Lymphangioma circumscriptum of the tongue: A case with marked hemorrhagic component

Lymphangioma circumscriptum (LC) is considered a superficial variant of lymphangioma with characteristic small lymphatic channels. Diagnosis is routinely made through histopathology in addition to immunostaining. An unusual case of LC presenting as a painless overgrowth of the tongue in a middle-aged male is reported, with emphasis on the clinical and histopathological differential diagnosis.

Immunohistochemical expression of K6, K8, K16, K17, K19, maspin, syndecan-1 (CD138), α-SMA, and Ki-67 in ameloblastoma and ameloblastic carcinoma: diagnostic and prognostic correlations

OBJECTIVE

To identify cutoff values of markers that correlate with the histopathologic diagnosis of ameloblastic carcinoma (AC) and/or the increased recurrence potential of ameloblastoma (AB).

STUDY DESIGN

Immunohistochemical expression (IHCE) of 9 selected markers were investigated in 18 non-recurrent ameloblastomas (NRABs), 6 recurrent ameloblastomas (RABs), and 5 ACs.

RESULTS

No significant difference in IHCE of K6, K8, K16, K17, K18, K19, maspin, or syndecan-1 was observed among study groups. α Smooth muscle actin (α-SMA)-positive area in central epithelial cells significantly differentiated between AB and AC (P = .017; t -test). Ki-67 score significantly differentiated between AB and AC (P < .005; t -test) and between AC and RAB (P = .015; ANOVA/post hoc).

CONCLUSIONS

Ki-67 score of 75 cells/HPF (ROC curve) is a potential indicator of AC. Clinical recurrence of AB may be predicted by α-SMA expression pattern. Syndecan-1 and α-SMA may indicate a higher aggressive potential of AB when expressed in the stroma.

Contribution of regulatory T cells to alleviation of experimental allergic asthma after specific immunotherapy

BACKGROUND

Allergen-specific immunotherapy (SIT) has been used since 1911, yet its mechanism of action remains to be elucidated. There is evidence indicating that CD4(+)FOXP3(+) regulatory T cells (Treg cells) are induced during SIT in allergic patients. However, the contribution of these cells to SIT has not been evaluated in vivo.

OBJECTIVE

To evaluate the in vivo contribution of (i) CD4(+) CD25(+) T cells during SIT and of (ii) SIT-generated inducible FOXP3(+) Treg cells during allergen exposure to SIT-mediated suppression of asthmatic manifestations.

METHODS

We used a mouse model of SIT based on the classical OVA-driven experimental asthma. Treg cells were quantified by flow cytometry 24 and 96 h post SIT treatment. We depleted CD4(+) CD25(+) T cells prior to SIT, and CD4(+)FOXP3(+) T cells prior to allergen challenges to study their contribution to the suppression of allergic manifestations by SIT treatment.

RESULTS

Our data show that depletion of CD4(+)CD25(+) T cells at the time of SIT treatment reverses the suppression of airway hyperresponsiveness (AHR), but not of airway eosinophilia and specific IgE levels in serum. Interestingly, the number of CD4(+)CD25(+)FOXP3(+) T cells is transiently increased after SIT in the spleen and blood, suggesting the generation of inducible and presumably allergen-specific Treg cells during treatment. Depletion of CD4(+)FOXP3(+) Treg cells after SIT treatment partially reverses the SIT-induced suppression of airway eosinophilia, but not of AHR and serum levels of specific IgE.

CONCLUSION AND CLINICAL RELEVANCE

We conclude that SIT-mediated tolerance induction towards AHR requires CD4(+)CD25(+) T cells at the time of allergen injections. In addition, SIT generates CD4(+)CD25(+)FOXP3(+) T cells that contribute to the suppression of airway eosinophilia upon allergen challenges. Therefore, enhancing Treg cell number or their activity during and after SIT could be of clinical relevance to improve the therapeutic effects of SIT.

