Cross-species costimulation: relative contributions of CD80, CD86, and CD40

BACKGROUND: The response of human CD4+ T cells against porcine cells is of comparable magnitude to that induced by human leukocyte antigen-mismatched allogeneic cells. This reflects productive interactions between key costimulatory molecules across the species barrier. Inhibition of these molecular interactions will be crucial in overcoming CD4+ T-cell-mediated rejection of xenografts. We have performed a detailed investigation to determine the expression profiles and relative contributions of the three key costimulatory molecules in the porcine-human xenogeneic response. Whereas only porcine CD86 is constitutively expressed on resting endothelial cells, both CD40 and CD80 are rapidly expressed after activation. All three costimulatory molecules are expressed by professional antigen-presenting cells. METHODS: We have isolated full-length cDNA clones for human and porcine CD80, CD86, and CD40. Human fibroblast cell lines (M1) coexpressing DR1 were transfected with these cDNAs and used in mixed lymphocyte reactions and flow cytometric studies in vitro. RESULTS: These data provide the first characterization of the expression profile and functional role of porcine CD80. Functional assays demonstrate that pCD40, pCD80, and pCD86 are independently capable of costimulating human CD4+ T cells, albeit with differing kinetics. Proliferative responses were of comparable magnitude to those obtained when costimulation was provided by human CD40, CD80, and CD86. CONCLUSIONS: These data have implications for therapy targeting the direct pathway of xenorecognition; costimulatory molecule blockade must be directed against both the B7/CD28 and CD40/CD40L pathways.     

The patient with a heart murmur: evaluation, assessment and dental considerations

BACKGROUND: Heart murmurs, a common finding in dental patients, are of major concern to dental professionals because certain dental procedures occasionally can induce severe cardiovascular complications. Murmurs may indicate existing heart disease that is a risk factor for infective endocarditis following a dental procedure, as well as more severe heart conditions such as congenital heart disease, atrial fibrillation or congestive heart failure. TYPES OF STUDIES REVIEWED: This review article is based on data published in peer-reviewed journals, including practice guidelines published by major dental and medical professional organizations. RESULTS: Echocardiography is the primary means of evaluating heart murmurs, and all dental professionals should become familiar with major aspects of an echocardiogram. Understanding the medical evaluation and assessment of a heart murmur fosters better communication with other health care professionals and results in improved patient care. CLINICAL IMPLICATIONS: Beyond the need to administer antibiotic prophylaxis, the dentist also needs to address the underlying causes of a patient's heart murmur. By providing dental care to such patients, oral health care providers become part of the patient's overall health care team.     

Profile of polio-compatible cases in Nigeria, 2006–2016

Background

The tremendous progress made by Nigeria towards polio eradication has recently suffered a setback with the isolation of circulating vaccine-derived poliovirus (cVDPV) type 2 from environmental samples and confirmation of four wild poliovirus (WPV) cases from acute flaccid paralysis (AFP) cases, with dates of onset of paralysis in July and August 2016. All these viruses were confirmed from the security-challenged northeastern state of Borno. Polio-compatible cases exist in Nigeria, and they indicate surveillance failure. Surveillance, therefore, has to be strengthened for the country to achieve certification. The objective of this paper is to highlight the epidemiological profile and magnitude of polio-compatible cases in Nigeria during the reporting period, as well as immunization and surveillance response activities conducted to close immunity and surveillance gaps.

Methods

We conducted a retrospective review of AFP surveillance performance and polio-compatible cases in Nigeria between 2006 and 2016 from the AFP database at the World Health Organization Country Office. We also reviewed and compared key epidemiological features of polio-compatible cases with those of wild poliovirus cases during the reporting period.

