Mandibular osteosarcoma with unusual expression of alpha-actin smooth muscle antibody

Mandibular osteosarcoma is a rare neoplasm, appearing in young adults as a mass often accompanied by pain, occasionally with paraesthesias, gingival haemorrhages and mobility of teeth, and rarely with ulceration of the skin or mucosa. Roentgenological lytic and/or sclerotic findings are non-specific. Some patients have a previous history of Paget's disease, antecedent radiation treatment, or fibrous dysplasia. Malignant osteoid production can be minimal, resulting in diagnostic difficulties. We report a case of a 33 year-old woman, who, in the absence of a clinical soil associated with the condition, was presented with advanced disease. Immunohistochemical study using alpha-actin smooth muscle antibody disclosed bizarre tumor cells with "dendritic" appearance, to our knowledge, never described thus far. This report draws attention to this uncommon neoplasm and reviews the pertinent literature related to this entity.

S100, alpha-smooth muscle actin and cytokeratin 19 immunohistochemistry in odontogenic and soft tissue myxomas

AIMS

To compare the expression of S100 protein, alpha-smooth muscle actin (alpha-SMA) and keratin 19 in odontogenic myxomas and non-odontogenic myxoid lesions.

METHODS

Formalin fixed, paraffin wax embedded tissue from seven odontogenic myxomas, three soft tissue myxomas, six hyperplastic myxoid dental follicles, two intramuscular myxomas, 12 cardiac myxomas, and seven normal dental follicles were examined immunocytochemically for S100 protein, alpha-SMA and cytokeratin 19 using the Streptavidin-biotin method.

RESULTS

A minority of odontogenic myxomas (three of seven) were positive for S100 and the staining was of moderate intensity and in all myxofibroblasts. Soft tissue myxomas, normal dental follicles, intramuscular myxomas, and most enlarged myxoid follicles were negative. In the cardiac myxomas the cells forming cords and islands were positive in approximately half (seven of 12), but the dispersed stellate myxoblasts were positive in only two cases. A population of cells in all the odontogenic myxomas and hyperplastic dental follicles contained alpha-SMA, but such cells were sparse in cardiac myxomas and present in only four cases. Cytokeratin 19 was present in odontogenic epithelium of odontogenic myxoma and follicles.

CONCLUSIONS

A minority of odontogenic myxomas, but not other oral myxoid lesions, may express S100 protein and this could cause difficulty distinguishing myxoma from myxoid nerve sheath tumours. Sparse myofibroblastic cells occurred in all types of myxoma tested. The epithelium sometimes found within jaw myxomas expresses cytokeratin 19 and this is consistent with an odontogenic origin.

Conservative surgical and orthodontic management of a child with central giant cell granuloma

Differential diagnosis and treatment modalities of giant cell granulomas have been a controversial matter since Jaffe first distinguished true giant cell tumours (TGCG) from central giant cell granulomas (CGCG). CGCG is a slowly growing and painless tumour usually treated by simple curettage but denotes a strong tendency to recurrence. A case report is presented to describe conservative therapy of CGCG in the maxilla of a young child: surgical enucleation of the tumour at the age of 11 years, though successful, was followed by progressive impaction of the maxillary right permanent canine. Orthodontic treatment aligned the maxillary teeth to accommodate autotransplantation of the impacted tooth. Clinical and radiographic evaluation of the patient 5 years after the initial surgical treatment showed good bony and periodontal healing around the transplanted canine and no recurrence of the CGCG. As the literature shows that distinction of the two tumours is difficult even by histological means, various clinico-pathologic factors involved in prognostic evaluation are discussed.

Anticardiolipin antibodies in pediatric patients with human immunodeficiency virus

OBJECTIVE

To study the presence of IgG and IgM anticardiolipin antibodies (aCL) in children with human immunodeficiency virus (HIV) infection and to determine their prevalence and clinical significance.

