نوشین افشار مقدم

Squamous cell carcinoma is the most common type of oral cancer that shows certain tissue changes. Laminin-5γ2 is a protein that plays a central role in migration of the neoplastic cells during tumor invasion. Expression of this protein in cells and stroma adjacent to tumor can confirm the cellular invasion. The aim of this study was to evaluate stroma in verrucous carcinoma and squamous cell carcinoma of the mouth using two markers α SMA and laminin 5 gamma 2.

In this retrospective descriptive-analytical study, 60 samples were selected with the diagnosis of squamous cell carcinoma and verrucous oral carcinoma. Then, two markers of α SMA and laminin 5 gamma 2 were examined in epithelium and mesenchymal stroma by immunohistochemistry. The vasculature was used as a positive immunoreactivity control for alpha-smooth muscle and the normal mucosa was used to control the positive immunoreactivity of laminin 5 gamma 2. The results were analyzed using Chi-square and Spearman correlation tests (α = 0.05).

Out of 31 SCC samples, 80.6% showed laminin 5 gamma 2 and 90.3% showed alpha smooth and out of 9 samples of varocus carcinoma, 66.7% showed laminin 5 gamma 2 and 77.8% showed alpha smooth actin. The higher the positive percentage of laminin, the higher the percentage of positive α SMA.

Expression of alpha smooth muscle actin and lamminin 5 gamma 2 was significantly higher in oral squamous cell carcinoma and there exists a correlation between expression of alpha smooth muscle actin and the increase in myofibroblasts takes place during the carcinogenesis process.

Oral cancers are the eighth most common cancers in males and the 15th in females. Squamous cell carcinoma comprises approximately 94% of oral malignancies. Oral cancer develops and progresses during two important biological stages. The aim of the present study was to determine the expression of E-cadherin protein in different stages of oral mucosa SCC after evaluation of the role of this protein in the tumorigenesis of oral mucosa squamous cells. In the present retrospective, descriptive- analytical study, 20 paraffin blocks fixed with formalin, consisting of 10 samples with a diagnosis of well-differentiated oral squamous cell carcinoma (OSCC) and 10 samples with a diagnosis of poorly differentiated OSCC, were selected and stained with immunohistochemistry technique, irrespective of the patient age and gender. In addition, 5 samples of normal oral mucosa were selected as controls. Then the stained samples were evaluated by two pathologists. Data were analyzed with Chi-squared, McNemar and Fisher’s exact tests using SPSS 20 (α = 0.05). The expression of E-cadherin marker exhibited a significant decrease with a decrease in histological differentiation of OSCC at different differentiation levels in terms of location, staining and presence and absence of staining homogeneity of the marker. In addition, the staining of the marker exhibited significant differences between poorly and well-differentiated cells. The results of the present study showed that the expression of E-cadherin protein decreased with poor histological differentiation of squamous cells.

Due to high mortality rate and prevalence of cancer, early detection is vital and important. Precancerous oral lesions have the potential to lead to SCC and therefore they should be carefully assessed. Brush cytology is a simple method, which obtains a sample from the epithelium. Computer analyses have an important role in interpretation of pathologic samples. An engineering team designed the software with neural networks, and the algorithm was trained with samples obtained from patients. In the second stage, brush cytology samples were collected from 20 patients with cancer and 20 healthy individuals. From each slide 50 digital images was captured with a camera under a microscope. The images were separately entered into the software program. The results were recorded as healthy and unhealthy. Statistical analyses were performed using Excel program. The software had 91 errors in a total of 2000 digital images. Comparison of the results provided by the software program and those of the scalpel biopsy of the patients with Fisher's exact test did not reveal any significant differences (p value = 0.004). Based on the results of this study, the designed software exhibited high specificity and sensitivity.

Oral Squamous Cell Carcinoma (OSCC) is one of the most prevalent cancers of oral cavity worldwide. The main components consisting basal lamina are collagen type IV and adhesive glycoprotein lamina. Local loss of basement membrane leads to formation of laminin-5, gamma-2 (laminin–5γ2) through proteolysis of basement membrane or synthesis in cytoplasm of neoplastic cells. Laminin–5γ2 is a protein that plays a central role in migration of the neoplastic cells during tumor invasion. Expression of this protein in cells and stroma adjacent to tumor can confirm the cellular invasion. The aim of this study was to evaluate expression of laminin–5γ2 in OSCC, verrucous carcinoma (VC), and dysplastic mucosa (DM), compared to normal mucosa (NM).
57, 31, 9,9, and 8 paraffin blocks of squamous cell, OSCC, VC, DM, and NM (as control group) were scored as laminin-5γ2 markers, respectively. The 10 and 40-fold magnifications were used to determine the percentage of colored cells. [Zamen1] All the data were statistically analyzed by Chi-square and Mann-Whitney tests using SPSS version 20.
the findings demonstrated that expression of laminin marker was positive in the epithelium of 61.3, 33.3, and 22.2% of the SCC, VC, and DM samples, respectively. On the other hand, it was negative in 100% of the NM samples. The distribution frequency of negative and positive laminin samples was assessed based on the type of lesions. The significance level was considered as 0.006, which is less than 0.05. There was a significant difference concerning the number of laminin positive lesions between the types of oral malignancies and normal mucosa. The SCC lesions revealed the highest positive results.
According to the results of this study, laminin–5γ2 expression in the basement membrane, extracellular matrix, and epithelium of malignant tumor tissue might indicate the invasive and metastatic behavior of the OSCC

