BACKGROUND: Charcot-Marie-Tooth is the most common inherited neuromuscular disorder. Rarely, it can be associated with heart failure and various arrhythmic disturbances. This case illustrates the challenges of making decisions to prevent sudden cardiac death in a patient with Charcot-Marie-Tooth disease. CASE SUMMARY: A 69-year-old male with a history of Type 1A Charcot-Marie-Tooth disease was admitted due to repetitive runs of ventricular tachycardia. Twelve-lead electrocardiogram, echocardiography, selective coronary angiography, and cardiac magnetic resonance did not clarify the cause of the electrical storm. As conservative therapy was not successful, radiofrequency ablation was chosen to treat the electrical storm. After this procedure, implantable cardioverter defibrillator (ICD) was implanted. The follow-up revealed severe perforation by the ventricular lead. An extraction was performed with no complications and a new lead was immediately implanted. The patient remains asymptomatic. Three episodes of non-sustained ventricular tachycardia were recorded during the last follow-up. DISCUSSION: This case illustrates the challenges of making decisions to prevent sudden cardiac death in a patient with Charcot-Marie-Tooth disease after successful ablation for electrical storm. Due to a lack of evidence, atypical origin of arrhythmia, and clinical presentation, we did not consider this as idiopathic arrhythmia and decided to implant an ICD, which was complicated by severe perforation by the lead. Specific recommendations for preventing sudden cardiac death in rare cardiac conditions, such as Charcot-Marie-Tooth disease, still need to be refined.
- Publication type
- Journal Article MeSH
- Case Reports MeSH
During development, tooth germs undergo various morphological changes resulting from interactions between the oral epithelium and ectomesenchyme. These processes are influenced by the extracellular matrix, the composition of which, along with cell adhesion and signaling, is regulated by metalloproteinases. Notably, these include matrix metalloproteinases (MMPs), a disintegrin and metalloproteinases (ADAMs), and a disintegrin and metalloproteinases with thrombospondin motifs (ADAMTSs). Our analysis of previously published scRNAseq datasets highlight that these metalloproteinases show dynamic expression patterns during tooth development, with expression in a wide range of cell types, suggesting multiple roles in tooth morphogenesis. To investigate this, Marimastat, a broad-spectrum inhibitor of MMPs, ADAMs, and ADAMTSs, was applied to ex vivo cultures of mouse molar tooth germs. The treated samples exhibited significant changes in tooth germ size and morphology, including an overall reduction in size and an inversion of the typical bell shape. The cervical loop failed to extend, and the central area of the inner enamel epithelium protruded. Marimastat treatment also disrupted proliferation, cell polarization, and organization compared with control tooth germs. In addition, a decrease in laminin expression was observed, leading to a disruption in continuity of the basement membrane at the epithelial-mesenchymal junction. Elevated hypoxia-inducible factor 1-alpha gene (Hif-1α) expression correlated with a disruption to blood vessel development around the tooth germs. These results reveal the crucial role of metalloproteinases in tooth growth, shape, cervical loop elongation, and the regulation of blood vessel formation during prenatal tooth development.NEW & NOTEWORTHY Inhibition of metalloproteinases during tooth development had a wide-ranging impact on molar growth affecting proliferation, cell migration, and vascularization, highlighting the diverse role of these proteins in controlling development.
