Demonstrating Agreement between Radio and Fluorescence Measurements of the Depth of Maximum of Extensive Air Showers at the Pierre Auger Observatory

We show, for the first time, radio measurements of the depth of shower maximum (X_{max}) of air showers induced by cosmic rays that are compared to measurements of the established fluorescence method at the same location. Using measurements at the Pierre Auger Observatory we show full compatibility between our radio and the previously published fluorescence dataset, and between a subset of air showers observed simultaneously with both radio and fluorescence techniques, a measurement setup unique to the Pierre Auger Observatory. Furthermore, we show radio X_{max} resolution as a function of energy and demonstrate the ability to make competitive high-resolution X_{max} measurements with even a sparse radio array. With this, we show that the radio technique is capable of cosmic-ray mass composition studies, both at Auger and at other experiments.

Effect of coping materials zirconia or polyetheretherketone with different techniques of fabrication on vertical marginal gap and fracture resistance of posterior crowns with composite veneering

BACKGROUND

Insufficient research has been conducted in the literature assessing the performance of zirconia and polyetheretherketone (PEEK) crowns in relation to the essential requirements of successful restorations, such as fracture resistance or margin adaptation. The purpose of this study was to evaluate the effect of the coping materials zirconia or PEEK with different fabrication techniques on the vertical marginal gap and fracture resistance of posterior crowns with composite veneering.

METHODS

Ceramic copings (n = 18) restoring mandibular first molar were fabricated from zirconia (Zircon.x, Presidentdental, Germany), milled PEEK (PEEK CAD) (breCAM.BioHPP, Bredent, Germany) and pressed PEEK (PEEK Press) (BioHPP Granules, Bredent, Germany) six specimens each (n = 6). The copings were veneered with high impact polymer composite (HIPC) material (breCAM.HIPC, Bredent, Germany). The vertical marginal gap was captured under a magnification of 40X. Five equidistant marks on each surface of the die distinguished the points of measurement for a total of 20 readings per sample. The analysis was completed using an image analysis system (ImageJ 1.53t, National Institute of Health, USA). The specimens were loaded to failure at a crosshead speed of 1 mm/min and the load at failure was recorded to measure the fracture resistance.

RESULTS

The marginal gap was analyzed using one-way ANOVA followed by Tukey's post hoc test. Fracture resistance was analyzed using Welch one-way ANOVA followed by the Games-Howell post hoc test. Marginal gap values showed a significant difference between the tested groups, with zirconia having significantly lower gap values (48.67 ± 11.98 µm) than both the PEEK CAD (108.00 ± 20.08 µm) and Press groups (108.00 ± 25.10 µm) (p < 0.001). However, the results of fracture resistance showed no significant difference (p = 0.06) with 1687.47 ± 253.29 N, 2156.82 ± 407.64 N, 2436.72 ± 725.93 N for zirconia, PEEK CAD, and Press, respectively. The significance level was p < 0.05.

CONCLUSIONS

Zirconia framework crowns have a smaller vertical marginal gap than milled and pressed PEEK crowns. Crowns fabricated from zirconia, PEEK CAD, or PEEK Press frameworks and veneered with composite resin have comparable fracture resistance lower than the maximum biting force in the posterior region.

CLINICAL RELEVANCE

Posterior crowns with zirconia frameworks are preferred over milled and pressed PEEK frameworks regarding margin adaptation, although all can safely survive the maximum occlusal forces without fracture.

Stress distribution and fracture resistance of green reprocessed polyetheretherketone (PEEK) single implant crown restorations compared to unreprocessed PEEK and Zirconia: an in-vitro study

BACKGROUND

It is unclear which crown materials are optimum to disperse the generated stresses around dental implants. The objective of this study is to assess stress distribution and fracture resistance of green reprocessed Polyetheretherketone (PEEK) in comparison to un-reprocessed PEEK and zirconia single implant crown restorations.

