An Immunohistochemical Analysis for Evaluating the Diagnostic Role of Myofibroblasts in Oral Squamous Cell Carcinoma using α-Smooth Muscle Actin Antibody.

Background: One of the most common types of malignancies affecting the head and neck region is oral squamous cell carcinoma (OSCC). Little less is known about the role of myofibroblasts in the pathogenetic process of OSCC. Hence, we assessed the involvement of myofibroblasts in the invasive process of OSCC using α-SMA (α-smooth muscle actin) antibody. Materials and Methods: Four study groups in total were organized as follows: 40 cases each of well-differentiated OSCC (WDOSCC), moderately differentiated OSCC (MDOSCC), poorly differentiated OSCC (PDOSCC), and controls make up Group 1, Group 2, Group 3, and Group 4, respectively. The percentage of α-SMA immunopositive cells and staining intensity (A) multiplied together to determine the final staining score (B). The final staining index was produced by multiplying staining intensity (A) by the proportion of immunopositive cells that were stained with α-SMA (B) (FSI). Score Zero was graded as Index Zero by FSI while scores One and Two received an Index Low rating, scores Three and Four an Index Moderate rating, and scores Six and Nine an Index High rating. Results: Significantly higher expression of myofibroblast was observed in OSCC group in comparison with the control group. However; no significant difference in myofibroblast expression was observed while comparing different grades of OSCC. Conclusion: We recommend using myofibroblasts as a stromal marker to track the severity and development of OSCC.

Establishment of the role of myofibroblasts in invasive process of oral squamous cell carcinoma: A pilot study.

Aims: To establish the role of myofibroblasts in invasive process of oral squamous cell carcinoma (OSCC). Materials and Methods: Four study groups were formed as follows: group 1 consisting of 30 cases of well-differentiated OSCC, group 2 consisting of 30 cases of moderately differentiated OSCC, group 3 consisting of 30 cases of poorly differentiated OSCC, and group 4 consisting of controls. Staining of all of the specimens was done using a-SMA antibody through immunohistochemistry (IHC) procedure. Multiplication product of staining intensity (A) and percentage of a-SMA-stained immuno-positive cells (B) gave a final staining index (FSI). According to FSI, score zero was graded as index zero; score one and two were graded as index low; score three and score were graded as index moderate; and score six, seven, eight and nine were graded as index high. Results: Mean FSI among specimens of groups 1, 2, 3, and 4 was 7.93, 8.47, 8.8, and 0, respectively. Non-significant results were obtained while comparing the mean final staining index among specimens of groups 1, 2 and 3. However; while comparing between groups 1 and 4, groups 2 and 4, and groups 3 and 4, significant results were obtained. While comparing the FSI among overall OSCC group (groups 1, 2 and 3) and controls (group 4), significant results were obtained. Conclusion: Myofibroblasts are an integral component of processes associated with the creation of a permissive environment for cancer invasion process in patients with OSCC. Clinical Significance: Myofibroblasts are associated with the creation of progressive and invasive processes of oral squamous cell carcinoma. Hence, they might be employed as a part of future target for therapeutics in cancer therapy.

Pterion formation in North Indian population: an anatomico-clinical study / Formación del pterion en una población del norte de India: un estudio anátomo-clínico

Pterion is a point of sutural confluence seen in the norma lateralis where frontal, parietal, temporal and sphenoid bones meet. This craniometric point is related to various structures in the cranial cavity like middle meningeal artery, anterior pole of insula and Broca's area. This study was done to find most common variation in its shape and presence of epipteric bones and to compare with other racial groups from previous study. Fifty adult human skulls of unknown sex taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Rsearch, Vallah (Amritsar, India) were examined on both sides for the type and position of the pterion. Four types of pterion formation were noted. Sphenoparietal was observed in 89%, frontotemporal in 7%, stellate in 4% and epipteric in 12% of cases. The pterion was found to be 3.1±0.44 cm on the right side, 3.4±0.40 cm on the left side from the frontozygomatic suture and 4.1±0.45 cm on the right side and 4.4±0.32 cm on the left side from the centre of zygoma. These variations in the sutural morphology is comparable to other population. Its position is of interest to anthropologists, forensic pathologists and surgeons who deserve further investigation in population of different area.

