Assessing the impact of body composition, metabolic and oxidative stress parameters on insulin resistance as a prognostic marker for reactive hypoglycemia: a cross-sectional study in overweight, obese, and normal weight individuals

Oxidative stress (OS) plays a pivotal role in the pathogenesis of insulin resistance (IR), particularly in its association with obesity. This study evaluate both the diagnostic and clinical significance of assessing oxidative status in patients affected by overweight and obesity displaying IR, especially with reactive hypoglycemic episodes (RH). A comprehensive examination of OS biomarkers was carried out, encompassing measurements of total oxidative capacity (TOC) and total antioxidant capacity (TAC). Our analysis results reveal noteworthy connections between OS levels and the severity of IR in overweight and obese patients. Moreover, in the study, we demonstrated the diagnostic utility of serum concentrations of TAC and TOC as indicators of the risk of RH, the occurrence of which, even at the stage of overweight, may be associated with increased OS and further development of obesity. Our findings imply that the evaluation of oxidative status could serve as a crucial diagnostic and prognostic tool for patients observed with IR and overweight and obesity. In conclusion, our study underscores the potential utility of assessing oxidative status in the context of IR and highlights the possibility of identifying novel therapeutic targets for the treatment of overweight and obese patients.

A clinical evaluation of efficacy of photodynamic therapy in treatment of reticular oral lichen planus: A case series

Background The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of reticular oral lichen planus (OLP). Methods Fifty patients aged 26-84, with 124 OLP lesions in total, underwent photodynamic therapy (PDT) mediated with topically applied 5% 5-aminolevulinic acid. ALA was activated by a custom-made diode lamp with a high-power LED emitting light at 630 nm and 300 mW delivered through an optical fiber probe. A light exposure dose was 150 J/cm2. The therapy comprised of 10 weekly illumination sessions. The lesions' response was macroscopically measured in millimeters with a periodontal probe and clinically evaluated at each session, then on completion of the series and throughout the 12-month follow-up. Results The baseline mean size of lesions was 3.99 cm2±3.73. The lesions on the buccal mucosa and lips (lining mucosa) were larger than those on the gingiva and tongue (masticatory mucosa) - 4.58 cm2±4.01 and 2.93 cm2±2.91 respectively. On completion of the therapy 109 sites improved, including 46 in complete remission. The mean reduction in size was 62.91% (p = 0.000000). 12-month after therapy mean reduction of the lesions was 78.7% (p = 0.000000), specifically 79.48% (p = 0.000000) within the lining mucosa and 76.11% on the masticatory mucosa. Conclusions The results proved that ALA-mediated photodynamic therapy with a 630 nm light was effective and as such it can be used as an optional treatment for symptomatic OLP.

Assessment of the effect of the corticotomy-assisted orthodontic treatment on the maxillary periodontal tissue in patients with malocclusions with transverse maxillary deficiency: a case series

Background

The aim of the study was to assess the effect of corticotomy–assisted orthodontic treatment on soft tissue clinical parameters in patients with malocclusions with transverse maxillary deficiency.

Methods

The study included 20 generally healthy adult individuals with malocclusion, who underwent a corticotomy-assisted orthodontic treatment in maxilla. During the corticotomy performed after full-thickness flap elevation, only the buccal cortical plate was cut with the use of OTS-7, OTS7–4, OTS7-3 ultrasound tips of the piezosurgery device (Mectron s. p. a., Italy). A clinical examination was performed prior to the corticotomy procedure, then repeated – 3, 6, 9 and 12 months after the procedure. The following parameters were assessed: FMPI (full mouth plaque index), FMBOP (full mouth bleading on probing), PD (probing depth), CAL (clinical attachment level), GR (gingival recession height), RW (recession width), PH (papilla height), PW (papilla width), BS (bone sounding), biotype and KT.

Results

There was a statistically significant reduction in PD (mean difference: 0.06; 95% Cl: − 0.33, − 0.18), CAL (mean difference: 0.07; 95% Cl: − 0.33, − 0.19), PH (mean difference: 0.26; 95% Cl: − 0.47, 0.05) and BS (mean difference: 0.13; 95% Cl: − 0.41, − 0.14) after the treatment. Statistically significant changes were also noted in relation to KT (mean difference: 0.17; 95% Cl: − 0.07, 0.27) and biotype (mean difference: 0.07; 95% Cl: 0.26, 0.39), which thickness increased significantly after the treatment. No statistically significant differences were observed in GR, RW and PW.

Conclusions

The corticotomy–assisted orthodontic treatment did not jeopardize the periodontal clinical status in maxilla. There is a need for further studies on a larger number of patient to compare the clinical findings with a control group as well as in patients with conventional orthodontic treatment in a longer follow-up time to find out more about the post-treatment periodontal tissue changes and stability.

Clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia

BACKGROUND

The aim of the study was clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia lesions.

METHODS

Twenty-three consecutive patients aged 21-79 were included to the study. In all patients 44 homogeneous, flat leukoplakia lesions were clinically diagnosed and confirmed histopathologically. Photodynamic therapy was performed with the use of Photolon(®) photosensitizer, containing 20% Chlorine-e6 and 10% dimethyl sulfoxide and a semiconductor laser, with power up to 300mW and a wavelength of 660nm. Ten illumination sessions were conducted with the use of superficial light energy density of 90J/cm(2).

RESULTS

At baseline the mean size of leukoplakia lesion was 6.5±5.10cm(2) while after photodynamic therapy 3±2.99cm(2). Significant reduction (on average by 53.8%) of leukoplakia lesions sizes was observed after therapy. Twelve (27.27%) lesions had been completely cured, 22 (50%) partially cured, although 10 (22.73%) lasted unchanged. The efficacy of PTD was comparable in women and men irrespective of age. There have been no adverse site effects during therapy noted.

