Suprabasal p53 immunoexpression is strongly associated with high grade dysplasia and risk for malignant transformation in potentially malignant oral lesions from Northern Ireland

AIMS: No good predictive marker for the malignant transformation of potentially malignant oral lesions (PMOLs) is currently available. This study re-evaluated the value of p53 immunoexpression to predict malignant transformation of PMOLs after discounting possible confounding factors. METHODS: PMOLs from 18 patients who showed progression to carcinoma, 16 of the respective carcinomas, and PMOLs from 18 matched controls were evaluated by immunohistochemistry (IHC) for p53 expression. A mouse monoclonal antibody that detects wild-type and mutant forms of human p53 was used. The p53 immunostaining pattern was also correlated with the degree of dysplasia. RESULTS: Suprabasal p53 staining was significantly associated with high grades of dysplasia (p < 0.01). The specificity and positive predictive value (PPV) for malignant transformation of suprabasal p53 staining were superior to the assessment of dysplasia, but sensitivity was inferior. All carcinomas derived from PMOLs with suprabasal p53 showed strong p53 immunostaining. However, the absence of suprabasal p53 staining and/or dysplastic changes did not preclude malignant transformation in a considerable proportion of PMOLs. CONCLUSIONS: This study confirms and extends previous findings that suprabasal p53 immunoexpression has a high PPV for malignant transformation of PMOLs and can be used as a specific marker for lesions that are at high risk for malignant transformation. The absence of suprabasal p53 staining (that is, absence of, or basal, p53 staining) is non-informative for prognostic purposes. Because of its limited sensitivity, p53 IHC is not a substitute for the assessment of dysplasia in the evaluation of PMOLs. Instead, p53 IHC emerges as a clinically useful supplement of histopathological assessment in the prognosis of PMOLs.     

Transitions to parenthood: his,hers, and theirs

This study explores marital processes that may underlie the apparent decline in satisfaction with marriage in partners becoming parents for the 1st time. The study assessed 47 couples expecting a 1st child and 15 couples not yet decided about having a child at pretest, post 1 (6 months post partum of 9 months after pretest) and post 2 (18 months postpartum or 21 months after pretest). Questionnaires examined: 1) psychological sense of self; 2) partners' role arrangements and communication; 3) parenting ideology; 4) perceptions of the family of origin; and 5) social support and life stress, including parents' work patterns. Parenthood seems to bring more change, and more negative change, in each of the 5 domains of family life that were investigated for comparable couples not having a 1st child experience over a similar period of time. Quantitative data support this conclusion in 4 of the 5 domains (individuals sense of self, marital, parent-child, and outside the family). Interview data suggest that new parents' relationships with their families of origin also undergo change at this time. Although shifts within domains often showed patterns similar to change in overall satisfaction with the marriage, the connection between the 2 was not linear and direct, especially for women. Men and women in transition to parenthood become increasingly different from one another; the results suggest that increased gender differentiation accompanying the transition to parenthood is a factor in accounting for marital satisfaction decline.     

The entorhinal cortex of the monkey: I. Cytoarchitectonic organization

As an essential preliminary to a series of experimental studies of the afferent and efferent connections of the monkey entorhinal cortex, we have carried out a detailed analysis of its cytoarchitectonic organization. Primarily on the basis of features observed in Nissl- and fiber-stained preparations, supplemented with Golgi-stained material and preparations stained for heavy metals by Timm's method and histochemically for acetylcholinesterase, the entorhinal cortex has been divided into seven fields that are named according to their rostrocaudal and mediolateral positions except for one rostrally located field that is named for the prominent input that it receives from the olfactory bulb. At rostral levels, the entorhinal cortex is marked by a number of morphological inhomogeneities. The neurons tend to be organized in patches that are surrounded by large, thick, radially oriented bundles of fibers. At caudal levels, the entorhinal cortex has a more distinctly laminated appearance, reminiscent of that in the neocortex, and most of the neurons and fiber fascicles are arranged in discrete radial columns. The cortical region adjoining the entorhinal cortex laterally, which is commonly known as the "perirhinal cortex," is in fact composed of two separate fields corresponding to areas 35 and 36 of Brodmann. Area 35 occupies the fundus and part of the lateral aspect of the rhinal sulcus. Area 36 extends from the lateral bank of the rhinal sulcus into the inferior temporal gyrus, where it borders fields TA and TE rostrally, and field TF of the parahippocampal gyrus caudally. The surface extents of each of the entorhinal fields have been determined by making "unfolded" two-dimensional maps of the region and measuring the areas with a computerized digitizing system.     

Sexual Contact as Risk Factor for Campylobacter Infection,Denmark

Campylobacteriosis is a disease of worldwide importance, but aspects of its transmission dynamics, particularly risk factors, are still poorly understood. We used data from a matched case-control study of 4,269 men who have sex with men (MSM) and 26,215 controls, combined with national surveillance data on Campylobacter spp., Salmonella spp., and Shigella spp., to calculate matched odds ratios (mORs) for infection among MSM and controls. MSM had higher odds of Campylobacter (mOR 14, 95% CI 10–21) and Shigella (mOR 74, 95% CI 27–203) infections, but not Salmonella (mOR 0.2, 95% CI 0–13), and were less likely than controls to have acquired Campylobacter infection abroad (χ² = 21; p<0.001). Our results confirm that sexual contact is a risk factor for campylobacteriosis and also suggest explanations for unique features of Campylobacter epidemiology. These findings provide a baseline for updating infection risk guidelines to the general population.     

SC phocomelia syndrome, premature centromere separation, and congenital cranial nerve paralysis in two sisters, one with malignant melanoma

Two middle age sisters had most manifestations of the SC phocomelia syndrome including postnatal growth retardation, symmetric limb deficiencies with radial aplasia and absent thumbs, facial anomalies with microcephaly, microphthalmia, hypoplastic nasal alae, and borderline to mild mental retardation. Unusual findings included congenital paralysis of some cranial nerves in both patients and malignant melanoma in the proposita. Cultured lymphocytes from both patients, and skin fibroblasts, Epstein Barr virus-transformed lymphocytes, and tumor cells from the proposita demonstrated premature separation of centromeric heterochromatin (PCS) of many chromosomes, a finding noted previously in the SC phocomelia syndrome and the similar but more severe Roberts syndrome. Extensive overlap of the phenotypes of the sisters and 15 other patients with either syndrome and PCS confirms that these are either allelic conditions or the same disease--designated Roberts-SC phocomelia syndrome. The role of PCS in the syndrome(s) remains uncertain since some patients with the characteristic clinical phenotypes are reported to lack it.     

Predicting esthetics of laminate veneers without tooth preparation

High expectations may contribute to stress in the patient and dentist during dental treatment. Esthetic and restorative results can be predicted for laminate veneers by using a powder blower and a liquid dispenser preoperatively to form self-cured resin veneers. Trial veneers are formed in a precision "salt and pepper" technique that conserves materials and time. The trial veneers are placed, without tooth preparation, on the treatment site so that the patient can preview the planned treatment and so that the dentist can explain proposed treatment in a reversible procedure. This may circumvent misunderstandings between dentist and patient and allow the consideration of alternate treatment plans.