Tip Of Papilla Research Articles

Topography, Composition and Structure of Incipient Randall Plaque at the Nanoscale Level

Randall identified calcium phosphate plaques in renal papillae as the origin of kidney stones. However, little is known about the early steps of Randall plaque formation preceding the onset of urolithiasis. Our objective was to characterize the composition and the initial formation site of incipient Randall plaque in nonstone forming, living patients. Median patient age was 67.7 years. A total of 54 healthy papillae from kidneys removed for cancer and without stones were analyzed by immunohistochemistry and von Kossa staining, field emission-scanning electron microscopy with energy dispersive x-ray analysis, μ-Fourier transform infrared spectroscopy, cryo-transmission electron microscopy coupled to selected area electron diffraction and electron energy loss spectroscopy. Incipient Randall plaque was observed in 72.7% of kidneys. As expected, carbonated apatite was the main component of microcalcifications but amorphous calcium phosphate and whitlockite were identified in 80% and 40% of papillae, respectively. Incipient plaques were noted in the deepest part of the papillae around the loop of Henle tip as well as around the vasa recta, representing 62.4% and 37.2% of microcalcifications, respectively. Plaques were rarely close to collecting ducts. At the nanoscale level incipient calcifications were often composed of several nanocrystals in organic material that looked like microvesicles. Incipient Randall plaque is frequent. It appears not only at the extreme tip of the renal papillae around the hairpin structure of the loop of Henle but also around the vasa recta. Nanoscale analyses suggest a local nucleation process promoting nanocrystal growth in a supersaturated milieu. In addition, plaques contain various calcium and magnesium phosphates, and not only carbonated apatite.

Analgesic Nephropathy–-A Painful Progression

One of the dreaded complications of long term analgesic intake is nephrotoxicity characterized by chronic interstitial nephritis and papillary necrosis. Much of the literature of its epidemiology dates back to 1960s and its impact on present day society is not well documented. Non steroidal anti inflammatory agents reduce pain by blocking prostaglandin generation. Prostaglandins have renal vaso dilatory effects in states of volume depletion to counteract the vasoconstrictive pressor hormones. Earlier analgesic tablets contained a mixture of aspirin, phenacetin and caffeine. Phenacetin and its metabolites have nephrotoxic potential and incidence of analgesic nephropathy was brought down in countries where it was banned. The concentration of phenacetin and its metabolite acetaminophen is increased at the tip of renal papilla due to counter current concentrating mechanism of the loop of henle. These are potent oxidants leading to cell injury due to lipid peroxidation, though their effects are normally counterbalanced by anti oxidant glutathione. Glutathione deficiency at the medulla can be precipitated by co ingestion of aspirin. The exact dose of analgesics which needs to be ingested is unclear but a daily ingestion of 5–8 tablets over 5 years results in clinical nephrotoxicity. The histopathology is one of chronic interstitial nephritis with renal fibrosis. Clinically the patient presents with polyuria, asthenia and anemia. The diagnosis is suspected in a patient with progressive chronic kidney disease without proteinuria. CT imaging of the kidneys show irregular scarred kidneys with papillary calcification and necrosis. Recently, COX-2 inhibitors are promoted as renal safe drugs, but may not be so given the multiple case reports of renal toxicity in post marketing surveys. The treatment of analgesic nephropathy includes discontinuation of offending drug, protein restricted diet, control of blood pressure and statins. In conclusion analgesic nephropathy is a preventable cause of chronic kidney disease and both the patients and treating physicians should be mindful of the potential nephrotoxcity of nonsteroidal anti inflammatory agents when administered for prolonged periods without monitoring renal function.

Evaluation of Proportion between Incisal Edge to Gingival Zenith Distance and Interdental Papilla in Maxillary Anterior Dentition of Indian Population.

