The researchers suggest that diabetes increases the degradation of the newly synthesized collagen from the conjunctive tissue. The altered metabolism of the collagen may predispose the diabetic patients not only to periodontal disease, but also to some other anomalies such as defective healing. The purpose of the study was to go through a histological analysis of the collagen fibers from the chorion in patients with diabetes mellitus and periodontal disease.
Materials and Methods: In our study we examined a total of 68 patients diagnosed with diabetes mellitus type 1 and 2. In these patients we achieved simple gingivectomy or tooth extraction in order to obtain gingival tissue fragments. The preparations included at paraffin and then stained with Hematoxylin-Eosin and trichromic after Goldner-Szeckeli method.
Results: In the patients with diabetes mellitus with an evolution of less than 10 years the collagen fibers appeared as dissociated by the inflammatory cells that were inserted among them. It was also noted the fragmentation of collagen fibers and sometimes even their lysis with subepithelial connective tissue disorganization. In patients with diabetes for over 10 years there has been noticed a plentiful collagen sclerosis, zones of collagen hyalinization with an increased number of fibrocytes.
Conclusion: The extracellular matrix is altered in the investigated patients with destructive lesions of collagen or collagen sclerosis.

Human milk is a dynamic physiological fluid. The short term and long term benefits of breast feeding are already very well established. Apart from the nutritional components, the human milk contains many growth factors & different kinds of live cells. Present study is an observational study of the cytological evaluation of the 100 samples of human milk collected in the first post partum week of Indian women. The interesting observation of the present study is the rising counts of the immune cells in the human milk which peak on day 5. This finding probably correlates with the greater immunological needs of the neonate in the first week. These cells help the neonate in providing cell mediated immune responses and protection against respiratory and gut infections. They also help in the process of the neonatal gut maturation. The counts of the epithelial cells in the human milk are observed to be steady throughout the, first post partum week. The mesenchymal stem cells observed in the human milk could be myoepithelial in origin. The higher levels of the growth factors like hepotocyte growth factor and vascular endothelial growth factor in the human milk when compared with the umbilical cord or the maternal serum could be attributed to the paracrine secretions by the stem cells. The observations of the present study are correlating with the physiological needs of the neonate in the most important period of the first week after the birth. The study further strengthens the concept of exclusive breast feeding.

The ultrastructural difference of the alimentary tract of the insectivore, Scincus scincus and the carnivore, Natrix tesstellata was described by using scanning and transmission electron microscopy. The oesophagus of S. scincus with many prominent longitudinal folds while in N. tessellata it has many primary longitudinal folds and secondary ramification. The oesophageal epithelium of both species has numerous goblet cells. The mucosal epithelial cells in both species contain large nucleus, endoplasmic reticulum, lysosomes and some vacuoles. Stomach had a meshwork of primary folds in S. scincus and it forms various folds forming many discrete, irregular pockets in N. tessellata. The mucosal cells in the stomach of S. scincus have many secretory granules while in N. tessellate it provided with numerous mucinogen granules in the gastric columnar cells. In S. scincus, the intestinal mucosa with many primary folds but it appeared as longitudinal secondary mucosal folds in Zig-Zag pattern enclosing a number of concavities in N. tessellata. The intestinal mucosal cells in both species consisted of regularly formed microvilli. There were numerous goblet cells in the intestine of both species. In conclusion, structural variation of the alimentary tract in the two species examined was related to difference in feeding habits.

The histochemical analysis of the salivary glands of Rhipicephalus sanguineus females (Latreille, 1806) (Acari, Ixodidae) fed for 2, 4 and 6 days (test group= TG) on hosts (New Zealand White rabbits) previously immunized with glandular extract of salivary glands obtained from females fed for 6 days (SGE6) was carried out in order to detect alterations in the secretion of glycoproteins, lipoproteins, acid phosphatase and calcium. It was here verified that the composition of the secretion produced by the glands of females from TG (2-6 days) was different from the one observed in those from control group (CG), with a gradual reduction in the synthesis of the components as feeding progressed, except for the proteins and calcium, which remained unaltered within the interval of 4 to 6 days and 2 to 4 days respectively. In the glands of females fed for 2 days (TG) there was increase in calcium staining, as well as a reduction in lipids and acid phosphatase, and staining for proteins and polysaccharides remained unaltered. In the females fed for 4 days (TG) there was a reduction in the intensity of staining of components, presenting an increase only for polysaccharides and calcium remained unaltered. In the glands of females fed for 6 days (TG) there was a reduction in the synthesis of the components, with an increase in proteins and calcium. Contrary to expected, it was verified that the alterations were more significant in the glands of females fed for 2 days than in the ones fed for 6 days, once the hosts were inoculated with antigens of the glandular tissue obtained from females fed for 6 days. In addition, it was verified that during the secretory cycle of glands from TG (2-6 days) a, c2, c5, d and f cells were the ones which presented the most histochemical alterations.