METHODS

We studied 34 children with HIV infection: 26 patients were classified P-2, and 8 were P-1 according to the Centers for Disease Control classification. HIV transmission was from mother to child in 33 cases. aCL were measured by ELISA:

RESULTS

IgG aCL were found in 28 (82%) and IgM aCL in 7 (20%). No difference in frequency and levels was found between class P-2 (85%, mean 54.5 PL units) and class P-1 (75%, mean 50.3 PL units). aCL were not related to the duration of the infection, clinical stage of disease, or with events like opportunistic infections. Children from sexually infected or intravenous drug user mothers showed no differences.

CONCLUSION

As in adults, aCL are commonly found in children with HIV infection. The significance of this finding is still unclear.

Global diagnostic ratings compared to DSM-III-R diagnoses in early dyskinesia

1. Two types of psychiatric diagnoses were obtained in a study of the course of early dyskinesia: DSM-III-R and Dimensional Global Ratings of Schizophrenia, Paranoia, Mania and Depression. 2. The strength of association between measures of vulnerability to developing tardive dyskinesia (TD), and clinical components from each of the two methods of obtaining psychiatric diagnoses was established by canonical correlations. 3. Overall, little difference was obtained between DSM-III-R categories and Global Ratings in terms of correlations with TD vulnerability measures. Using components from global diagnostic ratings, the Depression and Schizophrenia Scales made stronger contributions to the canonical functions than Mania and Paranoia. 4. Unipolar depressed patients appear more sensitive to NL: they developed TD after less NL exposure. 5. Dimensional classification appears to be a promising approach to capturing important characteristics of psychoses.

Eosinophilic ulceration of the oral mucosa. A case report

Chronic ulcerative lesions affecting the maxillary vestibular mucosa and the lower labial mucosa of a white female patient are described. Histopathologic examinations indicated a diagnosis of eosinophilic ulceration. Clinical aspects, pathogenesis, and histopathology of this uncommon lesion are discussed.

Ontogeny of the humoral immune response to human immunodeficiency virus type 1 in infants

In a cohort of infants born to human immunodeficiency virus type 1 (HIV-1)-infected mothers, changes in the levels of HIV-1 specific antibodies were measured during the first year of life. In uninfected children, the level of antibodies to six HIV-1 antigens (gp120, p66, p41, p31, p24, and p17) decreased continuously until becoming negative. In contrast, rising levels of one or more specific antibodies were detected in 9 of 12 infected children at a median age of 6 months. At 1 year of age, 8 infants were still asymptomatic and classified as P-1. All had serologic profiles consistent with de novo specific antibody production. In contrast, among the 4 infants who had early disease (class P-2), 3 had no significant rise in antibody to HIV-1. These results indicate that poor immune response, which could result from early infection of the infant, is often associated with rapid clinical progression.

Expression of intermediate filaments and actins in human dental pulp and embryonic dental papilla

The localization of different cytoskeletal proteins (keratin, vimentin, desmin, actin, and alpha-smooth muscle actin) was examined by immunohistochemistry in normal human adult dental pulp and compared with dental papilla of tooth germs. Keratin and actin were localized in enamel organ. Vimentin and actin were observed in the dental papilla and in the adult dental pulp. Desmin and alpha-smooth muscle actin were present only in the vessel walls. These data are discussed paying particular attention to the origin and the peculiar functional characters of the dental papilla and pulp.

Comparative immunohistochemical analysis between jaw myxoma and mesenchymal cells of tooth germ

The histogenesis of jaw myxoma is still debated. According to some authors it arises from the primitive mesenchymal components of developing teeth. In this study, we have studied the expression of S-100 protein and vimentin in dental follicle, dental papilla and periodontal ligament cells using monoclonal and polyclonal antibodies. Myxoma of the jaw expresses vimentin and S-100 protein. On the contrary, as compared to jaw myxoma, the normal developmental structures were immunonegative for S-100 protein but stained for vimentin. These results could indicate a difference in the derivation other than tooth mesenchyma.