Not many investigations have evaluated the relationship between the height of the interdental papillae, gingival zenith and maxillary anterior teeth. The assessment of these parameters can aid in fabricating definitive aesthetic restoration. The aim of this study was to evaluate the existence of proportional ratio between the incisal edge to gingival zenith (HGZ) and the tip of the interdental papilla (HIP) in maxillary anterior teeth for Indian population. One hundred healthy volunteers with an average age of 25-30 years comprised the evaluation group. Impression was made using irreversible hydrocolloid impression material and type IV Dental stone cast was made. A calibrated digital caliper measured the distance between HGZ and HIP. The values for all six maxillary teeth were recorded and the proportional ratio was evaluated and statistically analysed. The mean ratio between HGZ and HIP of all maxillary anteriors in 1(st) and 2(nd) quadrant was 1.80, 1.71, and 2.03 in central incisor, lateral incisor and canine respectively with p-value > 0.9. The mean proportional measurements for maxillary anterior teeth were determined and no definitive proportion existed between HGZ and HIP of maxillary anterior teeth.

Randall’s plaque and kidney stones: Recent advances and future challenges

Alexander Randall described eight decades ago a heterogeneous nucleation process at the tip of renal papillae giving birth to calcium oxalate stones. Kidney stones were for the first time described to originate from calcium phosphate plaques growing in the interstitial tissue, breaking urothelium and then promoting calcium oxalate crystals aggregation at their contact. During the next decades, few studies were dedicated to these Randall's plaques but the increasing incidence of calcium oxalate kidney stones, the development of endoscopic procedures allowing plaques visualization and series evidencing the high proportion of calcium oxalate stones generated on these plaques renewed interest in Randall's plaque. Although some progress has been carried during the past two decades, the origin of Randall' plaques, their composition, their role in kidney stones epidemic, their specific affinity for some crystalline phases, and their potential deleterious effects in kidney tissues are among the challenges that lie ahead.

Anatomy of the pallial tentacular organs of the scallop Nodipecten nodosus (Linnaeus, 1758) (Bivalvia: Pectinidae)

Tentacular organs comprise a variety of body projections that have specialized functions in several invertebrate phyla. In bivalve mollusks, tentacles of the mantle margin serve sensorial and secretory functions involved in predator detection and interactions with the surrounding environment. However, their morphological diversity, detailed anatomy, and functional roles have only been scarcely investigated. Bivalves from the family Pectinidae are of particular interest in this context given the diversity of pallial tentacles, including distinct tentacle types arising on different mantle folds, and even eye-bearing tentacles. Combining several microscopy techniques, the present study investigates the anatomy of tentacular organs in postmetamorphic stages (juveniles and adults) of the scallop Nodipecten nodosus (Linnaeus, 1758). Scallop tentacles are formed shortly after metamorphosis, and except for pigmentation, they grow with no major morphological modifications. Tentacular organs of N. nodosus comprise eye-bearing and short and long tentacles from the middle mantle fold as well as velar tentacles from the inner fold. Although all tentacle types share a common basic structure (i.e., ciliated epithelium, peripheral muscle bundles, and a central nerve), they exhibit marked differences in ciliary distribution, epithelial secretory activity, and type of muscle fibers. Cilia distribution at the distal tip of sensory papillae represents a unique condition for the long tentacles from the middle mantle fold, and mucous secretion is restricted to the middle fold tentacles (except for eyestalks). Strikingly, velar tentacles and middle fold tentacles exhibit striated and non-striated myofibers, respectively. The data presented herein are discussed in light of the functional anatomy of the bivalve mantle margin.

Evaluation of the association between embrasure morphology and central papilla recession by radiographic method.

The objective of this study was to evaluate the association between embrasure morphology and central papilla recession. The central papilla was assessed in 372 adults using standardized periapical radiographs of the maxillary central incisors. The following vertical distances were measured: h1, papilla tip to contact point (PT-CP); h2, proximal cementoenamel junction to contact point (pCEJ-CP); h3, bone crest to contact point (BC-CP); and h4, bone crest to papilla tip (BC-PT). Vertical lines were measured along the long axis of the tooth. Horizontal distance was measured as w2 (distance between the two central incisors at the proximal CEJ level, ie, the interdental width). All participants were divided into four groups according to their w2 and h2 measurements: narrow-long (w2 ≤ 2 mm and h2 > 4 mm), narrow-short (w2 ≤ 2 mm and h2 ≤ 4 mm), wide-long (w2 > 2 mm and h2 > 4 mm), and wide-short (w2 > 2 mm and h2 ≤ 4 mm). A statistically significant positive relationship was evident between central papilla recession and age, and a statistically significant negative relationship was evident between age and papilla height in all study groups. The study found that occurrence of central papilla recession is significantly related to age with a wide interdental width and long pCEJCP distance. However, other factors also determine whether the interdental papilla is present or not, and further study of the interaction among these factors is warranted.

