Pre-curettage cerclage in a viable triplet cervical pregnancy: A case report and review of literature

Background: Cervical ectopic pregnancy (CEP) is a rare and dangerous form of ectopic pregnancy in which the blastocyst is installed within the endo-cervical canal. CEP diagnosis requires special awareness to evaluate patient precisely. Individualizing controversial medical and surgical management strategies is of importance in medical practice. Case: A 35-year-old nulliparous woman on her 9th week of pregnancy was referred to our hospital with vaginal bleeding preliminary misdiagnosed as aborting intrauterine pregnancy. Transvaginal ultrasound revealed an empty uterus and a viable triplet pregnancy just below the level of internal os. Cervical curettage after cerclage suture placement procedure removed conception tissues completely. Consequently, in the next few hours vaginal bleeding decreased to minimal amount and vital signs remained within normal limits and there was no hematocrit change. On follow-up day 32, serum B-HCG became negative. Conclusion: CEP diagnosis requires special attention and awareness to evaluate patient precisely along with skillful assessment of possible risk factors. Lifesaving treatment beside fertility preservation was successful with pre-curettage cerclage

P53 Protein Expression in Dental Follicle, Dentigerous Cyst, Odontogenic Keratocyst, and Inflammatory Subtypes of Cysts: An Immunohistochemical Study

Objectives: An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. Methods: Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). Results: The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant (p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. Conclusions: The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression

Laparoscopic Transumbilical Appendectomy in Nonperforated Appendicitis in Pediatric Age Group

Introduction: Laparoscopic appendectomy has recently been trended to be performed by using a less trocar technique. In children, appendectomy is performed more by open approach; so this study was designed to compare benefits of&nbsp;non-invasive laparoscopic&nbsp;appendectomy with usual open technique. Materials and Methods: After obtaining institutional review board approval, from 2015 to 2018, 73 children with acute, nonperforated appendicitis were treated by single-incision laparoscopic or open approach. The patients were randomized to two treatment groups: 36 patients underwent open operation, and 37 by laparoscopic approach via single-incision in umbilicus. 3 cases of laparoscopic approach were converted to open surgery and removed from the study. In patient selection, cases of complicated appendicitis confirmed by imaging modalities were excluded. The outcomes were investigated in both groups by length of operation, duration of&nbsp;hospital stay, presence of postoperative fever, wound infection, ileus after operation, and pelvic abscess after surgery.&nbsp; Results: 73 appendectomies were carried out totally by single surgeon, 37 were single-incision laparoscopy and 36 underwent open procedure. Total anesthesia time and duration of operation showed significantly longer in the laparoscopic group. On the other hand, time to tolerate liquid diet was significantly shorter in the laparoscopic group. The duration of hospital stay showed similar duration in both groups. No mortality occurred in the study. Overall complications demonstrated&nbsp;no significant difference between two groups. Also there was no difference in infectious complications between the laparoscopic group and the open group Conclusion:&nbsp;Our study suggests that Assisted Transumbilical laparoscopic appendectomy is a reasonable alternative to open surgery for appendicitis in acute none ruptured condition. All analyzed complications were similar between the groups, suggesting that Assisted Transumbilical laparoscopic appendectomy is a suitable ingrained method in pediatric cases with appendiciti

Visceral adiposity-related dietary patterns and the risk of cardiovascular disease in Iranian adults: A population-based cohort study

BackgroundVisceral obesity is a significant predictor of cardiovascular disease (CVD). Diet may associate with CVD risk through its effects on visceral adiposity. This study aimed to find dietary patterns (DPs) related to indicators of visceral adiposity and to determine whether the DPs were associated with CVD risk.MethodsThis prospective study included 2,496 participants of the Tehran Lipid and Glucose Study (TLGS) without CVD, who were followed from the third study examination (2005–2008; baseline) to March 2018. DPs at baseline were determined using reduced rank regression (RRR) and partial least squares regression (PLS). The response variables were age and BMI-adjusted waist circumference (WC) and age-adjusted visceral adiposity index (VAI).ResultsTwo and three DPs were retained with RRR and PLS, respectively. The first patterns of each method were mainly characterized by adjusted-WC (RRR: 10.8%, PLS: 8.6%); none of them were associated with CVD risk. The second pattern of RRR and the third pattern of PLS were mainly explained by adjusted-VAI (RRR: 3.3, PLS: 2.1%). After adjusting for CVD risk factors, the hazard ratios [95% confidence intervals (CI)] for CVD in the second and third tertiles of the RRR-pattern 2 were 1.76 (1.15, 2.69) and 1.55 (1.00, 2.43) vs. the first tertile (p-trend: 0.058). This pattern had high positive loadings for non-leafy vegetables, pickled vegetables, fried vegetables, and bread and high negative loadings for eggs, cakes, butter, jam-honey, red meat, poultry, fish, juice, non-fermented dairy, and fruits. Per one SD increase in PLS-pattern 3 score, the risk of CVD was 19% higher (95%CI = 3–38%). This positive association was also observed across tertiles of the pattern (p-trend: 0.032). This pattern was characterized by high intakes of leafy vegetables, non-leafy vegetables, organ meat, soft drinks, olive oil, pickled vegetables, fried vegetables, and bread and low intakes of biscuits, cakes, butter, eggs, and non-fermented dairy.ConclusionFor each of the RRR and PLS approaches, a visceral-related DP that was positively linked to CVD was identified. These two patterns had a modest correlation. The pattern generated by PLS explained more variations in food groups and offered stronger evidence of association with CVD than the RRR-derived pattern

