History and evolution of the use of oral mucosa for urethral reconstruction

We report here the history and evolution of the use of oral mucosa in reconstructive urethral surgery since it was first used for urethroplasty in 1894.Since that time,many authors have contributed to develop,improve and popularize the use of oral mucosa as a substitute material.Paediatric urologists should be considered pioneers on the use of oral mucosa as they used it to repair primary and failed hypospadias.The use of oral mucosa to repair penile and bulbar urethral strictures was described,for the first time,in 1993.Important evolutions in the technique for harvesting oral mucosa from the cheek were reported in 1996.Today,oral mucosa is considered the gold standard material for any type of anterior urethroplasty in a one-or two-stage repair due to its biological and structural characteristics that make it a highly versatile that is adaptable to any environment required by the reconstructive urethral surgery.As the future approaches,tissue engineering techniques will provide patients with new materials originating from the oral epithelial mucosal cells,which are cultured and expanded into a scaffold.However,the path to reach this ambitious objective is still long and many difficulties must be overcome along the way.

Micronuclei in Nasal Mucosa, Oral Mucosa and Lymphocytes in Students Exposed to Formaldehyde Vapor in Anatomy Class

The frequency of micronuclei (MN) in cells of the nasal mucosa, oral mucosa and in lym-phocytes was evaluated for 25 students in anatomy classes exposed to formaldehyde (FA) overan 8-week period. Each student served as his or her own control. The time-weighted averageconcentration (TWA) of fOrmaldehyde in anatomical laboratories and in students' dormitorieswas 0. 508 ± 0. 299 mg/m3 and 0. 012 ± 0. 0025mg/m3, respectively. A higher frequency ofmicronuclei was observed in nasal and oral exfoliative cells after formaldehyde exposure (3. 85± 1. 48 vs 1 .20± 0. 676 and 0. 857 ± 0. 558 vs 0. 568 ± 0. 317, paired-t test: P< 0. 001and P < 0. 01, respectively). No significant increase in the frequency of lymphocyte micronu-clei was found after formaldehyde exposure (P >0. 05 ). The present study shows that nasalmucosa cel1s exposed through respiration are the chief target of FA-induced genotoxic effects

Bacterial-killing Effect of Atmospheric Pressure Non-equilibrium Plasma Jet and Oral Mucosa Response

Recently, plasma sterilization has attracted increasing attention in dental community ibr the atmospheric pressure non-equilibrium plasma jet （APNPs）, which is driven by a kilohertz pulsed DC power, may be applied to the dental and oral diseases. However, it is still in doubt whether APNPs can effectively kill pathogenic bacteria in the oral cavity and produce no harmful effects on normal oral tissues, especially on normal mucosa. The aim of this study was to evaluate the bacterial-killing effect of APNPs in the biofilms containing a single breed of bacteria （Porphyromonas gingivalis, Pg.）, and the pathological changes of the oral mucosa after treatment by APNPs. P.g. was incubated to form the biofilms in vitro, and the samples were divided into three groups randomly： group A （blank control）; group B in which the biofilms were treated by APNPs （the setting of the equipment： 10 kHz, 1600 ns and 8 kV）; group C in which the biofilms were exposed only to a gas jet without ignition of the plasma. Each group had three samples and each sample was processed for up to 5 min. The biofilms were then fluorescently stained, observed and photographed under a laser scanning confocal microscope. In the animal experiment, six male Japanese white rabbits were divided into two groups randomly （n=3 in each group） in terms of the different post-treatment time （1-day group and 5-day group）. The buccal mucosa of the left side and the mucosa of the ventral surface of the tongue were treated by APNPs for 10 min in the same way as the bacterial biofilm experiment in each rabbit, and the corresponding mucosa of the other sides served as normal control. The clinical manifestations of the oral mucosa were observed and recorded every day. The rabbits were sacrificed one or five day（s） after APNPs treatment. The oral mucosa were harvested and prepared to haematoxylin and eosin-stained sections. Clinical observation and histopathological scores were used to assess mucosal changes. The results showed the obvious P.g. biofilms were formed at 10 days, and most of the bacteria in groups A and C were alive under a laser scanning confocal microscope, but the bacteria in the group B were almost all dead. In animal experiment, no ulcers, anabrosis and oral mucositis were found in both the 1-day and 5-day groups. The aver- age mucous membrane irritation index was -0.83 and -0.67 in the 1-day and 5-day groups, respectively, suggesting that no intense mucosal membrane irritation responses occurred. It was concluded that APNPs could effectively kill Pg. in the biofilms and did not cause any pathological changes in the normal mucosa, suggesting that the plasma jet （APNPs） may be applied to oral diseases as a novel sterilization device in the future.

