Komali Rajkumar

Salivary and serum level of CYFRA 21‐1 in oral precancer and oral squamous cell carcinoma

BACKGROUND CYFRA 21-1, a constituent of the intermediate filament proteins of epithelial cells, is known to be increased in many cancers. This study was designed to estimate the levels of salivary and serum CYFRA 21-1 in patients with oral precancer and oral squamous cell carcinoma (OSCC) and compare them with healthy controls. MATERIALS AND METHODS Each group comprised of 100 subjects. Saliva and blood samples were collected from patients with OSCC, premalignant subjects, and normal healthy subjects. Serum and salivary CYFRA 21-1 levels were measured by enzyme-linked immunosorbent assay. Appropriate statistical tests were employed to assess diagnostic potency of CYFRA 21-1. RESULTS We found a significant increase in CYFRA 21-1 level in OSCC compared with PML and healthy subjects. Salivary CYFRA 21-1 levels in OSCC was threefold higher when compared to serum levels. PML group showed increased salivary CYFRA 21-1 when compared to control subjects, but it was significantly lower compared with OSCC. Receiver operator characteristic curve analysis showed salivary CYFRA 21-1 to have superior sensitivity in detecting OSCC compared with serum CYFRA 21-1. CONCLUSIONS The outcome of this study suggests that salivary CYFRA 21-1 can be utilized as a biomarker in early detection of oral cancer.

Validation of the diagnostic utility of salivary interleukin 8 in the differentiation of potentially malignant oral lesions and oral squamous cell carcinoma in a region with high endemicity

OBJECTIVE To evaluate the clinical utility of salivary interleukin 8 (IL-8) in the differential diagnosis of potentially malignant lesions (PMLs) and oral squamous cell carcinoma (OSCC) in a region with high oral cancer prevalence. STUDY DESIGN Saliva and blood samples were collected from 100 participants in each group (OSCC, PMLs, and healthy controls). Serum and salivary IL-8 levels were measured by enzyme-linked immunosorbent assay. The data were subjected to appropriate statistical analysis. RESULTS A significant increase in levels of serum and salivary IL-8 was found in OSCC compared with PMLs and healthy controls. Receiver operating characteristic curve analysis found salivary IL-8 to have superior sensitivity in detecting OSCC. A significant increase in IL-8 levels based on the histologic grading of OSCC was also observed. CONCLUSIONS This study confirms that salivary IL-8 can be a potent marker that can be used as a tool in the differential diagnosis of PMLs and OSCC.

Nondestructive characterization of musical pillars of Mahamandapam of Vitthala Temple at Hampi, India

This paper presents the first scientific investigation on the musical pillars of the Vitthala Temple at Hampi, India. The solid stone columns in these pillars produce audible sound, when struck with a finger. Systematic investigations on the acoustic characteristics of the musical pillars of mahamandapam (great stage) of the Vitthala Temple have been carried out. The 11 most popular pillars that produce sounds of specific musical instruments are considered for the investigations. The sound produced from these 11 most popular musical pillars was recorded systematically and different nondestructive testing techniques such as low frequency ultrasonic testing, impact echo testing, and in situ metallography were employed on the musical columns of these pillars. The peak frequencies in the amplitude spectrum of the sound produced from various columns in these pillars are correlated with the dimensional measurements and ultrasonic velocity determined using impact echo technique. The peak frequencies obtained experimentally have been found to have excellent correlation with the calculated flexural frequencies based on the dimensional measurements and ultrasonic velocities of the columns.

Evaluation of transforming growth factor beta1 gene in oral submucous fibrosis induced in Sprague-Dawley rats by injections of areca nut and pan masala (commercial areca nut product) extracts

CONTEXT Oral submucous fibrosis (OSF) is a potentially malignant oral disorder causally linked to the habit of chewing arecanut. The pathogenesis of the disorder is multifactorial and transforming growth factor beta (TGF-beta) is a prominent player in the induction of fibrosis. The alkaloids of the arecanut seem to target the TGF-beta and the deposition of collagen is predominantly mediated through this cytokine. AIMS AND OBJECTIVES The present study attempts to induce OSF in Sprague-Dawley rats by injections with solutions of arecanut and pan masala extracts. The tissues were then analysed for the TGF-beta1 gene by real time polymerase chain reaction. (rtPCR). MATERIALS AND METHODS Buccal mucosa of Sprague-Dawley rats were injectedwith arecanut and pan masala solutions on alternate days over a period of 48. weeks. Quantitative real time PCR was done to assess the expression of TGF-beta1 in the tissues. RESULTS OSF-like lesions were seen in both the arecanut and pan masala.treated groups. The histological changes included atrophic epithelium, partial or complete loss of rete ridges, juxta-epithelial hyalinization, inflammation and accumulation of dense bundles of collagen fibers subepithelially. Quantitative real-time PCR showed a significant upregulation of TGF beta1. A. peak fold change of 4.74 in the 18th. week was observed for the arecanut group while the pan masala group recorded a peak change of 4.9 in the 24th. week. CONCLUSION The study provides further evidence that arecanut and pan masala induce oral submucous fibrosisvia the TGF beta1 pathway.