The synthesis and subcellular distribution of pyridoxal phosphate in rat and bovine retinas

In the absence of any known studies dealing with status of vitamin B(6) metabolism in mammalian retinas, the concentration of pyridoxal phosphate and the activity of its synthesizing enzyme pyridoxal kinase were determined in rat retina and bovine retina and its subcellular compartments. In bovine retina, the highest concentration of pyridoxal phosphate (148 pmol/mg protein) was present in pellet 2 fraction containing synaptosomes comparable to those isolated from brain. The second highest concentration of pyridoxal phosphate (91 pmol/mg protein) was present in pellet 1 fraction containing large synaptosomes resembling photoreceptor cell terminals. The concentrations of pyridoxal phosphate in pellets 1 and 2 fractions were approx 3- to 6-fold higher than that found in the whole retina. The concentration of pyridoxal phosphate and the activity of pyridoxal kinase in the rat retina were considerably higher than those observed in the bovine retina. In general, no apparent correlation existed between the concentrations of pyridoxal phosphate and the activities of pyridoxal kinase in bovine retina and its subcellular compartments.

Histological evaluation of rat tissue response to GMTA, Retroplast, and Geristore retrograde filling materials

The aim of the study was to compare the short-term biocompatibility of grey mineral trioxide aggregate (GMTA), Retroplast and Geristore. Silicon tubes filled with the materials and empty control tubes were implanted in the dorsal connective tissue of 30 Wistar albino rats. The tubes and surrounding tissues were excised and prepared for histological examination at 1 week, 1 month and 2 months after implantation. Inflammatory cell counts and the presence or absence of necrosis adjacent to the materials and control tubes were recorded. Data were statistically analysed using one-way anova and Tukey's multiple comparisons tests. The empty control tubes were well tolerated. All tested materials showed a more severe initial reaction than the control group. With time, the reaction became chronic, with variable increase in the numbers of inflammatory cells. Retroplast recorded the most statistically significant increase in the sum of inflammatory cells. Although the increase in the sum of inflammatory cells was statistically significant for Geristore but not for GMTA, the inflammatory cell counts for both were comparable. It was concluded that the three materials continued to irritate tissues throughout the evaluation period. Retroplast was the least biocompatible of the three tested materials at 2 months, followed by Geristore then GMTA.

Effects of topically applied agents on intra-oral wound healing in a rat model: a clinical and histomorphometric study

OBJECTIVES

Topically applied chlorhexidine and hyaluronan have many studies supporting their use to enhance oral wound healing. Allantoin is widely used topically to promote epithelial proliferation and wound healing, with very little scientific evidence to support such uses. This study investigated and compared the influence of these agents on the healing of intra-oral excisional wounds with large epithelial and connective tissue defects.

METHODS

Excisional wounds, 3 mm in diameter, were made at the centre of the palate of 125 Wistar male albino rats. Five animals constituted the baseline group at time 0. The remaining animals were divided into four experimental and one control groups, in which chlorhexidine digluconate gel 0.2% (Perio.Kin®), hyaluronan gel (Gengigel®), allantoin 0.5% in vehicle gel, vehicle gel alone and nothing were applied daily to the wounds. The wound areas were measured photographically and the epithelialization rates were determined histologically at 0, 3, 7, 14 and 21 days post-surgery.

RESULTS

The mean wound area and mean distance between the epithelial margins decreased significantly with time in all experimental and control groups (P < 0.05). A significant rate of wound area reduction was observed following the use of Perio.Kin® and Gengigel® at 7 and 14 days. Perio.Kin® showed a significant rate of wound epithelialization at 7 days. Allantoin did not positively or negatively affect wound healing.

CONCLUSIONS

None of the tested agents had a negative effect on the rate of wound healing when applied on an excisional wound with epithelial and connective tissue defect. Positive results were achieved with Perio.Kin® and Gengigel®.

Reaction of rat connective tissue to Mineral Trioxide Aggregate and Diaket

BACKGROUND

The aim of this study was to compare the reaction of rat connective tissue to two root-end filling materials: white Mineral Trioxide Aggregate (WMTA) and Diaket.

