Antimicrobial peptide hCAP-18/LL-37 protein and mRNA expressions in different periodontal diseases.

OBJECTIVE: To investigate the levels of antimicrobial peptide hCAP-18/LL-37 protein and mRNA expression in gingival tissues with different periodontal disease. MATERIALS AND METHODS: Ten patients with generalized aggressive periodontitis, 10 patients with chronic periodontitis, and 10 healthy controls were included in this study. Periodontal parameters including probing depth, clinical attachment level, plaque index, and papilla bleeding index were assessed in study subjects. hCAP-18/LL-37 mRNA analysis by RT-PCR and immunohistochemistry were performed in 19 samples provided enough RNA in terms of concentration and integrity. RESULTS: This study demonstrated that hCAP-18/LL-37 was a product of neutrophils. Tissue samples of chronic periodontitis patients had significantly higher immunostaining of hCAP-18/LL-37 on neutrophils infiltrating in both epithelium and connective tissue compared with controls. hCAP-18/LL-37 mRNA expression levels in tissue samples of chronic periodontitis patients seemed to be upregulated compared with controls. While two generalized aggressive periodontitis patients showed downregulated hCAP-18/LL-37 mRNA expression levels, one generalized aggressive periodontitis patient showed slightly increased hCAP-18/LL-37 mRNA level compared with controls. CONCLUSIONS: hCAP-18/LL-37 has an important role in innate response during periodontal inflammation. Local deficiency in hCAP-18/LL-37 might be a confounding effect in the pathogenesis of generalized aggressive periodontitis.

Eruptive disseminated Spitz naevi: dermatoscopic features.

Eruptive disseminated Spitz naevi is a rarely reported condition. Although the dermatoscopic features of nondisseminated, solitary forms of Spitz naevi are well known, there are no reports describing the dermatoscopic features of eruptive disseminated variant. We report an additional case and describe the dermatoscopic features. Two patterns were observed. In all pink lesions, the vascular pattern was seen, composed of dotted, linear or comma-like vessels located at the centre of the meshes of the reticular depigmentation. In all brown lesions, we observed only the reticular pattern, which is quite interesting as the reticular pattern is a rare feature of Spitz naevi. This observation may be a special feature particularly seen in the eruptive disseminated variant. A superficial black network also accompanied reticular pattern in some lesions. In dichromatic lesions, both patterns were observed in different areas of the body.

Pemphigus vulgaris in childhood. A case report.

An 11-year-old girl with vesicles and eroded lesions on her oral mucosa and tongue was diagnosed as having pemphigus vulgaris. The diagnosis was confirmed by histopathologic and immunofluorescence studies. The patient was successfully treated with methylprednisolone and azathioprine. After two months maintenance therapy was started. She is still taking methylprednisolone and azathioprine as maintenance therapy and no recurrence has been observed.

Primary pulmonary rhabdomyosarcoma arising within cystic adenomatoid malformation: a case report and review of the literature.

The current report describes a 13-month-old boy with primary pulmonary rhabdomyosarcoma (RMS) that originated within a congenital cystic adenomatoid malformation (CCAM). To the best of our knowledge, he is the youngest patient of all primary pulmonary RMS cases reported in the English-language literature. The tumor, localized in left upper lobe, was removed completely, and histologic examination showed embryonal subtype. Postoperative systemic chemotherapy was carried out. Recent evaluation 15 months after resection has not identified any residual or recurrent disease. Primary pulmonary RMS, although very rare in the pediatric age group, should be considered in young patients with solitary pulmonary masses and associated cystic lesions.

P53 protein expression in eccrine poroma and porocarcinoma.

The role of p53 mutation has been shown in different human malignancies, including various skin cancers. In this study, we examined p53 protein expression in 25 eccrine poromas and 11 porocarcinomas by immunohistochemistry. P53 expression was observed in 88% (22 of 25) of eccrine poromas and 73% (8 of 11) of porocarcinomas. In eccrine poromas, percentage of cells reactive for p53 was less than 5% (low expresser) in 6 cases, 5 to 50% (moderate expresser) in 14 and greater than 50% (high expresser) in 2 cases. In terms of intensity, 13 cases showed weak staining, 8 moderate, and 1 case showed strong reactivity. On the other hand, 2 cases of porocarcinoma were low expresser, 2 were moderate and 4 were high expresser. All of the high expressers had also strong staining. This study has demonstrated that eccrine poromas showed significant p53 expression as much as porocarcinomas and, therefore, p53 positivity cannot be accepted as a valuable parameter for malignancy. P53 gene may involve in the carcinogenetic pathway of porocarcinoma but it is likely that other oncogenes may also have a role.

[Cowden syndrome (multiple hamartoma syndrome). Role of the dentist in early detection]. / Cowden-Syndrom (Multiple-Hamartome-Syndrom). Rolle des Zahnarzts bei seiner Früherkennung.

