Black Turmeric and Aloe Vera in the Management of Oral Submucous Fibrosis: A Prospective Clinical Study

Aim: To determine the therapeutic efficacy of Kali haldi in the management of Oral submucous Fibrosis (OSMF) v/s steroid therapy. Materials and Methods: A clinical prospective study was conducted on 42 patients of oral submucous fibrosis were equally divided into 2 groups. Group A patients were treated with a mixture of powdered Kali Haldi and aloe vera gel in equal ratio 3 times a day for 3 months. Group B patients were treated with intralesional injection of hydrocortisone and hyaluronidase for 6 weeks with oral antioxidant supplements for 3 months. Burning sensation, cheek flexibility, mouth opening, and tongue protrusion were evaluated before, during, and after treatment at an interval of 15 days, 1 month, 2, month and 3 months. Results: Statistically significant results were obtained at the end of 3 months duration for both the groups (P < 0.001). The Symptomatic correction was more evident in the case of Group A patients than Group B. Response of the ayurvedic regimen was potentially better as compared to the regular steroid therapy. Conclusion: The study concludes that Combination therapy works wonders in the case of OSMF in stages I, II, III and can be a good option, comparatively safe and with negligible side effects, but potent and equally effective management of oral submucous fibrosis. Henceforth, it will be better to do such kinds of studies on a vast scale including larger samples and longer duration to check the efficacy and durability of this ancient ayurvedic regimen.     

Pentoxifylline Therapy in the Management of Oral Submucous Fibrosis

Objectives: Oral submucous fibrosis is a common premalignant condition in the Indian subcontinent andis caused by chewing areca nut and other irritants in various forms. Its medical treatment is not yet fullystandardized. In this study we compared the efficacy of Pentoxifylline as compared to placebo. Materials andmethods: 75 patients suffering from oral submucous fibrosis were randomly divided into two groups A and B.Group A patients received placebo, while Group B patients received 400 mg. Pentoxifylline for a period of 7months. Treatment outcome was evaluated on the basis of improvement in symptom and sign scores. Student’s‘t’ test was applied for comparing the results. Results: The improvement in total (i.e. symptoms + sign) scorewas 25% in group A and 49.15% in group B. This difference was found to be statistically significant. (p < 0.05)Conclusion: Treatment regimen of group B was more effective. No significant side effects were seen. A follow upstudy is required to assess long term outcome of this therapy.     

Evaluation of Gustatory Function in Oral Submucous Fibrosis Patients and Gutka Chewers

Aim: The aim of the study is to assess and compare taste perception among Oral submucous fibrosis (OSMF)patients, Gutka chewers without OSMF and healthy subjects. Materials and methods: Ninety subjects (30 OSMF,30 Gutka chewers without OSMF and 30 controls) were enrolled in the study for assessing taste perception by filterpaper strips impregnated with different taste qualities. Taste perception assessment was also done in stage I, II and IIIOSMF subjects. The obtained data were analyzed using SPSS 20.0 software. Results: The gustatory defect was relatedto sweet, sour, bitter and salt, with significant changes in sour (33.3% showed hypoguesia) taste in OSMF subjects and13.3%showed hypoguesia to all tastants in gutka chewers and hypoguesia to salt, sour and bitter to grade III comparedin grade I and II. Conclusion: This study proved that there is significant alterations to taste perception with sour, salt,and bitter and then to sweet in OSMF subjects.     

