Analysis of erythrocytes in oral submucous fibrosis - A morphometric study.

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic progressive scarring oral disease caused due to areca quid chewing. The constituents of areca nut can enter into the circulation by swallowing the liquid mixture of areca quid which evokes oxidative stress on RBC membrane integrity. AIMS: To study the morphometric characteristics of erythrocytes under light microscopy and to assess the role of areca quid constituents on the morphology of circulating erythrocytes. MATERIALS AND METHODS: Peripheral blood smears prepared from blood samples of 50 patients selected according to Lai's classification. Group I: Normal individuals (10 cases); Group II: Mouth opening > 35 mm (10 cases); Group III: Mouth opening 30-35 mm (10 cases); Group IV: Mouth opening 20-30 mm (10 cases) and Group V: Mouth opening < 20 mm (10 cases). The slides were stained with Leishman's stain and assessed by light microscopy. A total of 100 randomly selected RBCs from 5 different fields in each smear were selected and the RBC circumference was measured and tabulated. STATISTICAL ANALYSIS AND RESULTS: Data was analyzed using GraphPad Prism 5.03 software. Tukey's multiple comparison test showed statistically significant difference (p < 0.05) between groups I and IV; I and V; II and IV; II and V; III and IV; III and V. CONCLUSION: These results suggest the possibility of cytotoxic effect of areca quid constituents on circulating erythrocytes in advanced cases of OSMF, which might result in microcytic anaemia.

Association of Human Papilloma Virus in Oral Squamous Cell Carcinoma: An Alarming Need for Human Papillomavirus 16 Screening in Cancer Patients.

BACKGROUND: The percentage of cancers of the tongue and palatine tonsils has continued to increase by 2%-4% among younger men. This increased prevalence of a subsection of oropharyngeal carcinoma can be associated with human papillomavirus (HPV). Among the head-and-neck cancers, a strong association with HPV infection is evident with oropharyngeal cancers, particularly tonsillar and basal tongue cancers. OBJECTIVES: Oral carcinoma, with an overall incidence of 16.1 adults per 100,000, is one of the leading malignancies worldwide, presenting a noticeable geographic variation in its distribution. Squamous cell carcinoma (SCC) being the most common of all oral malignancies, the objective of the study is to detect the HPV antigen p16 over-expression in patients with oral SCC using immunohistochemistry (IHC). MATERIALS AND METHODS: Oral SCC (OSCC) diagnosed formalin-fixed-paraffin embedded blocks were processed for IHC. RESULTS: Out of 50 cases, 3 were deferred due to insufficient tumor sample and 2/47 cases were p16 positive and the site was the lateral border of the tongue. CONCLUSION: The HPV antigen overexpression in patients with OSCC was investigated to detect the incidence of HPV in SCC of oral cavity. P16 was used as a marker for the detection of OSCC using IHC in HPV-induced OSCC. Positives were detected thus concluding the significance of studying HPV expression during diagnosis.

Primary intraosseous adenoid cystic carcinoma of the mandible: A rare clinical entity.

Central intraosseous adenoid cystic carcinoma (ACC) of the mandible, formerly known as cylindroma, is a rare neoplasm with only 47 cases reported in the literature. We present a case of central ACC involving the mandible of a 55-year-old male patient.

The role of myofibroblasts in the progression of oral submucous fibrosis: A systematic review.

Oral Submucous Fibrosis (OSMF) is a chronic progressive scarring oral disease predominantly affecting people of South Asian origin. It is characterized by juxtaepithelial inflammatory cell infiltration followed by fibrosis in the lamina propria and submucosa of the oral mucosa. The pathogenesis of the disease is not well established and a number of mechanisms have been proposed regarding the pathogenesis. A renewed interest has been shown in myofibrobasts which have been implicated to play a significant role in the pathogenesis of OSMF. The myofibroblast were initially identified by means of electron microscopy in granulation tissue of healing wounds as a modulated fibroblast exhibiting features of smooth muscle cells, with prominent bundles of microfilaments, dense bodies scattered in between, and gap junctions. The presence of myofibroblasts has successively been described in practically all fibrotic situations characterized by tissue retraction and remodeling. This review paper is an attempt to identify all the studies involving myofibroblasts and explaining the pathogenesis in a simplified manner.

