Probiotics-containing beverages and dental caries: A systematic review and meta-analysis

The aim was to evaluate the effect of probiotics-containing beverages on dental caries development by a systematic review and meta-analysis (PROSPERO CRD42021258010). PubMed, Embase, and Web of Science databases were assessed (up to October 2023) for randomized placebo-controlled trials that evaluated the consumption of probiotics-containing beverages having dental caries as endpoint. Risk of bias assessment (Cochrane Handbook) was performed for all studies. Risk ratio (RR), standardized mean difference (SMD) and 95% confidence interval (CI), were calculated for caries prevalence and caries increment, respectively. Meta-analysis was performed. Qualitative analysis of more than 2000 individuals aged from 1 to 84 years (9 studies) showed inconsistent effects of these probiotics-containing beverages. Synthesis of more than 1000 children and adolescents did not demonstrate a statistically significant difference in the proportion of individuals with cavitated lesions (RR 0.60 [95 % CI 0.34 to 1.08]; n = 2), but a significantly smaller increment of both cavitated and non-cavitated carious lesions (SMD -0.23 [95 % CI -0.39 to -0.08]; n = 4) was related to the consumption of probiotics-containing beverages. Certainty of evidence for caries prevalence and caries increment were moderate and low, respectively. Current evidence is not substantial to strengthen the impact of these beverages on caries development.

FLT3-directed UniCAR T-cell therapy of acute myeloid leukaemia

Adaptor chimeric antigen receptor (CAR) T-cell therapy offers solutions for improved safety and antigen escape, which represent main obstacles for the clinical translation of CAR T-cell therapy in myeloid malignancies. The adaptor CAR T-cell platform 'UniCAR' is currently under early clinical investigation. Recently, the first proof of concept of a well-tolerated, rapidly switchable, CD123-directed UniCAR T-cell product treating patients with acute myeloid leukaemia (AML) was reported. Relapsed and refractory AML is prone to high plasticity under therapy pressure targeting one single tumour antigen. Thus, targeting of multiple tumour antigens seems to be required to achieve durable anti-tumour responses, underlining the need to further design alternative AML-specific target modules (TM) for the UniCAR platform. We here present the preclinical development of a novel FMS-like tyrosine kinase 3 (FLT3)-directed UniCAR T-cell therapy, which is highly effective for in vitro killing of both AML cell lines and primary AML samples. Furthermore, we show in vivo functionality in a murine xenograft model. PET analyses further demonstrate a short serum half-life of FLT3 TMs, which will enable a rapid on/off switch of UniCAR T cells. Overall, the presented preclinical data encourage the further development and clinical translation of FLT3-specific UniCAR T cells for the therapy of AML.

Effect of a vinegar-hydrogen peroxide mixture on the surface properties of a cobalt-chromium alloy: A possible disinfectant for removable partial dentures

STATEMENT OF PROBLEM

A vinegar-hydrogen peroxide mixture has been reported to be effective in eliminating Candida albicans and Staphylococcus aureus from acrylic resin, and its action has been reported to be comparable with that of sodium hypochlorite or peracetic acid. However, the effects of this mixture on cobalt-chromium alloys remain unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the surface roughness, Knoop microhardness, surface free energy, and wettability of a cobalt-chromium alloy when exposed to a vinegar-hydrogen peroxide mixture.

MATERIAL AND METHODS

Fifty specimens of cobalt-chromium alloy were fabricated and immersed for 900 minutes, simulating 3 months of a daily 10-minute immersion in the following chemical agents (n=10): distilled water (W); 0.5% sodium hypochlorite (H); 3% hydrogen peroxide and water dilution in 1:1 ratio (HP); white-wine vinegar and water dilution in 1:1 ratio (V); and vinegar and hydrogen peroxide mixture in 1:1 ratio (VHP). Surface roughness, Knoop microhardness, surface free energy, and wettability were measured with single blinding before and after immersions. Data were statistically analyzed by using 2-way repeated measures ANOVA (α=.05).

RESULTS

The vinegar-hydrogen peroxide mixture did not affect the surface roughness or Knoop microhardness. However, 0.5% sodium hypochlorite significantly increased the roughness and decreased microhardness. Surface free energy and wettability increased after immersions, regardless of the types of solution.

CONCLUSIONS

Immersion in a vinegar-hydrogen peroxide mixture did not affect the surface characteristics of a cobalt-chromium alloy.

