-
International Journal of Surgery Case... Jun 2024Tumours of salivary glands are rare and have various histo-pathological subtypes. Myoepitheliomas were first classified by Sheldon et al. and the criterion to classify...
INTRODUCTION
Tumours of salivary glands are rare and have various histo-pathological subtypes. Myoepitheliomas were first classified by Sheldon et al. and the criterion to classify or diagnose it was first defined by Barnes et al. and Sciubba and Brannon. Myoepithelioma accounts for less than 1 % of all salivary gland tumours, 40 % of these tumours occur in the parotid gland while 21 % occur in the minor salivary glands. A case of myoepithelioma of a minor salivary gland of the cheek is described, emphasizing the problems of the differential diagnosis.
PRESENTATION OF THE CASE
A 40-year-old female reported to the department with a complaint of a cheek bite on her right side for a few months. The physical examination showed a presence of lobulated whitish mucosa on the right buccal mucosa at the level of the occlusal plane, on palpation it revealed a non-painful mass approximately 1.5 cm in radius, mobile to bimanual palpation. An excisional biopsy was performed under local anaesthesia. Microscopic and immunohistochemistry confirmed the tumour to be a myoepithelioma of a minor salivary gland with the absence of definitive features of malignancy.
DISCUSSION
Due to their infrequency and multiplicity of histopathology, myoepitheliomas present difficulties in diagnosis. Cellular varieties can be misdiagnosed as malignancies. A key to determining diagnostic criteria for myoepitheliomas is to study cellular morphology, cytoplasmic filament expression, and ultrastructural features of the tumour and apply this information to defining myoepitheliomas.
CONCLUSION
Myoepitheliomas are rare tumours, utilization of immunohistochemical staining and electron microscopy are useful tools for the diagnosis of myoepitheliomas to ensure proper treatment and follow-up.
PubMed: 38875824
DOI: 10.1016/j.ijscr.2024.109849 -
Vaccine: X Aug 2024Since the first use of vaccine tell the last COVID-19 pandemic caused by spread of SARS-CoV-2 worldwide, the use of advanced biotechnological techniques has accelerated... (Review)
Review
Since the first use of vaccine tell the last COVID-19 pandemic caused by spread of SARS-CoV-2 worldwide, the use of advanced biotechnological techniques has accelerated the development of different types and methods for immunization. The last pandemic showed that the nucleic acid-based vaccine, especially mRNA, has an advantage in terms of development time; however, it showed a very critical drawback namely, the higher costs when compared to other strategies, and its inability to protect against new variants. This showed the need of more improvement to reach a better delivery and efficacy. In this review we will describe different vaccine delivery systems including, the most used viral vector, and also variable strategies for delivering of nucleic acid-based vaccines especially lipid-based nanoparticles formulation, polymersomes, electroporation and also the new powerful tools for the delivery of mRNA, which is based on the use of cell-penetrating peptides (CPPs). Additionally, we will also discuss the main challenges associated with each system. Finlay, the efficacy and safety of the vaccines depends not only on the formulations and delivery systems, but also the dosage and route of administration are also important players, therefore we will see the different routes for the vaccine administration including traditionally routes (intramuscular, Transdermal, subcutaneous), oral inhalation or via nasal mucosa, and will describe the advantages and disadvantage of each administration route.
PubMed: 38873639
DOI: 10.1016/j.jvacx.2024.100500 -
JAAD Case Reports Jul 2024
PubMed: 38873248
DOI: 10.1016/j.jdcr.2024.04.031 -
Frontiers in Oral Health 2024In a murine model (LC) designed to abolish MHC-II expression in Langerhans cells (LCs), ∼18% of oral LCs retain MHC-II, yet oral mucosal CD4 T cells numbers are...
