Carnoy's Solution Research Articles

The impact of dihydropyrimidine dehydrogenase expression in pancreatic cancer patients who undergo curative resection with S-1 adjuvant chemotherapy

The antimetabolite drug, 5-fluorouracil (5-FU), is used in the treatment of various cancers, including basal cell carcinomas (BCCs). The authors hypothesized that keratocystic odontogenic tumors (KOTs) would respond to 5-FU treatment because of their similarities to BCCs in molecular etiopathogenesis.An ambispective cohort study of the treatment efficacy of topical 5-FU on KOTs was conducted. Independent variables included the topical application of 5% 5-FU or modified Carnoy's solution (MC) after enucleation and peripheral ostectomy at the University of Toronto from 2006 through 2014. Outcome variables included time to recurrence and peripheral nerve injury. KOT specimens in these patients were immunostained with p53, Ki-67, thymidylate synthetase (TS), thymidylate phosphorylase (TP), and dihydropyrimidine dehydrogenase (DPD) antibodies. Semiquantitative staining scores were calculated for all immunohistochemistry sections examined. Descriptive statistics were computed using Fisher exact test and Kaplan-Meier analysis as appropriate with the P value set at .05.Thirty-two patients with 32 KOTs were reviewed (41% in women and 59% in men). There were no KOT recurrences in the 5-FU group (n = 11), whereas there were 4 recurrences in the MC group (n = 21; P = .190). There was a significantly lower incidence of inferior alveolar nerve paresthesia with 5-FU treatment (P = .039). Immunohistochemical staining showed upregulation of TP (P < .0001) and DPD (P < .0001) and no change in TS (P > .05) in inflamed KOTs.5-FU effectively treats KOTs with less postoperative morbidity than conventional treatment with MC. Low TS and upregulated TP expressions in inflamed KOTs suggest increased 5-FU efficacy in inflamed KOTs. Topical 5-FU is a novel therapy for KOTs and provides a targeted molecular approach to treatment.

The study of calcified atherosclerotic arteries: an alternative to evaluate the composition of a problematic tissue reveals new insightincluding metakaryotic cells.

BackgroundCalcifications of atherosclerotic plaques represent a controversial issue as they either lead to the stabilization or rupture of the lesion. However, the cellular key players involved in the progression of the calcified plaques have not yet been described. The primary reason for this lacuna is that decalcification procedures impair protein and nucleic acids contained in the calcified tissue. The aim of our study was to preserve the cellular content of heavily calcified plaques with a new rapid fixation in order to simplify the study of calcifications.MethodsHere we applied a fixation method for fresh calcified tissue using the Carnoy’s solution followed by an enzymatic tissue digestion with type II collagenase. Immunohistochemistry was performed to verify the preservation of nuclear and cytoplasmic antigens. DNA content and RNA preservation was evaluated respectively with Feulgen staining and RT-PCR. A checklist of steps for successful image analysis was provided. To present the basic features of the F-DNA analysis we used descriptive statistics, skewness and kurtosis. Differences in DNA content were analysed with Kruskal-Wallis and Dunn’s post tests. The value of P < 0.05 was considered significant.ResultsTwenty-four vascular adult tissues, sorted as calcified (14) or uncalcified (10), were processed and 17 fetal tissues were used as controls (9 soft and 8 hard). Cells composing the calcified carotid plaques were positive to Desmin, Vimentin, Osteocalcin or Ki-67; the cellular population included smooth muscle cells, osteoblasts and osteoclasts-like cells and metakaryotic cells. The DNA content of each cell type found in the calcified carotid artery was successfully quantified in 7 selected samples. Notably the protocol revealed that DNA content in osteoblasts in fetal control tissues exhibits about half (3.0 ng) of the normal nuclear DNA content (6.0 ng).ConclusionTogether with standard histology, this technique could give additional information on the cellular content of calcified plaques and help clarify the calcification process during atherosclerosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12907-016-0036-6) contains supplementary material, which is available to authorized users.

Cytospecies Composition ofSimulium damnosumComplex (Diptera: Simuliidae) Breeding in Oyan River, Southwestern Nigeria

A cytotaxonomic study was carried out to determine the species composition and dynamics of Simulium damnosum sensu lato in Oyan River, an onchocerciasis mesoendemic area in southwest Nigeria. Simulium larvae were collected fortnightly from different attachments between March and November 2012 fixed in Carnoy's solution for laboratory identification using cytotaxonomic keys. A total of 255 Simulium larvae were obtained and identified from their polytene chromosomes. Simulium soubrense Beffa (56.5 %) and Simulium damnosum sensu stricto (43.5 %) were the two cytospecies observed. No new inversions were found in the larvae. Statistical analysis revealed a significant difference (P<0.05) in the abundance of S. damnosum s.s. and S. soubrense in relation to rainfall pattern. The sympatric breeding of both species in the area may suggest their involvement in the transmission of onchocerciasis in the area, as S. damnosum s.s. and S. soubrense Beffa are known vectors of Onchocerca volvulus in West Africa.

