The Effect of Tumor Resection and Radiotherapy on the Expression of Stem Cell Markers (CD44 and CD133) in Patients with Squamous Cell Carcinoma.

Background: Head and Neck Squamous Cell Carcinomas (HNSCCs) are heterogeneous malignancies that comprise 90% of the head and neck cancers. HNSCCs originate from the mucosal lining epithelium of the upper aerodigestive tract. Cancer stem cells (CSCs) that generate HNSCCs with the CD44, CD133, and ALDH phenotype and are resistant to radiotherapy and chemotherapy. In the current, the quantitative alteration in CD44 and CD133 expression pre- and post-tumor resection and radiotherapy was evaluated in HNSCC patients. Moreover, the alterations in the expression of Bax, Bak, Bcl-2, ALDH, and PTEN genes were measured. Materials and Methods: Flow cytometry was performed to evaluate the alterations in CD44 and CD133 surface markers pre- and posttumor resection and radiotherapy. Quantitative real-time RT-PCR (qRT-PCR) was conducted to investigate the mRNA expression levels of Bax, Bak, Bcl-2, ALDH, and PTEN. Results: The results indicated that the cancer stem cell CD44 surface marker significantly decreased after tumor resection and radiotherapy in HNSCC cases, while the decrease was insignificant for CD133 marker expression. mRNA expression level of Bcl-2 and ALDH was increased, but Bax and Bak gene expressions were reduced significantly Conclusion: The results also indicated that the expression of CD44 significantly decreased after tumor resection and radiotherapy. The upregulation of mRNA level of Bcl-2 and ALDH, and the downregulation of Bax and Bak gene expression were noted in these cases when compared to the healthy control group.

Evaluation of Infection and Effective Factors in Impacted Mandibular Third Molar Surgeries: A Cross-Sectional Study.

Materials and Methods: This cross-sectional study was performed on 148 patients. The incidence of infection was recorded one week, two weeks, and one month after surgery. Independent variables included age, gender, the presence of periapical radiolucent lesions measuring ≥3 mm, the caries of the adjacent second molar, education level of the surgeon, difficulty index, suture type, and flap type. The outcome variable was the incidence of infection. Results: Among the study subjects, 37.2% were male and 62.8% were female. The mean age was 25.24 ± 4.31 years at the time of surgery. Although early onset infection occurred in 3.4% of patients, none of them developed a delayed-onset infection during the four weeks after surgery. Pederson difficulty index (OR = 3.81, P=0.03) and the education level of the surgeon (OR = 0.14, P=0.021) were associated with postop infection. Conclusions: Based on the results of the current study, postop infection was rare. Furthermore, both the Pederson difficulty index and the education level of the surgeon could predict the risk of infection after impacted mandibular third molar surgeries.

Drug resistance against 5-fluorouracil and cisplatin in the treatment of head and neck squamous cell carcinoma: A systematic review.

Head and neck cancers are highly prevalent worldwide. Most of these lesions are diagnosed in the advanced stages of the disease. Thus, they do not often have a good long-term prognosis. Like other cancer types, head and neck cancers are managed by surgery, radiotherapy, and chemotherapy. Despite significant advances in the treatment of oral squamous cell carcinoma (OSCC), physicians encounter several challenges in the course of treatment. Various mechanisms mediate the clinical responses of a certain cancer to medications. Thus, efficient treatment planning requires adequate knowledge about the genes involved in drug resistance and the evaluation of the frequency percentage of resistance. Several studies have evaluated the causes and frequency percentages of 5-fluorouracil (5-FU) and cisplatin resistance. In this systematic review, all the relevant articles published until November 30, 2019, were retrieved from the Scopus, Embase, Medline, ISI, Web of Science, and Cochrane databases using certain MeSH and EMTTree keywords. A total of 2164 articles were retrieved of which, 18 were included in the review since they had reported the frequency percentages of drug resistance. Of all, 10 articles had evaluated cisplatin (1317 samples). A meta-analysis of the results revealed a frequency of 33% for cisplatin resistance. Eight studies had evaluated 5-FU (476 samples). A meta-analysis of the results revealed a frequency of 40.2 % for 5-FU resistance. Overcoming cisplatin resistance or 5-FU resistance can significantly enhance recovery in advanced HNSCC. Attempts should be made to eliminate the cause and use multi-drug regimens to increase the success rate of treatment.

