Chemical Composition in Juvenile and Mature Wood of Branch and Main Trunk of Leucaena leucocephala (Lam.) de Wit.

Secondary growth is the most dynamic developmental aspect during the terrestrialization of plants. The development of secondary xylem tissue composed of thick-walled cells with characteristic changes in its structure and chemistry facilitates the growth and development of woody plants. In the present study, the chemical composition of the secondary xylem of juvenile and mature wood from the branch and main trunk of Leucaena leucocephala, has been investigated and the differences established. The biochemical analysis of different cell wall components in the mature wood of the main trunk revealed high holocellulose and α-cellulose and less lignin content in the juvenile wood while its syringyl/guaiacyl (S/G) ratio was less than for the mature wood. As compared to the branch xylem, concentration of cell wall polysaccharides and lignin content was higher in both juvenile and mature wood collected from the main trunk. Thioacidolysis and GC-MS analysis of wood lignin from juvenile and mature wood showed that an increased concentration in lignin content in mature wood is associated with a corresponding increase in S/G ratio. The structural information of the acetylated lignin was investigated by 1H NMR spectroscopy. Our results indicate that the mature wood from the main trunk is superior in pulp yielding and lignin degradability as compared to the juvenile wood of the branch and trunk.

"The VA was the first place as a trainee that I felt like I had to hide many parts of myself": Lived experiences and recommendations for empowering transgender, nonbinary, and gender expansive VA psychology supervisors and supervisees.

Psychology trainees are increasingly diverse in terms of gender identity and gender expression (Lund & Thomas, 2022), yet clinical supervision models often overlook the unique needs, strengths, and experiences of transgender, nonbinary, and gender expansive (TNBGE) trainees and supervisors. The Department of Veterans Affairs (VA) remains the largest training network for psychology trainees and many American Psychological Association-accredited VA sites advertise focused training opportunities in lesbian, gay, bisexual, transgender, and queer health at both the internship and postdoctoral levels. As such, VA psychology training programs are uniquely positioned to impact the professional experiences of TNBGE psychology trainees and supervisors. Critical issues in supervision with TNBGE supervisees and supervisors in VA health care settings are reviewed utilizing themes and examples from the authors' lived experiences as TNBGE supervisors and supervisees. Recommendations are provided for supervisees, supervisors, and training directors in VA psychology training programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Melanotic Neuroectodermal Tumor of Infancy: A Rare Case Report.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, pigmented tumor. It is a locally aggressive neoplasm of neural crest origin with a high recurrence rate. It occurs in craniofacial sites in more than 90% of cases and most commonly in the maxilla. It may also occur in epididymis, testis, ovaries, soft tissue, and bones of the extremities. It occurs in infants younger than 1 year of age with a slight male preponderance. We report a rare case of a child presenting with midline frontal pigmented MNTI.

Risk factors for non-adherence among people with HIV-associated TB in Karnataka, India: A case-control study.

SETTING: Five select districts of Karnataka, India, providing anti-tubercular and antiretroviral therapy (ATT and ART) to people with Human Immunodeficiency Virus (HIV) - associated Tuberculosis (TB) through a single window care approach at the ART centres (seven ART centres and 16 link ART centres). OBJECTIVES: To determine the factors associated with non-adherence to concurrent therapy. DESIGN: We conducted a case-control study involving primary and secondary data collection. Starting January 2019, we consecutively enrolled people on at least three months of ATT until we enrolled 125 cases (non-adherent to concurrent therapy) and 375 controls (adherent to concurrent therapy). Adherence was defined as taking >95% ART doses and >90% ATT doses, every month over the last three months. We performed multivariable logistic regression to identify factors associated with non-adherence. RESULTS: The mean age of the cases and control was similar: 39.8 (standard deviation: 8.8) years. The risk factors for non-adherence were status non-disclosure (aOR = 2.06), zidovudine-based ART (aOR = 4.87), >3 side effects (aOR = 6.45), not receiving counselling before ATT initiation (aOR = 5.25) and non-receipt of co-trimoxazole prophylaxis (aOR = 9.90). CONCLUSION: Major determinants for non-adherence were clinical and treatment related factors.

SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients.

