Hyper-IgM Immunodeficiency with Enamel Defects: a Case Report

Background: Hyper-Immunoglobulin M (IgM) syndrome (HIGM) is a rare primary immunodeficiency in which defective B-cell isotype switching results in a phenotype characterized by elevated or normal serum IgM levels and low levels of other Ig classes, leading to an increased susceptibility to infection, neutropenia, autoimmune disorders, and malignancies. In this disease, a mutation occurs in the CD40 gene, leading to combined B-cell and T-cell immunodeficiencies. The oral manifestations include wound-like lesions, oral candidiasis, gingivitis, periodontitis, and enamel defects. Theoretically, systemic conditions affecting ameloblastic activity during enamel mineralization, such as abnormal oxygen levels resulting from hypoventilation in various respiratory diseases, result in enamel defects. Case presentation: We report a 10-year-old male with hyper-IgM immunodeficiency. The patient had suffered from frequent infections, respiratory problems, and bronchopneumonia from the age of 2 years. At 4 years of age, type 1 diabetes mellitus was diagnosed. During dental examinations, enamel defects were found in seven permanent teeth. Conclusion: A meticulous dental evaluation of children with systemic diseases is mandatory in order to discover possible developmental dental defects and to plan early interventions

Experimental and Simulation Study of Water Shutoff in Fractured Systems Using Microgels

Conformance control has long been a compelling subject in improving waterflood oil recovery. By blocking the areas previously swept by water, subsequently injected water is allowed to access the remaining unswept portions of the reservoir and thereby increase the ultimate oil recovery. One technique that has recently received a great deal of attention in achieving the so-called in-depth water shut-off\u27 is preformed gel injection. However, processing and predicting the performance of these gels in complex petroleum reservoirs is extremely challenging. As target reservoirs for gel treatments are mainly those with fractures or ultra-high permeability streaks, the ability to model the propagation of gels through a fractured reservoir was considered as a new challenge for this research study. The primary objectives of this work are to conduct laboratory work to understand the transport and propagation of microgel through fractures and develop conformance control schemes using a reservoir simulator to help in screening oil reservoir targets for effective particle gel applications to improve sweep efficiency and reduce the water production. Fractured experiments using transparent apparatus were performed to observe gel transport in matrix and fractures. The same set up was used to observe the effects of gel strength, gel particle size, and fracture size on gel transport. Numerical simulation of fluid-flow in fractured reservoirs can be computationally difficult and time consuming due to the large contrast between matrix and fracture permeabilities and the extremely small fracture apertures and the need for using unstructured gridding. In this work, a model that accurately represents the complex reservoir features, chemical properties, and displacement mechanisms is developed. The five-spot transparent fracture experiments allowed us to identify the transport mechanisms of microgels through fractures-conduits and also the control variables. With an integration of comprehensive gel transport modules and a novel Embedded Discrete Fracture Modeling (EDFM), gel rheological and transport properties of shear thinning viscosity, adsorption, resistance factors, and residual resistance factor, using multiple sets of fractures with dip angles and orientations were captured. The models were validated against lab measurements and implemented into a reservoir simulator called UTGEL. The mechanistic models and numerical tool developed will help to select future conformance control candidates for a given field and to optimize the gel chemistry and treatment

ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)

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