Results of the treatment of keratocystic odontogenic tumours using enucleation and treatment of the residual bony defect with Carnoy's solution

This retrospective study aimed to investigate the recurrence rate of keratocystic odontogenic tumours (KCOTs) treated by enucleation and the application of Carnoy's solution, and to assess the surgical morbidities associated with this treatment. KCOTs treated using a standard protocol of enucleation and the application of Carnoy's solution between 1990 and 2013 were evaluated. One hundred and five KCOTS in 105 patients (54 male, 51 female) were analysed. The mean follow-up period was 86.6 months (range 24–313 months). The recurrence rate was 11.4%. A postoperative inferior alveolar nerve neurosensory deficit occurred in 30.1% of the mandibular cases, with 16% of these being permanent. The postoperative infection and fracture rates were 1.9% and 0.9%, respectively. Younger age, multilocular KCOTs, larger tumour size, and longer antero-posterior lesion length on the radiograph were found to be risk factors for recurrence. It is concluded that enucleation and the application of Carnoy's solution to treat KCOTs results in a relatively low recurrence rate and a low rate of surgical morbidities.

Intra-puparial development and age estimation of forensically important Hermetia illucens (L.)

The black soldier fly, Hermetia illucens (L.) (Diptera: Stratiomyidae), is a generalist detritivore commonly present in the advanced decomposed and skeletonized remains stage, and may be useful in the estimation of the postmortem interval (PMI). In order to study the intra-puparial morphological characteristics of H. illucens (black soldier flies) under increasing temperatures, flies were obtained from a colony in a successional study conducted in the Panyu District of Guangzhou. After oviposition, eggs were incubated under constant temperatures of 20, 24, 28, 32 (±1) °C with 70% relative humidity and an L12:D12 photoperiod. Sampling began at the onset of the pupal stage (n=10) and continued daily. Pupae were fixed in Carnoy's solution and maintained in 75% ethanol. Intra-puparial morphological characteristics were photographed and recorded. Some typical intra-puparial morphological characteristics which are valuable for age estimation were documented and the relationships with time under different constant temperatures were listed. Eight phases were described on the basis of the intra-puparial morphological changes, including antennae, appendages, mouthparts, compound eyes, and respiratory horns. The time required for development was inversely correlated with temperature. This article provides fundamental data for forensic entomology in regard to the postmortem interval (PMI) estimation, particularly when the PMI is based on information about the pupa of H. illucens.

Role of Carnoy's solution in the treatment of keratocystic odontogenic tumor: A systematic review.

Introduction and ObjectiveThe keratocystic odontogenic tumor is a benign but aggressive neoplasm. As enucleation alone obtains high recurrence rates, some adjuvant treatments such as Carnoy’s solution have been proposed. The aim of this study is to evaluate the reduction of recurrences with the use of Carnoy’s solution as adjuvant in the treatment of keratocystic odontogenic tumors.Material and MethodsAn electronic search in Pubmed (MEDLINE), ScienceDirect and Cochrane databases was conducted with the key words “odontogenic keratocyst”, “keratocystic odontogenic tumor”, “carnoy’s solution”, “treatment” and “enucleation”. The inclusion criteria were clinical studies using Carnoy’s solution as adjuvant for the treatment of keratocystic odontogenic tumors, published in English, including at least 10 patients. Articles with an unclear reporting of the treatment applied, nonhuman studies, case reports and lesions associated to Gorlin-Goltz syndrome were excluded.ResultsAll the studies included were case series. The recurrence rate of enucleation ranged from 0% to 58.8%. With the only use of Carnoy’s solution as adjuvant treatment to the enucleation, recurrences varied from 0% to 100%. The use of ≥ 2 adjuvant treatments reduced the range between 0% and 7.9%.ConclusionsThe use of Carnoy’s solution as adjuvant therapy for the treatment of keratocystic odontogenic tumor has a grade C recommendation. Key words:Carnoy’s solution, keratocystic odontogenic tumor, treatment, recurrence.

Evaluation of Histomorphometric Changes in Tissue Architecture in Relation to Alteration in Fixation Protocol - An Invitro Study.

