Blastogenesis and Lymphokine Synthesis by T and B Lymphocytes from Patients with Periodontal Disease

Thymus-derived (T) and bone marrow-derived (B) lymphocytes were isolated from human peripheral blood and cultured with various mitogens and antigens. Purified protein derivative of tuberculin stimulated both purified T and B cells from patients with positive skin reactivity to purified protein derivative but did not stimulate nonimmune lymphocytes. Similarly, both T and B lymphocytes from patients with periodontal disease were stimulated to proliferate when incubated with dental plaque, whereas cells from normal individuals without gingivitis were unresponsive. In contrast, one component of plaque, bacterial endotoxins (lipopolysaccharide), minimally stimulated B lymphocytes from both normal or gingivitis patients. T lymphocytes from patients with periodontal disease were also stimulated by plaque antigen to produce chemotactic lymphokine activity (CTX) for human monocytes. B cells purified by the EAC rosetting method nonspecifically produced CTX without concomitant blastogenesis; however, after dissociation of adherent EAC these immune B cells did not spontaneously produce CTX. Lymphokine synthesis by B cells was not dependent on concomitant blastogenesis. Dissociated B cells from periodontitis patients also produced CTX activity after stimulation with dental plaque antigen. Therefore, both T and B lymphocytes, after stimulation with nonendotoxin antigenic components of plaque, proliferated and produced lymphokines, which are presumed to contribute to the pathogenesis of periodontal disease.     

Interaction of B7RP-1 with ICOS Negatively Regulates Antigen Presentation by B Cells

Stimulation of T cells through the T cell receptor is insufficient for optimal T cell activation. A second activation signal is necessary, being usually provided by the costimulatory molecule CD28. Recently, additional costimulatory pathways have been identified, including inducible costimulator (ICOS) and its ligand B7RP-1. We have examined the role of the B7RP-1/ICOS costimulatory pathway on antigen presentation by B cells, using the I-A^k and I-E^k-positive CH27 B cell line and several different T cell lines. We found that CH27 expressed B7RP-1 and PD-L1 whereas the T cell lines expressed ICOS and PD-1. In the presence of HEL, the T cell hybridomas C10 and 3A9 released IL-2, which is indicative of antigen-specific T cell activation by the CH27 cells. Unexpectedly, blocking antibodies for B7RP-1 and ICOS enhanced the IL-2 response in both T cells. As expected, an increase in the production of IL-2 was seen when blocking antibodies for PD-1 were used. Blocking with antibodies for I-A^k, CD28, B7.1, and B7.2 lead to a decrease in IL-2 production. Additionally we tested a Th1 and a Th2 T cell clone. Blockade of B7RP-1/ICOS lead to an increased IFN- response in Th1 cells (A.E7) and an increased IL-4 response in Th2 cells (D10.G4.1). Intracellular staining also showed an increase in cytokine production when the B7RP-1/ICOS pathway was blocked. In conclusion, the B7RP-1/ICOS pathway is negatively regulating T cell activation by B cells and may play a role similar to that of the PD-L1/PD-1 pathway.     

Application of capillary electrophoresis in clinical chemistry: the clinical value of urinary modified nucleosides

Urinary modified nucleosides were determined by capillary electrophoresis using a 300 mM SDS-25 mM sodium tetraborate-50 mM sodium dihydrogenphosphate buffer. The nucleosides were extracted from urine by phenylboronate affinity gel chromatography. In cancer patients the levels of the modified nucleosides are generally elevated. By an artificial neural network method breast cancer patients were differentiated from normal individuals, which indicates that the modified nucleosides could be of clinical value as tumor markers.     

