Effect of cell phone use on salivary components; a review of literature

Mobile phones have been increasingly used in the past decade and have become a cultural instrument. There is a great concern over the harmful effects of electromagnetic and radiofrequency waves as well as microwaves generated by mobile phones and their telecommunication stations on health. The saliva plays an important role in preserving oral homeostasis as the first defensive line against the microbial invasion which protects oral mucosa mechanically and immunologically. A search was run in Pub med, Goggle Scholar, Medline, and Web of Science databases using the following keywords: cell phone, mobile phone, antioxidant profile, saliva, oxidative stress, interleukin, and inflammation. Sixty-five published articles were identified. Studies on the use of cell phones as educational aids, the use of immune histochemistry on salivary glands, or the evaluation of saliva in individuals with specific conditions, such as the use of orthodontic brackets, were excluded. In addition, duplicate articles are eliminated, and finally, 14 articles were included in the present study. Nowadays mobile phone is very popular, causing concern about the effect it has on people’s health. Parotid salivary glands are in close contact with a cell phone while talking with the phone and the possibility of being affected by them; so this study was designed to investigate the effect of cell phone use on salivary components.

Rare case of metastatic adenocarcinoma to the maxillary sinus

Colorectal carcinoma metastases to the head and neck are exceedingly rare. Patients may present with vague symptoms that may lead to a delay in diagnosis. We report the case of a 51-year-old man with a known history of stage IIIB colorectal adenocarcinoma who presented with right-sided molar tooth bleeding and right-sided palate swelling that led to difficulty speaking, eating and weight-loss of 15 pounds. Imaging studies revealed a 3.1×4.8×3 cm mass that was centred around the posterior aspect of the maxilla. Pathology revealed moderately differentiated intestinal type adenocarcinoma of colonic subtype, immune histochemistry was positive for CDX2, CK20 and MUC2, thus confirming metastatic disease to the maxilla. The patient is undergoing chemoradiation therapy for palliation of his symptoms. Clinicians should be aware of this potentional site of metastatic disease and suspect the diagnosis in a timely manner to avoid delays in making a diagnosis.

Electroacupuncture suppresses glucose metabolism and GLUT-3 expression in medial prefrontal cortical in rats with neuropathic pain

Background Accumulating evidence has demonstrated that the electroacupuncture (EA) stimulation could effectively alleviate neuropathic pain. The medial prefrontal cortex (mPFC) is a vital part of the cortical representation of pain in the brain, and its glucose metabolism is mostly affected in the progression of pain. However, the central mechanism of EA analgesia remains unclear. Methods Fifty-four male SD rats were equally randomized into sham surgery (Sham) group, chronic constriction injury (CCI) group and EA stimulation (EA) group. The CCI model, involving ligature of the right sciatic nerve, was established in all animals except the Sham group. EA stimulation was applied on the right side acupoints of Huantiao (GB30) and Yanglingquan (GB34) in the EA group. Paw withdrawal threshold (PWT) and paw thermal withdrawal latency (PWL) were measured. The 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) was used to evaluate glucose metabolism changes in the mPFC. The expression of glucose transporter 3 (GLUT-3) in the mPFC was determined by immune histochemistry and ELISA. Results Comparing with CCI groups, EA treatment was obviously reversed CCI-induced mechanical allodynia (P < 0.01), thermal hyperalgesia (P < 0.01) and the increase of glucose metabolism in the left mPFC (P < 0.05). Furthermore, EA treatment significantly decreased the protein expression of GLUT-3 in the left mPFC (P < 0.01). Conclusions Our results indicate that EA analgesia effect may be related to suppressing the glucose metabolism and GLUT-3 expression in the mPFC. This study could provide a potential insight into the central mechanisms involved in the analgesic effect of EA.

Systemic AL amyloidosis presenting with diffuse alveolar septal involvement and respiratory failure: a case report and review of the literature

Background Amyloidosis is the extracellular deposition of amyloid fibril protein in any tissue or organ. The clinical manifestations of pulmonary amyloidosis are variable and without specific symptoms. We report a rare case of diffuse alveolar septal amyloidosis which is an extremely rare pattern of involvement, with a very poor prognosis, to improve our understanding of the disease. Case presentation A 27-year-old man complained of shortness of breath and cyanosis. High-resolution computed tomography revealed diffuse ground-glass opacifications with interlobular septal thickening in both lungs. The immune-histochemistry showed monoclonal lambda light chains. This case also showed nephrotic syndrome and cardiac arrhythmia, suggesting an involvement of the kidney and the heart. Diagnosis: The diagnosis was finally established by tru-cut transthoracic sonar guided lung biopsy (TSLB), and histological examination revealed Congo red-positive amorphous eosinophilic deposits in the alveolar sept. Interventions: The patient was admitted to a respiratory intensive care unit and put on non-invasive ventilation, then discharged on domiciliary oxygen therapy, and started treatment with chemotherapy melphalan 2 mg daily plus prednisone 60 mg daily immediately after the result of histopathology. Outcomes: Three months after treatment, dyspnea and hypoxemia improved, and he continued treatment. The patient was in a good clinical condition after 10 months of follow-up, but he died suddenly. Conclusion As it is difficult to distinguish diffuse alveolar septal amyloidosis from other interstitial and granulomatous lung diseases because of their similar symptoms and imaging findings, thus, transthoracic sonar guided lung biopsy and histological examination is very important in the diagnosis of diffuse alveolar septal amyloidosis.