Sexual dimorphism in tooth morphometrics: An evaluation of the parameters.

Aims and Objectives: Sexual dimorphism refers to the variations in tooth size and shape between the sexes. The consistency of these variations is valuable in the identification of the sex of an individual in times of mass disaster when whole body parts get destroyed or are unavailable. There exist differences in the expression of these variables across races and regions. This study aims to tabulate and identify the variations in tooth measurements using standarized reference points in an attempt to establish parameters of sexual dimorphism. Materials and Methods: 100 individuals (50 of each sex) in the age group 19-23 years were assessed for standard morphometric parameters of the maxillary central incisor, canine, premolar and molar. Odontometric measurements of established parameters were recorded from impression casts of the maxillary jaws. The mesiodistal width (MDW), the bucco-ligual width (BLW), the crown length (CL) and the cervical angle (CA) were charted among the teeth. The consistency of the variations was statistically analyzed and a logistic regression table was prepared to identify the sex of the individual from the tooth measurements.Results and Conclusions: The BLW, MDW and CL reflected significant variations among all the teeth to be effective in establishing sexual dimorphism. CA as a parameter was inadequate across all the teeth. The permanent maxillary canine was the most important tooth to be reflective of the gender and statistically significant to be utilized for gender determination.

Immunohistochemical evaluation of myofibroblasts using alpha-smooth muscle actin in oral submucous fibrosis

Introduction: Oral submucous fibrosis (OSMF) is a chronic debilitating disease and a premalignant condition of the oral cavity characterized by generalized submucosal fibrosis with a multifactorial etiology. Myofibroblasts are a unique group of cells phenotypically intermediate between smooth muscle cells and fibroblast exhibiting contractile properties, expressing α-smooth muscle actin (α-SMA) and are considered primary producers of extracellular matrix after injury. Their accumulation has been established as a marker of progressive fibrosis in various organs. The aim of the present study is to evaluate and compare the myofibroblasts in various histological grades of OSMF. Materials and Method: Fifteen cases of OSMF, which were further categorized histologically into early (5 cases), moderately advanced (5 cases) and advanced (5 cases), were subjected to immunohistochemical evaluation using α-SMA antibody for detection of myofibroblasts. Fifteen benign mucosal proliferation specimens were also stained for comparison. Results: The number of myofibroblasts in OSMF was significantly increased when compared to that of benign mucosal proliferations (P < 0.05). Additionally, a statistically significant increase in the myofibroblasts population between early and advanced stages was observed (P < 0.05). Conclusions: The results of the present study showed that expression of myofibroblasts within the OSMF group showed a progressive increase from the early OSMF through moderate OSMF and the advanced OSMF group indicating that myofibroblasts could serve as effective prognostic marker for disease progression in oral submucous fibrosis.

Prediction of Facial Profile Based on Morphometric Measurements and Profile Characteristics of Permanent Maxillary Central Incisor Teeth

The computation of facial profile from dental morphometrics has been a subject of great interest in forensic odontology. The use of teeth to draw a profile and facial features is valuable in times of mass disasters when body remains are unavailable due to extreme destruction. This study aims to identify and evaluate applicable parameters in the permanent maxillary central incisors and the face of an individual. A correlation of these parameters establishes a mathematical equation that further charts a tooth-facial profile table. Thirty soft and hard tissue landmarks on the face in the frontal and the lateral profiles (using standardized photographs) and seven landmarks on the facial/labial surface of the clinical crown of the permanent maxillary central incisor (using casts of the maxilla) were identified for the study. Based on these, a set of eight horizontal and seven vertical parameters on the face and four parameters on the tooth were created for the assessment. Internal and external correlations between the two were carried out and statistically analyzed. A logistic regression was made to predict the probability of the parameters most likely to be reproduced in the creation of the facial profile, based on tooth morphometrics. The results indicated a definite correlation between the facial and the tooth parameters. Among the multiple parameters, a definite correlation in the horizontal dimension could be established between the mouth width and the mesiodistal width (MDW) of the tooth. In the vertical dimension, a definite relationship existed between the crown height of the tooth and the width of the midface (zygoma-mandible). There exist divergences in the correlation of tooth and facial parameters.

