Therapeutic Potential of Dental Pulp Stem Cells According to Different Transplant Types

Stem cells are unspecialised cells capable of perpetual self-renewal, proliferation and differentiation into more specialised daughter cells. They are present in many tissues and organs, including the stomatognathic system. Recently, the great interest of scientists in obtaining stem cells from human teeth is due to their easy availability and a non-invasive procedure of collecting the material. Three key components are required for tissue regeneration: stem cells, appropriate scaffold material and growth factors. Depending on the source of the new tissue or organ, there are several types of transplants. In this review, the following division into four transplant types is applied due to genetic differences between the donor and the recipient: xenotransplantation, allotransplantation, autotransplantation and isotransplantation (however, due to the lack of research, type was not included). In vivo studies have shown that Dental Pulp Stem Cells (DPSCs)can form a dentin-pulp complex, nerves, adipose, bone, cartilage, skin, blood vessels and myocardium, which gives hope for their use in various biomedical areas, such as immunotherapy and regenerative therapy. This review presents the current in vivo research and advances to provide new biological insights and therapeutic possibilities of using DPSCs.

Ultrasound of the hand in systemic sclerosis

Systemic sclerosis is a chronic connective tissue disease characterized by multi-organ involvement but the main clinical changes occur in the hands, secondary to skin, joint and microvascular damage. Therefore the hand received a special attention for imaging and especially for ultrasound evaluation. In rheumatology US become an extension of the clinical examination and particularly in systemic sclerosis it has been proven to help with a better assessment of the skin, blood vessels, joints and tendons involvement. This evolution was allowed by permanent improvement of technology along with expanding the range of ultrasound applications which happened especially in past decade.

AYURVEDIC MANAGEMENT OF SYSTEMIC SCLEROSIS - A SINGLE CASE STUDY

Systemic sclerosis (SSc) is a multisystem autoimmune disorder caused by unknown factors. Which results in fibrosis of the skin, blood vessels, and visceral organs, including the gastrointestinal tract, lungs, heart, and kidneys. One among subset is referred to as diffuse cutaneous scleroderma and characterized by the rapid development of symmetric skin thickening of proximal and distal extremity, face, and trunk. When it affects on musculoskeletal system, the synovium in patients with arthritis is similar to that seen in early rheumatoid arthritis and shows edema with infiltration of lymphocytes and plasma cells. A 35-year-old house wife with this diagnosis came to OPD, which is managed by the principle of Amavata (diseases of connective tissue in Ayurveda) line of treatment. Vaitarana basti and Valuka sweda has done for 7 days with oral medication Vaishwanara churna ½ teaspoon with first morsal of food for 3 times. The QOL (quality of life) has been improved with in 7 days of treatment.

Neoplastic potential for malformations of the development of ecto- and mesodermal structures

Introduction.Malformations of ecto- and mesodermal structures represent various forms of abnormality of intrauterine systemic and local morphogenesis, arising at different times of embryonic development due to environmental factors, genomic, chromosomal or gene mutations. Dysregulation of cellular functions due to mutations and accumulation of defective proteins initiates tumor transformation of tissues e.g. hereditary diseases of ectomesodermal origin phakomatosis (hamartomatosis). The aim of the studywas to determine organ specificity, clinical manifestations, morphological features and the degree of progression of tumors of the nervous system and internal organs in hereditary diseases of ectomesodermal origin. Materials and methods.103 patients with hereditary phakomatosis were examined. All of them underwent a comprehensive clinical imaging examination, including magnetic resonance imaging, echocardioscopy, ultrasound examination of the abdominal organs, kidneys, retroperitoneal space, and computed tomography of the abdominal cavity and lungs. Results.The reason for the treatment of patients was the occurrence of focal neurological symptoms, focal and/or generalized epileptic seizures. Clinical manifestations were determined by the form of the disease. The risk of the development and progression of various neoplasms is the highest in neurofibromatosis type III, tuberous sclerosis, neurocutaneous melanosis, multiple endocrine neoplasia, angiomatosis of HippelLindau, Louis-Bar . Favorable benign and stable course, low malignant potential are distinguishing characteristics of pigment-vascular phakomatoses type IV. Conclusion.Knowledge of the clinical manifestations of various malformations of the skin, blood vessels, and the nervous system associated with tumor growth in cells and tissues is practically significant. Early diagnosis and the use of modern technologies of conservative and surgical treatment allow achieving a predictable result, prevent the development of severe complications, and significantly improve the quality of life of patients with this pathology.

