Immunohistological evaluation of revascularized immature permanent necrotic teeth treated by platelet-rich plasma: an animal investigation

Objective: pulp regeneration within the root canal of necrotic teeth is considered an ideal treatment to allow for continued root development and recover teeth vitality. This study aims to evaluate the inductive effect of platelet-rich plasma [PRP] on expression of angiogenesis factors and pulpal revascularization of immature necrotic teeth

Materials and Methods: in this experimental animal study, we randomly divided 28 immature premolars from two mixed breed dogs into four groups, two experimental, negative and a positive control. Premolars in negative control group were left intact to develop normally. In the positive control and experimental groups, we removed the pulps and induced pulp necrosis, after which the chambers were sealed. Then, we applied the revascularization protocol in the experimental teeth located in the right quadrant. Two months later, the same protocol was applied to the left quadrant. The root canals were disinfected by irrigation with sodium hypochlorite [NaOCl] solution and application a triple antibiotic past. Following the induction of a blood clot [BC] inside the canal space, the coronal portion of the canals was assigned to either of two experimental groups: group 1 [BC+PRP+ mineral trioxide aggregate [MTA]], group 2 [BC+MTA]. Access cavities were sealed with a Glass Ionomer. The jaws that held the teeth were processed for histologic analysis of newly formed tissue and immunohistochemical evaluation according to vascular endothelial growth factor [VEGF] and factor VIII expressions in the canals

Results: histological analysis demonstrated no significant difference in the formation of new vital tissue inside the root canals between groups1 [42.8%] and 2 [43.5%, P>0.05]. Based on immunohistochemical evaluation, micro-vessel density [MVD] of the granulation tissues in both groups were similar and were higher compared with the normal pulp. We observed strongly positive expressions of VEGF and factor VIII in the stromal and endothelial cells, with severe intensity after one month. Both factors showed down-regulation at three months postoperative

Conclusion: PRP could not increase the formation of new vital tissue. The immunohistochemical results showed that VEGF and factor VIII played a pivotal role in the formation of new vessels inside the root canals of immature, non-vital teeth

Sentinel node mapping for intra-thoracic malignancies: systematic review of the best available evidence

Introduction: Sentinel node mapping is a new technique of lymph nodal staging in solid tumors, which can decrease the morbidity of regional lymph node dissection considerably. Intra-thoracic tumors including non-small cell lung cancer [NSCLC] and esophageal carcinoma [EC] are among the solid tumors in which sentinel node [SN] mapping has been applied. In the current systematic review, we gathered the best available evidence [systematic reviews] in this regard and presented the results in a systematic review format

Material and methods: We searched MEDLINE and SCOPUS since the inception till 13 December 2014 using the following keywords: [lung OR esophagus OR esophageal] AND sentinel AND [systematic review OR meta-analysis OR metaanalysis]. No language limit was imposed on the search strategy. Systematic reviews and meta-analyses on SN mapping in EC or NSCLC were included in the current study. Narrative review articles were excluded from the study

Results: Overall five systematic review were included. One of the included studies was on SN mapping in NSCLC and four were on EC. Overall detection rate and sensitivity for EC and NSCLC were high and both were related to mapping technique, pathological involvement of the mediastinal nodes, size and location of the tumors

Conclusion: SN mapping is feasible and highly accurate in EC and NSCLC. Attention to the technique [using radiotracers, peri-tumoral injection] and restriction of the patients to less advanced cases [cN0 and T1, 2] would ensure the best results with high detection rate and sensitivity

Expression of epidermal growth factor receptor and the association with demographic and prognostic factors in patients with non-small cell lung cancer

Introduction: Growth, proliferation, survival, and differentiation are the prominent characteristics of cells, which are affected by cancer. Epidermal growth factor receptor [EGFR] plays a pivotal role in the effective control of these features. Given the significance of EGFR signaling pathway in non-small cell lung cancer [NSCLC], EGFR expression is influential on these cell characteristics. In this paper, we studied EGFR expression and its association with demographic factors, clinicopathological features, and prognosis of NSCLC patients

Materials and Methods: In this retrospective cohort study which was done during 2009-12 at Ghaem Hospital, Mashhad, Iran. EGFR expression was evaluated in 96 patients with formalin-fixed, paraffin-embedded NSCLC tissues [43 adenocarcinomas, 48 squamous-cell carcinomas, and 5 large-cell carcinomas] using immunohistochemistry [IHC]. Data analysis was performed by SPSS version 20.0

Results: Out of 96 specimens, approximately 53% were classified as positive for EGFR expression. The study group consisted of 68% [N=65] male and 32% [N=31] female subjects, with the mean age of 61.1 +/- 9.03 years. There was no difference between EGFR-positive and EGFR-negative patients in terms of the overall survival rate [P=0.49]. In addition, no association was observed between tumor histology and EGFR expression [P=0.08], while EGFR-positive adenocarcinoma [N=28, 29%] was more prevalent compared to other subtypes of NSCLC. Moreover, there were no differences between tumor subtypes and the overall survival rate of the patients [P=0.21], and no association was found between EGFR expression and the patients' demographic factors [e.g. age and gender]

Conclusion: The results of this study indicated that EGFR expression could not be a prognostic marker in NSCLC patients; however, it seems that using standardized IHC scoring is likely to yield more reliable data in this regard

stromal overexpression of CD10 in invasive breast cancer and its association with clincophathologic factors