STUDY OF HER2 NEU POSITIVITY IN GASTROINTESTINAL CANCERS AT A TERTIARY CARE HOSPITAL IN INDIA

Introduction- HER2 is now well recognized as a key factor in the development of certain solid human tumors .The expression of Her2/ Neu in gastrointestinal malignancies is new concept with paucity of literature. Aim- The present study was conducted in a tertiary care cancer hospital in India to evaluate Clinicopathological features in resected cases of gastrointestinal cancer cases and their correlation with Her2/Neu expression by Immunohistochemistry. Material & Methods- The present study was carried out in department of pathology at regional cancer tertiary centre from October 2017 to October 2019. The cases were selected on basis of inclusion & exclusion criteria.Her2/Neu expression was assessed in all 100 cases. Results- In present study HER2/neu status was determined on 100 cases by immune histochemistry and all IHC 3+ are accepted as HER2/neu positive cases, 2+ were equivocal and 1+/0 were negative. Out of 100 cases, 8 cases (8%) show HER2/neu 3+, 5 cases were HER2/neu 2+, 20 cases showed HER2/neu 1+ score and 67 cases showed Her2 Neu score 0. The mean age of all tumors was 53.7year (Standard Deviation 14.08 ) (P =0.59). Mean age of gastric and GEJ cancer 57.1 year (SD-12.01), small intestine cancer 57.7 year (SD-7.41), pancreatobiliary cancer 55.50 year (SD-14.86),colon cancer 54.5 year (SD-13.94),rectal cancer 52.1 year (SD- 15.45).Out of 100 cases , 59 cases were male and 41 were female (M:F= 1.4:1In the GIT tumors no statistically signicant association was found between her2/ neu status with histological type , T stage , size of tumor , grade and TNM stage . The only signicant association of Her/ 2 Neu was found with Modied Astler coller staging. Conclusion- Modied Astler Coller stage can be used as screening test for centers where facility of Her2neu test not available.

An unusual presentation of a retroperitoneal gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GIST) are soft tissue mesenchymal tumor originating from intestinal cells of Cajal which are pace makers of the intestine. GIST commonly arises from stomach and intestine although they seem to appear occasionally in mesentery, omentum and esophagus, but origin from retro-peritoneum is very infrequent. We herein report case of a huge retroperitoneal GIST measuring 16x13x9 cm size, in a 52-year-old lady occupying whole abdomen arising as pelvic mass. GIST was initially mistaken with associated large intramural fibroid uterus and a large pedunculated sub-serosa broad ligament fibroid. Patient was taken for abdominal open hysterectomy with complete tumor excision after all adhesions from adjoining intestine was separated. Histopathological examination of the mass confirmed it was retroperitoneal GIST with positive immune-histochemistry. Patient responded well to Imatinib therapy, and for last 4 years there has been no residual disease or recurrence as evidenced with regular follow up.

Detection of additional primary malignant tumor in cancer survivors: the use of PET/CT for image-guided biopsy

Background PET/CT is a well-established tool in the diagnostic workup of oncology patients. With the advance in diagnosis and therapy of oncology patients, survivors are at risk of developing additional malignancies. This study aimed to evaluate the yield of 18F-FDG PET/CT in biopsy guidance for the detection of unexpected additional primary malignancies in patients with known primary cancers. Medical records of patients underwent 18F-FDG PET/CT scans from July 2015 to December 2017 were reviewed, and 644 patients (346 men and 298 women; mean age 59.7, age range from 21: 78) who had been scanned for known cancers were included in this study. Lesions that were newly detected on PET/CT had not been previously detected by other modalities and were atypical in location for metastases were interpreted as suggestive of a new primary malignant tumor. These image findings guide the biopsy for histopathology, immune-histochemistry to confirm the diagnosis. Results PET-positive findings suggestive of new primary malignant tumors were found in 30 (4.67%) of 644 patients. In 21 (3.26%) of 644 patients, these lesions were pathologically proven to be malignant (20 true positive and 1 case false negative). Proven sites were lung (5 cases), colorectal (5 cases), breast (2 case), liver (2 cases), head and neck (2 cases), anal (1 cases), gastric (1 case), lymphoma (1 case), esophagus (1 case), and prostate (1 case). In 9/30 (30%) patients suspected to have additional primary, PET was falsely positive. Biopsy was taken for histology and immune-histochemistry with follow-up record that confirms the diagnosis to validate the PET/CT findings. Conclusions With the use of 18-F FDG PET/CT image- guided biopsy, additional primary malignancies were detected in at least 3.26% of oncology patients; thus, patient cure is possible if such malignancies are treated promptly and aggressively.