DERMATITE HERPETIFORME EM IDADE PEDIÁTRICA – UM DIAGNÓSTICO A TER EM CONTA

Introdução: A Dermatite herpetiforme é uma dermatose crónica, pruriginosa e polimórfica considerada o equivalente cutâneo da doença celíaca. Na população pediátrica é, com frequência, um diagnóstico difícil de evocar, quer pela sua raridade quer pelo polimorfismo das lesões cutâneas.Caso Clínico: Apresentamos um doente do sexo masculino de 8 anos, com lesões polimorfas nas superfícies extensoras dos membros evoluindo há 2 anos. A biopsia cutânea lesional demonstrou neutrófilos nas papilas dérmicas e a imunofluorescência directa peri-lesional revelou depósitos granulosos de IgA nas papilas dérmicas, estabelecendo o diagnóstico de dermatite herpetiforme. Estudo complementar subsequente confirmou a associação a doença celíaca e a adopção de uma dieta sem glúten levou à resolução clínica cutânea e da enteropatia.

Randall's plaque as the origin of calcium oxalate kidney stones.

Eight decades ago, Alexander Randall identified calcium phosphate deposits at the tip of renal papillae as the origin of renal calculi. The awareness that these "Randall's plaque" promote renal stone formation has been amplified during the past years by the development of endoscopic procedures allowing the in situ visualization of these plaques. Recent studies based upon kidney biopsies evidenced that apatite deposits at the origin of these plaque originate from the basement membranes of thin loops of Henle and then spread in the surrounding interstitium. In addition, scanning electron microscopy examination of calcium oxalate stones developed on Randall's plaque evidenced that plaque may also be made of tubules obstructed by calcium phosphate plugs. Hypercalciuria has been associated to Randall's plaque formation. However, several additional mechanisms may be involved resulting in increased tissular calcium phosphate supersaturation and the role of macromolecules in plaque formation remains elusive. At last, apatite crystals are the main mineral phase identified in plaques, but other calcium phosphates and various chemical species such as purines have been evidenced, revealing thereby that several mechanisms may be responsible for plaque formation.

Increase in collecting duct basal:apical AQP2 protein expression ratio with increasing depth along the corticopapillary axis positively correlates with maximum urine concentrating capacity in the kangaroo rat and Sprague‐Dawley rat (1137.2)

Our goal is to investigate the role of aquaporin 2 (AQP2) membrane expression in inner medullary (IM) collecting ducts (CD) relative to the urine concentrating mechanism by comparing basal‐to‐apical (B:A) AQP2 ratios of kangaroo rats (KR) with control and water‐restricted Sprague‐Dawley (SD). Previous studies have shown that vasopressin increases IMCD transepithelial water permeability, with apical AQP2 considered rate‐limiting, while in MCDK cells AQP2 is translocated to the basal membrane with hypertonicity and forskolin. The latter is seemingly inconsistent with the known role of AQP2. IM transverse sections at 1000‐µm intervals throughout the corticopapillary axis were labeled by immunohistochemistry for AQP2. The B:A AQP2 ratio at increasing 1000‐µm intervals from the IM border to papilla tip is ~2‐fold greater at each level in KR CD (.71, 1.23, 1.46, 1.18, 1.40, 1.51) relative to SD control (.46, .62, .65, .80, .88, 1.08) and SD water‐restricted (SDWR)(.41, .54, .54, .64, .54, .77). These results correlate with prior studies by others indicating peritubular hypertonicity elevates CD water permeability and B:A AQP2 ratios. Immunohistochemistry suggests a steady presence of basal AQP2 in KR and SDWR. Our data suggest a more significant role for basal AQP2 than presently realized. NIDDK DK083338, NSF 1OS095285, APS/NIDDK STEP‐UP, WAESO

