Pathologic Basis of Diseaseby Stanley L. Robbins is really the fourth edition of hisPathology. Appropriate updating and addition enhance the otherwise identical format, sequence, writing, and illustrations. So many medical students have benefited from this source that it may be the best known general book in the field. I recommend it even more now. Like his former texts, this will be enjoyed for its readability. He clearly lays out a great deal of information. When he includes minutiae, the reasons are clear and one feels that all the material is pertinent. Robbins keeps the whole field in perspective—that is, he does not dwell so long or so heavily on pathologic anatomy or pathogenesis as to tempt the reader to overlook clinical presentation or prognosis. A great strength of the subject of pathology is that it bonds strongly with many other medical sciences and specialties and thus occupies the

Pathologic Basis of Disease

Oral lichen planus: Focus on etiopathogenesis

Telomeres and telomerase are nowadays exploring traits on targets for anticancer therapy. Telomerase is a unique reverse transcriptase enzyme, considered as a primary factor in almost all cancer cells, which is mainly responsible to regulate the telomere length. Hence, telomerase ensures the indefinite cell proliferation during malignancy—a hallmark of cancer—and this distinctive feature has provided telomerase as the preferred target for drug development in cancer therapy. Deactivation of telomerase and telomere destabilization by natural products provides an opening to succeed new targets for cancer therapy. This review aims to provide a fundamental knowledge for research on telomere, working regulation of telomerase and its various binding proteins to inhibit the telomere/telomerase complex. In addition, the review summarizes the inhibitors of the enzyme catalytic subunit and RNA component, natural products that target telomeres, and suppression of transcriptional and post-transcriptional levels. This extensive understanding of telomerase biology will provide indispensable information for enhancing the efficiency of rational anti-cancer drug design.

https://www.mdpi.com/1422-0067/19/1/13/pdf

Telomerase Inhibitors from Natural Products and Their Anticancer Potential

Background: Individual identification is a subtle concept and often one of the most important priorities in mass disasters, road accidents, air crashes, fires, and even in the investigation of criminal cases. Matching specific features detected on the cadaver with data recorded during the life of an individual is an important aspect in forensics, and can be performed by fingerprint analysis, deoxyribonucleic acid matching, anthropological methods, radiological methods and other techniques which can facilitate age and sex identification. Sinus radiography is one such method that has been used for determination of the sex of an individual. Hence, an attempt is being made to use the different dimensions of the maxillary sinus in the determination of sex using coronal and axial sections of plain computed tomography (CT) scan. Materials and Methods: A total of 30 patients including 17 male and 13 female, visiting the Outpatient Department of the Mamata General Hospital were included as the study subjects. The dimensions of right and left maxillary sinuses of 30 subjects from plain CT were measured using SYNGO software and statistical analysis was done. Results: Sex determination using height, length, width, and volume of the maxillary sinus on both sides showed statistically significant results with a higher percentage of sexual dimorphism in the case of volume. Conclusion: Volume of the right maxillary sinus can be used as accurate diagnostic parameter for sex determination.

Sex determination using maxillary sinus

Gorlin-Goltz syndrome is a rare genetic condition showing a variable expressiveness. It is inherited in a dominant autosomal way. The strongest characteristic of the disease includes multiple basal cell carcinomas, jaw cysts, palmar and plantar pits, skeletal abnormalities and other developmental defects. Owing to the fact that the condition tends to be a multisystemic disorder, familiarity of various medical specialists with its manifestations may reduce the time necessary for providing a diagnosis. It will also enable them to apply adequate methods of treatment and secondary prevention. In this study, we present symptoms of the disease, its diagnostic methods and currently used treatments.

We searched 2 scientific databases: Medline (EBSCO) and Science Direct, for the years 1996 to 2011. In our search of abstracts, key words included nevoid basal cell carcinoma syndrome and Gorlin-Goltz syndrome.

We examined 287 studies from Medline and 80 from Science Direct, all published in English. Finally, we decided to use 60 papers, including clinical cases and literature reviews.

Patients with Gorlin-Goltz syndrome need particular multidisciplinary medical care. Knowledge of multiple and difficult to diagnose symptoms of the syndrome among professionals of various medical specialties is crucial. The consequences of the disease pose a threat to the health and life of patients. Therefore, an early diagnosis creates an opportunity for effective prevention and treatment of the disorder. Prevention is better than cure.

Gorlin-Goltz syndrome - a medical condition requiring a multidisciplinary approach

Background: Sexual dimorphism refers to the differences in size, shape, etc., between males and females. The dentition's use in sex assessment has been explored and advocated owing to its strength and resistance to peri- and post-mortem insults. Objectives: The study evaluated permanent maxillary incisors and canines for sexual dimorphism and estimated the level of accuracy with which they could be used for sex determination. Materials and Methods: The study was conducted on 100 subjects (50 males, 50 females). The mesiodistal dimension of permanent maxillary incisors and canines was measured and the data were subjected to statistical analysis. Result: Univariate analysis revealed that all permanent maxillary incisors and canines exhibited larger mean values of mesiodistal dimension in males compared to females but only canines were found to be statistically significant for sexual dimorphism. Conclusion: The study showed maxillary canines exhibiting significant sexual dimorphism and can be used for sex determination along with other procedures.

