Oxidized ATP inhibits T‐cell‐mediated autoimmunity

T cells directed against self antigens play an important role in several autoimmune diseases. The available immunosuppressive compounds used to treat autoimmune diseases are limited, and often they have side effects that limit their application. T cells express ATP receptors, which could be new target molecules to treat autoimmune disease. Here we analyzed the effect of oxidized ATP (oxATP), an inhibitor of the ATP receptor P2rx7, in different murine models of T‐cell‐mediated autoimmune diseases. Treatment with oxATP inhibited proliferation and effector function of T cells. In the systems we used, oxATP did not obviously interfere with the innate immune response, but strongly reduced antigen‐specific T‐cell responses. This treatment ameliorated T‐cell‐mediated autoimmune type I diabetes and autoimmune encephalitis in mice. In conclusion, oxATP was found to strongly inhibit activated T cells and could thus be used to target T‐cell‐mediated autoimmune disease.     

Magnetic versus manual guidewire manipulation in neuroradiology: in vitro results

Introduction Standard microguidewires used in interventional neuroradiology have a predefined shape of the tip that cannot be changed while the guidewire is in the vessel. We evaluated a novel magnetic navigation system (MNS) that generates a magnetic field to control the deflection of a microguidewire that can be used to reshape the guidewire tip in vivo without removing the wire from the body, thereby potentially facilitating navigation along tortuous paths or multiple acute curves.Method The MNS consists of two permanent magnets positioned on either side of the fluoroscopy table that create a constant precisely controlled magnetic field in the defined region of interest. This field enables omnidirectional rotation of a 0.014-inch magnetic microguidewire (MG). Speed of navigation, accuracy in a tortuous vessel anatomy and the potential for navigating into in vitro aneurysms were tested by four investigators with differing experience in neurointervention and compared to navigation with a standard, manually controlled microguidewire (SG).Results Navigation using MG was faster (P=0.0056) and more accurate (0.2 mistakes per trial vs. 2.6 mistakes per trial) only in less-experienced investigators. There were no statistically significant differences between the MG and the SG in the hands of experienced investigators. One aneurysm with an acute angulation from the carrier vessel could be navigated only with the MG while the SG failed, even after multiple reshaping manoeuvres.Conclusion Our findings suggest that magnetic navigation seems to be easier, more accurate and faster in the hands of less-experienced investigators. We consider that the features of the MNS may improve the efficacy and safety of challenging neurointerventional procedures.     

Introducing navigated transcranial magnetic stimulation as a refined brain mapping methodology

A major intrinsic limitation of transcranial magnetic stimulation (TMS) to map the human brain lies in the unclear relationship between the position of the stimulating coil on the scalp and the underlying stimulated cortex. The relationship between structure and function as the major feature constituting a brain mapping modality can therefore not be established. Recent advances in image processing allowed us to refine TMS by combining magnetic resonance imaging (MRI) modalities with TMS using a neuronavigation system to measure the position of the stimulating coil and map this position onto a MRI data set. This technique has several advantages over recent TMS mapping strategies. The position of the coil on the scalp can be held constant as verified by real time visual guidance. When evaluating higher cortical functions, the relationship between underlying cortical anatomy and the scalp stimulation site can be accurately assessed. Cortical motor output maps can be easily obtained for preoperative planning and decision making for mass lesions near rolandic cortex in patients. In conclusion, navigated TMS is a reliable alternative for localizing cortical functions and therefore may be a useful adjunct or in selected patients even a helpful alternative to other functional neuroimaging methods. Electronic Publication     

Klinische Bruchhäufigkeit von Klebebrackets

Zusammenfassung Vorteile der Bracket-Adhäsivtechnik sind die verbesserte Karies- und Parodontalprophylaxe, nicht mehr notwendige Separiersitzungen, entfallender Restlückenschluß nach der Entbänderung und nicht zuletzt die verbesserte Ästhetik gegenüber konventionellen Bändern. Als wichtiger Nachteil dieser Technik erweist sich aber die erhöhte Mißerfolgsrate. Der vorliegende Beitrag zeigt, daß nach 38 Monaten noch 93,4% der Brackets im Oberkiefer und 90,4% der Brackets im Unterkiefer unverändert in situ sind. Zwei Drittel aller nach 38 Monaten gelösten Brackets hatten sich schon nach etwa 15 Monaten gelöst. In etwa 90% aller Fälle erfolgte der Bruch zwischen Metall und Adhäsiv.