Urothelial or oral mucosa cells for tissue-engineered urethroplasty: A critical revision of the clinical outcome

Objective:To report the clinical outcome of urethral reconstruction by cultured urothelial or oral mucosa cells for tissue-engineered urethroplasty.Methods:We systematically searched for studies reporting the use of tissue-engineered techniques for hypospadias and urethral stricture repair in humans in PubMed and Embase(OvidSP)through January,1990 to June,2018.We excluded studies based on titles that clearly were not related to the subject,studies in which tissue-engineered biomaterial were used only in laboratory or experimental animals,and in the absence of autologous cultured epithelial cells.Studies were also excluded if they were not published in English,had no disease background and adequate follow-up.Finally,we search all relevant abstract presented at two of the main urological meetings in the last 10 years:European Association of Urology(EAU)and American Urological Association(AUA).Results:A total of six articles,reporting the clinical use of tissue-engineered techniques in humans,were fully reviewed in our review.The epithelial cells were harvested from the urethra(10 patients),the bladder(11 patients)and the mouth(104 patients).The tissue-engineered grafts were used in children for primary hypospadias repair in 16 cases,and in adults for posterior and anterior urethral strictures repair in 109 cases.Tissue-engineered grafts were showed working better in children for primary hypospadias repair than in adults for urethral strictures repair.Conclusion:One hundred and twenty-five patients received tissue-engineered urethroplasty using cultured epithelial cells for primary hypospadias or urethral strictures repair.The studies demonstrate a high degree of heterogeneity respect to epithelial cells(from urethra,bladder,and mouth),type of scaffold,etiology,site of urethral stricture,number of patients,follow-up and outcomes.

Electron Probe Microanalysis of Exogenous Pigmentation of Oral Mucosa Originating from Dental Alloy: Two Case Reports

Pigmentation of the oral mucosa is relatively common and has a wide variety of etiologies. Although most pigmented lesions of the oral mucosa are associated with deposition of melanin and accidental displacement of a dental alloy, accurate differential diagnosis of a pigmented lesion is important, especially in the case of malignant melanoma. We report two cases of oral mucosal pigmentation associated with accidental displacement of a dental alloy in which malignant melanoma was suspected. Excisional biopsy was carried out in these cases with the incision line set at approximately 5 mm from the lesions. Histopathologically, brownish foreign substances were observed in the lamina propria. Metal quantitative analyses of the extracted specimens were carried out by electron probe microanalysis (EPMA). The metal components and the mass concentration revealed that the metals were derived from a dental casting silver alloy in Case 1 and from a gold-silver palladium alloy in Case 2. Although exogenous pigmentation originating from a dental alloy is not rare, differential diagnosis of oral pigmented lesions is sometimes very difficult. In such cases, histopathological examination may be necessary for the diagnosis to exclude melanocytic lesions and EPMA may be effective to identify the causative dental alloy.