El pterion es un punto correspondiente con el extremo posterior de la sutura donde se ubican los huesos frontal, parietal, temporal y esfenoides. Este punto métrico del cráneo se relaciona con diversas estructuras en la cavidad craneal como la arteria meníngea media y polo anterior de la ínsula en el área de Broca. Este estudio se realizó para determinar la variación más común de la forma y presencia de huesos epiptéricos y comparar estos con otros grupos raciales. Cincuenta cráneos humanos adultos de sexo desconocido obtenidos en el departamento de anatomía, Sri Guru Ram Das Instituto de Ciencias Médicas e Investigaciones, Vallah (Amritsar, India) fueron examinados en ambos lados para el tipo y posición del pterion. Se observaron cuatro tipos de formación. Esfenoparietal en el 89% de las muestras, fronto temporal en el 7% de las muestras, estrelladas en 4% y epiptérico en el 12% de los casos. Desde la sutura frontocigomática el pterion se encontraba a 3,1±0,44 cm en el lado derecho, 3,4±0,40 cm en el lado izquierdo y desde el centro del hueso cigomático a 4,1±0,45 cm en el lado derecho y 4,4±0,32 cm en el lado izquierdo. Estas variaciones en la morfología de la sutura son comparables a otras poblaciones. Su posición es de interés para los antropólogos, patólogos forenses y cirujanos, y merece una mayor investigación en poblaciones de diferentes regiones.

8q24 and 17q prostate cancer susceptibility loci in a multiethnic Asian cohort.

OBJECTIVES: Recently, several genome-wide association studies have demonstrated a cumulative association of 5 polymorphic variants in chromosomes 8q24 and 17q with prostate cancer (CaP) risk in Caucasians, particularly those harboring aggressive clinicopathologic characteristics. The purpose of this study was to evaluate the influence of these variants on CaP susceptibility in Singaporean Asian men. MATERIALS AND METHODS: We performed a case-control study in 289 Chinese CaP patients and 412 healthy subjects (144 Chinese, 134 Malays, and 134 Indians), and examined the association of the 5 single nucleotide polymorphisms (SNPs) with CaP. RESULTS: In the healthy subjects, rs16901979 A-allele frequency was highest amongst Chinese (0.32) compared with Malays (0.13; P < 0.0001) or Indians (0.09; P < 0.0001); rs6983267 G-allele was highest in Indians (0.51) compared with Chinese (0.42; P = 0.041) or Malays (0.43; P = 0.077); whereas rs1859962 G-allele frequency was highest amongst Indians (0.56) compared with Chinese (0.40; P = 0.0002) or Malays (0.38; P < 0.0001). Individuals with the rs4430796 TT genotype were at increased CaP risk in the Chinese via a recessive model (odds ratios (OR) = 1.56, 95% CI = 1.04-2.33). Significant associations were observed for rs4430796 TT with Gleason scores of ≥ 7 (OR = 1.76, 95% CI = 1.14-2.73) and prostate-specific antigen (PSA) levels of ≥ 10 ng/ml at diagnosis (OR = 1.63, 95% CI = 1.01-2.63), as well as for rs6983267 GG with stage 3-4 CaPs (OR = 1.91, 95% CI = 1.01-3.61). A cumulative gene interaction influence on disease risk, which approximately doubled for individuals with at least 2 susceptibility genotypes, was also identified (OR = 2.18, 95% CI = 1.10-4.32). CONCLUSIONS: This exploratory analysis suggests that the 5 genetic variants previously described may contribute to prostate cancer risk in Singaporean men.

Variations in branching pattern of renal artery and arrangement of hilar structures in the left kidney: clinical correlations, a case report.

