Gut T cell-independent IgA responses to commensal bacteria require engagement of the TACI receptor on B cells.

The gut mounts secretory immunoglobulin A (SIgA) responses to commensal bacteria through nonredundant T cell-dependent (TD) and T cell-independent (TI) pathways that promote the establishment of mutualistic host-microbiota interactions. SIgAs from the TD pathway target penetrant bacteria, and their induction requires engagement of CD40 on B cells by CD40 ligand on T follicular helper cells. In contrast, SIgAs from the TI pathway bind a larger spectrum of bacteria, but the mechanism underpinning their production remains elusive. Here, we show that the intestinal TI pathway required CD40-independent B cell-activating signals from TACI, a receptor for the innate CD40 ligand-like factors BAFF and APRIL. TACI-induced SIgA responses targeted a fraction of the gut microbiota without shaping its overall composition. Of note, TACI was dispensable for TD induction of IgA in gut-associated lymphoid organs. Thus, BAFF/APRIL signals acting on TACI orchestrate commensal bacteria-specific SIgA responses through an intestinal TI program.

Polymyxin B infusion leading to cardiac arrest: a case report and literature review.

We describe a 52-year-old female patient who developed cardiopulmonary arrest due to neuromuscular paralysis after initiation of polymyxin B for septicemia caused by extended spectrum ß-lactamase-producing Klebsiella pneumoniae. Due to emerging antibiotic resistance patterns, use of polymyxins is increasing and an understanding of their toxicity is critical.

Fusarium head blight of cereals in Denmark: species complex and related mycotoxins.

Quantitative real-time polymerase chain reaction differentiating 10 Fusarium spp. and Microdochium nivale or M. majus was applied to a total of 396 grain samples of wheat, barley, triticale, oat, and rye sampled across Denmark from 2003 to 2007, along with selected samples of wheat and barley from 1957 to 2000, to determine incidence and abundance of individual Fusarium spp. The mycotoxins deoxynivalenol (DON), nivalenol, zearalenone, T-2, and HT-2 were quantified using liquid chromatography-double mass spectrometry. Major differences in the Fusarium species complex among the five cereals as well as great yearly variation were seen. Fusarium graminearum, F. culmorum, and F. avenaceum were dominant in wheat, with DON as the dominant mycotoxin. F. langsethiae, F. culmorum, and F. avenaceum were dominant in barley and oat, leading to relatively high levels of the mycotoxins T-2 and HT-2. F. graminearum, F. culmorum, and F. avenaceum dominated in triticale and rye. The nontoxigenic M. nivale/majus were present in significant amounts in all cereal species. Wheat and barley samples from 1957 to 1996 exhibited no or very low amounts of F. graminearum, indicating a recent increase of this pathogen. Biomass and mycotoxin data exhibited good correlations between Fusarium spp. and their corresponding mycotoxins under field conditions.

Performance of tunnel restorations at 3-6 years.

OBJECTIVES: the purpose of this study was to evaluate the success of the tunnel restoration method in the Norwegian public dental service. METHODS: all patients from three age cohorts (born 1975-1977) who had received one or more tunnel restorations at least 3 years earlier, at the public dental clinic in Kongsberg and a neighboring clinic in Numedal, were examined clinically and radiographically by two calibrated dentists. Individuals with two or more filled surfaces per year were classified as "caries active". The statistical analyses consisted of non-parametric Kaplan-Meyer estimates of the survival function, and rank tests for associations to the longevity data and the background variables. RESULTS: a total of 182 restorations in 94 patients were studied. Sixty-five percent of the restorations were considered successful. A total of 118 restorations were censored within the 76-month observation period. The median survival time was estimated to be 55 months, with a 95% confidence interval of 51-61 months. About 90% survived 3 years, while only 35% survived 5 years. Both caries activity and operator had significant effects on the survival period. On the other hand, there was no difference between "wells" and "tunnels", tooth type, tooth surface or jaw with regard to success rate. CONCLUSIONS: The tunnel preparation filled with currently available glass-ionomer cement is not a generally favorable alternative in primary approximal lesions. However, in the hands of a well-trained, careful operator it may be chosen as a semi-permanent solution for patients with modest caries activity.

Adjusting estimates of alveolar bone loss for missing observations: developing and testing a general model.

