Clinical manifestations of Grinspan–Potekaev syndrome on the buccal mucous membrane (a case report)

Grinspan–Potekaev syndrome is a rare disorder facing dentists in practical activity. That is why the detailed analysis of the disease clinical course peculiarities is important and urgently needed. The aim of the work: to analyze the clinical course of Grinspan–Potekaev syndrome on the buccal mucous membrane using the example of a patient treatment in the dental clinic Denta Plus (Zhytomyr city). Materials and methods. Bibliosemantic method (analysis, correlation, comparison, generalization, systematization of scientific literature on the studied issues), system analysis and logical generalization (for developing the algorithm of diagnostics and treatment), medical documentation analysis of the patient, who sought medical assistance in the dental clinic Denta Plus, were used. Results. The clinical course of Grinspan–Potekaev syndrome on the buccal mucous membrane was described and analyzed. The conducted diagnostic methods allowed to determine the diagnosis, to develop and to apply the complex drug therapy that positively influenced the general well-being, promoted the transformation of erosive-ulcerous form of lichen planus into less aggressive and safer exudative-hyperaemic one. The difficulties during the diagnostic and differential diagnostic stages concerned the fact that typical skin lesions were not observed and the “fern pattern” on the buccal mucous membrane (within the period of exacerbation) was not clear. Besides, the patient did not have any complaints specific to diabetes mellitus, therefore a blood glucose level and glycemic profile were determined only in the process of case follow-up, the patient was further referred to an endocrinologist, who diagnosed type 2 diabetes mellitus. Conclusions. The described case of Grinspan–Potekaev syndrome allowed to analyze the clinical course of the disease in the oral cavity within the exacerbation period and to examine the components of diagnostic and treatment process. The treatment response in Grinspan–Potekaev syndrome (with isolated manifestations of lichen planus on the buccal mucous membrane) depends not only on a dentist competence but also on cooperation between other specialists: dermatologist, oncologist, psychotherapist, family physician, and endocrinologist. Despite the positive clinical effect, the need to follow-up the further course of the disease is associated with the possibility of erosive-ulcerous form of lichen planus relapses and its malignant transformation.

Monitoring of cytogenetic instability by micronuclei assay of both immunocompetent and non-immunocompetent cells in tick-borne encephalitis patients depending on variants of glutathione-S-transferase genes in the genotype

Aim of this study was to study the dynamics of the frequency of cytokinesis-blocked T-lymphocytes with micronuclei in peripheral blood and the frequency of buccal micronucleated epithelium cells for a period of half a year in patients with acute tick-borne encephalitis, depending on burden of active and inactive variants of glutathione-S-transferase genes (GSTM1 and GSTT1) in the patient's genotype. We carried out micronucleus assay in immunocompetent and non-immunocompetent cells in 54 patients with acute tick-borne encephalitis and 35 healthy persons (control) residing in the Tomsk and Tyumen regions. To analyze the frequency of cytokinesis-blocked micronucleated T-lymphocytes was used venous peripheral blood as material for phytohemagglutinin-stimulated cultures, and to study the frequency of buccal micronucleated cells, samples of the buccal mucous membrane epithelial cells were obtained. To carried out both techniques of micronucleus assay, cytological preparations were prepared, which were stained using the Giemsa or Felgen methods. The material for the study was obtained repeatedly during admission of patients to treatment, and also after 1 week, 1, 3 and 6 months. Polymerase chain reaction was used to analyze the alleles of the GSTM1 and GSTT1 genes. As a result of this analysis was found a significant increase in the frequency of micronucleated cells in tick-borne encephalitis patients compared with the control group. In addition, the frequency of cytokinesis-blocked micronucleated T-lymphocytes was increased significantly higher than the one of micronucleated buccal cells. The most significant and prolonged increase in the frequency of micronucleated cells was associated with the mutant inactive variants of the genes GSTM1 (0/0) and GSTT1 (0/0). In the patients with burden the inactive forms of these genes, the cytogenetic instability of the cytokinesis-blocked blood T-lymphocytes could persist for up to six months. In case of buccal cells, the frequency of micronucleated cells was close to the one in the control group as early as 1-3 months after a course of treatment. Conclusion. It was found that the most increased and prolonged frequency of cytogenetically instable cells persisted in cytokinesis-blocked T-lymphocytes of peripheral blood of patients with tick-borne encephalitis who were carriers of the genotype with inactive variants of both GSTM1 (0/0) and GSTT1 (0/0 ) glutathione-S-transferase genes.