For replacement of the lost tissue due to trauma and burns, several methods were used; tissue expander in one of them, but few studies has been done about it. This study aimed to compare vascular density in the expanded tissue versus normal tissue in patients with missing tissue.
In a clinical trial study in 2015-2016, 25 candidates for tissue expander were enrolled. Subcutaneous tissue expander was placed and after completion of treatment, at the time getting expanders out of the body, 5 samples were given from expanded capsule, subcutaneous of expanded tissue, subcutaneous of not-expanded tissue, expanded skin, and not-expanded skin. Vascular density of the samples were determined by a pathologist and were compared with healthy tissue of adjacent area.
Findings: The mean vascular density in expanded capsule, subcutaneous of expanded tissue, and subcutaneous of not-expanded tissue were 8.96 ± 4.73, 7.36 ± 3.29, and 5.08 ± 2.40 per mm2, respectively; vascular density of subcutaneous of expanded and not-expanded tissue was statistically different (P Using expanded tissue for destroyed tissue replacement is an efficient method in patients who need it; developing tissue with this method leads to development of vascularity in expanded tissue.

This study aimed to determine the diagnostic values of frozen section compared with permanent pathology results for detection of characteristic of head and neck tumors.
In a cross-sectional study, 88 patients suffered from head and neck tumors and operated during 2010-2015 in Alzahra hospital, Isfahan, Iran, were enrolled. The results of frozen section and permanent pathology were extracted from hospital records and sensitivity, specificity, false negative, false positive, and negative and positive predictive values were calculated for frozen section.
Findings: Sensitivity, specificity, false negative, false positive, positive predictive value, and negative predictive value were as 89.8%, 94.4%, 5.6%, 10.2%, 95.7%, and 87.2%, respectively; and the accuracy of frozen section was 91.8%.
Frozen section test during surgeries is a good and valuable method for detection of characteristic of head and neck tumors. But, enough pathologist experience and precision of sampling by surgeon can lead to increase the accuracy rate of frozen section which finally leads to decrease of reoperation and relapse of disease, and better prognosis.

Salivary gland lesions comprise a wide group of lesions, including infectious and obstructive lesions and salivary gland tumors. Fine needle aspiration (FNA) is used primarily to identify these lesions; application of this method results in identification of cytologic features of the majority of salivary gland neoplasms and infectious lesions. The present study was undertaken to determine the accuracy of fine needle aspiration cytology in the diagnosis of parotid salivary gland lesions.
In the present descriptive/cross-sectional study, 170 parotid salivary gland specimen were included, which had been examined by FNA initially and then treated by surgical techniques and histopathologically evaluated. The results of both sampling techniques were compared and analyzed with SPSS 22. Chi-squared test, t-test, and sensitivity and specificity statistical tests were used for statistical analyses (α = 0.05).
Based on the results of chi-squared test and t-test,agreement rate between FNA and biopsy results was 87.64%, with sensitivity and specificity of FNA being 97% and 81.37%, respectively. False positive and false negative rates of FNA were 18.62% and 2.94%, respectively.
FNA can be applied primarily as an adjunctive technique for patient evaluation; subsequent steps should be taken based on the patient’s condition and the physician’s judgment.

Intraoperative consultation by frozen section method has an important role in decision making about the type and extent of surgery in almost all types of tissues and organs. This study was done to determine the diagnostic value of frozen section compared to permanent pathology in breast and ovarian masses.
In a cross sectional investigation, 153 breast and ovarian specimens were studied. The specimens had been submitted for frozen section to pathology lab of Alzahra Hospital, Isfahan, Iran during 2009-2014. Frozen section reports were compared with permanent pathology results as the gold standard method for accurate diagnosis.
Findings: There was an agreement of 96.7% between frozen section and permanent pathology. Sensitivity, specificity, false positive, false negative, positive predictive value, negative predictive value and accuracy of frozen section were 96.6%, 96.8%, 3.4%, 3.2%, 95.0%, 97.8% and 96.7%, respectively.
The results show high accuracy of frozen section for intraoperative diagnosis of breast and ovarian masses. Intraoperative consultation by frozen section can be used as a standard and valuable method to determine the type and extent of surgery in breast and ovarian masses.

Atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), low-grade and high-grade squamous intraepithelial lesion (LSIL and HSIL) are among epithelial cell abnormalities reported on Pap smear test. This study aimed to determine the frequency of ASC-US, ASC-H, LSIL and HSIL on Pap smear reports in the main educational hospital of Isfahan city, Iran. In this cross-sectional study, reports of ASC-US, ASC-H, LSIL, and HSIL on Pap smear test during 2008 to 2014 were extracted from the pathology archive of Alzahra Hospital. Demographic data of the patients were also extracted from the same archive. Data were analyzed using SPSS software. Descriptive statistics was used to determine the frequency of abnormalities. We found 46 reports of ASC-US, ASC-H, LSIL, and HSIL among 10754 Pap smear reports in the study time period. Of these, 36 (78.3%), 6 (13%), 3 (6.5%), and 1 (2.2%) were ASC-US, ASC-H, LSIL, and HSIL, respectively. The highest frequency of these epithelial cell abnormalities was reported in 2008 and 2009. Findings of this study show a low frequency of ASC-US, ASC-H, LSIL, and HSIL reports on Pap smear tests in the main educational hospital of Isfahan city. However, these statistics cannot be an exact representative of the frequency of these conditions throughout Isfahan Province. To determine the frequency of these epithelial cell abnormalities on Pap smear tests in Isfahan province, further studies on larger populations are necessary.

Evaluation and storage of serous fluid have a major role in clinical diagnosis and prognosis. We tried to evaluate and compare the quality of smears that have been prepared from refrigerated serous effusions according to preservative material in different days. This prospective, interventional, analytical study was performed on refrigerated serous effusions in the cytopathology deportment of Alzahra Hospital (Isfahan, Iran) during 2007-08. Totally, 20 samples, including 15 for malignant and 5 for benign cases, were selected. The samples were divided into two groups, i.e. a group without any protective material and another with albumin as a protective. Their morphological changes for diagnostic cells were evaluated on days1, 3, 6, 9, 12, and 15. The mean age of the participants was 60.3 ± 11.9 years. The percent of diagnostic cells between first to 6 days in both benign and malignant cases in albumin contained fluid were more than non-protected ones (P < 0.001). As time passed, the number of diagnostic cells decreased in both preserved and non-preserved groups. In fact, until the 3rd day, all specimens had diagnostic cells but on the 15th day, none of them had any diagnostic cells. The morphology of cytological preparation was preserved and interpretable after 6 days. Although we cannot preserve effusions for more than one week in our institution, adding albumin as a protective factor would provide the chance for longer preservation.

Stimulatory and/or inhibitory effects of angiotensin II is attributed to angiotensin receptor I. A few studies investigated the role of angiotensin receptor I on cardiovascular system in diabetic subjects. In this study, we evaluated the effects of losartan, an angiotensin II receptor I blocker, on myocardial capillary density in diabetic rats. A total number of 18 male rats were divided into 3 groups of control, diabetic, and diabetic receiving losartan. Diabetes was induced by intraperitoneal injection of streptozotocin (55 mg/kg). A daily dose of 15 mg/kg intraperitoneal losartan was injected to the treatment group. After 21 days, blood samples were taken and myocardial tissue was evaluated by immunohistochemistry. Myocardial capillary density in diabetic animals was lower than the control group (P 0.05). Losartan could not significantly change capillary density in myocardial tissue of the diabetic rats (P 0.05). It seems that losartan administration does not have beneficial effects on myocardial capillary density in diabetic animals.

The cytological diagnoses of serous effusions are usually made by routine cytomorphology with certainty. However, overlapping cases sometimes exist between reactive mesothelial and adenocarcinoma cells. We tried to evaluate the diagnostic utility of epithelial membrane antigen (EMA) monoclonal antibody in distinguishing between reactive mesothelial cells and adenocarcinoma in serous effusions. Paraffin blocks and hematoxylin and eosin stained slides of peritoneal and pleural fluid cell blocks were retrieved from cytology archive of Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, during 2006-2010. From among 1025 slides which were screened to ascertain their appropriate diagnoses, 90 paraffin embedded cell blocks, 30 cases for adenocarcinoma and 60 cases for reactive mesothelial groups were selected for immunocytochemistry staining. Cellular reactivity, intensity, and pattern of staining for EMA were evaluated by anti-human EMA "clone E29". Statistical analyses and tests of significance were performed using SPSS. Mean age of the patients in the reactive mesothelial and adenocarcinoma groups were 50.28 and 55.16 years, respectively. The malignant group included 22 (73.33%) female and 8 (26.66%) male cases. In the reactive group however, 16 (26.66%) females and 44 (73.33%) males were studied. The mean numbers of immunoreactive cells for EMA in adenocarcinomatous and reactive mesothelial cells were 97.5 ± 7.62 and 21.6 ± 30.43, respectively (P = 0.001). In addition, 30 (100%) and 8 (13.33%) severe immunoreactive cases were observed in the metastatic adenocarcinoma and reactive mesothelial groups, respectively (P = 0.001). Immunocytochemical staining for EMA is a useful diagnostic tool for distinguishing effusions containing malignant cells from those with benign cells. We particularly suggest the precise evaluation of pattern and intensity of immunoreactive cells for EMA.