A Blackish Gingiva Revealing a Metastatic Melanoma of the Oral Mucosa

Background and Objective: Malignant melanoma is the most aggressive skin cancer because it has very strong metastatic power. Endobuccal localization is very rare. Its discovery is often made in the late stage, which leads to a consistently pessimistic diagnostic. We report a case of palatal melanoma at the metastatic stage. Case Report: A 43-year-old woman presented left lateral cervical swelling associated with dyspnea for 5 months. She had regularly taken chewing tobacco for 4 years and had developed blackish gums. The endobuccal examination showed a blackish non-haemorrhagic swelling of 5 cm of the long axis, located at the level of the palatal vault, associated with pigmentation in teeth 21, 22, and 23. The anatomopathological examination confirmed the melanoma. The spreading assessment revealed pleural and hepatic metastasis. The proposed treatment was palliative treatment. The patient died 2 months later. Conclusion: Melanoma of the oral mucosa is a very aggressive tumor. The scarcities of dental care among the Malagasy people exacerbate the delay in diagnosis. Its management is still challenging in Madagascar.

Characteristics of benign lymphoadenosis of oral mucosa

AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

Role of Protein Kinase C<i>δ</i>-Mediated Spleen Tyrosine Kinase (Syk) Phosphorylation on Ser in the Amplification of Oral Mucosal Inflammatory Responses to <i>Porphyromonas gingivalis</i>

The signaling events underlying oral mucosal inflammatory responses to P. gingivalis and its key endotoxin, lipopolysaccharide (LPS), relay primarily on the LPS engagement of Toll-like receptor-4 (TLR4), and the activation of IκB-kinase complex (IKK) and mitogen-activated protein kinases (MAPKs that exert their control over transcription factors implicated in the regulation of iNOS and COX-2 proinflammatory genes expression). Since spleen tyrosine kinase (Syk) has emerged recently as a major amplifier in the production of proinflammatory mediators, we investigated the process of recruitment and interaction of Syk with TLR4 in salivary gland acinar cells in response to P. gingivalis LPS. Our findings revealed that stimulation of the acinar cells with the LPS leads to protein kinase Cδ (PKCδ)-mediated phosphorylation of Syk on Ser which results in its localization with the membrane associated TLR4 complex and the activation through phosphorylation on Tyr. Further, our results support the involvement of Syk in the amplification of transcription factors involved in the assembly and expression of transcription complexes associated with the induction in COX-2 and iNOS genes. Therefore, our data suggest that PKCδ is a primary linchpin affecting the Syk recruitment to the membrane localized TLR4, and hence affects the efficiency of the kinase activation and the magnitude of oral mucosal inflammatory response to P. gingivalis.

A Case of Exfoliation of Oral Mucosal Epithelium in a Patient with Anti-Desmoglein 1 Antibody-Positive and Anti-Desmoglein 3 Equivocal Antibody

Pemphigus is an autoimmune bullous disease observed with lesions in the skin and mucosa. Pemphigus is classified by antibodies against desmogleins, which is cadherin type intercellular adhesion factors involved in adhesion between epidermal cells. In this case, because erosion of the oral mucosa was the primary symptom, a relationship with membrane-dominant pemphigus vulgaris was strongly suspected. And in terms of histopathology, findings not conflicted with pemphigus vulgaris were observed, but given all these different findings, the results did not correspond with bullous pemphigoid in clinical findings, and with pemphigus foliaceus and pemphigus vulgaris in various testing results, leading us to believe this represented a very rare case. We started oral health care, and when application of steroid ointment to the entire surface of the mucosa was continued, symptoms disappeared within approximately 2 months. In this case, relapse has not yet occurred and periodic follow-up was continued.