OBJECTIVE: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. METHODS: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. RESULTS: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as "failures". CONCLUSION: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements.

Immunolocalization of ß-(1-4)-D-galactan, xyloglucans and xylans in the reaction xylem fibres of Leucaena leucocephala (Lam.) de Wit.

Cell wall architecture of tension wood fibres represents a suitable biological system to study the mechanism of growth and maintenance of posture of trees growing under various physical and physiological growth constraints. In the present study, we investigated the spatial distributions of ß-(1-4)-D-galactan, xyloglucan and xylans (both less and highly substituted) in the opposite and tension wood fibres of bent Leucaena leucocephala by immunolabelling with monoclonal antibodies LM5, CCRCM1, LM10 and LM11 specific to these carbohydrate epitopes. The presence of non-lignified, tertiary wall layer is the typical tension wood characteristic associated with the reaction xylem fibres in Leucaena. LM5 labelling of opposite fibres showed weak labelling in the cell walls indicating less concentration of ß-(1-4)-D-galactans while tension wood showed strong labelling in the tertiary wall layer suggesting the gelatinous layer (G-layer) has a strong cross linking with ß-(1-4)-D-galactans. Xyloglucan distribution was more in the compound middle lamellae and the primary wall-S1 layer boundary of tension wood fibres as compared to that of opposite wood. A weak labelling was also evident near the boundary between the G-layer and the secondary wall of tension wood fibres. The secondary wall of opposite and tension wood fibres showed a strong distribution of both ls ACG Xs (LM10) and hs ACG Xs (LM11) while a weak labelling was noticed in the compound middle lamella. Tension wood fibres also showed strong xylan labelling mainly confined to the lignified secondary walls while the G-layer showed weak xylan labelling. In conclusion, our results suggest that ß-(1-4)-D-galactans and xyloglucans could be implicated in the tensile stress generation within the G-layer of tension wood fibres of Leucaena leucocephala.

Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion.

BACKGROUND: Endoscopic ultrasound is seldom available at paediatric centres; therefore drainage of pancreatic pseudocysts in children has traditionally been achieved by surgery. OBJECTIVE: This study assessed the feasibility and safety of performing image-guided internal drainage of pancreatic pseudocysts with a flanged self-expanding covered nitinol pancreatic pseudocyst drainage stent. MATERIALS AND METHODS: We conducted a retrospective case note review of children undergoing image-guided cystogastrostomy at two paediatric hospitals. Percutaneous access to the stomach was achieved via an existing gastrostomy tract or image-guided formation of a new tract. Under combined ultrasound, fluoroscopic or cone-beam CT guidance the pancreatic pseudocysts were punctured through the posterior wall of the stomach. A self-expanding covered nitinol stent was deployed to create a cystogastrostomy opening. RESULTS: Image-guided cystogastrostomy was performed in 6 children (4 male; median age 6 years, range 46 months to 15 years; median weight 18 kg, range 13.8-47 kg). Two children had prior failed attempts at surgical or endoscopic drainage. Median maximum cyst diameter was 11.5 cm (range 4.7-15.5 cm) pre-procedure. Technical success was 100%. There were no complications. There was complete pseudocyst resolution in five children and a small (2.1-cm) residual pseudocyst in one. Pseudocyst-related symptoms resolved in all children. CONCLUSION: Pancreatic pseudocyst drainage can be successfully performed in children by image-guided placement of a cystogastrostomy stent. In this cohort of six children there were no complications.

Cardiovascular Manifestations and Complications of Loeys-Dietz Syndrome: CT and MR Imaging Findings.

