Macrophages derived from bone marrow modulate differentiation of myeloid dendritic cells.

Dendritic cells (DC) are specialized antigen-presenting cells. Bone marrow monocytes have been widely used to generate murine myeloid DC. We found that mouse macrophages derived from bone marrow CD11b+ monocytes influenced the differentiation of these precursors into DC. Modulation of differentiation was demonstrated by the down-regulation of CD11c, CD40, and CD86 expression and by IL-12 production. DC differentiated in the presence of conditioned medium from bone marrow-derived macrophage culture (MCM) had impaired ability to stimulate proliferation of, and IFN- gamma production by, allogeneic CD4+ T cells. This inhibition of DC differentiation was mainly mediated by secretory products from macrophages but not by cell-cell contact. MCM contained higher concentrations of macrophage-colony-stimulating factor (M-CSF), IL-10, and TGF- beta1, whereas IL-6 remained unchanged compared with conditioned medium from fresh monocytes. M-CSF may be the major mediator in MCM inhibiting DC differentiation. This study demonstrates an important influence of bone marrow-derived macrophages on DC precursors during DC differentiation.

[Barium-pudding: a new medium for videofluoroscopic examination].

The evaluation of swallowing function is crucial in the management of dysphagic patients. It includes clinical assessment and laboratory tests that consist of fiberoptic endoscopic examination of swallowing (FEES) and videofluoroscopic examination. The "modified barium swallow" has been regarded as the standard procedure of videofluoroscopic examination since its introduction in 1983. The technique enables the entire process of deglutition to be observed with the benefits of safety, easily performance, and information. However, pitfalls developed in patients with pseudobulbar paralysis. Discrepancy always occurs between barium meals and real food and the refusal of swallow and misswallowing to the airway in videofluoroscopic examination sometimes occurs because of the unsatisfactory taste of barium meal. All these things make the procedure impractical and inaccurate. We developed a barium sulfate pudding that is better tasting, similar to real food as a pudding, is adequate to visualise on videofluoroscopic examination, and has the ability to represent the patient's capacity to swallow solid food. We present a case of hypoxic encephalopathy where the patient was considered to be in danger of aspiration when swallowing any consistency of foods. Barium-pudding study showed the patient had the ability to eat solid food with safety. We removed her nasogastric tube following barium-pudding assessment and successfully restored her oral feeding function within 2 weeks. Barium-Pudding is a better medium of videofluoroscopic examination by which to evaluate the swallowing function of solid food than Barium paste in patient, who have disturbed swallowing.