Oral health status among Iranian veterans exposed to sulfur mustard: A case-control study.

BACKGROUND: Sulfur mustard (SM) is a chemical warfare agent that has been repeatedly used since World War I. SM has chronic and deleterious effects on different body organs such as lungs, skin and eyes. OBJECTIVES: To determine dental and oral health status of chemical victims of SM who were exposed to SM during the Iraqi-Iran war. MATERIAL AND METHODS: In this case-control study, 100 male subjects exposed to SM were chosen as cases, and 100 non-exposed volunteers were chosen as controls. These groups were selected randomly according to their referral number, and were matched regarding age. Collection of information was performed using Oral Health Assessment Form designed by the World Health Organization. Quantitative and qualitative data were compared between the groups using independent samples t-test and Chi-square test, respectively. RESULTS: There was a significant difference between the case and control groups with respect to the frequencies of oral candidiasis, pharyngeal erythema and/or hyperplasia, hairy tongue and reflux disease, being higher in the former group. There was also a positive association between the frequency of candidiasis and the percentage of disability; pharyngeal erythema and/or hyperplasia and use of salmeterol spray; and between hairy tongue and antibiotic use in the case group. CONCLUSIONS: Exposure to SM and the use of drugs for controlling long-term complications does not increase the risk of tooth decay, tooth loss, and intra and/or extra oral lesions in patients, but may be associated with increased incidence of oral candidiasis, pharyngeal erythema and/or hyperplasia, hairy tongue and reflux disease.samples of oral precancerous and cancerous lesions to test sensitivity and specificity and thus validate the clinical applicability of fluorescence imaging in (pre)cancerous diagnostics. Key words:Sulfur mustard, oral health, candidiasis.

Th1 Cytokine Production Induced by Lactobacillus acidophilus in BALB/c Mice Bearing Transplanted Breast Tumor.

BACKGROUND: The immunomodulative effects of Lactic Acid Bacteria as probiotics have been already demonstrated. OBJECTIVES: The current study aimed to evaluate the effect of oral administration of Lactobacillus acidophilus on the immune responses and patterns of cytokine production in the BALB/c mice bearing breast cancer. MATERIALS AND METHODS: The current study used thirty inbred BALB/c mice, six- to eight-week-old; they were divided into two groups of 15 each. One group was used as control in each assay. The L. acidophilus (ATCC4356) used in the study was inoculated in MRS broth and cultivated overnight at 37°C under anaerobic conditions, then collected by centrifugation, and re-suspended in Phosphate-buffered Saline (PBS) media. After preparation of the proper amount of the suspension, it was orally administered to the mice via gavage and the control mice received an equal volume of PBS in the same manner. RESULTS: The results showed that oral administration of L. acidophilus as a potent immunostimulator agent could motivate the proliferation of immune cells. Moreover, it could increase the production of IFN-γ and decrease the production of IL-4, known as Th2 cytokines, in the spleen cell culture. The results showed that the survival time of the L. acidophilus administered mice significantly increased in comparison to that of the control mice. CONCLUSIONS: The current study findings suggested that L. acidophilus can promote immune responses with Th1 bias and may increase the antitumor response. Further, the consumption of this probiotic strain may help to manage the immune response in tumor condition, but more studies are needed to investigate the other mechanisms of this effect.

Assessment of 120 maxillofacial aneurysmal bone cysts: a nationwide quest to understand this enigma.