METHODS

Twenty crowns (n = 20) were obtained, five from zirconia and fifteen from pressed PEEK that were subdivided into 3 groups of five specimens each (n = 5) according to weight% of reprocessed material used. A 100% new PEEK was used for the first group, 50% new and 50% reprocessed PEEK were used for the second group, and a 100% reprocessed PEEK was used for the third group. Epoxy resin model with dental implant in the second mandibular premolar was constructed with strain gauges located mesially and distally to the implant to record strain while a load of 100 N was applied with 0.5 mm/min then specimens of all groups were vertically loaded till failure in a universal testing machine at cross head speed 1 mm/min. Data was statistically analyzed by using One-way Analysis of Variance (ANOVA) followed by Post-hoc test when ANOVA test is significant.

RESULTS

No significant difference between strain values of tested groups (p = 0.174) was noticed. However, a significant difference between fracture resistance values was noticed where the zirconia group recorded a significantly higher value (p < 0.001).

CONCLUSIONS

Implant restorative materials with different moduli of elasticity have similar effects regarding stresses distributed through dental implant and their surrounding bone. Reprocessed PEEK implant restorations transmit similar stresses to dental implant and surrounding bone as non-reprocessed PEEK and zirconia restorations. Zirconia failed at higher load values than all tested PEEK restorations but all can be safely used in the posterior area as crown restorations for single implants.

CLINICAL RELEVANCE

Applying "green dentistry" principles may extend to include reprocessing of pressed PEEK restorative materials without affecting the material's shock absorption properties.

Effect of different intraoral scanners and post-space depths on the trueness of digital impressions

BACKGROUND

The trueness of intraoral scanners (IOSs) has been evaluated in many clinical situations. However, the tests of their performance when scanning post-space preparations are still lacking.

OBJECTIVES

The aim of the present study was to compare the trueness of the digital impressions of post spaces with different depths, captured by means of different IOSs.

MATERIAL AND METHODS

Digital impressions of teeth (N = 16) with post spaces of depths of 8 mm and 10 mm were captured. Three IOSs were used, including Primescan AC, Medit i500 and CS 3600. The STL files were compared to the files obtained from the traditional impression scanning performed with an InEos X5 desktop scanner. Then, reverse engineering software measured the trueness values, which were analyzed using the two-way analysis of variance (ANOVA), followed by Tukey's post-hoc test. The significance level was set at p < 0.05.

RESULTS

Significant differences were found between the scanners in terms of root mean square (RMS) values (p < 0.001). The highest RMS value was found for CS 3600 (0.30 ±0.11 mm), followed by Primescan AC (0.26 ±0.09 mm), while the lowest value was found for Medit i500 (0.18 ±0.05 mm). The 8-millimeter-deep post spaces had a significantly higher RMS value than the 10-millimeter-deep ones (0.28 ±0.10 mm and 0.21 ±0.09 mm, respectively) (p = 0.009).

CONCLUSIONS

The Medit i500 scanner showed the highest post-space digital impression trueness as compared to Primescan AC and CS 3600. In the digital impressions captured with CS 3600, the 10 mm postspace depth had higher trueness than the 8 mm depth. Moreover, CS 3600 was less able to capture the full length of both the 8 mm and 10 mm post-space depths than Primescan AC and Medit i500.

Impact of Digital Health on Awareness innovations

Background

In the era of increasingly expanding digital ecosystem, infodemic became highly risky, especially the information sources which are non-evidence based. This problem is magnified due to the vulnerability of most internet users, especially the adults & adolescent's information seekers who lack health literacy. Communication is the foundation of driving successful outcomes inside of the healthcare ecosystem; leveraging the right techniques for all populations is critical to build successful care delivery including in virtual care scenarios

Objective

The objective of this abstract is to explore the patterns of digital health usage among population and their level of awareness towards choosing online health information (OHI) as well as its impact on the awareness innovations, and crossing the gap between healthcare professionals and patients to increase patient engagement with remote devices and empower them to take control of their own health.

Methods

Digitalization of healthcare is not just about adopting new digital technology but it's about reforming the healthcare sector for the digital age using the power of data, AI, cloud-based platforms, and new business models to improve behavioral economics, health outcomes, and improve the human care experience for patients and staff alike.

In order to discover the next steps in the future of communication technology and how this can be best utilized by healthcare professionals and consumers, an approach of translational research methodology of T1 and T2 was applied, T1 was the translation from research to application and T2 is translation from application to adaptation of the community, leveraging new tools such as the Cloud and AI, to see if they can build automated, reliable, interoperable workflows.