The occurrence of missing teeth is a vexing and growing problem in epidemiological studies of dental disease. The number of units of measurement (i.e., teeth/tooth sites) varies between persons and may affect summary statistics in descriptive studies as well as in analytical studies. The purpose of the present study was to develop a general model to adjust summary statistics for missing teeth. The proposed method was applied to alveolar bone loss in current smokers, former smokers, and non-smokers, from 45 to 64 years of age (n = 812). Alveolar bone loss was measured on bitewing radiographs. The adjustment method was based on the assumption that the probability of losing a tooth was an increasing function of alveolar bone loss. The main finding of the present study was that mean alveolar bone loss increased after adjustment for the number of missing teeth. This increase was larger for current smokers than for non-smokers, indicating that the effects of smoking were slightly underestimated when missing sites were ignored. Further research is required for the model to be applied to other data, estimating different types of dental disease with various degrees of disease prevalence and various numbers of missing teeth, and for validating the adjustment method by means of longitudinal data.

Reducing costs of censuses in Norway through use of administrative registers.

"For some years it has been the policy of Statistics Norway to collaborate with various governmental agencies in order to use administrative registers in statistics production. This policy has been supported politically, and a new Statistics Act has been useful in these efforts. The purpose of this paper is to present the strategy and methodology used to produce statistics in general, census statistics in particular, when based on a combined use of administrative registers and directly collected data. Experiences from Norwegian censuses since 1960 will be presented."

[CT of primary cerebral lymphoma in non-immunosuppressed patients]. / CT af primaert cerebralt lymfom hos ikkeimmunsupprimerede patienter.

In the last 10-15 years primary lymphoma of the brain has tripled in frequency in the non-immunosuppressed population. The correct diagnosis by CT-examination is difficult as primary lymphoma imitates different pathological conditions. Five examples from a series of 13 patients are presented.

Age estimation of adults from dental radiographs.

Previous studies have shown that with advancing age the size of the dental pulp cavity is reduced as a result of secondary dentine deposit, so that measurements of this reduction can be used as an indicator of age. The aim of the present study was to find a method which could be used to estimate the chronological age of an adult from measurements of the size of the pulp on full mouth dental radiographs. The material consisted of periapical radiographs from 100 dental patients who had attended the clinics of the Dental Faculty in Oslo. The radiographs of six types of teeth from each jaw were measured: maxillary central and lateral incisors and second premolars, and mandibular lateral incisors, canines and first premolars. To compensate for differences in magnification and angulation on the radiographs, the following ratios were calculated: pulp/root length, pulp/tooth length, tooth/root length and pulp/root width at three different levels. Statistical analyses showed that Pearson's correlation coefficient between age and the different ratios for each type of tooth was significant, except for the ratio between tooth and root length, which was, therefore, excluded from further analysis. Principal component analyses were performed on all ratios, followed by regression analyses with age as dependent variable and the principal components as independent variables. The principal component analyses showed that only the two first of them had significant influence on age, and a good and easily calculated approximation to the first component was found to be the mean of all the ratios. A good approximation to the second principal component was found to be the difference between the mean of two width ratios and the mean of two length ratios, and these approximations of the first and second principal components were chosen as predictors in regression analyses with age as the dependent variable. The coefficient of determination (r2) for the estimation was strongest when the ratios of the six teeth were included (r2 = 0.76) and weakest when measurements from the mandibular canines alone were included (r2 = 0.56). Measurement on dental radiographs may be a non-invasive technique for estimating the age of adults, both living and dead, in forensic work and in archaeological studies, but the method ought to be tested on an independent sample.

Late psychosocial outcome in severe traumatic brain injury. Preliminary results of a third follow-up study after 20 years.

More than 20 years after severe head injury the preliminary results of the present study indicate that the very late psychosocial outcome differed much in the individual subjects. The most decisive negative factors were severely disturbed behaviour and lack of insight. Improvement many years after injury was, however, possible. During the years the relationship between parent(s) and severely head injured sons often became strained. After the first posttraumatic year or two the patient with severe behavioural deficits must be helped to adopt some other type of living.

[Ultrasound in the detection of foreign bodies in the extremities]. / Ultralydskanning til påvisning af fremmedlegemer i ekstremiteterne.

The aim of the investigation was to examine the value of ultrasound in the detection of foreign bodies. In an experimental model fragments of wood, metal and glass placed in meat were all easily detectable with ultrasound. Twenty patients with a suspected foreign body in an extremity were examined. The investigation was inconclusive regarding wood fragments. Metal fragments, visible on X-ray pictures, were difficult to see with ultrasound. Glass fragments were clearly visible with ultrasound technique. With adequate equipment, ultrasound will facilitate the detection and removal of glass fragments in the tissue.

[Marfan syndrome and pregnancy, complicated by dissecting aneurysm]. / Marfan-Syndrom und Schwangerschaft, kompliziert durch das Aneurysma dissecans.