Instrument flight to the inner ear

Surgical robot systems can work beyond the limits of human perception, dexterity and scale making them inherently suitable for use in microsurgical procedures. However, despite extensive research, image-guided robotics applications for microsurgery have seen limited introduction into clinical care to date. Among others, challenges are geometric scale and haptic resolution at which the surgeon cannot sufficiently control a device outside the range of human faculties. Mechanisms are required to ascertain redundant control on process variables that ensure safety of the device, much like instrument-flight in avionics. Cochlear implantation surgery is a microsurgical procedure, in which specific tasks are at sub-millimetric scale and exceed reliable visuo-tactile feedback. Cochlear implantation is subject to intra- and inter-operative variations, leading to potentially inconsistent clinical and audiological outcomes for patients. The concept of robotic cochlear implantation aims to increase consistency of surgical outcomes such as preservation of residual hearing and reduce invasiveness of the procedure. We report successful image-guided, robotic CI in human. The robotic treatment model encompasses: computer-assisted surgery planning, precision stereotactic image-guidance, in-situ assessment of tissue properties and multipolar neuromonitoring (NM), all based on in vitro, in vivo and pilot data. The model is expandable to integrate additional robotic functionalities such as cochlear access and electrode insertion. Our results demonstrate the feasibility and possibilities of using robotic technology for microsurgery on the lateral skull base. It has the potential for benefit in other microsurgical domains for which there is no task-oriented, robotic technology available at present.

The thermal conductivity of cortical and cancellous bone

Surgical interventions close to vulnerable structures, such as nerves, require precise handling of surgical instruments and tools. These tools not only pose the risk of mechanical damage to soft tissues, but they also generate heat, which can lead to thermal necrosis of bone or soft tissues. Researchers and engineers are trying to improve those tools through experimentation and simulations. To simulate temperature distributions in anatomical structures, reliable material constants are needed. Therefore, this study aimed at investigating the thermal conductivity of cortical and cancellous bone. Accordingly, a custom-made steady-state experimental setup was designed and validated. 6 bovine and 3 human cortical bone samples, as well as 32 bovine cancellous bone samples, with variable bone volume fraction were tested. The cancellous bone samples were scanned by micro-computed tomography (µCT) and micro-finite element (µFE) voxel models were created to calculate iteratively the thermal conductivity of the bone marrow. The experimental results provided 0.64 ± 0.04 W/mK for bovine cortical bone and 0.68 ± 0.01 W/mK for human cortical bone. A linear dependency of thermal conductivity on bone volume fraction was found for cancellous bone [R-square (R2) = 0.8096, standard error of the estimates (SEE) = 0.0355 W/mK]. The thermal conductivity of the bone marrow was estimated to be 0.42 ± 0.05 W/mK. These results will help to improve thermal finite element simulations of the human skeleton and aid the development of new surgical tools or procedures.

Bispecific antibody releasing-mesenchymal stromal cell machinery for retargeting T cells towards acute myeloid leukemia blasts

Bispecific antibodies (bsAbs) engaging T cells are emerging as a promising immunotherapeutic tool for the treatment of hematologic malignancies. Because their low molecular mass, bsAbs have short half-lives. To achieve clinical responses, they have to be infused into patients continously, for a long period of time. As a valid alternative we examined the use of mesenchymal stromal cells (MSCs) as autonomous cellular machines for the constant production of a recently described, fully humanized anti-CD33-anti-CD3 bsAb, which is capable of redirecting human T cells against CD33-expressing leukemic cells. The immortalized human MSC line SCP-1 was genetically modified into expressing bsAb at sufficient amounts to redirect T cells efficiently against CD33 presenting target cells, both in vitro and in an immunodeficient mouse model. Moreover, T cells of patients suffering from acute myeloid leukemia (AML) in blast crisis eliminated autologous leukemic cells in the presence of the bsAb secreting MSCs over time. The immune response against AML cells could be enhanced further by providing T cells an additional co-stimulus via the CD137-CD137 ligand axis through CD137L expression on MSCs. This study demonstrates that MSCs have the potential to be used as cellular production machines for bsAb-based tumor immunotherapy in the future.

