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Biomedical subjects

J P Handlers

Publications and source records attributed to J P Handlers.

At least 19 recordsLinked to original sources
PubMed2001

Diagnosis and management of oral soft-tissue lesions: the use of biopsy, toluidine blue staining, and brush biopsy.

Upon discovery of a lesion after thorough oral soft-tissue examination, the dentist is confronted with the often-troublesome decision of how best to manage the patient. The management protocol must provide for early diagnosis in the case of oral cancer so as to reduce cancer morbidity and mortality. Options for management would include an observation period of some defined time, use of toluidine blue stain or oral brush biopsy to screen the lesion, or immediate biopsy and follow-up. This article reviews the assets and limitations of each and suggests a rational, science-based approach to diagnosis and management.

Biopsy↗
PubMed1999

Oral manifestations of gastrointestinal disease.

A variety of gastrointestinal diseases can be associated with lesions of the oral cavity. The lesions usually correlate to active intestinal disease, but they may present prior to any other evidence of the disease and even be used to initiate diagnosis and treatment. This paper reviews the more common oral manifestations of gastrointestinal disease and their dental management.

Gastrointestinal Diseases↗
PubMed1991

Central odontogenic fibroma: clinicopathologic features of 19 cases and review of the literature.

The odontogenic fibroma is a benign neoplasm infrequently reported in the literature (20 cases). Nineteen additional examples are reported. This lesion occurs most frequently in the maxilla anterior to the molars and displays a striking female predilection. On occasion, it may be associated with an unerupted mandibular third molar. Histomorphologically, it is not encapsulated. A spectrum of fibrous connective tissue stroma is present: from myxoid to densely hyalinized and from relatively acellular to cellular. Calcification may or may not be present. It is distinguished by the presence of sparse cords and islands of inactive odontogenic epithelium. Enucleation or surgical curettage is appropriate therapy and recurrence is low. As there appears to be no correlation of histologic pattern with clinical behavior, it seems unnecessary to try to separate the tumor into two variants.

Adolescent↗
PubMed1990

Segmental odontomaxillary dysplasia. Report of eight cases and comparison with hemimaxillofacial dysplasia.

We report an analysis of eight cases with features as described for hemimaxillofacial dysplasia and compare our cases with those of that original report by Miles and associates. Patients were young and had bone and/or gingival enlargement, dental abnormalities, and unique radiographic and histologic features. Osseous and dental abnormalities were confined to the maxillary alveolus extending from the canine region to the tuberosity. Ipsilateral facial hypertrichosis was not observed. The condition seems to remain stable without significant progression and is hypothesized to be a developmental abnormality. We propose the term segmental odontomaxillary dysplasia (SOD) as a more precise descriptor for the constellation of features observed.

Adolescent↗
PubMed1990

Solid adenoid cystic carcinoma of the maxilla.

Seven cases of solid variant of adenoid cystic carcinoma of the maxilla are reported. Clinical and radiographic characteristics suggest origin within the maxillary alveolar bone. Swelling was minimal and disproportionate to the extensive, diffuse bone destruction universally present. Histologic features were typical of this neoplasm occurring in other sites and consisted of diffusely infiltrating islands of small, closely packed monomorphous cells with sparse cytoplasm, indistinct borders, and small hyperchromatic nuclei. Four of five patients with follow-up data died of their disease. This confirms the lethality of the solid variant. Rationale is presented for considering these malignancies to be of primary intraosseous origin.

Adult↗
PubMed1988

Oral hairy leukoplakia: ultrastructural observations.

On the basis of the clinical appearance and the light microscopic findings, we determined 16 biopsy specimens to be possible examples of oral hairy leukoplakia. All 16 specimens were studied by means of electron microscopy. Ten of these specimens contained typical herpes-type viral particles in the epithelial cells of the upper stratum spinosum. None of the specimens contained ultrastructural evidence of human papillomaviruses.

Candida↗
PubMed1988

Oral hairy leukoplakia: a light microscopic and immunohistochemical study.