Morphometric Analysis in Potentially Malignant Head and Neck Lesions: Oral Submucous Fibrosis

Objective: The objective of this study is to analyze cases of oral submucous fibrosis (OSMF) Grade I, II, IIIand IV morphometrically with regard to epithelium, vasculature and fibrosis and determine any correlationwith histological grading after Pindborg and Sirsat. Materials and methods: Eighty three oral submucous fibrosiscases were analyzed morpometrically using an interactive image analysis system in the Department of Pathology,M.L.N Medical College, Allahabad, U.P, India. Paraffin embedded sections of 3-4 μm thickness were stainedwith hematoxylin/eosin, Van Gieson’s picric acid and acid fuchsin stain and Masson’s trichrome stains. Imageanalysis was performed with specific software (Image –Pro Plus 6.0) and data obtained were finally transportedto Excel sheets for calculation of average values for each parameter. Results:With the grading criteria applied,9 cases of OSMF were grade I, 32 grade II, 39 grade III and 3 grade IV. Clinical trismus was most frequent inGrade IV followed by Grade III, II and I respectively. OSMF Grade I cases did not show any measurableamount of collagenization, whereas it showed a significant increase with OSMF I and II grades [Pearson’s χ2test= 85.72; p= 0.051] and OSMF-III and IV [Pearson’s χ2test=188.74; p< 0.001]. Numbers of endothelial cellsper low power field consistently decreased with the increasing grade. Conclusions: We concluded that meanblood vessel area and the mean vessel diameter showed a marked increase in grade II and a marker decrease ingrade IV and the grade III, collagen thickness (μm) increases according to increasing grade while density ofendothelial cells decreases .     

Estimation of Superoxide Dismutase and Glutathione Peroxidase in Oral Submucous Fibrosis,Oral Leukoplakia and Oral Cancer - A Comparative Study

Present study was undertaken to estimate and compare erythrocyte superoxide dismutase (E-SOD) andGlutathione peroxidase (GPx) levels in oral submucous fibrosis, oral leukoplakia and oral cancer patients andage/sex matched healthy subjects, 25 in each group. Statistically significant (P<0.001) decrease in E-SOD andGPx levels were observed in OSF, oral leukoplakia and oral cancer groups as compared to the control group.Oral leukoplakia group showed lower levels in comparison with OSF (P>0.05). Oral cancer group had the lowestlevels amongst the study groups. Imbalance in antioxidant enzyme status may be considered as one of the factorsresponsible for the pathogenesis of cancer and may serve as a potential biomarker and therapeutic target toreduce the malignant transformation in oral premalignant lesions/conditions.     

Clinical Assessment of Efficacy of Omega 3 in Oral Submucous Fibrosis Patients - A Randomized Controlled Trial

Background: Oral submucous fibrosis (OSMF) is a chronic, potentially malignant condition affecting the oral cavity. Omega 3 has shown innumerable health benefits in yesteryears. So, the aim of the study was to evaluate the efficacy of Omega 3 in the medical management of this disease. Methods: A randomized controlled trial was designed and 48 clinically confirmed patients of OSMF (24 in each group) completed the study. Patients of both the groups were given biweekly intralesional injections of dexamethasone 1.5ml, hyaluronidase 1500 IU mixed with lignocaine for 6 weeks. Additionally, group A received a placebo (lactose capsule) for 3 months while group B received 1gm of omega 3 (flaxseed oil) three times daily continuously for 3 months. Patients were followed every month for 3 months and then, after 6 months and one year. Results: During the first two months, improvement was observed in both the groups independently but intergroup comparison showed no significant difference. However, after 3 months statistically significant (p<0.05) improvement among all three clinical parameters i.e. inter-incisal distance (mean improvement in group A = 3.79±1.07mm and group B = 6.58±1.24mm, p=0.019), tongue protrusion (mean improvement in group A = 1.87±1.54mm and group B = 4.62±1.78mm, p=0.044) and cheek flexibility (mean improvement in group A = 2.08±1.38mm and group B = 3.50±1.84mm, p=0.035) was observed in group B when compared to group A. In contrast, statistically significant improvement in burning sensation was observed after one month itself in group B when compared to group A (mean drop in group A = 2.5±0.78 points and group B = 6.0±1.144 points, p<0.05). Conclusion: Omega 3 in conjunction with intralesional injections is an effective therapy when compared to intralesional injections alone in treatment of patients with OSMF (grade II and III) with no side effects.     