Preparation of good tissue specimens for microscopy requires complete fixation. No ideal fixative has been found till date, with every fixative showing advantages and disadvantages. Appropriate fixation is required to maintain clear and consistent morphologic features for histologic examination. Pathologists mostly examine formalin fixed tissue sections and are less used to the morphologic changes induced by other fixatives. Underfixed and overfixed tissue in various fixatives can lead to tissue architectural changes which can affect its diagnostic value. To assess sectioning ability, staining intensity and microscopic details of tissues kept in different fixatives at different time intervals. Fresh tissue specimen i.e., goat tongue was collected and its middle-third portion was used for the study purpose. The tissue was grossed into 10 equal pieces and kept in various fixatives (10% Buffered formalin, Carnoy's solution, Absolute ethyl alcohol, Bouin's fluid) for five different time intervals (6, 12, 18, 24 and 30 hours) and normal tissue processing steps were carried out followed by sectioning and staining. During sectioning, sectioning parameter was assessed. Following sectioning, sections were observed under light microscope and were histologically evaluated for staining and microscopic details. To calculate the sectioning parameter Fisher's exact test was used and to assess parameters for staining and microscopic details Mann-Whitney U test was used. According to the study, 10% buffered formaldehyde is considered as a superior fixative under all parameters followed by Bouin's fluid, Carnoy's solution and Absolute alcohol. In our study, it was concluded that 10% buffered formaldehyde should be continued as a routine fixative however, other fixatives can be used depending upon the non-availability of required fixative or in case of emergencies. Pathologist should be accustomed to histologic and morphologic changes of underfixed and overfixed tissue which can affect its diagnostic value.

Unicystic ameloblastoma of mandible: Nondentigerous variant – A rare case report

Ameloblastomas are benign epithelial odontogenic tumors. The World Health Organization (2005) classified ameloblastomas into solid/multicystic, extraosseous/peripheral, desmoplastic and unicystic types. Unicystic ameloblastoma (UA) is a less frequently occurring tumor and accounts for 10 to 15% of all the intraosseous ameloblastomas. Ninety percent of the UAs are found in the mandible with predominance towards molar-ramus region. Approximately 50–80% of UAs are associated with impacted tooth (dentigerous variant). This case report is an effort to bring forth a case of UA in a 35-year-old female who presented with an asymptomatic swelling involving the right and left parasymphsis region through the midline, which is uncommon for UA and is not associated with an impacted tooth (nondentigerous variant). The lesion was confirmed by histopathological evaluation, treated by complete enucleation and curettage with extraction of teeth number 31 to 35 and 41 to 45, followed by chemical cauterization with 5% Carnoy's solution, and rehabilitated with fixed partial denture after 7 months.

The use of Carnoy's solution following enucleation of ameloblastoma: ten year's experience

The use of Carnoy's solution following enucleation of ameloblastoma: ten year's experience

Interventions for the treatment of keratocystic odontogenic tumours.

The keratocystic odontogenic tumours (KCOTs) account for between about 2% and 11% of all jaw cysts and can occur at any age. They are more common in males than females with a male:female ratio of approximately 2:1. Although they are benign, KCOTs are locally very aggressive and have a tendency to recur after treatment. Reported recurrence rates range from 3% to 60%. The traditional method for the treatment of most KCOTs is surgical enucleation. However, due to the lining of the cyst being delicate and the fact that they frequently recur, this method alone is not sufficient. Adjunctive surgical treatment has been proposed in addition to the surgical enucleation, such as removal of the peripheral bone (ostectomy) or resection of the cyst with surrounding bone (en-bloc) resection. Other adjunctive treatments proposed are: cryotherapy (freezing) with liquid nitrogen and the use of the fixative Carnoy's solution placed in the cyst cavity after enucleation; both of which attempt to address residual tissue to prevent recurrence. To assess the available evidence comparing the effectiveness of interventions for the treatment of KCOTs. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 17 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 2), MEDLINE via Ovid (1946 to 17 March 2015) and EMBASE via Ovid (1980 to 17 March 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials comparing one modality of intervention with another with or without adjunctive treatment for the treatment of KCOTs. Adults, over the age of 18 with a validated diagnosis of solitary KCOTs arising in the jaw bones of the maxilla or mandible. Patients with known Gorlin syndrome were to be excluded. Review authors screened trials for inclusion. Full papers were obtained for relevant and potentially relevant trials. If data had been extracted, it would have been synthesised using the fixed-effect model, if substantial clinical diversity were identified between studies we planned to use the random-effects model with studies grouped by action provided there were four or more studies included in the meta-analysis, and we would have explored the heterogeneity between the included studies. No randomised controlled trials that met the inclusion criteria were identified. There are no published randomised controlled trials relevant to this review question, therefore no conclusions could be reached about the effectiveness or otherwise of the interventions considered in this review. There is a need for well designed and conducted randomised controlled trials to evaluate treatments for KCOTs.

