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Ilana Kaplan

Publications and source records attributed to Ilana Kaplan.

16 recordsLinked to original sources

The influence of inflammation on the polarization colors of collagen fibers in the wall of odontogenic keratocyst.

Epithelial-mesenchymal interactions have been found to play a role in the pathogenesis of odontogenic keratocyst (OKC). In the present study we investigated the effect of inflammation in the OKC wall on the polarization colors of Picrosirius red-stained collagen fibers. 50 cases of OKC were selected and separated into two groups according to the inflammatory intensity: those with mild-to-moderate inflammation (Group A), and those with intense inflammation (Group B). The polarization colors of the collagen fibers were recorded separately for thick and thin fibers. Polarization colors of the thin fibers were in the green- to yellow spectrum, without significant differences between the groups. However, polarization colors of the thick fibers significantly differ between the groups. In Group B, the frequency of thick fibers with green birefringence decreased significantly, whereas fibers with red polarization colors increased in frequency (4.6% and 44%, respectively) compared with Group A (12.3% and 23.6%, respectively). It can than be concluded that inflammation has an impact on the packing of collagen fibers in the connective tissue wall of OKC as reflected by their birefringence colors under polarized light. In the presence of dense inflammation, the percentage of thick fibers with green birefringence decreases, with an increase in thick fibers with red birefringence which appeared more packed.

Azo Compounds↗

Traumatic ulcerative granuloma with stromal eosinophilia: a reactive lesion of the oral mucosa.

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a benign lesion of the oral mucosa of an unclear pathogenesis. We analyzed the profile of the inflammatory infiltrate in 12 cases of TUGSE by using immunohistochemical analysis and polymerase chain reaction-based repertoire analysis to detect T- and B-cell receptor gene rearrangements. The inflammatory infiltrate consisted in most cases of B and T lymphocytes, macrophages, abundant eosinophils, and large atypical cells. In 5 cases, CD30+ cells were found. Spectratyping analysis displayed a polyclonal rearrangement of the T-cell receptor g gene in 6 cases and oligoclonality in 5 cases. Monoclonality was observed in 1 case that also fulfilled histologic criteria for lymphoma. Healing was uneventful in all cases, including the one suspected of being lymphoma, with no recurrences in more than 2 years'follow-up. TUGSE can be regarded reactive. Some cases, however, may harbor a dominant clonal T-cell population; in these cases, long-term follow-up is mandatory.

Adolescent↗

Oral squamous cell carcinoma around dental implants.

It is well documented that oral squamous cell carcinoma (OSCC) is related to risk factors such as smoking and alcohol consumption as well as premalignant lesions and conditions such as leukoplakia, oral lichen planus (OLP), and previous malignancy of the upper respiratory system and gastrointestinal tract. Osseointegrated dental implants are rarely reported in association with OSCC. This article presents 2 cases of OSCC adjacent to dental implants in patients at risk for oral cancer--1 was a heavy smoker with OLP; the other had a history of previous oral and colon cancer. Six additional cases of malignancy adjacent to dental implants were retrieved from the literature; the majority of cases had at least 1 recognized risk factor for oral cancer. Although such cases are rarely reported, patients at risk for oral cancer, especially those with multiple existing risk factors, that present with failing dental implants should be thoroughly evaluated to rule out the presence of malignancy disguised as peri-implant disease.

Aged, 80 and over↗

Glandular odontogenic cyst: treatment and recurrence.

