Irena Tanaskovic

ARTreat project: Three-dimensional numerical simulation of plaque formation and development in the arteries

Atherosclerosis is a progressive disease characterized by the accumulation of lipids and fibrous elements in arteries. It is characterized by dysfunction of endothelium and vasculitis, and accumulation of lipid, cholesterol, and cell elements inside blood vessel wall. In this study, a continuum-based approach for plaque formation and development in 3-D is presented. The blood flow is simulated by the 3-D Navier-Stokes equations, together with the continuity equation while low-density lipoprotein (LDL) transport in lumen of the vessel is coupled with Kedem-Katchalsky equations. The inflammatory process was solved using three additional reaction-diffusion partial differential equations. Transport of labeled LDL was fitted with our experiment on the rabbit animal model. Matching with histological data for LDL localization was achieved. Also, 3-D model of the straight artery with initial mild constriction of 30% plaque for formation and development is presented.

Histochemical and immunohistochemical analysis of ruptured atherosclerotic abdominal aortic aneurysm wall

BACKGROUND/AIM The main complication of the atherosclerotic abdominal aortic aneurysm (AAA) is her rupture that begins with lesion in intima and rupture. The purpose of this work was to determine immunocytochemical and morphofunctional characteristics of the cells in aortic wall in ruptured atherosclerotic abdominal aortic aneurysm. METHOD During the course of this study, 20 samples of atherosclerotic AAA were analyzed, all of them obtained during authopsy. The samples were fixed in 4% formalin and embedded in paraffin. Sections of 5 microm thickness were stained histochemically (of Heidenhain azan stain and Periodic acid Schiff--PAS stain) and immunocytochemically using a DAKO LSAB+/HRP technique to identify alpha-smooth muscle actin (alpha-SMA), vimentin, myosin heavy chains (MHC), desmin, S-100 protein, CD45 and CD68 (DAKO specification). RESULTS The results of our study showed that ruptured atherosclerotic AAA is characterized by a complete absence of endothelial cells, the disruption of basal membrane and internal elastic lamina, as well as a presence of the remains of hypocellular complicated atherosclerotic lesion in intima. On the plaque margins, as well as in the media, smooth muscle cells (SMCs) are present, which express a alpha-SMA and vimentin (but without MHC or desmin expression), as well as leukocyte infiltration, and a large number of foam cells. Some of the foam cells show a CD68- immunoreactivity, while the others show vimentin- and S-100 protein-immunoreactivity. Media is thinned out with a disorganized elastic lamellas, while adventitia is characterized by inflammatory inflitrate (infection). CONCLUSION Rupture of aneurysm occurs from the primary intimal disruption, which spreads into thinned out media and adventitia. Rupture is caused by unstable atherom, hypocellularity, loss of contractile characteristics of smooth muscle cells in intima and media, neovascularization of the media, as well as by the activity of the macrophages in the lesion.

Murine Cytomegalovirus Infection Induces Susceptibility to EAE in Resistant BALB/c Mice

In contrast to C57BL/6 mice, BALB/c mice are relatively resistant to the induction of experimental autoimmune encephalomyelitis (EAE) after challenge with MOG35–55 peptide. Here, we provide the first evidence that infection with murine cytomegalovirus (MCMV) in adulthood abrogates this resistance. Infected BALB/c mice developed clinical and histological signs similar to those seen in susceptible C57BL/6 mice. In addition to CD4+ cells, large proportion of cells in the infiltrate of diseased BALB/c mice was CD8+, similar with findings in multiple sclerosis. CD8+ cells that responded to ex vivo restimulation with MOG35–55 were not specific for viral epitopes pp89 and m164. MCMV infection favors proinflammatory type of dendritic cells (CD86+CD40+CD11c+) in the peripheral lymph organs, M1 type of microglia in central nervous system, and increases development of Th1/Th17 encephalitogenic cells. This study indicates that MCMV may enhance autoimmune neuropathology and abrogate inherent resistance to EAE in mouse strain by enhancing proinflammatory phenotype of antigen-presenting cells, Th1/Th17, and CD8 response to MOG35–55.