First lesions of Cowden syndrome appear in the oral cavity and on the skin. Malignant transformation is a late, common event in thyroid and breast. The early diagnosis of Cowden disease prior to the development of internal malignancy, particularly of the breast and the thyroid gland, is very important. We emphasize that the dentist may be the first health care professional who recognizes the syndrome, and this is a crucial step in the prevention and cure of the predictable malignancy. This article presents a typical case of Cowden disease.

Subcutaneous granuloma annulare and IgA-IgG2 deficiency.

Subcutaneous granuloma annulare (SGA) is a benign granulomatous disease occurring in childhood, with lesions most commonly located about the elbow, knee and scalp. the etiology of SGA remains obscure. We present a typical case with SGA also showing laboratory findings of IgA and IgG2 deficiency. Histologic findings of the lesions on the scalp were characterized by multiple large foci of complete collagen degeneration with a peripheral pallsade of histiocytes; the foci of degeneration was edematous basophilic. In contrast to current literature, an abnormality in the cellular immune system was not found. However, immune defects (IgA and IgG2 deficiency) related to the humoral immune system were observed.

Pseudo-Kaposi's sarcoma (Mali type).

A 75-year-old man presented with lesions on his right leg and on the dorsum of the penis, which had appeared 5 years ago following long distance travel. His right leg was swollen, and there was a dark-violet-colored, slightly elevated lesion extending to the thigh and penis. Histologic examination revealed thickening of the arteriolar walls and diffuse proliferation of the vascular structures surrounding the arterioles and dissecting the dermal collagen fibers. Immunohistochemical staining for Factor VIII R-A reacted positively with arteriolar endothelium, but was negative on thin-walled vascular spaces. Femoral angiography showed multiple fine arteriovenous (A-V) shunts especially at the one-third distal lower region of the right leg.

Liposarcoma of soft tissue: MRI findings with pathologic correlation.

OBJECTIVE: To evaluate the MRI findings of liposarcomas of different histologic types and correlate these with the histopathologic features. DESIGN: The MR images of seven liposarcomas were reviewed retrospectively to assess the tumor size, location, margination, signal characteristics and enhancement patterns in different histologic types. PATIENTS: Seven liposarcomas comprising three well-differentiated, two myxoid and two pleomorphic types were evaluated. RESULTS AND CONCLUSION: All tumors showed well-defined and mostly lobulated margins. The well-differentiated liposarcomas were composed mainly of fat with septations or nodules, were hyperintense on T2-weighted images, and demonstrated faint enhancement or no enhancement following intravenous contrast. Myxoid liposarcomas were homogeneous or mildly heterogeneous and a pseudocapsule was present in one case. Pleomorphic types showed a markedly heterogeneous internal structure. Both myxoid and pleomorphic lesions-showed moderate or marked heterogeneous enhancement after contrast administration. Well-differentiated liposarcomas may be differentiated from other types of the tumor by their largely lipomatous appearance. The malignancy grade increases in parallel with tumor heterogeneity and contrast enhancement.

Magnetic resonance imaging of intramuscular haemangiomas with emphasis on contrast enhancement patterns.

Fifteen patients with intramuscular haemangiomas were evaluated with magnetic resonance imaging (MRI). Phleboliths were demonstrated by plain films or CT in six cases, which are characteristic for haemangioma. MRI showed intermediate or slightly high signal intensity on T1-weighted spin-echo images, and overall extremely bright signal on T2-weighted images. Twelve patients had a heterogeneous signal intensity and serpentine pattern on all sequences. A draining vessel was identified in a patient with histologically confirmed diagnosis of arteriovenous type of hemangioma. In three cases with localized small lesions, the MR appearance on T1 and T2-weighted conventional spin-echo sequences was homogenous. Two of the three showed a serpentine pattern on contrast enhanced images. In a patient with a soft tissue mass suspected of representing a haemangioma, MRI may provide more specific information, regarding the characteristics and extent of the lesion than other imaging techniques. In small localized lesions, contrast enhanced MRI may also offer significant advantage, making the identification of serpentine pattern possible which is a characteristic morphological feature of haemangioma.

Multicentric reticulohistiocytosis.

We describe a 42-year-old man with a five-year history of arthritis mutilans-like destructive joint changes and with a one-year history of nodules on the fingers, ears, oral mucosa, pharynx, larynx, vocal cords, some being ulcerated and haemorrhagic. He was diagnosed as having rheumatoid arthritis; however, biopsies from the nodules on the oral mucosa and ear revealed multicentric reticulohistiocytosis. The large nodule over the olecranon process, simulating a rheumatoid nodule but diagnosed as multicentric reticulohistiocytosis with biopsy; ulcerated and haemorrhagic nodules on the oral mucosa; and rapidly progressive joint destructions make our case interesting.

Eosinophilic cystitis induced by mitomycin-C.

Eosinophilic cystitis is an unusual form of cystitis which is characterized by irritative voiding symptoms and haematuria. In the report herein two adult cases of eosinophilic cystitis treated with intravesical Mitomycin-C instillations for prophylaxis of bladder carcinoma are presented and the literature is reviewed.