Results

(1) Digitalizing Legacy Communication to Streamline Patient Care and Healthcare Operations:

 • Communication is the foundation of driving successful outcomes inside of the healthcare ecosystem; leveraging the right techniques for all populations is critical to build successful care delivery including in virtual care scenarios

 • Expand - a member of ICOM Group created ‘MyHealth Digest’ Website and Mobile Application. The vision of this digital platform is to put clear patient communication at the heart of healthcare, improving patient experience and quality of care by connecting them with the best professors and doctors in each specialty, and reducing health inequalities.

(2) Support operational, therapeutic, and clinical decision-making with AI:

 • Integrate AI levers into workflows to support operational, clinical, and shared decision-making along the patient pathway

 • Learn how to overcome obstacles such as clinician resistance and resource constraints to scale AI pilot schemes into efficient systems used organization wide

 • Understand the latest advancements in AI that have refined algorithm accuracy and further increased the rate that patient data is analyzed

(3) Increase patient engagement with remote devices and empower them to take control of their own health

 • Improve the regularity of your patient's interaction with remote devices to manage costs, reduce readmissions and improve patient progress outside of the clinical setting

 • Empower self-health through instructions that are simple and touchpoints for information that are very accessible

 • Leverage patient data to understand adherent and non-adherent patients and tailor targeted interventions where necessary

(4) Ensure digital health is a force for greater health equity

 • Break down barriers and create Digital Health for all by expanding the availability of digital messaging, self-service, and translation services

 • Overcome problems of connectivity by leveraging devices that trigger off cellphone towers to provide the critical updates your clinician requires

 • Provide standardized devices for all patients under your care, that not only enable access to all but also simplify the process of patient monitoring for your clinicians

Conclusion

Digital Technologies are integral to daily life, and the world's population has never been more connected. Innovation, particularly in the digital field, is happening at an unprecedented scale. Even so, its application to improving the health of populations remains largely untapped, and there is immense scope for use of digital health solutions.

Awareness nowadays is empowered by the digital technologies and health innovation, to accelerate global attainment of health and well-being.

Fracture Resistance of Custom Lithium Disilicate Implant Restorations with Two Fabrication Techniques and Two Designs

PURPOSE

To compare the fracture resistance of a press-on ceramic custom implant restoration with pressed and cemented restorations.

MATERIALS AND METHODS

Thirty-two (32) lithium disilicate (IPS e.max Press) custom hybrid abutment restorations were fabricated. The restorations were divided into two groups (n = 16) according to the construction technique: the commercial control group (C) and the press-on group (P). For the control group, lithium disilicate restorations were pressed and cemented on titanium bases. For the press-on group, lithium disilicate pressable ceramic (IPS e.max Press) was pressed on the titanium bases with injection molding. Each group was further divided according to the restoration design, either screw- or cement-retained, into two subgroups of eight specimens each. Specimens of C group were divided into screw-retained (cemented hybrid abutment crown, CHAC) or cement-retained (cemented hybrid abutment, CHA). Specimens of the P group were also divided into screw-retained (pressed hybrid abutment crown, PHAC) and cement-retained (pressed hybrid abutment, PHA). The specimens were subjected to static loading until failure with a universal testing machine. Two-way analysis of variance (ANOVA) was used to assess the effect of different techniques and designs on the fracture resistance of the samples (P < .05), followed by one-way ANOVA and Tukey honest significant difference (HSD) test (α = .05).

RESULTS

C group showed higher mean fracture resistance (812.443 ± 129.14 N) than P group (596.71 ± 108.83 N), and the difference was statistically significant (P < .05). Regarding restoration design, HA groups showed higher mean fracture resistance (742.621 ± 153.82 N) than HAC (666.53 ± 163.07 N) groups with no statistically significant difference. CHA showed the highest mean fracture resistance (817.65 ± 161.76 N), while PHAC showed the lowest mean fracture resistance values (525.83 ± 47.29 N).

CONCLUSION

The commercial cemented lithium disilicate restorations showed higher fracture resistance than the press-on restorations, although both showed a maximum load capacity that was greater than physiologic incisal force in the anterior region, and both hybrid abutments and hybrid abutment crowns were equally efficient in withstanding occlusal loading forces.

