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Biomedical subjects

J C Greene

Publications and source records attributed to J C Greene.

At least 19 recordsLinked to original sources

Histopathology of smokeless tobacco lesions in professional baseball players. Associations with different types of tobacco.

We examined 142 biopsy specimens of smokeless tobacco-associated oral mucosal lesions from 133 professional baseball players. Four types of epithelial change were observed in the specimens: hyperparakeratosis, hyperorthokeratosis, pale surface staining, and basal cell hyperplasia. These types of epithelial change were associated with the type of smokeless tobacco used (snuff or chewing tobacco) but not with the duration (years) or amount (hours per day) of use. The thickness of hyperkeratosis in a specimen correlated directly with the amount of smokeless tobacco use. The use of snuff was more frequently associated with development of oral mucosal lesions than was the use of chewing tobacco, and snuff appeared to cause a greater variety and severity of epithelial change than did chewing tobacco.

Adult

Reduction of Langerhans cells in smokeless tobacco-associated oral mucosal lesions.

Localized absence of epithelial Langerhans cells (LC) has been shown to affect systemic immune responses, allow microbial colonization and play a possible role in carcinogenesis. Because use of smokeless tobacco is associated with abnormal oral mucosal changes and development of carcinoma, we examined lesion and control specimens from 17 current users of smokeless tobacco to determine whether lesions showed changes in LC number or antigen expression. We identified LC by immunohistochemistry with antibodies to the antigens T6, HLA-DR, HLA-DQ, and HLA-DP. Lesion specimens contained fewer LC (means of 6 LC/mm and 10 LC/mm2) than did the corresponding control specimens (means of 14 LC/mm and 30 LC/mm2), and in each pair of lesion and autologous control specimens the reduction in LC was on average 58% (range, 3% to 95%). There were no apparent differences between lesion and control specimens in the number of LC expressing each of the four marker antigens. Reductions in LC occurred in all types of smokeless tobacco-associated lesions, regardless of increased epithelial thickness or changes in keratinization. Our data indicate that smokeless tobacco reduces the number of Langerhans cells at its site of contact with the oral mucosa.

Antigens, Surface

Smokeless tobacco use and health effects among baseball players.

The effects of smokeless tobacco (ST) use were studied in 1109 members of major and minor league professional baseball teams during spring training in 1988. The prevalence of current ST use was 39%. The median age at initiation among users was 18 years, and the median duration of use was 5 years. Among users, 75% cited a snuff brand as their usual ST product. Oral leukoplakia was present in 46% (196/423) of current-week ST users and 1.4% (7/493) of nonusers (odds ratio, 60; 95% confidence interval, 28 to 130). Prevalence of oral leukoplakia among ST users increased with hours used per day and decreased with time lapsed since last use, and was higher in snuff users than in chewing tobacco users. Of the subjects with oral leukoplakia who underwent punch biopsy, 91 had benign hyperkeratosis and one had mild dysplasia. Overall prevalence of dental caries, gingivitis, and plaque did not differ between ST users and nonusers. In analyses confined to facial surfaces of mandibular incisor teeth, where ST is most commonly used, there were significant increases among users in both gingival recession and attachment loss. Users of ST did not differ from nonusers in blood pressure, pulse, total or high-density lipoprotein cholesterol level, or white blood cell count, but among users high-density lipoprotein cholesterol levels were inversely associated with serum cotinine levels. The major health effects of ST use among professional baseball players are oral leukoplakia and localized periodontal disease. The study population was young, physically fit, and characterized by relatively moderate short-term ST use.

Adolescent

Preventive dentistry. II. Periodontal diseases, malocclusion, trauma, and oral cancer.

This is the second of two articles reviewing the recommendations of the US Preventive Services Task Force for interventions by physicians, nurses, and other clinicians to prevent the major oral diseases and conditions. Physicians and other health professionals should be aware of their many opportunities to assist in preventive oral health care and should take appropriate action in collaboration with the patient's dentist.

Humans

Advances in the epidemiological study of oral-facial diseases.

Both demographic patterns and disease distribution are changing rapidly in the United States. These developments have led to the recognition that the epidemiology of many conditions is poorly understood, and that other research has thus been hindered. Four areas of epidemiological study were chosen for detailed analysis of how new technology will affect the conduct of future research. These areas, selected because information about them will be increasingly needed in an aging society, were periodontitis, temporomandibular disorders (TMD) and other orofacial pain, salivary gland disturbances, and health services research. The potential effect of new technology was examined in the short, intermediate, and long term. While the nature of epidemiological study is unlikely to change with the advent of new technology, the scope of potential studies will become broader. Advances in diagnostic techniques from elsewhere will permit far more precise diagnosis than is possible at present. Computer technology will permit an efficient system of epidemiological surveillance to provide current data on trends in tooth loss, caries, and periodontitis--data which will complement the results of national surveys. Analytical studies to produce hypotheses on the etiology of oral conditions, especially in such poorly-understood areas as chronic pain and TMD, will help direct clinical research in those areas.

Computers

Hazards of occupational transmission and strategies for prevention of infectious disease in dental education.

The emergence of AIDS has alerted the nation's health care community to the dangers of occupational transmission of infectious disease. This article assesses the risk of occupational transmission in the health care setting and examines two prevention strategies: vaccination programs and infection control protocols. The implementation of these strategies by the School of Dentistry, University of California at San Francisco, is recounted to illustrate an institutional response to the issue of infection control in the dental setting.

Acquired Immunodeficiency Syndrome

Indicators for oral health and their implications for industrialized nations.

The World Health Organization's adoption in 1979 of 'health for all by the year 2000' as a worldwide target promoted the formulation of specific oral health goals by the Fédération Dentaire Internationale in 1981. Such goals are useful to governments and the private professional sector as a focus for programme planning and implementation and as a means of measuring progress. Recent evidence that caries prevalence is already declining in some industrialized nations, including the USA, suggests that most developed countries will meet or surpass the goals adopted by the FDI by the year 2000. However, keeping these trends moving in the right direction will require a sustained effort on the part of both the public and the private sector.

Adolescent