Multiple Clinical Findings on The Tongue: Variants of Normal or Pathologic Condition? (A Case Report)

Various normal and pathologic findings might occasionally be found on the tongue and might confuse some patients and clinician due to its atypical presentation. This case report aimed to present a case report of multiple oral findings related to variants of normal and pathological findings on the tongue: geographic tongue, fissured tongue, and central papillary atrophy. A 53-year-old male patient came to Universitas Indonesia Dental Hospital for a dental check-up. Objective examination in the tongue showed depapilated areas surrounded by keratinized lining in the ventral and lateral left and right area of the tongue, multiple fissures in all over the dorsum of the tongue, and an ovoid redness area in the middle of 2/3 posterior dorsum part of the tongue. All those findings were asymptomatic. Those clinical findings were diagnosed as geographic tongue, fissured tongue, and central papillary atrophy. This case presents unique multiple variants of normal and pathological findings in the tongue. It is important to an oral health professional to have knowledge and ability to determine normal anatomy, variants of normal and pathological lesions. Patients should be informed and educated about oral mucosa normal variations and related clinical findings so they would not develop unnecessary anxiety. Keywords: central papillary atrophy, fissured tongue, geographic tongue, normal variations

The Function of microRNAs in Pulmonary Embolism: Review and Research Outlook

Pulmonary embolism (PE) is a common pathologic condition that frequently occurs in patients with deep venous thrombosis. Severe PE may critically suppress cardiopulmonary function, thereby threatening the life of patients. Chronic pulmonary hypertension caused by PE may lead to deterioration of respiratory dysfunction, resulting in complete disability. MicroRNAs (miRNAs) are a group of abundantly expressed non-coding RNAs that exert multiple functions in regulating the transcriptome via post-transcriptional targeting of mRNAs. Specifically, miRNAs bind to target mRNAs in a matching mechanism between the miRNA seed sequence and mRNA 3ʹ UTR, thus modulating the transcript stability or subsequent translation activity by RNA-induced silencing complex. Current studies have reported the function of miRNAs as biomarkers of PE, revealing their mechanism, function, and targetome in venous thrombophilia. This review summarizes the literature on miRNA functions and downstream mechanisms in PE. We conclude that various related miRNAs play important roles in PE and have great potential as treatment targets. For clinical application, we propose that miRNA biomarkers combined with traditional biomarkers or miRNA signatures generated from microchips may serve as a great predictive tool for PE occurrence and prognosis. Further, therapies targeting miRNAs or their upstream/downstream molecules need to be developed more quickly to keep up with the progress of routine treatments, such as anticoagulation, thrombolysis, or surgery.

Molecular Chaperones and miRNAs in Epilepsy: Pathogenic Implications and Therapeutic Prospects

Epilepsy is a pathologic condition with high prevalence and devastating consequences for the patient and its entourage. Means for accurate diagnosis of type, patient monitoring for predicting seizures and follow up, and efficacious treatment are desperately needed. To improve this adverse outcome, miRNAs and the chaperone system (CS) are promising targets to understand pathogenic mechanisms and for developing theranostics applications. miRNAs implicated in conditions known or suspected to favor seizures such as neuroinflammation, to promote epileptic tolerance and neuronal survival, to regulate seizures, and others showing variations in expression levels related to seizures are promising candidates as useful biomarkers for diagnosis and patient monitoring, and as targets for developing novel therapies. Components of the CS are also promising as biomarkers and as therapeutic targets, since they participate in epileptogenic pathways and in cytoprotective mechanisms in various epileptogenic brain areas, even if what they do and how is not yet clear. The data in this review should help in the identification of molecular targets among the discussed miRNAs and CS components for research aiming at understanding epileptogenic mechanisms and, subsequently, develop means for predicting/preventing seizures and treating the disease.

