Periodontal Disease in Patients with Ischemic Stroke - an Exploratory Study.

Objective: The aim of this study was to assess the periodontal disease parameters in patients with ischemic stroke. Materials and methods: The study included 21 patients with ischemic brain stroke and a control group that was matched in number, age, and gender. All participants underwent a standard periodontal examination. The inclusion criterion of this study was the presence of at least 15 teeth. Periodontal epithelial surface area, periodontal inflamed surface area (PISA), and periodontal disease stage were determined. All participants were given a questionnaire to determine oral health-related quality of life (OHQL). Stroke risk factors were assessed. Results: Stroke patients had a significantly higher OHQL score than the control group (20.81 vs. 12.57) and a full-mouth plaque score (FMPS, 27.57 vs. 16.83), while full-mouth bleeding score (FMBS) was significantly higher in the control group than in the hospital group (10.17 vs. 6.42). For PISA, statistically significant negative correlations were found for smoking, cholesterol levels, and LDL levels, while significant positive correlations were found for FMBS, clinical attachment level and probing depth. Conclusion: Although PISA does represent the amount of periodontal tissue that is inflamed, tooth loss due to advanced periodontal disease combined with oral hygiene limitations imposed by the hospital setting and the stroke recovery process remain the most significant obstacles for a more meaningful understanding of the data represented by specific clinical, laboratory and various demographic parameters that characterize the two diseases.

Sociodemographic Determinants and Common Reasons for Visiting the Emergency Dental Service in the City of Zagreb.

OBJECTIVE: The objective of the study was to determine the sociodemographic and clinical parameters of patients who visit the emergency dental service and their most common diagnoses. MATERIALS AND METHODS: The data were collected on the basis of a survey filled out by patients. A total of 1730 out of 6732 patients (26%) were surveyed using a questionnaire to analyze sociodemographic status, dental visits, the description and dynamics of the symptoms. After the data collection, methods of descriptive data presentation and of inferential statistics were made in SPSS. RESULTS: Survey results show that most subjects (60.4%) came during the weekends and holidays. The subjects, 73.1% of them, stated that they had already used this type of service, and 65.8% did not visit their dentist beforehand. The largest number of subjects (62.2%) reported that they needed emergency service within a week after their problems had begun. The most common diagnoses included face and jaw abscesses (27.3%). There is a statistically significant difference between the number of patients who went to the emergency dental service and completed the questionnaire over the course of several months contrary to patients who were there in May and June (59.7%) compared to July and August (40.3%). CONCLUSIONS: Most subjects had clear indications for being referred to an emergency dental service. Most of the emergency conditions were mainly due to irregular visits to the dentist. Patient education and preventive programs would probably have reduced the number of visits.

5-azacytidine enhances proliferation in transplanted rat fetal epiglottis.

Fetal rat epiglottis and its developmental potential in ectopic transplants under the influence of the epigenetic drug was investigated. Epiglottises from 17-days-old rat embryos were transplanted under kidney capsules of adult rats for 14 days. 5-azacytidine (5 mg/kg) was injected intraperitoneally during first three days and controls were sham treated. TEM, immunohistochemical detection and quantitative stereological analysis of the Proliferating Cell Nuclear Antigen (PCNA) expression (numerical density N(v)) were performed. Typical chondroblasts with long surface processes and sparse lipid droplets were found in fetal epiglottis and chondrocytes with shorter processes, numerous lipid droplets and elastic fibers in adult. PCNA was expressed in almost all cells of the fetal epiglottis while in the adult it was expressed in minority of cells. In transplants, differentiation progressed towards the differentiation found in the adult. Application of 5-azacytidine increased the capacity for proliferation (N(v PCNA)) in comparison to controls but no difference in differentiation was observed. Data about the developmental potential and induction of proliferation in mammalian epiglottis by epigenetic modulation is of importance for regenerative medicine.

Development of epithelia in experimental teratomas derived from rodent embryos.

Investigation of developmental potential of various embryonal tissues is important for design of new approaches to regenerative medicine aimed at supplementing tissues damaged by trauma or disease. Rodent embryos have been extensively used in experiments designed for investigation of developmental potential to give rise to various types of epithelia such as superficial epithelia, neuroepithelium and sometimes even malignantly transformed epithelium in teratoma-like structures. These experiments have been done in vitro, in transplants in vivo and by combined in vitro-in vivo methods.

Development of epithelia in the ectopic transplant of the fetal rat epiglottis.

Embryonic in situ development is strictly regulated within the specific microenvironment of developing tissues. However, for regenerative medicine purposes (supplementation of damaged tissues/organs), transplantation to ectopic sites has been considered. To investigate developmental potential of fetal epiglottic epithelia at an ectopic site, fetal epiglottis was transplanted under the kidney capsule and its development compared to fetal and adult epiglottis. Seventeen-day-old Fischer rat epiglottides were microsurgically isolated under a dissecting microscope and transplanted under the kidney capsule of adult males. After 14 days, classic histology and immunohistochemical detection of the Proliferating Cell Nuclear Antigen (PCNA) were done in isolated and accordingly fixed transplants. The 17-day-old fetal epiglottis and adult epiglottis were processed in the same way. The 17-day-old fetal epiglottides were covered with immature epithelium expressing PCNA in almost all cells. Adult epiglottis was covered with two types of epithelia (stratified squamous epithelium and ciliated pseudostratified epithelium). In the stratified squamous epithelium PCNA was abundantly expressed in the basal cell layer and absent from more superficial and more differentiated cells. Transplants survived well during the experimental period. On their surface ciliated pseudostratified epithelium could be easily recognized, but squamous epithelium was almost absent. PCNA was expressed in basal cells of the ciliated pseudostratified epithelium and was absent from the more differentiated superficial cells. It seems that at this ectopic site further differentiation of the epiglottic epithelia can proceed but differentiation of squamous epithelium seems not to be favored. It seems that this ectopic site is optimal for further differentiation of the epiglottic epithelium towards ciliated pseudostratified epithelium.

Differentiation of epiglottal epithelia during prenatal and postnatal human development.

Differentiation of epiglottal epithelia during human development was for the first time investigated by the light microscopy and documented in celoidine collection of human embryos from the Archive of the Department of Histology and Embryology, School of Medicine University of Zagreb, Croatia. At 6 weeks epiglottal swelling was found to be covered by a simple squamous epithelium consisting of a single layer of cells. At 8 weeks epithelium changed to a two-layered cuboidal epithelium which at the end of the 8th week transformed to multilayered columnar epithelium without cilia and goblet cells. In the one-day-old newborn, the majority of epiglottis was found to be covered by the mature ciliated columnar pseudostratified epithelium with goblet cells while only a minor part of the oral surface next to the tongue by the stratified squamous epithelium. This unexpected finding is in contrast to the domination of the stratified squamous epithelium found at the age of 13 years and in 35-years-old adult. Reversal of proportion covered by different types of epithelia between birth and puberty /adulthood is probably connected to the establishment of the air-flow which could be stimulating for differentiation of stratified squamous epithelium.