Ultrasound Effect on Neural Differentiation of Gingival Stem/Progenitor Cells

Dental pulp loss due to caries or pulpitis can affect the longevity of teeth. Dental pulp tissue engineering necessitates the use of progenitor cells that has the potential to differentiate into neural, vascular and odontoblasts like cells. Previous reports have shown that human gingival progenitor cells (HGPCs) can be differentiated into different cell types; however neural differentiation of these cells, to the best of our knowledge, has not been reported. Low intensity pulsed ultrasound (LIPUS) has been reported to enhance cell differentiation. The aims of this study were (1) to explore the potential neural differentiation of HGPCs and (2) to investigate the effect of LIPUS on the differentiation of HGPCs when incubated under neuroinductive conditions. The HGPCs were isolated from human interdental papilla proximal to the premolar teeth that were extracted for orthodontic purpose. The HGPCs were induced to differentiate into neural lineage using a neuroinductive culture medium. HGPCs were divided into four groups; control group, neuro-induction (NI) group, ultrasound group (LIPUS), and a combined NI+LIPUS group. HGPCs were harvested for immunostaining and q-PCR after 1 day. Immunostaining for neuron specific antigens and q-PCR suggested that HGPCs can be differentiated into neural lineage and that selected neurodifferentiation markers can be enhanced by LIPUS.     

Occurrence of longitudinal stent compression before stent deployment: Two case studies

Several recent reports have described the occurrence of longitudinal stent deformation(LSD, defined as the distortion or shortening of a stent along the longitudinal axis), following its successful deployment. However, few reports have described LSD prior to any stent deployment. This previously unrecognized complication is the result of modifications to stent design. It has been noted that the new-generation stent platforms have a reduced number of connectors, which in turn causes a reduction in longitudinal stent strength. To corroborate previous findings by our lab and others(Vijayvergiya et al, 2013), we describe here two cases of LSD prior to stent deployment that occurred due to crushing of the proximal stent edge by the guide catheter while attempting to withdraw the crimped stent. In addition, we discuss the associated risk factors, such as the length of the stent, and specific management strategies, including technical guidelines and use of fluoroscopic guidance for maneuvering the stent during the procedure.     

Wilson disease: copper deficiency and iatrogenic neurological complications with zinc therapy

A 17‐year‐old female was diagnosed with Wilson disease and commenced on oral zinc therapy. She re‐presented 6 months later with a fall and had classical signs of subacute combined degeneration of the spinal cord confirmed on nerve conduction studies, as a result of zinc‐induced copper deficiency. After 6 months of copper therapy, she made a complete recovery with no residual neurological deficits. Early detection of zinc‐induced copper deficiency and stringent follow‐up mechanisms are crucial. Early initiation of copper replacement may both limit and completely reverse neurological deficits.     

Increased serum level of soluble receptor for advanced glycation end products (sRAGE) in type 2 diabetic patients with nephropathy

Activation of the receptor for advanced glycation end products (RAGE) has been implicated in the development of diabetic vascular complications. Soluble RAGE (sRAGE) could act as a decoy for the RAGE ligands and may thus exert a cytoprotective effect. Since RAGE is upregulated by advanced glycation end products (AGEs), the same could be implied for sRAGE. We aimed to investigate the role of sRAGE as a marker of early diabetic nephropathy. Forty-eight type 2 diabetic patients, further subdivided into group 1 without renal affection (10 patients), group 2 with microalbuminuria (25 patients), and group 3 with proteinuria (13 patients), and age-matched control group 4 (17 subjects) were included. Serum sRAGE, urea, creatinine, plasma glycated hemoglobin (HBA1c), and urinary albumin excretion (albumin/creatinine ratio) were measured. sRAGE levels were significantly higher in groups 2 and 3when compared to groups 1 and 4. No significant difference was found on comparing groups 2 and 3 together or on comparing groups 1 and 4. There was a significant positive correlation between sRAGE level and all the studied parameters (p?<?0.05) as well as a significant association between the sRAGE positivity within the three diabetic groups and the degree of proteinuria. Although sRAGE level was found to be significantly higher in the microalbuminuria group when compared to both the control and diabetics with normal kidney groups, the absolute value did not differ significantly from the proteinuria group. So we say that sRAGE can be used as a marker of diabetic nephropathy; however, its absolute level cannot be used to distinguish different degrees of renal affection.