Role of Awareness Activities in Mega-Events

Background

Cardiovascular diseases remain to be one of the leading causes of death worldwide. There are some well-established risk factors such as a genetic disposition (hereditary), hypertension (high blood pressure), diabetes mellitus, obesity, high cholesterol level, poor dietary habits, inactive lifestyle, and smoking. The Egyptian direction is to invest in developing educational programs on cardiovascular diseases for the whole community and particularly for women. This initiative is echoed by experts who call for urgent action to improve care, prevent disease and increase awareness of cardiovascular diseases generally and within the women community. The Egyptian community is in great need to public awareness campaigns about cardiovascular diseases especially myocardial infarction and stroke. The CardioVascular Research, Education, Prevention foundation (CVREP) in collaboration with Stent Save a Life (SSL) initiative Egypt and the American Heart Association (AHA) and its initiative “Go Red For Women”, initiated a very successful awareness campaign for physicians and for public during the mega cardiovascular conference CardioAlex.21. ICOM Group (International Center for Organization and Marketing) in collaboration with Expand created a comprehensive public awareness program during CardioAlex.21 held in Alexandria, Egypt during the period 01 – 04 June, 2021.

Aim

Building awareness to the community to the signs and the “must take actions” in cardiovascular emergencies, as heart attacks.

Methods

A very creative campaign was held at the last day of CardioAlex.21 in Alexandria, Egypt, in which, ICOM and Expand teams organized a Marathon (Run) followed by an educational lecture for physicians and a session for public along with screening clinics stations for all attendees to have an onsite check up on their blood pressure and blood glucose level. “GO RED FOR WOMEN”, addressed the message for women to raise the awareness of cardiovascular risks and a very informative discussion was held. The audience questions were answered by SSL Board who moderated the session on a one-to-one story telling technique which made the sessions very interesting. Data was collected from persons who attended the session representing the Egyptian society.

Results

Eighty persons attended the awareness day, 54% of which were middle-aged participants with an age mean of 50 years old. 60% were women, 55% completed secondary education or more and 77% of them reported to have heard about heart attacks while, more than half stated they knew someone who had it. This campaign raised the public awareness regarding cardiovascular disease and how a minute is life changing, knowing how to react if someone experienced one or more of the heart attack symptoms as well as the proper management of MI patients. Also, the healthy lifestyle after undergoing a PPCI procedure was discussed.

Fracture Resistance and Strain Analysis of Zirconia Copings With Vertical Knife Edge and Three Horizontal Finish Line Designs; Chamfer, Deep Chamfer and Shoulder With Two Cementation Techniques

Objective: The purpose of this in vitro study is to evaluate the effect of four finish line configurations and two cement types on the fracture resistance of zirconia copings. Material and Methods: Forty yttrium tetragonal zirconia polycrystals copings were manufactured on epoxy resin dies with four preparation designs: knife edge, chamfer, deep chamfer 0.5, 1 mm and shoulder 1 mm. The copings were cemented with two cement types (glass ionomer and resin cement); (n = 5). Two strain gauges were attached on each coping before they were vertically loaded till fracture with a universal testing machine. Data were analyzed by 2-way analysis of variance ANOVA (p < .05). Fractured specimens were examined for mode of failure with digital microscope. Results: Knife edge showed the highest mean fracture resistance (987.04 ± 94.18) followed by Chamfer (883.28 ± 205.42) followed by Shoulder (828.64 ± 227.79) and finally Deep chamfer finish line (767.66 ± 207.09) with no statistically significant difference. Resin cemented copings had higher mean Fracture resistance (911.76 ± 167.95) than glass ionomer cemented copings (821.55 ± 224.24) with no statistically significant difference. Knife edge had the highest strain mean values on the buccal (374.04 ± 195.43) and lingual (235.80 ± 103.46) surface. Shoulder finish line showed the lowest mean strain values on the buccal (127.47 ± 40.32) and lingual (68.35 ± 80.68) with no statistically significant difference. Resin cemented copings had higher buccal (295.05 ± 167.92) and lingual (197.38 ± 99.85) mean strain values  than glass ionomer copings (149.14 ± 60.94) and (90.27 ± 55.62) with no statistically significant difference. Conclusion: Vertical knife edge finish line is a promising alternative and either adhesive or conventional cementation can be used with zirconia copings.   KEYWORDS Cementation; Flexural strength; Prosthodontics; Tooth preparation; Zirconium.