PURPOSE: To investigate the correlation between clinical characteristics, radiologic features, treatment modalities, and treatment outcome of glandular odontogenic cyst, and to suggest a treatment protocol based on these results. PATIENTS AND METHODS: The study included a total of 56 cases, 49 from the literature and 7 new cases. Demographic data, locularity and radiographic extension, cortical plate integrity, treatment modalities, follow-up, and recurrence were analyzed. RESULTS: There were 34 male and 22 female patients aged 14 to 74 years (mean, 48 years). The mandible was involved in 41 cases (73.2%) and the maxilla in 15 (26.8%), predominantly in the anterior region; 53.6% of the lesions were unilocular and 46.4% multilocular. Large lesions were found in 78.5% of cases. Cortical integrity was compromised in 53.6% (cortical perforation in 39.3% and thinning or erosion of the cortical plate in 14.3%). Recurrence occurred at a rate of 29.2%, within 0.5 to 7 years (mean, 2.9 years). Mean follow-up was also 2.9 years. Two patients had 3 recurrences each. Recurrence was associated with minor surgery such as enucleation or curettage; none of the patients treated by peripheral ostectomy, marginal resection, or partial jaw resection had a recurrence. Compared with the patients without recurrence, the recurrence group had a higher frequency of multilocularity than the nonrecurrent group (64.3% vs 41.2%) and of compromised cortical integrity (71.4% vs 47.1%). CONCLUSION: Glandular odontogenic cyst is an aggressive lesion. Treatment by enucleation or curettage alone is associated with a high recurrence rate. Small unilocular lesions can be treated by enucleation. In large uni- or multilocular lesions, an initial biopsy is recommended. Surgical treatment of large lesions should include enucleation with peripheral ostectomy for unilocular cases and marginal resection or partial jaw resection in multilocular cases. Marsupialization followed by second phase surgery is an option for lesions approaching vital structures. Follow-up should continue for at least 3 years (up to 7 years in cases with features associated with increased risk).

Adolescent↗

The use of molecular markers as an aid in the diagnosis of glandular odontogenic cyst.

UNLABELLED: (1) To investigate the use of p53, Ki67, and PCNA as an aid in the diagnosis of glandular odontogenic cyst (GOC); (2) To compare the expression of these markers in GOC, low-grade mucoepidermoid carcinoma (MEPCa), and radicular cyst with mucous metaplasia (RCM) as an aid in the differential diagnosis; (3) To establish guidelines for the diagnosis of GOC. STUDY GROUP: 35 patients: 10 GOC, 15 RCM, 9 MEPCa. Immunostaining of archival specimens for p53, Ki67, PCNA. Twenty-nine articles (1987-2004) with detailed histopathological descriptions of GOC, analyzed for frequency of histopathological characteristics. Mean p53 labeling index (LI) was higher in GOC (3.0+/-4.3%) and MEPCa (4.9+/-7.4%) than in RCM (0.4+/-1.2%, p=0.048). Ki67 LI was higher in GOC (4.4+/-4.7%) and RCM (3.7+/-6.7%) than in MEPCa (0.7+/-1.6%, p=0.03). There were no significant differences in the expression of PCNA. In the literature, the most consistent histopathological characteristics of GOC included epithelial spherules/"knobs"/whorls (82.8%), cuboidal eosinophilic cells (65.5%), goblet cells (65.5%), intraepithelial glandular/microcystic ducts (58.6%), variations in lining width (55.2%), ciliated cells (51.7%) and mucous pools/mucous-lined crypts (41.4%). These histopathological features were divided into major and minor signs. The diagnosis of GOC should be based on at least the focal presence of the major signs. Measurement of p53 and Ki67 may aid in the differential diagnosis of GOC.

Adult↗

Neoplasms associated with paraneoplastic pemphigus: a review with emphasis on non-hematologic malignancy and oral mucosal manifestations.

The review included 163 cases of paraneoplastic pemphigus (PNP) reported between 1990 and 2003, including a new unique case of PNP associated with occult breast cancer and an ovarian cyst of borderline malignancy. Hematologic-related neoplasms or disorders were associated with 84% of the cases, with non-Hodgkin lymphoma (38.6%) as the most frequent, followed by chronic lymphocytic leukemia (18.4%) and Castleman's disease (18.4%). The non-hematologic neoplasms comprised 16% of all cases: epithelial origin-carcinoma (8.6%), mesenchymal origin-sarcoma (6.2%), and malignant melanoma (0.6%). Carcinoma cases comprised 58% of the non-hematologic neoplasms. Carcinoma cases (n = 14) consisted of adenocarcinoma (n = 7), squamous cell carcinoma (n = 2), multiple skin tumors probably basal cell carcinoma (n = 1), and bronchogenic carcinoma (n = 1). Of the 10 (6.2%) sarcoma cases, there was one case each of leiomyosarcoma, liposarcoma, malignant nerve sheath tumor, poorly differentiated sarcoma, reticulum cell sarcoma, dendritic cell sarcoma and inflammatory myofibroblastic tumor. The oral mucosa was involved in all of cases. Isolated oral ulcerations were the first sign in 45% of the cases. Diffuse and persistent oral ulcerations with a progressive course could be a sign of malignancy, either recognized or occult. In the absence of a clear diagnosis, malignancy should be suspected and extensive work-up performed. The full spectrum of signs of PNP may not be present initially. Repeated biopsies, direct and indirect immunofluorescence as well as screening indirect immunofluorescence on murine bladder are required for diagnosis. Clinicians should be highly suspicious when signs and symptoms suggestive of PNP are present in cancer patients, of hematologic and non-hematologic origin.

