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Introduction Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that exhibits the potential for recurrence and metastasis but rarely involves the oral cavity. Presentation Of Case We report the management and long term follow up of recurrent EHE in a 23- year-old woman. The lesion initially presented as a small area of erythematous gingival swelling with localised bone loss around the lower anterior teeth. It was treated by buccal and lingual stripping of the gingival tissues. The patient suffered local recurrence after 7 years and was treated with a wider surgical excision of the buccal and lingual gingivae, conserving the adjacent teeth and bone with an excellent cosmetic outcome. Over 21 years later, there have been no further recurrences. Discussion This case highlights the management challenges of EHE and is the only case in the literature to have reported a case of mandibular gingivae with a long review period of 21 years. Conclusion Oral EHE is an unpredictable lesion with a relatively benign course, unlike non-oral EHE where up to one third of cases may metastasise. Because of the propensity to recur locally after excision and curettage, a wide local excision with close clinical follow has been suggested in the literature as the treatment of choice for oral lesions. However, the lack of metastases from oral lesions, the small size, mandibular site and bland histology in this case suggests that a limited soft tissue excision and bone curettage, with long term follow-up would be appropriate for similar gingival lesions in future. [ABSTRACT FROM AUTHOR]

This study compared higher education dental undergraduate student performance in online assessments with performance in traditional paper-based tests and investigated students' perceptions of the fairness and acceptability of online tests, and showed performance to be comparable. The project design involved two parallel cross-over trials, one in Year 3 ( n = 132) of the dental curriculum, one in Year 5 ( n = 134). A total of 266 students undertook related tests of the same knowledge base in both online and traditional paper formats. Order of presentation of the test form was randomized. One hundred and thirty-two students in Year 3 additionally completed questions concerning their perceptions of the acceptability and fairness of the online examination process. Focus group discussions were held with groups of students ( n = 30) from both Year 3 and 5 to explore their perceptions of the online format. The online tests were created using the commercial software package MaxExam (Bristol, UK). The results were analysed using repeated measures analysis of variance (ANOVA) with the order of presentation being entered as a variable in the analysis. The results of the study showed that for both Years 3 and 5 students there was a high degree of consistency in performance between the two versions of the tests, although a minority of students performed better in the online version of the test. Over 70% of students rated the online test as acceptable, and 90% felt that the online format did not disadvantage them even in a 'high-stakes' situation. From these results, we conclude that online assessment does not confer any disadvantage to students. Students perceive such assessment to be both fair and acceptable, and to have some advantages over the traditional paper-based methods of assessment. [ABSTRACT FROM AUTHOR]

Objective: To assess the educational effectiveness of delivering continuing professional education (CPE) from dental schools to small groups of dentists at distant sites via videoconferenced links using relatively inexpensive equipment and ISDN2 links.Design: 41 videoconferences between the four campuses of London Dental Schools and postgraduate centres in South East England were assessed using a pre-piloted questionnaire which contained open and specific questions. The questionnaire was given to all participants at the end of each videoconference. Answers to the specific questions were graded using the Likert scale.Results: 40 of the 41 videoconferences were completed satisfactorily and were attended by 257 participants, all of whom completed questionnaires. However, no individual question was answered by all the participants. Of the responses 90% were positive on the topics of appropriateness of the teaching material for delivery by videoconference and of its educational level. 90% of responses also indicated a wish to attend further videoconferences and satisfaction at avoiding the need to travel to London for similar educational activity. 87% rated the lecturers as good or excellent in their use of the medium. 85% of responses indicated that the question and answer sessions within the videoconferences were useful and 82% that the visual aids enhanced the sessions. The technical aspects of the videoconferences were rated positively but to a lesser extent than the educational aspects with 69% of positive responses for visibility of visual aids, 54% for sound quality and 76% for the lecturers use of the technology. The technical aspects of the videoconferences improved during the pilot study. In response to the open questions, participants stated that they found the most useful aspects of the videoconferences were not having to travel, access to first rate lecturers, the discussions and the opportunity to interact with experts.Conclusions: The participants in this pilot study were positive about the use of videoconferencing to deliver educational material from dental schools to small groups. Once the technology has improved, this medium has the potential to provide CPE for dentists at work or at home in response to their specific needs. [ABSTRACT FROM AUTHOR]

The origin of the stromal, stellate and multinucleate cells in oral giant cell fibroma is unclear. Sixteen giant cell fibromas were stained immunocytochemically for keratin (MNF 116), vimentin, S-100 protein, neurofilaments, glial fibrillary acidic protein, alpha-smooth muscle actin, desmin, CD31 (PECAM-1), CD68, Factor XIIIa and prolyl 4-hydroxylase (5B5). In all cases positive staining was found with vimentin and prolyl 4-hydroxylase, indicating a functional fibroblast phenotype. Reactivity for Factor XIIIa was seen in two cases and in only one was a small number of giant cells stained, suggesting that the majority of oral giant cell fibromas are unrelated to the histologically similar fibrous papule of the nose or facial angiofibroma. [ABSTRACT FROM AUTHOR]

Abstract: Background: Positron emission tomography (PET) imaging using the radiotracer 18F-Fluorothymidine (FLT) has been proposed as an imaging biomarker of tumour proliferation. If FLT-PET can be established as such it will provide a non-invasive, quantitative measurement of tumour proliferation across the entire tumour. Results from validation studies have so far been conflicting with some studies confirming a good correlation between FLT uptake and Ki-67 score and others presenting negative results. Methods: Firstly we performed a systematic review of published studies between 1998 and 2011 that explored the correlation between FLT uptake and Ki-67 score and examined possible variations in the methods used. Studies were eligible if they: (a) included patients with cancer, (b) investigated the correlation between Ki-67 measured by immunohistochemistry and FLT uptake measured with PET scanning, and (c) were published as a full paper in a peer-reviewed scientific journal. Secondly a meta-analysis of the correlation coefficient values reported from each study was performed. Correlation coefficient (r) values were extracted from each study and 95% confidence intervals (CIs) were calculated after applying Fisher’s z transformation. For subgroup analysis, studies were classified by the index used to characterise Ki-67 expression (average or maximum expression), the nature of the sample (whole specimen or biopsy) and the cancer type. Findings: Twenty-seven studies were identified as eligible for the meta-analysis. In the studies we examined there were variations in aspects of the methods and reporting. The meta-analysis showed that given an appropriate study design the FLT/Ki-67 correlation is significant and independent of cancer type. Specifically subgroup analysis showed that FLT/Ki-67 correlation was high in studies measuring the Ki-67 average expression regardless of use of surgery or biopsy samples (r =0.70, 95% CI=0.43–0.86, p <0.001). Of the studies that measured Ki-67 maximum expression, only those that used the whole surgical specimen provided a significant r value (r =0.72, 95% CI=0.54–0.84, p <0.001). Studies that used biopsy samples for Ki-67 maximum measurements did not produce a significant r value (r =0.04, 95% CI=−0.18–0.26, p =0.71). In terms of the cancer type subgroup analysis there is sufficient data to support a strong FLT/Ki-67 correlation for brain, lung and breast cancer. No publication bias was detected. Interpretation: This systematic review and meta-analysis highlights the importance of the methods used in validation studies comparing FLT-PET imaging with the biomarker Ki-67. The correlation is significant and independent of cancer type provided a study design that uses Ki-67 average measurements, regardless of nature of sample, or whole surgical samples when measuring Ki-67 maximum expression. Sufficient data to support a strong correlation for brain, lung and breast cancer exist. However, larger, prospective studies with improved study design are warranted to validate these findings for the rest of the cancer types. [Copyright &y& Elsevier]