Insight on Ameliorative Role of Selenium Nanoparticles and Niacin in Wound Healing on Adult Female Albino Mice

Background:

Wound healing is a complex process necessary for repairing damaged tissues and preventing infection. Selenium nanoparticles (Se NPs) were known due to their antioxidant and antimicrobial effects, also niacin has angiogenesis and antioxidant effects that are important in wound healing.

Objective:

The present study was conducted to investigate the effect of Se NPs and niacin in reducing and accelerating the wound healing time in mice.

Methods:

A simple wet chemical method has been modified to synthesize Se NPs in order to investigate their effect and niacin on reducing the wound healing in 80 adult female albino mice (250 mm2 full thickness open excision wound) that were divided into eight groups (10 mice/each). After 30-days, the mice were sacrificed, blood and tissue samples were taken for analysis.

Results:

The results showed that the percentage of wound area had been significantly reduced in Se NPs and niacin treated groups compared to the positive control. The level of Vascular Endothelial cell Growth Factor and Collagenase I in Se NPs and niacin groups significantly exceed those of other groups while Nitric Oxide (NO) was significantly decreased in treated groups. Liver and kidney functions showed the lower toxicity effect of Se NPs and niacin. Skin tissue showed the wound healing effect of Se NPs and niacin by regenerating skin layer compared to the positive group.

Conclusion:

Se NPs and niacin play an important role in accelerating and reducing the time of wound healing while they were antagonistic to each other.

Detection and antibiotic resistance of Mycoplasma gallisepticum and Mycoplasma synoviae among chicken flocks in Egypt

Background and Aim:

Mycoplasma gallisepticum (MG) and Mycoplasma synoviae (MS) are the most significant pathogens of avian mycoplasmosis. This study aimed to isolate and identify MG and MS from chickens and detect the various virulence genes in the isolates. Moreover, the efficacies of different antibiotics were tested to identify suitable treatment regimens.

Materials and Methods:

We isolated MG and MS from 487 chicken samples of different ages located in different Governorates in Egypt using conventional isolation methods. The isolates were characterized by polymerase chain reaction (PCR) and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and then tested for antibiotic sensitivity by the minimum inhibitory concentration (MIC) method.

Results:

The prevalence of MG among the isolates was 9.85%, with the highest percentage isolated from air sacs, while the prevalence of MS among the isolates was 1.6%. Moreover, the highest levels of the prevalence of both MG and MS were during the winter and autumn sampling, while the lowest levels were in the summer and spring. Following the 16S rRNA-based detection of Mycoplasma isolates, 14 MG and 5 MS isolates were identified by different PCR-based detection methods for various virulence genes. Nine MG isolates contain the mgc2 gene, six MG isolates contain the gapA gene, and three MS isolates contain the vlhA gene. We validated a duplex PCR method for the simultaneous identification of MG and MS, based on 100% of the MG and MS isolates generating common bands at 55 and 17 kDa, respectively. The MIC method identified tiamulin and spiramycin as the antibiotics of choice for the treatment of MG and MS infections, respectively.

Conclusion:

For more precise diagnosis of Mycoplasma infections in chicken flocks, conventional isolation methods must be confirmed by PCR. SDS-PAGE analysis helps in epidemiological studies and vaccine preparation. The MIC method can be used to help develop therapies to control avian mycoplasmosis infections.