Caenorhabditis chinkari sp. n. (Nematoda: Rhabditida) from Chinkara of Alipore Zoological Garden, Kolkata, West Bengal, India

Caenorhabditis chinkari sp. n. is described and illustrated. The species is characterized by the body size (1.07–1.40 μm ♀; 0.76–1.01 μm ♂) and the presence of anteriorly closed ellipsoidal bursa whose posterior end is blunt or rounded, with smooth edge throughout, papillae pattern 2 + 1 + 3 + 3 in males. Distal tips of caudal papillae 1, 2 and 3 attached to the dorsal surface of bursa, 4 and 9 to ventral surface and 5, 6, 7, and 8 to edge. It was collected from the faecal samples of Chinkara (Gazella gazella bennettii Sykes, 1831), captivated at the Alipore Zoological Garden, Kolkata, India. The collected samples were maintained in a culture plate in the laboratory and certain aspects of its biology and the ecology have been noted. Besides, C. avicola, C. bovis, C. clavopapillata and C. genitalis, this paper highlights the occurrence of another new species of the genus Caenorhabditis (Osche, Abteilung Systematik 81: 190–280, 1952; Dougherty, The genera of the subfamily Rhabditinae Micoletzky, 1922 (Nematoda): 69–76, 1953) in association with a vertebrate host.

Developmental immunolocalization of the Klotho protein in mouse kidney epithelial cells.

A defect in Klotho gene expression in the mouse results in a syndrome that resembles rapid human aging. In this study, we investigated the detailed distribution and the time of the first appearance of Klotho in developing and adult mouse kidney. Kidneys from 16-(F16), 18-(F18) and 20-day-old (F20) fetuses, 1- (P1), 4- (P4), 7- (P7), 14- (P14), and 21-day-old (P21) pups and adults were processed for immunohistochemistry and immunoblot analyses. In the developing mouse kidney, Klotho immunoreactivity was initially observed in a few cells of the connecting tubules (CNT) of 18-day-old fetus (F) and in the medullary collecting duct (MCD) and distal nephron of the F16 developing kidney. In F20, Klotho immunoreactivity was increased in CNT and additionally observed in the outer portion of MCD and tip of the renal papilla. During the first 3 weeks after birth, Klotho-positive cells gradually disappeared from the MCD due to apoptosis, but remained in the CNT and cortical collecting ducts (CCD). In the adult mouse, the Klotho protein was expressed only in a few cells of the CNT and CCD in cortical area. Also, Klotho immunoreactivity was observed in the aquaporin 2-positive CNT, CCD, and NaCl cotransporter-positive distal convoluted tubule (DCT) cells and type B and nonA-nonB intercalated cells of CNT, DCT, and CCD. Collectively, our data indicate that immunolocalization of Klotho is closely correlated with proliferation in the intercalated cells of CNT and CCD from aging, and may be involved in the regulation of tubular proliferation.

Telomere Length Differences upon Keratinization and its Variations in Normal Human Epidermal Keratinocytes

Telomeres are the physical ends of chromosomes, and are cleaved with each cell division. Telomere loss results from not only incomplete DNA replication (“end replication problem”), followed by the processing of chromosome, but also exposure to various DNA damaging agents. Human epidermis is constantly replaced through replication at the basal layer, followed by upward movement and terminal differentiation at the suprabasal layer. The objective of this study was to assess differences in telomere length between basal and suprabasal keratinocytes, and variations of telomere lengths among basal cells. We investigated terminal restriction fragment (TRF) length in fractions of epidermal cells by Southern blot analysis. Time-dependent trypsin treatment to epidermis divided into basal cell rich and suprabasal cell rich fractions. In the five skin samples from various sites of the body, the mean TRF length were 5,932 ± 470 (range 5,182-6,630) bp in basal cell rich fraction showing 21.5% ± 5.8% (range 12.6-28.6%) of keratin 10 (K10)-positivity, which is marker of keratinizing suprabasal cell, and 5,320 ± 640 (range 4,495-6,212) bp in suprabasal cell rich fraction showing 78.8% ± 4.0% (range 72.8-83.0%) of K10-positivity. It was calculated that K10 positive cells have 1,091 ± 963 (range 248-2,650) bp shorter telomeres compared to K10 negative cells. In addition, fluorescence in situ hybridization (FISH) study showed that columnar groups of keratinocytes with statistically longer telomere in each nucleus than the other epidermal cells in the vicinity occupied occasionally between the tip of dermal papilla and the bottom of rete ridge. The present study showed that the keratinizing suprabasal cells have shorter telomeres compared to basal cells. FISH study showed that some groups of epidermal cells having different replicative histories among the groups of epidermal cells in the vicinity.

