Expression of transforming growth factor ? and its correlation with lipodystrophy in oral submucous fibrosis: an immunohistochemical study

Objective: In our routine review of Oral Submucous Fibrosis (OSMF) biopsies, we observed decreased adipose tissue even though most are from buccal mucosa. Pathogenesis of OSMF has demonstrated the role of Transforming Growth Factor ? (TGF ?), in causing fibrosis. This study aims to correlate the role of TGF ? with loss of adipose tissue in OSMF. Study Design: From our archives, 84 OSMF cases (24 early and 60 advanced OSMF) were screened for adipose tissue. Immunoexpression of TGF ? in these cases were investigated. Results: Adipose tissue was seen in 67% of early OSMF and in 13% of advanced cases. Early cases showed more intense TGF ? staining of epithelium, fibroblast, macrophages and inflammatory cells than the advanced cases. Conclusion: These findings suggest that TGF ? plays a key role in causing lipodystrophy in OSMF and is secreted more during early course of the disease than in advanced stage

Attitudes of general dental practitioners towards biopsy procedures

Objectives: A dentist is required to detect and recognise oral lesions and inform the patient accordingly by providing a diagnosis and adequate treatment plan. Biopsy serves as an important aid in achieving this goal; however, its use is not so widespread in general dental practice. The objective of the present study was to explore the attitudes of general dental practitioners in Belgaum city towards biopsy for diagnosis of oral lesions. Material and methods: A self designed questionnaire was administered to 74 general dental practitioners in Belgaum city, in the southern region of India, consisting of several items addressing the socio-demographic and professional aspects and their attitudes towards oral biopsy procedures. Results: The response rate was exceptionally high i.e. 90.54%. All the dentists felt that biopsy was an important tool in diagnosis of oral lesions but many still did not venture to undertake it on their own and preferred referring it to a specialist or higher care centre. This was mainly due to lack of experience and patient factors. There were also conflicting results regarding referral diagnostic pathology services and preservation of the biopsy specimens. Conclusion: This emphasizes the need for higher levels of importance to be placed on this aspect in undergraduate and postgraduate dental curriculum. Organisation of specific training or continuing dental education programmes to enhance their practical skills could aid in increasing the utility of this important tool in diagnosis of oral lesion

Oral Juvenile Hyaline Fibromatosis: A Rare Entity

Juvenilna hijalina fibomatoza iznimno je rijedak poremećaj kod dojenčadi i djece, a javlja se prema zakonima autosomno recesivnog nasljeđivanja. Izgleda poput multiple kožne ili subkutane tumorne tvorbe, sporo se razvija i češća je u području glave i vrata te gornjeg dijela trupa. Često je povezana s gingivnom hipertrofijom, teškom fleksularnom kontrakturom udova i koštanom lezijom. Nema mentalne retardacije. Histološki se te lezije sastoje od obilne eozinofilne osnovne tvari s neravnomjerno raspršenim fibroblastima. Ekscidirane lezije u ranim stadijima bogatije su stanicama. Točno podrijetlo eozine hijaline tvari nije poznato. Nedavno je pronađen defekt kromosoma 4q21 povezan s lokusom gena – 2 za kapilarnu morfogenezu. Diferencijalna dijagnoza za juvenilnu hijalinu fibromatozu uključuje i infantilnu sistemsku hijalinozu, za koju se zna da je alelna. Trenutačno nema široko prihvaćene učinkovite terapije ni za juvenilnu hijalinu fibromatozu ni za infantilnu sistemsku hijalinozu. Juvenilna hijalina fibromatoza i infantilna sistemska hijalinoza ponekad se teško razlikuju jer su vrlo slične. Mi izvještavamo o slučaju juvenilne hijaline fibromatoze kod 10-godišnje djevojčice s pretežno gingivalnom hiperplazijom.Juvenile hyaline fibromatosis is an exceedingly rare disorder of infants and children which appears to have autosomal recessive inheritance. It is characterized by multiple, slowly growing dermal or subcutaneous tumors, especially in the head and neck region and upper trunk, often associated with gingival hypertrophy, severe flexural limb contractures and bone lesions. There is no mental retardation. Histologically, these lesions are composed of copious eosinophilic, homogenous ground substance with unevenly dispersed fibroblasts. Lesions excised in early stages are more cellular. The precise nature of the eosinophilic hyaline material is not known. Recently, a defect on chromosome 4q21 associated with the locus of the capillary morphogenesis gene – 2, has been demonstrated. The differential diagnosis of juvenile hyaline fibromatosis includes infantile systemic hyalinosis, which is now known to be allelic. Currently, no widely accepted effective treatment exists for juvenile hyaline fibromatosis or infantile systemic hyalinosis. Infantile systemic hyalinosis and juvenile hyaline fibromatosis are sometimes difficult to separate since they show significant overlap. We report one such unusual case of juvenile hyaline fibromatosis in a 10 year old female presenting mainly with gingival hyperplasia