Development of the New Zealand White Rabbit Eye: I. Pre- and Postnatal Development of Eye Tunics

The New Zealand white (NZW) rabbit has been and is right now regularly utilized in ophthalmic surgery evaluation. Inside NZW rabbit eye, the visibility of ocular structures throughout surgical procedure is fantastic. Younger rabbits are used in different ages for the evaluation of ophthalmic surgery. Complete studies of ocular development in the NZW rabbits have not been reported previously. The aim of the present investigation was to describe the major landmarks and the time course of the pre- and post-natal development of the complete eye tunics of the NZW rabbit to give a superb model as well as a fruitful area for further ophthalmological investigations. Serial histological sections of NZW rabbit prenatal (E13-E28) and post-natal (P1-P14) stages were examined, respectively. The eye of the NZW rabbit developed in a similar manner to that of the human and domestic animals eyes; the principal differences were at the time of occurrence of certain developmental events, absence of pigmentation which represent an exploited benefit for ophthalmic surgery, remarkable Bowman's membrane at E25, poor developed ciliary stroma and juvenile retinal layer until P9. In human, the basic morphogenetic processes of the development of eye tunics are completed towards the end of the first half of gestation period. However, the latter represents the beginning stage of the development of eye tunics in the rabbit. Thus, allowing various extensive ophthalmic researches to be performed.

Glanders outbreak at Tehran Zoo, Iran

BACKGROUND AND OBJECTIVES

In December 2010 four, lions and one tiger died at the Tehran zoo. Out of all samples, Burkholderia mallei (causative agent of Glanders) was isolated just from ulcer sample of the tiger which was imported to Iran from Russia.

MATERIALS AND METHODS

One nasal swab from a tiger and fifteen blood samples with anticoagulant belonging to one tiger and fourteen lions (four dead lions and eleven live lions) were collected and were inoculated directly onto the selective media. The isolate was identified by morphological and biochemical and API BBL tests and PCR using specific primers (Bma- IS407-flip). The standard (Razi Type Culture Collection RTCC: 2375) and tiger isolates were inoculated into 2 guinea pigs. All residue solipeds and carnivores were checked by Malleination test and Complement Fixation (CF) Test respectively.

RESULTS

One isolate of B. mallei was isolated from tiger's nasal swab. Both of B.mallei strains were recovered from inoculated animals. All of solipeds were negative by malleination test, however, 11 lions including 4 dead and 7 live lions out of 14 lions were positive in CF test for Glanders and all were put down by the authorities.

CONCLUSION

Active surveillance of Glanders is essential for solipeds, especially it's more important while being used to feed valuable carnivores like lions and tigers. Therefore, a reliable test like malleination must be carried out twice (first before transferring and one month after quarantine). Both test results should be negative for use for feeding.

Screening for cervical carcinoma using visual inspection with acetic acid

OBJECTIVE

To assess the performance of visual inspection with acetic acid (VIA) as a screening test for early detection of cervical carcinoma in the Dakahlia Governorate in Egypt.

METHODS

Diluted acetic acid (5%) was applied to the cervix during routine gynecologic examination. Women with positive results were referred for colposcopy. Those with negative results were referred for colposcopy only when they had clinical indications.

RESULTS

Among the 5,000 women who were screened using VIA, 409 were referred for colposcopy. Cervical intraepithelial neoplasia (CIN) was diagnosed in 151 (60%) of the 253 women with positive screening results and in 4 of the 156 women with negative screening results. There were 39 women with high-grade and 116 with low-grade CIN. The sensitivity and negative predictive value of the VIA screening test was 97%. Its positive predictive value was 60% for all grades of CIN and 90% for high-grade CIN.

CONCLUSION

Visual inspection with acetic acid, although associated with a relatively high rate of false-positive results, is a valuable test for the screening of cervical carcinoma.

Abnormal zinc and copper metabolism in hepatic steatosis

Abnormal Zinc and Copper metabolism were studied in rats with tetracycline-induced fatty liver and compared with normal rats. The present work recorded decreased serum zinc concentration with increased copper concentration in the tetracycline-injected rats. The results also showed that the liver and heart zinc were significantly decreased; meanwhile it was observed that the concentration of zinc in the kidney tissue of fatty liver rats was significantly raised in comparison with those of normal rats. Histopathological studies of the kidney tissue showed degenerative changes in the tables with areas of focal necrosis. Renal tubular necrosis in such cases is largely caused by the toxic degradation products of tetracycline metabolism. The kidney lesion together with impaired gastrointestinal absorption contributed to the hypozincaemia observed in the present results. Although the present data showed a significant reduction in serum zinc and significant rise in plasma insulin in the fatty liver rats there was nonsignificant correlation between the two variables as compared with the normal rats. The positive correlation between serum zinc concentration and reduced high-density lipoprotein cholesterol (HDL-C) emphasizes the role of zinc deficiency in atherosclerotic disease in fatty liver.