We describe in schizophrenia the alterations of classical neurotransmitters and neuropeptides in the mesolimbic system, the hippocampus and the prefrontal cortex. The susceptibility genes, which encode dopamine hyperactivity and glutamate and GABA hyperactivity, are described. Using a neural network in the mesolimbic system, the coherence between the risk genes and the cellular mechanisms is derived. The therapeutic and adverse effects of the commonly prescribed second-generation antipsychotic drugs are pointed out. We suggest examining the risk genes in a large cohort of schizophrenic patients in order to have a tool to choose the appropriate antipsychotic drug. We recommend psychoeducation in the therapy of schizophrenic patients so that they can better deal with the schizophrenic symptoms and the adverse effects.

Aim: To test for human papillomavirus (HPV) DNA in material obtained from p16INK4a (p16) immunohistochemistry (IHC) stained slides of formalin-fixed paraffin-embedded (FFPE) tumor biopsies.
Background: HPV is a favorable prognostic factor in oropharyngeal squamous cell carcinoma (OSCC), where tonsillar and base of tongue squamous cell carcinoma (TSCC and BOTSCC) dominate. Hence. HPV DNA testing as a predictive marker is desirable even when FFPE material is unavailable. Glass slides with p16 staining, often used as a surrogate marker for HPV, are however generally available. Furthermore, the combination of HPV DNA and p16 positivity is established as being better than testing for HPV DNA, or p16 alone, and almost equivalent as testing for E6 and E7 mRNA for determining HPV driven OSCC. Presence of HPV DNA was therefore examined in cells from glass slides previously stained for p16.
Materials and methods: DNA extracted from cells scraped off glass slides from 23 TSCC; 24 BOTSCC and 50 cancers of unknown primary (CUP) of the head and neck, with known HPV DNA and p16 status was tested for presence of HPV by a bead-based multiplex assay.
Results: DNA was obtained from 95.9% of the TSCC/BOTSCC/CUP slides and exhibited 93.5% (87/93) concordance with the HPV DNA status of the original FFPEs, with 38/42 (90.5%) of the originally HPV DNA positive/p16 positive remaining HPV DNA positive and all HPV DNA negative samples staying negative.
Conclusion: A 93.5% concordance was obtained between the HPV DNA status of the original FFPEs and DNA obtained from p16 stained glass slides. Of the HPV DNA positive IHC samples 38/38 100% were derived from HPV DNA positive/p16 positive FFPE biopsies, while all HPV DNA negative samples stayed HPV-negative. This approach allows for safer identification of HPV-positive tumors, and useful for following patients with HPV-positive tumors in retrospective studies and for future decision-making.

Background: Chronic myelogenous leukemia (CML) is a clonally myelopoliferative disorder of the hematopoietic stem cell. Arginase activity is high during the mitotic cycle. In addition, TGF-β1 is one of cytokines that responsible for immune cell dysfunction in patients with cancer.
Methods: Blood samples from six diagnosed CML cases studied and compared with control subjects. The first three CML cases were in accelerated –phase (AP)-CML which, resistant to chemotherapy. The other three cases responded for the treatment. Cytokinesis Blocked Micronucleus (CBMN) assay, arginase and TGF-β1 levels were estimated for each CML and control groups.
Results and Conclusion: The treatment resistant group is characterized by low incidences of binucleated and necrotic cells and low micronuclei expressions. Whereas, high frequencies of nucleoplasmic bridges (NPBs) were scored (anaphase nucleoplasmic bridges). Increased levels of arginase and TGF-β1 were recorded in the treatment resistant group when compared with control and treated groups. The resistant cases characterized by low incidences of binucleated cells and micronuclei and high count of NPBs explained by the high rate of mitotic division. Whereas, the levels of arginase and TGF- β1 were increased in the resistant cases in comparison with those of treatment responded and control groups. Cytokinesis Blocked Micronucleus assay designed as diagnostic tool for differentiation between responding or resistance chemotherapy in CML cases. Arginase, TGF-β1 levels recorded highly significant rules for the same object.

