Biomedical subjects
Publications and source records attributed to F J Kratochvil.
The role of oral pathologists as members of the comprehensive health care team is reviewed. The importance of utilizing an Oral Pathology Service in the everyday practice of dentistry and medicine and the inherent medicolegal considerations are discussed. Standards of care for submission of surgically removed oral tissues is an issue that warrants further delineation.
Lingual exfoliative cytologic specimens (scrapings) were obtained from 18 patients positive for human immunodeficiency virus with clinical oral hairy leukoplakia. Buccal mucosal scrapings were obtained from 12 of these patients. The specimens were processed for examination by transmission electron microscopy (TEM). Sixteen (89%) of the lingual specimens revealed infection of keratinocytes by herpes-type virus. There was no evidence of virus infection in the 12 buccal mucosal scrapings. Fungal hyphae were seen by TEM in 14 (78%) of the lingual scrapings and two (17%) of the buccal scrapings. One exfoliative specimen and two biopsy specimens were stained for Epstein-Barr virus DNA with a DNA probe. The demonstration of herpes-type virions by TEM in keratinocytes from a lesion clinically suspected to be hairy leukoplakia provides direct, objective diagnosis. Furthermore, use of exfoliative cytologic specimens provides a clinically simple, noninvasive technique.
The case of an anterior mandibular radiolucent area, which unexpectedly yielded salivary gland tissue, is described. Salivary gland depressions in the posterior mandible are readily recognized because of their almost pathognomonic radiographic appearance. A salivary gland inclusion in the anterior mandible in the proximity of teeth may create a diagnostic dilemma where superimposed periapical pathosis is present. The clinical importance lies in the recognition and appropriate treatment of the lesion. For the anterior salivary gland inclusion, a biopsy and a microscopic examination provide the most reliable diagnosis.
We are presenting a case of multifocal, virus-associated dysplasia of the oral cavity. We believe this case represents bowenoid papulosis, which usually is limited to the genital region. The patient, a 21-year-old white man, had recently completed therapy for Hodgkin's disease. An oral examination revealed multiple red 3 to 6 mm macules scattered over the oral mucosa, involving the buccal and labial mucosa, palate, and gingiva. The favored clinical diagnosis was candidiasis. Histologically, the biopsy specimen showed severe epithelial dysplasia. Three additional oral biopsies of different sites were performed and revealed similar histology. Immunohistochemical stains for human papillomavirus were done, and two of four lesions stained positively. Transmission electron microscopy revealed intranuclear viral particles consistent with human papillomavirus. Further questioning and examination of the patient revealed that he had lesions of the penis that were clinically and histologically bowenoid papulosis. In addition, he admitted to oral-genital sex during the period of therapy for Hodgkin's disease. This is the first reported case of oral bowenoid papulosis, and it supports a viral cause for this disease process.
The clinical, histologic, and histomorphometric features of 42 giant cell tumors (GCT) of long bones and 49 central giant cell granulomas (CGCG) of the jaws were compared. These findings were also correlated with the clinical behavior of 25 cases of CGCG for which follow-up information was available. There was a female predilection for both lesions. The mean ages of patients with CGCG and GCT were 21 and 25 years, respectively. In contrast to CGCG, GCT rarely occurred in persons below the age of 10 years. The only statistically significant quantitative difference between the lesions at the histologic level was the greater number of nuclei in the giant cells of the GCT. There were four significant histologic differences between the two lesions, but 26% of the GCTs were histologically similar to most of the CGCGs and 10% of the CGCGs were histologically similar to most of the GCTs. Five of the 25 patients with CGCG for whom follow-up information was available had recurrences. The average age of those five patients was 11 years, compared to 29 years for those patients without recurrence. All five patients with recurrence were under 17 years of age, and they constituted 45% of the patients in this age group with follow-up. There were no quantitative or histologic differences between the recurrent and nonrecurrent CGCGs that were useful in predicting the likelihood of recurrence. Our findings suggest that the GCT and the CGCG represent a spectrum of a single disease process modified by the age of the patient and the site of occurrence.
Mandibular bone resorption in normal and osteoporotic rats was measured using standard scintillation techniques for tritiated tetracycline (H3-TC). Thirty-four Sprague-Dawley rats were labeled with H3-TC at 4-9 weeks of age. Ten animals were then sacrificed for baseline radioactivity levels, while 12 experimental animals were given a high protein, low calcium diet, and 12 control animals were given a normal calcium diet. Osteoporotic and normal diets were instituted for 90 days. The results show a significant reduction in the quantity of bone in the experimental group (P less than .05) as compared to the control group. In addition, serum samples collected were found to contain significantly elevated (P less than .01) alkaline phosphatase level in the experimental group when compared to the control group.
Previous studies have examined the effects of osteoporosis on the vertebra, femur, and tibia. However, few studies have examined the effects on the mandible by using an animal model to quantify bone resorption. Osteoporosis was induced through pair feedings of a high protein, low calcium diet. Before this induction, experimental and control animals were injected subcutaneously with radioactive tritiated tetracycline. Bone resorption was quantified by measuring the amount of radioactivity present after the test diets were given for 90 days. Standard scintillation techniques were used for extracting the radioactivity from each half mandible. The following conclusions can be made from the results of this investigation: A significant difference in mandibular bone resorption was associated with an osteoporotic inducing diet high in protein and low in calcium. Bone resorption in the experimental group of animals was 17% greater than in the control group. Alkaline phosphatase may be an important indicator of osteoporosis in the Sprague-Dawley rat. Elevated levels were found in those with the osteoporotic diet. The animals in the control and experimental groups consumed similar amounts of their respective diets. No significant difference was found in the weight gains of either group. The histologic picture, although not pathognomonic for osteoporosis, was consistent with many findings in the literature describing osteoporosis. This study has shown that osteoporotic diets may increase the amount of bone resorption in the mandibles of Sprague-Dawley rats.