Use of Immunohistochemistry in the differential diagnosis of Small Round Blue cell tumors.

Objectives: Objective of the study is to differentiate and sub-categorize malignant small round blue cell tumors by using immune-histochemistry. Study Design: Descriptive Observational study. Setting: Meezan Private Lab, Faisalabad, Pakistan. Period: 5 years, from July 2014 to June 2019. Material & Methods: Sample Size: 126 cases of Round blue cells tumors. Sampling Technique: Non probability purposive sampling. Data Collection Procedure: 126 cases which fulfilled the inclusion and exclusion criteria were selected for the study. All these cases were subjected to immunohistochemistry. The IHC technique used was based on Peroxidase anti-peroxidase (PAP) method. Based on site and morphological clues, initially Leukocyte common antigen (LCA), Myogenin, Cytokeratin (CK), Desmin, chromogranin, Neuron specific enolase (NSE), S-100, Smooth muscle actine (SMA) and CD99 were used. Further immune stains panels were used afterwards, as and when needed like CD20, CD3, CD30, BCL2, CD117, Ki-67, Tdt, synaptophysin, SMA, CD56, Melan A, HMB45 and WT1. Results: Out of 126 cases of small round blue cell tumors, 35 (27.8 %) cases were diagnosed as diffuse large B cell lymphoma, 6 as Lymphoblastic lymphoma, 4 as Burkitt’s lymphoma, and 6 cases as NK/T cell lymphoma. Ewing’s sarcoma/PNET (12/126, 9.5%) was the 2nd highest in frequency, followed by Rhabdomyosarcoma, Synovial sarcoma, Malignant melanoma, and Germ cell tumor, which were all 9/126 each with 7.1 %. Conclusion: Immunohistochemistry is an important tool for appropriate and clear differential diagnosis of malignant small round blue cell tumors of childhood.

Bone marrow involvement as a rare manifestation of relapsed choroidal melanoma

Choroidal Melanoma is the most common primary intra-ocular malignancy. Incidence of primary choroidal melanoma is about 6 cases per 1 million population. It disseminates hematogenously. The most common site of metastasis is liver. Metastatic melanoma involving the bone marrow is rare, occurring in 5% of patients with disseminated disease. However, Choroid melanoma with bone marrow involvement is very rare. Only a few case reports are published in literature. Authors present a case of bone marrow metastasis from choroid melanoma in 55 years old female who has been treated for primary choroidal melanoma by enucleation of left eye three years back. In the evaluation of symptomatic anemia, features suggestive of bone marrow infiltration by choroidal melanoma were observed on bone marrow aspiration and biopsy. The diagnosis was confirmed by positivity of immune-histochemistry markers HMB-45 and Melana.

Novel phenotypes observed in patients with ETV6-linked leukaemia/familial thrombocytopenia syndrome and a biallelic ARID5B risk allele as leukaemogenic cofactor

Background. The phenotypes of patients with the recently discovered, dominant, ETV6-linked leukaemia predisposition and familial thrombocytopenia syndrome are variable, and the exact mechanism of leukaemogenesis remains unclear.Patients and Methods. Here, we present novel clinical and laboratory phenotypes of seven individuals from three families with ETV6 germline mutations and a refined genetic analysis of one child with additional high-hyperdiploid acute lymphoblastic leukaemia (HD-ALL), aiming to elucidate second oncogenic hits.Results. Four individuals from two pedigrees harboured one novel or one previously described variant in the central domain of ETV6 (c.592C>T, p.Gln198* or c.641C>T, p.Pro241Leu, respectively). Neutropenia was an accompanying feature in one of these families that also harboured a variant in RUNX1 (c.1098_1103dup, p.Ile366_Gly367dup), while in the other, an autism-spectrum disorder was observed. In the third family, the index patient suffered from HD-ALL and life-threatening pulmonary mucor mycosis, and had a positive family history of ‘immune’ thrombocytopenia. Genetic analyses revealed a novel heterozygous mutation in the ETS domain of ETV6 (c.1136T>C, p.Leu379Pro) along with absence of heterozygosity of chromosome (10)(q21.2q21.3), yielding a biallelic leukaemia risk allele in ARID5B (rs7090445-C). The neutrophil function was normal in all individuals tested, and the platelet immune histochemistry of all three pedigrees showed delta-storage-pool defect-like features and cytoskeletal defects.Conclusions. Our clinical observations and results of high-resolution genetic analyses extend the spectrum of possible phenotypes cosegregating with ETV6 germline mutations. Further, we propose ARID5B as potential leukaemogenic cofactor in patients with ETV6-linked leukaemia predisposition and familial thrombocytopenia syndrome.