Effect of ultraviolet radiation on Ia expression by keratinocytes

Many skin diseases, such as graft-versus-host disease (GVHD), are marked by lymphocyte infiltrates in the skin. Severity of these diseases is often correlated with the induced expression of class II antigens (human, HLA-DR,; murine, Ia) by the keratinocytes. This suggests that HLA-DR-expressing keratinocytes may be involved in the pathogenesis of these diseases. Since some of these diseases are effectively treated with ultraviolet radiation (UVR), this study was conducted to determine whether UVR alters the keratinocyte expression of class II antigens. To test this hypothesis, 2 models of experimentally induced keratinocyte Ia expression were employed. First, athymic nude mice with one ear protected by electrical tape were exposed to UVR (450 J/m2/day on 4 consecutive days). They were then given an i.v. injection of normal mouse serum (NMS) to induce keratinocyte Ia expression. Keratinocytes in the UVR-exposed skin of these animals were not induced to express Ia; however, Ia-expressing keratinocytes were observed in the epidermis of shielded skin sites. Likewise, it was determined that UVR was capable of downregulating keratinocyte expression of Ia when administered to nude mice 7 d after receiving an injection of NMS. Second, employing a clinically relevant model, we found that Ia expression by keratinocytes in mice undergoing experimentally induced GVHD was abrogated by UVR treatment. This appeared to be a direct effect of the UVR, since keratinocytes in shielded skin sites and mucosal cells in the intestinal epithelium of animals with GVHD were shown to express Ia. These data provide compelling evidence for our hypothesis that decreased HLA-DR expression by keratinocytes in diseased skin treated with UVR is a mechanism by which UVR exerts its therapeutic effect.

An animal model of antibody binding in cutaneous lupus

To study antibody binding in cutaneous lupus, we used human skin grafted onto nude mice. By immunofluorescence examination, mice injected with anti-Ro (SS-A) sera from subacute cutaneous or neonatal lupus erythematosus patients showed evidence of human IgG deposited in the skin, while mice injected with anti-native DNA or normal sera did not. We present evidence that there is specific binding of anti-Ro (SS-A) antibodies to Ro (SS-A) antigen in the skin, and we propose that these antibodies may be directly involved in cutaneous disease.

Biology of Langerhans cells: analysis by experiments to deplete Langerhans cells from human skin

In vivo studies have demonstrated that various treatments of skin, e.g., UV irradiation, topical corticosteroids, and tape-stripping, will temporarily deplete the epidermis of Langerhans cells (LC). Whether this loss represents simply a loss of cell surface markers unique to LC, or actual depletion of cells, is unknown. By design, normal human skin transplanted to the congenitally athymic (nude) mouse is a system devoid of circulating precursors for human LC. Because LC have been shown to be of bone marrow origin, any depletion of these cells in this system should be permanent. Treatments to deplete LC from human skin grafts on nude mice after grafting included: (a) large doses of UV radiation (400 mJ/cm2 every 48 h, X 3), (b) potent high-dose topical corticosteroids (2.5 mg betamethasone valerate/cm2 every day, X 5), (c) tape-stripping (X 20). Treatments before grafting included: (a) treating donor skin with 900 R of gamma irradiation, (b) complement fixing monoclonal antibody to Ia-like antigens of LC, followed by fresh complement, (c) monoclonal antibody conjugated to toxins. Quantitation of the number of LC was analyzed on control and treated epidermal sheets using immunodiagnostic reagents, anti-HLA-DR, and surface ectoenzymes , ATPase. Results show that both UV irradiation and topical corticosteroids reduce the number of LC by these analyses. However, within 3 weeks, recovery to pretreatment levels has occurred. X-irradiation and tape-stripping were without effect. Despite evidence that the monoclonal antibody, complement, and toxic systems were delivered to the LC within the epidermis, there is no evidence that these treatments resulted in a decrease in LC. It appears that LC are currently either long-lived or replaced locally from a proliferative pool and that certain cell membrane determinants of human LC are somewhat differentially sensitive to UV radiation and corticosteroids.