Distribution and levels of cell surface expression of CD33 and CD123 in acute myeloid leukemia

Owing to the more recent positive results with the anti-CD33 immunotoxin gemtuzumab ozogamicin, therapy against acute myeloid leukemias (AMLs) targeting CD33 holds many promises. Here, CD33 and CD123 expression on AML blasts was studied by flow cytometry in a cohort of 319 patients with detailed information on French–American–British/World Health Organization (FAB/WHO) classification, cytogenetics and molecular aberrations. AMLs of 87.8% express CD33 and would therefore be targetable with anti-CD33 therapies. Additionally, 9.4% of AMLs express CD123 without concomitant CD33 expression. Thus, nearly all AMLs could be either targeted via CD33 or CD123. Simultaneous presence of both antigens was observed in 69.5% of patients. Most importantly, even AMLs with adverse cytogenetics express CD33 and CD123 levels comparable to those with favorable and intermediate subtypes. Some patient groups with unfavorable alterations, such as FMS-related tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations, high FLT3-ITD mutant/wild-type ratios and monosomy 5 are even characterized by high expression of CD33 and CD123. In addition, blasts of patients with mutant nucleophosmin (NPM1) revealed significantly higher CD33 and CD123 expression pointing toward the possibility of minimal residual disease-guided interventions in mutated NPM1-positive AMLs. These results stimulate the development of novel concepts to redirect immune effector cells toward CD33- and CD123-expressing blasts using bi-specific antibodies or engineered T cells expressing chimeric antigen receptors.

[Cerebral listeria abscess in a patient with gastric cancer]

HISTORY AND PRESENTATION ON ADMISSION: A 70-year-old woman with a history of gastric cancer and palliative chemotherapy was admitted with disturbed consciousness.

INVESTIGATIONS

The cranial CT showed a tumor in the left parietocccipital region so that a cerebral metastasis was suspected. However further investigations including cranial MRT, liquor and blood culture collection showed that the immunocompromised patient suffered from a Listeria monocytogenes sepsis with subsequent meningitis and a cerebral abscess.

TREATMENT AND COURSE

During an antibiotic treatment with ampicillin and gentamycin a rapid neurological improvement and normalization of the liquor findings was achieved.

CONCLUSIONS

Listeria monocytogenes is a rare but relevant cause of systemic inflammations in immunocompromised patients. The differentiation between cerebral abscess and metastasis in cancer patients can be complex but is important concerning differential therapeutic approaches.

Regional gray matter reduction and theory of mind deficit in the early phase of schizophrenia: a voxel-based morphometric study

OBJECTIVE

We tested the association between theory of mind (ToM) performance and structural changes in the brains of patients in the early course of schizophrenia.

METHOD

Voxel-based morphometry (VBM) data of 18 patients with schizophrenia were compared with those of 21 controls. ToM skills were assessed by computerized faux pas (FP) tasks.

RESULTS

Patients with schizophrenia performed significantly worse in FP tasks than healthy subjects. VBM revealed significantly reduced gray matter density in certain frontal, temporal and subcortical regions in patients with schizophrenia. Poor FP performance of schizophrenics correlated with gray matter reduction in the left orbitofrontal cortex and right temporal pole.

CONCLUSION

Our data indicate an association between poor ToM performance and regional gray matter reduction in the left orbitofrontal cortex and right temporal pole shortly after the onset of schizophrenia.

Targeted infection of endothelial cells by avian influenza virus A/FPV/Rostock/34 (H7N1) in chicken embryos

The tissue tropism and spread of infection of the highly pathogenic avian influenza virus A/FPV/Rostock/34 (H7N1) (FPV) were analyzed in 11-day-old chicken embryos. As shown by in situ hybridization, the virus caused generalized infection that was strictly confined to endothelial cells in all organs. Studies with reassortants of FPV and the apathogenic avian strain A/chick/Germany/N/49 (H10N7) revealed that endotheliotropism was linked to FPV hemagglutinin (HA). To further analyze the factors determining endotheliotropism, the HA-activating protease furin was cloned from chicken tissue. Ubiquitous expression of furin and other proprotein convertases in the chick embryo indicated that proteolytic activation of HA was not responsible for restriction of infection to the endothelium. To determine the expression of virus receptors in embryonic tissues, histochemical analysis of alpha2,3- and alpha2,6-linked neuraminic acid was carried out by lectin-binding assays. These receptors were found on endothelial cells and on several epithelial cells, but not on tissues surrounding endothelia. Finally, we analyzed the polarity of virus maturation in endothelial cells. Studies on cultured human endothelial cells employing confocal laser scanning microscopy revealed that HA is specifically targeted to the apical surface of these cells, and electron microscopy of embryonic tissues showed that virus maturation occurs also at the luminar side. Taken together, these observations indicate that endotheliotropism of FPV in the chicken embryo is determined, on one hand, by the high cleavability of HA, which mediates virus entry into the vascular system, and, on the other hand, by restricted receptor expression and polar budding, which prevent spread of infection into tissues surrounding endothelia.