CXCL1-CXCR2 axis mediates neutrophils recruitment in rat oral mucosa

A lot of researches have shown that besides acting as essential contributors in innate immune response, neutrophils involved in the interaction between innate and adaptive immune responses by generation of a cascade of chemokines. But the data on relationship between chemokines and neutrophils recruitment in oral mucosa have been little available. In the present study, on a rat model characterized by neutrophils infiltration, a distinct profile of cytokines and receptors in oral mucosa was presented by the techniques of PCR array. Moreover, among these cytokines, upexpression of CXCL1 and its receptor, CXCR2, was found to correlate with the level of myeloperoxidase (MPO), a biomarker of neutrophils infiltration, and the up-expression of CXCL1-CXCR2 was suppressed by FK506, an immunosuppressive agent. Our results indicated that CXCL1-CXCR2 axis might play an important role in mediating neutrophils recruitment in oral mucosa, which will give new insights into the mechanisms of innate and adaptive immune responses of oral mucosa.

Studies on Biological Characteristics of Rabbit Oral Mucosal Epithelial Cells

Objective:The biological characteristics of rabbit oral mucosal epithelial cells(OMECs) were studied and the suitable procedure for the culture of OMECs was explored.Methods:Cultured OMECs by different surface disinfection,by different Dispase Ⅱ preparation,in different medium,in different calciumion concentration of K-SFM medium.Results:Microbial contamination of cell culture could significantly reduce with 2% iodine solution used for sterilization of oral cavity before cell culture.The OMECs digested with Dispase Ⅱin K-SFM could attach to the culture flask quickly,the OMECs digested with Dispase Ⅱ in PBS rare attached to the culture flask.The proliferations of OMECs cultured in 0 or 0.09 mmol/L calcium concentrations of K-SFM medium showed not statistically significant.the OMECs grew fast with serum,but it was easy to differentiate into fibroblast-like cells.Conclusion:OMECs could grow well and had the typical oral mucosal epithelial cell morphology by the procedure that described in this experiments.

Promoting oral mucosal wound healing using a DCS-RuB_(2)A_(2) hydrogel based on a photoreactive antibacterial and sustained release of BMSCs

The high occurrence rate and difficulties in symptom control are listed as the major problems of oral mucosal disease by medical professionals.Following the development of oral mucosal lesions,the oral microenvironment changes,immunity declines,and continuous bacterial stimulation causes wound infection.Traditional antibacterial drugs are ineffective for oral mucosal lesions.To overcome this problem,a light-responsive antibacterial hydrogel containing sustained-release BMSCs was inspired by the trauma environment in the oral cavity,which is different from that on the body surface since it mostly remains under dark conditions.In the absence of light,the hydrogel seals the wound to form a barrier,exerts a natural bacteriostatic effect,and prevents invasion by foreign bacteria.Simultaneously,mesenchymal stem cells are presented,and the released growth factors and other substances have excellent anti-inflammatory and angiogenic effects,which result in rapid repair of the damaged site.Under light conditions,after photo-induced shedding of the hydrogel,RuB_(2)A exerts an antibacterial effect accompanied by degradation of the hydrogel.Results in a rat oral mucosal repair model demonstrate that DCS-RuB_(2)A_(2)-BMSCs could rapidly repair the oral mucosa within 4 days.Sequencing data provide ideas for further analysis of the intrinsic molecular mechanisms and signaling pathways.Taken together,our results suggest that this light-responsive antibacterial hydrogel loaded with BMSCs can be used for rapid wound repair and may advance the development of therapeutic strategies for the treatment of clinical oral mucosal defects.

Oral mucosal conditions and some related factors in 140 Uygur centenarians

Objective To investigate the condition of the oral mucosae in Xinjiang Uygur centenarians and explore some related factors Methods The oral mucosae and mucosal exfoliative cells of 140 Xinjiang Uygur centenarians were examined Saliva and blood were collected from some centenarians Salivary immunoglobulins (IgA, IgM, IgG), complements (C 3 and C 4), nitrous oxide (NO), 10 trace elements, serum sex hormones, thyroid hormones and osteocalcin (OST) were analysed using immunoglobulin, complement and NO kits, an ionochromatophotometer, and the kits for sex hormones and thyroid hormones, and fluorescence enzyme linked immunosorbent assay, respectively Results Most centenarians (64 29%) had normal labial, buccal, palatal and gingival mucosae The abnormal changes in mucosae were mainly vascular nevus patches and senile plaques Their mucosal exfoliative cells showed similar characteristics to those in elderly Han The centenarians who had normal mucosae had higher level of the trace element molybdenum (Mo) in their saliva than who had abnormal mucosae ( P <0 01) Conclusion The oral mucosal condition of Uygur centenarians was generally good The abnormal changes in oral mucosae of the centenarians were lesions not harmful to health and may be related to the lower level of Mo in their saliva

