Connective tissue growth factor in human gingiva, and studies of lysyl oxidase processing proteinases

Thesis (D.Sc.D)--Boston University, Henry M. Goldman School of Dental Medicine, 2001 (Oral Biology)Includes bibliographical references (leaves 67-86).The first part of our studies is focused on gingival overgrowth. Gingival overgrowth is characterized by excess extracellular matrix (ECM) accumulation. TGF-J31 regulation of connective tissue growth factor (CTGF) was assessed for the first time in human gingival cells and tissues. CTGF protein is strongly induced by TGF-J31 in human gingival fibroblasts. Exogenous addition of CTGF to gingival fibroblasts stimulates production of lysyl oxidase enzyme activity up to 1.5-fold after 48 hours, and 50 ng/ml CTGF stimulated insoluble collagen accumulation by only 1.5 to 2.0 fold after 4 to18 days of treatment. Thus, although CTGF itself contributes to increased insoluble collagenous extracellular matrix accumulation, CTGF does not mediate more potent effects of TGF-J31. Gingival overgrowth samples obtained from patients undergoing therapy with phenytoin, nifedipine, and cyclosporin A and control tissues from systemically healthy donors were subjected to immunohistochemistry by staining with CTGF, and TGF-J3 l antibodies. The results indicate for the first time increased levels of CTGF protein in overgrown gingival tissues, particularly in phenytoin induced gingival overgrowth. The second part of our studies is focused on the Bmpl-related genes. The Bmpl gene encodes bone morphogenetic protein 1 (BMP-1) and mammalian Tolloid-like (mTLD), both of which have procollagen C-proteinase activity. Two BMP-1/mTLD­related protease genes named mammalian Tolloid-like 1 and 2 (Till and Tll2) have recently been described. The present study determines and compares the abilities of recombinant BMP-1, mTLD, mTLL-1, and mTLL-2 to process a recombinant pro-lysyl oxidase fusion protein in vitro. Results suggest that recombinant BMP-1, mTLD, and mTLL-1 productively cleave pro-lysyl oxidase at the correct physiological site in vitro, and that BMP-1 itself appears to be the most efficient lysyl oxidase processing activity while mTLL-2 was shown to process pro-lysyl oxidase slowly in vitro. These studies suggest that pro-lysyl oxidase processing may depend principally on the presence of Bmpl gene products, and that mTLL-1, and mTLL-2 may contribute to pro-lysyl oxidase processing

Intraocular Hemorrhage due to use of Sildenafil in a Patient with Diabetes

Sildenafil is one of the most commonly used drugs for sexual dysfunction or to increase libido, and it regulates endothelial nitric oxide synthase enzyme via selective phosphodiesterase-V inhibition. Sildenafil can be easily obtained without a medical indication or prescription yet it is not considered as a completely safe medication. Hemoptysis and hemorrhagic stroke are some important adverse effects of sildenafil. The case of the current report was a 67-year-old diabetic patient with simultaneous anterior and posterior segment hemorrhage after the use of 100 mg sildenafil citrate. Anterior chamber clearance and pars plana vitrectomy were performed for the patient because the hyphema and vitreous hemorrhage did not resolve during the follow-up period. There are very limited data available in the literature suggesting an increase in the risk of hyphema or vitreous hemorrhage due to the use of sildenafil. This is the first report that reveals the bleeding effect of sildenafil use in a patient with type 2 diabetes

The Relationship of Neutrophil to Lymphocyte Ratio with Vitreomacular Traction Syndrome

This study was conducted to reveal the role of systemic low-grade inflammation by calculating the Neutrophil/Lymphocyte Ratio (NLR) in Vitreomacular Traction Syndrome (VMTS) of different etiologies. A retrospective examination was made of the medical records at a tertiary referral hospital. The study included 31 patients with diabetic VMTS, 27 patients with idiopathic VMTS, and 35 healthy subjects as the control group. The White Blood Cell (WBC) counts and Neutrophil-to-Lymphocyte Ratio (NLR) was compared. There were  insignificant differences between the groups in terms of mean age and female/male ratio (P>0.05). The mean ± Standard Deviation (SD) of NLR was calculated as 2.43 ± 0.83 in the diabetic VMTS group, 2.38 ± 0.96 in the idiopathic VMTS group, and 1.83 ± 0.52 in the control group (P=0.007). The values of the diabetic and idiopathic VMTS groups were significantly higher than those of the control group (P=0.002 and P=0.032, respectively). However, differences between the diabetic and idiopathic VMTS groups were insignificant (P=0.651). This study found significantly higher NLR in patients with diabetic and idiopathic VMTS than the control group. Elevated NLR could therefore be a potential indicator of VMTS, irrespective of the etiology