Impact of stromal CD45RO+ immune cells on proliferation and dedifferentiation in node-negative squamous cell carcinomas of cheek mucosa.

BACKGROUND: The most fundamental trait of cancer cells involves their ability to sustain chronic proliferation. Tumors have a complex cellular ecology that establishes the malignant potential of the tumor. In these ecosystems, innate immune cells are highly represented. Many contradictory reports have been published regarding the impact of tumor-infiltrating immune cells on proliferation of the tumors. AIM: This study aims to assess the impact of CD45RO+ve immune cells on proliferation and dedifferentiation of node-negative squamous cell carcinomas of cheek mucosa (SCC-CM). MATERIALS AND METHODS: Thirty formalin-fixed paraffin-embedded tissue blocks of previously diagnosed node-negative SCC-CM subclassified as Grade I SCC - 10 cases; Grade II SCC - 10 cases; and Grade III SCC - 10 cases (Broders' classification - 1927). Immunohistochemistry performed on each selected tissue section using anti-p53 and anti-CD45RO as primary antibodies. Semi-quantitative analyses performed for all the tissue sections to assess the p53 and CD45RO expression. p53:CD45RO expression ratio calculated. The data were statistically analyzed using GraphPad Prism 5 for Windows. RESULTS: Our results showed statistically significant increase (P = 0.0006) in p53 expression and decrease (P = 0.0044) in CD45RO+ immune cell response with the decrease in differentiation of SCC-CMs using Fisher's exact test and statistically significant increase (P < 0.001) in p53:CD45RO expression ratio with decrease in differentiation using one-way ANOVA. CONCLUSION: Based on all these findings from the present study, we perceive the following findings. In node-negative SCC-CMs, CD45RO+ immune cells play a possible role in controlling the dedifferentiation of the tumor and in limiting the proliferative potential of the tumor cells which are tumor antagonistic in nature.

Correlation and estimation of stature from cephalofacial measurements: A study on Western Uttar Pradesh population.

BACKGROUND: Identification of an individual from fragmented remains is still a very challenging task for forensic experts in spite of the many studies which have been carried out till date, across the globe. Stature, one of the criteria of personal identification, has a definite and proportional biological relationship with every part of the human body which includes the cephalofacial (CF) region. At instances, where only CF remains are available, it becomes difficult for the forensic scientist to identify the deceased since there is a paucity of studies pertaining to the estimation of stature from CF dimensions. Results from such a study can be used as database for forensic investigations and other anthropometric studies. AIM: To estimate stature of an individual using data derived from CF measurements. MATERIALS AND METHODS: The study was conducted on 540 representative candidates (270 males and 270 females) in the age group of 20-25 years. Stature (S) and CF measurements (maximum head length [MHL], maximum head breadth [MHB], horizontal circumference of head [HHC], bigonial diameter [BGD], and morphological facial length [MFL]) of each candidate were recorded and tabulated. The statistical analysis was performed using SPSS Statistics v. 19.0 (IBM, Armonk, NY, USA) for the CF dimensions obtained. Comparisons were made between the CF measurements recorded with respect to the gender using statistical mean, standard deviation, range, and Pearson's correlation coefficient, and linear regression equation of height to the parameters recorded was derived. RESULTS: Findings suggest that all the CF measurements are significantly correlated with stature (P < 0.01). MHL, MHB, and HHC show higher correlation coefficients (r value) when compared to MFL and BGD. The CF measurements arranged in descending order based on their r value is HHC > MHL > MHB > MFL > BGD. In general, head measurements show lower values of standard error of estimate (SEE) compared to facial measurements. Among both sexes, HHC shows the least and BGD shows the highest SEE value when compared to all the other CF measurements. CONCLUSION: It can be concluded that the recommended anthropometric measurements provided serve as a template and confirm that there are geographical and sexual dimorphism in anthropometric parameters; therefore, these should be considered in forensic or criminal investigations.

Antrochoanal polyp arising from benign pseudocyst of maxillary antrum.