METHODS

Each of the materials was placed in dentine tubes and implanted subcutaneously in the dorsal connective tissue of 21 Wistar albino rats. Tissue biopsies were collected 7, 30, and 60 days after the implantation procedure. The specimens were processed and stained with hematoxylin and eosin and examined microscopically. After determining inflammatory cell numbers in sections from each specimen, inflammatory reaction scores were defined as follows: 0; no or few inflammatory cells (no reaction), 1; less than 25 cells (mild reaction), 2; 25 to 125 cells, (moderate reaction), and 3; 125 or more cells (severe reaction). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney tests.

RESULTS

There were statistically significant differences in the median inflammatory cell numbers throughout the three test periods, with the most severe degree of inflammation observed at the one-week period. Few cases of necrosis were observed with WMTA. Diaket exhibited the most severe degree of inflammation and necrosis. After 30 days, both materials provoked moderate inflammatory reaction. The eight-week period showed the least severe degree of inflammation in all groups.

CONCLUSIONS

It was concluded that WMTA exhibits a more favourable tissue response compared with Diaket which induced more severe inflammatory reaction than WMTA and the control.

Plunging arteriovenous malformation in the floor of the mouth: a case report

An arteriovenous malformation (AVM) is composed of abnormal communications between arteries and veins without the normal intervening capillary bed. An 11-year-old male presented with a painless, doughy submandibular mass. Surgical excision was performed through an intraoral approach; the mass and the surgical field, did not exhibit any significant intraoperative bleeding typical of vascular lesions. Histopathological examination of the specimen revealed a diagnosis of an AVM, with the presence of organizing thrombi within arteries and veins. These abundant thrombi, previously unreported in the arterial part, may explain the negligible intraoperative bleeding.

Nerve sheath myxoma (neurothekeoma) of the gingiva, a case report and review of the literature

Nerve sheath myxoma (NSM) is a benign peripheral nerve sheath tumor that rarely occurs in the oral cavity. Among the 23 reported intraoral cases, no lesion has previously been reported on the gingiva. In this report, we describe the first gingival case of oral neurothekeoma with histopathologic and immunohistochemical characteristics. The patient, a 32 year old female presented with a slowly growing gingival mass diagnosed clinically as an epulis. The lesion was surgically excised. Histopathologically, the lesion presented as a submucosal multinodular mass composed of spindle and stellate-shaped cells with a myxoid background. Immunohistochemically, the tumor cells were sporadically positive for S-100 and NSE and negative for GFAP, EMA, SMA, CD68 and HMB45. The immunoprofile of this lesion confirmed a Schwann cell origin. The lesion was followed up for 10 months with no reports of recurrence.

Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature

BACKGROUND

Chronic granulomatous disease is an extremely rare primary immunodeficiency syndrome that can be associated with various oral complications. This can affect high number of patients. However, data on oral complications is sparse. Here we will review the literature and describe the orofacial findings in 12 patients.

FINDINGS

The age range was 5-31 years. Oral findings were variable, and reflected a low level of oral hygiene. They included periodontitis, rampant caries, gingivitis, aphthous-like ulcers, and geographic tongue. One patient had white patches on the buccal mucosa similar to lichen planus. Another patient had a nodular dorsum of the tongue associated with fissured and geographic tongue. Biopsies from the latter two lesions revealed chronic non-specific mucositis. Panoramic radiographs showed extensive periodontitis in one patient and periapical lesions in another patient.

CONCLUSION

Patients with chronic granulomatous disease may develop oral lesions reflecting susceptibility to infections and inflammation. It is also possible that social and genetic factors may influence the development of this complication. Therefore, oral hygiene must be kept at an optimum level to prevent infections that can be difficult to manage.

Intracoronal sealing comparison of mineral trioxide aggregate and glass ionomer

OBJECTIVE

The purpose of this study was to determine the effectiveness of mineral trioxide aggregate and glass ionomer when placed coronally as double-sealing materials over gutta percha.