Traditionally, anatomy textbooks describe each kidney to receive irrigation from a single renal artery. However, current literature reports great variability in renal blood supply, the number of renal arteries and the arrangement of hilar structures on the left side. Here a case is described where, on the right side, the renal artery had its origin from the abdominal aorta, as normally occurs, and followed a normal course and relations in the hilum. There were three renal arteries on the left side. The left main renal artery took origin from the anterior aspect of the abdominal aorta. The other two arteries took their origin from a common trunk coming out of the lateral aspect of abdominal aorta inferior to the main left renal artery. The renal vein at the hilum was found between the main renal artery and the ventral branch of the common trunk, anteriorly, and the dorsal branch of the common trunk, posteriorly. Such variation has great implications when surgery is indicated, as in renal transplants, urological and radiological procedures, renovascular hypertension, renal trauma and hydronephrosis. As the number of renal surgical and radiological interventions increase, a better understanding of the anatomy of renal arteries and their branches gain importance. To plan the adequate surgical procedure and to avoid any vascular complication, Multi Detector Computer Tomography (MDCT), angiography and arteriography should be performed prior to surgery (nephrectomy).

Marginal mandibular branch of the facial nerve: An anatomical study.

Smile is one of the most natural and important expressions of human emotion. Man uses his lips mainly to register his emotions. Thus, the slightest asymmetry or weakness around the lips and mouth may transform this pleasant expression into embarrassment and distortion. The circumoral musculature, the major part of which is supplied by the marginal mandibular branch of the facial nerve, is the main factor in this expression. Therefore, an injury to this nerve during a surgical procedure can distort the expression of the smile as well as other facial expressions. This nerve often gets injured by surgeons in operative procedures in the submandibular region, like excision of the submandibular gland due to lack of accurate knowledge of variations in the course, branches and relations. In the present study, 50 facial halves were dissected to study the origin, entire course, termination, branches, muscles supplied by it, its anastomoses with other branches of facial nerve on the same as well as on the opposite side and its relations with the surrounding structures. The marginal mandibular branch of the facial nerve was found superficial to the facial artery and (anterior) facial vein in all the cases (100%). Thus the facial artery can be used as an important landmark in locating the marginal mandibular nerve during surgical procedures. Such a study can help in planning precise and accurate incisions and in preventing the unrecognized severance of this nerve during surgical procedures.

Pharmacogenetics of target genes across doxorubicin disposition pathway: a review.

Increased understanding of the molecular mechanisms of tumor heterogeneity combined with rapid advances in the field of pharmacogenetics and pharmacogenomics have fuelled studies on individualizing anticancer therapy. Doxorubicin (Adriamycin), is an anthracycline glycoside antibiotic originally produced by Streptomyces peucetius var. caesius, and is widely used either as a single agent or in combination with other chemotherapeutic regimens for curative, adjuvant, and palliative treatment in cancer patients. The pharmacogenetics of doxorubicin has not been well characterized. The polygenic influence of functional candidate gene variants across doxorubicin biochemical pathway is hypothesized to contribute to its heterogeneity in disposition, influencing the efficacy of treatment and occurrence of adverse effects like cardiomyopathy in patients undergoing doxorubicin based adjuvant and neo-adjuvant chemotherapy. The pharmacogenetics of Asian population differs from that of other ethnic groups, particularly from Caucasian and African populations, and indicates an important role of ethnicity in determining predictive end points during chemotherapy and in individualizing treatment. This review comprehensively examines the pharmacogenetics of the regulatory nuclear receptor Pregnane-X Receptor (PXR), influx (SLC22A16) and efflux drug transporters (ABCB1, ABCG2, ABCC5, ABCB5 and RLIP76) and drug metabolizing enzymes (CBR1, CBR3) across the biochemical pathway of doxorubicin in Asian breast cancer patients receiving doxorubicin based adjuvant chemotherapy. The influence of functional genetic variants on the inter-individual variability in pharmacokinetics of doxorubicin and its major metabolite are also discussed. The incorporation of non-genetic factors and subsequent validation of these findings in different patient and population groups will be valuable in tailoring doxorubicin dosage regimens to an individual to maximize therapeutic efficacy and minimize adverse reactions, leading to improved clinical outcomes.