STUDY OF ESTROGEN RECEPTOR AND PROGESTERONE RECEPTOR IN SQUAMOUS CELL CARCINOMA TISSUE OF ORAL MUCOSA

By means of the enzyme linked affinity histothemical method, 45 cases of squamous cell carcinoma(SCC) of the oral mucosa and 15 cases of the approximately normal oral mucosal tissue were detected for estrogen receptor(ER) and progesterone receptor(PR). The results indicated that In the SCC tissue of the oral mucosa there were 5 cases of ER+ and PR- and 32 cases of both ER+ and PR+. Thirty-seven cases, the summation of the above two items, were considered as receptor(+),therefore the rate of the receptor(+) being 82.22%. ER+ and PR+ were cd related to the sex and age of patients, the neck lymph nodes' metastasizing or not and affected parts of the tumor, while they were related to the differentiation degree of the tumor. The rate of receptor(+) decreased with the decrease of the differentiation degree of the tumor. By X2 test a remarkable difference between grade Ⅰand grade Ⅲ of SCC of the oral mucosa was shown. It is suggested that SCC of the oral mucosa may probobly be hormone dependent tumor. The authors consider that the SCC detection for ER and PR could not only be one of the indices of biologic characteristics for that tumor but also as bases of anti-hormone treatment.

The mucosal immune system in the oral cavity——an orchestra of T cell diversity

The mucosal immune system defends against a vast array of pathogens, yet it exhibits limited responses to commensal microorganisms under healthy conditions. The oral-pharyngeal cavity, the gateway for both the gastrointestinal and respiratory tracts, is composed of complex anatomical structures and is constantly challenged by antigens from air and food. The mucosal immune system of the oral-pharyngeal cavity must prevent pathogen entry while maintaining immune homeostasis, which is achieved via a range of mechanisms that are similar or different to those utilized by the gastrointestinal immune system. In this review, we summarize the features of the mucosal immune system,focusing on T cell subsets and their functions. We also discuss our current understanding of the oral-pharyngeal mucosal immune system.

ORAL TRANSMUCOSAL BACK PERMEATION OF ALFENTANIL IN DOGS──A NOVEL METHOD TO DETERMINE BLOOD ALFENTANIL CONCENTRATION

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P^（53） PROTEIN OVEREXPRESSION IN PREMALIGNANT AND MALIGNANT LESIONS OF ORAL MUCOSA：IMMUNOHISTOCHEMICAL OBSERVATION

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口腔黏膜黑色素瘤冷冻消融治疗专家共识

冷冻消融治疗有着悠久的历史,其抗肿瘤机制、组织病理变化已较明确,且大量临床实践表明冷冻消融治疗安全有效,理论上是一种理想的肿瘤治疗手段。以往一直受冷媒和冷冻设备的限制,制约了其疗效和临床应用。随着以氩氦刀为代表的新一代冷冻消融设备的出现,在制冷效率、消融范围、精准测温等方面取得了长足的进步,极大地推动了肿瘤冷冻消融技术的推广。该共识系统性地总结了冷冻消融技术的机制、口腔黏膜黑色素瘤冷冻治疗的适应证、临床治疗流程、不良反应及处理、冷冻联合治疗等,旨在为口腔黏膜黑色素瘤冷冻消融治疗的规范化开展提供参考。

