Do patients with oral squamous cell carcinoma express receptor tyrosine kinase-like orphan receptor 1? Results of an observational study.

CONTEXT: The receptor tyrosine kinase-like orphan receptor 1 (ROR1) is a transmembrane protein of the receptor tyrosine kinase family. The expression of ROR1 has been linked to cancers. AIMS: This study aimed to investigate the expression of ROR1 in oral squamous cell carcinoma (OSCC). SETTINGS AND DESIGN: This prospective observational study was conducted at a tertiary referral center for treatment of oral carcinoma from November 2013 to December 2016. SUBJECTS AND METHODS: One-step quantitative reverse transcription-polymerase chain reaction (30 oral cancer tissues and ten normal oral tissue samples) was performed to characterize the expression of the ROR1 gene in oral cancer. STATISTICAL ANALYSIS USED: Analyses of all tumor samples were carried out at least twice, and the mean value was calculated. The differences in ROR1 messenger RNA (mRNA) expression between OSCC tissue and nontumorous gingival tissue was statistically analyzed using Mann-Whitney U-test. The correlations between the clinicopathological parameters and ROR1 mRNA expression were analyzed using Kruskal-Wallis test χ2 value. RESULTS: There were 17, 5, 3 and 1 cases of OSCC of buccal mucosa, tongue and lower alveolus lip, respectively. Nearly 88.5% of cases had a history of tobacco consumption. The most common OSCC type was T2N1M0. There was no difference in ROR1 fold change between controls and cases (P = 0.06), but there was a trend for downregulation of ROR1 expression from controls to cases. Subgroup analysis revealed the downregulation of ROR1 expression in controls versus Grade II that was significant (P = 0.04). CONCLUSIONS: There was no change in the expression of ROR1 between cases and controls. A study involving a larger sample size needs to be formulated and conducted for investigating the relation between expression and regulation of ROR1 in OSCC.

Candidal Prevalence in Diabetics and its Species Identification.

CONTEXT: Candida species is a part of the normal mouth flora. Diabetes mellitus is a predisposing factor for the onset of oral candidiasis. AIM: The objective of this study was to estimate salivary glucose in patient with diabetes and healthy individuals, to determine total candidal counts as well as different candidal species in the saliva of patients with diabetes and nondiabetics. SETTINGS AND DESIGN: A sample size of 80 patients was taken. Out of 80 patients, 30 patients were uncontrolled diabetes patients (Group I), 30 patients were controlled diabetes patients (Group II), and 20 patients were healthy individuals (Group III). SUBJECTS AND METHODS: From all the salivary samples, salivary glucose estimation was done using the glucose oxidase-peroxidase method. Candidal colony-forming units (CFUs) were determined from all the salivary samples. CHROMagar Candida medium was used for the identification of various Candida species. STATISTICAL ANALYSIS USED: One-way ANOVA was used to test for differences between the means of the three groups. Pearson's correlation coefficient test was used to evaluate the relationships between the variables. RESULTS: The mean salivary glucose levels were higher in Group I followed by Group II and Group III. The mean candidal CFU was significantly higher in Group I than in Group II and Group III. CONCLUSION: Candida glabrata was the predominant species found and more so in patients with diabetes and needs further study. Other common species isolated was C. albicans. Species identification can help in better treatment strategies and gain good control over the disease.

Comparison of efficacy of local anesthetic solution, distilled water and normal saline as emergency fixatives.

CONTEXT: Adequate tissue fixation is fundamental to good quality histological sections. Owing to undesirable effects of 10% buffered formalin, its availability in clinics is questionable. Thus, the present study was conducted with a novel approach to fixation, together with the scope of finding fixative properties of more commonly used reagents available at the clinics. AIMS: The present study was aimed to compare the efficacy of local anesthetic solution, normal saline (NS) and distilled water (DW) with that of 10% neutral-buffered formalin. SETTINGS AND DESIGN: It is a single-blinded study where histological assessment of fixation was done to assert if the tissues procured were sufficient or insufficient for the clinical diagnosis with/without any problems. SUBJECTS AND METHODS: Forty soft-tissue specimens obtained from 2 goat tongue were used. Tissues each were directly immersed in local anesthesia, DW, NS solution and formalin for 12 and 24 h each and labeled as Group I and Group II, respectively. The sections were evaluated for staining quality and were subjected to statistical analysis. STATISTICAL ANALYSIS USED: Kruskal-Wallis test was employed to assess the differences in histological quality scores. Comparison between the tissues of the two groups was estimated with Mann-Whitney U-test. Kappa Statistic was used to measure the interobserver variation. RESULTS: There was a significant difference (P ≤ 0.05) in the efficacy of all the three emergency fixatives. CONCLUSIONS: On the basis of the results obtained, local anesthetic solution can be used as an emergency fixative.

Quantification of circulating plasma cell free DNA fragments in patients with oral cancer and precancer.