Computer simulation and experimental analysis of LDL transport in the arteries

Atherosclerosis develops from oxidized low-density lipoprotein molecules (LDL). When oxidized LDL evolves in plaque formations within an artery wall, a series of reactions occur to repair the damage to the artery wall caused by oxidized LDL. Macrophages accumulate inside arterial intima, they started to collect oxidized LDL and form foam cells. Smooth muscle cells accumulate in the atherosclerotic arterial intima, where they proliferate and secrete extracellular matrix to form a fibrous cap. In this study, experimental model of LDL transport on the isolated blood vessel from rabbit on high fat diet after 8 weeks is simulated numerically by using a specific model and histological data. The 3D blood flow is governed by the Navier-Stokes equations, together with the continuity equation. Mass transfer within the blood lumen and through the arterial wall is coupled with the blood flow by the convection-diffusion equation. LDL transport in lumen of the vessel is described by Kedem-Katchalsky equations. The inflammatory process is solved using three additional reaction-diffusion partial differential equations. Matching of histological rabbit data is performed using 3D histological image reconstruction and 3D deformation of elastic body. Computed concentrations of labeled LDL of 5.2 % and macrophages distribution of 4.2% inside the media are found to be in good agreement with experimental results. This simulation study provides a useful tool for understanding and prediction of LDL transport through the arterial wall and evolution of atherosclerotic plaques.

Continuous controllable balloon dilation: a novel approach for cervix dilation

BackgroundCervical dilation using mechanical dilators is associated with various complications, such as uterine perforation, cervical laceration, infections and intraperitoneal hemorrhage. To achieve safe and painless cervical dilation, we constructed a new medical device to achieve confident mechanical cervical dilation: a continuous controllable balloon dilator (CCBD).MethodsControlled pumping of incompressible fluid into the CCBD increases the pressure and outer diameter of the CCBD, continuously dilating the cervical canal. The reliability of the CCBD was confirmed in vitro (testing for consistency and endurance, with no detected risk for breakage) and in vivo. A multi-center clinical study was conducted,with 120 pregnant women randomly assigned to one of three groups: Group I,control group, no dilation;Group II,mechanical dilation, Hegar dilator (HeD); and Group III,CCBD. The tissue material for histological evaluation was obtained from the endocervical mucosa before and after dilation using the HeD or CCBD.ResultsThe CCBD dilations were successful and had no complications in all 40 patients of Group III. The cervical tissue was markedly less damaged after CCBD dilation compared with HeD dilation (epithelium damage: 95% (HeD) vs. 45% (CCBD), P <0.001; basal membrane damage: 82.5% (HeD) vs. 27.5% (CCBD), P <0.001; stromal damage: 62.5% (HeD) vs. 37.5% (CCBD), P <0.01). Cervical hemorrhagia was observed in 90% of the patients after HeD dilation versus in 32.5% of the patients after CCBD dilation.ConclusionsThe CCBD should be used as a replacement for mechanical dilators to prevent uterine and cervical injury during cervical dilation.Trial registrationISRCTN54007498

ST2 Deficiency Ameliorates High Fat Diet-Induced Liver Steatosis In BALB/c Mice

ABSTRACT Non-alcoholic fatty liver disease (NAFLD) is strongly associated with obesity, but the molecular mechanisms of liver steatosis and its progression to non-alcoholic steatohepatitis and fibrosis are incompletely understood. Immune reactivity plays an important role in the pathogenesis of NAFLD. The IL-33/ST2 axis has a protective role in adiposity and atherosclerosis, but its role in obesity-associated metabolic disorders requires further clarification. To investigate the unresolved role of IL-33/ST2 signalling in NAFLD, we used ST2-deficient (ST2-/-) and wild type (WT) BALB/c mice maintained on a high-fat diet (HFD) for 24 weeks. HFD-fed ST2-/- mice exhibited increased weight gain, visceral adipose tissue weight and triglyceridaemia and decreased liver weight compared with diet-matched WT mice. Compared with WT mice on an HFD, ST2 deletion significantly reduced hepatic steatosis, liver inflammation and fibrosis and downregulated the expression of genes related to lipid metabolism in the liver. The frequency of innate immune cells in the liver, including CD68+ macrophages and CD11c+ dendritic cells, was lower in HFD-fed ST2-/- mice, accompanied by lower TNFα serum levels compared with diet-matched WT mice. Less collagen deposition in the livers of ST2-/- mice on an HFD was associated with lower numbers of profibrotic CD11b+Ly6clow monocytes and CD4+IL-17+ T cells in the liver, lower hepatic gene expression of procollagen, IL-33 and IL-13, and lower serum levels of IL-33 and IL-13 compared with diet-matched WT mice. Our findings suggest that the IL-33/ST2 axis may have a complex role in obesity-associated metabolic disorders. Although it is protective in HFD-induced adiposity, the IL-33/ST2 pathway promotes hepatic steatosis, inflammation and fibrosis.