不同剂量右美托咪定口腔黏膜喷雾或滴鼻用于小儿脑电图检查的镇静效果

目的观察不同剂量右美托咪定(Dex)口腔黏膜喷雾或滴鼻用于小儿脑电图(EEG)检查的镇静效果。方法151例患儿根据Dex口腔黏膜喷雾2.5 ug/kg、3 ug/kg,Dex滴鼻2.5 ug/kg、3 ug/kg,随机分为D1组(38例)、D2组(38例)、D3组(37例)和D4组(38例)。记录患儿给药前(T_(0)),给药后10 min(T_(1))、20 min(T_(2))、30 min(T_(3))、40 min(T_(4))警觉镇静量表(OAA/S)评分、MAP、HR、SpO_(2)。观察患儿镇静一次成功率、诱导时间、检查时间、苏醒时间、不良反应和不同时间点4组患儿的镇静效果和MAP、HR、SpO_(2)。结果D1与D3组、D1与D2组起效时间和D3与D4组的苏醒时间差异有统计学意义(P<0.05);T_(2)时的D1与D2组、D3与D4组和T_(4)时的D3与D4组的OAA/S评分差异有统计学意义(P<0.05);T_(2)时的D1与D2组的MAP差异有统计学意义(P<0.05);T_(1)时的D1与D2组、T_(3)时的D1与D2组和D3与D4组的HR差异有统计学意义(P<0.05)。结论小儿EEG检查前应用Dex 3ug/kg滴鼻,诱导时间快、成功率高、镇静效果好,是一种安全有效的EEG检查前的镇静方法。

Sweet综合征口腔黏膜表现1例报道及文献回顾

目的探讨Sweet综合征的口腔黏膜病损表现,为临床早发现并正确诊断该病提供参考。方法报道1例60岁女性Sweet综合征患者的口腔黏膜病损表现,并结合相关文献对Sweet综合征进行分析。结果患者双下肢皮肤红斑伴口腔黏膜破溃疼痛3 d,患者皮损症状较轻,但口腔黏膜多发性大面积糜烂,疼痛明显,故首诊于口腔科。患者发病过程中伴有发烧,体温38.5℃;实验室检查示C反应蛋白升高(35.2 mg/L),血沉加快(77.00 mm/h);患者两侧膝盖及下肢可见散在分布红色斑块,轻度压痛,皮损组织病理学检查示:真皮全层见散在不成熟中性粒细胞聚集灶浸润。根据患者临床体征和实验室检查,皮损组织病理结果的镜下符合Sweet综合征的表现,诊断为Sweet综合征。给予患者1 mL复方倍他米松注射液肌肉注射仅1次;患者对糖皮质激素治疗效果反应良好;口腔采用复方氯己定溶液含漱,病损黏膜处重组牛碱性成纤维细胞生长因子溶液外用,3次/d,疗程为1周;用药4 d后复诊,体温恢复正常,口腔病损明显减轻;2周后复诊,小腿及膝盖处红斑几乎全部消退,口腔黏膜病损基本消失;半年后随访,结果显示皮损未复发;2年后随访,病情稳定,病损未见复发。回顾相关文献表明,Sweet综合征是一种少见的病因不明的炎性反应性皮病,临床上可分为3种类型:特发型、肿瘤相关型以及药物诱导型,男女患病比为1∶4,典型临床表现为急性出现的疼痛性红色斑块或结节,病损多位于四肢,常伴发热,外周血中性粒细胞数目增多,血沉加快,C反应蛋白阳性。系统应用糖皮质激素是本病最重要的治疗方法,大多数患者可在短期内改善皮损,但可能会存在潜在感染或停药后复发的情况。部分Sweet综合征患者可伴有口腔病损,但目前有关Sweet综合征在口腔黏膜表现的病例报道却很少,使得临床容易误诊。结论口腔黏膜病损可能为Sweet综合征的皮肤外表现,应综合考虑患者的全身情况,尽快完善皮肤活检以明确诊断,以免延误病情。