An Atypical Case of Enterovirus Meningitis Presenting with Unilateral Optic Disc Swelling and Minimal Optical Symptoms.

PURPOSE: To report a case of unilateral disc swelling as the only presentation of enterovirus meningitis in a 43-year-old male who presented with reduction in visual quality. METHODS: Vision was 20/20 unaided in both eyes and the only ocular finding was left optic disc edema accompanied by left relative afferent pupillary defect. Visual field examination revealed a generalized reduction in sensitivity, a paracentral scotoma and a superior and inferior arcuate defect. Apart from a marginally elevated white blood cell count, the evaluation for common diseases associated with unilateral disc swelling was negative. A comprehensive neurology and rheumatology assessment,the orbital, brain and cervical spine Magnetic Resonance Imaging (MRI), the chest and abdomen Computed Tomography (CT) and chest radiograph had no findings. However, the cerebrosipinal fluid (CSF) examination indicated the presence of enterovirus RNA. RESULTS: A diagnosis of enterovirus meningitis was established.Patient's general health was not affected and symptoms gradually settled, with no specific anti-enteroviral treatment. CONCLUSION: Only the CSF analysis provided interesting evidence of the site of the visual dysfunction.

S100A8 and S100A9 are elevated in chronically threatened ischemic limb muscle and induce ischemic mitochondrial pathology in mice.

Objective: The objective of the present study was to determine whether elevated levels of S100A8 and S100A9 (S100A8/A9) alarmins contribute to ischemic limb pathology. Methods: Gastrocnemius muscle was collected from control patients without peripheral arterial disease (PAD; n = 14) and patients with chronic limb threatening limb ischemia (CLTI; n = 14). Mitochondrial function was assessed in permeabilized muscle fibers, and RNA and protein analyses were used to quantify the S100A8/A9 levels. Additionally, a mouse model of hindlimb ischemia with and without exogenous delivery of S100A8/A9 was used. Results: Compared with the non-PAD control muscles, CLTI muscles displayed significant increases in the abundance of S100A8 and S100A9 at both mRNA and protein levels (P < .01). The CLTI muscles also displayed significant impairment in mitochondrial oxidative phosphorylation and increased mitochondrial hydrogen peroxide production compared with the non-PAD controls. The S100A8/A9 levels correlated significantly with the degree of muscle mitochondrial dysfunction (P < .05 for all). C57BL6J mice treated with recombinant S100A8/A9 displayed impaired perfusion recovery and muscle mitochondrial impairment compared with the placebo-treated mice after hindlimb ischemia surgery. These mitochondrial deficits observed after S100A8/A9 treatment were confirmed in the muscle cell culture system under normoxic conditions. Conclusions: The S100A8/A9 levels were increased in CLTI limb muscle specimens compared with the non-PAD control muscle specimens, and the level of accumulation was associated with muscle mitochondrial impairment. Elevated S100A8/A9 levels in mice subjected to hindlimb ischemia impaired perfusion recovery and mitochondrial function. Together, these findings suggest that the inflammatory mediators S100A8/A9 might be directly involved in ischemic limb pathology.

Novel γ-sarcoglycan interactors in murine muscle membranes.

BACKGROUND: The sarcoglycan complex (SC) is part of a network that links the striated muscle cytoskeleton to the basal lamina across the sarcolemma. The SC coordinates changes in phosphorylation and Ca++-flux during mechanical deformation, and these processes are disrupted with loss-of-function mutations in gamma-sarcoglycan (Sgcg) that cause Limb girdle muscular dystrophy 2C/R5. METHODS: To gain insight into how the SC mediates mechano-signaling in muscle, we utilized LC-MS/MS proteomics of SC-associated proteins in immunoprecipitates from enriched sarcolemmal fractions. Criteria for inclusion were co-immunoprecipitation with anti-Sgcg from C57BL/6 control muscle and under-representation in parallel experiments with Sgcg-null muscle and with non-specific IgG. Validation of interaction was performed in co-expression experiments in human RH30 rhabdomyosarcoma cells. RESULTS: We identified 19 candidates as direct or indirect interactors for Sgcg, including the other 3 SC proteins. Novel potential interactors included protein-phosphatase-1-catalytic-subunit-beta (Ppp1cb, PP1b) and Na+-K+-Cl--co-transporter NKCC1 (SLC12A2). NKCC1 co-localized with Sgcg after co-expression in human RH30 rhabdomyosarcoma cells, and its cytosolic domains depleted Sgcg from cell lysates upon immunoprecipitation and co-localized with Sgcg after detergent permeabilization. NKCC1 localized in proximity to the dystrophin complex at costameres in vivo. Bumetanide inhibition of NKCC1 cotransporter activity in isolated muscles reduced SC-dependent, strain-induced increases in phosphorylation of extracellular signal-regulated kinases 1 and 2 (ERK1/2). In silico analysis suggests that candidate SC interactors may cross-talk with survival signaling pathways, including p53, estrogen receptor, and TRIM25. CONCLUSIONS: Results support that NKCC1 is a new SC-associated signaling protein. Moreover, the identities of other candidate SC interactors suggest ways by which the SC and NKCC1, along with other Sgcg interactors such as the membrane-cytoskeleton linker archvillin, may regulate kinase- and Ca++-mediated survival signaling in skeletal muscle.