胰腺癌患者血清中S100A8与S100A9水平及其临床意义

目的检测胰腺癌患者血清S100A8与S100A9的水平及探讨其临床意义。方法收集胰腺癌患者90例,同期纳入体检健康者50例为对照组。检测两组研究者血清中S100A8和S100A9的水平。分析胰腺癌患者血清S100A8和S100A9水平与其临床病理特征的相关性。对所有患者疗后随访6个月,比较死亡组与存活组患者血清中S100A8和S100A9水平。结果胰腺癌患者血清中S100A8和S100A9水平显著高于对照组(P<0.01)。胰腺癌患者血清中S100A8和S100A9水平与患者年龄、性别、肿瘤部位无显著相关(P>0.05),与其分化程度、临床分期呈明显相关(P<0.01)。6个月随访结果:27例死亡,18例存活,其中死亡组患者入院时血清S100A8和S100A9水平明显高于存活组,比较有显著性差异(P<0.01)。结论胰腺癌患者血清中S100A8和S100A9水平明显提高,且与其恶性程度密切相关,可能对临床评估胰腺癌预后有一定参考价值。     

Effect of Lysyl Oxidase G473 A Polymorphism on Lysyl Oxidase and Total Soluble Collagen Expression in Oral Submucous Fibrosis

Background: Oral submucous fibrosis (OSF) is a debilitating collagen-metabolic disorder leading to submucosal fibrosis and trismus. Lysyl oxidase (LOX), a critical collagen biosynthetic enzyme, is up-regulated in OSF. Polymorphisms in the Lysyl oxidase gene have been associated with increased risk of OSF and might affect normal collagen synthesis, accumulation, or degradation, crucial in determining fibrosis severity. Methods: One hundred OSF cases and 100 controls were genotyped for LOX G473A(Arg158Gln) polymorphism by polymerase chain reaction-restriction fragment length polymorphism. The expression of LOX was estimated both by quantitative mRNA analysis and western blot. Total soluble collagen was evaluated from mucosal tissue obtained from OSF cases. Immunohistochemical (IHC) localization of type 1 collagen was performed in mucosal tissue obtained from patients carrying various genotypes. Results: Heterozygous G473A genotype was significantly higher in OSF cases [2.063(95% CI =1.059-4.016)], among 26-40 years age-group [4.375(95% CI=1.323-14.267),p=0.029] and in male patients [2.38 (95% CI= 1.107-5.121), p= 0.042]. LOX expression was significantly higher in cases of the heterozygous or homozygous carrier (p <0.001). We found the total soluble collagen level significantly (p <0.001) higher among patients carrying GA or AA genotype. IHC revealed focal deposition of type1 collagen in the submucosal tissue; comparatively higher deposition was evident in mucosal tissue of OSF patients carrying AA genotype. Conclusions: These findings suggest LOX G473A polymorphism confers an increased risk of OSF and may affect collagen accumulation in OSF cases.     

S100A7和S100A4在外阴鳞癌与外阴硬化性苔藓中的表达及意义

目的:检测外阴鳞癌（vulvar squamous cell carcinoma,VSCC）及外阴硬化性苔藓（vulvar lichen sclerosus,VLS）中S100A7和S100A4蛋白的表达,探讨其与疾病的发生发展关系。方法:采用免疫组化方法测定S100A7及S100A4蛋白在25例VSCC、20例VLS及15例外阴正常皮肤组织中的表达,并结合临床病理资料进行分析。结果:S100A7蛋白在VLS和VSCC中的表达明显高于正常皮肤（P＜0.05）,且早期VLS中的表达高于进展期（P＜0.05）;Ⅲ期VSCC中的表达高于Ⅰ-Ⅱ期（P＜0.05）,高分化VSCC中的表达高于中低分化（P＜0.05）。S100A4蛋白在VLS中的表达与正常皮肤无明显差异（P＞0.05）,但早期VLS中的表达高于进展期（P＜0.05）;S100A4在VSCC的癌巢中几乎不表达,但在间质细胞中的表达高于正常皮肤（P＜0.05）,中低分化VSCC中的表达高于高分化（P＜0.05）。S100A4表达与临床分期无关。结论:S100A7和S100A4蛋白高表达与VSCC的发生、发展有关,与VLS的进展呈负相关。     