METHOD AND MATERIALS

Seventy extracted anterior teeth were cleaned, shaped, and obturated with gutta percha and Sealapex. After removing 4 mm of coronal gutta percha, the teeth were randomly divided into 3 groups. In two experimental groups of 30 teeth each, 4 mm of either mineral trioxide aggregate or glass ionomer was placed in the chamber over gutta percha. A positive control group of 5 teeth received no barrier. A negative control group of 5 teeth was covered completely with sticky wax. All teeth, except the negative controls, were covered with 2 layers of sticky wax except for the access openings. Teeth were immersed in Pelikan ink for 48 hours, and then were decalcified, dehydrated, and cleared. Leakage into the canals was measured in millimeters and statistically analyzed between the two experimental groups using the Mann-Whitney test.

RESULTS

Results showed that the glass ionomer group leaked significantly more than the mineral trioxide aggregate group (P < .001).

CONCLUSION

It was concluded from this study that mineral trioxide aggregate may be preferred over glass ionomer as a seal intracoronally following root canal treatment to prevent coronal microleakage.

Antioxidant enzyme levels in oral squamous cell carcinoma and normal human oral epithelium

BACKGROUND

The antioxidant enzymes (manganese- and copper-zinc-containing superoxide dismutases, catalase and glutathione peroxidase) limit cell injury induced by reactive oxygen species. The purpose of the study was to determine whether human oral squamous cell carcinomas have altered antioxidant enzyme levels. This study is the first to undertake this task in human oral mucosa and squamous cell carcinoma.

METHODS

Semiquantitative immunohistochemistry was used to examine 26 archived oral squamous cell carcinoma biopsies. Fourteen well-differentiated and 12 poorly differentiated tumors were examined, as were 12 specimens of oral mucosa. All sections were reviewed by two oral and maxillofacial pathologists, and image analysis of the immunostained sections was performed using NIH Image. Antioxidant enzyme staining intensities were compared in the different groups by Duncan's multiple range test.

RESULTS

In general, mucosal basal cells displayed lower antioxidant enzyme levels than spinous cells, and primary tumor cells displayed lower antioxidant enzyme staining intensities than did their normal cell counterparts. Moreover, poorly differentiated tumor cells showed lower antioxidant enzyme staining intensities than well-differentiated tumor cells. Manganese-containing superoxide dismutase staining intensities were, however, higher in well-differentiated oral squamous cell carcinomas than their normal cells of origin.

CONCLUSIONS

Detection of antioxidant enzymes may be a useful future marker in the molecular diagnosis of the oral cancer. Moreover, it may be possible to not only monitor the effectiveness of chemopreventive and therapeutic strategies in oral cancer using these enzymes, but to monitor tumor recurrence.

Immunolocalization and adenoviral vector-mediated manganese superoxide dismutase gene transfer to experimental oral tumors

The anti-oxidant enzyme system protects cellular macromolecules against damage from reactive oxygen species. One component of this system, manganese superoxide dismutase (MnSOD), has also been shown to display tumor suppressor gene-like activity. The purpose of this study was to examine changes in MnSOD expression during hamster cheek pouch carcinogenesis, and the effects of MnSOD overexpression using an adenoviral vector. Tumor induction was carried out using 7,12-dimethylbenz[alpha]anthracene. Animals were killed at periodic intervals, and cheek pouch tissues were excised and examined for MnSOD expression by immunohistochemistry and digital image analysis. We observed a reduction in MnSOD expression as early as 2 weeks after the start of carcinogen application. Low MnSOD expression persisted until the end of the 23-week experimental period. Solid hamster cheek pouch carcinoma xenografts were then established in nude mice. An adenoviral vector encoding the human MnSOD gene was delivered to the xenografts by direct injection. We observed high, immediate expression of MnSOD in the xenografts that persisted for 10 days following cessation of viral construct delivery. Delivery of the MnSOD construct resulted in a maximal 50% reduction in tumor growth compared with untreated controls. Our results suggest that MnSOD may be a tumor suppressor gene in the hamster cheek pouch model system.

