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A case report of angiosarcoma of maxillary gingiva: Histopathology aspects
Firstine Kelsi Hartanto, Shin Hin Lau
May-August 2018, 2(2):77-83
Angiosarcoma is a rare malignant tumor, which most often occurs in the skin and soft tissue. Its occurrence in the head and neck region, and the intraoral region in particular, is uncommon. The aim of this case report is to highlight the importance of histopathological examination and to underscore the characteristic features of angiosarcoma.
A 52-year-old female presented with a growth in the right maxillary portion of the interdental region of her molar teeth. The growth had been present for approximately one month. A computerized tomography (CT) scan showed metastatic tumors in the lungs, liver, bone, and soft tissue of maxillary gingiva. Intraoral examination found a soft and mobile pedunculated ovoid mass at the right palatal gingiva; the mass was reddish-blue in color. An incisional biopsy was performed to confirm the diagnosis and plan for further treatment. Histopathologic examination revealed malignant endothelial cells in a vasoformative growth pattern, with numerous vascular channels lined with neoplastic endotheliumforming intraluminal buds, projections, and papillae. These projections were interspersed with the tumor cells. Immunohistochemistry analysis showed these endothelial cells demonstrated strong positive immunoreactivity with CD31, factor VIII, and FLi-1. A diagnosis of angiosarcoma was made.
Because intraoral angiosarcoma is rare and its clinical presentation can resemble other vascular lesions, it can be a challenging diagnosis for clinicians and pathologists. In the present case, the diagnosis of intraoral angiosarcoma was made based on clinical and histopathology findings. The microscopic features of malignant endothelial cells and the presence of intraluminal projections, supported by positive immunoreactivity with CD31, factor VIII, and FLi-1, confirmed the diagnosis.
Angiosarcoma poses a diagnostic challenge to dental practitioners and oral pathologists due to the rarity of occurrence in the oral cavity. Histopathological examination is critical for an accurate diagnosis.
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Pomegranate juice inhibits periodontal pathogens biofilm
Armelia Sari Widyarman, Olivia Puspita Suhalim, Dhara Nandary, Citra Fragrantia Theodorea
September-December 2018, 2(3):101-108
) fruits are commonly regarded as medicinal plant in Indonesia, and the polyphenols found in pomegranate juice (punicalagin and ellagic acid) have been shown to have antibacterial properties.
Using monospecies and multispecies biofilms, we sought to examine the effects of pomegranate juice on the viability of three periodontal pathogens:
Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans
Biofilm assays were performed using crystal violet. Pomegranate juice was obtained from pomegranates using a juicer, and the juice was then diluted into different concentrations with phosphate saline buffer. The three pathogens were cultured in both monospecies and multispecies plates. Pomegranate juice was then added to each biofilm well. These were then incubated for 1h, 6h, or 24h, after which the optical density (OD) of the biofilm mass was measured using a microplate-reader (490 nm). Biofilm without treatment was used as a negative control and 0.2% chlorhexidine gluconate as a positive control. Data were analyzed with a one-way ANOVA; the level of significance was set at p<0.05.
Compared to the negative control, biofilm mass was significantly decreased after treatment with pomegranate juice across all concentrations and incubation times, for both monospecies and multispecies abiofilm (
<0.05). The best results were achieved with
biofilm, with 100% concentration (OD 0.34 ± 0.03);
, 50% concentration (OD 0.22 ± 0.01); and
, with 25% concentration (OD 0.87 ± 0.08), as well as with a multispecies biofilm with a 50% concentration in 1h incubation time (OD 0.09 ± 0.02).
Pomegranate juice effectively inhibited the biofilm formation of
P. gingivalis, A. actinomycetemcomitans, and T. denticola
. Pomegranate juice may therefore be used as an alternative therapy in preventing periodontal disease. Additional research should explore this effect in an environment that mimics oral cavities.
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Enzymatic activity of bromelain isolated pineapple (
) hump and its antibacterial effect on
Dewi Liliany, Armelia Sari Widyarman, Erni Erfan, Janti Sudiono, Melanie S Djamil
May-August 2018, 2(2):39-50
is the frequent cause of oral infections, such as periodontitis, infected root canals, and peri-radicular abscesses. Pineapple (
) fruit contains bromelain, one of proteolytic enzymes associated with several health benefits. Bromelain has been shown to promote healthy digestion, stimulate the immune system, improve cardiovascular conditions, and accelerate wound healing. Bromelain compounds possess antiinflammatory and anticancer properties and exhibit antibacterial activity.
To analyze the enzymatic activity of bromelain extracted from pineapple hump and investigate the antibacterial effect of bromelain against
Pineapple hump was dried and extracted with maceration technique. Further purification was obtained by ammonium sulfate fractionation, dialysis and ion exchange chromatography. Minimum inhibitory concentration (MIC) test using diffusion and dilution techniques tested the antibacterial activity of the bromelain extract towards
. A one-way analysis of variance (ANOVA) test analyzed the significance of the differences in the
inhibition zones after treatment with a range of bromelain extract concentrations. Differences were considered statistically significant if
The specific activity of bromelain in the crude extract was 62.89 U/mg. Furthermore, bromelain activity using ammonium sulfate fractionation was 50.99 U/mg, dialysis was 54.59 U/mg, and ion exchange chromatography was 152.38 U/mg. The bromelain extract showed effective inhibitory and bactericidal activity against
. The results of the inhibition test using a bromelain extract purified by ion exchange chromatography demonstrated that a concentration as small as 12.5% was effective in inhibiting the growth of
The highest enzymatic activity of bromelain was found after purification with ion exchange chromatography. Bromelain exerted an antibacterial effect against a potent endodontic pathogen, but further studies are needed to explore this effect.
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