PURPOSE: Study was aimed to quantify plasma level of total, short and long fragmented cell-free DNA (cfDNA) along with DNA integrity in patients with oral cancer, oral precancer and tobacco users without lesions and normal controls. In addition, study evaluated the correlation of cfDNA with clinicopathologic parameters of oral cancer. METHODOLOGY: Plasma samples were collected preoperatively from 44 patients with oral cancer, 40 patients with oral precancer, 40 tobacco users without any oral lesion and 40 healthy controls without any tobacco habit. cfDNA extraction was carried out from the plasma followed by quantitative and qualitative assessment of extracted DNA. Quantity of short and long fragmented DNA was assessed by using PCR with two different primer sets for the beta-actin gene, amplifying short (102 bp) and long (253 bp) products. The DNA integrity index was measured by calculating the ratio of quantity of long fragmented to short fragmented DNA. All quantitative cfDNA parameters were statistically analyzed to verify their correlation with clinicopathologic parameters. RESULTS: Results showed that total cfDNA level, short and long fragmented cfDNA concentration and DNA integrity was significantly higher in oral cancer group as compare to other (p=0.0001). Study demonstrated that there is no correlation total, short and long cfDNA and DNA integrity with tumor size and histologic type or grading. But positive correlation of total cfDNA was found with nodal metastasis (p=0.001) and clinical stages (p=0.006). CONCLUSION: Quantitative analysis of total cfDNA may be applied as a screening marker for early detection of precancer and cancer as well as for prognostication of oral cancer. Additionally, plasma levels of short and long fragmented cfDNA and DNA integrity index can be applied for early detection of oral cancer.

Effect of Conventional and Microwave Tissue Processing Technique on DNA Integrity: A Comparative Molecular Analysis.

BACKGROUND: Methods of diagnostic molecular biology are routinely applied on formalin-fixed, paraffin-embedded tissues processed via conventional method. Recently, there has been a growing interest to use microwave technology in histopathology laboratories to overcome the deficiencies of the conventional processing method. Thefore, this study was aimed to compare and analyze the quality and quantity of DNA obtained from tissues processed by conventional and microwave tissue processing techniques and to further ascertain the applicability of the latter for PCR (polymerase chain reaction based research). METHODS: Thirty fresh tissues of oral squamous cell carcinoma (OSCC) were included, and each sample was cut into two equivalent halves. One tissue half was processed by conventional manual method whereas the other half was processed using a domestic microwave oven. DNA was obtained from all the tissues which were then subjected to Polymerase chain reaction (PCR) to evaluate GAPDH (Glyceraldehyde-3-phosphate dehydrogenase) gene expression. RESULTS: The results revealed better DNA yield from microwave processed tissue while the quality of the DNA was alike from both the techniques. CONCLUSION: On the basis of the results obtained, it can be concluded that DNA produced by microwave processed tissues was similar to that obtained by conventional processing technique in terms of quantity and quality. Thus, microwave processed tissue samples can be successfully used for further molecular studies and researches.

Ameloblastic carcinoma of the mandible: Report of a case and review.

Ameloblastic carcinoma is a rare malignant odontogenic neoplasm that can arise either as a de novo lesion or from pre-existing ameloblastoma. Histopathologically, the tumor retains an ameloblastomatous differentiation pattern but shows cytological features of malignancy. Owing to variable biologic behavior and paucity of long-term follow-up cases, there has been no clear consensus on treatment protocol. The present case of ameloblastic carcinoma arose in the mandible of a 24-year-old male. Surgical treatment involved resection of the mandible along with regional lymph nodes. The patient has been on follow up for the past one year without any recurrence or metastases. An update on ameloblastic carcinoma encompassing the histogenesis, immunohistochemical features and treatment aspects are included.

Vinegar as a disinfectant of extracted human teeth for dental educational use.

CONTEXT: Extracted human teeth are routinely used in dentistry to learn technical and preclinical skills. Centers for Disease Control and Prevention (CDC) has adopted guidelines for infection control of extracted teeth used for research and teaching, requiring that teeth be sterilized before use. Many of the proposed disinfection methods starting from use of formalin, sodium hypochlorite and to autoclaving have their own drawbacks and may not be practical. AIM: To assess the effectiveness of vinegar for disinfection/sterilization of extracted human teeth. MATERIALS AND METHODS: A total of 80 extracted non-carious human teeth were kept in seven disinfectant media-10% formalin, 3% hydrogen peroxide, 5.25% sodium hypochlorite, 70% alcohol, vinegar, neem extract and normal saline. Ten samples were placed in each disinfectant individually for a period of 7 days, at room temperature. In all, 10 teeth were treated with microwave irradiation at 650 W for 3 min. Later, teeth from each group were placed individually in separate test tubes containing 10 ml of tryptic soy broth at 37°C for 48 h to observe the evidence of growth of microorganisms. Semiquantitative analysis of all the samples was done in Clade agar at 37°C for 48 h. STATISTICAL ANALYSIS USED: The number of teeth disinfected in each group was compared using Chi square test. RESULTS: 10% formalin, 3% hydrogen peroxide and vinegar were totally effective. The result was statistically significant with a Chi square value of 61.414 and P < 0.001. CONCLUSIONS: Vinegar can be used as an effective disinfectant medium for extracted human teeth.