Pyostomatitis vegetans in childhood

Pyostomatitis vegetans is an oral eruption, characterized by small pustules, ulcers and erythematous vegetations of the labial and buccal mucosae as well as labial-attached gingivae. Its importance lies in its high correlation with inflammatory bowel disease. It is commonly associated with skin and inflammatory bowel disease and is rare in children. We here report a sister and brother with onset of the disease at the age of 5 and 7 years, respectively. It is the first report of familial pyostomatitis vegetans occurring in the youngest patients hitherto reported.

CONCLUSION

The observation of two sibs with pyostomatitis, vegetans pyoderma gangrenosum and inflammatory bowel disease suggest a hereditary disposition to this rare triad.

Chondromyxoid fibroma of the jaws. Case report and review of the literature

Chondromyxoid fibroma is a benign tumor of bone that is characterized by chondroid and myxoid differentiation and by ultrastructural and immunohistochemical evidence of chondral origin. It is rare in the jaws and skull bones, where only about 2% of all cases have been reported. A review of the 20 acceptable gnathic cases in the literature and of the current case revealed both a higher incidence in the mandible (76%) than in the maxilla (24%) and an equal sex distribution. The sites of occurrence in both jaws are compatible with origin from developmental cartilaginous remnants. The controversies regarding malignant transformation and therapeutic approach are addressed.

Pharmacological effects of selected flavonoids on rat isolated ileum: structure-activity relationship

1. Eleven selected flavonoids were studied to evaluate their effects on the rat isolated ileum and to determine their structure-activity relationships. 2. The flavonoids rutin and 3',5,7-trihydroxy-4' methoxyflavone-7-rutinoside, which have a sugar moiety (O-rha-glu), had no significant effect on the ileum, indicating that the presence of sugar substitution reduces the biological activity of the flavonoids. 3. Nine other flavonoids caused inhibition of tonic and phasic contractions of the ileum with the following order of potency from highest to lowest: galangin, quercetin, chrysin, xanthomicrol, flavone, naringenin, fisetin, morin, and flavanone. 4. Flavones were more potent than flavanones, indicating that the double bond at carbon 2-3 increases the potency of the flavonoid. 5. Galangin, quercetin, chrysin, and xanthomicrol, which have hydroxyl substituents on carbon 3 and/or 5, showed higher potency than flavone, indicating that such hydroxyl groups are essential for the activity. 6. Galangin was more potent than quercetin, morin, and fisetin, suggesting that the hydroxyl substituents on ring B attenuate the potency. 7. Quercetin caused more potent relaxation of the ileum than morin, suggesting that the presence of a hydroxyl group at C-2' of ring B attenuates the myolytic activity.

Dissociation between epileptic seizures induced by convulsant drugs and alteration in the concentrations of pyridoxal phosphate in rat brain regions

Allylglycine increased the concentration of pyridoxal phosphate in cerebral cortex from 1011.4 +/- 25.0 to 1318.0 +/- 66.3 and decreased it in cerebellum from 1289.0 +/- 49 to 1147.7 +/- 119.4 ng/g wet tissue during the preictal period. Mercaptopropionic acid increased the concentration of pyridoxal phosphate in cerebellum from 1525 +/- 91 to 1985.7 +/- 275 ng/g wet tissue. Similar effects were noted in hippocampus and cerebral cortex. Picrotoxin increased the concentration of pyridoxal phosphate in hippocampus from 938.7 +/- 44 to 1043 +/- 118 but decreased it in cerebral cortex from 1124.52 +/- 124 to 979.4 +/- 15 ng/g wet brain. The effects of strychnine were identical to those of allylglycine. Bicuculline reduced the concentration of pyridoxal phosphate in cerebral cortex from 1184 +/- 61 to 1075.14 +/- 78 ng/g wet brain.