- MeSH
- Hypoxia-Inducible Factor 1, alpha Subunit metabolism genetics MeSH
- Matrix Metalloproteinase Inhibitors pharmacology MeSH
- Hydroxamic Acids pharmacology MeSH
- Metalloproteases metabolism genetics MeSH
- Molar embryology growth & development metabolism enzymology MeSH
- Morphogenesis MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Odontogenesis * MeSH
- Cell Proliferation * MeSH
- Gene Expression Regulation, Developmental MeSH
- Tooth Germ embryology metabolism enzymology MeSH
- Animals MeSH
- Check Tag
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Esthetics, Dental MeSH
- Dental Implantation methods MeSH
- Informed Consent MeSH
- Middle Aged MeSH
- Humans MeSH
- Malocclusion surgery MeSH
- Patient Preference MeSH
- Zirconium MeSH
- Dental Implants, Single-Tooth * MeSH
- Crowns MeSH
- Dental Prosthesis, Implant-Supported methods MeSH
- Dental Prosthesis Design methods MeSH
- Dental Prosthesis Repair * methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Tooth Bleaching methods MeSH
- Adult MeSH
- Humans MeSH
- Root Resorption * surgery MeSH
- Dental Prosthesis Retention methods MeSH
- Incisor surgery MeSH
- Root Canal Therapy methods MeSH
- Inflammation complications MeSH
- Crowns MeSH
- Dental Prosthesis Repair methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Úvod a cíl: Autotransplantace zubů u dospělých pacientů představuje výzvu kvůli nízké pravděpodobnosti revaskularizace zubní dřeně vyžadující ošetření kořenových kanálků. Toto ošetření nejen komplikuje celkové ošetření, ale v některých případech jej činí neproveditelným. Cílem této práce je prozkoumat alternativní postupy pro autotransplantaci zubů u dospělých pacientů, které by eliminovaly potřebu následného ošetření kořenových kanálků donorového zubu. Metodika: Pro zodpovězení této otázky provedl autor rešerši v online databázích Scopus, Web of Science a MEDLINE. Výsledky: Současné protokoly pro autotransplantované zuby s ukončeným vývojem doporučují ošetření kořenových kanálků před operací anebo 14 dní po operaci. Studie řídící se těmito protokoly prezentují vysokou úspěšnost a prediktabilitu. Alternativním přístupem je zahájit ošetření kořenových kanálků pouze v případě výskytu postoperačních komplikací. Tento přístup však přináší výzvy v postoperačním hodnocení klinického stavu zubní dřeně. Pro zvýšení potenciálu zubní dřeně pro revaskularizaci lze provést extraorální resekci kořenového hrotu (EORR). Závěr: Pro klinickou praxi je důležitý správný výběr případů i s ohledem na anatomii endodontu. Riziko komplikací alternativních postupů ve srovnání se současnými protokoly zastiňuje potenciální benefity. EORR v kombinaci s metodami umožňujícími objektivní měření revaskularizace zubní dřeně může představovat možnosti pro další výzkum.
Introduction and aim: Tooth autotransplantation in adult patients presents a challenge due to the low probability of pulp revascularization, often requiring root canal treatment (RCT). RCT not only complicates the overall procedure, but in some cases makes the procedure unfeasible. The aim of this review is to explore alternative procedures for tooth autotransplantation in adult patients that could eliminate the need for elective RCT of the donor tooth. Materials: To address this question, the authors conducted a literature search in the online databases Scopus, Web of Science, and MEDLINE. Results: The current protocols involve performing RCT before or 14 days after surgery. Recent studies that follow these protocols show high predictability and success rate. An alternative approach is to initiate RCT only in the case of postoperative complications. However, this protocol poses challenges in the postoperative assessment of the clinical condition of the pulp. To enhance the potential for pulp revascularization, an extraoral root-end resection (EORR) may be performed. Conclusion: For clinical practice, proper case selection, including consideration of endodontic anatomy, is crucial. The risk of complications associated with alternative approaches outweighs their potential benefits compared to current protocols. EORR, combined with methods enabling an objective measurement of pulp revascularization, may offer opportunities for further research.