A Cross Sectional Study of Oral Submucous Fibrosis in Central India and the Effect of Local Triamcinolone Therapy

The use of processed arecanut is on the increase. In the impending danger of increased occurrence of oral submucous fibrosis and subsequent oral cancer following this habit is colossal. So an attempt is made to clinically evaluate the condition and to evaluate the effect of triamcinolone on this condition. Using the clinical data collected from the patients presenting in the ENT OPD of NSCB Medical College Hospital, Jabalpur, a cross sectional study was done and the effect of intralesional triamcinolone on this condition is noted by biweekly submucosal injections of 40 mg triamcinolone for 12 weeks and followed up for 1 year. The effect of therapy was evaluated subjectively by improvement in symptoms and objectively by increase in mouth opening. The age of occurrence and sex predilection also showed a significant change with more young males being affected by the condition. There was no significant correlation between effect of triamcinolone therapy and duration of addiction but a significant correlation (P < 0.0001) was noted with the frequency of addiction per day. A significant improvement in mouth opening is observed following local triamcinolone therapy. The results imply that the exposure and the frequency of chewing habits, and not mere the duration that is significant in producing the condition and affecting the treatment outcome. Local triamcinolone therapy has good effect in the initial stages of the disease. The fact that more youngsters are being affected needs serious consideration.     

非小细胞肺癌患者血清中 S100 A4和 S100 A6表达及其临床意义

目的：探讨S100A4和S100A6在非小细胞肺癌患者血清中的表达及其临床意义。方法筛选非小细胞肺癌患者共36例,同期纳入健康体检者50例为对照组。采取酶联免疫吸附试验（ ELISA）法测定2组血清S100A4和S100A6水平;比较2组血清S100A4和S100A6水平,分析血清S100A4和S100A6水平与患者临床特征的相关性。2组随访2年,比较死亡患者与存活患者的血清S100A4和S100A6水平。结果与对照组比较,非小细胞肺癌组患者血清中S100A4和S100A6水平明显升高（P＜0．01）。血清S100A4和S100A6水平与非小细胞肺癌患者的年龄、性别及病理类型无相关性（P＞0．05）,而与肺癌患者的分化程度、TNM分期及淋巴结转移有显著性相关（P＜0．01）。随访2年共有10例患者死亡,26例存活;死亡患者入院时血清S100A4和S100A6水平明显高于存活组（P＜0．01）。结论非小细胞肺癌患者血清S100A4和S100A6水平明显升高,对非小细胞肺癌的诊断和预后判断具有一定临床价值。     

Exploratory Study to Evaluate Changes in Serum Lipid Levels as Early Diagnostic and/or Prognostic Indicators for Oral Submucous Fibrosis and Cancer among Gutkha Consumers in India

Background: In India smokeless tobacco users account for 25.9% of total tobacco use, Gutkha being themost common form. This study evaluated the association between serum lipid profile and Gutkha use as anearly diagnostic and/or prognostic indicator for oral submucous fibrosis (OSMF) and oral cancer (Oral Ca) innon-smokers and non-alcohol consumers. Materials and Methods: A total of 163 participants were recruitedfrom two sites in India. Participants were divided into four groups: individuals without any Gutkha chewinghabit and without any oral lesions (control group), individuals with Gutkha chewing habit but without any orallesions (GWL), patients with a confirmed clinical diagnosis of OSMF, and patients with a confirmed diagnosis ofOral Ca. Mixed linear modelling (MLM) was conducted to detect the change in mean serum lipid levels amongfour groups. Results: The sample consisted of 69% males and 31% females. Results of MLM show an inverserelationship between serum lipid levels in OSMF, and Oral Ca groups when compared to the control group.Conclusions: The results of our study demonstrated that GWL, OSMF and Oral Ca patients had lower serumlipid levels. Low serum lipid levels could be an indicator of initial neoplastic changes in oral cancer.     

