPC genes, and the findings were compared with two carbapenem-susceptible K. pneumoniae isolates (one ESBL-positive and one ESBL-negative). All the outbreak isolates were resistant to all fluoroquinolones and β-lactam antibiotics tested, including carbapenems, and were sensitive only to colistin, gentamicin and most of them also to tigecycline. On RAPD-PCR, all 15 outbreak isolates were identical to each other and clearly distinguishable from control strains, indicating clonality. The KPC-3 enzyme was identified by nucleotide sequencing analysis in all outbreak isolates but not in the control strains. These findings should alert government and medical authorities to institute stringent control measures and to initiate research into therapeutic and preventive strategies.     

Early shear bond strength of a one-step self-adhesive on orthodontic brackets

OBJECTIVE: The purpose of this study was to determine whether a self-adhesive universal cement, RelyX Unicem (3M ESPE, Seefeld, Germany), can be used successfully to bond orthodontic brackets to enamel. MATERIALS AND METHODS: Forty human molars were cleaned, mounted, and randomly divided into two groups: 20 orthodontic brackets were bonded to teeth using RelyX Unicem, and 20 brackets were bonded using the Transbond XT (3M Unitex, Monrovia, Calif) adhesive system. The teeth were debonded within 30 minutes after initial bonding using a universal testing machine. After debonding, the enamel surface was examined under 10x magnification to determine the amount of residual adhesive remaining on the tooth. Student's t-test was used to compare the shear bond strength (SBS) of the two groups, and the chi-square test was used to compare the Adhesive Remnant Index (ARI) scores for the two adhesive systems. RESULTS: The mean SBS of the brackets bonded using the RelyX Unicem was 3.7 +/- 2.1 MPa and was significantly lower (t = 2.07, P = .048) than the SBS of the brackets bonded with the Transbond system (x = 5.97 +/- 4.2 MPa). The comparisons of the ARI scores between the two groups (chi(2) = 17.4) indicated that bracket failure mode was significantly different (P = .002) with more adhesive remaining on the teeth bonded with Transbond XT. CONCLUSIONS: The SBS of the self-adhesive universal cement needs to be increased for it to be successfully used for bonding orthodontic brackets.