Expression of type I and type III collagens in oral submucous fibrosis: An immunohistochemical study

Background: Oral submucous fibrosis (OSMF) is a potentially malignant collagen - metabolic disorder linked to consumption of betel quid and areca nut. The deposition of collagen and its major subtypes have been the subject of intense scrutiny in the etiopathogenesis of the disorder. Aims and Objectives: The present study was planned to immunohistochemically identify the expression of collagens I and III (COL I and III) in different grades of OSF and compare it with normal oral mucosa and scar tissue. Materials and Methods: Archival paraffin sections of 72 cases of various grades of OSMF, ten cases of normal mucosa as controls and four cases of scar tissue were stained with antibodies to COL I and III (BioGenex Laboratories, CA, USA) to evaluate the collagen subtypes on paraffin sections. The expression was quantified by image analysis software (Jenoptik Optical System, ProgRes ® Capture Pro, version 2.8.8) and statistically analyzed. Results: COL I and III stained all the tissues ubiquitously. COL I was more in ratio and quantity in all the grades of OSMF, normal mucosa, and scar tissue. The proportion of COL I to COL III seemed to increase with progressive grades of OSF. Interestingly, during the process of fibrosis COL III seems to be deposited earlier and gradually replaced by COL I resulting in a skewed ratio vis a vis normal oral mucosa and scar tissue. Conclusions: COL I expression was found to be proportionate with advancing grades of OSF while COL III expression increased in Grade I but subsequently decreased as severity of OSF increased. The increase in COL I at the expense of COL III showed a similar pattern in the submucosa while in the deeper muscle only Grade III cases reflected the trend. While all cases of OSF revealed excessive expression in comparison with normal oral mucosa, the comparison with scar tissue was variable.

Oral melanocytic nevi: Report of two cases with immunohistochemical elaboration of their probable origin and maturation

Oral melanocytic nevi are localized developmental tissue malformations of nevus cells in the oral mucosa. Relatively rare in occurrence compared to their dermal counterparts, considerable debate exists in the literature related to their origin, development and maturation, and their relationship to oral melanocytes.We report two cases of oral melanocytic nevi with classical clinical presentation. The histopathology was consistent with the known patterns of oral melanocytic nevi. Special stains such as Masson Fontana, further substantiated the observation. S-100 and HMB-45 were applied to immunohistochemically elaborate the cell population. Interestingly two distinct cell populations were detected in the lesions. Type A cells in the center of the lesion were S-100 positive, indicating a neural origin and immaturity in development, while peripheral type B cells stained positive with HMB-45, indicating melanocytic origin and mature development.

Transforming growth factor β2 (TGF-β2) in pathogenesis of oral submucous fibrosis: An immunohistochemical study

Background and Objectives: Oral Submucous Fibrosis (OSF) is a potentially malignant oral disorder causing fibrosis of the oral mucosa. Commonly associated with the habit of chewing areca nut in its raw or refined forms, the progressive fibrosis causes intense debility and probable malignant transformation. Arecoline, flavinoids and tannins in the areca nut may activate pro-fibrotic cytokines like transforming growth factor beta (TGF-β) leading to fibrosis. TGF-β and its isoforms probably represent the major pathway in the deposition of collagen fibers in this condition. Very little is known of the role of TGF-β2, as compared withTGF-β1, in OSF. The present study aims to evaluate TGF-β2 immunohistochemically in OSF with a view to understanding its role in the pathogenesis. Materials and Methods: TGF-β2 antibody was detected immunohistochemically on archival paraffin sections of 70 cases of various grades of OSF, 10 cases of normal oral mucosa and five cases of scar tissue. The presence and distribution of the antibody was noted and a quantification of the positive areas was also done using image analyses software and correlated in proportion to the rest of the tissue. Results: Expression of TGF-β2 was more in all grades of OSF when compared with that of normal oral mucosa but less than that expressed in scar tissue. The antibody was detected in epithelium, around the blood vessels, in areas of inflammatory infiltrate, fibroblasts and in muscles. The intensity and proportion of expression paralleled increasing grades of OSF. There was increased expression of the antibody in the epithelium, which is probably the source, but no correlation to epithelial changes (hyperplasia, atrophy or dysplasia) was noted. Conclusion: TGF-β2 is a prominent cytokine in the TGF-β induced pathway of fibrosis but probably plays a contributory role to the main isoform TGF-β1. Its role as a marker of malignant transformation, as seen in other systemic malignant lesions, remains inconclusive in OSF.