Comparison of the Hounsfield unit in CT scan with the gray level in cone-beam CT.

Background. The present study was undertaken to compare the Hounsfield Unit (HU) in computed tomography (CT) with the gray level in CBCT in human tissues. Methods. In this study, 25 different soft and hard tissues were evaluated in 21 patients. CBCT images were taken with Newtom VGi machine (Verona, Italy) and CT images were prepared with Somatom Sensation unit (Siemens, Germany). The HU values of soft and hard tissues were compared with the gray level values of CBCT images. Results. There was a strong correlation between the HU in CT and the gray level in CBCT in soft tissues (P<0.001, R2 = 0.85) and hard tissues (P<0.001, R2 = 0.74) and in general (P<0.001, R2 = 0.91). Conclusion. A high degree of agreement was seen between HU in CT and gray level in CBCT in both hard and soft tissues. Since the gray level in CBCT was similar to HU in CT and can be used as a parameter determine bone density in implant treatment and also to determine the bone type, the CBCT technique is recommended in such cases due to its low radiation dose, short time and low cost compared to CT.

Compatibility of Clinical and Histopathological Diagnosis of Oral Lesions in Iranian Patients

Objective: To determine compatibility between clinical diagnosis and the pathological reports of biopsies from oral lesions. Material and Methods: In this descriptive study, 1146 clinical files of patients referring to Tabriz Faculty of Dentistry from 2004 to 2016 were retrieved and evaluated. The kappa coefficient was calculated for each file for compatibility of clinical and pathological diagnosis. Results: In relation to clinical (40.2%) and pathological (39.2%) diagnosis, irritational lesions of soft tissues exhibited the highest frequency. In 72.3% of cases, the clinical and pathological diagnosis were compatible and in 27.7% of cases these diagnosis were not compatible. The highest compatibility rates were detected for irritational lesions of soft tissues (81.5%) and mucocutaneous lesions (76.9%). There was no compatibility for osseous malignant tumors, inflammatory tissues, granulation tissues, metastatic lesions and hematologic disorders. Conclusion: Approximately one-third of clinical and histopathological diagnosis were not compatible. Therefore, to reach a correct diagnosis, the clinical, radiographic and histopathological views should be evaluated simultaneously.

Effect of Ferula persica plant methanol extract on the level of Cox-2 in induced squamous cell carcinoma (SCC) in rat tongue.

Background: More than 90% of oral cancers are cases of squamous cell carcinoma. Standard treatment of cancer includes a combination of surgery, chemotherapy and radiotherapy. Each of these treatments, however, brings about certain problems and side effects. Today herbal medicine, has become a more preferable option in dealing with health problems or preventing them because this type of medicine has better compatibility with the body and does not cause undesirable side effects. In this study , the effect of Ferula persica plant methanol extraction on Cox-2 levels in SCC induced rat tongue is conducted in vivo. Methods: In this lab research, 75 rats from SD race in the age - range of 2/5 - 3 months were selected and put in five groups. In order to induce tongue carcinoma, 4- Nitroquinoline 1 (4 NQO) powder was used 3 times a week for each rat. Furthermore, Ferula persica extract was given to each of the groups in order to examine Cox-2 changes in the blood. Results: Comparison of Cox-2 average in various groups resulted in the observation that there was significant difference between the Cox-2 levels in the groups which had only received carcinogen and the other groups. In this group, Cox-2 level was less and in the group that had received Ferula extract (500 mg) along with carcinogen , Cox-2 level was found to be more than other groups. Conclusion: Ferula persica extract does not have reducing effect on serum Cox-2.

Pulp bleeding color is an indicator of clinical and histohematologic status of primary teeth.