Sex determination using mesiodistal dimension of permanent maxillary incisors and canines

Gorlin-Goltz syndrome is an autosomal dominant inherited disorder characterized by the presence of multiple odontogenic keratocysts along with various cutaneous, dental, osseous, ophthalmic, neurological, and sex organ abnormalities. Early diagnosis is essential as it may progress to aggressive basal cell carcinomas and neoplasias. Gorlin-Goltz syndrome has rarely been reported from India. We report here one such patient, diagnosed at a rural hospital.

Gorlin-Goltz syndrome.

Recent attention has been directed toward the role of mast cells in the pathogenesis of oral lichen planus. Mast cells are responsible for trafficking inflammatory cells into the connective tissue that in turn helps in progression and maintenance of chronicity of oral lichen planus (OLP). OLP is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology, and lesions contain few B-cells or plasma cells and minimal deposits of immunoglobulin or complement. Hence, OLP is ideally positioned for the study of human T-cell-mediated inflammation and autoimmunity. This study was done to evaluate the mast cell count using toluidine blue stain in OLP and compares it with oral lichenoid reaction (OLR), and to propose the possible role of mast cells in the pathogenesis of OLP and OLR. Ten cases each of OLP and OLR and five cases of normal buccal mucosa were taken from the archives of Department of Oral Pathology. The samples were stained with toluidine blue using standard toluidine blue method by Wolman 1971. An increase in mast cell count was observed in OLP and OLR in comparison to normal oral mucosa. However, no significant differences in mast cell count were noted between OLP and OLR.

Role of mast cells in pathogenesis of oral lichen planus

Background: Neoplasia results from various genetic and epigenetic factors. Our study focused on the pathogenesis which involved an imbalance in various molecular mechanisms which regulated cell proliferation and apoptosis. The anti-apoptotic mechanism is regulated by Bcl-2 gene, while Ki-67 is expressed exclusively in nuclei of proliferating cells. This study was done to evaluate the basic pathologic process which underlay well and poorly differentiated oral squamous cell carcinoma (OSCC).

Materials and Methods: Thirty cases of oscc were selected, out of which 11 were well differentiated, 9 were moderately differentiated and 10 were poorly differentiated. Three slides of 4μm thickness were prepared out of each sample, which were then subjected to Hematoxylin and eosin stain (H&E) staining and two types of immunohistochemical (IHC) staining. Immunohistochmical markers used were Ki-67 (proliferative marker using MIB-1 (Molecular Immunology Borstel 1) antibody) and Bcl-2 (anti-apoptotic marker). The number of MIB-1 and Bcl-2 positive cells was calculated from ten different high power fields, by counting the number of positive cells per 50 cells in each field, by making a grid pattern. The overall percentage value for each case was evaluated for MIB-1 and Bcl-2 positive cells. Karl-Pearson’s co-relation coefficient was calculated between MIB-1 and Bcl-2 in each group. The aim of this study was to co-relate the expression of Ki-67, a proliferative marker, by using MIB-1 antibody and Bcl-2, an anti-apoptotic marker in various grades of oscc and also to determine whether there was any co-relation between these two markers in the 30 cases of oscc .

Results: A statistically significant increase for MIB-1 and a statistically significant decrease for Bcl-2 was found in well to moderately to poorly differentiated Squamous cell carcinoma (SCC). A statistically significant co-relation was also found between MIB-1 and Bcl-2 in poorly differentiated oscc .

Conclusion: MIB-1 expression is predominant in well, moderate and poorly differentiated SCCs. Bcl-2 expression is predominant in well differentiated than in moderately and poorly differentiated oscc , which suggested that apoptosis probably played a major role in the early stages of carcinogenesis.

Expression of Bcl-2 and MIB-1 Markers in Oral Squamous Cell Carcinoma (OSCC)- A Comparative Study.

Background Azadirachta indica (neem), belongs to the family of Meliaceae plants, is found in the Indian subcontinent. The neem tree is colloquially referred to as the village pharmacy due to its array of biological properties. Every part of the neem tree like its bark, leaves, sap, fruit, seeds, and twigs find a multitude of uses. It is customary to use them for management of skin diseases and various other infections. The anticancer properties of neem have been studied in the past and these include its ability to modulate the tumour environment, increase the cytotoxic ability of host monocytes and suppress the proliferation of tumour cells. The present review was conducted with the objective of scrutinizing and assimilating data about the usefulness Azadirachta indica in oral cancer from all the previously done work. Material and methods A planned review was conducted of all the studies that investigated the role of Azadirachta indica in oral cancer. Literature search was carried out using PubMed, Scopus and Google scholar databases. In addition to electronic searching, hand searching, cross referencing and various internet engines were also used to collect data. The articles were perused and articles not pertinent to our search were omitted. Results and conclusion The anticancer properties of neem were evaluated and the active constituents of neem have been demonstrated to unequivocally have preventive and therapeutic potential against oral cancer. Although, greater exploration of the anticancer properties of neem are required in order to effectively integrate it into the routine management of oral cancer.

Keya Sircar

Papers

Sex determination using mesiodistal dimension of permanent maxillary incisors and canines

Gorlin-Goltz syndrome.

Role of mast cells in pathogenesis of oral lichen planus

Expression of Bcl-2 and MIB-1 Markers in Oral Squamous Cell Carcinoma (OSCC)- A Comparative Study.

A review of the anticancer activity of Azadirachta indica (Neem) in oral cancer.