CONCLUSIONS

Within the limits of the study it can be concluded that photodynamic therapy with the use of Chlorine-e6 can lead to considerable reduction of oral leukoplakia lesions size thus may be useful in clinical practice. However there is a need of further studies on larger number of cases and longer follow-up time.

[Radiation induced leiomyosarcoma. Review of literature and case report]

Post-irradiation sarcomas of head and neck appear seldom, and among them leiomyosarcoma (LMS) is exceptionally rare. 11 cases of this tumour, associated with previous irradiation and situated in this anatomical area have been described so far. The aim of this study was to describe 56 year-old patient with LMS and to compare this case with the others described in the literature. What brought our attention were scanty clinical symptoms coexisted with extensive radiological changes. Radiotherapy can give rise to the development of LMS in different moments of time after the treatment of primary tumor has been finished. In this aspect patients who undergone radiotherapy in the early stage of live and who are more susceptible to this kind of treatment should be followed up more closely and carefully.

Expression of Bcl-xL, Bax, and p53 in primary tumors and lymph node metastases in oral squamous cell carcinoma

Disturbances in expression of apoptosis-associated proteins take part in the development and progression of many human malignancies. The aim of this study was the assessment of correlations among proteins involved in apoptosis-Bcl-xL, Bax, and p53-as well as relationships of these proteins with selected clinicopathological features in oral squamous cell carcinoma. Consequently, we examined by immunohistochemistry, using the avidin-biotin-peroxidase method, Bcl-xL, Bax, and p53 expression in 56 samples of primary oral squamous cell carcinoma and in 22 matched pairs of primary and metastatic tumors. The evaluation of immunostaining of Bcl-xL, Bax, and p53 was analyzed in 10 different tumor fields, and the mean percentage of tumor cells with positive staining was evaluated. The significance of the associations was determined using Spearman correlation analysis and the chi-square test. We found positive Bcl-xL, Bax, and p53 immunostaining in 44.6%, 28.6%, and 58.9% of the studied primary tumors and in 63.6%, 45.5%, and 72.7% of lymph node metastases, respectively. Analysis of associations among studied proteins revealed positive correlation between Bcl-xL and Bax in primary tumors (P<0.03, r=0.307). Statistically significant relationship between p53 expression in primary oral cancers and its expression in lymph node metastases (P<0.02) as well as increased expression of Bcl-xL, Bax, and p53 in metastatic sites compared with primary tumors could indicate an association of these proteins with oral cancer progression and development of metastases. Moreover, we suppose that knowledge about heterogeneity between primary and metastatic tumor might help to understand mechanisms of oral cancer progression.

Insulin-like growth factor-I receptor in human oral cancer

The purpose of the study was to evaluate the expression of IGF-IR in primary tumours and lymph node metastases of oral cancers and the correlation between expression of IGF-IR and some clinicopathological features. Fifty-seven (57) oral cancers were examined by immunohistochemical studies, using the avidin-biotin-peroxidase method. Our study included only oral cancers, classified histopathologically as squamous cell carcinoma (7 cases in G1 grade, 44 (G2) and 6 (G3); 23/pT1 stage, 18/pT2, 7/pT3 and 9/pT4). Positive immunostaining for IGF-IR was noted in 32, out of 57 (56.1%) of oral tumours. We found a tendency (p=0.081) toward an association between IGF-IR expression in the primary tumours and their stage (pT3 and pT4). A comparison between the primary tumours and matching lymph node metastases revealed that 13, out of 20, (65%) cases showed a convergence between primary tumours and matching lymph node metastases with regard to either negative or positive staining.

The role of Bak expression in apoptosis of the oral squamous cell carcinoma (OSCC) and metastases to lymph nodes (LNMs)

The immunohistochemical method was applied to show Bak expression in oral squamous cell carcinoma and its metastases to lymph nodes (LNMs). Bak expression was evaluated by immunohistochemical methods in specimens with oral squamous cell carcinomas and their lymph node metastases. Immunohistochemical studies were performed, using goat polyclonal Bak antibodies (Santa Cruz Biotechnology, USA) at 1:200 dilution. Our studies revealed over expression (64%) of Bak in the cytoplasm of epithelial cells in primary tumours (PTs) and in (75%) LNMs. No statistically significant correlations were observed between Bak immunoreactivity and age, pT and G of the carcinoma in PTs and LNMs. We conclude that expression of Bak may be useful for better characterising and predicting the prognosis of OSCC but cooperative studies are needed to assess its applications in the clinical practice.

Evaluation of lymphocyte populations and subpopulations extracted from inflamed periodontal tissues

The aim of the present study was evaluation the distribution of B- and T-cells and T-cell subsets in periodontal tissues from patients with different periodontitis forms. Periodontal tissue samples were collected from group P patients during routine surgical procedures, while from group C during tooth extraction for orthodontic or prosthetic purposes. Directly after collection, tissue samples were placed in a criostat or fixed in 10% buffered formalin for 24 h at room temperature. Following fixation the material was embedded in paraffin and subjected to routine histological techniques. Examinations of B- and T-lymphocytes populations and T-lymphocytes subsets were made with the use of immunohistochemical method. In C group single T and B lymphocytes were found in histological examination in pocket epithelium zones. In early onset periodontitis (EOP) patients in inflammatory infiltration lymphocytes T were dominating while in adult periodontitis (AP) patients dominating were B lymphocytes. Mean CD4/CD8 ratio in control group was 1.7 and in EOP and AP patients 1.1 and 2.6 respectively.