Epigenetic Alterations Associated with the Overall Survival and Recurrence Free Survival among Oral Squamous Cell Carcinoma Patients.

Oral squamous cell carcinoma (OSCC) is a fatal disease caused by complex interactions between environmental, genomic, and epigenetic alterations. In the current study, we aimed to identify clusters of genes whose promoter methylation status correlated with various tested clinical features. Molecular datasets of genetic and methylation analysis based on whole-genome sequencing of 159 OSCC patients were obtained from the The Cancer Genome Atlas (TCGA) data portal. Genes were clustered based on their methylation status and were tested for their association with demographic, pathological, and clinical features of the patients. Overall, seven clusters of genes were revealed that showed a significant association with the overall survival/recurrence free survival of patients. The top ranked genes within cluster 4, which showed the worst prognosis, primarily acted as paraneoplastic genes, while the genes within cluster 6 primarily acted as anti-tumor genes. A significant difference was found regarding the mean age in the different clusters. No significant correlation was found between the tumor staging and the different clusters. In conclusion, our result provided a proof-of-principle for the existence of phenotypic diversity among the epigenetic clusters of OSCC and demonstrated the utility of the use epigenetics alterations in devolving new prognostic and therapeutics tools for OSCC patients.

Mucoadhesive Hybrid Polymer/Liposome Pastes Based on Modified Polysaccharides.

Mucoadhesive hybrid polymer/liposome paste is a new drug delivery system presenting controllable and tailorable delivery mechanism. By using mucoadhesive material, the delivery can be more specific and local. Here, we present a study investigating the effect of polymer type, concentration, functional end group, and cross-linking on the release profile of nanoliposomes from polymer pastes. Polymer pastes can be expected to combine the mucoadhesion mechanisms of dry and wet dosage forms but have not been studied extensively. To better understand the mucoadhesion of pastes, we investigated a series of pastes based on the same polymer and used different chemical modifications that can produce interactions at different levels. Native and thiolated polymers presented enhanced mucoadhesion in a wet environment in comparison to acrylated polymers which dissolved rapidly because of the enhanced solubility of PEG chains in water. Paste cross-linking resulted in a sustained release profile compared to non-cross-linked pastes. Pectin-SH pastes, especially 3% (w/v), showed a linear liposomal release profile which is ascribed to the combination of ionic cross-linking and disulfide bridging. By configuring the polymer type or concentration, we can control the release mechanisms and achieve distinct inherent properties which can be applied for diverse medical applications.

Practitioners' challenges in diagnosing oral and maxillofacial tumors.

OBJECTIVE: Oral cancer is an increasingly growing health care burden in many parts of the world. Due to the relatively low prevalence of oral cancer, screening will lead to a low yield and a high proportion of false positive results. Clinical examination without histologic diagnosis can lead to misdiagnosis in over 40% of cases, especially when premalignant lesions are involved. However, clinical examination is effective especially in detecting the early stages of oral cancer, particularly in high-risk patients, such as smokers and alcoholics. The purpose of the current paper is to describe several cases of failure to diagnose lesions in the oral cavity during clinical and radiographic examinations, and to discuss how these diagnosis failures may be mitigated. METHOD AND MATERIALS: A series of three cases of oral tumors ranging from benign to malignant that were not recognized and referred in a timely manner, are presented. CONCLUSION: The difficulties faced by clinicians in diagnosing oral lesions are elucidated in this case series. The current case series, presenting instances in which pathologies were not detected and/or treated in spite of obvious signs, should serve as a warning for dental professionals. The general practitioner is the "first line of defense" for symptomatic and asymptomatic patients, and therefore the implementation of well-established screening protocols is of paramount importance. In light of the low sensitivity ratio of oral examinations, use of biopsies is mandatory when a lesion is suspected.