Evaluation of squamous cell carcinoma antigen 1 expression in oral squamous cell carcinoma (tumor cells and peritumoral T-lymphocytes) and verrucous carcinoma and comparison with normal oral mucosa

Background: Squamous cell carcinoma antigen (SCCA) is used as a prognostic marker for recurrence of squamous cell carcinoma in various sites, including head and neck. Studies suggest that its high serum levels are correlated to some clinical features, such as nodal metastasis. However, it is still unknown if high SCCA in patients with SCCA tissue expression in tumor cells are related to peripheral T-lymphocytes. Therefore, we did this study to evaluate SCCA expression in squamous cell carcinoma and verrucous carcinoma and to compare it with normal oral mucosa, also investigating the correlation between serum-based and tissue-based antigen levels.&nbsp;Methodology: In this study, the immunohistochemistry (IHC) technique was used to determine the SCCA1 expression pattern in 81 specimens divided into 3 groups, including oral squamous cell carcinoma, verrucous carcinoma, and normal oral mucosa. Serum-based and tissue-based antigen levels of 20 oral squamous cell carcinoma cases were compared by the western blot assay. SCCA expression was also evaluated and compared in both tumor cells and peripheral T-lymphocytes by the immunofluorescence assay. Results: Our results showed that the SCCA levels in SCC specimens were significantly lower than in verrucous carcinoma and normal and hyperplastic oral mucosa specimens. We found no correlation between the IHC expression of SCCA and serum levels. SCCA was well expressed in both tumor cells and peripheral T-lymphocytes. Conclusion: Decreasing SCCA in SCC specimens suggested that SCC tumor cells may affect more than the serum levels of SCCA in some patients. In addition, expression of SCCA in peripheral T-lymphocytes showed that both tumor cells and T-lymphocytes may cause serum SCCA.&nbsp

Disulfiram-Loaded Niosomes Reduces Cancerous Phenotypes in Oral Squamous Cell Carcinoma Cells

Objective: Surgery and chemotherapy are the most common therapeutic strategies proposed for oral squamous cellcarcinoma (OSCC). However, some of the disadvantages associated with the current methods like unwanted sideeffects and poor drug response lead the scientist to seek for novel modalities and delivery approaches to enhance theefficacy of treatments. The study aimed to assess the effectiveness of disulfiram (DSF)-loaded Niosomes on cancerousphenotypes of the OSCC cells.Materials and Methods: In this experimental study, an optimum formulation of DSF-loaded Niosomes was developedfor the treatment of OSCC cells to reduce drug doses and improve the poor stability of DSF in the OSCC environment.The design expert software was utilized to optimize the particles in terms of size, polydispersity index (PDI), andentrapment effcacy (EE).Results: Acidic pH increased the release rate of DSF from these formulations. The size, PDI, and EE of Niosomeswere more stable at 4°C compared to 25°C. The results indicated that DSF-loaded Niosomes could induce apoptosis(P=0.019) in the OSCC cells compared to the control group. Moreover, it could reduce colony formation ability(P=0.0046) and also migration capacity of OSCC cells (P=0.0015).Conclusion: Our findings indicated that the application of proper dose of DSF-loaded Niosomes (12.5 μg/ml) increasesapoptosis, decreases colony formation capacity and declines the migration ability of OSCC cells

Human Gastric Mucins Differently Regulate Helicobacter pylori Proliferation, Gene Expression and Interactions with Host Cells