Bulk Fill Kompozit Rezinin Farklı Tekniklerle Uygulanmasının Mikrosızıntı Ve Mikrosertlik Üzerine Etkisinin Değerlendirilmesi

Introduction: The aim of the study was to compare microleakage and microhardness properties of bulk-fill composite resin (Tetric Evo Ceram Bulk-Fill IVW and IVB, Ivoclar/Vivadent, Liechtenstein) following bulk and incremental insertion techniques. Methods: Class I cavities (4X4X4mm) were prepared in 28 intact caries-free third molars and restored incrementally with horizontal layers of 2mm and bulk technique of 4mm thickness, respectively. To test the microleakage, the teeth were subjected to basic fuchsine dye penetration. They were subsequently sectioned buccolingually. Microleakage was evaluated under stereomicroscope and microhardness was measured by Vickers microhardness test (Shimadzu HMV-2, Japan) on sectioned surfaces of 1-2-3mm depths and analyzed statistically. Results: There was no significant difference among microleakage scores between bulk and incremental insertion techniques (ANOVA p;gt;0.05). In microhardness tests, there was no significant difference between the two shades (IVW, IVB) (ANOVA p;gt;0.05). There was a statistically significant difference in microhardness through the material among 1, 2 and 3 mm depths when bulk insertion technique was used (p;lt; 0.05). Conclusion: Microleakage findings revealed that there was no difference among insertion techniques on shrinkage of the material. There was a statistically significant difference on microhardness through the bulk filled insertion of the tested composite resin.Amaç: Bu çalışmanın amacı tek tabaka ve tabakalama tekniğiyle uygulanan bulk-fill kompozit rezinin (Tetric Evo Ceram Bulk-Fill; IVW ve IVB, Ivoclar/Vivadent, Liechtenstein) mikrosızıntı ve mikrosertlik özelliklerinin karşılaştırılmasıdır. Yöntem: Çekilmiş 28 adet çürüksüz üçüncü molar diş üzerinde hazırlanan Sınıf I kaviteler (4X4X4mm) sırasıyla 2 ve 4 mm'lik tabakalar halinde iki farklı renkte rezin kompozitle restore edildi. Mikrosızıntı testi için dişler bazik fuksin kullanılarak boya penetrasyonuna tabi tutuldu. Restore edilen dişler daha sonra bukko-lingual yönde ortadan ikiye separe edildi. Mikrosızıntı, stereomikroskop kullanılarak x20 büyütmede değerlendirildi. Separe edilen diş parçaları akrilik rezin bloklara yerleştirildi ve uygulanan kompozitin 1-2-3 mm derinliklerinde mikrosertlik testi gerçekleştirildi ve elde edilen verilere istatistiksel analiz uygulandı (Wilcoxon Signed Ranks Test, ANOVA, Bonferroni). Bulgular: Mikrosızıntı testinde tek tabaka ve tabakalama tekniği arasında istatistiksel anlamlı fark görülmedi (p>0.05). Mikrosertlik testinde iki farklı renk (IVW, IVB) kompozit rezin restorasyon arasında benzer şekilde istatistiksel anlamlı fark belirlenmedi (p>0.05). Tek tabaka halinde uygulanan kompozit rezin restorasyonlarda 1,2 ve 3 mm derinliklerinde üst tabakadan alt tabakalara doğru azalan mikrosertlik değerleri arasında istatistiksel olarak anlamlı fark belirlendi (p 0.05). Sonuç: Mikrosızıntı bulguları, farklı uygulama tekniklerinin kompozit rezin materyalin büzülmesi üzerine etkisinin olmadığını ortaya çıkardı. Mikrosertlik bulgularına göre, tek tabaka uygulanan kompozitlerin istatistiksel olarak anlamlı sertlik farklılıklarının olduğu görülmüştür

Evaluation of Risk Factors in Caries Formation in Children

Background/Aim: The aim of this study was to evaluate the risk factors in caries formation and relationships between each other in children