Intraosseous carcinoma of the jaws—A clinicopathologic review. Part I: Metastatic and salivary‐type carcinomas

This is the first part of a 3‐part comprehensive review of intraosseous carcinoma of the jaws. We have outlined 4 groups of intraosseous carcinoma of the jaws (metastatic, salivary‐type, odontogenic, and primary intraosseous carcinoma), emphasizing the need for accurate diagnosis and the problems associated with changing classification systems, standardization of diagnostic criteria and nomenclature, and the accuracy of existing literature. In this first part, the features of metastatic and the very rare salivary‐type carcinomas of the jaws are examined with particular emphasis on histologic and immunohistochemical characteristics, diagnostic difficulties, and uncertainties. © 2012 Wiley Periodicals, Inc. Head Neck, 2012     

Molecular Staging of Surgical Margins in Oral Squamous Cell Carcinoma Using Promoter Methylation of p16INK4A, Cytoglobin, E-cadherin, and TMEFF2

Background

Local recurrence in oral squamous cell carcinoma (OSCC) despite clear surgical margins may indicate the presence of residual, sub-microscopic disease. Molecular assessment of surgical margins may provide a greater prognostic sensitivity compared to histopathology. We aimed to determine whether promoter methylation in deep and mucosal resection margins can predict recurrence in OSCC.

Methods

Forty-eight consecutive OSCC cases were recruited and a 5 mm³ tumor sample plus 5 deep and 5 mucosal margin samples were snap frozen. Clinical, pathological, adjuvant therapy, and outcome data were recorded. Tumors were informative if >5 % promoter methylation was found for ≥1 of 4 genes using qMSP. Margins were declared molecularly positive if >1 % promoter methylation was found in any margin.

Results

Thirty (63 %) of 48 cases were methylation informative. Mucosal margin samples were largely positive for methylation (26 of 30, 87 %), indicating the presence of field cancerization. Methylation at ≥1 gene promoters in ≥1 deep margin correlated with the presence of close/involved mucosal margins (P = 0.027) and increased pT status (P = 0.027) but not the status of deep margins, recurrence, or survival.

Conclusions

The current gene panel did not add prognostic information to histopathological reporting of resection margins. Future efforts should concentrate on improving gene selection, informativity, and assay performance in the patient group with intermediate indications for adjuvant therapy.     

Papillary syringadenoma of the lower lip: report of a case

A case of papillary syringadenoma that was located on the right side of the vermilion border of the lower lip in a 24-year-old man is described. The neoplastic epithelium showed two types of carbohydrate with variable topographical distribution and histochemical reaction. The cystic tumor areas showed subepithelial accumulations of mucopolysaccharides, probably related to topical collagen degradation.     

Electroencephalographic peak alpha frequency correlates of cognitive traits

EEG peak alpha frequency (PAF) has been shown to differentiate groups of adults with higher memory performance from those of lower performance, groups of children with advanced reading ability from matched controls, and to predict state-dependent working memory. The present study attempted to explore PAF as a predicting variable for verbal and attentional cognitive trait abilities in young adults. Nineteen undergraduate students had their EEG recorded during initial rest, reading, and post-reading rest, and at a different day were evaluated on reading, vocabulary, and attentional performance. Results showed significant correlations of reading vocabulary and response control with PAF during reading and post-reading recordings, but not during initial rest. PAF may reflect some general cognitive ability that is not necessarily memory or reading, possibly response control or the ability to acquire vocabulary. It is suggested that cognitive ability traits may reflect the ability to induce cognitive states.     

Growth kinetic analysis of bi-recombinant poliovirus vaccine strains

Attenuated strains of Sabin poliovirus vaccine replicate in the human gut and in rare cases may cause vaccine-associated paralytic poliomyelitis (VAPP). Mutations at specific sites of the genome and recombination between Sabin strains may result in the loss of the attenuated phenotype of OPV (Oral Poliovirus Vaccine) strains and the acquisition of traits characteristic of wild polioviruses, such as increased neurovirulence and loss of temperature sensitivity. In this study, we determined the phenotypic traits such as temperature sensitivity and growth kinetics of eight OPV isolates (six bi-recombinant and two non-recombinant). The growth phenotype of each isolate as well as of Sabin vaccine strains in Hep2 cell line at two different temperatures (37 and 40°C) was evaluated using two different assays, RCT test (Reproductive Capacity at different Temperatures) and one-step growth curve analysis. Moreover, the nucleotide and amino acid positions in the genomes of the isolates that have been identified as being involved in the attenuated and thermo sensitive phenotype of Sabin vaccine strains were investigated. Mutations that result in loss of the attenuated and thermo sensitive phenotype of Sabin vaccine strains were identified in the genomes of all isolates. Both mutations and recombination events correlated well with the reverted phenotypic traits of OPV-derivatives. In the post-eradication era of wild polioviruses, the identification and the characterization (genomic and phenotypic) of vaccine-derived polioviruses become increasingly important in order to prevent cases or even outbreaks of paralytic poliomyelitis caused by neurovirulent strains.     

Multiple bowel perforations requiring extensive bowel resection and hysterectomy after microwave endometrial ablation

Heavy menstrual bleeding, or menorrhagia, is a primary cause of morbidity in women. Herein, we present the case of a 41-year-old woman who underwent day-surgery endometrial microwave ablation because of dysfunctional uterine bleeding. She had undergone previous laparoscopic sterilization, and had no other risk factors except for a retroverted uterus. The procedure was performed without any documented difficulties. The patient was readmitted the following day with clinical signs of acute abdomen. Emergency laparotomy revealed a large perforation on the anterior uterine wall, full-thickness burns in the distal ileum, and multiple ischemic areas in the ileum, cecum, and ascending colon secondary to microwave burns. A right hemicolectomy was required, with extended ileal resection and subtotal hysterectomy with ovarian conservation. Although microwave endometrial therapy seems to offer many advantages, in particular in terms of efficiency and technique, complications occur, and extensive safety measures must be implemented to prevent adverse effects such as occurred in this patient.     

Maternal mortality in Greece, 1996-2006

Objective

To present retrospective data for maternal deaths in Greece from 1996 to 2006.

Methods

Demographic information and information on the causes of death was provided by the Hellenic Statistical Authority. Maternal deaths were assessed by cause of death, maternal age, and place of residence. The maternal mortality ratio (MMR) was estimated and expressed as the number of deaths per 100 000 live births.

Results

From 1996 to 2006, 29 deaths were attributed to pregnancy and childbirth, yielding a total MMR of 2.63. The leading cause of direct deaths was hemorrhage and that of indirect deaths was cardiac disease. There was a borderline significant decline in the MMR during the study period. The MMR was significantly higher at the extremes of the reproductive age range.

Conclusion

Maternal mortality in Greece is low; however, no formal data have been published since 1996. Knowledge of the causes of maternal death can lead to the prevention of maternal deaths and safer motherhood.