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Oral Diseases (oral + disease)
Selected AbstractsEconomic globalization and oral healthORAL DISEASES, Issue 3 2001MH Hobdell OBJECTIVES: To briefly review the origins of economic globalization and examine the evidence available concerning its possible impact on oral health. DESIGN: Based on Medline searches 1966,1999 and review of Health Wrights: Politics of Health database. SPECIFIC ORAL DISEASES: Dental caries, destructive periodontal diseases, cancrum oris and oral cancer. CONCLUSIONS: The reported growing disparity between rich and poor populations, both internationally and nationally, is arguably being exacerbated by economic globalization. Increasing levels of the above specific oral diseases might be attributed, in part, to this economic phenomenon. [source] Considerations in establishing an oral disease clinical research centerORAL DISEASES, Issue 7 2010ML Barnett Oral Diseases (2010) 16, 586,591 High quality clinical research is necessary to improve oral health and translate research findings to the practice of dentistry. This has led many academic institutions to consider establishing a formal clinical research center. This is not a trivial undertaking and requires that the center have an appropriate physical infrastructure, trained investigators with recognized expertise in the planning and conduct of high quality clinical research, and very importantly, a financial plan to assure its long-term sustainability. The purpose of this paper is to provide some guidance and practical advice with respect to factors that should be considered in developing and maintaining a successful oral disease clinical research center. [source] Using Cochrane reviews for oral diseasesORAL DISEASES, Issue 7 2010HV Worthington Oral Diseases (2010) 16, 592,596 Objectives:, To provide readers with information about the Cochrane Oral Health Group and how the reviews on oral diseases have contributed to guideline developments and the commissioning of trials. Materials and methods:, Examples have been selected from the reviews published on The Cochrane Library. Descriptions are given of how these reviews have been used in guideline development and commissioning of trials. Readers are updated on reviews focused on the management of oral cancer and the new venture of diagnostic test reviews. Results:, Reviews on the management of oral diseases due to cancer treatments have been included in guidelines and changed practice in the UK. Cochrane reviews on Bell's Palsy have led to a randomised controlled trial which has changed the evidence base. The Cochrane review on recall intervals between routine appointments has input into the NICE guideline and resulted in a randomised controlled trial to look at different intervals including a risk-based interval. Conclusion:, We hope this article will give readers information on the work of the Cochrane Oral Health Group and insight into the diversity of reviews in oral diseases. The reviews are successfully being used to change practice and as background for the funding of large-scale clinical trials. [source] Short-term effects of periodontal therapy as an adjunct to anti-lipemic treatmentORAL DISEASES, Issue 7 2010Ö Fento Oral Diseases (2010) 16, 648,654 Objective:, This study was conducted to assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti-lipemic treatment. Materials and Methods:, The study population consisted of 20 patients aged 34,62 years with diagnoses of hyperlipidemia and chronic periodontitis. All patients used statin to treat their elevated levels of low-density lipoprotein cholesterol. Blood samples were obtained for measurement of serum lipids, fasting plasma glucose, and high sensitive C-reactive protein. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment level, and percentage of bleeding on probing, were evaluated. All parameters were assessed in each subject at baseline, after 3 months as a control (at the time of periodontal treatment), and 3 months after the non-surgical periodontal treatment that included scaling and root planning. Results:, All lipid parameters decreased after the periodontal treatment, but only the decreases in total cholesterol and low-density lipoprotein cholesterol levels reached statistical significance compared to baseline (P = 0.002 and P = 0.003, respectively). Conclusion:, Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care. [source] Attenuation of radiation- and chemoradiation-induced mucositis using gamma- d -glutamyl- l -tryptophan (SCV-07)ORAL DISEASES, Issue 7 2010B Watkins Oral Diseases (2010) 16, 655,660 Objective:, To evaluate the efficacy of a novel immunomodulating peptide (SCV-07) in attenuating the course of radiation-induced mucositis in an established animal model of oral mucositis (OM). Material and Methods:, In three separate experiments, golden Syrian hamsters received either an acute radiation challenge to the buccal mucosa of eight fractionated doses of 7.5 Gy of radiation over a 2-week-period, or a combination of acute radiation and cisplatin. In each experiment, animals were treated with varying doses or schedules of SCV-07 or placebo. OM