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Statement of Problem: The role of the microbial plaque in caries etiology and periodontal diseases has been"nproved and the mechanical methods for plaque control have special limitations, consequently, chemical"nmethods have been suggested. One of the most effective materials is Chlorhexidine Gluconate that is"ncommonly used as mouth rinses. However, the medicated formulations of chewing gums, due to several"nproperties, have been paid attention. It should be noted that a new formulation to satisfy the consumers' taste"nseems necessary."nPurpose: The aim of this study was to present a new formulation for chewing gums containing chlorhexidine"nto achieve a pleasant taste coupled with their effectiveness and anti-plaque properties maintenance."nMaterials and Methods: In this double blind, crossover, prospective clinical trial, 18 volunteers were"ninvestigated. Chlorhexidine Gluconate was used and added to the gum-base by Manitole. In order to cover the"nbitter taste of the drug Aspartam, mint essence and Mentole were used. After gums production, the profile of"ndrug dissolution was evaluated by jaw movement simulating system. It took 5 days to study each type of"nchewing gums without any mechanical plaque control method. Medicated and placebo chewing gums were"nidentical in shape, size, color and formulation. The washout period was 2 days. Chewing gums were used"nevery 12 hours for 20 minutes. To determine plaque score, Turesky- Gilmore- Glickman modification index"nwas used. Other variables including: subjective evaluation of taste, cleansing effect and taste disturbance were"nassessed through filling a checklist. The data were analyzed by Paired t test and Wilcoxon test."nResults: During 20 mins, 80% of the drug was released from the gum-base. The mean difference of plaque"nscore between the initial and final stages at the first trial was -0.1589 and at the second trial was 2.994 which"nwas statistically significant (P

So-called primary yolk sac tumors of the vulva are very rare and often have an aggressive disease course. Their molecular features have not been previously characterized. There is also a well-documented group of SMARCB1 (INI-1)-deficient vulvar neoplasms, which includes proximal-type epithelioid sarcoma and myoepithelial carcinoma. Until now, "vulvar yolk sac tumors" and SMARCB1-deficient neoplasms were considered unrelated diseases. After reviewing an index case of a vulvar yolk sac tumor with loss of SMARCB1 by immunohistochemistry, we retrospectively identified 2 additional cases diagnosed as vulvar yolk sac tumors. Patient ages were 34, 32, and 25 years old, and 2 tumors were associated with a pregnancy. All 3 cases showed morphology typical of a yolk sac tumor, and by immunohistochemistry all were positive for SALL4, glypican-3, keratins, and lacked CD34 positivity. All tumors also demonstrated loss of SMARCB1 in tumor cells. Targeted molecular profiling was performed in 2 cases and identified 2 copy deletion of SMARCB1, without genomic alterations typically seen in gonadal yolk sac tumors. In the third case, isochromosome 12p was not identified by fluorescence in situ hybridization. All 3 patients had either local recurrences or distant metastases, and 2 died of disease. One patient had progressive disease while receiving the enhancer of zeste homolog 2 inhibitor tazemetostat. Overall, these findings suggest that vulvar tumors with pure yolk sac-like morphology may represent morphologic variants of SMARCB1-deficient tumors and not veritable germ cell neoplasia. This potential reclassification may have both prognostic and treatment implications and warrants study of additional extragonadal yolk sac tumors., Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)