Skeletal stem and progenitor cells maintain cranial suture patency and prevent craniosynostosis

Cranial sutures are major growth centers for the calvarial vault, and their premature fusion leads to a pathologic condition called craniosynostosis. This study investigates whether skeletal stem/progenitor cells are resident in the cranial sutures. Prospective isolation by FACS identifies this population with a significant difference in spatio-temporal representation between fusing versus patent sutures. Transcriptomic analysis highlights a distinct signature in cells derived from the physiological closing PF suture, and scRNA sequencing identifies transcriptional heterogeneity among sutures. Wnt-signaling activation increases skeletal stem/progenitor cells in sutures, whereas its inhibition decreases. Crossing Axin2LacZ/+ mouse, endowing enhanced Wnt activation, to a Twist1+/− mouse model of coronal craniosynostosis enriches skeletal stem/progenitor cells in sutures restoring patency. Co-transplantation of these cells with Wnt3a prevents resynostosis following suturectomy in Twist1+/− mice. Our study reveals that decrease and/or imbalance of skeletal stem/progenitor cells representation within sutures may underlie craniosynostosis. These findings have translational implications toward therapeutic approaches for craniosynostosis.

Comparative Study of Native or Nano Quercetin on Epigenetic Modification and Nephropathy Biomarkers Post Challenges in Diabetic Hamsters

Aims: The aim of this study is to examine the regulatory effects of quercetin nanoparticles (QNPs) compared with native quercetin either with or without metformin against the abnormal molecular and biochemical pathways that eventually culminate in the pathologic condition clinically known as diabetic nephropathy (DN) in hamsters Methodology: After synthesis and characterization of the QNPs, seventy male adult hamsters are divided as following; G1:healthy control, G2:untreated DN hamsters, G3:DN+metformin G4:DN+native quercetin, G5:DN+QNPs, G6:DN+native quercetin+ metformin and G7: DN + QNPs + metformin. Results: Our results illustrated that the effect of QNPs + metformin is the most effective in IRS-1 and GLUT-4 gene expression that correlated with inhibition of HDACs which in turn improved diabetic and nephropathy biomarkers, this effectiveness followed by G6 then G3 and finally G4 after G5. These results were confirmed by immunohistochemical examinations. Levels of antioxidant and inflammatory biomarkers also reflected the protective effect of our treatments. Conclusion: All tested treatments significantly exhibit renal improvement.

New Rehabilitation Concept for Maxillary Edentulism: A Clinical Retrospective Study of Implant Crown Retained Removable Partial Dentures

There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.

Multilocular Simple Bone Cyst of the Mandible: Part 2: Histopathologic Appearance and Brief Review of the Literature

The purpose of this report is to highlight the histopathologic appearance of the mandibular simple bone cyst (SBC) – a pathologic condition which continues to stay an enigma for a lot of colleagues. Cone-beam computed tomography of a two-chamber SBC (ie, multilocular type) of the mandibular body in a 41-year-old white female is analyzed. Brief literature review is also performed giving the possibility to understand all intraoperative appearances of the SBCs and contemporary techniques of its management.

Peptides contained in the composition of Laennec that contribute to the treatment of hyperferritinemia and iron overload disorders

Introduction. Hemosiderosis is a pathologic condition that accompanies liver, lung, and other organ diseases. Polypeptide-containing drug Laennec contributes to the elimination of excessive iron deposits in tissues.Aim. The study was aimed to identify peptides contained in the composition of the drug that take part in the regulation of iron homeostasis and correction of hemosiderosis and hyperferritinemia.Materials and Methods. The study of the drug composition was conducted with hybrid mass-spectrometry and modern methods of analysis of Big Data based on the topological approach to recognition.Results. The preparation contains 19 peptides that are potentially important for the regulation of iron homeostasis. These peptides help to treat the disorders of iron metabolism by regulating the levels of the main hormone of iron homeostasis hepcidin by reducing the synthesis of ferritin and by exhibiting anti-inflammatory and immunomodulatory effects.Conclusion. The identified peptides allowed the authors to describe the molecular mechanisms of the iron overload elimination that are known from experimental and clinical studies of the analyzed polypeptide drug.

Medical Management in Moyamoya Disease

Medical treatment seems to be not entirely helpful in the treatment of Moyamoya disease. No evidence supports the benefits of any drug treatment in Moyamoya disease. The ischemic or hemorrhagic event in Moyamoya disease is not preventable with any medical treatment. However, most of the physicians still prescribe the antithrombotic drug for Moyamoya patients with an ischemic event. Moreover, the standard guidelines recommend administering antithrombotic medications to treat Moyamoya with the ischemic event, even the risk of hemorrhagic complication. Antihypertensive drugs are routinely prescribed in Moyamoya patients with or without elevated blood pressure. A literature review about medical treatment in Moyamoya disease should help determine its use in this pathologic condition.