Adenocarcinoma↗

The correlation between epithelial cell proliferation and inflammation in odontogenic keratocyst.

The objective of this study was to investigate the effect of inflammation on Ki-67 and PCNA labeling indices of odontogenic keratocysts. The study included 45 cases of OKC. From each case, three 5-microm sections were cut and stained with hematoxylin and eosin and with monoclonal antibodies for PCNA and Ki-67. In 10 high power fields (HPF), the type of epithelial lining was recorded separately for each field (metaplastic squamous or classic parakeratinized). Labeling indices for Ki-67 and PCNA and the inflammatory infiltrate density in the depth of 1 HPF adjacent to the basement membrane were recorded for each HPF. Parameters were compared between fields, and for each case the average inflammatory score and average labeling indices were calculated, and cases compared. No inflammation was observed in 24.5% of cases, mild in 30.5% and moderate to severe in 45%. Foci of metaplastic non-keratinizing epithelium were observed in 64% of cases, which were twice as common in inflamed cysts (90%) than in non-inflamed cysts (44%). The average labeling indices for PCNA and Ki-67 yielded no significant differences between inflamed and non-inflamed cysts. When compared between HPF's, there was an increase in the Ki-67 labeling index in metaplastic epithelium in areas with moderate to severe inflammation score (p=0.036). PCNA labeling index did not significantly change between areas with low and high inflammation. No differences in labeling indices were observed between areas of classic and metaplastic epithelium with equal inflammation density. A focal increase in Ki-67 expression adjacent to moderate to severe inflammation was found, with no significant effect on the overall proliferation activity of the cysts.

Cell Division↗

Clear-cell variant of calcifying epithelial odontogenic tumor: clinical and radiographic characteristics.

OBJECTIVES: Clear cells have been reported in approximately 8% of cases of calcifying epithelial odontogenic tumor (CEOT). The purpose of this study was to describe the clinical and radiographic features of clear-cell CEOT (CCEOT). STUDY DESIGN: Eighteen cases of CCEOT were identified by review of the literature from 1958 to 2001, and a new one was added (total 19; 12 central, 7 peripheral). RESULTS: Fourteen tumors (74%) were located in the mandible, with the central lesions favoring the posterior area and the peripheral lesions the anterior-bicuspid area. Radiographic features were as follows: 50% radiolucent, 50% mixed radiolucent-radiopaque; 92% unilocular; 64% well-defined noncorticated borders, 27% well-defined corticated borders, 9% irregular borders. Cortical perforation was common (67%) compared with CEOT without a clear-cell component (6.7%). Recurrence was reported in 17% of the central lesions and none of the peripheral ones. CONCLUSIONS: CCEOT is a distinct variant of CEOT; its high tendency for cortical perforation may indicate a more aggressive behavior.

Adult↗

Periapical actinomycosis: a clinicopathologic study.

OBJECTIVE: We sought to evaluate the incidence and clinical outcome of an accidental finding of actinomycotic colonies in periapical lesions submitted for histologic examination. STUDY DESIGN: The study included all periapical biopsy specimens submitted for histologic examination between 1997 and 2000. Sections of paraffin-embedded tissues, 5 microm, were cut and stained by using hematoxylin and eosin, periodic acid-Schiff, and the Gram stain. The presence of typical branching colonies of filamentous bacteria staining positive for periodic acid-Schiff and Gram stain was indicative of Actinomyces. RESULTS: Typical actinomycotic colonies were identified in 17 of 963 (1.8%) periapical biopsy specimens. The mean patient age was 42, and males were predominant (65%). The maxilla was the most frequently involved site (65%), with equal distribution in the anterior and posterior areas. Radiographically, most cases presented as well-demarcated radiolucent lesions. Malignancy was suspected in 3 cases. Of the periapical lesions, 15 were epithelialized, and in 4 cases, a true epithelial-lined lumen was found, which was diagnosed as a radicular cyst. A residual cyst was diagnosed in 1 case, and in 1 case, an epithelial lining was not identified. Treatment included surgical curettage and a short course of antibiotic therapy. Healing was uneventful in all cases. CONCLUSIONS: Periapical actinomycosis is not common. Its outcome is favorable after surgical curettage supplemented by short-term antibiotic treatment. The relationship of periapical actinomycosis with the more serious cervicofacial actinomycosis should be evaluated.