钙结合蛋白S100A7在肺癌中的选择性表达

背景与目的 S100A7是S100蛋白家族成员,它的过表达与一些癌的发生和转移密切相关,本文旨在探讨S100A7在肺癌中的差异表达.方法 采用RT-PCR、Western blot和免疫组化等技术探讨了S100A7蛋白在肺癌及其癌旁组织中的表达差异.结果 S100A7只在肺鳞癌和大细胞肺癌组织中有表达,而在肺腺癌、小细胞肺癌及其他亚型的肺癌组织、癌旁组织和正常肺组织中不表达;并发现S100A7蛋白的表达在高分化的癌细胞中较强.结论 S100A7蛋白可选择性地在不同亚型的肺癌中表达,很可能成为肺癌亚型诊断的标志蛋白之一.     

Efficacy of Curcumin in Combination with Intralesional Dexamethasone with Hyaluronidase in the Treatment of Oral Submucous Fibrosis: A Randomized Controlled Trial

Objective: The objective of this study was to determine the efficacy of curcumin in combination with  intralesional dexamethasone with hyaluronidase in the treatment of oral submucous fibrosis (OSF). Methods: This randomized, double blind, parallel design, clinical trial was conducted at B.P. Koirala Institute of Health Sciences, Nepal. Thirty-four patients with clinically diagnosed OSF were randomized into two groups (17 participants in each) with baseline treatment of intralesional dexamethasone with hyaluronidase for 6 weeks for the both. Curcumin (2gm/day) was provided to Group A (Test) and Group B (Control) received placebo. Interincisal mouth opening, tongue protrusion, cheek flexibility and visual analogue scale (VAS) scoring of burning sensation of oral mucosa was recorded at baseline, 6, 8 and 12 weeks follow-up and independent t-test was used to compare the improvements in two groups. Results: On comparing the 6 weeks and baseline values, in Group A and B the mean difference in mouth opening was 8.82±1.33 mm and 5.53±1.17 mm respectively (p<0.001), in cheek flexibility was 2.94±1.02 mm and 1.94±1.24 mm respectively (p=0.02) and in tongue protrusion was 6.23±1.48 and 3.65±1.37 mm respectively (p<0.001). The findings were consistent in the 8 weeks follow-up. In 12 weeks follow-up, on comparing with the baseline values, in Group A and B, the mean difference in mouth opening was 8.71±1.16 mm and 5.35±1.22 mm respectively (<0.001), ), in cheek flexibility was 2.81±1.01 mm and 1.76±1.35 mm respectively (p=0.02) and in tongue protrusion was 6.06±1.48 and 3.35±1.50 mm respectively (p<0.001). Both the arms showed 100% improvement in burning sensation in 6, 8 and 12 weeks follow-up. Conclusion: Curcumin in combination with intralesional dexamethasone with hyaluronidase is efficacious in the treatment of OSF.     

血清S100A8和S100A9对原发性肝癌的临床诊断价值

目的 探讨原发性肝癌患者血清S100A8和S100A9的表达水平及其与临床病理特征的相关性.方法 收集原发性肝癌患者共90例,同期选择在我院进行体检健康者50例作为对照组;检测2组血清S100A8和S100A9的水平;分析肝癌患者血清S100A8和S100A9水平与临床病理特征的相关性;比较随访期间死亡组与存活组患者血清S100A8和S100A9表达.结果 与对照组比较,肝癌组患者血清S100A8和S100A9均显著升高(P＜0.01).肝癌患者血清S100A8和S100A9的高表达与患者的年龄、性别、大小、病理分型无关(P＞0.05),而与TNM分期、分化程度、淋巴结转移以及血行转移有关(P＜0.01).所有患者6个月定期随访,31例死亡,59例存活;死亡组患者入院时血清S100A8和S100A9表达均显著高于存活组,差异有统计学意义(P＜0.01).结论 原发性肝癌患者血清S100A8和S100A9水平均显著升高,与肝癌的恶性程度关系密切,有望成为原发性肝癌预后的重要评判指标.     