Small intestinal metastasis from head and neck tumors is very rare. We herein report the case of a 71-yearold male with severe duodenal stricture due to duodenal metastasis from head and neck cancer whose duodenal stricture was conservatively relieved by endoscopic stenting. The patient had been treated with total laryngectomy and postoperative radiotherapy 13 months before visiting our department with complaints of a loss of appetite and vomiting. Esophagogastroscopy revealed a large submucosal tumor with severe obstruction in the duodenum. The histological findings of biopsy specimens showed moderately differentiated squamous cell carcinoma. He was thus diagnosed to have duodenal metastasis from the original supraglottic larynx cancer. Because his general condition was not sufficient to allow additional chemo-radiotherapy or surgery to be performed, conservative endoscopic stenting was employed to relieve the obstructive symptoms. After the stenting, the symptoms all immediately disappeared. When patients with head and neck tumors present with gastrointestinal bleeding and/or symptoms such as intestinal obstruction, endoscopic stenting appears to be useful for the palliative relief of such symptoms.

Background: Interleukin 23 (IL-23) and interleukin 23 receptor (IL-23R) play a role in the pathogenesis of multiple autoimmune processes and renal inflammation, but research has yet to clarify the histological association of IL-23/IL-23R and transplant kidney allografts.
Methods: Between July 2009 and August 2011, 31 renal transplant recipients who received sonography-guided kidney allograft biopsy were enrolled in this retrospective study. The patients were divided into two groups including group A (patients reaching composite outcome) and group B (patients not reaching composite outcome). The composite outcome was defined as serum creatinine (Scr) doubling and lower estimated glomerular filtration rate (eGFR). Specimens of 31 patients were examined by the immunohistochemical stain of IL-23 and IL-23R in allograft kidneys, and clinico-pathological associations were evaluated.
Results: Of the 31 patients, group A had 15 patients (48.3%) and group B had 16 patients (52.7%). Group A had significantly higher SCr, lower eGFR, and low serum albumin (p=0.024). Univariate analysis showed that group A was negatively associated with atrophic glomerular mesangial cell cytoplasmic IL-23R expression (p=0.044). The decreased expression of IL-23R could be due to higher acute antibody-mediated rejection with heavy proteinuria in our study. In other words, the more the glomerular damage due to antibody-mediated rejection, the less the expression of IL-23R in atrophic glomerular mesangial cell cytoplasma.
Conclusions: The patients with composite outcome may have decreased expression of IL-23R in atrophic glomerular mesangial cell cytoplasm.

Background: CT-guided core biopsy and fine needle aspiration have been used for diagnosis of peripheral lung lesions, and both methods have advantages and disadvantages. In our institution, CT-guided core needle biopsy with onsite cytology adequacy evaluation of touch preparations is the standard method for evaluation of peripheral lung lesions.
Methods: The study was approved by Institutional Review Board. We retrospectively reviewed the cytology reports of all lung core needle biopsies during 2009-2012. The clinical information was collected from chart review.
Results: There were total 215 cases during the study period. The average lesion size (in 190 available cases) was 3.46 cm. The average passes were 3.3/lesion. The final diagnoses included 132 malignancies, 70 benign and 13 atypical. Twenty-four cases had follow-up resections. There were two false negative diagnoses due to sample errors and there was no false positive case with a positive predictive value of 100%. The final adequate rate was 99.5% (214/215), and only one case was unsatisfactory. In the 204 patients with available information of post-procedure chest X-ray, 140 (68.6%) had no pneumothorax, and 64 (31.4%) had pneumothorax including 48 mild (23.5%), 3 moderate (1.5%), 2 severe (1%), 3 tension pneumothorax (1.5%), and 8 with chest tubes placed during procedure (3.9%).
Conclusions: Our study showed that CT-guided core biopsy with onsite cytology evaluation has high adequate and low atypical rates. Lung core biopsy can provide more accurate tumor classification and specific diagnoses for non-neoplastic lesions. Adequate tissue is often available for molecular study. The complication rate of pneumothorax in core needle biopsy is compatible to that of fine needle aspiration.

Background: This study was designed to describe different oral mucosal changes present in HIV/AIDS patients taking antiretroviral therapy (ART) in Pakistan and to compare these changes with CD4+ lymphocyte count and plasma viral load.
Methods: Oral smears, from n=35 patients taking antiretroviral therapy, were prepared and examined microscopically using routine and special stains. CD4+ lymphocyte count was determined using flow cytometry. Latest plasma viral load levels were recorded from the patient`s updated laboratory record and patients were clinically examined and staged according to WHO clinical staging system.
Results: Oral lesions were present in 63% of the patients with oral pigmentation in 45.7%, chronic periodontitis in 20%, linear gingival erythema in 2.9%, pseudomembranous candidiasis, oral ulcers and xerostomia each in 5.7% cases while mucositis, oral hairy leukoplakia and oral wart each in 2.9% cases. On cytological examination, fungi were detected in 48.5% smears. Inflammation was seen in 65.7% smears, micronuclei in 51.4%, nuclear atypia in 37.1% and dysplastic changes in 17.1% (grade 1 in 83.3% and grade 2 in 17%) smears. Most of the oral mucosal changes were seen with low CD4+ lymphocyte count but no association was seen with high viral load.
Conclusions: This study describes different oral mucosal changes present in HIV/AIDS patients taking antiretroviral therapy (ART) in Pakistan and highlights their importance as a marker of immunosuppression and disease progression as these changes have strong association with low CD4+ lymphocyte count.