Current Role of Carnoy's Solution in Treating Keratocystic Odontogenic Tumors

To understand the frequency of use of Carnoy's solution, as a means of chemical curettage, for treating the keratocystic odontogenic tumor (KCOT). A Web-based survey was distributed by e-mail to 6,880 members listed in the 2013 American Association of Oral and Maxillofacial Surgeons directory. Eight hundred nine participants across the United States responded to the survey (12% response rate). The most common procedures performed to definitively treat a KCOT were enucleation plus mechanical curettage (curette with or without peripheral ostectomy; 66%). Of the survey participants, 198 (25%) currently use Carnoy's solution, 111 (56%) of whom are using the solution with chloroform and 83 (42%) are using it without chloroform. Carnoy's solution remains a common method of chemical curettage for the definitive treatment of the KCOT. Carnoy's solution with and without chloroform is being used for chemical cautery.

Use of Carnoy's Solution as a Conservative Alternative in the Treatment of Aggressive Odontogenic Lesions: A Series of 12 Cases

Use of Carnoy's Solution as a Conservative Alternative in the Treatment of Aggressive Odontogenic Lesions: A Series of 12 Cases

Carnoy's Solution as an Adjunct Therapy: 2 Case Reports and Literature Review

Carnoy's Solution as an Adjunct Therapy: 2 Case Reports and Literature Review

Significantly Decreased Recurrence Rates in Keratocystic Odontogenic Tumor With Simple Enucleation and Curettage Using Carnoy's Versus Modified Carnoy's Solution

A variety of modalities has been suggested for treatment of keratocystic odontogenic tumor (KOT), including Carnoy's solution (CS) and modified Carnoy's (without chloroform) solution (MC). The purpose of the present study was to investigate the effect of CS versus MC as it relates to the KOT recurrence rates when used in conjunction with simple enucleation and curettage (E&C) for treatment of KOT. A retrospective cohort study of patients with a pathologic diagnosis of KOT treated with E&C and application of CS or MC by 3 surgeons at a single center from January 1996 to April 2014 was completed. The demographic, clinical, radiographic, and histologic data were collected for each patient. All disease recurrences were confirmed by biopsy. The primary outcome variable of the study was the interval to recurrence, with the predictor of CS versus MC. Other variables included in the analysis were gender, age, surgeon, and lesion location. Multivariate analysis, including the Wilcoxon test and χ(2) test of associations, was performed. A total of 210 patient medical records were reviewed, with 80 patients meeting the final study criteria. Of the 80 patients, 44 were in the CS arm and 36 in the MC arm. The median age was 47years (range 10 to 89) in the CS group and 50years (range 14 to 72) in the MC group (P= .70). Women accounted for 43% (19 of 44) and 44% (16 of 36) of the patients in the CS and MC treatment arms, respectively (P=.91). The lesions were found in the mandible in 26 of the 44 patients (59%) treated with CS and 22 of the 36 patients (61%) treated with MC (P= .85). Surgeon 1 treated 37 of the 44 patients (84%) and 21 of 36 patients (58%) in the CS and MC groups, respectively (P= .01). The recurrence rate was 10% for the CS arm and 35% for the MC arm (P= .027; hazard ratio 6.9). In the present retrospective study, the recurrence rate of KOTs treated by E&C with application of CS is significantly lower than that of MC. The data provided could be considered by the Food and Drug Administration for a clinical trial of CS in patients with KOT.

Recurrence rates of keratocystic odontogenic tumors in patients treated by enucleation and curettage with or without Carnoy's solution

Recurrence rates of keratocystic odontogenic tumors in patients treated by enucleation and curettage with or without Carnoy's solution

ALK translocation detection in non-small cell lung cancer cytological samples obtained by TBNA or EBUS-TBNA.

