ABSTRACT
The purpose of this article is to report the orthodontic treatment of a patient with extremely delayed development of the maxillary lateral incisors. At 7 years of age, the boy's permanent maxillary lateral incisors had not erupted. A radiograph showed no tooth germs in place, although well-defined radiolucent areas were evident. Removal of the radiolucent areas was contemplated, but it was rejected in favor of a conservative approach. At age 13, peg-shaped maxillary lateral incisors erupted; they were positioned during orthodontic treatment and reshaped with composite restorations, providing good esthetics and function.
Subject(s)
Dental Restoration, Permanent , Incisor/physiopathology , Tooth Abnormalities/physiopathology , Tooth Eruption , Tooth, Deciduous/abnormalities , Cephalometry/statistics & numerical data , Child , Dental Restoration, Permanent/methods , Fused Teeth , Humans , Incisor/abnormalities , Labial Frenum/abnormalities , Labial Frenum/surgery , Male , Palatal Expansion Technique , Tooth Abnormalities/rehabilitation , Tooth, Unerupted/physiopathologySubject(s)
Acute Kidney Injury/surgery , Graft Rejection/pathology , Hemorrhage/prevention & control , Kidney Transplantation , Kidney/pathology , Acute Kidney Injury/complications , Adult , Biopsy/methods , Catheterization, Peripheral , Hemorrhage/complications , Humans , Jugular Veins , Male , Transplantation, HomologousABSTRACT
Several studies have implicated the angiogenic cytokine vascular endothelial growth factor (VEGF) in the development of diabetic nephropathy, but no data are available about its local activity during human disease. Glomeruli from 52 archival biopsies from type II diabetics were evaluated and compared to 10 renal biopsies without kidney disease (controls). Glomerulosclerosis, capillary rarefaction, glomerular and endothelial cell proliferation, apoptosis, VEGF expression, as well as receptor-bound VEGF indicating local VEGF activity, and phosphorylation of the signal transduction molecule Akt were investigated. Owing to substantial heterogeneity of glomerular lesions in individual biopsies, these parameters were correlated with the degree of injury in individual glomeruli rather than biopsies. Severe glomerular capillary rarefaction was linked to the degree of glomerulosclerosis. While cellular apoptosis was detected independent of the stage of injury, endothelial cell proliferation indicating capillary repair was markedly increased only in mildly/moderately injured glomeruli. In controls, VEGF was predominantly expressed in podocytes, whereas receptor-bound VEGF was confined to the glomerular endothelium. VEGF expression was increased in all diabetic glomeruli by many different cell types. In contrast, VEGF receptor activation was increased predominantly in the endothelium of only mildly injured glomeruli, but significantly decreased in more severely injured glomeruli. Diabetic nephropathy is associated with glomerular capillary rarefaction. Despite overall increased glomerular VEGF, the decreased receptor-bound VEGF on the endothelium may be an indicator of an insufficient capillary repair reaction.