Data networks as cascades

In apparent contrast to the well-documented self-similar (i.e., monofractal) scaling behavior of measured LAN traffic, recent studies have suggested that measured TCP/IP and ATM WAN traffic exhibits more complex scaling behavior, consistent with multifractals. To bring multifractals into the realm of networking, this paper provides a simple construction based on cascades (also known as multiplicative processes) that is motivated by the protocol hierarchy of IP data networks. The cascade framework allows for a plausible physical explanation of the observed multifractal scaling behavior of data traffic and suggests that the underlying multiplicative structure is a traffic invariant for WAN traffic that co-exists with self-similarity. In particular, cascades allow us to refine the previously observed self-similar nature of data traffic to account for local irregularities in WAN traffic that are typically associated with networking mechanisms operating on small time scales, such as TCP flow control.To validate our approach, we show that recent measurements of Internet WAN traffic from both an ISP and a corporate environment are consistent with the proposed cascade paradigm and hence with multifractality. We rely on wavelet-based time-scale analysis techniques to visualize and to infer the scaling behavior of the traces, both globally and locally. We also discuss and illustrate with some examples how this cascade-based approach to describing data network traffic suggests novel ways for dealing with networking problems and helps in building intuition and physical understanding about the possible implications of multifractality on issues related to network performance analysis.

The changing nature of network traffic

In this paper, we report on some preliminary results from an in-depth, wavelet-based analysis of a set of high-quality, packet-level traffic measurements, collected over the last 6-7 years from a number of different wide-area networks (WANs). We first validate and confirm an earlier finding, originally due to Paxson and Floyd [14], that actual WAN traffic is consistent with statistical self-similarity for sufficiently large time scales. We then relate this large-time scaling phenomenon to the empirically observed characteristics of WAN traffic at the level of individual connections or applications. In particular, we present here original results about a detailed statistical analysis of Web-session characteristics, and report on an intriguing scaling property of measured WAN traffic at the transport layer (i.e., number of TCP connection arrivals per time unit). This scaling property of WAN traffic at the TCP layer was absent in the pre-Web period but has become ubiquitous in today's WWW-dominated WANs and is a direct consequence of the ever-increasing popularity of the Web (WWW) and its emergence as the major contributor to WAN traffic. Moreover, we show that this changing nature of WAN traffic can be naturally accounted for by self-similar traffic models, primarily because of their ability to provide physical explanations for empirically observed traffic phenomena in a networking context. Finally, we provide empirical evidence that actual WAN traffic traces also exhibit scaling properties over small time scales, but that the small-time scaling phenomenon is distinctly different from the observed large-time scaling property. We relate this newly observed characteristic of WAN traffic to the effects that the dominant network protocols (e.g., TCP) and controls have on the flow of packets across the network and discuss the potential that multifractals have in this context for providing a structural modeling approach for WAN traffic and for capturing in a compact and parsimonious manner the observed scaling phenomena at large as well as small time scales.

Regulation of receptor binding affinity of influenza virus hemagglutinin by its carbohydrate moiety

The hemagglutinin (HA) of the fowl plague virus (FPV) strain of influenza A virus has two N-linked oligosaccharides attached to Asn123 and Asn149 in the vicinity of the receptor binding site. The effect of these carbohydrate side chains on the binding of HA to neuraminic acid-containing receptors has been analyzed. When the oligosaccharides were deleted by site-specific mutagenesis, HA expressed from a simian virus 40 vector showed enhanced hemadsorbing activity. Binding was so strong under these conditions that erythrocytes were no longer released by viral neuraminidase and that release was significantly reduced when neuraminidase from Vibrio cholerae was used. Similarly, when these oligosaccharides were removed selectively from purified viruses by N-glycosidase F, such virions were unable to elute from receptors, although they retained neuraminidase activity. Thus, release of FPV from cell receptors depends on the presence of the HA glycans at Asn123 and Asn149. On the other hand, receptor binding was abolished when these oligosaccharides were sialylated after expression in the absence of neuraminidase (M. Ohuchi, A. Feldmann, R. Ohuchi, and H.-D. Klenk, Virology 212:77-83, 1995). These observations indicate that the receptor affinity of FPV HA is controlled by oligosaccharides adjacent to the receptor binding site.