Antrochoanal polyps (ACPs) are benign lesions that arise from the mucosa of the maxillary antrum, grow into the maxillary sinus, and reach the choana with nasal obstruction being their main symptom. Most of these lesions are small and clinically silent and found as incidental finding, but large cysts which occupy the entire antrum have also been reported in literature. Nasal endoscopy and computer tomography (CT) are the golden standard in the diagnosis of ACPs, and enucleation by Caldwell-Luc approach is the recommended treatment for larger antral cysts. This article is a report of a 9-year-old male patient diagnosed with ACP arising from a benign cyst of maxillary antrum with characteristic clinical, CT, and histopathological features along with brief review of literature.

Giant Peripheral Ossifying Fibroma of the Posterior Mandible-A Rare Case Report.

Large, atypical peripheral ossifying fibromas are known as giant peripheral ossifying fibromas. These lesions have often been associated with heterogeneous clinical and radiographic characteristics subsequently leading to their misdiagnosis. Biopsies have been the gold standard for the diagnosis of such lesions. This study reports on an acute presentation of giant peripheral ossifying fibroma, clinically mimicking a malignant lesion due to its atypical presentation along with its characteristic histological features, which led to the establishment of the diagnosis.

Indolent palatal swelling: Catch 22.

We present an interesting but intriguing case of an indolent palatal swelling. The lesion was asymptomatic causing little discomfort to the patient and thus was an incidental clinical finding. Provisional diagnosis was a benign, minor salivary gland tumor. Clinical differential diagnoses included benign lymphoepithelial lesion or mucus extravasation phenomenon. Nevertheless, we also considered malignancies such as mucoepidermoid carcinoma, lymphoma, and neoplasm of the maxillary sinus. However, the histopathology revealed a rare clinicopathologic entity prompting immediate treatment of the lesion.

Grading angiogenesis in oral squamous cell carcinoma: a histomorphometric study.

CONTEXT: Like normal tissues, tumors require an adequate supply of oxygen, metabolites and an effective way to remove waste products. This is achieved by angiogenesis, which is defined as the process by which new blood vessels are produced by sprouting from preexisting vasculature. There is a large spectrum of physiological and pathological processes in which angiogenesis occur, ranging from tissue hypertrophy, wound healing, and inflammation to tumors. AIMS: The present study was designed to morphometrically evaluate the angiogenesis in different grades of oral squamous cell carcinomas (OSCCs) under light microscope by the use of H and E stained sections and to assess that whether the parameters of vascularity like mean vascular density (MVD), mean vascular area (MVA), and total vascular area (TVA) can be used to histologically grade the tumors. SUBJECTS AND METHODS: A total of 10 cases each of well-, moderately- and poorly-differentiated SCC cases were retrieved from the archives of the Department of Oral Pathology and Microbiology and were morphometrically analyzed for mean vascular density (MVD), MVA, and TVA. Ten cases of normal oral mucosa were taken as Control. Statistical analysis was done using  SPSS 19.0 version (IBM, Armonk, NY, USA) software for windows. Group mean for MVD, TVA and MVA were calculated for 10 cases of each group. "Student's t-test" was applied to assess the intergroup variation of mean values of MVD, TVA, and MVA. RESULTS: Our results showed significant differences between all the three parameters, that is, MVD, MVA and TVA when poorly differentiated OSCC was compared with the normal mucosa, well- and moderately-differentiated OSCC. However, when comparison was made between the well- and moderately-differentiated OSCC, the differences in the three parameters were present but not statistically significant. CONCLUSION: There was an increased MVD, MVA and TVA in poorly differentiated OSCC, which could be used as an additional criterion to histologically grade the tumor.

MRI of the lung gas-space at very low-field using hyperpolarized noble gases.

In hyperpolarized (HP) noble-gas magnetic resonance imaging, large nuclear spin polarizations, about 100,000 times that ordinarily obtainable at thermal equilibrium, are created in 3He and 129Xe. The enhanced signal that results can be employed in high-resolution MRI studies of void spaces such as in the lungs. In HP gas MRI the signal-to-noise ratio (SNR) depends only weakly on the static magnetic field (B(0)), making very low-field (VLF) MRI possible; indeed, it is possible to contemplate portable MRI using light-weight solenoids or permanent magnets. This article reports the first in vivo VLF MR images of the lungs in humans and in rats, obtained at a field of only 15 millitesla (150 Gauss).