PURPOSE: Compared with other maxillofacial lesions, oral and maxillofacial (OM) aneurysmal bone cysts (ABCs) are rare, and most studies have been case reports. Because the features or radiographic findings of 1 case could not be representative of the whole, conclusions cannot be drawn and data analyses will not be feasible. Our aim was to assess and describe the clinical and histopathologic characteristics of a large sample of subjects with ABCs. To our knowledge, the present case series of OM ABCs is the largest ever reported. MATERIALS AND METHODS: To address our research purpose, we designed and implemented a retrospective case series. A multicenter retrospective cohort study of patient charts dated from 1967 to 2013 (46 years) at 10 major universities in 8 cities was undertaken to assess OM ABCs nationwide. Subjects were included if they had documented chart data and definitive histopathologic slides confirming the diagnosis and treatment of ABC. They were excluded if their histopathologic slides did not confirm the diagnosis of an ABC. Data were collected, and special forms were completed. Variables such as age, gender, site (ie, maxilla, mandible, anterior, posterior), histologic type (ie, solid, mixed, vascular), signs, symptoms, radiographic features (ie, radiolucency, unicystic or multilocular), and outcomes (ie, treatment modal, recurrence, complications) of the lesion were evaluated and documented by OM surgeons and confirmed by OM pathologists for assurance. Data analyses were performed using Statistical Package for Social Sciences, version 20, software (SPSS, Chicago, IL) (P < .05). RESULTS: We assessed the medical records and histopathologic slides of 120 patients diagnosed and treated for OM ABCs nationwide. Of these patients, 69 were male (57.5%) and 51 were female (42.5%), with no predilection found. The key findings were as follows. The mean age of occurrence was 20.7 ± 2.5 years (range 4 to 78), and occurrence was significantly greater in the first 2 decades of life (P < .001). The incidence was 2.6 cases/year. ABCs were significantly more common in the mandible (P < .05) and posterior areas (P < .05). The most common histopathologic type was the mixed type (P < .05). Firm swelling was the most common clinical presentation (P < .05); all cases were radiolucent and commonly unilateral (P < .05). Most were treated by excision and curettage. Recurrence was reported in 11 patients (9.2%) during the follow-up period (1 to 45 years). CONCLUSIONS: The present retrospective cohort found ABCs with a variable presentation, disease course, and histopathologic type, with no gender predilection. ABCs were significantly more common in childhood and adolescence and in the mandible and posterior areas of the jaws. Of the cases reviewed, 90% were treated by excision and curettage. ABCs had a relatively low recurrence rate (<10%), precluding the need to perform aggressive surgery primarily.

Hydatid cyst of the pancreas mimicking neoplasm.

Hydatid disease is a cyclozoonotic infection caused by the cestode genus Echinococcus. It occurs throughout the world and is especially common in sheep- and cattle-raising regions of Africa, Australia, New Zealand, India, the Middle East, South America, and the Mediterranean. The incidence of humans infected with hydatid disease is approximately 1-2:1000. It is higher in rural areas. Infection occurs via ingestion of infected meat. Hydatidosis is caused by sheep and cattle ingesting tapeworm eggs in dog feces. These eggs hatch in the duodenum and invade the liver, lungs, or bones of sheep and cattle. Humans are infected by ingesting the infected meat from these animals. In the organs, the embryo transforms into a cyst, which develops the germinal epithelium that produces capsules, larval forms, and eventually the infectious scolices. Although hydatid cyst of the pancreas is rare, it must be considered in the differential diagnosis of pancreatic lesions. We present a rare case.

Evaluation of FLASH - PCR forrapid detection of Mycobacterium tuberculosis from clinical specimens.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) is the oldest known bacterial disease in humans. Due to the rise of morbidity in recent years, early diagnosis of the disease is necessary. MATERIALS AND METHODS: In this study we used Fluorescent Amplification-Based Specific Hybridization (FLASH) PCR to targetIS6110 for rapid detection of M. tuberculosis (MTB). To investigate the important factors influencing the risk of TB, data from patients and their medical records were analyzed. RESULT: The sensitivity and specificity of FLASH-PCR for detecting MTB were determined as 93.33% and 92.5%, respectively. The findings of this study have suggested that removal of the contaminants in FLASH-PCR sign ificantly reduced the detection time, and MTB was much more rapidly detected in the clinical specimens compared to the conventional culture and smear examination. Results of the medical survey showed that the majority of TB patients were males, over 51 years old, smokers, with pulmonary TB and normal chest X-ray (CXR). CONCLUSION: MTB can be rapidly detected inclinical specimens using FLASH-PCR in comparison with culture and smear examination.

Incontinentia pigmenti.

Incontinentia pigmenti (IP) or Bloch-Sulzberger syndrome is a rare X-linked dominant genodermatosis related to the NF kappa B essential modulator (NEMO) gene with approximately 800 cases reported worldwide. It usually occurs in females characterized by cutaneous, skeletal, neurological, ocular and dental abnormalities as well as an increased risk of childhood malignancies. Herein, we report a case of IP in a 14-year-old girl emphasizing early diagnosis and adding to the current literature on the subject.