Dizajn, razvoj i vrednovanje novih nanoemulzija za transdermalnu primjenu celekoksiba

The aim of the present study was to investigate the potential of nanoemulsion formulations for transdermal delivery of celecoxib (CXB). The in vitro skin permeation profile of optimized formulations was compared with CXB gel and nanoemulsion gel. Significant increase in the steady state flux (Jss), permeability coefficient (Kp) and enhancement ratio (Er) was observed in nanoemulsion formulations T1 and T2 (p < 0.05). The highest value of these permeability parameters was obtained in formulation T2, which consisted of 2% m/m of CXB, 10% m/m of oil phase (Sefsol 218 and Triacetin), 50% m/m of surfactant mixture (Tween-80 and Transcutol-P) and 40% m/m of water. The anti-inflammatory effects of formulation T2 showed a significant increase (p < 0.05) in inhibition after 24 h compared to CXB gel and nanoemulsion gel on carrageenean-induced paw edema in rats. These results suggested that nanoemulsions are potential vehicles for improved transdermal delivery of CXB.U radu su opisana ispitivanja nanoemulzija za transdermalnu primjenu celekoksiba (CXB). Profil permeacije kroz kožu ispitivan je in vitro i uspoređivan sa CXB gelom i nanoemulzijskim gelom. U formulacijama T1 i T2 postignuto je značajno povećanje ustaljenog fluksa (Jss), koeficijenta permeabilnosti (Kp) i povećanje omjera (Er) (p < 0.05). Najveće vrijednosti parametara permeabilnosti dobivene su u formulaciji T2 koja je sadržala 2% m/m CXB, 10% m/m uljne faze (Sefsol 218 i Triacetin), 50% m/m površinski-aktivnih tvari (Tween-80 i Transcutol-P) i 40% m/m vode. Protuupalno djelovanje formulacije T2 na edem šape štakora uzrokovan karageninom značajno je povećano (p < 0.05) poslije 24 h u usporedbi sa CXB gelom i nanoemulzijskim gelom. Rezultati ukazuju na poboljšanu isporuku celekoksiba putem nanoemulzija

Epithelial-mesenchymal transition - A fundamental mechanism in cancer progression: An overview

The epithelial-mesenchymal transition (EMT) has a significant role in embryogenesis. EMT is also implicated as a fundamental step development of invasive phenotypes associated with progression of cancer. EMT confers the cancer cells with migratory and invasive properties that allow them to come into the stroma, which creates a conducive environment for cancer progression and metastasis. Moreover, acquisition of EMT is linked with resistance to chemotherapy that could lead to recurrences and enhance the morbidity and mortality related to cancers. Consequently, EMT has been associated with carcinogenesis, invasion, metastasis, recurrence, and chemoresistance. Research into EMT and its role in cancer pathogenesis has advanced in a rapid pace, but since its participation shows considerable variation among different cancer types and the exact mechanism operative in different cancers remains ambiguous; EMT continues to be a significant issue for research. In this review, we present an overview of EMT, its role in cancer progression and the clinical implication of its identification

Peripheral cemento-ossifying fibroma: Report of a recurrence case

Peripheral cemento-ossifying fibroma [PCOF] is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Here, we report a case of POCF in a 13-year-old male, which was previously surgically excised and had recurred after a period of 9 months. PCOF should be considered in differential diagnosis of such reactive hyperplastic lesions originating from the gingiva. Hence, early diagnosis with proper surgical excision and aggressive curettage of the adjacent tissues are essential for prevention of recurrence

Oral lichenoid lesions: Clinico-pathological mimicry and its diagnostic implications

