Syphilis was the first sexually transmitted disease to be diagnosed in childhood. Most developed countries controlled syphilis effectively after the 1950s and congenital syphilis became rare. Since the late 1990s there has been a resurgence of syphilis in developed and developing countries and the WHO estimates that at least half a million infants die of congenital syphilis every year. The earliest reference to the dental manifestations of congenital syphilis was by Sir Jonathan Hutchinson, Assistant Surgeon at The London Hospital in 1861. Three main dental defects are described in congenital syphilis; Hutchinson's incisors, Moon's molars or bud molars, and Fournier's molars or mulberry molars. Although many physicians, dentists, and pathologists in developed countries will be aware of the dental features of syphilis, most will never have seen a case or made the diagnosis. The purpose of this article is to review some of the history of congenital syphilis, remind healthcare professionals of the features, and bring to their attention that the changes are still prevalent and that milder cases can be mistaken for other causes of hypoplasia.
The standard-of-care for the detection of laryngeal pathologies involves distinguishing suspicious lesions from surrounding healthy tissue via contrasts in colour and texture captured by white-light endoscopy. However, the technique is insufficiently sensitive and thus leads to unsatisfactory rates of false negatives. Here we show that laryngeal lesions can be better detected in real time by taking advantage of differences in the light-polarization properties of cancer and healthy tissues. By measuring differences in polarized-light retardance and depolarization, the technique, which we named ‘surgical polarimetric endoscopy’ (SPE), generates about one-order-of-magnitude greater contrast than white-light endoscopy, and hence allows for the better discrimination of cancerous lesions, as we show with patients diagnosed with squamous cell carcinoma. Polarimetric imaging of excised and stained slices of laryngeal tissue indicated that changes in the retardance of polarized light can be largely attributed to architectural features of the tissue. We also assessed SPE to aid routine transoral laser surgery for the removal of a cancerous lesion, indicating that SPE can complement white-light endoscopy for the detection of laryngeal cancer.
Evaluation of: Eckert AW, Schutze A, Lautner MHW, Taubert H, Schubert J, Bilkenroth U. HIF-1α is a prognostic marker in OSCC. Int. J. Biol. Markers 25(2), 87-92 (2010). Oral squamous cell carcinoma is the most common cancer in the oral cavity, accounting for 95% of all malignancies. Predicting prognosis and survival of oral cancer patients has been challenging. To date, there are no molecular markers that can be used reliably in routine clinical practice, other than clinical and histological parameters. Numerous molecules have been tested in order to achieve the above objective. Hypoxia-inducible factor (HIF)-1α is a molecule that is mainly activated under hypoxic conditions. According to the article under evaluation, tumors negatively or weakly expressing HIF-1α had a 5-year disease-specific survival of 80% or more, whereas the disease-specific survival in cases with moderate or strong HIF-1α expression was only 49.4 and 33.6%, respectively. The mean disease-specific survival time was 54 months for patients whose tumors showed negative or weak HIF-1α expression, whereas patients with moderate or strong HIF-1α expression survived on average only 38 months (p = 0.001). HIF-1α may have a role to play in diagnostic and clinical practice to predict prognosis of oral cancer, provided the findings are confirmed by more reliable investigations in addition to immunohistochemistry analysis.
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