Řeč, pohyb, správný ontogenetický vývoj jedince, kognice, emoce, schopnost učit se, paměť – a s výčtem bychom mohly pokračovat. To vše je přímo závislé na rovnováze, za kterou stojí rytmus realizovaný v optimálním tempu s dostatečnou intenzitou a v pravidelně se opakujících, časově dobře volených intervalech. Často si, vlivem zautomatizovaných činností, neuvědomujeme, s jakou pravidelností, plánováním a organizovaností vykonáváme základní motorické vzorce, které se intuitivně a naprosto přirozeně učíme prostřednictvím dostatečně intenzivních intervalových rytmických aktivit. A právě terapie v logopedické praxi vedená intenzivně a intervalově napomáhá u dětí a žáků příznivě ovlivňovat prognózu jejich řečového vývoje, bez ohledu na to, zda využíváme direktivní, nebo nedirektivní přístup. To je mimo jiné potvrzeno také v závěru uvedeným stručným kazuistickým příkladem klientky se závažnou myofunkční poruchou.
Speech, movement, proper ontogenetic development of the individual, cognition, emotions, ability to learn, memory and the list could go on. All of these are directly dependent on balance, which is based on the rhythm realised at an optimal pace with sufficient intensity and in regularly recurring intervals of well-chosen timing. Often, due to automated activities, we are not aware of the regularity, planning and organisation with which we perform the basic motor patterns that we intuitively and quite naturally learn through sufficiently intense interval rhythmic activities. And it is precisely the therapy in Speech Therapy practice conducted intensively and at intervals, that helps to positively influence the prognosis of children and pupils in their speech development, regardless of whether we use a directive or non-directive approach. This is confirmed, among other things, by the brief case example of a client with a severe myofunctional disorder, presented in the end of the paper.
- MeSH
- Dysarthria etiology therapy MeSH
- Language Disorders diagnosis etiology therapy MeSH
- Language Tests MeSH
- Humans MeSH
- Malocclusion MeSH
- Nervous System growth & development MeSH
- Speech Disorders * diagnosis etiology therapy MeSH
- Speech Therapy methods MeSH
- Learning physiology MeSH
- Child Development MeSH
- Check Tag
- Humans MeSH
OBJECTIVES: This study aimed to investigate the impact of bleaching agents based on carbamide or hydrogen peroxide on dental ceramics in vitro, utilizing scanning electron microscopy (SEM) and elemental analysis via inductively coupled plasma optical emission spectroscopy (ICP-OES). METHODS: CAD/CAM ceramics (IPS e.max®CAD, IPS Empress®CAD, Vitablocs® Mark II, Celtra Duo, and inCoris TZI) were treated with bleaching agents using either 10%, 20%, 30% carbamide peroxide or with 35%, and 40% hydrogen peroxide. RESULTS: Surface elemental release was not significantly affected by the type or concentration of bleaching agent (p>0.05). Ion release in feldspathic ceramics was significantly higher than in other ceramic materials (p⟨0.0001). Microstructural surface changes were observed in all materials except for lithium disilicate and zirconia-reinforced lithium silicate ceramics. CONCLUSIONS: All bleaching agents tested in this study showed a similar impact within each material type tested regarding total mass loss, elemental composition, or surface structure. CLINICAL RELEVANCE: Lithium disilicate and zirconia-reinforced lithium silicate ceramics were the most resistant to bleaching agents. In contrast, feldspathic ceramic showed the highest ion release and surface deterioration when exposed to all bleaching agents tested.
- MeSH
- Computer-Aided Design * MeSH
- Carbamide Peroxide * chemistry MeSH
- Ceramics * chemistry MeSH
- Tooth Bleaching Agents * chemistry MeSH
- Microscopy, Electron, Scanning MeSH
- Hydrogen Peroxide * chemistry MeSH
- Surface Properties MeSH
- Materials Testing MeSH
- Zirconium chemistry MeSH
- Dental Porcelain * chemistry MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Tooth Extraction * adverse effects MeSH
- Photography, Dental MeSH
- Cephalometry MeSH
- Humans MeSH
- Face * MeSH
- Facial Muscles MeSH
- Postoperative Period MeSH
- Bicuspid surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