Gastric air contrast: useful adjunct to hepatic artery scintigraphy

The utility of scintigraphic views obtained after administration of sodium bicarbonate-citric acid-simethicone crystals (E-Z-GAS) for the determination of gastric extrahepatic perfusion was evaluated in 20 technetium-99m macroaggregated albumin hepatic arterial perfusion studies performed in 19 patients. These crystals produce carbon dioxide gas, distend the stomach, and allow better delineation of gastric activity (extrahepatic perfusion to the stomach). Conversely, a lack of change in activity in the left upper quadrant after the effervescent crystals have been ingested suggests no gastric activity (and no extrahepatic perfusion to the stomach). These "air-contrast" views added useful information in 16 of 20 studies. In three cases prior hepatic arterial perfusion studies without air contrast were misinterpreted as lacking extrahepatic perfusion, which was only recognized on subsequent studies through the use of the air-contrast views. In another case extrahepatic perfusion was erroneously diagnosed on a hepatic arterial perfusion study without air contrast, with a follow-up air-contrast hepatic arterial perfusion study showing this to have been a false-positive diagnosis. Air-contrast views of the stomach can be extremely helpful in verifying or excluding the diagnosis of gastric extrahepatic perfusion on technetium-99m macroaggregated albumin hepatic arterial perfusion studies.     

Vergleichende In-vitro-Untersuchungen von selbstbohrenden und selbstschneidenden Schrauben

Self-drilling screws are gaining increasing importance in maxillofacial surgery. This study assesses which screw design, self-drilling or self-tapping, is best suited to various locations of the human skull. With regard to different areas in the human midface, mandible, and cranium, the thickness of cortical bone varies as well as the relative proportion of cortical to cancellous bone. Criteria used to judge the success of screws were minimal insertion torque and minimum temperature, maximum pullout strength, and minimum deformation and destruction of the bone. To mimic the variations in anatomical conditions, 1-mm and 3-mm-thick cortical bone specimens and cancellous bone blocks were prepared. Eight screws of three types (self-tapping, self-drilling/self-tapping, conically shaped self-drilling) were inserted into the different bone specimens. Torque and temperature were measured during the insertion procedure. Subsequently, the screws were carefully removed and the specimens were processed for histological evaluation. The same insertion protocol was used to test the pull-out strength of the screws. The conically shaped screw showed best results in cancellous bone for all parameters. The self-tapping screw with a pilot hole performed best in thick cortical bone and the self-drilling/self-tapping screw performed better than did the others in thin bone. The results suggest the three screw designs to be optimal for different locations of the human skull. This project provides the data for a planned in vivo study that will evaluate the long-term influence of deformation and temperature on stability and osseointegration of the screws.     

Algorithms for identification of Guillain–Barré Syndrome among adolescents in claims databases

Background

Health insurance claims databases can provide data for studies of vaccine-related Guillain–Barre’ Syndrome (GBS), but not all patients with a diagnostic ICD-9-CM code for GBS have the disease. The objective of this study was to evaluate the positive predictive values (PPVs) of claims-based algorithms for identifying GBS cases in 4 claims database environments.

Methods

Potential cases were adolescents ages 11–21 with at least one claim for GBS (ICD-9-CM code 357.0). Medical record reviews by a panel of 3 neurologists were conducted for case confirmation. Claims data considered for inclusion in the case-ascertainment algorithm included coding position, physician specialty, visit type, diagnostic tests. PPVs were used to assess the contribution of study factors in predicting case status.

Results

Among 361 individuals with a GBS diagnosis code, 106 were confirmed overall (PPV = 0.29), varying from 0.24 to 0.56 across the 4 sites. Requiring the GBS code to be associated with a neurologist visit (PPV = 0.53) or to be in a primary position on an inpatient claim (0.56) improved the performance. A composite algorithm including a primary inpatient GBS code and a neurologist visit associated with any GBS code gave the highest PPV (0.70). Incorporating claims for diagnostic testing had little impact on the PPV. Findings were generally similar across study sites.

Conclusions

Algorithms were able to identify GBS cases better than the single occurrence of the diagnostic code for GBS, and these algorithms may perform similarly in different claims environments.