As the diagnosis of non-small cell lung cancer (NSCLC) is based on cytology in around 70% of cases, it is important to use the same material for molecular analyses. Fluorescence insitu hybridization (FISH) is the only approved test for the detection of the translocation and inversion of anaplastic lymphoma kinase (ALK), but the optimal procedures for the fixation or staining of the sample before FISH evaluation have not been established. We investigated whether ALK gene status determined by FISH in a prospectively enrolled case series of patients was affected by fixation and staining. One hundred and fifteen cytological samples were obtained by transbronchial needle aspiration (TBNA) or endobronchial ultrasound (EBUS)-TBNA from 109 patients with NSCLC. All samples were evaluated for epidermal growth factor receptor (EGFR) mutation by pyrosequencing and for ALK rearrangement by FISH. Specimens for ALK determination had been fixed with Cytofix(®) and/or Carnoy's solution or 10% formalin (cell blocks) and variously stained. Sixteen (14%) of the 115 samples were mutated for EGFR and 99 (86%) showed wild-type EGFR status. Of these 115 samples, 79 (69%) were negative for echinoderm microtubule-associated protein like 4 (EML4)-ALK translocation, nine (8%) were positive and 27 (23%) were unevaluable. In particular, 19 (26%) of the 72 Papanicolaou-stained smears fixed with Cytofix were unevaluable because of inadequate samples or cell overlapping; neither of the two May-Grünwald-Giemsa-stained samples were evaluable. Ten of 17 smears used for rapid on-site evaluation (ROSE) and immediately post-fixed in Carnoy's solution or 80% alcohol were evaluable. In this series, smears were unevaluable as a result of inadequate samples, cell overlapping or lack of fixation performed immediately after FNA.

Keratocystic Odontogenic Tumour with Extraosseal Spread: Evaluation of the Effect Carnoy's Solution.

Keratocystic odontogenic tumour is relatively rare benign tumour. It is characterized by its fast aggressive growth and high risk of recurrence. Treatment is always surgical: conservative (enucleation, marsupialization) or aggressive (enucleation followed by application of Carnoy's solution, cryotherapy; peripheral ostectomy or en block resection of the jaw). Authors analysed retrospectively 22 patients who fulfilled inclusion criteria, i.e. had odontogenic keratocystic tumour of mandible, wherein antero-posterior dimension was at least 30 mm, and the tumour penetrated into the surrounding soft tissues. All patients underwent tumour enucleation, in 11 patients Carnoy's solution was given into the bone cavity after enucleation. The recurrence rate in the evaluation at least 36 months after surgery was both patient groups the same: 45.4%.

Gorlin Goltz syndrome: A case report

Not many cases have been reported in India, and hence we report here a rare case of Gorlin Goltz syndrome (GGS) especially in young patients without any skin lesions. A 21 year old male reported to our department, with swelling in the lower posterior region of the right side of jaw since last 2 years. Thorough extraoral and intraoral examinations along with orthopantomogram (OPG), CT scan (skull) and chest radiograph helped in proper diagnosis of the condition. No skin lesion in the form of basal cell nevus, palmar or plantar pits, or keratosis were present. All the cystic lesions of the jaws were enucleated surgically and chemical cauterization done by Carnoy's solution. No sign of recurrence observed still date. Our case highlights the importance of the awareness of this rare syndrome, especially in young patients without any skin lesions because early verification of the disease prevent recurrence and better survival rates from the existent disease.

Surgical management of a high ramal odontogenic keratocyst

Odontogenic keratocysts (OKCs) are benign, they are often locally destructive and tend to recur after conservative surgical treatment. There has been a shift in the treatment modality from conservative procedures like marsupialization and enucleation to the more conventional surgical methods. However, the recurrence rate after marsupialization, followed by enucleation is not significantly higher than that after aggressive modalities. The goals of treatment should eliminate the potential for recurrence and minimize the surgical morbidity. Future treatment may involve molecular-based modalities, which may reduce or eliminate the need for aggressive surgical management. A case report is presented in which isolated OKC at the level of sigmoid notch is treated by surgical enucleation and chemical cauterization (with Carnoy's solution).

Comparison of results of the manual and automated scoring of micronucleus frequencies in 60Co-irradiated peripheral blood lymphocytes for triage dosimetry

Scoring micronuclei in the peripheral blood lymphocytes of individuals exposed to ionizing radiation is a rapid biodosimetry assay. Peripheral blood lymphocytes from five individuals were exposed in vitro to 0–5Gy of 60Co γ-radiation at a dose rate of 0.76Gy/min. The blood cultures were initiated with RPMI-1640 (80%) supplemented with FBS (20%), stimulated with mitogen and incubated at 37°C for 44h. At the 44th hour, cytochalasin-B (6µg/mL) was added, and the cultures were incubated for 28h more. The cells were harvested with a pre-chilled hypotonic solution (0.075M) and fixed with a Carnoy's solution (methanol/acetic acid 5:1). Giemsa- and propidium-iodide-stained cells affixed to slides for microscopy were scored manually and automatically with the micronucleus scoring software from MetaSystems. The micronucleus frequencies determined in the Giemsa-stained cells by manual and automated scoring were 23.6% different (P<0.0001) with an efficiency of 24.9%. Slides stained with propidium iodide are a better choice for automated scoring than Giemsa-stained ones.