Oral cavity is commonly affected by number of lichenoid lesions, whose clinical and histopathologic features overlap due to the presence of inflammatory cells in connective tissue. Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. The literature discussed in the article is an attempt to segregate individual lichenoid lesions by defining clinical and histopathologic variations among each other, which avoids the diagnostic problem

Histomorphometric analysis of nuclear and cellular volumetric alterations in oral lichen planus, lichenoid lesions and normal oral mucosa using image analysis software

Introduction: Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. Aims: To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. Materials and Methods: A retrospective study was done on 25 histologically diagnosed cases each of oral lichen planus, oral lichenoid lesions, and normal oral mucosa. Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Statistical Analysis: Analysis of variance test (ANOVA) and Tukey′s post-hoc test. Results: The basal cells of oral lichen planus showed a significant increase in the mean nuclear and cellular areas, and in nuclear volume; there was a significant decrease in the nuclear-cytoplasmic ratio as compared to normal mucosa. The suprabasal cells showed a significant increase in nuclear and cellular areas, nuclear diameter, and nuclear and cellular volumes as compared to normal mucosa. The basal cells of oral lichenoid lesions showed significant difference in the mean cellular area and the mean nuclear-cytoplasmic ratio as compared to normal mucosa, whereas the suprabasal cells differed significantly from normal mucosa in the mean nuclear area and the nuclear and cellular volumes. Conclusions: Morphometry can differentiate lesions of oral lichen planus and oral lichenoid lesions from normal oral mucosa. Thus, morphometry may serve to discriminate between normal and premalignant lichen planus and lichenoid lesions. These lesions might have a high risk for malignant transformation and may behave in a similar manner with respect to malignant transformation

Clinicopathological predictors of extent of cervical lymph node metastases in locally advanced squamous cell carcinoma of mandibular gingivobuccal sulcus

Introduction: Locally advanced mandibular gingivobuccal sulcus (GBS) squamous cell carcinoma (SCC) has variable extent of cervical lymph node metastasis. Tumor thickness reliably predicts cervical lymph node metastases in early oral SCC, its reliability in predicting the extent of neck-node positivity in locally advanced GBS SCC is poorly studied. Objectives: The objective of this study is to study the association of extent of neck-node metastases with gross tumor thickness (GTT), preoperative histological differentiation (HD), and presence of clinical skin infiltration (CSI) in locally advanced SCC of mandibular GBS. Methodology: Biopsy-proven patients with locally advanced SCC of mandibular GBS, underwent composite resection with neck dissection from Level V to Level I, from January 2012 to February 2016 were included in this study. The intraoperative GTT was measured, the HD of primary tumor and presence of CSI were noted. Specimens were grossed as per guidelines established by the Royal College of Pathologists. The data were analyzed using SPSS version 22, Chi-square test, and Spearman's Rank correlation test. Results: In 130 patients, with gross tumor thickness >1 cm in 64 (49%) and 1 cm, moderate-poor HD on biopsy, and presence of CSI were associated with extensive ipsilateral cervical lymph node metastases including Levels IV and V. These factors can help in predicting the extent of the neck dissection

Activation of latent TGF-\beta 1 by low-power laser in vitro correlates with increased TGF-β1 levels in laser-enhanced oral wound healing

The term Laser "Photobiomodulation" was coined to encompass the pleiotropic effects of low-power lasers on biological processes. The purpose of this study was to investigate whether transforming growth factor (TGF)-\beta had a role in mediating the biological effects of low-power far-infrared laser irradiation. We assayed for in vitro activation using various biological forms of cell-secreted, recombinant, and serum latent TGF-\beta using the p3TP reporter and enzyme-linked immunosorbent assays. We demonstrate here that low-power lasers are capable of activating latent TGF-\beta1 and -\beta3 in vitro and, further, that it is capable of "priming" these complexes, making them more amenable to physiological activation present in the healing milieu. Using an in vivo oral tooth extraction-healing model, we observed an increased TGF-\beta1, but not \beta3, expression by immunohistochemistry immediately following laser irradiation while TGF-\beta3 expression was increased after 14 days, concomitant with an increased inflammatory infiltrate. All comparisons were performed between laser-irradiated wounds and nonirradiated wounds in each subject essentially using them as their own control (paired T-test p<0.05). Low-power laser irradiation is capable of activating the latent TGF-\beta1 complex in vitro and its expression pattern in vivo suggests that TGF-play a central role in mediating the accelerated healing response