Helicobacter pylori colonizes the mucus niche of the gastric mucosa and is a risk factor for gastritis, ulcers and cancer. The main components of the mucus layer are heavily glycosylated mucins, to which H. pylori can adhere. Mucin glycosylation differs between individuals and changes during disease. Here we have examined the H. pylori response to purified mucins from a range of tumor and normal human gastric tissue samples. Our results demonstrate that mucins from different individuals differ in how they modulate both proliferation and gene expression of H. pylori. The mucin effect on proliferation varied significantly between samples, and ranged from stimulatory to inhibitory, depending on the type of mucins and the ability of the mucins to bind to H. pylori. Tumor-derived mucins and mucins from the surface mucosa had potential to stimulate proliferation, while gland-derived mucins tended to inhibit proliferation and mucins from healthy uninfected individuals showed little effect. Artificial glycoconjugates containing H. pylori ligands also modulated H. pylori proliferation, albeit to a lesser degree than human mucins. Expression of genes important for the pathogenicity of H. pylori (babA, sabA, cagA, flaA and ureA) appeared co-regulated in response to mucins. The addition of mucins to co-cultures of H. pylori and gastric epithelial cells protected the viability of the cells and modulated the cytokine production in a manner that differed between individuals, was partially dependent of adhesion of H. pylori to the gastric cells, but also revealed that other mucin factors in addition to adhesion are important for H. pylori-induced host signaling. The combined data reveal host-specific effects on proliferation, gene expression and virulence of H. pylori due to the gastric mucin environment, demonstrating a dynamic interplay between the bacterium and its host

Orthokeratinized Odontogenic Cyst of the Maxilla: Report of a Case and Review of the Literature

The orthokeratinized odontogenic cyst is a relatively rare developmental odontogenic cyst of the jaws that occurs predominantly in males between the third and fourth decades. According to the 2005 World Health Organization’s classification, orthokeratinized odontogenic cyst is not a part of the keratocystic odontogenic tumor spectrum. We present a case of a 41-year-old male with a history of remarkable lingual expansion in the anterior part of the maxilla since last year with rapid growth in the last three months as a unilocular well–defined radiolucent lesion extending from maxillary left central incisor to the right second premolar. Orthokeratinized odontogenic cyst is a specific type of keratinized odontogenic cysts which is completely different from keratocystic odontogenic tumor from the viewpoint of the clinical and pathological features

Correlation of Bcl-2 and COX-2 Expression in Oral Lichen Planus

Background and Aim : Lichen planus is a common immune-mediated disease that is associated with an increased risk of malignant transformation in the oral cavity. Synchronous up-regulation of COX-2 and down-regulation of Bcl-2 have been demonstrated in some malignancies. The aim of this study was to assess the correlation between COX-2 and Bcl-2 expression and their role in dysplastic changes of oral lichen planus (OLP ). Materials and Methods : This study was performed on 47 paraffin blocks with the diagnosis of OLP and 16 blocks with the diagnosis of focal fibrous hyperplasia (control group). Immunohistochemical staining was performed using antibodies against COX-2 and Bcl-2. Spearman’s rank correlation coefficient and Mann-Whitney test were used for data analysis .  Results : A significant correlation was observed between the intensity of sub-epithelial inflammation and the severity of basal cell layer degeneration (P=0.048). Significant up-regulation of Bcl-2 and COX-2 was detected in sub-epithelial inflammatory infiltration (P<0.001, P=0,003). The amount and intensity of Bcl-2 and COX-2 expression were significantly correlated in sub-epithelial lymphocytic infiltration (P=0.013, P=0.019 ).  Conclusion : Our findings indicated the effective role of Bcl-2 expression in decreasing the apoptosis in the inflammator y infiltrate unlike the epithelium. The significant correlation of the intensity of Bcl-2 expression in the epithelium and the sub-epithelial inflammatory infiltrate with COX-2 expression and also the correlation of the intensity of inflammation with the severity of basal layer hydropic degeneration may imply that these two markers can induce malignant transformation in the affected epithelium in an indirect manner by the continuation of inflammation and activation of carcinogenic mechanisms

Bifidobacterium bifidum does not show cell toxicity on leukemic cells of AML patients but induced cell death on K562 cell line

Background:     Leukemia is a kind of blood cancer diseases which are generally known as neoplasm. There are two types of blood cancer called acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). This type of leukemia targets plasma cells and prevents the production of antibodies in the body and makes the immune system vulnerable to infections. Methods:     Blood samples from 10 people with AML and 10 normal individuals were collected who were defined as the case and control groups, respectively. PBMCs were isolated by Ficoll hypaque and cultured in order to the MTT assay. Then, the cell wall of Bifidobacterium bifidum bacterium was treated in five concentrations on these cells and the MTT test was performed at 24, 48 and 72hrs. Also, K562 leukemia cell was cultured then after; the MTT test was performed in the same protocol. The expression of BAX, Bcl2, β-actin genes were assessed by real-time PCR after 48 and 72hrs of treatment. Results:     The results of MTT test could not show any significant differences in extracted PBMCs from individuals as compared to control group. But, K562 cell line in treatment with the cell wall of Bifidobacterium bifidum showed a significant cell toxicity effect at 48 and 72hrs versus non-treated K562 cells. BAX gene expression was significantly increased versus β-actin gene control only on K562 cell line, but not on AML derived leukemic cells. Conclusion:     According to the obtained results, Bifidobacterium bifidum, as a probiotic bacterial species, can impact the growth and/or proliferation of cancer cells; however, it could depend on the type of cancer cells