Expression of Ia antigen on epidermal keratinocytes after the grafting of normal skin to nude mice

During the course of experimentation designed to evaluate the migration of host Langerhans cells (LC) into normal skin grafted onto nude mice, we observed that the epidermal cells of these grafts were induced to express la determinants solely of graft origin. The data presented herein indicate that the expression of la by normal epidermal cells correlates with the infiltration of host LC into the graft. This la expression is restricted to the keratinocytes within the epidermis of the grafted skin, is first observed 7 to 9 days post-grafting, and persists within the grafted skin for greater than 12 wk. The induction of la expression by keratinocytes appears to be the result of the environment that is provided by the nude mouse host and is independent of both passenger lymphocytes within the skin graft and allogeneic differences between graft and host. We strongly believe that these studies provide the basis for the development of an experimental animal model system for investigating the potential role that la expression by epidermal cells may play in enhancing the immune response to antigens encountered in the skin.

Expression of Ia antigen on epidermal keratinocytes after the grafting of normal skin to nude mice

During the course of experimentation designed to evaluate the migration of host Langerhans cells (LC) into normal skin grafted onto nude mice, we observed that the epidermal cells of these grafts were induced to express la determinants solely of graft origin. The data presented herein indicate that the expression of la by normal epidermal cells correlates with the infiltration of host LC into the graft. This la expression is restricted to the keratinocytes within the epidermis of the grafted skin, is first observed 7 to 9 days post-grafting, and persists within the grafted skin for greater than 12 wk. The induction of la expression by keratinocytes appears to be the result of the environment that is provided by the nude mouse host and is independent of both passenger lymphocytes within the skin graft and allogeneic differences between graft and host. We strongly believe that these studies provide the basis for the development of an experimental animal model system for investigating the potential role that la expression by epidermal cells may play in enhancing the immune response to antigens encountered in the skin.

Biology of Langerhans cells: selective migration of Langerhans cells into allogeneic and xenogeneic grafts on nude mice

A major question challenging immunobiologists relates to those mechanisms that control the selective movement of cells involved in immune and inflammatory processes at various tissue sites such as the skin. Little is known about those influences that control the selective migration of macrophage-like Langerhans cells (LC) to normal epidermis, where it is uniformly distributed. Mechanistically, this includes the interaction of blood-borne LC precursors with the vascular endothelium of the skin and those factors that control the migration of the LC into the avascular epidermal component of the skin. By using (i) monoclonal antibodies specific for I-region associated Ia antigens found on LC from various inbred strains of animals and (ii) the congenitally athymic (nude) mouse as an immunologically compromised recipient of allografts and selected xenografts, we developed a model system to study the factors that restrict LC migration into the epidermis. Using this model, which excludes the need to lethally x-irradiate graft recipients, we established that: (i) the ingress of LC does not show major histocompatibility complex restriction [LC of the nude host are capable of migrating into the epidermis of allogeneic and certain xenogeneic (rat) skin grafts]; (ii) host LC are incapable of migrating into the epidermis of guinea pig or human skin grafts; (iii) the ingress of host LC into the epidermis of the graft is not accompanied by an overgrowth of the graft by host epidermis; and (iv) LC or LC precursors are capable of dividing in the skin or, alternatively, represent an extremely long-lived cell population. The specificity of this model system provides a powerful tool to help understand many aspects of LC biology. Grafting human skin to the nude mouse not only provides a biologic support system for the graft but also is, by design, a system that is devoid of contaminating circulating precursor cell types. Manipulation of the experimental conditions is quite easy and provides a highly specific means to investigate many parameters of LC function.

Cell-mediated hyperacute rejection. I. Acute, accelerated, and hyperacute reactions

The morphology of first-set rejection of allogeneic murine skin grafts differs strikingly from that usually seen subsequent to sensitization. In the former, graft epithelium appears to be the primary target; in the latter, the endothelium of graft vessels. This difference suggests that different subsets of effector T cells may be involved. This paper reports an attempt to isolate, for further characterization, a T cell population associated with first-set rejection. The relationships between acute and hyperacute rejection of organ transplants and of murine skin grafts are discussed, as is the possible role of endothelium-specific antigens and receptors sites.