Splenic tuberculosis: a case report.

Splenic tuberculosis is an unusual clinical phenomenon, especially in immunocompetent hosts. It often demonstrates diagnostic complexity, which makes the identification of the agent difficult. We encountered the case of a middle-aged immunocompetent male who claimed to be suffering from pain in the left hypochondriac region without any indication of cough, hemoptysis, weight loss or fever. When physically examined, he had splenomegaly without any other clinical findings. This was further confirmed by imaging. A splenectomy was performed, and samples were taken for histopathological examination and microbiological analysis. Gross examination of the specimen showed multiple nodules coalescing to form a large yellowish-white mass of solid consistency. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epitheloid cells and Langhan's type giant cells throughout the splenic pulp. PCR verified the diagnosis of Mycobacterium tuberculosis infection. No primary focus of infection was detected in the lungs or any other organs.

In vivo induction of necrosis in mice fibrosarcoma via intravenous injection of type B staphylococcal enterotoxin.

The bacterial superantigen staphylococcal enterotoxin B (SEB) is a potent inducer of cytotoxic T-cell activity and cytokine production in vivo. We investigated the possibility of the therapeutic application of SEB in patients with fibrosarcoma. The anti-tumor effect of SEB in mice with inoculated fibrosarcoma (WEHI-164) was examined by intravenous (IV) and intratumoral (IT) injection and the sizes of the inoculated tumors, IFN-gamma production, and CD4+/CD8+ T cell infiltration were determined. The inoculated tumors were also examined histologically. In the mice in the IV-injected group, a significant reduction (P < 0.02) of tumor size was observed in comparison with mice in the IT-injected and control groups. Furthermore, the mice in the IV-injected group showed significantly higher levels of IFN-gamma (P < 0.009) and CD4+/CD8+ T cell infiltration when compared with the other groups (P < 0.02). A significantly higher frequency of necrosis in tumor tissues was also observed in mice in the IV-injected group (P < 0.05). Our present findings suggest that tumor cell death is caused by increased cytotoxic T-cell activity and cytokine levels in response to the IV injection of SEB and that SEB may be a good option for use as a novel therapy in patients with fibrosarcoma.

Surgical management of a complex odontoma associated with impacted maxillary first, second, and third molars.

Odontomas are mixed odontogenic tumors of the jaws with both epithelial and mesenchymal origins. These tumors usually are small and at times are disregarded; however, there are times when dentists will need to remove such tumors (for example, when they are symptomatic, when they enlarge or impede tooth eruption, when orthodontic treatment is required, or when they are associated with teeth that require removal, such as impacted third molars). Although odontomas are not uncommon and are familiar to practitioners, postsurgical complications may result if dentists are not aware of the potential pitfalls associated with the surgical removal of large maxillary odontomas. This article reports a typical case of a complex odontoma and addresses points and pitfalls concerning surgery to remove maxillary complex odontomas.

Orofacial granulomatosis of the lower lip and cheek: report of a case.

Orofacial granulomatosis (OFG) is a granulomatous disease of the orofacial region. This clinicopathological entity describes patients with oral lesions characterized by persistent and/or recurrent labial enlargement, ulcers, and a variety of other orofacial features, which on biopsy have lymphedema and noncaseating granulomas. The cause is idiopathic but appears to represent an abnormal immune reaction. This may be a manifestation of Crohn's disease (CD) since some patients with oral lesions develop typical bowel symptoms of CD in ensuing months to years; tooth-associated infections, sarcoidosis, food or contact allergies, and viruses have also been implicated in causing OFG. Clinical features of OFG are highly variable and sometimes so insidious that signs and symptoms are frequently not severe enough to cause alarm. The lips are most commonly involved and demonstrate a nontender, persistent swelling. Because of the relatively nonspecific clinical findings associated with granulomatous diseases, a microscopic diagnosis of granulomatous inflammation often presents a diagnostic dilemma for clinicians. We report a case of OFG of the lower lip and cheek and describe its management to add to the current body of literature on the subject.