Loeys-Dietz syndrome (LDS) is a recently described genetic connective tissue disorder with a wide spectrum of multisystem involvement. LDS is characterized by rapidly progressive aortic and peripheral arterial aneurysmal disease. LDS and the other inherited aortopathies such as Marfan syndrome have overlapping phenotypic features. However, LDS is characterized by a more aggressive vascular course; patient morbidity and mortality occur at an early age, with complications developing at relatively smaller aortic dimensions. In addition, there is more diffuse arterial involvement in LDS, with a large proportion of patients developing aneurysms of the iliac, mesenteric, and intracranial arteries. Early diagnosis and careful follow-up are essential for ensuring timely intervention in patients with arterial disease. Cross-sectional angiography has an important role in the baseline assessment, follow-up, and evaluation of acute complications of LDS, the thresholds and considerations of which differ from those of other inherited aortopathies. In this article, LDS is compared with other genetic vascular connective tissue disorders. In addition, the genetic, histopathologic, and cardiovascular manifestations of this disease process are reviewed, with a focus on computed tomographic and magnetic resonance imaging findings. Online DICOM image stacks and supplemental material are available for this article. ©RSNA, 2018.

Simultaneous Distinction of Monospecific and Mixed DFS70 Patterns During ANA Screening with a Novel HEp-2 ELITE/DFS70 Knockout Substrate.

Systemic autoimmune connective tissue disorders are characterized by circulating antinuclear antibodies (ANA). Although there are several technologies available for ANA screening, indirect immunofluorescence (IIF) using Human epithelial cells-2 (HEp-2) substrate remains the primary and recommended method because of its superior sensitivity. HEp-2 substrates can detect a multitude of patterns resulting from autoantibody binding to various protein and nucleic acid autoantigens distributed throughout the nucleus and cytoplasm of the cells. The great diversity of monospecific and mixed patterns resulting from positive reactions on HEp-2 substrate also complicate the interpretation and accuracy of reporting. One specific example which received utmost attention recently is the dense fine speckled 70 (DFS70) pattern resulting from autoantibodies that specifically bind to a protein called lens epithelium derived growth factor (LEDGF). Lack of clear association with a specific systemic autoimmune disease and high prevalence in healthy populations have made accurate interpretation of DFS70 pattern important. Accurate distinction of DFS70 pattern from disease-associated patterns using conventional HEp-2 substrate is challenging. Moreover, frequent co-occurrence of DFS70 pattern along with disease-associated patterns such as homogeneous, speckled, and mixed homogeneous-speckled patterns complicate the IIF interpretation. The goal of this paper is to demonstrate the utility of a novel engineered HEp-2 IIF substrate that retains all advantages of conventional HEp-2 substrate while simultaneously providing the ability to distinguish DFS70 pattern with high confidence in both monospecific and mixed ANA positive examples. The new substrate is further able to unmask disease-associated ANA patterns previously concealed by DFS70 pattern.

Dynamic Susceptibility Contrast-Enhanced MR Perfusion Imaging in Assessing Recurrent Glioblastoma Response to Superselective Intra-Arterial Bevacizumab Therapy.

BACKGROUND AND PURPOSE: Recurrent glioblastoma currently has no established standard of care. We evaluated the response of recurrent glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab by using dynamic susceptibility contrast-enhanced MR perfusion imaging. We hypothesized that treatment response would be associated with decreased relative CBV and relative CBF. MATERIALS AND METHODS: Patients were accrued for this study from larger ongoing serial Phase I/II trials. Twenty-five patients (14 men, 11 women; median age, 55 years) were analyzed. Four distinct ROIs were chosen: 1) normal-appearing white matter on the contralateral side, 2) the location of the highest T1 enhancement in the lesion (maximum enhancing), 3) the location of highest relative CBV in the lesion (maximum relative CBV), and 4) nonenhancing T2 hyperintense signal abnormality surrounding the tumor (nonenhancing T2 hyperintensity). RESULTS: There was a statistically significant median percentage change of -32.34% (P = .001) in relative CBV in areas of maximum relative CBV following intra-arterial bevacizumab therapy. There was also a statistically significant median percentage decrease in relative CBF of -30.67 (P = .001) and -27.25 (P = .037) in areas of maximum relative CBV and maximum tumor enhancement, respectively. Last, a trend toward statistical significance for increasing relative CBV in nonenhancing T2 hyperintense areas (median percent change, 30.04; P = .069) was noted. CONCLUSIONS: Dynamic susceptibility contrast-enhanced MR perfusion imaging demonstrated a significant decrease in tumor perfusion metrics within recurrent glioblastomas in response to superselective intra-arterial cerebral infusion of bevacizumab; however, these changes did not correlate with time to progression or overall survival.