Determination of toxicity indicators and assessment of the sensibilizing action of the preparation for the external use ‘Ointment for wounds’

The purpose of the work is a determination of toxicity and sensitizing effects of a new external preparation ‘Ointment for wounds’, based on the essential oils of Siberian pine, eucalypt, tea-tree, cedar, clove, and oil solution of chlorophyllite. The experimental study was performed on rats weighing 160–190 g, 2–3 months of age and mice weighing 18–21 g, 3 months of age. At the stages of preclinical study, it was determined acute and subacute effects of the drug, when administrated on the skin and directly into the stomach of experimental animals. The skin-irritant effect of the phytopreparation was investigated when applied to the skin and buccal mucous membrane. The sensitizing effect of the ointment was evaluated by reproducing local reactions. The acute toxicity assessment was performed on the survival rate of laboratory animals after oral administration of the preparation at doses from 5,000 to 25,000 mg/kg of body weight, with 5,000 units increments. Subacute toxicity in the experiment was evaluated by the dynamics of morphological and biochemical parameters of blood and the study of the coefficients of laboratory animals’ internal organs mass. It was found that the introduction of the drug ‘Ointment for wounds’ in the stomach did not cause significant changes in the behavior of rats, all animals remained alive. Studies have shown the absence of skin-irritant effect of the preparation, as well as the absence of irritant effect on the buccal mucous membrane. Even in a long-term experiment to study subacute toxicity when applied to the skin, no toxic effects of the preparation on the basis of essential oils and oil solution chlorophyllite of were found. The index sensitizing effect of the preparation was less than one, indicating the absence of sensitizing effect. According to the classification of substances by toxicity and danger (requirements of SOU 85.2-37-736:2011 and GOST 12.1.007-76) belong to hazard class IV. In general, ‘Ointment for wounds’ does not have a toxic effect on the functions of vital organs, and at repeated administration is almost harmless

Морфометрична характеристика слизової оболонки порожнини рота і зміна показників гуморального імунітету при впливі різних типів запальної реакції за умови експериментального гастродуоденіту

Introduction. Mucous membrane of the oral cavity is a sensitive indicator of evaluation of pathological processes of gastrointestinal tract, due to its morphological features difference compared with other mucous membranes. At digestive system diseases, depending on the lesion level of one organ or another, morphological changes of mucous membrane of all oral cavity parts take place and changes in immunological parameters of animal blood.The aim of the study – to examine and evaluate changes of morphometric parameters of the mucous membrane of the oral cavity of the buccal area and changes of humoral immunity under the influence of various types of inflammatory reaction at experimental gastroduodenitis.Materials and Methods. The experimental study was carried out on 42 male rats with weight 180-200 g. For all animals they modeled acute gastroduodenitis during 7 days. Hypoergic type of inflammatory reaction was modeled with intramuscular injection of alkylating cytostatic cyclophosphamide. Hyperergic type of inflammatory reaction was modeled with intramuscular injection of pyrogenal on physiological solution. Normoergic type of inflammatory reaction developed in the animals with experimental gastroduodenitis without additional injection of any substances. In order to make the experiment the animals were divided into 4 groups. The animals were withdrawn from the experiment with rapid decapitation under thiopental – with sodium anesthesia. Anatomic preparation of the oral cavity buccal area and morphometric measurements were made, using the methodology of H. H. Avtandilov. During morphometric examination they measured mucous membrane thickness, epithelial layer, lamina propria, basal membrane, specific gravity of damaged epitheliocytes of osteoid layer, relative volume of capillaries. In animals we determined the level of the concentration of Ig A, M, G in serum in a semi-automatic biochemical analyzer «Humalyzer 2000». Results processing was made at the department of system statistical research of the State Higher Educational Institution « I. Ya.HorbachevskyTernopilStateMedicalUniversity, Ministry of Public Health ofUkraine» in the software package Statsoft STATISTIKA.Results and Discussion. According to the results of the experimental study we found changes in the oral mucosa. The cause of buccal mucous membrane thinning was significant thinning of the epithelial layer, which can be explained by degenerative changes of different intensity. At the same time other structural components of mucous membrane of the buccal area of the oral cavity, namely basement membrane and lamina propria, were thickened on the contrary. The most evident dystrophic changes of the epithelium of buccal mucous membrane at microscopy were revealed in the animals with hyperergic type of inflammatory reaction. The important indicator of alteration processes in the mucous membrane of the oral cavity is specific part of damaged epitheliocytes, that 10 day study on indicators was increased relatively to control in these listed groups. Circulatory disturbance played an important role in the pathogenesis changes of mucous membrane of the oral cavity buccal area at modeled gastroduodenitis against the background of various types of inflammatory reaction. It appeared as level intensification of capillaries relative volume at morphometric investigation. In male white rats with hyperergic, normoergic, hypoergic TIR and morphometric changes in buccal areas consistent with immunological parameters. It was found that the levels of Ig A, M, G were higher relative to controls in all investigated groups of animals. The obtained results confirm that the changes of morphometric and immunological parameters depend on the type of inflammatory reaction.Conclusions. Changes of morphometric data were accompanied with thickness decrease of mucous membrane and epithelial layer, increase of thickness of the lamina propria, basement membrane, specific part of damaged epitheliocytes of osteoid layer and capillaries relative volume during 10 days of the experiment regardless of the inflammatory reaction type. Changes in humoral immunity accompanied by rising levels of Ig classes A, M and G relative control within 10 days. The most significant changes were found in animals with hyperergic type of inflammatory reaction, the least – with hypoergic type of inflammatory reaction in animals normoergic type of inflammatory reaction of change took an intermediate position.