Oral manifestations associated with inherited hyperhomocysteinemia: A first case description.

Hyperhomocysteinemia is a rare disease caused by nutritional deficiencies or genetic impairment of cysteine metabolism. To date, no oral manifestations of hyperhomocysteinemia have been described in humans. Therefore, to our knowledge, the present case report is the first description of a hyperhomocysteinemic patient showing oral tissue alterations leading to both early tooth loss and failed implant osseointegration. The patient presented with a methylenetetrahydrofolate reductase gene mutation (677T polymorphism) leading to mild hyperhomocysteinemia. The radiologic analysis showed hyperdense lesions scattered in the maxillae. The histologic observations indicated alterations in both collagen and elastic networks in the gingiva and dermis. Interestingly, the presence of ectopic mineralized inclusions was noted in both periodontal ligament and gingiva. Strong osteoclastic activity was associated with abnormal calcification of trabecular spaces. Uneven oral tissue remodeling due to high tissue levels of homocysteine could explain the pathologic manifestations observed in this case.

Impact of breast vs. formula feeding mode on primary teeth lead level. Retrospective clinical study and literature review.

UNLABELLED: Lead exposure is a global environmental problem inducing lifelong adverse health effects. Children's exposure to lead, from birth to 6 months, is typically dominated by dietary sources. The first primary mandibular molar could provide an integrated record of lead exposure. The aim of this study is to detect the level of lead in the first primary molar of a group of Lebanese children born between 1990 and 2000, living in Beirut and suburbs, and to compare the amount of lead according to gender and feeding mode. MATERIALS AND METHODS: A group of 53 first primary molars belonging to 53 Lebanese children (31 girls and 22 boys), and aged 9 to 12 years old, were included in the study. The primary outcome variable of the study was the amount of lead level (mg/kg) in the first primary mandibular molars taken at the time of the natural exfoliation and measured by ICP/MS (Inductively Coupled Plasma Mass Spectrometry). Children included in the study were fed exclusively with formula feeding or maternal feeding for six months. RESULTS: The mean lead level of the first primary molar was 0.678 mg/kg +/- 0.717. The mean lead was significantly higher among children fed with instant formula milk (0.876 +/- 0.802) than breastfed children (0.455 +/- 0.540), (p = 0.044). No significant difference was found between girls (0.595 < or = 0.548) and boys (0.794 +/- 0.905), (p = 0.440). CONCLUSION: Within the limitations of this study, we found a statistically significant difference in the teeth lead level between breastfeeding and formula feeding, in favor of breastfeeding. This difference proves once more the importance of breastfeeding ; on the other hand, the Lebanese children accumulated lead in their teeth to levels below the international levels.

Prognostic significance of EGFR, p53 and E-cadherin in mucoepidermoid cancer of the salivary glands: a retrospective case series.

OBJECTIVE: Evaluate the prognostic significance of EGFR, p53 and E-cadherin known, along with histopathologic criteria, in mucoepidermoid cancer (MEC) of the salivary glands. MATERIALS & METHODS: Retrospective case series review between January 1994 and December 2002 of all patients with salivary glands mucoepidermoid cancer treated at one university hospital. Histopathology review and immunohistochemistry study for EGFR, p53 and E-cadherin was undertaken on formalin-fixed, paraffin embedded surgical specimens. Clinicopathological parameters were reviewed and survival analysis was conducted to study the prognostic significance of these factors. SETTINGS: All patients were treated by the same multidisciplinary team which included three head and neck surgeons, one plastic surgeon, two medical oncologists and one radiation oncologist at Hôtel-Dieu de France, a tertiary care university hospital of Saint-Joseph University, Beirut-Lebanon. RESULTS: Thirteen patients were treated for MEC during this period. The parotid gland was the most common site. Mean survival in this series was 61 +/- 8 months (95% CI = 46-77 months). Positive lymph nodes status was a significant predictor of poor survival. EGFR and p53 were correlated to histological grade. EGFR tended also to be more elevated in major salivary gland tumors. CONCLUSION: EGFR and p53 expressions were highly correlated to high histological grade, making them an interesting target for further investigation as prognostic factors in MEC.