Water-soluble prodrugs of paclitaxel containing self-immolative disulfide linkers.

A new series of disulfide-containing prodrugs of paclitaxel were designed, synthesized and evaluated against 6 cancer cell lines. Some of these prodrugs exhibited nearly equal or slightly better anticancer activity when compared to that of paclitaxel. These prodrugs contain water-soluble groups such as amino, carboxyl, hydroxyl, amino acids, etc., and exhibited 6-140 fold increase in aqueous solubility when compared to paclitaxel. One of these prodrugs exhibited improved water solubility, better in vitro anticancer activity and significantly superior oral bioavailability in mice when compared to those of paclitaxel. Thus, we have identified a very promising lead compound for further optimization and evaluation as a potentially bioavailable water-soluble prodrug of paclitaxel.

Effect of Azadirachta indica (Neem) and Aloe vera as compared to subantimicrobial dose doxycycline on matrix metalloproteinases (MMP)-2 and MMP-9: An in-vitro study.

BACKGROUND: A critical outcome of periodontal diseases is degradation of collagen in the periodontal tissues, by enzymes such as Matrix Metallo-Proteinases (MMPs). Doxycycline is known to down-regulate the activity of MMPs. Azadirachta indica (Neem) and Aloe vera are herbs known to have an anti-inflammatory effect. The present study was designed to evaluate the anti-inflammatory effect of Neem and Aloe vera by way of its inhibitory effect on MMP-2 and MMP-9 activity in cases of chronic periodontitis and compare it with doxcycline. MATERIALS AND METHODS: A total of 30 subjects were enrolled in this study. Gingival tissue samples were obtained from patients diagnosed with the chronic periodontitis. The tissue extracts were treated with the said drug solutions and inhibition of MMP-2 and MMP-9 was analyzed. Enzymatic activity was detected by electrophoresis. The data was subjected to Student's paired t-test. RESULTS: The results showed that the activity of MMP-2 and MMP-9 was significantly decreased by the use of doxycycline, Neem and Aloe vera. A 53.5% reduction in the MMP-2 and 52.5% reduction in the MMP-9 activity was seen when samples were subjected to Neem treatment at the concentration of 1500 µg/ml. Tissues treated with Aloe vera in the concentration of 2000 µg/ml showed a 20.09% reduction in the MMP-2 and 20.4% reduction in the MMP-9 activity. Doxycycline in the concentration of 300 µg/ml, showed an 82.1% reduction in the MMP-2 and 82.6% reduction in the MMP-9 activity. CONCLUSION: The present study demonstrated an inhibitory effect of Neem and Aloe vera on MMP-2 and MMP-9, which are involved in the extracellular matrix degradation during periodontitis.

Distribution of tension wood like gelatinous fibres in the roots of Acacia nilotica (Lam.) Willd.

KEY MESSAGE: The present study unravels the anatomical characteristics and distribution patterns of cell wall polymers in the G-fibres found in the roots of A. nilotica using different microscopy techniques (light, electron and immunofluorescence microscopy). The present study was aimed to investigate the anatomy of reaction xylem in the positively gravitropic roots of Acacia nilotica growing in compact and waterlogged soils. The roots collected from the two different sites showed occurrence of gelatinous fibres throughout xylem radii from a distance of 4 cm from the soil surface. The thickness of gelatinous layer (G-layer) increased in the root collected from the deeper soil. Further, the ultrastructural studies revealed a complete replacement of S2 and S3 layers in G-fibres nearer to root tip region as compared to the root portion close to upper part of the soil surface. In addition, these fibres demonstrated intense lignification in compound middle lamellae region of G-fibre walls. Moreover, the vessel density and their width increased considerably near the root tip region. The immunofluorescence analysis suggested that the ß-1,4-galactans were prevalent in G-layer, whereas the xylan was restricted to only regions of lignified secondary wall. The similarities in distribution pattern and anatomical features of G-fibres in waterlogged and non-waterlogged roots suggest the occurrence of G-fibres as inherent characteristics in the roots of Acacia nilotica.

Mandibular facial talon cusp: a rare case report.