Embrasure morphology and central papilla recession.

Background:The aim of this study was to ascertain the effects of vertical and horizontal distances between the maxillary central incisors on the presence of interproximal dental papilla and to assess the association between the embrasure morphology and central papilla recession.Materials and Methods:The central papilla was visually assessed in 50 subjects using the standardized periapical radiographs of maxillary central incisors. The following vertical distances were measured; distance from the contact point to papilla tip, CP to proximal cementoenamel (pCEJ) junction, bone crest to CP (BC-CP) and BC-PT. The horizontal distance measured was interdental width (IDW) at pCEJ level. The measurements were recorded using a digital electronic caliper.Results:Significant association between the embrasure morphology and central papilla recession was observed for all study groups. All the interdental variables were significantly related to the presence of interdental papillae, with BC-CP distance being the strongest determinant of central papilla presence. The percentage of interdental papilla presence was 100% when the BC-CP distance was ≤6 mm and IDW ranged between 0.5 and 1.5 mm. Central papilla recession was observed most frequently with wide-long and narrow-long embrasure morphology.Conclusion:In relation to maxillary central incisors, all the interdental variables have significant influences on the presence of interdental papillae, with distance from BC to CP being the strongest determinant of central papilla presence.

A new species ofAllogenus(Tricladida, Maricola, Uteriporidae) from South Georgia, Sub-Antarctica

South Georgia is a remote sub-Antarctic island, considered a marine biodiversity ‘hotspot’ in the Southern Ocean. During a survey along the north coast of South Georgia several marine planarians were found. One of the specimens was a new species ofAllogenus(Uteriporidae), which is described here asAllogenus sluysisp. nov. The new species has the characteristics of the genus and can be distinguished from the type and only known species,Allogenus kerguelensis, by its smaller size, blackish-brown pigmentation, presence of three retinal cells in each eye cup, position of its testes half-way between the ventral and dorsal body surfaces or at a slightly more ventral position, and by having an ejaculatory duct that opens centrally at the tip of the penis papilla. The presently known geographical distribution ofAllogenus, the heterogeneous marine planarian species composition in South Georgia, and the distribution of these species in this region are in agreement with a previously proposed vicariance hypothesis, albeit that dispersal cannot be ruled out.

Non invasive and surgical measurement of length of soft tissue from the tip of interdental papilla to the alveolar crest

Various methods, including clinical and radiographic techniques, can be used to assess periodontal regeneration in interproximal areas. The goal of the present study was to compare the papilla length relative to the alveolar bone crest measured by clinical, intrasurgical, and radiographic techniques. The study sample included 250 interproximal papillae in 68 patients with generalized chronic periodontitis. The papilla length from the alveolar bone crest was measured clinically (as the actual papilla length, APL), intrasurgically (as the bone probing length, BPL), and radiographically (as the radiographic bone length, RBL). Measurements were standardized by using acrylic resin stents, XCP rinn, a paralleling technique, and/or a radiographic grid. The mean (± standard deviation) for RBL was 4.9±0.8mm, BPL was 5.1±0.6mm, and APL was 5.1±0.6mm. Correlations between RBL and APL and between BPL and APL were 0.918 and 0.943, respectively (both P<0.01). If the clinical recordings are appropriately standardized, then noninvasive radiographic methods can be used to evaluate the papilla length with good accuracy.