was scored in a blinded fashion using digital images obtained during the experimental period. Results:, We found that SCV-07 reduced the severity and duration of both acute and fractionated radiation-induced OM. Similarly, when radiation and chemotherapy were used to induce OM, treatment with SCV-07 significantly reduced the duration of ulcerative OM. The therapeutic benefit was dependent on both dose and schedule of administration. Conclusion:, Taken together, we found SCV-07 was able to modify the duration and severity of oral mucositis and was dependent on schedule and dose. [source] The use of quality of life measures in oral medicine: a review of the literatureORAL DISEASES, Issue 5 2010R Ni Riordain Oral Diseases (2010) 16, 419,430 Objectives:, To explore the use of patient reported quality of life measures in oral medicine, to highlight the importance of use of these measures in oral medicine practice and to provide guidance for the selection of such measures in the future. Methods:, A detailed literature review was undertaken to investigate the use of quality of life measures in oral medicine. The databases searched were MEDLINE (through PubMed), EMBASE, CINDHL, Web of Science Citation Index and the Cochrane Database of Systematic Reviews and randomised controlled trials. Results:, The initial literature search yielded a total of 5310 citations; however, only 63 of these fulfilled the inclusion criteria. Twenty-two articles were regarding oral mucosal conditions, 14 related to orofacial pain disorders and 27 were regarding salivary gland-related conditions. Conclusions:, The evaluation of quality of life in oral medicine has a broad applicability, providing information in treatment-based studies and population-based studies. A predominance of generic and oral health specific quality of life measures are being used to a limited extent in oral medicine practice. A scarcity of reports of the development, validation or use of disease specific measures is evident. [source] Craniofacial and dental findings in cystinosisORAL DISEASES, Issue 5 2010CW Bassim Oral Diseases (2010) 16, 488,495 Objectives:, Cystinosis is a rare autosomal recessive lysosomal storage disorder with developmental and mineralization anomalies as part of its clinical presentation. The objective of this study was to provide the first systematic assessment of the craniofacial and dental characteristics associated with cystinosis. Study Design:, Oral and radiographic evaluations were performed on 73 patients with cystinosis. Analyses of cephalometry (n = 20), taurodontism (n = 47), caries (n = 47), enamel defects (n = 48), soft tissue anomalies (n = 48), and dental age (n = 41) were performed on the cystinosis group, and compared with age- and sex-comparable controls or standards. Results:, Cystinosis patients manifested relative mandibular deficiency, an increased facial height, and a reduced airway space. Taurodontism and enamel defects were significantly more prevalent in cystinosis patients compared with controls (P < 0.0001 and P = 0.027, respectively). Children (aged <15 years) with cystinosis also demonstrated a significant delay, of almost 9 months, of their dental development (P < 0.001). Conclusion:, Novel craniofacial and dental features are associated with cystinosis. Craniofacial deficiencies may influence the swallowing and respiratory complications seen in cystinosis. Renal pathology and associated mineral imbalance may explain the dental root and enamel anomalies found in cystinosis patients; the developmental delays in cystinosis include delayed dental formation. [source] Marathon of eponyms: 12 Ludwig anginaORAL DISEASES, Issue 5 2010C Scully Oral Diseases (2010) 16, 496,497 The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarises data about Ludwig angina. [source] Triage screening for osteoporosis in dental clinics using panoramic radiographsORAL DISEASES, Issue 4 2010A Taguchi Oral Diseases (2010) 16, 316,327 Many patients with osteoporosis go undiagnosed because typically no symptoms are present before a fracture. Triage screening to refer patients to appropriate medical professionals for further investigation would be useful to address the increase in the incidence of osteoporotic fractures. Dental clinics may offer a new triage screening pathway because dentists frequently take radiographs of bones in the course of dental treatment. A major premise for such triage screening in dental clinics is that dentists can readily use a screening tool in their dental practice. For example, cortical width and shape of the mandible detected on panoramic radiographs may be appropriate indices for triaging individuals with osteoporosis. To date, several investigators have demonstrated significant associations between cortical indices on panoramic radiographs and bone mineral density of the skeleton generally, such as the spine and femur, biochemical markers of bone turnover and risk of osteoporotic fractures. Further, in two recent Japanese clinical trials, approximately 95% of women who were identified by trained dentists in their clinics using cortical shape findings did have osteopenia or osteoporosis. These