A RARE CASE OF PSEUDOXANTHOMA ELASTICUM

Pseudoxanthoma elasticum (PXE) is also known as Gronblad-Strandberg syndrome. It belongs to the group of connective tissue disorders that affect the elastic tissue of the skin, blood vessels, and the eyes. Both autosomal dominant and recessive patterns of inheritance can be seen. Skin lesions consist of small, yellowish papules in rows or a lacy pattern, which may coalesce to form larger patches. The skin is soft, lax and slightly wrinkled. Common sites affected in PXE are the sides of the neck, below the collar bones, the armpits, abdomen, groins, perineum and thighs. Currently there is no effective treatment for the condition. As it can be passed to next generation genetic counselling can be helpful.

Anesthetic Management of a Patient With Systemic Sclerosis and Microstomia

Systemic sclerosis (SSc) is an autoimmune disease that can cause fibrosis in vital organs, often resulting in damage to the skin, blood vessels, gastrointestinal system, lungs, heart, and/or kidneys. Patients with SSc are also likely to develop microstomia, which can render dental treatment difficult and painful, thereby necessitating advanced anesthetic management. This is a case report of a 61-year-old woman with a history of SSc with microstomia, interstitial pneumonia, and gastroesophageal reflux disease in whom intravenous moderate sedation was performed using a combination of dexmedetomidine and ketamine for dental extractions. Both anesthetic agents are known to have analgesic effects while minimizing respiratory depression. Consequently, the increased discomfort caused by opening the patient's mouth and stretching the buccal mucosa was sufficiently managed, permitting an increase in maximum interincisal opening and completion of treatment without complications. Patients with SSc present with serious comorbidities that can negatively impact anesthetic management, so the implementation of an anesthetic plan that takes such risks into account is required. Furthermore, emergency airway management is likely to be difficult in patients with microstomia. For intravenous moderate sedation, combined use of dexmedetomidine and ketamine, which have analgesic effects while minimizing respiratory depression, may be particularly effective in patients with SSc and microstomia.

Ocular side effects of antirheumatic medications: a qualitative review

TopicThis paper reviews the ocular side effects of medications used in the treatment of rheumatological conditions.Clinical relevanceRheumatic diseases are inflammatory conditions that may affect the skin, blood vessels, joints, muscles and internal organs. Immunosuppressive agents are often used as treatment and while powerful, they carry side effects and toxicities that need careful monitoring. Ophthalmic complications have been reported with the use of antirheumatic medications; however, there is a lack of literature synthesising these reports. This paper addresses this gap and hopes to inform both rheumatologists and ophthalmologists as they work together on the management of patients with rheumatological conditions.MethodsPubMed literature search was conducted from November to September 2019 searching for ocular side effects with the use of 25 rheumatological drugs.ResultsA total of 111 papers were included in this review. Adverse side effects were divided into non-infectious and infectious causes. Traditional disease-modifying antirheumatic drugs (DMARDs) were associated with pruritus, irritation and dryness of the conjunctiva while biologic DMARDS showed reports of new-onset/recurrent uveitis and demyelinating conditions. Infectious side effects included episodes of cytomegalovirus retinitis, toxoplasmic chorioretinitis and endophthalmitis. Other serious side effects were encountered and included in this review.ConclusionThe goal of this paper is to inform healthcare providers about potential ocular side effects from rheumatological medications. Healthcare providers are encouraged to learn more about these ophthalmic complications and find relevance within their clinical practice.

Nature of crop contents of an amblyceran pigeon louse, Colpocephalum turbinatum (Phthiraptera: Insecta)

Selected haemetophagous phthirapterans have been convicted to act as reservoir and transmitter of pathogens among their hosts. Amblyceran Phthiraptera are generally believed to exhibit varying degree of haemetophagy. The microscopic examination of 100 adults (both sexes) and 47 nymphal instars of an amblyceran louse, Colpocephalum turbinatum revealed their non haemetophagous nature as any red content compatible with host blood was not detected in their crops. The crops of the lice were found packed with only feather barbules. On seven instances the pieces of egg chorion and in 20 cases the presence of epidermal tissue were also detected in crop contents. However, the presence of any triturating agent (any structure which can help in grinding the feather contents) was not noticed. SEM studies on the ventral side of the head of the louse do not indicate the presence of any pointed gear which can be used to pierce the skin blood vessels of host. Present study suggests that few amblyceran species of Phthiraptera are not in haemetophagous in nature.

Perspectives on the Molecular and Biological Implications of Tropoelastin in Human Tissue Elasticity

The elasticity of a range of vertebrate and particularly human tissues depends on the dynamic and persistent protein elastin. This elasticity is diverse, and comprises skin, blood vessels, and lung, and is essential for tissue viability. Elastin is predominantly made by assembling tropoelastin, which is an asymmetric 20-nm-long protein molecule. This overview considers tropoelastin’s molecular features and biological interactions in the context of its value in tissue repair.