Primary carcinoma of renal calyx

Renal calyx carcinoma (RCXC) may mimic collecting duct carcinoma (CDC) or urothelial carcinoma (UC) of the renal pelvis. RCXC is distinguished from CDC and UC of the renal pelvis as having the tumor epicenter in the renal calyx, with limited involvement of the surrounding renal pelvis surface urothelium. In this study, we summarize our experience with this entity.Ten cases of RCXC, including 9 cases with urothelial differentiation (RCXC-UC) and 1 case with salivary gland-type differentiation (RCXC-SC), were identified. Ten consecutive cases of UC were selected for comparison, with extensive renal pelvis involvement and with secondary renal parenchymal invasion. Two cases of collecting duct carcinoma (CDC) were also examined. Immunohistochemistry (IHC) was performed on representative tissue blocks for PAX8, PAX2, CK5, CK7, CK20, p63, GATA3, AMACR, RCC, CD10, vimentin, S100, and MSA.The 10 cases of RCXC (M:F=4:6, ages: 62–91 years, mean: 76) presented with renal masses of 3–6cm. Ureteroscopic studies and renal pelvic washings showed atypical/malignant cells in three cases. Seven patients were treated with nephrectomy followed by radiation±chemotherapy, and all cases developed metastases to lymph nodes or liver/lung/bone.In all 7 cases with nephrectomy, there was extensive renal parenchymal involvement with infiltrating borders and diffuse spread along collecting ducts. Six RCXC-UC contained focal squamous differentiation. The RCXC-SC displayed features of adenoid cystic and basaloid features. In situ UC, with or without papillary components, was identified in the calyces in all 7 nephrectomy cases with remaining renal pelvis harboring small tumor burden in 5 cases, and no tumor in another 2 cases. Of the three cases without nephrectomy, no tumor in the renal pelvis could be visualized with endoscopy, however one case was associated with UC of the urinary bladder. Of 10 control UC cases, tumor was limited to the tip of renal papilla in 7 cases, extensive in 3 cases, and with no extension into the collecting ducts. RCXC-UC were all positive for p63, CK5, CK7, and PAX2, with all negative for RCC. PAX8 (70% positive) and GATA3 (50% positive) reactivity was variable. The 10 UC cases shared IHC properties with RCXC-UC but frequent negativity for PAX8 and positivity for GATA3.RCXC is an aggressive neoplasm with high risk of metastases. Similar to CDC, it is located in the renal papilla and rarely with clinically visible renal pelvis tumor or ureteral urine positive for tumor cells. Unlike CDC and non-calyceal UC, RCXC shows predominantly urothelial and squamous differentiation and is associated with an in situ component of adjacent renal calyces. By IHC, RCXC exhibited features intermediate between UC and CDC with decreased or negative immunoreactivity for PAX8 and GATA.

Urine-Concentrating Mechanism in the Inner Medulla

The ability of mammals to produce urine hyperosmotic to plasma requires the generation of a gradient of increasing osmolality along the medulla from the corticomedullary junction to the papilla tip. Countercurrent multiplication apparently establishes this gradient in the outer medulla, where there is substantial transepithelial reabsorption of NaCl from the water-impermeable thick ascending limbs of the loops of Henle. However, this process does not establish the much steeper osmotic gradient in the inner medulla, where there are no thick ascending limbs of the loops of Henle and the water-impermeable ascending thin limbs lack active transepithelial transport of NaCl or any other solute. The mechanism generating the osmotic gradient in the inner medulla remains an unsolved mystery, although it is generally considered to involve countercurrent flows in the tubules and vessels. A possible role for the three-dimensional interactions between these inner medullary tubules and vessels in the concentrating process is suggested by creation of physiologic models that depict the three-dimensional relationships of tubules and vessels and their solute and water permeabilities in rat kidneys and by creation of mathematical models based on biologic phenomena. The current mathematical model, which incorporates experimentally determined or estimated solute and water flows through clearly defined tubular and interstitial compartments, predicts a urine osmolality in good agreement with that observed in moderately antidiuretic rats. The current model provides substantially better predictions than previous models; however, the current model still fails to predict urine osmolalities of maximally concentrating rats.

