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Article
Immunohistochemical analysis of estrogen and progesterone receptors expression in gingival lesions

Authors: Ahlam H. Majeed --- Alla S. Saeed
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2011 Volume: 23 Issue: 1 Pages: 34-38
Publisher: Baghdad University جامعة بغداد

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Abstract

ABSTRACT
Background: Some lesions in the oral cavity and mostly on the gingiva have predominant predilection towards
females. Such lesions occur most commonly in the first fourth decades of life when changes in sex hormones levels in
the blood are obvious , for example pyogenic granuloma is a tumor like lesion of oral cavity that is considered to be
non-neoplastic in nature and arises in response to local irritation.
The present study aimed to evaluate the role of female sex steroid hormones in pathogenesis of pyogenic
granuloma (P.G) , peripheral giant cell granuloma (P.G.C.G), and peripheral ossifying fibroma (P.O.F) , on human
gingiva as a target organ .
Materials and Methods: This Study conducted on 40 case of reactive gingival lesions as a study group and 10
specimens of normal gingival tissue as acontrol group. These samples are collected to evaluate the expression of
estrogen and progesterone by using immuinohistochemistry .The study group included 15 case of P.G, 13 case of
P.G.C.G and 12 case of P.O.F. An immunohistochemical staining with estrogen monoclonal antibody marker and
anti progesterone monoclonal antibody were performed. All tests were carried out on 4&#956;m sections from formalin
fixed parraffin embedded tissues.
Results: The age range of the subject in this study is 10 -59 years and the male to female ratio was 14/26 (1:1.85) for
study group while it was 5/5 (1:1) for control group . The cases have been already diagnosed, three subtypes of
gingival lesions were studies . These include 15 case of P.G (37.5 %), 13 case of P.G.C.G (32.5 %) and 12 case of P.O.F
(30 %). After immunohistochemical staining, all subjects in the control group showed negative expression for estrogen
and progesterone, while in the study group, 11 estrogen and progesterone receptors were detected. Eight of these
receptors were ER and three were PR .Estrogen was detected in the three lesions while progesterone was not
detected in P.G. In order of decreasing frequency, the ERs and PRs were found in PG.C.G (n=6), P.G (n=3) and P.O.F.
(n=2). The expression of these receptors was distributed in three site including epithelial, inflammatory and
mesencymal cells. Progesterone expression was much less than that’s of estrogen in both quantity (proportion of
positive cell) and intensity. Significant difference for expression of these receptors was found between the three
types of the lesions. This study showed significant difference in ERs expression between males and females. The
positivity of ERs receptor in females was more than males. On the other hand no significant difference for PRs
expression was found between males and females.
Conclusions : Estrogen and progesterone may play a role in the pathogenesis of the three oral lesions , P.G , P.G.C.G
and P.O.F by mechanism other than hormone receptor interaction , such mechanism may attributed to levels of
circulating hormones .Increase levels of these hormone may induce the release of inflammatory mediators from mast
cell and stimulate the proliferation of fibroblast .
Key word: Gingival lesions, estrogen, progesterone, immunohistochemistry. (J Bagh Coll Dentistry 2011;23(1):34-38).

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Article
Immunohistochemical expressions of matrix metalloproteinase-9 and Vimentin in oral squamous cell carcinoma

Authors: Ahlam H.Majeed --- Afrah A.Khalil
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2009 Volume: 21 Issue: 4 Pages: 54-58
Publisher: Baghdad University جامعة بغداد