Stromal myofibroblasts in nonmetastatic and metastatic oral squamous cell carcinoma: An immunohistochemical study.

BACKGROUND AND AIMS: Myofibroblasts are one of the important components of the tumor microenvironment which could possibly play an important role in tumor progression. The purpose of this study was to compare the presence of α-smooth muscle actin (α-SMA) and CD34 positive fibroblasts in nonmetastatic and metastatic oral squamous cell carcinoma and to evaluate their role in tumor metastasis. MATERIALS AND METHODS: Ten cases each of histologically proven metastatic and nonmetastatic oral squamous cell carcinoma formed the study group. The tissue sections were stained immunohistochemically for α-SMA and CD34. The stromal spindle cells positive for these markers in the study groups were counted and compared. RESULTS: α-SMA positive cases were more in the metastatic group and CD34 positive cases were found to be more in the nonmetastatic tumors. CONCLUSIONS: Though difference in the staining pattern was statistically nonsignificant, the inverse relationship between α-SMA and CD34 positive cells is indicative of dynamic nature and the influence of tumor stroma in tumor progression and metastasis.

Dens invaginatus (Type III B).

Dens invaginatus or 'dens in dente' is a developmental malformation of the tooth resulting from infolding of the dental papilla before calcification. This article presents a case of dens invaginatus occurring in maxillary right lateral incisor of a 45-year-old male patient. The patient presented with pain and clinically missing maxillary right canine. The tooth was found to be non-vital. Radiographic examination revealed the tooth-in-tooth appearance of lateral incisor with a dilated pulp chamber. The crown of impacted canine was found within the pulp chamber of lateral incisor. Owing to this unique clinical presentation, both the lateral incisor and the impacted canine were extracted. Histopathologic examination confirmed the diagnosis of Dens invaginatus Type III B. A brief review on etiopathogenesis, radiographic features and treatment of dens invaginatus has also been included.

Cancer Therapy: A Continuance of Health Burden.

BACKGROUND: Cancer diagnosis coupled with emotional impact converge to create one of the most difficult physical and emotional periods of life. Cancer treatment causes plethora of short and long term complications which can be so debilitating that patient may interrupt treatment. Pretreatment oral assessment and supportive oral care during and after cancer therapy can increase quality of life and supportive care costs. METHODS: Study was conducted on 189 patients (86: head and neck cancer cases, group I and 103: other than head and neck cancer cases, group II) receiving cancer therapy. Patients were subjected to clinical assessment and findings were recorded in specially designed proforma and complete oral (objective and subjective) and constitutional findings were recorded. RESULTS: Among the patients undergoing chemotherapy in both groups, prevalence of oral findings was found to be highest with methotrexate whereas constitutional symptoms was found to be highest with doxyrubicin. Whereas in radiotherapy patients subjective and objective oral symptoms increased from 10th - 30th fractionated dose of radiations and then subsequently decreased and constitutional symptoms were found to be consistent in all fractionated dosages with lowest at 50th fraction. Under combined chemo and radiotherapy patients, constitutional symptoms were highest than the oral findings. CONCLUSIONS: Cancer therapy can greatly damage the normal tissues and diminish patients quality of life and often leads to serious clinical sequelae. Therefore, therapy induced damage should be anticipated and prevented whenever possible and managed early.

An anthropometric analysis of facial height, arch length, and palatal rugae in the Indian and Nepalese population.

INTRODUCTION: A country such as India abounds with diverse population groups with distinct anthropometric characteristics. Among these, numerous Nepalese population groups are present in different states of India comprising one of the most common immigrant races. The aim of the study is to compare two distinct races, Indians and Nepalese on the basis of facial height proportions, arch length and palatal rugae patterns and assess their significance in racial identification. MATERIALS AND METHODS: A total of 120 subjects comprising of 60 Indians and 60 Nepalese were selected, with each group including 30 males and 30 females. Facial heights were measured using sliding digital calipers, arch lengths with the help of a brass wire and rugae patterns were traced on dental casts obtained with alginate impressions. RESULTS: Facial height measurements did not give significant results for racial or gender identification of given races. Differences between arch length parameters were found to be significant between the two population groups. Secondary and fragmentary palatal rugae forms were found to be more common in Nepalese than Indians. CONCLUSION: The Indian and Nepalese have similar anthropometric characteristics with regard to facial height. However, arch length and palatal rugae characteristics vary between the two races.

Dermoid cyst of the floor of the mouth with abundant hair: a case report.

Dermoid cysts are developmental cysts and considered to develop from enslavement of epithelial debris in the midline during closure of the mandibular and hyoid brachial arches. These cysts are painless, slow growing and most commonly occur in young adults with no gender predilection. They are uncommon in the head and neck region. Oral dermoid cysts are found usually in the submental or sublingual triangle in variable relation to mylohyoid, geniohyoid, and genioglossus muscle. The cyst is lined by epidermis like epithelium and contains dermal adnexal structures in the cyst wall. We report a case of dermoid cyst arising in the sublingual region of a young adult male with abundance of hair which is rare finding.