We compared the light microscopic features and immunoperoxidase staining for human papillomavirus antigen of oral hairy leukoplakia (OHL) and flat condylomatous lesions of the cervix. Our findings support the conclusion that OHL and flat condylomatous lesions of the cervix are not similar morphologically or etiologically. Therefore the term koilocyte seems inappropriate to describe the swollen epithelial cells in OHL. The various diagnostic criteria for a diagnosis of OHL were reviewed. On the basis of the review of our cases of OHL and our review of the literature, we conclude that a definitive diagnosis of OHL requires either the biochemical evidence of Epstein-Barr virus or the ultrastructural demonstration of herpesviruses in suspected lesions.

Antigens, Viral, Tumor↗
PubMed1988

CEA immunoreactivity in odontogenic tumors and keratocysts.

Forty-five oral tumors and cysts were stained immunohistochemically for the presence of carcinoembryonic antigen (CEA). CEA, or a CEA-like antigen that is not nonspecific cross-reacting antigen (NCA), was demonstrated in the majority of aggressive or malignant tumors showing squamous differentiation, including cases of ameloblastoma, odontogenic carcinoma, and squamous carcinoma. CEA immunoreactivity was also found in cases of odontogenic keratocyst and focally in squamous odontogenic tumors but was not found in any of the ameloblastic fibromas, myxofibromas, odontogenic adenomatoid tumors, malignant melanomas, or apical cysts.

Carcinoembryonic Antigen↗
PubMed1987

Extranodal oral lymphoma. Part II. Relationships between clinical features and the Lukes-Collins classification of 34 cases.

Thirty-four cases of extranodal oral lymphoma were classified according to the Lukes-Collins system on the basis of morphology and immunoperoxidase staining, and these findings were correlated with the clinical features of each case. Vestibule and gingiva, mandible, palatal soft tissue, and maxilla were, respectively, the most common locations for all the tumors, and the most frequently stated signs and symptoms were swelling, pain, paresthesia, anesthesia, ulceration, and discoloration. Eighty percent of the lymphomas were composed of transformed follicular center cells or postfollicular cells. Patients with lymphomas composed of nontransformed follicular center cells had a greater mean age than those with tumors of transformed follicular center cells or postfollicular cells, and a trend of decreasing age with increasing B cell transformation of the tumor type was seen. Within each Lukes-Collins category, the percentage of tumors that presented with bone involvement increased as the tumor category advanced in B cell transformation. Follow-up information indicated that the prognosis was poorest with postfollicular lymphomas, intermediate with transformed follicular center cell lymphomas, and best with nontransformed follicular center cell lymphomas.

Adult↗
PubMed1986

Extranodal oral lymphoma. Part I. A morphologic and immunoperoxidase study of 34 cases.

Thirty-four cases of oral lymphoma were classified by the Lukes-Collins system on the basis of morphology and immunoperoxidase staining. Ninety-seven percent of these were morphologically identified as B-cell neoplasms: 6% SCFCC, 9% LCFCC, 26% SNCFCC, 24% LNCFCC, 12% IBS, and 18% malignant plasma cell proliferations. Monoclonal immunoperoxidase staining for cytoplasmic immunoglobulin was positive in 41% of the cases overall, but 100% of the cases of immunoblastic sarcoma and malignant plasma cell lesions stained positively.

B-Lymphocytes↗
PubMed1985

Oral features of Wegener's granulomatosis.

A review of the dental literature yielded ten cases of Wegener's granulomatosis manifesting in the oral cavity, but only one was found in the medical literature. The most common oral lesion is hyperplastic gingiva, which is red to purple, with many petechiae. Tooth mobility, loss of teeth, and failure of wounds to heal are also common manifestations. The disease may remain localized in the oral cavity for unusually long periods of time before multiorgan involvement occurs. Histologically, oral biopsy tissue does not exhibit the characteristic features of vasculitis and granulomas. There are, however, diagnostic histologic features that are consistently present, including pseudoepitheliomatous hyperplasia, epithelioid histiocytes, giant cells, and eosinophils. Failure to recognize these diagnostic clinical and histologic features resulted in a 24-month delay in the diagnosis and treatment of our patient.

Child↗