Human odontoblasts contain S-100 protein-like immunoreactivity

S-100 protein is a group of three closely related isoforms (S-100ao, S-100a, and S-100b). This protein was first described as unique to the nervous system but it has also been identified subsequently in a variety of cell types of neuroectodermal (i.e., melanocytes, glial cells) and non-neuroectodermal origin (i.e., Langerhans cells, adipocytes, chondrocytes). In the present investigation the presence of S-100 protein was studied in human odontoblasts using a specific polyclonal antibody directed against S-100 protein in immunoperoxidase labelling experiments. The S-100 protein was detected in the cytoplasm of odontoblasts. This result suggests that S-100 protein can play a role in odontoblast functions.

[Myxoma of the jaws]

A review of the literature and two observations made by the Authors regarding maxillary myxoma allow a closer analysis to be made of this rare benign tumour which is, however, often recurrent in young adults. Maxillary myxoma is identified by the appearance of a non-inflammatory and often painless swelling which, in radiological terms, appears to have a zone of multilocular and sometimes unilocular osteolysis. In histological terms, this globular whitish-greyish gelatine-like tumour is made up of an abundant stroma which encloses star-shaped or fusiform cells and rare collagen fibres. Treatment should be conservative where possible since radical surgery does not preclude recurrence; follow-up should be regular and long in order to ensure an early diagnosis of recividation. Although it is considered an odontogenic tumour, the odontogenic nature of maxillary myxoma has not been undisputably ascertained. The term maxillary myxoma is therefore preferable to that of odontogenic myxoma.

[Focal epithelial hyperplasia]

Five cases of "focal epithelial hyperplasia" (FEH) of the oral mucosa observed in Switzerland are reported. The patients were of Turkish and North African extraction. The lesions of FEH were multiple, painless, located at various sites of the oral mucosa including the tongue in the form of either soft papules or hard nodules. Evidence of a human papilloma virus origin was ascertained. Among the 1067 cases reported in the literature and reviewed for this study, this condition has been described to occur among American Indians, Eskimos and North African, also in Israeli and European cases the disorder was often reported in individuals of Turkish or North African extraction.

[Psychogenic oral paresthesia]

Psychogenic oral paresthesia represent a proteiform condition, more and more frequent. The failure to recognize it can lead to unjustified investigations or/and procedures. These manifestations are secondary to a psychic problem which varies in severity. In most cases, the establishment of a trust relationship, explanations to the patient and eventually a psychotherapy are sufficient to eliminate the symptoms. In severe cases, a psychotherapy or a psychiatric treatment are almost always necessary.

[Lichen planus. Clinical diagnosis, epidemiology and pathogenesis]

Lichen planus is a common mucocutaneous disease of unknown etiology which was initially described a century ago. The specific etiology remains unclear. A number of relationships between lichen planus and other conditions have been noted. The lesions occur most commonly on the buccal mucosa. Gingival involvement occurs in approximately 10% of reported cases. The appearance of lichen planus is extremely variable which leads to confusion with other clinically similar disease entities.

Corneal wound healing in monkeys 18 months after excimer laser photorefractive keratectomy

Excimer laser keratomileusis (photorefractive keratectomy, direct corneal ablation) for myopic corrections of 2.00 diopters (n = 1), 4.00 D (n = 4), and 8.00 D (n = 3) was performed on eight corneas of four Rhesus monkeys. All animals were followed for 18 months. The ablations healed normally and no epithelial erosions occurred. Serial slit-lamp microscope examinations revealed that a variable amount of corneal haze developed in all animals; this haze progressively faded during the follow-up period. Histopathology revealed an epithelium of normal thickness, basement membrane abnormalities, increased number and activity of stromal keratocytes, and a variable amount of newly secreted extracellular matrix in the anterior stroma. These findings suggest that excimer laser keratomileusis induces a mild wound healing response in the anterior cornea which displays considerable individual variability and persists up to 18 months.