findings support the possibility that dental clinics may offer a new triage platform to identify individuals with otherwise undetected osteoporosis. [source] Regulation of type I plasminogen activator inhibitor in human gingival fibroblasts with cyclosporine AORAL DISEASES, Issue 4 2010Y-C Ho Oral Diseases (2010) 16, 396,401 Objectives:, Cyclosporine A (CsA) is used as an immunosuppressive agent and its prominent side effect is the induction of gingival overgrowth. Type I plasminogen activator inhibitor (PAI-1) has shown to play an important role in CsA-induced gingival overgrowth. However, little is known about whether factors can modulate CsA-induced PAI-1 expression. Methods:, Cytotoxicity, reverse transcriptase-polymerase chain reaction, and enzyme-linked immunosorbent assay were used to investigate the effects of Human gingival fibroblasts (HGFs) exposed to CsA. In addition, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, interlukin-1,, tumor necrosis factor-,, mitogen-activated protein kinase kinase (MEK) inhibitor U0126, signal-regulated protein kinase (ERK) inhibitor PD98059 and cell-permeable glutathione precursor N -acetyl- L -cysteine (NAC) were added to test how they modulated the effects of CsA-induced PAI-1 expression. Results:, The concentration of CsA higher than 500 ng ml,1 demonstrated cytotoxicity to HGFs (P < 0.05). Periodontal pathogens as well as proinflammatory cytokines were found to increase the CsA-induced PAI-1 mRNA and protein expression (P < 0.05). Pharmacological agents NAC, U0126, and PD98059 were found to decrease the CsA-induced PAI-1 mRNA and protein expression (P < 0.05). Conclusions:, Cyclosporine A (CsA) may predispose to gingival overgrowth under inflammatory environments. The regulation of PAI-1 expression induced by CsA might be critically related with the intracellular glutathione and the ERK-MAPK pathway. [source] Design and statistical analysis of oral medicine studies: common pitfallsORAL DISEASES, Issue 3 2010L Baccaglini Oral Diseases (2010) 16, 233,241 A growing number of articles are emerging in the medical and statistics literature that describe epidemiologic and statistical flaws of research studies. Many examples of these deficiencies are encountered in the oral, craniofacial, and dental literature. However, only a handful of methodologic articles have been published in the oral literature warning investigators of potential errors that may arise early in the study and that can irreparably bias the final results. In this study, we briefly review some of the most common pitfalls that our team of epidemiologists and statisticians has identified during the review of submitted or published manuscripts and research grant applications. We use practical examples from the oral medicine and dental literature to illustrate potential shortcomings in the design and analysis of research studies, and how these deficiencies may affect the results and their interpretation. A good study design is essential, because errors in the analysis can be corrected if the design was sound, but flaws in study design can lead to data that are not salvageable. We recommend consultation with an epidemiologist or a statistician during the planning phase of a research study to optimize study efficiency, minimize potential sources of bias, and document the analytic plan. [source] Altered expression of mRNA for HIF-1, and its target genes RTP801and VEGF in patients with oral lichen planusORAL DISEASES, Issue 3 2010M Ding Oral Diseases (2010) 16, 299,304 Objective:, To explore a potential causal contribution of the transcription factor HIF-1, and its target gene, RTP801 and VEGF, to the development of oral lichen planus (OLP). Design relevant:, Twenty-two adult OLP patients were enrolled in this study. All OLP diagnoses were verified by histopathological characteristics. Normal mucous specimens were collected from 12 controls after various oral surgeries. Material and method:, RNA was isolated from OLP and control specimens. Microarray was performed using BiostarH-40s gene chip. Expression of HIF-1,, VEGF and RTP801 was evaluated using quantitative real-time polymerase chain reaction (qPCR). Unpaired t -test and one-way ANOVA was used for statistical analysis. Results:, Microarray results showed that RTP801 expression was lower in OLP than in controls (779 vs 3090). qPCR further confirmed that expression of RTP801 was similarly lower in OLP than in controls (0.363 vs 1.473, P < 0.001); expression of VEGF was also lower in OLP (0.448 vs 1.74, P = 0.012). In contrast, expression of HIF-1, was higher in OLP than in controls (11.12 vs 1.628, P < 0.001). Conclusion:, The oral mucosa of OLP is hypoxic. Genes that are activated by hypoxia, such as RTP801 and VEGF, and their signal cascades may be novel potential therapeutic targets for OLP. [source] The G1 cell cycle arrest of macrophages infected with Aggregatibacter actinomycetemcomitansORAL DISEASES, Issue 3 2010H Kasai Oral Diseases (2010) 16, 305,309 Objectives:, Infection of murine macrophage cell line J774.1 with the periodontopathic bacterium Aggregatibacter actinomycetemcomitans induces apoptotic cell death. The infection