Malignant melanoma of gingiva: Report of a rare case

According to the World Health Organization, oral malignant melanoma (OMM) is a rare disease, accounting for only 0.8% of all melanomas, 8% of head and neck melanomas, and up to 0.5% of all oral malignancies. OMM presents as a pigmented lesion with asymmetrical borders, irregular surface characteristics, and a distinct color. Melanoma-associated pigmented lesion of the oral cavity does not possess clinical specificity and frequently divert the clinical diagnosis; hence, differential diagnosis becomes mandatory. Furthermore, the unpredictable pathophysiological behavior and delayed detection, contributes for poor prognosis of the disease. As a result, the 5 years survival rate is only 10–25%. Commonly OMM is seen in maxillary gingiva of males. However, we report a rare case of a middle-aged female having pigmentations and growth over mandibular gingiva.

GHB acid: A rage or reprive

Gamma-hydroxybutyric acid (GHB) is a naturally occurring analog of gamma-aminobutyric acid (GABA) that has been used in research and clinical medicine for many years. GHB was used clinically as an anesthetic in the 1960s but was withdrawn due to side effects that included seizures and coma. GHB has been implicated in a number of crime types; most notably in drug-facilitated sexual assault. GHB is abused by three main groups of users: Body builders who use the substance believing that it stimulated the release of growth hormone; sexual predators who covertly administer the drug for its sedative and amnesic effects and club-goers (rave parties) who take the drug for its euphoric effects. The short-lived hypnotic effects, relative safety and widespread availability of the drug have made it particularly well suited to this role. The drug has an addictive potential if used for long term. The primary effects of GHB use are those of a CNS depressant and therefore range from relaxation, to euphoria, confusion, amnesia, hallucinations, and coma. Despite the increased regulation, GHB remains widely available through the Internet where one can easily purchase the necessary reagents as well as recipes for home production. There are reports of patients being unresponsive to painful stimuli and cases of oral self-mutilations linked to the abuse of GHB, though quiet rare. Such cases should remind odontologists that intra-oral lesions may be the result of self-mutilation either due to mental illness or altered states caused by the use of prescription or non-prescription drugs.

VEGF and CD 34: A correlation between tumor angiogenesis and microvessel density-an immunohistochemical study

Background:

Angiogenesis is the formation of new vessels from preexisting ones which takes place by capillary sprouting. It is seen in healing, at sites of injury and collateral circulation in ischemia. It is also seen in tumors, as once the original blood supply of a tumor is exhausted it cannot grow without further blood supply. Also as the angiogenic capacity of a tumor increases, its microvasculature, that is, microvessel density (MVD) also increases. Based on this literary evidence we carried out an immunohistochemical (IHC) study to observe the relationship between the expression of vascular endothelial growth factor (VEGF) [angiogenesis] and CD 34 [MVD] in oral squamous cell carcinoma (OSCC).

Aim:

To evaluate the correlation between expression of VEGF and CD 34, the role of MVD in progression of OSCC and to compare the degree of angiogenesis in different grades of OSCC.

Settings and Design:

In this study we observed the relation between angiogenesis and MVD and the overall effect of this on oral cancer.

Materials and Methods:

Thirty-three cases of OSCC were stained with hematoxylin and eosin, (H and E) to confirm the diagnosis and immunohistochemically using VEGF and CD 34 antibody. The slides were evaluated for positivity and intensity of staining.

Statistical Analysis:

The result was subjected to statistical analysis using analysis of variance (ANOVA) test and Fisher's exact test.

Results:

VEGF positivity as well as MVD was found to be independent of the grade of the tumor. Tumor MVD was found to be independent of expression of VEGF.

GHB acid: A rage or reprive

Gamma-hydroxybutyric acid (GHB) is a naturally occurring analog of gamma-aminobutyric acid (GABA) that has been used in research and clinical medicine for many years. GHB was used clinically as an anesthetic in the 1960s but was withdrawn due to side effects that included seizures and coma. GHB has been implicated in a number of crime types; most notably in drug-facilitated sexual assault. GHB is abused by three main groups of users: Body builders who use the substance believing that it stimulated the release of growth hormone; sexual predators who covertly administer the drug for its sedative and amnesic effects and club-goers (rave parties) who take the drug for its euphoric effects. The short-lived hypnotic effects, relative safety and widespread availability of the drug have made it particularly well suited to this role. The drug has an addictive potential if used for long term. The primary effects of GHB use are those of a CNS depressant and therefore range from relaxation, to euphoria, confusion, amnesia, hallucinations, and coma. Despite the increased regulation, GHB remains widely available through the Internet where one can easily purchase the necessary reagents as well as recipes for home production. There are reports of patients being unresponsive to painful stimuli and cases of oral self-mutilations linked to the abuse of GHB, though quiet rare. Such cases should remind odontologists that intra-oral lesions may be the result of self-mutilation either due to mental illness or altered states caused by the use of prescription or non-prescription drugs.