Paranasal sinus aspergilloma is a rare disease of sinus which is sometimes considered as mycetoma. In this condition, there is gathering of fungal mycelium in sinus cavity without bone or vessels invasion. It presented as a chronic sinusitis with headache, nasal discharge and obstruction. Diagnosis of aspergillosis infection has often dependent on clinical judgment combined with radiologic evaluation and demonstration of the fungus in tissue specimens obtained from the presumed site of infection. Case Report: A 53-year-old man with uncontrolled insulin dependent diabetes mellitus presented with six month history of headache. He had used various drug prescribed by different physicians in the past six months without any effect. Because of progressive headache, he was admitted in the department of otolaringology and surgical debridement was done. Histopathological examination was suggestive of maxillary sinusitis with fungal ball of aspergilluma. The patient treated with itraconazole and after 6 months, he felt better with no clinical and paraclinical signs. Since fungal sinusitis presentation is similar to chronic sinusitis and in the other hand, the incidence of aspergillosis is increasing, the early diagnosis and treatment is important especially when the clinical and paraclinical signs are suggestive.

We tried to evaluate the diagnostic utility of HBME-1 in distinguishing between reactive meso-thelial cells and adenocarcinoma in body serous effusions. We examined 52 cytologic specimens of serous effusions processed by cell block technique retrieved from the pathology archive of Al-zahra hospital (Isfahan). They were categorized in two groups: Group I. 26 effusions containing reactive mesothelial cells from patients with no evidences of malignancy based on cyto-morphology, clinical data and imaging; and Group II. 26 effusions containing adenocarcinomatous cells from patients with diagnosis established by routine histology. Immunostaining with HBME-1 was performed using an Envision technique. Statistical analysis was performed with SPSS software. Statistical significance was found with HBME-1 when comparing both adenocarcinoma versus meso-thelial cells (P = 0.001). Also, we found HBME-1 outlined cell membranes in reactive mesothelial cells versus cytoplasmic pattern in adenocarcinoma cells (P = 0.001). The staining intensity for adenocarcimoma cells in-cluded: Negative in 7 cases (26.9%); score + in 4 cases (15.38%), score ++ in 11 cases (42.30%) and score +++ in 4 cases (15.38%). In mesothelial cells, Negative and score + was not seen, score ++ was in 3 cases (11.5%), and score +++ in 23 cases (88.5%) (P = 0.001). The staining pattern and intensity for HBME-1 is a usufull panel for differentiation of adenocarci-noma and mesothelial cells. The only limitation of this marker is ovarian carcinoma that shows the same pattern as reactive mesothelial cells.

Abstract Silymarin the active principle of Silybum marianum has antifibrotic effects in hepatic fibrosis by several mechanisms. Since the pathogenesis of fibroproliferative diseases is similar the effect of silymarin in bleomycin-induced pulmonary fibrosis was evaluated in this study. Silymarin (50 mg/kg i.p.) was administered two days before the bleomycin instillation (3 U/kg) and throughout the test interval in mice. After two weeks lung tissues of mice were evaluated for fibrosis by biochemical measurement of collagen deposition and histological analysis of pathological lung changes. Data were evaluated by one-way ANOVA and Dunnett analysis. P

Breast cancer is the most common cancer in women. Lymph node involvement is the most important prognostic factor in this cancer. Since there is no consensus about the relationship between lymphocytic infiltration and breast cancer prognosis, this study was conducted to investigate the correlation between stromal lymphocytic reaction and lymph node involvement in grade 1 ductal carcinoma of breast in Isfahan during 2004. In this cross sectional study 182 formalin - fixed and paraffin-embedded breast cancer tissue specimens were evaluated. Samples were classified according to the number of lymph nodes and age. Finally, the correlation between these parameters and stromal lymphocytic infiltration was examined. T student, one-way analysis of variance and χ 2 were used for statistical analysis. There is a significant correlation between stromal lymphocytic infiltration and lymph node involvement (P=0.001), whereas there is no significant correlation between menopause and stromal lymphocytic infiltration (P=0.09). The research results indicated that tumors with severe stromal lymphocytic reaction are associated with high possibility of lymph node involvement. More research is recommended.