Consideration of the Therapeutic Potential of Irrigants in Endodontic Therapy

Abstract The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.

Computer Simulation of Electroporation and Drug Transport Through Membranes

In this study, experimental electroporation model with human aorta tissue is compared with computational modeling. The segments in native state of the aorta are treated by electroporation method through a series of electrical impulses from 50 to 2500 V/cm. The Pennes Bioheat equation is used to solve heat transfer problems. Different conductivity values are used in order to fit the experimental results. It has been shown that there are a smaller number of vascular smooth muscle cells (VSMC) nuclei at the tunica media, while the elastic fibers morphology is maintained 24 h after electroporation. Additionally we studied with computational model of plaque formation and progression the reduction of the plaque size with electroporation. The initial results have been shown plaque reduction for carotid artery case. Future studies are necessary for design of a new device for in vivo ablation with electroporation of plaque stenosis.

The mineral content of the hard dental tissue of mesiodens

OBJECTIVE Mesiodens is the most common form of supernumerary tooth mainly located between the maxillary central incisors. Its etiology is not completely understood but both genetic and environmental factors are assumed. The degree of mineralization and inorganic element content in hard tooth tissues is poorly understood as well as is the durability and suitability for allo- and auto-transplantation. Therefore aim of this study was to examine the content of inorganic elements. MATERIALS AND METHODS This study included 26 mesiodens teeth and 26 normal central incisor teeth as controls. All specimens were prepared for SEM/EDS analysis which was aimed at specific sites on the enamel, dentine and cementum in order to evaluate the weight percentage and ratio of important inorganic elements. RESULTS and Conclusion. The results showed that there was a difference in the weight percentage of selected inorganic elements (calcium, phosphorus, oxygen, carbon, magnesium and sodium) in all three types of dental hard tissues but the differences were mostly expressed in the cementum tissue. The statistical analysis showed that the differences were marginally significant especially for calcium and phosphorus values and ratio in the enamel and dentine. The carbon and magnesium content in all three hard tissues showed the most differences, but overall, the hard tissues mineral content of the mesiodens did not differs significantly from healthy teeth.

Quality of Root Canal Fillings in a Bosnian Adult Population Treated in Public and Private Dental Clinics / Kvalitet Punjenja Kanala Korena Kod Odraslog Stanovništva U Bosni I Hercegovini Lecenih U Državnim I Privatnim Stomatološkim Klinikama

Abstract The aim of this study is to examine the technical quality of root canal fillings in an adult population in the Republic of Srpska, Bosnia and Herzegovina, who were treated in public dental institutions and private dental clinics. Radiographs of faculty patients, aged 25-60 years old, who came for the first time were examined for the technical quality of root canal fillings. Patients with endodonticallytreated teeth were invited for an interview to reveal the providers of the endodontic treatment. The percentages of teeth with adequate length (p<0.01) and taper (p<0.01) in institutions of public health cases were significantly greater than those in private clinic cases. In addition, the frequency of teeth with adequate root canal fillings in patients treated in public dental institutions was significantly greater than those treated in private dental clinics (p<0.01). A significantly higher percentage of adequate canal fillings is present in teeth where endodontic treatment was performed in public dental institutions compared to private dental clinics. This result indicates the need to improve the quality of endodontic treatment through more intensive training for dentists in private practice.