comparative study of cathepsin d expression in peripheral and central giant cell granuloma of the jaws by immunohistochemistry technique

Statement of the Problem: Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage

Purpose: This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics

Materials and Method: The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells [labeling index], the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared

Results: The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9 +/- 4.03 and 95.6 +/- 2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups [p= 0.586]. The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma [p> 0.001]. Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion [p= 0.001]

Conclusion: The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma

Study of p21 expression in oral lichen planus and oral squamous cell carcinoma by immunohistochemical technique

Statement of the Problem: Lichen planus is a mucocutaneous disease that is relatively common in middle aged individuals. Some studies have shown that oral lichen planus has a potential to progress to squamous cell carcinoma.p21 is a cyclin-dependent kinase inhibitor that regulates the cell cycle, thus it acts as an inhibitor in cell proliferation

Purpose: This study was aimed to evaluate and compare the immunostaining of p21 [as a proliferation inhibitory factor] in oral lichen planus [OLP] and oral squamous cell carcinoma [OSCC]

Materials and Method: In this descriptive cross-sectional study, p21expression was investigated in 24 samples of oral lichen planus [OLP], 24 samples of oral squamous cell carcinoma [OSCC] and 24 samples of oral epithelial hyperplasia [OEH] by employing immunohistochemical staining

Results: The mean percentage of p21-positive cells in OSCC [54.5 +/- 6.6] was significantly higher than that in OLP [32.8 +/- 6.08] and OEH [9.4 +/- 3.8]. Moreover, OLP samples expressed p21 significantly higher than the OEH. Kruskal Wallis test revealed a statistically significant difference between the groups regarding the intensity of staining [p< 0.001]

Conclusion: According to the findings of this study, the expression of p21 might be related to the potential carcinogenic transformation of lichen planus to SCC. Therefore, continuous follow-up periods for OLP are recommended for diagnosis of the malignant transformations in early stages

Scrub typhus associated with systemic lupus erythematosus: a case report

The etiology of systemic lupus erythematosus [SLE] is largely unknown and there is a probable contribution of genetic, hormonal, immunological and environmental factors for its manifestation. The widespread immunological destruction of many organs in SLE and the associated decreased immunity increase the risk of infections. Steroids and other immunosuppressant are important in the treatment of SLE, but they further increase the risk of infections, and sometimes with rare organisms. We present a case of an adolescent girl with prolonged fever, joint pains and without skin rashes. The initial diagnosis was SLE. She was treated with steroids with improvement in her general condition and relief of joint pains. However the fever persisted and subsequent investigations revealed an associated scrub typhus. The fever subsided after treatment with oral tetracycline. There were no complications of scrub typhus. Since scrub typhus infection is not common in the Arabian Peninsula the disease was not initially thought of. In the investigation of prolonged fever in SLE, viral, bacterial, protozoal as well as rickettsial diseases should be borne in mind

continuing dilemma of hyperinvasive strongyloidiasis syndrome: a case report and review of literature

A 28-year-old man from Bangladesh was admitted to Al-Jahra Hospital in Kuwait with an Addison's crisis after suddenly stopping steroids prescribed for uveitis. His hospital stay was further complicated by severe gastritis, peritonitis and meningitis. Investigations revealed Strongyloides stercoralis in the sputum, stomach aspirate and duodenal mucosa. The patient died in spite of intensive treatment. The problem of hyperinvasive strongyloidiasis syndrome is reviewed