In a murine model (LC) designed to abolish MHC-II expression in Langerhans cells (LCs), ∼18% of oral LCs retain MHC-II, yet oral mucosal CD4 T cells numbers are unaffected. In LC mice, we now show that oral intraepithelial conventional CD8αβ T cell numbers expand 30-fold. Antibody-mediated ablation of CD4 T cells in wild-type mice also resulted in CD8αβ T cell expansion in the oral mucosa. Therefore, we that MHC class II molecules uniquely expressed on Langerhans cells mediate the suppression of intraepithelial resident-memory CD8 T cell numbers via a CD4 T cell-dependent mechanism. The expanded oral CD8 T cells co-expressed CD69 and CD103 and the majority produced IL-17A [CD8 T cytotoxic (Tc)17 cells] with a minority expressing IFN-γ (Tc1 cells). These oral CD8 T cells showed broad T cell receptor Vβ gene usage indicating responsiveness to diverse oral antigens. Generally supporting Tc17 cells, transforming growth factor-β1 (TGF-β1) increased 4-fold in the oral mucosa. Surprisingly, blocking TGF-β1 signaling with the TGF-R1 kinase inhibitor, LY364947, did not reduce Tc17 or Tc1 numbers. Nonetheless, LY364947 increased γδ T cell numbers and decreased CD49a expression on Tc1 cells. Although IL-17A-expressing γδ T cells were reduced by 30%, LC mice displayed greater resistance to in early stages of oral infection. These findings suggest that modulating MHC-II expression in oral LC may be an effective strategy against fungal infections at mucosal surfaces counteracted by IL-17A-dependent mechanisms.
PubMed: 38872986
DOI: 10.3389/froh.2024.1408255 -
Oropharyngeal stenosis in patient with oral submucous fibrosis: a case report with 8-year follow-up.BMC Oral Health Jun 2024Oral submucous fibrosis (OSF) is a chronic, progressive condition affecting the oral mucosa associated with areca nut consumption. It leads to restricted tongue...
Oral submucous fibrosis (OSF) is a chronic, progressive condition affecting the oral mucosa associated with areca nut consumption. It leads to restricted tongue movement, loss of papillae, blanching and stiffening of the mucosa, difficulty in opening the mouth, and challenges in eating due to inflammation and fibrosis. This report presents a rare case of oropharyngeal stenosis secondary to OSF in a 43-year-old male with a history of chewing betel nut. A surgical procedure similar to Uvulopalatopharyngoplasty was performed to excise the submucous oropharyngeal stenosis and to reconstruct the uvula, palatoglossal arch, and palatopharyngeal arch. At 8 years postoperatively, the patient exhibited a normal mouth opening and oropharyngeal aperture.
Topics: Humans; Male; Oral Submucous Fibrosis; Adult; Areca; Constriction, Pathologic; Follow-Up Studies; Oropharynx; Uvula
PubMed: 38872152
DOI: 10.1186/s12903-024-04467-4 -
Revista Do Instituto de Medicina... 2024Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine...
Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine clinical assessments, serological screening, and HPV data for planning prevention policies. This study aimed to identify HPV and its specific types in the cervical, anal, and oral mucosa of HIV-seropositive women, associating it with viral load and lymphocyte count. Sociodemographic characteristics, health data (CD4+ and CD8+ T cell counts and viral load), and biological samples (cervical, anal, and oral) were collected from 86 HIV-positive women undergoing antiretroviral therapy. Data were classified according to the presence or absence of HPV-DNA, HPV-DNA presence at one or more anatomic sites, and level of oncogenic risk, considering low- and high-risk oncogenic HPV-DNA groups. The presence of HPV in the cervicovaginal site was 65.9%, 63.8% in anal canal, and 4.2% in oral mucosa. A viral load ≥75 HIV copies/mL was associated with the presence of HPV-DNA. There was an association between viral load and the low-risk HPV or high-risk HPV groups. We found a high prevalence of HPV infection in HIV-seropositive women, particularly in the cervical and anal mucosa, with viral load ≥75 HIV copies/mL being associated with HPV-DNA presence.