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Summary Direct bracket-bonding has many advantages since it means improved prophylaxis of caries and of periodontitis. Separation of teeth prior to bonding and the closure of band spaces are no longer necessary. In addition aesthetics is much better compared to conventional bands. However, an important disadvantage of direct bonding appears to be the failure rate. The present study shows that after 38 months merely 93,4% of maxillary brackets and 90,4% of mandibular brackets are still in place. Two thirds of those brackets which were finally lost failed after 15 months. In about 90% of the investigated failures the fracture was observed to be between the bracket metal and the adhesive.

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Résumé Les avantages de la technique adhésive pour fixer les brackets sont: Une meilleure prophylaxie de la carie et des parodontopathies, la suppression des séances de séparation nécessaires, la suppression de la fermeture d'un espace restant après la dépose des bagues et une meilleure esthétique en comparaison avec les bagues conventionnelles. Toutefois, un inconvénient important de cette technique est la proportion élevée des échecs. Le présent exposé met en évidence qu'après une période de 38 mois, 93,4% des brackets au maxillaire supérieur et 90,4% des brackets au maxillaire inférieur étaient encore inchangés in situ. 2/3 de tous les brackets enlevés après 38 mois, s'étaient déjà détachés après une période d'environ 15 mois. Dans environ 90% de tous les cas, la rupture s'était produite entre le métal et l'adhésif.

     

Morgagni hernia. A rare form of diaphragmatic hernia

The Morgagni hernia is the rarest form of diaphragmatic hernias. Knowledge has been accumulated over time of combinations with other congenital malformations, familial occurrence, and traumatic genesis. Morgagni hernia has been more often recordable from women, along with rising age and usually located on the right hand side. Embryonic disorder of diaphragmatic differentiation is believed to be the major aetiological factor. Vitamin deficit as well as some chemical substances, primarily active in the foetal period, have become known as additional factors of predisposition. Intensive diagnosis to rule out malignancy is absolutely essential because of the variability of symptoms of this type of hernia. Colon fragments and large omentum were found to be most often contained in the hernial sac. Contrast medium X-ray checks of the gastrointestinal tract and pneumoperitoneum are preferential methods of examination. Exploratory laparotomy is generally considered the optional therapeutic approach because of possible saving of liver veins, safe removal of the hernial sac, and the possibility of abdominal exploration. Preoperative wide-range sterile covering of the patient's body around the site of surgery is recommended to allow for possible thoractomy, as may be required.     

Association of cervical internal carotid artery aneurysm with ipsilateral vertebrobasilar aneurysm in two children: a segmental entity?

Introduction A combination of cervical and intradural aneurysm in children in the absence of systemic disorders has previously not been reported. Case report We report two boys with an identical combination of fusiform cervical internal carotid aneurysm and ipsilaterally located vertebrobasilar aneurysm. They had no history of trauma, they did not display any personal or familial signs of systemic disease, and the testing for collagen disease was negative. The location and appearance of the aneurysms and the identical anatomical disposition in the patients indicated a non-randomly distributed segmental vulnerability. Conclusion The cases demonstrate primary morphological signs of a developmental error being expressed in two seemingly separate segments but linked by the hypoglossal artery. It suggests a segmental error related to this embryonic vessel. They also show that few phenotypes are specific for a genotypic disorder and highlight the importance of analysing different etiologies for aneurysm formation and anatomical disposition when taking treatment strategy decisions.