A history of recent frequency in cough and sputum was presented in a 73-year-old male. A neck CT scan revealed a heterogeneously enhanced and poorly-demarcated mass, measuring approximately 35 × 35 mm, arising from the right cricoid cartilage and projecting into the airway. The inadequate cytologic specimen contained few individual cells or small clusters of tumor cells having pleomorphic and sometimes spindle- or multi-nuclei, and abundant clear or vacuolated cytoplasm, along with an amount of metachromatic chondroid stroma. We first interpreted it merely as carcinoma. A total laryngectomy was performed, and gross examination showed a multilobulated and firm mass with a grayish to whitish, fleshy and glistening appearance, involving the cricoid cartilage and cricothyroid muscle. However, the overlying surface tracheal mucosa was smooth. Microscopically, the tumor was predominantly composed of a solid proliferation of atypical chondrocyte-like cells having hyperchromatic bi- or multi-nuclei in a lobular fashion, embedded in an abundant chondroid matrix, associated with cellular spindled cell foci. Therefore, we finally made a diagnosis of grade 2 chondrosarcoma with spindle cell components. We should be aware that owing to its characteristic features, cytopathologists might be able to determine correct diagnosis, based on multiple and adequate cytology samplings.

Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic condition that results from an allergic immune response to Aspergillus fumigatus, most often occurring in a patient with bronchial asthma or cystic fibrosis. ABPA is diagnosed by constellation of clinical, laboratory, and radiographic criteria. In the absence of typical presentation, ABPA can be misdiagnosed. Our patient presented with a 3 cm right lower lobe lung mass and sub-centimeter right upper lobe lung nodules. The clinical features led to a presumptive diagnosis of lung carcinoma. The patient underwent preoperative bronchial washing and endobronchial biopsy. The washing sample showed large amount of thick mucus containing abundant eosinophils, Charcoat-Leyden crystals, and degenerated cellular debris consistent with “allergic mucin”. These findings were initially overlooked and considered non-specific. Repeat sampling (needle biopsy) showed marked reactive pneumocyte hyperplasia in the background of inflammation, which was misdiagnosed as adenocarcinoma with lepidic growth pattern. The correct diagnosis was made only after the surgical resection of the lesion. Diagnosis of ABPA can be missed due to general unfamiliarity with this entity and its clinical presentation similar to the lung tumor. Accurate diagnosis can be derived from the bronchial washing if the features of “allergic mucin” are recognized and confirmed with microbiological examination.

Objective: The aim of our work was to identify by Western Blot technique (WB) the oncoproteins generated by E6 and E7 genes of high risk Human Papillomavirus (HR-HPV), resulting from integration of viral genomes into cervical cell DNA and their interactions with tumor suppressor human proteins p53 and pRb in premalignant or malignant cervical lesions.
Methods: The study was performed on 2,500 women from Caserta Local Health Authority who underwent cervical cytology from June 2010 to September 2011. Informed consent of participants was obtained. The cell samples taken by brushing were stored in liquid based cytology (LBC) and in physiological solution for WB analysis. Cytology diagnoses was based on 2001 Bethesda classification. Proteomic research was performed according to size after extraction and SDS (Sodium Dodecyl Sulfate) electrophoresis. Proteins of interest were detected by primary monoclonal antibodies and WB analysis.
Results: Cytology results of 2,500 women were positive for abnormalities of epithelial cells in 3.1%. Atypical squamous cells of undetermined significance (ASC-US) were 1.3%, Low Squamous Intraepithelial Lesion (L-SIL) 1.7% and High Squamous Intraepithelial Lesion (H-SIL) or worse 0.2%. The integration of E6 and E7 genes with their oncoproteins expression were found in 3.1% of ASC-US and in all cases of SIL or worse. On the other hand positive interactions of E6/p53 proteins and E7/pRb were found in 4.8% of L-SIL, in 75.0% of H-SIL or worse and in no ASC-US.
Conclusions: Results show that the integration of viral genomes (E6 and E7) is present in all H-SIL or worse and in several L-SIL, but only the most advanced lesions, histologically confirmed, have shown the E6/p53 interaction and E7/pRb. Our protocol allows a selection of women with advanced lesions toward cancer to obtain appropriate management.