Combined Application of Human Amniotic Membrane Mesenchymal Stem Cells and a Modified PGS-co-PCL Film in an Experimental Model of Myocardial Ischemia-Reperfusion Injury

According to the World Health Organization (WHO), about 3.9 million people die annually of ischemic heart disease (IHD). Several clinical trials have shown that stem cell therapy is a promising therapeutic approach to IHD. Human amniotic membrane mesenchymal stem cells (hAMSCs) positively affect the repair of myocardial ischemia-reperfusion (MI/R) injury by stimulating endogenous repair mechanisms. The differentiated hAMSCs with and without modified PGS-co-PCL film were applied in the myocardium. MI/R injury was induced by ligating the left anterior descending artery in 48 male Wistar rats. The rats were divided into four groups, (n = 12) animals: heart failure (HF) as the control group, HF + MSCs, HF + MSCs + film, and HF + film. Echocardiography was performed 2 and 4 weeks after MI/R injury moreover the expression of the VEGF protein was assessed in the rat heart tissue via immunohistochemistry. In vitro, our result shows fantastic cell survival when seeded on film. In vivo, the left ventricle ejection fraction (LEVD), fractional shortening (FS), end-diastolic (EDV), and stroke volume (SV) have been increased and systolic volumes decreased in all treatment groups in comparison with control. Although combination therapy has a more positive effect on hemodynamic parameters, there is no significant difference between HF + MSCs + film with other treatment groups. Also, In the IHC assay, expression of the VEGF protein significantly increased in all intervention groups. The implantation of MSCs and the modified film significantly enhanced the cardiac functional outcome; in this regard, enhancement in cell survival and VEGF expression are involved as underlying mechanisms in which cardiac film and MSCs exert a beneficial effect.

Antimicrobial photodynamic therapy with dendrosomal curcumin and blue laser against Porphyromonas gingivalis

BACKGROUND

Periodontitis is a chronic inflammatory disease that leads to the loss of tooth-supporting structures. Porphyromonas gingivalis is one of the main pathogens responsible for periodontitis. Because of the limitations of antibiotic use, various alternative approaches have been developed. Antimicrobial photodynamic therapy uses photosensitizers and light to eliminate pathogens. Curcumin is a promising photosensitizer, but has low bioavailability and water solubility. However, dendrosomes can efficiently encapsulate curcumin, overcoming these obstacles. This study aimed to evaluate the efficacy of photodynamic therapy with blue laser and dendrosomal curcumin against Porphyromonas gingivalis.

METHODS

In this in vitro experiment, the minimum inhibitory concentration (MIC) of dendrosomal curcumin was determined using a serial dilution approach. Porphyromonas gingivalis suspensions were subjected to blue laser irradiation (447 nm, output power 100 mW) for 30 to 180 s. Finally, several subMIC dendrosomal curcumin concentrations and blue laser irradiation periods were applied to the bacterial suspensions. The negative control group received no therapy, whereas the positive control group was treated with 0.2% chlorhexidine. Consequently, the colony count of each group was calculated.

RESULTS

Treatment of Porphyromonas gingivalis with dendrosomal Curcumin at concentrations of 8-250 μg/mL significantly reduced bacterial growth compared to untreated group. 90 second exposure to a blue laser (31.8 J/cm2) completely inhibited the growth of Porphyromonas gingivalis. Blue laser irradiation for 60 s (21.2 J/cm2) markedly reduced bacterial growth but did not completely prevent its survival. Photodynamic therapy using dendrosomal curcumin at concentrations of 2-4 μg/mL and irradiation for 30-90 s resulted in complete eradication of Porphyromonas gingivalis compared to controls (P < 0.05).

CONCLUSION

The reduction in survival of Porphyromonas gingivalis following photodynamic therapy with dendrosomal curcumin and blue laser indicates that this technique could be a useful approach to eradicate Porphyromonas gingivalis infections.