Pregnant women with a Marfan syndrome carry a risk of developing an aortic arc dissection. As the developing aneurism may be diagnosed by echocardiography, this method should be applied repeatedly during pregnancy. We report the case of a Marfan patient, who developed an acute aortic dissection during the third trimester of her pregnancy and discuss the guidance and surveillance of Marfan patients who are or wish to become pregnant.

A non-invasive technique for age at death determination.

Several methods for age at death determination of human skeletal remains have been developed. These methods have, especially in combination, proved to be useful in making individual identification of skeletal material in forensic cases. This study is based on the known correlation between actual age and structural changes in trabecular bone tissue. Using X-rays taken from live individuals, it provides a useful non-invasive ageing technique for the forensic examiner. An initial pilot study defined five phases of age-related changes in the trabecular tissue of the proximal end of the femur. A total of 60 X-rays, randomly selected, and covering an age span from 14 years to 94 years, were subsequently scored in blind trials. The results demonstrate a clear relationship between age and changes in the trabecular structures. Based on this relationship it is possible to obtain an age estimate by identification of one of the five phases. An exact age determination of a single individual was not possible, but could be approximated to within 20 years. In forensic cases, however, where the removal of soft tissue is not always possible, this method can contribute to the final age determination when used in conjunction with other well-known methods, and thereby strengthen the final age estimate.

Fish viruses: isolation of an icosahedral cytoplasmic deoxyribovirus from sheatfish (Silurus glanis).

An icosahedral cytoplasmic deoxyvirus has been isolated from moribund sheatfish (Silurus glanis) fry of a commercial warm water recirculation aquaculture unit with cumulative mortalities of up to 100%. The agent replicated in BF-2 and in FHM cells at 20-30 degrees C producing cytoplasmatic inclusion bodies followed by lysis of the cells. The DNA containing virus proved to be labile to chloroform. Infected BF-2 cells revealed hexagonal particles in the cytoplasm measuring about 125-135 nm in diameter. The virus consisted of a central electron-dense core and a electron-translucent zone. The isolate shares characteristics with the Iridoviridae.

Detection of a baculovirus in the tiger prawn Penaeus monodon.

In postlarval Penaeus monodon from a hatchery in Asia a baculovirus was detected in the epithelial cells of the hepatopancreas by electron microscopy. The baculovirus was identified as the Monodon baculovirus (MBV).

Do young patients have worse outcomes after severe blunt head trauma?

The influence of age on very late outcome was examined in 40 patients who had received very severe blunt head trauma (post-traumatic amnesia greater than or equal to 1 month), and who were aged 15-44 years when injured. The patients were first seen on average 4.5 months after injury and then at two follow-up examinations in their homes 2.5 and 10-15 years after the trauma. There was no significant correlation between age when injured and post-traumatic amnesia. The frequency of 13 late cognitive, behavioural, social and subjective problems was examined at the second follow-up and compared with the observations made 2.5 years after injury. A statistical analysis indicated that the younger the patient the higher the risk of late behavioural and emotional sequelae. The results have been related to information and observations obtained from the home visits.

Paroxetine: pharmacokinetic and antidepressant effect in the elderly.

To evaluate the pharmacokinetic properties, efficacy, and tolerability of paroxetine in elderly depressed patients, a clinical study was set up--initially at Aalborg Psychiatric Hospital in Denmark, and subsequently at the University Hospital in Linköping, Sweden. A total of 21 patients with a median age of 72 years were included in the study. After a single dose of 20 or 30 mg of paroxetine followed by two drug-free days, treatment continued with 20 or 30 mg daily for seven weeks. The majority of patients showed a continuous reduction in their HAMD scores, starting in the second week of treatment. Paroxetine was well tolerated at the doses given, and side-effects were mostly mild and transient. Steady-state, pre-dose plasma levels of paroxetine showed considerable variability, and the median steady-state concentration was higher in elderly patients compared with data from a previous study in young volunteers. Elimination half-lives also showed variability between these elderly patients, but tended to be longer after cessation of multiple dosing than after a single dose. They also tended to be longer than in the young volunteers. The results of this study do not advocate reduced doses of paroxetine in the elderly, but further studies are warranted.

Census statistics through combined use of surveys and registers?

"In this paper we present some results from a study [concerning Norway] on the feasibility of producing census statistics through the combined use of surveys and registers. The main finding is that if one is willing to relax a little on the need for accuracy of statistics for 'small' areas, the large majority of the census statistics can be produced by such a combined use of data sources."