Neuraminidase is essential for fowl plague virus hemagglutinin to show hemagglutinating activity

When hemagglutinin (HA) of fowl plague virus (FPV) was expressed in CV-1 cells by a simian virus 40 vector, hemadsorption was barely detectable, although HA was exposed at the cell surface. However, treatment of HA-expressing cells with Vibrio cholerae neuraminidase (VCNA) resulted in extensive hemadsorption. VCNA treatment enhanced the electrophoretic mobility of the HA1 subunit of HA, indicating the removal of sialic acid. When two oligosaccharides in the vicinity of the receptor binding site of FPV HA were deleted by site-specific mutagenesis, VCNA treatment was not required for hemadsorption. Mutants which retained one of these oligosaccharides and mutants in which oligosaccharides not adjacent to the receptor binding site were deleted needed VCNA treatment to show hemadsorption. VCNA treatment also enhanced hemadsorption of vector-expressed HA of the WSN strain, which had a complex-type oligosaccharide in the vicinity of the receptor binding site, but had no effect on hemadsorption of Hong Kong type HA, which has a high-mannose type oligosaccharide adjacent to the receptor binding site. These results indicate that sialic acid on oligosaccharides near the receptor binding site interferes with hemadsorption. Thus, the neuraminidase is essential for FPV HA to show hemagglutinating activity.

House dust mite-specific T cells in the skin of subjects with atopic dermatitis: frequency and lymphokine profile in the allergen patch test

The mechanism underlying positive patch tests with house dust mite-allergen, Dermatophagoides pteronyssinus (Der p), in patients with atopic dermatitis was investigated by isolating T cells from the test sites of two patients. Eighty-five T cell clones (TCC) were established from the epidermis and dermis of lesional skin by the limiting-dilution method with Der p and interleukin (IL)-2. With restimulation assays, 29 of 60 TCCs tested demonstrated specific proliferation; 85% were of the CD3+, CD2+, and CD4+ phenotype. Der p-specific T cells constituted 0.4% to 2.7% of lesional T cells, and they were more frequent in the skin than in the blood of the patients by one order of magnitude. The mitogen-stimulated lymphokine profile of 55 TCCs was assessed; 42% (11/26) of the allergen-specific TCCs secreted IL-4 but almost no interferon-gamma, as described for the Th2 subset of the mouse. Also, six selected TCCs supported IgE secretion by autologous lymphocytes. Only three of 26 allergen-specific, skin-derived TCCs demonstrated a Th1-like lymphokine profile. These results support the specific nature of Der p-induced patch test lesions in patients with atopic dermatitis, and the results demonstrate also that a considerable proportion of lesional T cells are allergen-specific, IL-4-producing T cells that are capable of enhancing IgE production.

Characterization of grass pollen reactive T-cell lines derived from lesional atopic skin

Since it has been hypothesized that atopic dermatitis represents a cellular immune reaction to exogenous aeroallergens, we investigated whether lesional skin contains allergen-specific T-cells and which lymphokines they might secrete. Using phytohaemagglutinin or grass pollen for the cloning procedure, we established a series of T-cell lines from the skin of two patients. When rechallenged with the allergen, three out of 12 dermal lines which had been cloned with the pollen extract and three out of 20 epidermal lines cloned with PHA were found to proliferate specifically. With one exception, allergen-specific lines were CD4+, CD8-, alpha/beta receptor +. The reaction pattern to the single components of the grass allergen extract was assessed with the line UH-D3. Further, the proliferative response to Lolium perennis was inhibited by HLA-DR antibody, indicating its dependence on structures of the MHC class II complex. Only one out of four CD4+ allergen-reactive lines secreted considerable interferon-gamma activity but all secreted interleukin-4. The relative predominance of IL-4 points to a possible role of skin-derived T-cells in the synthesis of IgE. The identification of allergen-specific T-cells in lesional skin of patients with atopic dermatitis is consistent with the hypothesis that their dermatitis represents a T-cell-mediated immune reaction.

[Pregnancy luteoma, a differential diagnostic problem]

Luteomas in pregnancy are benign ovarian tumours which can occur uni- or bilaterally and are mostly detected during laparotomy or Caesarean section. These tumours and the possible virilisation of mother and child regress spontaneously post partum. The described case shows the differential diagnostic problems involved in this rare type of tumour.

Activation of the human leukocyte proteinases elastase and cathepsin G by various surfactants

A systematic study comprising 28 synthetic ionic and nonionic surfactants was carried out in order to examine their effect on the activity of elastase and cathepsin G from human leukocytes against 4-nitroanilide substrates. The whole spectrum, ranging from a complete loss to a pronounced rise in enzymatic activity, was observed at a 0.1% (w/v) surfactant concentration. Most significantly, benzalkonium chloride led to a five-fold increase in elastase activity.