The effects of Kinesio tapes on facial swelling following bimaxillary orthognathic surgery in the supraclavicular region

BACKGROUND

Several osteotomies are required for orthognathic surgery to reposition the jaws correctly. This study aimed to evaluate whether Kinesiotaping can reduce swelling, pain, and trismus following orthognathic surgery of the facial skull.

MATERIALS AND METHODS

The present study consists of two phases. In the split-mouth phase, 16 skeletal class III patients underwent Bimax Orthognathic surgery, and Kinesiological tape (KT) was applied on one half of the face. In the prospective case-control phase, 30 patients were divided into two groups. Kinesio tape was applied on both sides of the face of the Kinesio group, and pressure dressing and ice therapy were used for the second group. The tape was parallel to the lower border of the mandible along its entire length, tangent to the labial commissure area on the studied side. The tape was placed in place for 5 days. Edema was evaluated by measuring the distance from the menton to the lower edge of the tragus. The maximum mouth-opening trismus was evaluated, and the VAS index was used to evaluate pain.

RESULTS

There was evidence of swelling reduction after KT; within the same study, differences between the left and right sides as well as for the same side were statistically significant (p < 0.001). As a result of tapping lymphatic Kinesio tape on the affected area, tension was reduced, and lymphatic circulation was restored. Blood and lymph microcirculation was improved, enabling the body to heal itself.

CONCLUSION

Kinesio tape reduced swelling after orthognathic surgery in a positive way. As a simple, non-traumatic, economical method, Kinesio taping seems promising.

Evaluation of the Effect of Common Analgesics on Pulpal Sensibility Tests: A Clinical Trial

INTRODUCTION

Accurate diagnosis is one of the most important steps before endodontic treatment. The aim of this study was to assess the effect of 2 commonly used analgesics namely ibuprofen and acetaminophen on the cold and electric pulp test (EPT) results in participants with symptomatic irreversible pulpitis (SIP).

METHODS

This clinical trial evaluated 41 participants with pain due to SIP. The cold test and EPT were performed for teeth with SIP, and also for the corresponding tooth with healthy pulp in the contralateral quadrant. The participants then received 500 mg acetaminophen, 400 mg ibuprofen, or the placebo in the 3 groups. The cold test and EPT were repeated at 20, 40, and 60 minutes after medication intake, and the results were compared with the pretreatment values.

RESULTS

In the acetaminophen group, the results of cold test significantly decreased 40 (P < .05), and 60 (P < .05) minutes after analgesic intake in teeth with SIP and after 40 minutes (P < .05) in the corresponding contralateral teeth with healthy pulp. In the ibuprofen group, the cold test results significantly decreased at 20 (P < .05), 40 (P < .05), and 60 (P < .05) minutes after analgesic intake in teeth with SIP and after 40 minutes (P < .05) in the corresponding contralateral teeth with healthy pulp. The EPT results were not significantly affected by the studied analgesics at any time point (P > .05). There was no significant difference among the study groups regarding sex (P > .05).

CONCLUSION

It appears that both acetaminophen and ibuprofen can affect the pulpal response to the cold sensibility test. However, the studied medications had no significant effect on the EPT results. Therefore, dental clinicians should be aware of the possible effects of such medications on the cold test response.

Data-Driven Model-Free Adaptive Control of Z-Source Inverters

The universal paradigm shift towards green energy has accelerated the development of modern algorithms and technologies, among them converters such as Z-Source Inverters (ZSI) are playing an important role. ZSIs are single-stage inverters which are capable of performing both buck and boost operations through an impedance network that enables the shoot-through state. Despite all advantages, these inverters are associated with the non-minimum phase feature imposing heavy restrictions on their closed-loop response. Moreover, uncertainties such as parameter perturbation, unmodeled dynamics, and load disturbances may degrade their performance or even lead to instability, especially when model-based controllers are applied. To tackle these issues, a data-driven model-free adaptive controller is proposed in this paper which guarantees stability and the desired performance of the inverter in the presence of uncertainties. It performs the control action in two steps: First, a model of the system is updated using the current input and output signals of the system. Based on this updated model, the control action is re-tuned to achieve the desired performance. The convergence and stability of the proposed control system are proved in the Lyapunov sense. Experiments corroborate the effectiveness and superiority of the presented method over model-based controllers including PI, state feedback, and optimal robust linear quadratic integral controllers in terms of various metrics.