[Intramandibular inclusions of salivary gland tissue]

Salivary gland tissue inclusions in the mandible appear as well delimited radiolucency areas, asymptomatic, usually located in the mandibular angle and sometimes in the premolar canine and symphysis regions. The examination of 8,500 radiographs has demonstrated an incidence of one radiolucent area at the mandibular angle every 500 radiographs. Our result is slightly inferior to the mean reported in the literature. Seven cases were examined. Six of them have been treated surgically and histologically. At exploration a defect in the lingual cortical plate was found. The cavities were filled by salivary gland tissue. The contents of the cavities were attached via the lingual cortical defect to the near salivary gland. The cause of such radiolucency situated in the mandibular angle seems to be an altered resorption and apposition process of the bone triggered by a modification of the salivary glands elasticity; on the contrary, the salivary inclusions in the symphysis region is referred to as embryonic origin. In the literature different terms are used often in relation with a pathogenetical hypothesis; in this paper we suggest rather a description terminology such as intramandibular salivary tissue.

Scanning slit delivery system

We describe the structure and function of a delivery system designed for use with an argon fluoride excimer laser for corneal surgery. The basic principle of the delivery system is to shape the laser beam with a slit mask to a defined configuration. The image of the slit is moved across the cornea in a mathematically defined pattern to ablate a given amount of tissue, creating a new anterior radius of curvature for the cornea. The location of the beam on the cornea is determined by a rotating dove prism and a translating spherical lens, each of which is controlled by computer-regulated servomotors. The system is versatile and can be used for laser myopic or hyperopic keratomileusis, for correction of astigmatism by surface ablation, for creation of radial or transverse linear cuts, for excision of corneal buttons, and for uniform lamellar corneal smoothing procedures. The delivery system is currently used in the laboratory for the ablation of nonhuman primate corneas.

Canthaxanthin retinopathy. Anatomic and functional reversibility

Canthaxanthin intake is associated with golden yellow crystalline deposits in the retina around the macula and low static luminance threshold. Our study assesses the anatomic and functional reversibility of canthaxanthin retinopathy. The number of retinal deposits was evaluated in nine patients, two to four times over a mean period of 55 months. There was no significant difference after a nine-month follow-up. A statistically significant decrease in the number of retinal deposits was found after an observation period of 26 months. The deposits disappeared slowly, while some remained even seven years after canthaxanthin therapy was discontinued. Threshold static perimetry performed on eight patients with retinopathy and seven controls did not differ significantly between the two groups at the end of the follow-up period. The results demonstrate that canthaxanthin retinopathy is reversible.

Racial differences in sports performance

The purpose of this paper is twofold: (a) to present data on racial differences in sport performance and (b) to comment briefly on theories, hypotheses and studies, whether they be biological, psychological or sociological in nature, that have attempted to explain the observed differences. Available data are mainly drawn from studies focusing on American professional sports. The results indicate that Afro-American athletes largely dominate the sport scene in a few sports and across a wide range of performance indicators. Although it is impossible at this time to conclude with satisfaction on the causes of racial differences, sociological explanations seem best to explain the observed performance differentials.

Immunohistochemical staining for vimentin filaments and S-100 protein in myxoma of the jaws

Two jaw myxomas have been analyzed by a panel of antibodies to characterize this tumour type. Vimentin, but not keratin, neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), neurofilament (NF), desmin and Factor VIII-related antigen (FVIII-AG), demonstrated positivity in the cytoplasm of the neoplastic cells. Moreover, an antibody against S-100 protein also showed a strong positive reaction in the cytoplasm of the tumour cells examined. Thus directly indicating a mesenchymal derivation for odontogenic myxoma, and is the first demonstration of S-100 protein within the cells of this tumour type.