Talon cusp (TC) is a relatively uncommon developmental anomaly characterized by cusp-like projections from the cemento-enamel junction to a variable distance toward the incisal edge of an anterior tooth. It usually presents on palatal/lingual surface of the anterior teeth. Studies have revealed that it consists of enamel, dentine and a variable amount of pulp tissue. Presence of this cusp on the facial surface of an anterior tooth is a rare finding with very few cases being reported in the literature. The effects of TCs are mainly aesthetic and functional. The management requires a sufficient knowledge of the present clinical entity and the problems associated with it. Early detection and treatment plays a very vital role in avoiding the future complications. The present case reports a 25-year-old male patient with a facial TC on the mandibular left central incisor in which a prophylactic enameloplasty was carried out to avoid the stagnation of debris and stain.

Fabrication of solution processed carbon nanotube embedded polyvinyl alcohol composite film for non-volatile memory device.

Carbon nanotubes (CNTs) were synthesized by chemical vapor deposition using nickel coated stainless steel prepared by electrophoretic deposition. CNTs were embedded in polyvinyl alcohol (PVA) which acts as an organic insulator to fabricate Si/PVA/CNT/PVA/Al Metal-Insulator-Semiconductor type memory devices. The effect of CNT content in the charge storage capacity of PVA-CNT composite film was investigated. The hysteresis obtained from the capacitance-voltage (CV) measurement resulted in a memory window of 1.9 V with 3% CNT loading with the gate voltage sweep of +/- 6 V at 1 MHz under room temperature. The memory window of the devices was due to electron injection into the CNT charge storage elements from the top electrode through PVA. The extensive pi-conjugation along the CNT axis traps the electrons in the CNT network. The ON/OFF state current ratio of Si/Al/PVA-CNT/AI device with 3% CNT in PVA demonstrated significantly a lower turn-on voltage of -1 V and a higher ON/OFF state current ratio of 10(7). The non-volatile and reprogrammable switching behavior of the device demonstrated the characteristic of a rewritable memory.

Thrombus length estimation in acute ischemic stroke: a potential role for delayed contrast enhanced CT.

PURPOSE: Thrombus length has been shown to be an important determinant of recanalization using intravenous thrombolysis in hyperacute ischemic stroke. Various studies have attempted to quantify thrombus based on non-contrast CT (NCCT) or CT angiography (CTA). However, thrombus may not be seen on NCCT, and CTA may fail to delineate the distal extent of the thrombus. Contrast enhanced CT (CECT) following CTA can be used to estimate infarct core, but we investigated whether the angiographic data available on these images provided reliable information on thrombus length. MATERIALS AND METHODS: 15 consecutive patients, mean age 81 years (range 63-93), with terminal internal carotid artery or M1-middle cerebral artery occlusions underwent NCCT, CTA (bolus tracked technique), and CECT (acquired 80 s post initial CTA injection). Three radiologists assessed thrombus length on thin slice NCCT, and CTA and CECT. RESULTS: CTA overestimated thrombus length relative to NCCT (p<0.001) and CECT (p<0.001). There was less difference between CTA and CECT estimation in patients with good collateral scores (p<0.05). There was good correlation between NCCT and CECT (Pearson's correlation coefficient=0.90, 95% CI 0.81 to 0.95, p<0.001). Inter-rater reliability assessed using intraclass correlation was 0.95 (95% CI 0.87 to 0.98) for NCCT and 0.98 (95% CI 0.94 to 0.99) for CECT. CONCLUSIONS: CTA regularly overestimates thrombus length as the distal end of the thrombus is not delineated. This can be overcome through the use of a CECT acquisition which can reliably be used to estimate thrombus length.

Delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: proposal of an evidence-based combined clinical and imaging reference standard.

SUMMARY: Aneurysmal subarachnoid hemorrhage is associated with high morbidity and mortality, with delayed neurologic deficits from delayed cerebral ischemia contributing to a large portion of the adverse outcomes in this patient population. There is currently no consensus reference standard for establishing the diagnosis of delayed cerebral ischemia either in the research or clinical settings, ultimately limiting strategies for preventing delayed infarction and permanent neurologic deficits. There are currently both clinical and imaging-based criteria for the diagnosis of delayed neurologic deficits and vasospasm, respectively, however, neither clinical nor angiographic assessment alone has been shown to identify patients who develop adverse outcomes from delayed infarction. Thus, the purpose of this work is to propose a 3-tiered combined imaging and clinical reference standard based on evidence from the literature to standardize the diagnosis of delayed cerebral ischemia, both to allow consistency across research studies and to ultimately improve outcomes in the clinical setting.