Evaluation of Secondary Thermal Hyperalgesia Resulting from Pulpal Inflammation in Patients with Symptomatic Irreversible Pulpitis

INTRODUCTION

Inflammation can lead to hyperalgesia and allodynia by activation or sensitization of peripheral and central nervous system neurons. This study aimed to assess the occurrence of secondary thermal hyperalgesia in patients with symptomatic irreversible pulpitis (SIP).

METHODS

The cold sensitivity test (visual analog scale) was performed for the tooth with SIP, its adjacent sound tooth, the same sound tooth in the opposite jaw, and the contralateral sound tooth in the opposite quadrant of the same jaw. Next, the tooth with SIP underwent root canal treatment, and 3 weeks later, after complete elimination of pain, the teeth underwent cold sensitivity testing again.

RESULTS

A total of 64 patients, including 41 women and 23 men 18-65 years old, were evaluated in this study. The response to the cold sensitivity test significantly decreased in the tooth with SIP (P < .001), its adjacent sound tooth (P < .001), and the same sound tooth in the opposite jaw (P = .004) but not in the contralateral sound tooth in the opposite quadrant of the same jaw (P = .45) after endodontic treatment. No significant difference was noted between men and women in the groups (P > .05).

CONCLUSIONS

Hypersensitivity to cold test due to pulpal inflammation can also result in exaggerated response of the adjacent sound tooth and the same tooth in the opposite jaw to cold sensitivity test; these observations can be explained by the central and peripheral sensitization mechanisms.

Irisin Peptide Protects Brain Against Ischemic Injury Through Reducing Apoptosis and Enhancing BDNF in a Rodent Model of Stroke

Evidence has shown therapeutic potential of irisin in cerebral stroke. The present study aimed to assess the effects of recombinant irisin on the infarct size, neurological outcomes, blood-brain barrier (BBB) permeability, apoptosis and brain-derived neurotrophic factor (BDNF) expression in a mouse model of stroke. Transient focal cerebral ischemia was established by middle cerebral artery occlusion (MCAO) for 45 min and followed reperfusion for 23 h in mice. Recombinant irisin was administrated at doses of 0.1, 0.5, 2.5, 7.5, and 15 µg/kg, intracerebroventricularly (ICV), on the MCAO beginning. Neurological outcomes, infarct size, brain edema and BBB permeability were evaluated by modified neurological severity score (mNSS), 2,3,5-triphenyltetrazolium chloride (TTC) staining and Evans blue (EB) extravasation methods, respectively, at 24 h after ischemia. Apoptotic cells and BDNF protein were detected by TUNEL assay and immunohistochemistry techniques. The levels of Bcl-2, Bax and caspase-3 proteins were measured by immunoblotting technique. ICV irisin administration at doses of 0.5, 2.5, 7.5 and 15 µg/kg, significantly reduced infarct size, whereas only in 7.5 and 15 µg/kg improved neurological outcome (P < 0.001). Treatment with irisin (7.5 µg/kg) reduced brain edema (P < 0.001) without changing BBB permeability (P > 0.05). Additionally, irisin (7.5 µg/kg) significantly diminished apoptotic cells and increased BDNF immunoreactivity in the ischemic brain cortex (P < 0.004). Irisin administration significantly downregulated the Bax and caspase-3 expression and upregulated the Bcl-2 protein. The present study indicated that irisin attenuates brain damage via reducing apoptosis and increasing BDNF protein of brain cortex in the experimental model of stroke in mice.