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Abstract

ABSTRACT
Background: Squamous cell carcinoma is a malignant neoplasm of stratified squamous epithelium; it occurs in
different sites and has potential destructive growth and invasive with distant metastasis. The aims of the study were
to evaluate the expression of matrix metalloproteinase-9 and Vimentin immunohistochemistry and to correlate them
with the clinicopathological parameters in oral squamous cell carcinoma.
Materials and methods: twenty prospective and eleven retrospective paraffin- embedded formalin- fixed blocks of
oral squamous cell carcinoma were included in this study. Haematoxylin & Eosin stain (H & E) and
immunohistochemical staining was done by using monoclonal antibodies for anti-matrix metalloproteinase and anti-
Vimentin.
Results: positive immunohistochemical staining for MMP-9 was seen in 100% of collective cases while it was seen in
93.5% for Vimentin.
Conclusions:There was no correlation found between the two markers. MMP-9 expression was found in all cases with
no correlation with clinicopathological parameters so it can be used as a diagnostic tumor marker rather than a
prognostic marker. Vimentin was expressed in most OSCC cases with significant correlation with tumor size and
stage. Vimentin can be used as a good prognostic tumor marker.
Key word: Oral squamous cell carcinoma, Matrix metalloproteinase-9, Vimentin. (J Bagh Coll Dentistry 2009; 21(4):
54-58).

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Article
Immunohistochemical Expression of Actin and S100 in Pleomorphic Adenoma and Mucoepidermoid Carcinoma

Authors: Ahlam H. Majeed. --- Farah S. Rasheed
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2011 Volume: 23 Issue: 2 Pages: 51-55
Publisher: Baghdad University جامعة بغداد

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Abstract

ABSTRACT
Background: Tumors of the salivary glands constitute an important area in the field of oral and maxillofacial
pathology. These tumors have a special status in human neoplasia and probably the most complex histopathologic
features of the body organs and being heterogeneous. Pleomorphic adenoma (PA) is the most common benign;
and mucoepidermoid carcinoma(MEC) is the most common malignant salivary gland tumors. Many investigations
have showed that myoepithelial cells play a major role in the histogenesis of PA and may be important in many
MECs. The aims of the study are to determine the presence and distribution of myoepithelial cell related
immunomarkers Actin and S100 in PA and MEC and to explore the histogenesis of these tumors in relation to the
above mentioned markers.
Materials and methods: Seventeen formalin fixed paraffin embedded tissue blocks of PA, and other fifteen tissue
blocks of MEC were included in the study. Diagnostic confirmation was performed through examination of
hematoxylin and eosin sections. Both tumors were immunohistochemically analyzed for the presence of actin and
S100 protein.
Results: There was a positive immunoreactivity for the expression of actin in PA (100%) with different score values,
while for MEC, actin was negatively expressed in all of the cases (except in one case). There was a highly statistical
significant difference in the actin immunoexpression between the two tumors (p=0.000).
There was a positive immunoreactivity for S100 protein expression in all of the cases of PA and MEC (100%) with
different score values; however, there was no statistically significant difference in the S100 immunoexpression
between them (p=0.545).
Conclusion: The myoepithelial cells are associated with the histogenesis of salivary PA, and the negative expression
of actin in squamous, intermediate and mucous cells of MEC can be explained by the non-involvement of the
myoepithelial cells in the histogenesis of this tumor.
Key words: Pleomorphic Adenoma, Mucoepidermoid Carcinoma, Actin, S100. (J Bagh Coll Dentistry 2011;23(51-55).

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Article
Incidence of Hodgkin's lymphoma of head and neck in Baghdad city

Authors: Ahlam H. Majeed --- Muna S. Merza
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 4 Pages: 49-51
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Hodgkin's lymphoma (HL), formerly called Hodgkin's diseases is an uncommon form of lymphoma. Theincidence of Hodgkin's lymphoma shows marked heterogeneity with respect to age, gender, race, geographicarea, social class and histological subtype. This study was carried out in an attempt to evaluate the incidence ofHodgkin's lymphoma of head and neck in Baghdad city.Materials and Methods: The diagnosed cases of Hodgkin's lymphoma of head and neck region in Baghdad citybetween (1990-1999) were collected and analyzed according to age, gender, site and the histopathologicalsubtypes of the tumor.Results: Out of (702) cases of Hodgkin's lymphoma of ten years between (1990-1999),(362 ) of them were occurred inthe head and neck region including (202) males and (160) females. The remaining (340) cases were occurred inother lymph nodes of the body.Conclusion: This study revealed that predominant histopathological subtype of Hodgkin's lymphoma is the mixedcellularity type that showed more predominance in male especially among young age groups and low incidencewith advancing age