Results

The non-polio AFP rate improved from 6.5 in 2006 to 19.5 in 2016. The corresponding figures for stool adequacy rates were 88 and 98%. The total number of polio-compatible cases reported during the reporting period was 888, with the highest number (194) of cases reported in 2006 and the least (24) in 2016. Clusters of polio-compatible cases were reported every year during the reporting period except in 2015. The highest number (65) of polio-compatible cases in clusters was reported in 2006. The key epidemiological features of polio-compatible and wild poliovirus cases were similar.

Conclusion

AFP surveillance performance has improved significantly during the reporting period. Surveillance gaps still existed as shown by the presence of orphan viruses and polio-compatible cases, and these gaps need to be identified and closed to achieve certification.

     

Color Stability of Dental Composites after Immersion in Beverages and Performed Whitening Procedures

ObjectivesThe study aimed to compare the color stability of two different light-cured composites after immersion in three liquids and the effectiveness of 16% carbamide peroxide (CP) in removing the discoloration.Material and methodsColor stability of a microhybrid (Z250, 3M ESPE) and nanocomposite (Z550, 3M ESPE) was evaluated after immersion in instant coffee, tea, Coca-Cola, and deionized water as a control group (n=5). Samples were kept in liquids for four hours daily at 37°C for 30 days. Furthermore, 16% CP was applied for the following 14 days, simulating night whitening. A digital spectrophotometer was used for color measurement based on the CIEL*a*b* color coordinates. The color changes (∆E) were measured at baseline, after immersion in the beverages, and also after the teeth whitening procedure. Mixed and factorial ANOVA followed by Bonferroni’s post-hoc test were used for statistical evaluation (p≤0.05).ResultsTested resin composites showed a color change over the acceptability threshold (ΔE*> 3.48) after immersion in coffee and tea. Nanocomposite reported a significant increase in discoloration in coffee after 30 days (p <0.05). The color of both materials significantly changed (p<0.05) along all three L*a*b* axes in coffee and tea to darker, yellow, and red. Whitening with 16% CP was effective in removing external discoloration in both examined composite materials.ConclusionCoffee and tea induced clinically detectable color changes in dental composites tested, with cumulative effects. Whitening represents an efficient method for the removal of surface discoloration in composite restorations.     

Intimal Sarcoma in the Aortic Arch Partially Obstructing the Aorta with Metastasis to the Brain

Primary tumors of the aorta are rare entities. We report the unusual manifestation of an aortic intimal sarcoma that presented as a brain metastasis in a 56-year-old, otherwise healthy woman. After the brain mass had been resected, multiple imaging methods revealed pseudocoarctation and the primary tumor in the aortic arch. To our knowledge, this is the first report of the diagnosis of an aortic intimal sarcoma with use of real-time, 3-dimensional transesophageal echocardiography.     

Prevalence of TMD among Children Provided with Fixed Orthodontic Treatment

BackgroundAccording to available scientific references and textbooks, there are contradictory views concerning the etiology of signs and symptoms of TMD.ObjectivesThe aim of this study was to determine a correlation between the incidence of signs and symptoms of TMD in children aged 12-18 who do not wear a fixed orthodontic appliance and the incidence of signs and symptoms of TMD in children who wear a fixed orthodontic appliance.Material and MethodsThe total number of 120 subjects were included in this survey and divided into two groups. There were 60 respondents in the experimental group that consisted of 30 boys and 30 girls with different types of malocclusion, who were treated with a fixed orthodontic straight wire technique. The remaining 60 respondents, which was a group that also consisted of 30 boys and 30 girls, were patients with neutroclusion.ResultsThe results of the study have shown that the TMJ clicking sound symptom, the most common symptom of TMD, occurs with almost equal prevalence in both groups of respondents; specifically, 56.4% in orthodontic patients, and 46.6% in the control group respondents. A statistically significantly higher percentage of female respondents in both groups have experienced headache problems (p <0.03).ConclusionOn the basis of the statistics obtained as a result of this research, we can come to the conclusion that there is no correlation between the fixed orthodontic treatment and the development of signs and symptoms of TMD.