Role of NF‐κB in the pathogenesis of psoriasis elucidated by its staining in skin biopsy specimens

NF-κB is a transcription factor belonging to the Re1 family, and it regulates the activity of a large number of proinflammatory genes. Its role in psoriasis, which is a prototype chronic inflammatory disease, is therefore expected to be considerable. It has been found that many of the triggering factors for psoriasis initiate inflammation by activation of NF-κB. Skin biopsies of 74 psoriatic cases were studied for the grade of NF-κB staining. They were then correlated with the histopathological indices of severity, especially epidermal hyperplasia and inflammatory infiltrate. Epidermal nuclear positivity for NF-κB correlated with the grade of epidermal hyperplasia (P = 0.043). There was a significant correlation between grade of basal cell positivity of NF-κB and inflammatory infiltrate (P = 0.004). Lymphocyte staining showed a strong correlation with epidermal and basal cell staining pattern for NF-κB (P = 0.004 and 0.003, respectively). There was, however, no correlation of lymphocyte staining with any histopathological parameter. There was also a peculiar propensity for NF-κB to show a positive nuclear stain at the tips of dermal papillae. The study has demonstrated that translocation of NF-κB in the epidermis and basal cells is responsible for two of the key pathological features of psoriasis, epidermal hyperplasia, and inflammation. We have postulated that translocation of NF-κB in lymphocytes, in psoriatic skin leads to NF-κB translocation in the epidermis and basal cells. NF-κB is therefore likely to be one of the key molecules in the pathogenesis of psoriasis.

Papilla regeneration by injectable stem cell therapy with regenerative medicine: long-term clinical prognosis

Black triangle (BT), an open interproximal space between teeth, can cause aesthetic concerns, food impaction, phonetic difficulties and periodontitis. The aim of this study was to determine the possibility and long-term prognosis of novel papilla regeneration with regenerative medicine, i.e. tissue-engineered papilla (TEP), and to investigate the potential of a tissue-engineering method for soft-tissue augmentation, especially aesthetic improvement of BT, with mesenchymal stem cells (MSCs) as the isolated cells, platelet-rich plasma (PRP) as the growth factor and hyaluronic acid (HA) as the scaffold. The parameters were assessed from a clinical point of view by measuring the distance from the tip of the interproximal papilla to the base of the contact area in each study region. The mean volumes, operation times and follow-up periods of TEP were 1.32 ± 0.25 ml, 2.2 ± 1.62 times and 55.3 ± 17.7 months; the mean improved BT values were 2.55 ± 0.89 mm. An aesthetic improvement was achieved. TEP was able to provide aesthetic improvement of black triangle and predictable results, and could emerge as another novel option for periodontal regenerative therapy in periodontal diseases.

An analysis on the factors responsible for relative position of interproximal papilla in healthy subjects

PurposeThis study examined the factors that can be associated with the appearance of the interproximal papilla.MethodsOne hundred and forty-seven healthy interproximal papillae between the maxillary central incisors were examined. For each subject, a digital photograph and periapical radiograph of the interdental embrasure were taken using a 1-mm grid metal piece. The following parameters were recorded: the amount of recession of the interproximal papilla, contact point-bone crest distance, contact point-cemento-enamel junction (CEJ) distance, CEJ-bone crest distance, inter-radicular distance, tooth shape, embrasure space size, interproximal contact area, gingival biotype, papilla height, and papilla tip form.ResultsThe amount of recession of the interproximal papilla was associated with the following: 1) increase in contact point-bone crest, contact point-CEJ, and CEJ-bone crest distance; 2) increase in the inter-radicular distance; 3) triangular tooth shape; 4) decrease in the interproximal contact area length; 5) increase in the embrasure space size; and 6) flat papilla tip form. On the other hand, the amount of gingival recession was not associated with the gingival biotype or papilla height. In the triangular tooth shape, the contact point-bone crest distance and inter-radicular distance were longer, the interproximal contact area length was shorter, and the embrasure space size was larger. The papilla tip form became flatter with increasing inter-radicular distance and CEJ-bone crest distance.ConclusionsThe relative position of the interproximal papilla in healthy subjects was associated with the multiple factors and each factor was related to the others. A triangular tooth shape carries a higher risk of recession of the interproximal papilla because the proximal contact point is positioned more incisally and the bone crest is positioned more apically. This results in an increase in recession of the interproximal papilla and flat papilla tip form.