Focus on the positive: anxiety modulates the effects of emotional stimuli on hemispheric attention.

People with high levels of trait anxiety are said to orient attention selectively to threatening stimuli (Bradley, Mogg, White, Groom, & de Bono, 1999; MacLeod, Mathews, & Tata, 1986), but this effect is sometimes difficult to replicate. We suggest a reason for this difficulty is that typical tests of the spatial attention bias in anxiety failed to consider together: (1) the differential effects of positive and threatening stimuli on attention in anxiety, (2) the separate contributions of each hemisphere to the attention bias, and (3) whether the attention bias in anxiety is restricted to orienting or can be observed more strongly in the conflict or alerting networks of attention. We compared the effects of schematic angry, happy, and neutral face cues using a lateralized version of Posner's Attention Network Task (Lateralized Attention Network Test) which distinguishes spatial Orienting Cost (due to an invalid cue; disengagement) from spatial Orienting Benefit (due to a valid cue; hypervigilance), and which considers executive Conflict resolution and Alerting in addition to spatial Orienting in each hemisphere separately. We tested participants with high and low trait anxiety measured by the STAI-TA (Spielberger, Gorsuch, & Lushene, 1983). Surprisingly, happy face cues rather than angry face cues interacted with target visual field and participant level of anxiety. Happy face cues presented to participants with low anxiety elicited maximal Orienting Benefit and minimal Orienting Cost for targets presented to the left visual field. Anxious individuals failed to benefit from happy cues in the left visual field. We suggest that lateralized positive cues can provide a more sensitive index of attention changes in anxiety than is provided by centrally-presented threatening cues.

Comprehensive mutation analysis of PIK3CA, p14ARF, p16INK4a and p21Waf1/Cip1 genes is suggestive of a non- neoplastic nature of phenytoin induced gingival overgrowth.

BACKGROUND: Dilantin sodium (phenytoin) is an antiepileptic drug, which is routinely used to control generalized tonic clonic seizure and partial seizure episodes. A few case reports of oral squamous cell carcinomas arising from regions of phenytoin induced gingival overgrowth (GO), and overexpression of mitogenic factors and p53 have presented this condition as a pathology with potential to transform into malignancy. We recently investigated the genetic status of p53 and H-ras, which are known to be frequently mutated in Indian oral carcinomas in GO tissues and found them to only contain wild type sequences, which suggested a non-neoplastic nature of phenytoin induced GO. However, besides p53 and H-ras, other oncogenes and tumor suppressors such as PIK3CA, p14ARF, p16INK4a and p21Waf1/Cip1, are frequently altered in oral squamous cell carcinoma, and hence are required to be analyzed in phenytoin induced GO tissues to be affirmative of its non-neoplastic nature. METHODS: 100ng of chromosomal DNA isolated from twenty gingival overgrowth tissues were amplified with primers for exons 9 and 20 of PIK3CA, exons 1α, 1ß and 2 of p16INK4a and p14ARF, and exon 2 of p21Waf1/Cip1, in independent reactions. PCR amplicons were subsequently gel purified and eluted products were sequenced. RESULTS: Sequencing analysis of the twenty samples of phenytoin induced gingival growth showed no mutations in the analyzed exons of PIK3CA, p14ARF, p16INK4a and p21Waf1/Cip1. CONCLUSION: The present data indicate that the mutational alterations of genes, PIK3CA, p14ARF, p16INK4a and p21Waf1/Cip1 that are frequently mutated in oral squamous cell carcinomas are rare in phenytoin induced gingival growth. Thus the findings provide further evidence that phenytoin induced gingival overgrowth as a non-neoplastic lesion, which may be considered as clinically significant given the fact that the epileptic patients are routinely administered with phenytoin for the rest of their lives to control seizure episodes.