Management of an Endodontic-Periodontal Lesion in a Maxillary Lateral Incisor with Palatal Radicular Groove: A Case Report

The radicular groove is a developmental anomaly that predisposes the tooth to periodontal break-down. Sometimes the situation becomes more complicated by pulp necrosis and development of a combined endodontic-periodontal lesion which is a diagnostic and treatment challenge for the clinician. This report presents the successful management of an endodontic-periodontal lesion in a maxillary lateral incisor that has a developmental palatal radicular groove using a combination of nonsurgical endodontic therapy and periodontal regenerative techniques.

CONCLUSION

The combination of nonsurgical endodontic and periodontal regenerative treatment is a predictable method in treating combined endodontic-periodontal lesions caused by palato-gingival groove.

Improvement of tissue survival of skin flaps by 5α-reductase inhibitors: possible involvement of nitric oxide and inducible nitric oxide synthase

Background:

Skin flap grafting is a popular approach for reconstruction of critical skin and underlying soft tissue injuries. In a previous study, we demonstrated the beneficial effects of two 5α-reductase inhibitors, azelaic acid and finasteride, on tissue survival in a rat model of skin flap grafting. In the current study, we investigated the involvement of nitric oxide and inducible nitric oxide synthase (iNOS) in graft survival mediated by these agents.

Methods:

A number of 42 male rats were randomly allocated into six groups: 1, normal saline topical application; 2, azelaic acid (100 mg/flap); 3, finasteride (1 mg/flap); 4, injection of L-N^G-nitroarginine methyl ester (L-NAME) (i.p., 20 mg/kg); 5, L-NAME (20 mg/kg, i.p.) + azelaic acid (100 mg/flap, topical); 6, L-NAME (20 mg/kg, i.p.) + finasteride (1 mg/flap, topical). Tissue survival, level of nitric oxide, and iNOS expression in groups were measured.

Results:

Our data revealed that azelaic acid and finasteride significantly increased the expression of iNOS protein and nitric oxide (NO) levels in graft tissue (P < 0.05). These increases in iNOS expression and NO level were associated with higher survival of the graft tissue.

Conclusion:

It appears that alterations of the NO metabolism are implicated in the azelaic acid- and finasteride-mediated survival of the skin flaps.

Sealing ability of mineral trioxide aggregate and calcium-enriched mixture cement as apical barriers with different obturation techniques

INTRODUCTION

Endodontic treatment in pulpless immature teeth is challenging due to the lack of an apical stop. Insertion of an apical plug is an alternative to conventional long-term apexification with calcium hydroxide. The aim of this study was to compare the apical microleakage of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as apical plugs with three different obturation techniques.

METHODS AND MATERIALS

This experimental study was conducted on 130 single rooted human teeth with one canal. Samples were randomly divided into 2 experimental groups (n=60) and two negative and positive control groups containing 5 samples each. After cleaning and shaping, an open apex configuration was prepared in all samples. MTA or CEM cement apical plugs with 5 mm thicknesses were placed. Then, each group was divided to 4 subgroups and the remaining space of root canals were filled with either lateral compaction or thermoplasticized injectable gutta-percha or was obturated by filling the entire canal with apical plug material. In one remaining subgroup the canal space was left unfilled. Microleakage was measured by the fluid filtration method and results were analyzed by means of the two-way ANOVA test.

RESULTS

There were no significant differences between microleakage of MTA and CEM cement apical plugs (P=0.92). The difference between three obturation methods was not significant, either (P=0.39).

CONCLUSION

MTA and CEM cement have similar sealing ability as apical plugs and no significant difference was found in microleakage of the three groups.

Serum level of homocysteine, folate and vitamin-B12 in epileptic patients under carbamazepine and sodium valproate treatment: a systematic review and meta-analysis

Background

Numerous studies have shown that long term treatment with anticonvulsants may be an important risk factor for the onset of atherosclerosis, or worsening of its symptoms. There are many contradictory reports regarding these effects.