induces cell cycle arrest in the G1 phase prior to the appearance of apoptotic cells. This study determined the involvement of various cell cycle-related signal molecules in A. actinomycetemcomitans-induced G1 cell cycle arrest. Materials and Methods:, Cell cycle in J774.1 cells infected with A. actinomycetemcomitans was analyzed with a flow cytometer. Immunoblot analysis was also employed to determine the expression levels of intracellular signal molecules. Results:, Flow cytometric analysis revealed that the percentage of cells in the G1 phase increased to 77.2% at 12 h after A. actinomycetemcomitans infection. Additionally, according to immunoblot analysis, expression levels of hyperphosphorylated forms of retinoblastoma protein (ppRb) declined in J774.1 cells following A. actinomycetemcomitans infection, whereas hypophosphorylated Rb (pRb) expression levels were elevated slightly. Expression levels of cyclin D1 and D2 in the cells decreased gradually postinfection; CDK2, CDK4, CDK6 and cyclin E levels were not changed. Furthermore, postinfection, p21CIP1/WAF1 expression increased at 6 h, followed by a subsequent decrease. Conclusion:, These findings suggest that cyclin D1 and D2 and p21CIP1/WAF1 participate in G1 cell cycle arrest in A. actinomycetemcomitans-infected J774.1 cells. [source] Unexpected roles for bone marrow stromal cells (or MSCs): a real promise for cellular, but not replacement, therapyORAL DISEASES, Issue 2 2010É Mezey Oral Diseases (2010) 16, 129,135 Adult and embryonic stem cells have drawn a lot of attention in the last decade as new tools in regenerative medicine. A variety of such cells have been discovered and put forward as candidates for use in cell replacement therapy. Investigators hope that some, if not all, of our organs can be replaced or restored to function; that new livers, kidneys, and brain cells can be produced. Many reviews have already been written about stem cells and their potential use in regenerating tissues. In this study, we would like to call attention to a different application of a special group of adult stem cells, the stromal cells in the bone marrow (also called mesenchymal stem cells or MSCs). These cells have been discovered to modulate immune function. They can easily be expanded in culture and surprisingly, they also seem not to be immunogenic. Thus, they can be removed from donors, expanded, stored in freezers, and used as allogeneic transplants in a variety of diseases in everyday medicine. [source] Clinical and psychological characteristics of TMD patients with trauma historyORAL DISEASES, Issue 2 2010H-II Kim Oral Diseases (2010) 16, 188,192 Objective:, The purpose of this study was to investigate clinical and psychological characteristics of temporomandibular disorders (TMD) patients with trauma history. Materials and methods:, The clinical and psychological characteristics of 34 TMD patients with trauma history were compared with those of 340 TMD patients without trauma history. Craniomandibular index (CMI) was used for clinical characteristics of TMD patients. Symptom severity index (SSI) was used to assess the multiple dimensions of pain. Symptom checklist-90-revision (SCL-90-R) was used for psychological evaluation. Results:, Temporomandibular disorders patients with trauma history displayed significantly higher CMI and palpation index. TMD patients with trauma history also exhibited higher values in duration, sensory intensity, affective intensity, tolerability, scope of symptom, and total SSI score. In addition, these patients showed significantly higher values in symptom dimensions of somatization, depression, anxiety, phobic anxiety, and paranoid ideation. Among the symptom dimensions of SCL-90-R, somatization showed the most significant correlations with CMI and SSI. Conclusions:, Temporomandibular disorders patients with trauma history displayed more severe subjective, objective, and psychological dysfunction than those without trauma history. Pain of myogenous origin, history of physical trauma, and psychosocial dysfunction were all closely related. [source] Lack of association between IRF6 polymorphisms (rs2235371 and rs642961) and non-syndromic cleft lip and/or palate in a Brazilian populationORAL DISEASES, Issue 2 2010LMR Paranaíba Oral Diseases (2010) 16, 193,197 Background:, Interferon regulatory factor 6 (IRF6) gene has emerged as a potential susceptibility gene for non-syndromic cleft lip and/or palate (NSCL/P) in different populations. The aim of this study was to determine the association of IRF6 rs2235371 and rs642961 polymorphisms with NSCL/P in a Brazilian population. Methods:, Two hundred and twenty-eight patients affected by NSCL/P and 126 healthy individuals were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Results:, Overall genotype distributions of rs2235371 and rs642961 polymorphisms were as expected by Hardy-Weinberg equilibrium test. The rs2235371 polymorphic genotype GA was identified in 10.1% of the patients with NSCL/P and in 10.3% of the control group, revealing no statistical difference. Similarly, the frequency of rs642961 minor genotypes (GA and AA) was quite similar between control group (28.6%) and NSCL/P group (25.4%), without significant difference. Conclusion:, Our findings are consistent with a lack of involvement of IRF6 rs2235371 and rs642961 polymorphisms in the NSCL/P pathogenesis in the Brazilian population. [source] Marathon of eponyms: 2 Bell palsy (idiopathic facial palsy)ORAL DISEASES, Issue 4 2009C Scully The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185,186). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarises data about Bell paralysis. [source] Marathon of Eponyms: 1 Albers-Schönberg disease (osteopetrosis)ORAL DISEASES, Issue 3 2009C Scully Abstract: The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009 in press). The use of eponyms in diseases of the head and neck is mainly in specialities dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This paper summarises data about Albers-Schönberg disease. [source] Color Atlas of Oral Diseases in Children and AdolescentsTHE LARYNGOSCOPE, Issue 3 2000Norman R. Friedman MD No abstract is available for this article. [source] Langerhans cell histiocytosis: oral/periodontal involvement in adult patientsORAL DISEASES, Issue 8 2009S Annibali Objective:, Langerhans cell histiocytosis (LCH) is a clonal proliferative multisystem disease. Although bone and mucosae have been classified as non-risk organs, their involvement may increase the risk of disease progression. Oral and periodontal lesions are burdened with a significant impairment of quality of life for associated signs, symptoms and loss of function. Most of information regards paediatric disease; the disease in adults has received limited attention. Subjects and Methods:, A total of 31 adult patients affected by immuno-histopathology confirmed LCH have been prospectively examined; attention was paid to the occurrence and characterization of oral lesions. Results:, Twelve patients developed oral lesions. Posterior regions of jawbones were always affected; the involvement of anterior regions was not constant. Unifocal oral involvement was significantly associated with multisystemic disease while multifocal lesions were associated with unisystemic disease. Oral disease presented with soft tissue ulcers (50% of cases), gingival bleeding (66.7%), pain (83.4%), periodontal damage (50%), tooth mobility (16.7%), non-healing extraction socket (8.3%); 41.6% of patients complained of negative outcomes on quality of life. Oral lesions were easily handled with local measures. Conclusions:, Posterior regions require attention; single oral lesions may be part of multisystemic disease; oral and periodontal lesions may be early signs of disease reactivation. [source] Understanding the ,epidemic' of complete tooth loss among older New ZealandersGERODONTOLOGY, Issue 2 2010Philip V. Sussex doi:10.1111/j.1741-2358.2009.00306.x Understanding the ,epidemic' of complete tooth loss among older New Zealanders Objective:, The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand's historic ,epidemic of edentulism' and how they operated. Method:, In-depth, semi-structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Results:, Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a ,sub-optimal' natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction-based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to ,calcium theory' and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient-initiated transitions to edentulism were ultimately facilitated by an accommodating profession. Conclusion:, The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease. [source] Direct fluorescence visualization of clinically occult high-risk oral premalignant disease using a simple hand-held deviceHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2007Catherine F. Poh DDS Abstract Background A considerable proportion of oral cancer and precancer is not clinically apparent and could contribute significantly to the late diagnosis and high mortality of oral cancer. A simple method to identify such occult change is needed. Methods Patients in the Oral Dysplasia Clinics at British Columbia are currently being examined with a simple hand-held device that permits the direct visualization of alterations to autofluorescence in the oral cavity. Tissue showing loss of autofluorescence is biopsied. Results We present 3 representative cases in which occult lesions were identified with fluorescence visualization during longitudinal follow-up, resulting in the diagnosis of a primary dysplasia in case 1, a second primary cancer in case 2, and cancer recurrence in case 3. Conclusions This is the first report of the diagnosis of occult oral disease using a simple noninvasive device. These early examples indicate the potential value of this technology to guide the management of patients with oral lesions, facilitating the detection of high-risk changes not apparent with white-light visualization. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] Mucous membrane pemphigoid, thymoma, and myasthenia gravisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2000Haideh Yazdani Sabet In November 1997, approximately 1 year before being evaluated at the Mayo Clinic, Rochester, a 63-year-old woman presented with erosive tongue lesions that were diagnosed by her physician as oral lichen planus. The lesions responded well to 3 months of treatment with systemic and topical corticosteroids and topical antiyeast medication. She stopped taking the medications and had a relapse. A few months after the oral lesions developed, her left eyelid became ptotic. Results of magnetic resonance imaging of her brain were normal, and the ptosis resolved spontaneously after 2 weeks. One year later, her right eyelid began to droop, and the results of edrophonium testing were positive. She was prescribed prednisone, 30 mg daily, and pyridostigmine, as needed. The ptosis improved, but never fully resolved. Radiography revealed a left ,,thyroid nodule,'' but computed tomography did not show a mediastinal mass. She was advised to have the ,,nodule'' removed surgically and came to the Mayo Clinic, Rochester, for a second opinion. Her medical history was significant for the following: tinnitus, glaucoma, early bilateral cataracts, and long-standing hypertension, for which she took losartan, 50 mg twice daily. Other medications included: prednisone, 30 mg daily; pyridostigmine as needed; famotidine, 40 mg daily; and eyedrops for glaucoma. She denied any history of hyperthyroidism or hypothyroidism, head and neck irradiation, family history of thyroid disease, or diplopia. Hepatitis serologic studies revealed hepatitis B exposure and recovery, hepatitis C immunity, and a previous hepatitis A viral infection. On examination at the Mayo Clinic, Rochester, an erosive hypertrophic plaque was noted on the posterior dorsal half of the tongue, and vesicles and erythematous erosions on the hard and soft palates ( Fig. 1a). A lace-like white pattern was seen on the buccal mucosa bilaterally, and a small erosive patch on the left buccal mucosa ( Fig. 1b). Ocular and nasal mucous membranes were normal in appearance, and there were no pertinent skin findings. Dermatopathologic examination of an excisional biopsy specimen from the left dorsum of the tongue demonstrated an ulcer with epitheliomatous hyperplasia and a granulomatous reaction, presumably due to yeast infection. Silver staining showed hyphae and yeast at the base of the tongue ulcer. The results of the direct immunofluorescence study were negative and revealed no lichenoid changes on hematoxylin and eosin staining. Indirect immunofluorescence testing of the serum revealed a 1 : 80 titer of basement membrane zone antibodies, reflecting pemphigoid. This test was positive on repeat study. Salt-split skin on monkey esophagus revealed an epidermal pattern of basement membrane zone antibodies. Treatment included fluocinonide gel applied to the involved areas four times daily and oral antiyeast therapy (fluconazole, 200 mg once daily by mouth) while the rest of the evaluation was being completed. Figure 1(a). Erosive hypertrophic tongue plaque. Figure (b) ,. Erosive patch on the buccal mucosa. As part of the evaluation of the ptosis, a myasthenia gravis antibody panel was performed. It revealed the following abnormalities: striated muscle antibody at 1 : 480 (reference range, <1 : 60), acetylcholine receptor binding antibody at 6.33 nmol/L (reference range, ,,0.02 nmol/L), acetylcholine receptor blocking antibody at 31% (reference range, 0,25%), and acetylcholine receptor modulating antibody at 100% (reference range, 0,20%), suggesting thymoma. Treatment included pyridostigmine, 30,45 mg 3,4 times daily, to control the myasthenia symptoms, while the ill-defined neck mass was being evaluated. A mildly enlarged thyroid was noted on physical examination. Hematology panel revealed thyroid-stimulating hormone (TSH) levels in the low normal range; the thyroid microsomal antibody was normal. Chest radiography showed minor tracheal deviation, and a previous computed tomogram showed what appeared to be a 3-cm enlarged mass in the thyroid. Ultrasonographically guided thyroid biopsy did not show malignancy, but a benign mesenchymal-type tumor was found and surgical excision was planned. Intraoperatively, a thymoma of the left cervical thymic tongue was found. At 6 months' follow-up, the ptosis and oral mucosal lesions had improved significantly, although she continued topical corticosteroid therapy intermittently for minor erosive oral disease. [source] Fatty acid status in captive and free-ranging black rhinoceroses (Diceros bicornis)*JOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 3 2008M. Clauss Summary The fatty acid (FA) patterns of plasma/serum triglycerides (TG), phospholipids (PL) and cholesteryl esters (CE) of captive and free-ranging black rhinoceroses (Diceros bicornis) were investigated. Free-ranging animals (n = 28) stemmed from four different regions. Captive animals sampled included specimens from North American (n = 11) and three different European facilities (n = 6). The European animals were tested on 1,4 different diets, resulting in a total of 15 blood samples. Regardless of differences between the free-ranging animals from different regions, differences between captive and free-ranging animals were relatively uniform: captive animals had higher overall