Breast carcinoma is the most common non-skin malignancy in women. More recently, it has been suggested that extracellular proteinase has also regulated growth factors and cytokines that might contribute to tumor progression. CD10 is a 90-110kd cell surface zinc-dependent metalloproteinase. Since CD10 is structurally similar to matrix metalloproteinase and stromelysin, it might facilitate cancer cell invasion and/or metastasis. The aim of this study was investigation the rate of CD10 expression in the stromal cells of invasive ductal breast carcinomas, Immunohistochemical aspects, then any other aspects to be able to clarify its correlation with other clinicopathological factors of this disease. One hundred patients with histopathologic diagnosis of invasive ductal carcinoma and 50 patients with fibroadenoma of breast [as the control group] have selected, then 150 paraffin blocks have obtained. The stained slides by immunohistochemistry method for CD10 marker have examined separately by two pathologists, and discrepancies have reviewed in common session to get the final result. Stromal CD10 has detected in 28% of the IDC. No kind of immunoreactivity has identified in the stromal cells of normal breast. Stromal CD10 expression in IDC has significantly correlated with increasing tumor size [p<0.001], increasing histologic grade [p<0.001], the presence of nodal metastases [p<0.001] and estrogen receptor negative status [p=0.003]. Stromal CD10 expression in IDC has closely correlated with invasion and metastasis and it might play an important role in the pathogenesis of IDC

Malignant peripheral nerve sheath tumor in the maxilla: report of a rare case

Malignant peripheral nerve sheath tumor [MPNST] is a rare malignant tumor that develops either from a preexisting neurofibroma or de novo. The cell of origin is believed to be the Schwann cell and possibly other nerve sheath cells. In this report, we describe a rare case of MPNST that arise from the socket of second left maxillary molar that has been already extracted in a young man. He was referred to a dentist's office with a tumor-like mass of soft tissue on his left maxillary gingiva. Biopsy and histopathologic examination was performed and based on histologic and immuno-histochemical findings, the diagnosis of MPNST was made. MPNST is a rare malignant tumor in the oral cavity. Dentists must be careful and conscious because this rare malignancy can occur in gingiva and can mimic the clinical feature of any benign gingival enlargements

Myxoid type of malignant fibrous histiocytoma of the maxillary sinus: a case report

Myxofibrosarcoma was originally described as the myxoid variant of Malignant Fibrous Histiocytoma [MFH], a high-grade and aggressive sarcoma, which is very uncommon in the head and neck region, with about 100 cases reported up to now. MFH occurring in the maxillary sinus is so rare that only 23 cases have been reported. We hereby report a case of myxofibrosarcoma in the maxillary sinus. The case was a 54-year-old male with symptoms of toothache in the right posterior maxillary teeth, a swelling adjacent to maxillary molar region and symptoms of chronic maxillary sinusitis. In clinical examination, the teeth were sensitive to percussion and palpation, but no caries and restoration was detected on his molar teeth. He was suffering from local pain and tenderness over his midface and mild fever, fatigue and some nonspecific vague pain. CT scan showed a mass lesion involving right nasal cavity, maxillary and ethmoidal sinuses. A lowgrade malignancy arising from the right maxillary sinus was highly suspected. A surgery was done to remove the mass. The histological and immunohistochemical studies proved the diagnosis of myxoid variant of Malignant Fibrous Histiocytoma. Therefore radiotherapy and chemotherapy was started for the patient but six months later the symptoms returned and CT scan showed a right maxillary and ethmoidal mass that extended to base of the skull. Maxillectomy and ethmoidectomy were performed for the patient, but 2 months later he died because of the extension of the tumor, which confirmed the necessity of early diagnosis. Amplified radical surgery is the first choice of treatment. The second surgery has special value to the recurrent patients. Radiotherapy alone or chemotherapy alone is not effective to MFH of head and neck region

case report of unusual vasculitic reaction after methocarbamol injection

Descriptive case report of a 42-year old woman with coetaneous vasculitis, and severe abdominal pain, which was led to diagnostic laparotomy. These presentations are probably as a side effect of Methocarbamol injection. This is the first report according to our literature search [PubMed, google scholar, ISI web of knowledge, ProQuest, MD consult, Science Direct, SCOPUS] about Methocarbamol related vasculitis from 1966 since now. Vasculitis is not a known side effect of Methocarbamol. This case indicates, likely the potential for development of vasculitis with this medication

Comparison of multiplex PCR and acid fast and auramine -rhodamine staining for detection of Mycobacterium tuberculosis and non tuberculosis mycobacteria in paraffin- embedded pleural and bronchial tissues with granulomatous inflammation and caseous necrosis

The aim of this study was to compare the sensitivity and specificity of Acid fast and Auramine-Rhodamine staining and Multiplex PCR for the detection of Mycobacterium tuberculosis complex and non tuberculosis Mycobacteria on formalin fixed paraffin embedded tissues [FFPE]. Forty cases of FFPE pleural and bronchial tissue with chronic granulomatous inflammation and caseous necrosis and 10 cases with bronchogenic carcinoma as controls were investigated. We designed a Multiplex PCR DNA amplification method with two targets: 123bp DNA fragment from IS6110, which is present only in mycobacterium tuberculosis complex and 162bp DNA encoding Ag 85complex which is present in all of mycobacteria. The FFPE also stained by Acid fast and Rhodamine-Auramine staining method. In 26 samples [65%] 123 bp and 162 bp DNA fragments were detected together [12 in bronchial samples and 14 in pleural samples].The 162 bp fragment wasn't detected alone. The sensitivity of PCR was 65% and the specificity was 100%. Eleven cases were positive for Acid fast staining. There was 27.5% sensitivity and 100% specificity. Thirteen cases were positive for Auramine-Rhodamine staining [A-R-S]; there was 32.5% sensitivity and 100% specificity. All of the 10 controls were negative for 123 bp, 162 bp DNA fragments, for Acid fast and Auramine-Rhodamine staining. Multiplex PCR is a sensitive, specific and rapid method for detection of M tuberculosis in FFPE tissues