OBJECTIVES: This study was carried out to investigate whether the changes in hematologic characteristic and color of pulpal bleeding is associated with clinical and histologic status of the pulp in primary teeth. MATERIALS AND METHODS: A total of 211 primary molars in 103 patients, 3-6 years old, were treated. One hundred eight teeth had pulpectomy, 57 teeth had pulpotomy after pulp exposure during caries excavation, and 46 teeth had pulpotomy after accidental pulp exposure in sound dentin. After pulpal exposure, pulpal blood was collected in capillary tubes for blood color and hematologic assessment. Coronal and radicular pulp tissues were amputated for histologic assessment. RESULTS: Blood color was significantly darker in pulpectomy cases and samples with severe inflammation. The differences were clinically perceptible by the human eye. A significant negative correlation was detected between white blood cell (WBC) count and blood color. The counts of neutrophils and lymphocytes were significantly different between treatment groups. In addition, WBC, eosinophil, monocyte, neutrophil, and basophils counts were significantly different between degrees of inflammation in coronal pulp. Moreover, severe inflammation was higher in pulpectomy group versus pulpotomy groups. Pulp tissue calcification was also significantly higher in the pulpectomy cases. CONCLUSIONS: Considering the significant difference in pulpal blood color between the pulpectomy and pulpotomy cases, and between the different levels of pulpal inflammation; blood color can be a valid clinical diagnostic criterion of pulpal status and can be used for the selection of appropriate pulp treatment strategy. CLINICAL RELEVANCE: This study shows that pulp bleeding color can be used for selection of an appropriate pulp treatment method in primary teeth.

Prevalence of Head and Neck Tumors in Children under 12 Years of Age Referred to the Pathology Department of Children's Hospital in Tabriz during a 10-year Period.

Background and aims. Head and neck tumors are the most common complaints of people referring to different medical sections, especially in children. The aim of this study was to evaluate the prevalence of these tumors in children less than 12 years of age to provide a better perspective for future studies. Materials and methods. All the files in Department of Pathology at Tabriz Pediatric Hospital from 2001 to 2011 were screened for head and neck tumors in children under 12 years of age. Data including age and gender as well as the type, the location, and benign/malignant characteristic of the tumor were recorded. Data were analyzed by SPSS 15 statistical software, using descriptive statistics and chi-square test. Results. A total of 160 cases were identified. Most of the tumors were benign (68%) and most of the tumors occurred in the neck region (41%). The most frequent benign and malignant tumors were lymphangioma and non-Hodgkin lymphoma, respectively. The majority of benign tumors were found in children younger than 2 years old (P=0.007), but there was no age predilection for malignant tumors. Conclusion. According to our results, benign tumors were more prevalent than malignant ones. Although a low rate of benign tumors in males shows that more attention should be paid to the early diagnosis of head and neck tumors.

Correlation of histopathologic features with demographic, gross and radiographic findings in giant cell granulomas of the jaws.

Background and aims. The correlation between morphology of giant cells in peripheral granulomas of the jaws and the aggressive behavior of the lesion is unknown. This study investigated the correlation between the histopathologic features with demographic, gross and radiographic findings in giant cell granulomas. Materials and methods. In this analytical study, data from 23 cases of central giant cell granuloma (CGCG) and 42 cases of peripheral giant cell granuloma (PGCG) were analyzed, focusing on age, gender, location, and gross and radiographic features. For each patient, microscopic slides were assessed in terms of histologic features of giant cells and stroma. Results. No significant differences were found in the mean number of nuclei or the size of nuclei and giant cell distribution patterns between the jaws and genders in both lesions (P >0.05). Correlation between the mean number of nuclei and age was positively significant and correlation between the size of nuclei and age was negatively significant (P < 0.05). In addition, correlation between the mean number and size of nuclei and the size of the lesion was significant (P < 0.05). Correlation between stroma and aggressiveness of CGCGs was not statistically significant. Correlation between histopathologic features and radiographic findings was not statistically significant (P > 0.05). Conclusion. There were correlations between the mean number of nuclei per giant cell and the size of the lesion and age, and between the size of nuclei and size of the lesion. No relation was observed between histopathologic and radiographic features.

Inverted papilloma of the palate with malignant transformation.

The inverted papilloma is a unilateral sinonasal benign tumor which is characterized by aggressive local invasion, high recurrence rate, and transformation into malignancy. The etiology of inverted papilloma is still unknown. Possible causes include allergy, chronic sinusitis, occupational exposure to dusts and aerosols, tobacco, and viral infections. Treatment is complete surgical excision and close postoperative follow-up is necessary. Here we report a case of inverted papilloma arising from the hard palate with malignant transformation in a 41-year-old female. Clinical and histological features and treatment are discussed with the review of literature.