Explore the source record for details and available documents.
Epithelioid hemangioendothelioma (EH) is a recently described unusual vascular neoplasm of the soft tissues. Apparently identical tumors have also been described in the lung and and liver. Although no previous reports have described these lesions in the head and neck, twelve cases from this region are reported here. There is a wide age distribution throughout adulthood of affected patients. The 4-year-old patient in this series is the youngest thus far reported. There is no sex predilection. The submandibular region is the head and neck site most frequently involved. The unusual histologic appearance of these tumors is demonstrated by the fact that only one case was originally diagnosed as a vascular neoplasm. Nests and cords of pleomorphic epithelioid cells, spindle cells, and vacuolated cells and a hyalinized or myxochondroid stroma are features that distinguish EH. All eight of the tumors tested showed factor VIII-related antigen immunoreactivity. EH has a biologic potential intermediate between that of hemangioma and conventional angiosarcoma.
Explore the source record for details and available documents.
Adult rhabdomyomas are uncommon, benign neoplasms of the head and neck region. They are usually solitary, but may rarely be multifocal. We report the clinical and morphologic features of a multifocal adult rhabdomyoma apparently present in the floor of the mouth of an elderly woman for 20 years. At the time of exploratory surgery, the surgeon believed there was diffuse multinodular enlargement of both sublingual glands. The differential diagnosis of a biopsy specimen that was taken for frozen section included salivary gland oncocytosis, a reactive process. On examination of permanent sections, however, the lesion was found to be a multifocal rhabdomyoma. No evidence of salivary gland tissue was found. Ultrastructural study demonstrated the characteristic attempts by this tumor to recapitulate its origin from skeletal muscle by the formation of abnormal contractile elements.
A survey involving 137 patients treated with 203 removable partial dentures was conducted in England, the Netherlands, and the United States from samples of 1-year and 5-year posttreatment data. The objectives were to (1) develop a practical clinical and radiologic method to evaluate the results of removable partial denture treatment and (2) establish baseline values and results of removable partial denture treatment for use by all investigators. The results indicated the following: 1. Gingival pocket depth around abutment teeth was reduced at posttreatment examination. 2. There was an increase in posttreatment abutment teeth mobility that was greater in mandibular than maxillary teeth. Mobility increase was less for abutment teeth than for control teeth. 3. There was a slight loss of bone around abutment teeth that was about equal to loss around control teeth. 4. Oral care (plaque index) showed that 62.4% of all tooth surfaces had plaque accumulation at posttreatment examination. 5. Eleven of 616 abutment teeth (1.78%) were extracted.
Explore the source record for details and available documents.
This investigation was designed to evaluate the forces developed in supporting structures by removable partial dentures with attachment retainers. The attachments tested were the (1) Sterngold type 7, (2) Dalbo MK, and (3) Thompson dowel. The study utilized a photoelastic model with stress areas recorded photographically. The results showed that: 1. Splinted abutments are indicated when using the tested attachment retainers. 2. With single abutments, the attachment retainers induced distal force on the teeth which resulted in unfavorable horizontal bone forces. 3. The Dalbo MK attachments produced the most force on the edentulous regions and the least force on the abutment teeth. 4. The Thompson dowel and Sterngold type 7 attachment retainers induced similar stress patterns on single abutments and both produced distal abutment forces. 5. The Thompson dowel induced more favorable stress patterns when the abutments were splinted.
Explore the source record for details and available documents.
The results of this study showed that: 1. The design of a retainer with a mesial rest in conjunction with a buccal I-bar or a wrought-wire and cast lingual arm exhibited the most favorable distribution of vertically applied forces. 2. Retainer designs with a distal rest tend to move the clinical crown distally and the root mesially at the apex, resulting in horizontal forces in the bone. 3. Placing rests of distal-extension removable partial dentures more anteriorly provides an axis of rotation that directs applied forces in a more vertical direction. 4. The distal rest in conjunction with circumferential retainers developed greater horizontal forces within the supporting structures.
1. This study has described the osseous reconstruction of deficient edentulous ridges in adult rhesus monkeys. The rebuilt osseous ridges did not resorb under complete prosthetic function over a 4 month period. 2. Remodeling of the graft proceeded along the usually observed patterns with mature cortices forming in the grafted areas within 6 months. 3. This procedure has been duplicated for clinical patients with reasonably good results, restoring function in otherwise untenable prosthetic situations whic had been refractory to other types of prosthetic and surgical treatment. 4. In the future, this method of marrow-bone grafting with a simultaneous subperiosteal implant may restore function in many edentulous patients who have experienced extreme resorption over the mandibular ridge and in whom conventional implant techniques or the usual type of bone grafting procedures has not been successful.
Explore the source record for details and available documents.