Objectives

We performed a systematic review and meta-analysis of the published studies in order to see whether the atherogenic outcomes could be related to any serum biochemical abnormalities.

Materials and Methods

Published articles indexed in PubMed, ISI web of science, Science Direct and Scopus databases from 1990 to 2011 were retrieved using a comprehensive search strategy. After omitting the unrelated articles and duplicates, articles met the eligibility criteria for critical appraisal were included in the analysis. Data were summarized in standard data abstraction forms and subjected to analysis by STATA software.

Results

Finally, ten published studies were included in the meta-analysis. Results showed that carbamazepine and sodium valproate consumption are associated with a significant elevation of the serum homocysteine levels. On the other hand, medication with carbamazepine is associated with a reduction of the level of folate in the serum and that of sodium valproate is associated with a reduction of serum level of vitamin B12.

Conclusions

According to the results of this study, as carbamazepine and valproate sodium consumption can result in elevated serum levels of homocysteine and decreased levels of folate and vitamin B12, and the atherogenic effect of increased serum homocysteine level is well established, the patients under these medications should be monitored for possible atherogenic effects.

BCL-2 and Bax Expression in Skin Flaps Treated with Finasteride or Azelaic Acid

Despite all modern surgical techniques, skin flap that is considered as the main method in most reconstructive surgeries puts the skin tissue at danger of necrosis and apoptosis derived from ischemia. Therefore, finding a treatment for decreasing the apoptosis derived from flap ischemia will be useful in clinic. In present study, we evaluated the effect of azelaic acid 20% and finasteride on expression of BCL-2 and bax proteins after the skin flap surgery. For this purpose, 21 rats were entered in three groups including control, azelaic acid 20% and finasteride, all experienced skin flap surgery and then flap tissue was assessed for determining the expression of proteins in 5 slices prepared from each rat that were graded between - to +++ scales. Both azelaic acid and finasteride increased the expression of BCL-2 protein (p < 0.05) and decrease the expression of bax protein (p < 0.05). These results suggested an antiapoptotic role for finasteride and azelaic acid in preserving the flap after the ischemia reperfusion insult.

Determination of free L-carnitine levels in type II diabetic women with and without complications

BACKGROUND

Studies on the determination of carnitine levels and nutritional status in patients of type II diabetes.

OBJECTIVE

We designed this study to determine changes of serum-free L-carnitine in type II diabetic women.

DESIGN

A cross-sectional study (case-control study).

SETTING

Clinical of Endocrinology and Metabolism, Sina Hospital, Pharmacological Research Center, Tabriz Medical university, Iran.

PATIENTS AND METHODS

Taking into account the importance of the control of diabetes, in the present case-control study, the levels of serum-free L-carnitine, blood glucose and lipids, systolic and diastolic blood pressure, body mass index (BMI) and nutritional status assessed in the case and control groups which were selected by the simple sampling method. The control group (n=18) included patients with no complications and the case group (n=33) was grouped into three subgroups including patients with retinopathy, hyperlipidemia and neuropathy.

RESULTS

Study results indicated that the mean serum-free L-carnitine concentration in the case group was significantly lower than its mean concentration level in the control group, 39.63+/-8.99 vs 53.42+/-0.93 micromol/l, respectively (P<0.001). Serum-free L-carnitine in retinopathy, hyperlipidemia and neuropathy case subgroups were 39.03+/-9.89, 39.63+/-8.99 and 40.44+/-12.50 micromol/l, respectively (P>0.05). No significant difference was found between the serum-free carnitine levels of the case subgroups. The mean blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol levels and systolic and diastolic blood pressure were significantly higher in the case group than in the control group.

CONCLUSION

In this study, the mean serum-free L-carnitine levels in diabetic patients with complications was almost 25% lower than in diabetic patients with no complications. On the basis of the study results, carnitine supplementation in diabetic patients, especially in patients with diabetes complications, might be useful.