Psoriasin(S 100A7)蛋白的结构与功能

Psoriasin(S100A7)是一种分子量为22.9 kD的同源二聚体蛋白,属于S100蛋白家族成员。通过与钙离子结合,参与细胞内外重要的生命活动。其基因定位于染色体1q21.2-q22。Psoriasin(S100A7)蛋白最初是从银屑病异常增生的角化细胞中分离得到的,故称为Psoriasin,即银屑素。Psoriasin在异常增生的角化细胞、膀胱鳞状细胞癌和原位及浸润乳腺癌中表达上调。Psoriasin这种分泌和表达特征有可能作为膀胱鳞状细胞癌和乳腺癌等恶性肿瘤的候选标志物。     

结肠癌组织中S100A4基因的表达及其意义

目的:检测S100A4基因在结肠癌细胞系及结肠癌组织中的表达,探讨其与结肠癌的关系。方法:运用RT-PCR法检测不同结肠癌细胞系S100A4基因的表达;选取结肠癌及其相应癌旁组织各61例,通过原位杂交方法检测S100A4基因的表达。结果:S100A4基因在癌旁正常结肠组织中不表达,而在结肠癌中阳性率为34.4%,明显增高,P<0.05。在存在淋巴结转移的患者中16例(55.2%)S100A4基因阳性表达,而在无淋巴结转移者中只有5例(15.6%)阳性,P=0.001。Dukes分期A期的4例患者表达均为阴性,B期25例患者中3例(12.0%)阳性,C期15例患者中7例(46.7%)阳性,D期17例患者中11例(64.7%)阳性。此外,肿瘤长径>3cm、大体病理分型为隆起型以及病理分级差的患者,S100A4基因阳性率较高,但是差异无统计学意义,P>0.05。结肠癌中S100A4基因表达增高,S100A4的表达与肿瘤的临床分期和淋巴结转移密切相关。临床分期晚及伴有淋巴结转移的患者S100A4基因表达明显增高。结论:S100A4基因与肿瘤的侵袭及转移密切相关,是判断结肠癌生物学行为及预后的有价值指标。     

S100A9在宫颈鳞状细胞癌中的表达

的：探讨S100A9在宫颈鳞状细胞癌组织中的表达.方法：采用实时定量RT-PCR的方法检测12例宫颈鳞状细胞癌组织及10例正常宫颈组织中S100A9 mRNA的表达水平.结果：S100A9 mRNA在宫颈鳞状细胞癌组织中的相对表达量为2.72±2.50,在正常宫颈组织中的相对表达量为8.34±2.94,差异具有统计学意义（P〈0.01）.结论：S100A9在宫颈鳞状细胞癌组织中表达下调,可能是宫颈鳞状细胞癌变过程中具有抑癌作用的基因.     

S100A4蛋白在结肠腺瘤和结肠癌中的表达

[目的]探讨S100A4蛋白在结肠腺瘤和结肠癌中的表达及其临床意义。[方法]用免疫组化法检测S100A4在15例正常肠黏膜、80例结肠腺瘤和60例结肠癌中的表达。[结果]S100A4蛋白在正常肠黏膜中无表达,在结肠腺瘤中阳性率为16.25%,在结肠癌中阳性率为56.67%。[结论]S100A4与结肠腺瘤和结肠癌的发生发展密切相关,是预测结肠肿瘤进展的有用指标。