An adult case of group A streptococcus meningitis associated with steroid-responsive meningoencephalitis.

A previously healthy 80-year-old woman presented to our service in a comatose state. On examination the patient had fever and neck stiffness. Laboratory investigation showed polymorphonuclear pleocytosis in cerebro-spinal fluid (CSF). These findings prompted us to a diagnosis of bacterial or viral meningitis and combination therapy consisting of ceftriaxone, vancomycin and acyclovir was started immediately. Two days later, culture of blood yielded Streptococcus pyogenes (group A streptococcus; GAS). The antibiotic therapy was converted to intravenous ampicillin for 14 days. Fever resolved quickly, however, somnolence persisted. Fluid attenuated inversion recovery image of the brain, taken on the day 29, showed focal hyperintense lesions on the right subcortical area in the temporal and parietal lobes. Three times repeated intravenous steroid pulse therapy (methylprednisolone 1,000 mg/day, 3 days) resulted in complete improvement of her consciousness disturbance. We considered the present case to be a steroid-responsive meningoencephalitis caused by GAS infection.

An analysis of the biofilms adhered to framework alloys using in vitro denture plaque models.

The purpose of this study was to perform a quantitative and qualitative evaluation of the biofilms formed on framework alloys in vitro. The biofilms formed by unfiltered fresh human saliva or Streptococcus mutans and/or Candida albicans on commercially pure titanium and gold-copper-platinum demonstrated higher amounts than other alloy and resin samples. In contrast, the silverpalladium-copper-gold showed a significantly decreased level of biofilm formation. Although the adhesion level of Streptococcus mutans on cobalt-chromium was high, that of Candida albicans was less extensive. A T-RFLP analysis and qualitative PCR of the microbes in the biofilms were performed. In a cluster analysis of all T-RFLP profiles, the cobalt-chromium pattern was integrated into one cluster. On qualitative PCR, the existence of microorganisms related to caries, preriodontitis and aspiration pneumonia was observed. Our results showed that the biofilm formation on each framework alloy was different in terms of both the quantity and quality.

Osteogenic differentiation of human dental papilla mesenchymal cells.

We isolated dental papilla from impacted human molar and proliferated adherent fibroblastic cells after collagenase treatment of the papilla. The cells were negative for hematopoietic markers but positive for CD29, CD44, CD90, CD105, and CD166. When the cells were further cultured in the presence of beta-glycerophosphate, ascorbic acid, and dexamethasone for 14 days, mineralized areas together with osteogenic differentiation evidenced by high alkaline phosphatase activity and osteocalcin contents were observed. The differentiation was confirmed at both protein and gene expression levels. The cells can also be cryopreserved and, after thawing, could show in vivo bone-forming capability. These results indicate that mesenchymal type cells localize in dental papilla and that the cells can be culture expanded/utilized for bone tissue engineering.