Article
Survey of Reasons for Extraction of Permanent Teeth in Al-Tajiat and Al-Qaderia Villages

Authors: Lehadh M. Al-Azzawi --- Ahlam H. Majeed --- Wasan H. Younis
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2005 Volume: 2 Issue: 2 Pages: 196-199
Publisher: Babylon University جامعة بابل

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Abstract

The purpose of the study is to collect information on the reason of extraction of permanent teeth, randomly selected, in rural areas, in two Iraqi villages (Al-Qaderia, and Al-Tajiat) in the sixth trial carried out the University of Baghdad. Oral examination of (847) individuals, were performed, 352 from the first village and 495 from the second village, between 5-85 years of age, were extracted during 10 days of working activity, males were (43.2%) while females were (56.5%).From 310 patients had tooth extracted, about (87.74%) of the teeth were extracted for dental caries and (12.26%) for periodontal disease. Significant difference was found between the first and second villages which were (30.65%) of caries of the 1st village.(57.09%) of caries of the 2nd village, not significant difference was found for periodontal disease which were (5.8%) of 1st village (6.45 %) of 2nd village. Caries was the most important reason for tooth extraction in both villages than periodontal disease. More teeth lost due to caries among females than males and significant difference was found between multiple and single tooth extraction. Dental practitioners should promote target initiatives for prevention and treatment of diseases in order to reduce in particular the incidence of tooth extraction because of caries and periodontal disease.

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Article
Immunohistochemical expression of Basic fibroblast growth factor-2 and Heparanase in oral squamous cell carcinoma

Authors: Karrar N. Shareef كرار شريف --- Ahlam H. Majeed احلام مجيد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 1 Pages: 94-98
Publisher: Baghdad University جامعة بغداد

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Abstract

Back ground: The aim of this study was to evaluate the expression of fibroblast growth factor-2 and Heparanase inoral squamous cell carcinoma, and to correlate the two studied marker with each other and withclinicopathologicalfinding including grade, stage.Methods: Sections of 30 formalin-fixed paraffin embedded blocks specimens of oral squamous cell carcinoma wereimmunostained to assess the expression of fibroblast growth factor-2 and Heparanse in oral squamous cellcarcinoma cases.Results: The expression of fibroblast growth factor-2 and Heparanase were positive in all oral squamous cellcarcinoma cases (100%). The positive expression of fibroblast growth factor-2 was significantly correlated with tumorsite (p=0.016),and clinical presentation(p-value =0.003).The positive expression of Heparanse was significantlycorrelated with tumor grade(p-value =0.002) .On other hand there was non-significant correlation between fibroblastgrowth factor-2 ,Heparanase and other clinicopathological parameters .Statistically significant correlation was foundbetween the expressions of fibroblast growth factor-2 and Heparanase(p-value= 0.021).Conclusion: The fibroblast growth factor-2 and Heparanase positive expression was noted in all cases of oralsquamous cell carcinomasignifying their important role in the angiogenesis and lymph node metastasis in oralsquamous cell carcinoma, furthermore they cooperate in promoting vascularization, suggesting that fibroblastgrowth factor-2 and heparanase are promising targets for the development of anticancer therapeutics for headand neck malignancies


Article
Incidence of non Hodgkin’s lymphoma of head and neck in Baghdad city

Authors: Muna S. Merza منى ميرزا --- Ahlam H. Majeed احلام حميد مجيد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2005 Volume: 17 Issue: 1 Pages: 35-37
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Malignant lymphomas in the head and neck region are relatively uncommon but may occur as a part of widely disseminated disease or as a primary lesion. This study was carried out in an attempt to evaluate the incidence of Non-Hodgkin's Lymphoma of head and neck in Baghdad city over ten years (1990-1999).Materials and methods: Cases of Non Hodgkin’s Lymphoma of head and neck in Baghdad city were collected and evaluated regarding sex, age, site and histopathological subtype of tumor.Results: Out of the total of (426) cases of Non-Hodgkin's Lymphoma of the body, (137) were showed to affect the head and neck region including 78 males and 59 females.Conclusions: Our findings showed that the principle site affected with Non-Hodgkin's Lymphoma was the cervical lymph nodes followed by the tonsils with the predominant histopathological subtypes was the lymphocytic Lymphoma followed by Reticular cell sarcoma.


