Re: Hinduja K, Samuel R, Mitchell S. Problem-based learning: is anatomy a casualty? Surgeon 2005; 3 (2):84-87.
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Biomedical subjects
Publications and source records attributed to B McCartan.
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The objective of this study was to examine the histological features of apparently normal oral mucous membrane adjacent to lesions of oral lichen planus. Twenty-six patients attending an oral medicine unit with clinical lesions typical of oral lichen planus had biopsies of lesional and perilesional sites. Biopsies were examined for histopathological features of oral lichen planus. Twenty-two (85%) of lesional biopsies and 12 (46%) of the perilesional biopsies were reported as either typical or showing some features of lichen planus. Twelve of these 22 cases (55%) had both lesional and perilesional biopsies reported as either typical or showing some features of lichen planus. These 12 cases represented 46% of all cases. In four cases (15%) neither the lesional nor the adjacent perilesional biopsy was reported as lichen planus. The inflammatory process in oral lichen planus may extend beyond the confines of the clinical lesion into adjacent mucous membrane of normal appearance.
Minor surgical procedures to the inner (mucosal) aspect of the lower lip may occasionally cause numbness of the overlying skin. This study was designed to find, by means of dissection and computerized three-dimensional reconstruction, why surgical interference with nerve fibres in the deep aspect of the lip can cause neurological deficit in the superficial layers. Thirteen cadaveric lips were examined by dissection under a surgical microscope (9 lips) or serial sectioning and computerized three-dimensional reconstruction (4 lips). Muscle mass, minor labial salivary glands and nerve fibres were identified and traced. Three patterns of mental nerve distribution were seen on dissection and two on computerized reconstruction; these latter corresponded to two of the patterns seen on dissection. Fibres passing close to the labial minor salivary gland mass were seen to travel towards the superficial aspect of the lip, terminating in the dermis. It is clear that there is no safe anatomical space for minor surgical procedures to the inner (mucosal) aspect of the lower lip if avoidance of cutaneous numbness is an important consideration. However, we describe a technique that may minimize the possibility of cutaneous numbness.
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OBJECTIVES: Patterns of attendance at the Dublin Dental Hospital's Accident and Emergency Clinic in 1996 were compared with figures from 1993 to look for changes, especially in the light of changing provision of public funding for dental treatment for medical card holders and dependants. METHODS: An audit of patient clinical records for one month in 1996 was compared to previously published data relating to 1993. RESULTS: While patient numbers were similar in the two time periods (718 in 1993 versus 708 in 1996), the proportion of attendances by medical card holders or their dependants dropped from 48 per cent to 36 per cent. The proportion of non urgent treatments had also dropped over the three years. CONCLUSIONS: Changes in the provision of publicly funded dental treatment for medical card holders and dependants has reduced the proportion of such patients attending the clinic. However, their places have been taken by other patients.
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Ten probands with tuberous sclerosis (TS) and 20 first degree relatives were examined for evidence of pitted enamel hypoplasia; 100% of TS patients had pitting, compared to 65% of relatives and 72% of 25 controls. We found that 70% of TS cases had more than 14 pits per person compared with only 5% of relatives and 4% of controls; 85% of relatives and 84% of controls had fewer than six pits per person. Our results confirm that significantly increased numbers of dental enamel pits are found in persons with TS compared to controls. These results suggest that examination for the presence or absence of dental enamel pits is not a useful screening test for first degree relatives to detect otherwise unsuspected subjects with tuberous sclerosis. However, the lack of pits in first degree relatives in our study is probably largely because none of the relatives appeared to carry the TS gene.
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Thirty patients with psoriatic arthropathy (PA) were age- and sex-matched with patients with plaque psoriasis alone to investigate a possible link between Sjögren's syndrome (SS) and PA. The results of clinical examination, Schirmer's test, maximal stimulated salivary flow rate, haematological and serological investigations were compared in the two groups. Median maximal stimulated salivary flow rate was significantly reduced in patients with PA suggesting that salivary glands are affected in this condition. One patient with PA had SS.
Recent outbreaks of bovine babesiosis caused by Babesia bovis in Swaziland had indicated the presence of the vector tick Boophilus microplus in the country although it had never before been directly identified. Engorged female Boophilus ticks were collected from cattle at diptanks in the course of a tick resistance survey and used to map the distribution of the two different species of Boophilus. B. decoloratus was found to be widespread throughout the country. B. microplus was identified for the first time in Swaziland and was found to have a patchy distribution. The implications of these findings are discussed.