The regulation of dendritic cell function by calcium-signaling and its inhibition by microbial pathogens.

Dendritic cells (DC) are the sentinels of the immune system, linking innate with adaptive responses. The functional responses of DC are subject to complex regulation and serve as targets for pathogens. Ca2+-mediated signal transduction pathways serve a central regulatory role in DC responses to diverse antigens, including TLR ligands, intact bacteria, and microbial toxins. This review summarizes the major mechanisms of Ca2+-signaling that DC utilize to regulate maturation and antigen presentation, including a Ca2+-calmodulin (CaM)-CaM kinase II pathway that is localized to phagosomes and is targeted by the human intracellular pathogen, Mycobacterium tuberculosis. Restoration of functional Ca2+ signaling in DC may provide a novel mechanism to enhance therapy and promote vaccine efficacy to infectious diseases, including tuberculosis.

Dental complications during and after tracheal intubation.

Surveyed were 133 directors of training programs in anesthesiology. The directors reported an average incidence of 1:1,000 dental injuries during or after 1,135,212 tracheal intubations in 1 year. A well-documented dental evaluation before delivery of anesthetics and appropriate precautions and protective devices during intubation will prevent most dental trauma related to the delivery of general anesthetics. Also, early use of dental and risk management services often will ensure timely resolution of such problems.

The use of infrared thermography in the evaluation of oral lesions.

This study was conducted to quantitate the degree of inflammation associated with oral lesions by using infrared thermography. It was reasoned that the increased vascularity associated with inflamed tissue may result in measurable increases in surface temperature. One subject with normal oral mucosa and three subjects with oral lesions of varying causes were studied with a thermal video system, using an infrared imager and microprocessor. A clinical photograph of each subject was obtained. Multiple thermograms were made in a temperature range of 30.0 C to 34.2 C at a sensitivity of 0.2 C. Photographs were taken on different occasions to determine whether the temperature readings could be duplicated and to test the accuracy of each reading. The normal surface temperature of the control subject's mucosa was significantly cooler than were the temperatures of the inflamed areas in the subjects with lesions induced by chemotherapy. The temperature of the areas of stomatitis was consistent (subject 3, mean = 33.7 C; subject 4, mean = 33.9 C). The necrotic center of a traumatic ulcer inhibited measurement of an underlying inflamed base and, thus, was equivalent to the control in temperature (subject 1 (control), mean = 31.9 C; subject 2 (necrotic lesion), mean = 31.7 C). These results suggest that infrared thermography may provide a means to quantitatively assess the degree of mucosal inflammation.

The use of infrared thermography in the evaluation of oral lesions.

We have attempted to quantify the degree of inflammation associated with oral lesions through the use of infrared thermography, since the increased vascularity associated with inflamed tissue might result in measurable increases in surface temperature. This would provide a better measure of the relief of pain and inflammation associated with cancer chemotherapy mucositis by an antiinflammatory drug such as benzydamine hydrochloride than the subjective pain scales now employed. One subject with normal oral mucosa and three subjects with oral lesions of varying aetiology were studied with a Hughes Series 4000 PROBEYE thermal video system utilizing an infrared imager and microprocessor. A 35-mm camera was used to obtain a colour photograph of each subject. Multiple thermograms were made in a temperature range of 30.0 degrees C to 34.2 degrees C at a sensitivity of 0.2 degrees C. Photographs were taken on different occasions to determine whether the temperature readings could be duplicated and to test the accuracy of each reading. The normal surface temperature of the control subject's mucosa was found to be significantly cooler than clinical areas of inflammation in patients with lesions induced by chemotherapy. The temperature of the areas of stomatitis was remarkably consistent (Subject C means 33.7 degrees C; Subject D means 33.9 degrees C). Interestingly, the necrotic center of a traumatic ulcer inhibited measurement of an underlying inflamed base and was thus equivalent in temperature to the normal control (Normal means 31.9 degrees C; Subject B necrotic lesion means 31.7 degrees C). These results suggest that infrared thermography may represent a means to assess quantitatively the degree of mucosal inflammation. Additional studies are in progress.

Severe oral hemorrhage and sepsis following bone marrow transplant failure.

Aplastic anemia is a failure of all the cellular components of the bone marrow and, untreated, usually results in death from bleeding and/or infection within 4 months. Treatment by bone marrow transplantation offers the only means of survival. When a bone marrow graft fails, the patient is extremely susceptible to severe infection and/or hemorrhage. In this case, a bone marrow transplantation in a 34-year-old white man with aplastic anemia failed. Among the medical problems that subsequently developed were severe, prolonged and life-threatening oral bleeding and infection.