The effect of regular dental cast artifacts on the 3D superimposition of serial digital maxillary dental models.

Superimpositions of serial 3D dental surface models comprise a powerful tool to assess morphological changes due to growth, treatment, or pathology. In this study, we evaluated the effect of artifacts on the superimposition outcome, using standard model acquisition and superimposition techniques. Ten pre- and post-orthodontic treatment plaster models were scanned with an intraoral scanner and superimposed using the iterative closest point algorithm. We repeated the whole process after manual removal of plaster artifacts, according to the current practice, as well as after re-scanning the cleaned models, to assess the effect of the model acquisition process derived artifacts on the superimposition outcome. Non-parametric multivariate models showed no mean effect on accuracy and precision by software settings, cleaning status (artifact removal), or time point. The choice of the superimposition reference area was the only factor that affected the measurements. However, assessment of individual cases revealed significant differences on the detected tooth movement, depending on artifact removal and on the model acquisition process. The effects of all factors tended to decrease with an increase in the size of the superimposition reference area. The present findings highlight the importance of accurate, artifact-free models, for valid assessment of morphological changes through serial 3D model superimpositions.

Early anterior crossbite correction through posterior bite opening: a 3D superimposition prospective cohort study.

Objectives: To assess the effectiveness, clinical performance, and potential adverse effects of early anterior crossbite correction through opening of the bite. Subjects and methods: The sample consisted of 16 consecutive patients (8.0 ± 0.9, range: 6.2-9.3 years) with dental anterior crossbite in the mixed dentition who were treated through posterior bite opening. Patients were prospectively followed until a minimum of 6 months post-treatment and there were no drop-outs. Results: In 14 patients (87.5 per cent), the anterior crossbite was corrected. Results remained stable without any retention regime. Active treatment of the successfully treated cases lasted 2.5 months (range: 0.6-8.9). Crossbite correction of central incisors was achieved by a 2.05 mm (range: 0.97-5.45) forward movement and 9.25° (range: 2.32-14.52°) buccal inclination of the crowns (P < 0.05). The antagonists showed spontaneous adaptation of their position in the opposite direction (P < 0.05). No important adverse effects were recorded. Limitations: This was a non-comparative controlled study, on a limited sample. Conclusions: Bite opening is a promising, simple, and non-compliance approach for early dental anterior crossbite correction. The technique of 3D superimposition and analysis of digital models used here, allowed precise evaluation of single tooth movement in all three planes of space.

Assessment of different techniques for 3D superimposition of serial digital maxillary dental casts on palatal structures.

Serial 3-dimensional dental model superimposition provides a risk-free, detailed evaluation of morphological alterations on a patient's mouth. Here, we evaluated accuracy and precision of five palatal areas, used for superimposition of maxillary 3D digital dental casts. Sixteen pre- and post-orthodontic treatment dental casts of growing patients (median time lapse: 15.1 months) were superimposed on each palatal area using the iterative closest point algorithm. Area A (medial 2/3 of the third rugae and a small area dorsal to them) was considered the gold standard, due to high anatomical stability. Areas B, C, and D added a distal extension along the midpalatal raphe, an anterior extension to the second rugae, and the remaining palatal surface, respectively. Area E was similar to A, located more posteriorly. Non parametric multivariate models showed minimal or no effect on accuracy and precision by operator, time point, or software settings. However, the choice of superimposition area resulted in statistically significant differences in accuracy and clinically significant differences in detected tooth movement (95% limits of agreement exceeding 1 mm and 3°). Superimposition on area A provided accurate, reproducible, and precise results. Outcomes were comparable for area B, but deteriorated when alternative areas were used.

Clinical outcomes of lingual orthodontic treatment: a systematic review.

OBJECTIVES: To assess the available evidence on the effectiveness of lingual orthodontic treatment and related clinical parameters through a systematic review of relevant studies. MATERIALS AND METHODS: Eligible clinical studies published from January 2000 to March 2015 were identified through electronic (five major databases) and hand searches. Risk of bias was assessed using the Cochrane risk of bias tool for prospective studies and a specially designed tool for retrospective studies. RESULTS: From the 3734 articles identified by the search, after application of specific inclusion and exclusion criteria, 16 papers were included in the study. Eleven studies were retrospective, four were prospective, and only one was a RCT. In detail, six studies evaluated differences of the treatment outcome from the pre-treatment set-up prediction, two studies evaluated the effect of treatment on periodontal and microbial parameters, and 10 studies assessed various clinical treatment related parameters. Despite several promising findings, the quality of evidence supporting them was found to be low in most cases. CONCLUSIONS: This systematic review showed encouraging results on the clinical outcome of lingual orthodontic treatment, especially in regards to the achievement of individualized treatment goals and the reduction of decalcifications on the bonded surfaces of the teeth. However, additional well-designed prospective clinical trials with larger samples are needed to confirm those findings. Several aspects of lingual orthodontic treatment were difficult to be conclusively evaluated due to the study design, the heterogeneity, the small samples sizes, and the high risk of bias seen in the majority of the included studies.