Article
The Value of Cytobrush Technique in The Diagnosis of Oral Ulcerative Lesion

Authors: Bashar H. Abdullah --- Ahlam .H .Majeed --- Kutaiba.Kb. Al-Rawy --- Halaa .F.Al-Ani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2009 Volume: 6 Issue: 3-4 Pages: 484-493
Publisher: Babylon University جامعة بابل

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Abstract

A total of 49 patients were included in this study, 29 patients with oral benign and malignant lesions, and 20 healthy individuals were included as control.All these cases were examined by using cytobrush technique.The study aimed to evaluate the sensitivity and specificity of cytobrush method in the detection of precancerous and cancerous lesions of oral mucosa.The results of cytobrush method were compared with those of scalpel biopsy of suspicious oral lesions.The brush method has high sensitivity and specificity rate (88% sensitivity, 100% specificity). The cytobrush method was a highly accurate method of detecting oral precancerous andcancerous lesions (93% accuracy rate).Although the histological pattern was the definitive diagnosis in those patients, but when the lesion was doubtful, the cytological examination (cytobrush technique) was not only supportive but also diagnostic. It can aid in confirming the nature of apparently benign oral lesionsand, more significantly, revealing those that are precancerous and cancerous when they are not clinically suspected of being so.All cytobrush positive results should be referred for scalpel biopsy and histology to completely characterize the lesion.

شملت هذه الدراسة 49 شخصا، تسعة وعشرون منهم يعانون من تقرحات فموية حميدة أو خبيثة، أما العشرون الآخرون فهم أصحاء وتم اعتبارهم كمجموعة سيطرة. كل هذه الحالات تم فحصها باستعمال طريقة الفرشاة الخلوية. الهدف من الدراسة هو تقييم حساسية وخصوصية طريقة الفرشاة الخلوية في تحديد التقرحات السرطانية وما قبل السرطانية التي تصيب بطانة الفم، ونتائج هذه الطريقة قورنت مع الطريقة المشرطية لأخذ العينة من التقرحات الفموية المتوقعة.طريقة البابانيكولا استعملت لغرض صبغ المسحات التي أخذت بطريقة الفرشاة الخلوية، ويتم معاينتها تحت المجهر الضوئي.أظهرت نتائج البحث أن هناك معدل عالي لحساسية وخصوصية هذه الطريقة ( 88% للحساسية و 100% للخصوصية) ، لذلك فان طريقة الفرشاة الخلوية ذات دقة عالية في تعيين التقرحات الفموية السرطانية وما قبل السرطانية ( 93% معدل الدقة).نستنتج من ذلك انه بالرغم من ان الحالة النسجية تعطي التشخيص النهائي للحالة، إلا أن طريقة الفرشاة الخلوية ليست فقط داعمة للتشخيص بل هي طريقة تشخيصية أيضا.

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Article
The role of Matrix Metalloproteinase-2 and -9 with their Tissue Inhibitors in Oral Lichen Planus………………………………………………………………………………………...……..