Actinomyces↗

Oral cancer cells differ from normal oral epithelial cells in tissue like organization and in response to lycopene treatment: an organotypic cell culture study.

We established distinctive monolayer and organotypic cell culture techniques to assess possible differences in cross-talk and spatial and structural organization of oral cancer cells compared with normal oral cells and also to evaluate possible differential responses of the cells to carotenoids. In monolayers, we investigated the effect of lycopene on the proliferation of an established oral cancer cell line, KB-1, and compared it with a primary cell line obtained from normal oral mucosa. Lycopene exerted a significant inhibitory effect on KB-1 cell proliferation inducing a dose-dependent downregulation of proliferating cell nuclear antigen (PCNA) associated with upregulation of connexin-43 (Cx-43) expression, whereas in the normal oral mucosal cells lycopene did not affect either PCNA expression, which was very low, or the expression of Cx-43, which was basically very high. Lycopene significantly inhibited the formation of colonies induced by the carcinogen 3-methylcholanthrene (MCA) on normal oral cells and almost completely abrogated the hyperplastic effect induced by MCA. KB-1 cells and normal oral epithelial cells in the organotypic cell culture method differed in their stratification and intercellular adhesion patterns as well as in the expression profile of cytokeratins, vimentin, and Cx-43. Lycopene induced Cx-43 expression in KB-1 cells grown by the organotypic raft method, similar to KB-1 cells grown as monolayers. We conclude that lycopene is a promising chemopreventive, pro-differentiating, and anticarcinogenic agent. No adverse effects of lycopene were detected in normal cells cultured in either monolayer or organotypic systems.

Anticarcinogenic Agents↗

Peripheral giant cell granuloma associated with dental implants.

BACKGROUND: Peripheral giant cell granuloma (PGCG) is a well-circumscribed lesion confined to the alveolar and gingival mucosa. PGCG is considered a reactive lesion caused by local irritation or trauma. The objectives of the present study were to evaluate the incidence of PGCG in peri-implant lesions submitted for histologic examination, to establish its correlation with implant failure, and to discuss its pathogenesis. METHODS: The study was conducted on 25 periimplant biopsy specimens submitted for histological examination between 1999 and 2001. Sections (5 microm) of paraffin embedded tissues were cut and stained with hematoxylin and eosin. RESULTS: From the 25 specimens, three (two males and one female, ranging in age from 31 to 69 years) were identified as peripheral giant cell granuloma. The posterior mandible was affected in two cases and the anterior maxilla in one. The clinical appearance was an exophytic mass with a bleeding surface. The time interval between implantation and lesion development was from several months to 6 years. Recurrence following curettage was found in all cases. The implants were stable; however, two were removed either because of bone loss around the implant or because of several recurrences. In all cases healing was uneventful. CONCLUSIONS: Peripheral giant cell granuloma can develop in association with dental implants. Clinically, the lesions are similar to the classical PGCG. In the present study, the precise incidence could not be concluded because of the small number of selected cases. Due to the aggressive nature of the lesion and the high recurrence rate, implants can fail unless the lesion is detected early and proper surgical removal is performed. Tissue removed from the peri-implant area should always be submitted for histologic examination for accurate diagnosis.

Adult↗

Plasma and buccal mucosal cell response to short-term supplementation with all trans-beta-carotene and lycopene in human volunteers.