proportions of polyunsaturated fatty acid (PUFA), due to levels of linoleic acid (LA, 18:2n6) that were drastically increased as compared to free-ranging animals. In contrast, levels of alpha-linolenic acid (ALA, 18:3n3) were consistently lower on conventional zoo diets. n6/n3 ratios for TG, PL and CE were 1.6, 10 and 8 in samples from free-ranging animals, respectively, as compared to 4.1,16.3, 16,148 and 40,277 in samples from captive animals. There was a distinct correlation between the proportion of grain-based products (commercial concentrates, plain grains and bread) in the diets of the European animals and the measured levels of n6 PUFA. An animal from a facility with a very low proportion of grain products in the diet nevertheless had high LA readings, most probably due to the use of sunflower oil as 2% (dry matter basis) of its diet. One animal that received a high proportion of grass meal pellets due to an oral disease had increased ALA contents after the diet change. These results allow conclusions on the suitability of diets fed in captivity: the black rhinoceros is prone to several uncommon diseases that have been suspected to be linked to oxidative damage, possibly due to the disposition of this species to excessive iron storage. An unnatural dietary loading with PUFAs would exacerbate this problem. Additionally, n6 FAs are known as precursors of pro-inflammatory mediators, and their overrepresentation could therefore exacerbate any inflammatory processes. Therefore, the current practice of using grain-based feeds as major ingredients in captive rhinoceros diets is discouraged. Diet items containing ALA (a precursor of anti-inflammatory mediators) such as, fresh grass, fresh browse, the respective silages should be included at higher levels in diets for captive black rhinoceroses. Grass meal pellets, although a good source of ALA and linked with high levels of ALA in an animal of this study, must be chosen with care for black rhinoceroses due to their particular proneness for high iron contents. [source] Amylase and cyclic amp receptor protein expression in human diabetic parotid glandsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2010Monica Piras J Oral Pathol Med (2010) 39: 715,721 Background:, Salivary dysfunction and oral disorders have been described in both type 1 and type 2 diabetes mellitus. However, the cellular and molecular consequences of diabetes on oral tissues remain to be ascertained. The purpose of this investigation was to study, by means of electron microscopy, the morphologic and molecular changes that occur in salivary glands during diabetes. Methods:, Biopsy samples of parotid glands were excised from non-diabetic and diabetic (type 1 and type 2) consenting patients and processed by standard methods for routine morphology and electron microscopic immunogold labeling. Specific antibodies were used to determine and quantify the expression of secretory proteins (alphaamylase and the regulatory subunit of type II protein kinase A). Results:, Morphologic changes in the diabetic samples included increased numbers of secretory granules, and alterations in internal granule structure. Quantitative analysis of immunogold labeling showed that labeling densities were variable among the parotid gland samples. In type 1 diabetes amylase expression was greater than in non-diabetic glands, whereas in type 2 diabetes it was not significantly changed. Expression of type II regulatory subunits was slightly, although not significantly, increased in acinar secretory granules of type 1 diabetic samples and was unchanged in type 2 diabetic samples. Conclusions:, Our data show that diabetes elicits specific changes in secretory protein expression in human salivary glands, thus contributing to the altered oral environment and oral disease associated with diabetes. [source] Assessment of predictors of global self-ratings of oral health among Korean adults aged 18-95 yearsJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2010Hae-Young Kim DDS Abstract Objectives: The aims of this study were to assess predictors of global self-ratings of oral health (GSROH) and to examine whether they varied by age among Korean adults aged 18-95 years. Methods: Data from 4,546 adults aged 18-95 years completing the Korean National Oral Health Survey 2006 were included in the analysis. Results: Subjects' mean age was 43.5 years, with 12.1 percent aged ,65 years; 47.8 percent were men; and 2.5 percent were edentulous. The predictors of GSROH in adults were number of missing teeth, concern about oral health, and difficulty in chewing. While wearing removable dentures was associated only in elders, perceived treatment need was associated in younger age groups. The number of decayed and filled teeth was significant only in the 18-44 age group. Conclusions: GSROH status was associated with measures of oral disease, oral functional problems, oral health behaviors, concerns, and perceived treatment needs, and it varied by age. [source] Nutrition, oral health and the young childMATERNAL & CHILD NUTRITION, Issue 4 2007Sudeshni Naidoo Abstract Oral health is integral to general health and essential to