Topics: Humans; Female; Viral Load; Papillomavirus Infections; Adult; HIV Infections; DNA, Viral; Cervix Uteri; Papillomaviridae; Middle Aged; Lymphocyte Count; Mouth Mucosa; Anal Canal; Prevalence; Cross-Sectional Studies; Socioeconomic Factors; CD4 Lymphocyte Count; Risk Factors; Human Papillomavirus Viruses
PubMed: 38865574
DOI: 10.1590/S1678-9946202466036 -
Molecular Genetics & Genomic Medicine Jun 2024As a screening method, inaccuracies in noninvasive prenatal screening (NIPS) exist, which are often attributable to biological factors. One such factor is the history of... (Review)
Review
BACKGROUND
As a screening method, inaccuracies in noninvasive prenatal screening (NIPS) exist, which are often attributable to biological factors. One such factor is the history of transplantation. However, there are still limited reports on such NIPS cases.
METHODS
We report an NIPS case of a pregnant woman who had received a stem cell transplant from a male donor. To determine the karyotype in the woman's original cell, we performed chromosome microarray analysis (CMA) on her postnatal blood and oral mucosa. To comprehensively estimate the cell-free DNA (cfDNA) composition, we further performed standard NIPS procedures on the postnatal plasma. Moreover, we reviewed all published relevant NIPS case reports about pregnant women with transplantation history.
RESULTS
NIPS showed a low-risk result for common trisomies with a fetal fraction of 65.80%. CMA on maternal white blood cells showed a nonmosaic male karyotype, while the oral mucosa showed a nonmosaic female karyotype. The proportion of donor's cfDNA in postnatal plasma was 94.73% based on the Y-chromosome reads ratio. The composition of cfDNA in maternal plasma was estimated as follows: prenatally, 13.60% maternal, 65.80% donor, and 20.60% fetal/placental, whereas postnatally, 5.27% maternal and 94.73% donor.
CONCLUSIONS
This study expanded our understanding of the influence of stem cell transplantation on NIPS, allowing us to optimize NIPS management for these women.
Topics: Humans; Female; Pregnancy; Male; Adult; Cell-Free Nucleic Acids; Noninvasive Prenatal Testing; Stem Cell Transplantation; Tissue Donors; Trisomy
PubMed: 38860502
DOI: 10.1002/mgg3.2479 -
International Journal of Nanomedicine 2024Reducing the first-pass hepatic effect via intestinal lymphatic transport is an effective way to increase the oral absorption of drugs. 2-Monoacylglycerol (2-MAG) as a...
PURPOSE
Reducing the first-pass hepatic effect via intestinal lymphatic transport is an effective way to increase the oral absorption of drugs. 2-Monoacylglycerol (2-MAG) as a primary digestive product of dietary lipids triglyceride, can be assembled in chylomicrons and then transported from the intestine into the lymphatic system. Herein, we propose a biomimetic strategy and report a 2-MAG mimetic nanocarrier to target the intestinal lymphatic system via the lipid absorption pathway and improve oral bioavailability.
METHODS
The 2-MAG mimetic liposomes were designed by covalently bonding serinol (SER) on the surface of liposomes named SER-LPs to simulate the structure of 2-MAG. Dihydroartemisinin (DHA) was chosen as the model drug because of its disadvantages such as poor solubility and high first-pass effect. The endocytosis and exocytosis mechanisms were investigated in Caco-2 cells and Caco-2 cell monolayers. The capacity of intestinal lymphatic transport was evaluated by ex vivo biodistribution and in vivo pharmacokinetic experiments.
RESULTS
DHA loaded SER-LPs (SER-LPs-DHA) had a particle size of 70 nm and a desirable entrapment efficiency of 93%. SER-LPs showed sustained release for DHA in the simulated gastrointestinal environment. In vitro cell studies demonstrated that the cellular uptake of SER-LPs primarily relied on the caveolae- rather than clathrin-mediated endocytosis pathway and preferred to integrate into the chylomicron assembly process through the endoplasmic reticulum/Golgi apparatus route. After oral administration, SER-LPs efficiently promoted drug accumulation in mesenteric lymphatic nodes. The oral bioavailability of DHA from SER-LPs was 10.40-fold and 1.17-fold larger than that of free DHA and unmodified liposomes at the same dose, respectively.