Despite interest in the health-beneficial role of carotenoids little is known about the specific storage metabolism and mechanisms involved in various target tissues. The aim of the study was to search for a relatively simple non-invasive method to detect and determine the cellular effects of supplemented dosage of beta-carotene and lycopene to peripheral tissues such as the buccal mucosa in relation to the plasma concentrations. Subjects (30) were allocated into five different subgroups of 6 volunteers. The change in concentration of all-trans-beta-carotene and lycopene in plasma and in buccal mucosal cells was measured in groups of volunteers supplemented with either 15 mg, 30 mg or placebo capsules in a randomised double blind study for a period of 7 days. With the exception of supervised high fat (40 g carotenoid free sunflower oil) breakfasts and capsule ingestion the volunteers ate their habitual diets. Plasma lycopene and beta-carotene concentrations were determined at baseline and following one week of capsule ingestion. In all the supplemented groups the plasma carotenoid levels were significantly higher than in the placebo group indicating absorption of the supplement. Carotenoid concentrations, expressed per unit protein, assayed in buccal mucosal cells before (at baseline) and at the end of the study were found to be significantly higher in the groups supplemented at 30 mg/d, of either carotenoid as compared to the 15 mg/d or placebo supplemented groups. We conclude that buccal mucosal cells respond readily to changes in plasma beta-carotene and lycopene concentration. These observations suggest that dietary carotenoids are quickly incorporated into rapidly turning over mucosal tissues. It is not clear if the change in carotenoid content of the plasma is reflected in existing cells or only in those concurrently produced during the elevated plasma concentration. If desquamated buccal mucosal cells reflect habitual plasma carotenoid concentration then it is not an appropriate tissue for the measurement of acute changes.

Analysis of Variance↗

Carcinoma cuniculatum of the jaw: a rare variant of oral carcinoma.

Carcinoma cuniculatum is a rare variant of carcinoma usually involving the foot. Only 13 cases have been described in the oral cavity, none of which was in the English-language literature. We describe a 56-year-old man who presented with a soft exophytic mass in the maxillary gingiva, alveolar bone destruction, and loosening of the teeth. Histopathologic study revealed thin papillary projections covered by a thick keratin layer in the superficial areas and multiple, branching keratin-filled crypts surrounded by well-differentiated squamous epithelium with only mild cytologic atypia but frequent mitosis. Immunohistochemistry results of p53 and polymerase chain reaction analyses for human papillomavirus 6, 11, 16, and 18 DNA were negative. The diagnosis was carcinoma cuniculatum of the jaw. The literature on this unusual oral pathosis is reviewed and the diagnostic challenge described. We suggest that carcinoma cuniculatum may sometimes be misdiagnosed as squamous cell carcinoma or verrucous carcinoma and, therefore, might be more prevalent than the small number of published cases implies.

Carcinoma, Verrucous↗

Lateral neck mass.

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Adenolymphoma↗

Lycopene inhibits proliferation and enhances gap-junction communication of KB-1 human oral tumor cells.

Cell-cell interaction via gap junctions is considered to be a key factor in tissue homeostasis, and its alteration is associated with the neoplastic phenotype. Experimental and epidemiologic data suggest that carotenoids, particularly lycopene and beta-carotene, can reduce the risk of certain cancers. The aim of this study was to assess whether lycopene and beta-carotene interfere at some stage with the carcinogenic processes in human cancer cells derived from the oral cavity. KB-1 cells, originating from a human oral cavity tumor, were incubated with different concentrations of lycopene or beta-carotene delivered via the cell culture media from stock solutions in tetrahydrofuran. Lycopene strongly and dose dependently inhibited proliferation of KB-1 human oral tumor cells. beta-Carotene was a far less effective growth inhibitor. Lycopene (3 and 7 micro mol/L) significantly upregulated both the transcription (P < 0.005) and the expression (P < 0.05) of connexin 43, a key protein in the formation of gap-junctional communication. beta-Carotene (3 micro mol/L) tended to upregulate connexin 43 expression (P = 0.07) and significantly affected transcription of connexin 43 at 7 micro mol/L (P < 0.05). Gap-junctional communication measured by scrape-loading dye transfer and electron microscopy showed that lycopene enhanced gap-junctional communication between the cancer cells, whereas beta-carotene was less effective in this regard. The pattern of cellular uptake and incorporation into cancer KB-1 cells differed significantly between the carotenoids. beta-Carotene was avidly and rapidly incorporated into KB-1 cells, whereas lycopene uptake into the cells took place after longer incubation periods and only at the highest concentrations. The results of the present study further support the hypothesis that carotenoids in general, and lycopene in particular, may be effective anticarcinogenic agents in oral carcinogenesis.

Base Sequence↗