well-being and quality of life. Socio-behavioural and environmental factors play a significant role in oral disease and oral health. Dental caries is a global disease with few populations exempt from its effects. In developing countries, as development increases so does dental caries and children are at the forefront of the disease disadvantage. There is a growing need to identify high caries risk groups accurately to commence prevention from a young age. The effect of early intervention in childhood on general and dental health with both population and high-risk approaches also needs examining. As an educational tool, the paediatric food-based dietary guidelines may play a significant role in nutrition and oral health interventions. This paper provides information on nutrition, including access to fluoride and use of sugar. Oral health concerns, such as early childhood caries, which are important for the young child, are also discussed. [source] Selective induction of human beta-defensin mRNAs by Actinobacillus actinomycetemcomitans in primary and immortalized oral epithelial cellsMOLECULAR ORAL MICROBIOLOGY, Issue 6 2003E. C. Feucht Human beta-defensin-2, and -3 (hBD-2, -3) are small inducible antimicrobial peptides involved in host defense. Actinobacillus actinomycetemcomitans, a gram-negative facultative anaerobe, is frequently associated with oral disease in humans. A. actinomycetemcomitans, strain JP2, was examined for its ability to modulate hBD-2 and -3 gene expression in normal human oral epithelial cells (NHOECs) and in OKF6/Tert cells, an immortalized cell line derived from human oral epithelial cells. Stimulation of both cell types by live bacteria, at a minimal bacteria/cell ratio of 500 : 1, resulted in increased hBD-3 gene expression. This was not evinced for hBD-2 in either cell type with live bacteria, even at bacteria/cell ratios exceeding 500 : 1. The increased hBD-3 gene expression was dependent upon viable bacteria, and not their lipopolysaccharides (LPS), since heat-killed A. actinomycetemcomitans did not induce hBD-3 transcript expression. The overall similarity between results obtained in OKF6/Tert cells and NHOECs suggest that the OKF6/Tert cell line may be a useful tool in the study of beta-defensin expression in oral epithelium. [source] Cytokine profiles in parotid saliva from HIV-1-infected individuals: changes associated with opportunistic infections in the oral cavityMOLECULAR ORAL MICROBIOLOGY, Issue 2 2000K. P. Black The purpose of this study was to quantitate levels of cytokines in parotid saliva of subjects infected with human immunodeficiency virus-1 (HIV-1) and to determine if the cytokine profiles differ in subjects with an oral opportunistic infection, i.e., candidiasis or oral hairy leukoplakia. Parotid saliva samples were obtained from HIV-infected individuals with or without candidiasis or oral hairy leukoplakia and from healthy controls and were assessed by ELISA for levels of interleukin (IL)-1, IL-2, IL-4, IL-5, IL-10, transforming growth factor-,, tumor necrosis factor-, and interferon (IFN)-,. Saliva from HIV-infected subjects with oral candidiasis had significantly higher levels of IFN-, than that seen in HIV-infected individuals with no oral disease and significantly higher levels of IL-2, IL-5 and IFN-, than saliva of healthy controls. No significant difference was seen in cytokine levels in saliva from HIV-infected subjects with no oral infections and healthy controls. The HIV-infected subjects with oral hairy leukoplakia displayed significantly higher levels of both IL-1, and IFN-, compared with the HIV and no oral disease group and a higher level of IFN-, than seen in saliva from the healthy control group. In comparing cytokine levels from both HIV and oral disease groups, significant differences were detected in levels of IL-5 and IL-10. These results indicate that the profile of salivary cytokines is altered as a result of the oral opportunistic infection candidiasis or oral hairy leukoplakia and also by concurrent HIV infection. [source] "Stains" on their self-discipline: Public health, hygiene, and the disciplining of undocumented immigrant parents in the nation's internal borderlandsAMERICAN ETHNOLOGIST, Issue 4 2009SARAH HORTON Ph.D. ABSTRACT Histories of the role of public health in nation building have revealed the centrality of hygiene to eugenic mechanisms of racial exclusion in the turn-of-the-20th-century United States, yet little scholarship has examined its role in the present day. Through ethnography in a Mexican migrant farmworking community in California's Central Valley, we explore the role of oral hygiene campaigns in racializing Mexican immigrant parents and shaping the substance of their citizenship. Public health officials perceive migrant farmworkers' children's oral disease as a "stain of backwardness," amplifying Mexican immigrants' status as "aliens." We suggest, however, that the recent concern with Mexican immigrant children's oral health blends classic eugenic concerns in public health with neoliberal concerns regarding different immigrant groups' capacity for self-governance. [source] | ||||||||||||||||||||||||||||