CONCLUSION
SER-LPs improved oral bioavailability through efficient intestinal lymphatic transport. These findings of the current study provide a good alternative strategy for oral delivery of drugs with high first-pass hepatic metabolism.
Topics: Animals; Liposomes; Biological Availability; Caco-2 Cells; Humans; Administration, Oral; Artemisinins; Intestinal Absorption; Male; Tissue Distribution; Particle Size; Mice; Lymphatic System; Rats, Sprague-Dawley; Rats; Biomimetic Materials; Intestinal Mucosa
PubMed: 38859952
DOI: 10.2147/IJN.S462374 -
IDCases 2024Common organisms associated with community-acquired pneumonia include , , and . Pneumonia can rarely be caused by an organism such as , as in our case. This organism...
Common organisms associated with community-acquired pneumonia include , , and . Pneumonia can rarely be caused by an organism such as , as in our case. This organism belongs to the Mitis group within the and typically coexists with humans in the oral cavity. We present a case of bacteremia and community acquired pneumonia in a previously healthy 40-year-old male, for whom infective endocarditis has been ruled out, and who was successfully treated with ceftriaxone. While most reported cases of involve infective endocarditis, our case is the first identified instance of community acquired pneumonia caused by . This case highlights that pneumonia with , typically considered a commensal in the oral mucosa microbiota of humans, is possible, as seen in our case. Unlike previous cases in the literature, our patient did not have infective endocarditis, which is the common presentation of this bacterium. Instead, he solely presented with pneumonia, marking the first reported case in the literature of causing pneumonia.
PubMed: 38854926
DOI: 10.1016/j.idcr.2024.e02004 -
International Medical Case Reports... 2024Recurrent oral erythema multiforme (ROEM) is an uncommon subtype of erythema multiforme. Immunoglobulin E (IgE) is essential in acute allergy reactions and chronic...
BACKGROUND
Recurrent oral erythema multiforme (ROEM) is an uncommon subtype of erythema multiforme. Immunoglobulin E (IgE) is essential in acute allergy reactions and chronic allergic inflammatory disorders.
PURPOSE
This report aims to describe the advantages of total IgE screening for detecting mouthwash allergic reactions associated with ROEM.
CASE PRESENTATION
A 29-year-old woman came to the Oral Medicine clinic complaining of canker sores all over her mouth and swollen lips accompanied by crusts that had been bleeding easily two months prior. Complaints worsened after the patient used alcohol-containing mouthwash without a history of fever or other symptoms. Extra-oral examination showed upper and lower lip edema with hemorrhagic crusts that bleed easily. No lesions were found in other parts of the body. Intra-oral examination showed ulcers, multiple, irregular in almost the entire oral mucosa. Laboratory examination revealed non-reactive anti-HSV-1 IgG and a total IgE serum level of 612.00 IU/mL. The diagnosis based on the examination results is recurrent oral erythema multiforme.
CASE MANAGEMENT
The patient was instructed to stop using alcohol-containing mouthwash, maintain oral hygiene, a healthy lifestyle, adequate hydration, and a balanced diet. Prednisone, benzydamine HCL mouthwash, 0.025% hyaluronic acid mouthwash, multivitamins, and hydrocortisone cream were given as pharmacological therapy. The oral lesions improved in 12 days and the total IgE serum level examination showed a decrease (385 IU/mL).
CONCLUSION
The total IgE examination can be a screening tool for mouthwash allergy-related reactions to disease and represents the response of ROEM therapy as evidenced by clinical improvement.
PubMed: 38854841
DOI: 10.2147/IMCRJ.S468876