Authors: Tha'er Kassim Al-Kassam, --- Ahlam H. Majeed --- Haider S. Kadhim
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 745-750
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Oral Lichen Planus (OLP) is a chronic inflammatory mucosal disease,presenting various clinical forms. Both antigen- specific and non- specific mechanismsinvolved in the pathogenesis of OLP.Matrix Metallo Proteinases (MMPs) and theirinhibitors are one of the mechanisms that would be activated in this disease.Objective: to explore the expression of Matrix MetalloProteinases (2&9) and theirinhibitors and correlation between them in oral lichen planus.Method: Twenty five paraffin embedded blocks of OLP and six of sequamous cellcarcinoma were collected from the records of Oral Diagnosis Department. Six negativecontrol cases were freshly obtained from Maxillofacial Center in the SpecializedSurgeries Hospital in Baghdad. All samples were investigated for the expression ofMMPs & Tissue Inhibitors of Matrix MetalloProteinases (TIMP) byImmunohistochemistry (IHC).Results: Expression of MMP-2,-9, TIMP-1 and TIMP-2 were detected at highersignificant level in keratinocytes and lymphocytes of OLP cases as compared to controlhealthy group (p<0.0001). There was no significant difference between the expression ofMMP-2, TIMP-1 and TIMP-2 in lymphocytes and keratinocytes. However MMP-9expression showed significant difference with MMP-2& TIMP-1&-2 in lymphocytes.There was non significant correlation between the expression of MMP-2, MMP-9, TIMP-1 and TIMP-2; and the morphological types of OLP.Conclusion: High expressions of MMPs and TIMPs in OLP may indicate their role inpathogenesis of the disease as there is no expression of these enzymes in the controlhealthy; so they could be a diagnostic of aid in OLP.

Keywords

Oral Lichen Planus --- MMP-2 --- MMP-9 --- TIMP-1 --- TIMP-2


Article
Detection of ERBB2 (Her2/neu) and P16 (INK4A) genes in oral squamous cell carcinoma using fluorescent in situ hybridization (FISH)

Authors: Hiba A. Abdulameer هبة عبد الامير --- Ahlam H. Majeed احلام مجيد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 4 Pages: 46-51
Publisher: Baghdad University جامعة بغداد

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Abstract

Background Head and neck cancers account for approximately 5% of all carcinomas in industrialized countries, witha worldwide incidence of 500,000 new cases annually. Nearly all head and neck cancers (90%) are squamous cellcarcinomas (SCCs), and >50% of tumors arise in the oral cavity. It is important to know what prognostic factors canfacilitate diagnosis, optimize therapeutic decisions, and improve the survival of these patients. A member of theepidermal growth factor receptor (EGFR) family, HER2/neu, has received much attention because of its therapeuticimplications. The p16 gene produces P16 protein, which in turn inhibits phosphorylation of Rb, thus inhibiting the Rbinducedrelease of transcription factor EF1 and cell cycle progression. Genetic aberration analyzed by fluorescence(FISH) to measure the gene copy number. The aims of the present study are to detect HER2/neu amplification andP16 deletion in oral squamous cell carcinoma and correlate them with various clinicopathological parameters (age,sex, clinical presentation, tumor site, tumor stage, tumor grade).Materials and Methods Thirty formalin-fixed paraffin embedded tissue blocks of oral squamous cell carcinoma whichwere collected from laboratories archives included in this study. H&E stain was done for each block for reassessmentof histological examination. DNA probes were used to detect copy numbers of the HER2/neu and P16 genes usingfluorescent in situ hybridization technique (FISH).Results FISH evaluation showed that HER2/neu gene amplification was found in 12 cases (40%), while 18 cases (60%)showed no amplification. Among the cases in which amplification was not found, 8 cases (44.45%) showed polysomyof chromosome 17.P16 gene deletion was found in 20 cases (66.7%) while 10 cases (33.3%) showed no deletion.Conclusions: HER2/neu amplification and P16 deletion were observed in studied oral squamous cell carcinomasamples using FISH, however, statistically non significant correlation with all clinicopathological findings (age, sex,clinical presentation, tumor site, tumor stage, tumor grade) and also between both genes were found in the presentstudy. It is premature to conclude that HER-2/neu and P16 alterations may have prognostic significance, but it is alsotoo early to dismiss that possibility without a larger, perhaps multicenter study

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