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Biomedical subjects

M Schifter

Publications and source records attributed to M Schifter.

8 recordsLinked to original sources

Chronic suppurative osteomyelitis of the mandible: case report.

BACKGROUND: Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as Australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis (CSO) of the mandible in a 75 year old man. The precipitant factor was thought to be a retained tooth root in the (right) posterior body of the mandible. METHODS: Treatment included a pre-surgical course of antibiotics (clindamycin 300mg, p.o. q.i.d. for two weeks) followed by removal of the retained root, surgical débridement of the affected bone, the intra-oral draining sinus, and resection of the cutaneous sinus tract. Specimens were taken for bacterial cultures and antibiotic sensitivity testing, and the resected tissue sent for histopathological review. RESULTS: On clinical and radiographic review at three months, the patient was well, completely symptom free and the osteomyelitis had fully resolved. CONCLUSION: This case report demonstrates the typical features of CSO. The combination of antibiotic therapy and surgical débridement was effective in the treatment of chronic suppurative osteomyelitis of the mandible utilizing intravenous sedation, and so averting the need for a general anaesthetic.

Aged↗

Epithelial p53 gene expression and mutational analysis, combined with growth fraction assessment, in oral lichen planus.

The immunohistochemical detection of epithelial p53 protein expression in oral lichen planus (OLP) biopsies was supplemented with molecular analysis for mutations of the p53 gene using the polymerase chain reaction - single stranded conformational polymorphism (PCR-SSCP) technique. p53 protein expression, in the basal epithelial cell layer, as detected by the DO7 and 1801 antibodies, was significantly more frequent in OLP compared with other oral keratoses and normal mucosa, as was the growth fraction. The 10 OLP biopsies that had the most frequent p53 staining (plus a case of OLP found in continuity with a SCC) were screened by the PCR-SSCP technique, but no mutations were detected in the p53 gene (exons 5 9). The p53 overexpression in the OLP samples may be a physiological response to the hyper-proliferative state, as revealed by the growth fraction determination. This may usefully serve to protect against mutagenesis, and so be a factor in the low incidence of carcinoma associated with OLP.

Adult↗

Antibiotic strategy in orofacial/head and neck infections in severe neutropenia.

A strategy for empiric antibiotic therapy for orofacial/head and neck bacterial infections that appear as clinical swellings in patients with severe neutropenia is assessed. Daily examinations were made in the hospital. Only those with peripheral blood neutrophil counts < 100/mm3 that persisted for at least 5 days after the commencement of resolution of the swelling were included in this article. The strategy consisted of sequential additions of a beta-lactam/aminoglycoside combination, metronidazole to intensify anaerobe cover and a beta-lactamase stable agent (such as vancomycin and floxacillin) as dictated by clinical signs. Progressive and complete resolution of infection occurred in 26 of 27 patients treated.

Adolescent↗

Zoster sine herpete of the trigeminal nerve.

Zoster sine herpete infection that involves the trigeminal nerve is rarely reported. The present case details a case of varicella zoster virus infection of the mandibular division of the left trigeminal nerve without evidence of a vesicular eruption. The diagnosis was established on clinical findings and was supported by the demonstration of an IgG antibody titer of > 1:640 during the acute phase of the disease.

Adult↗

Perineural spread of squamous cell carcinoma involving trigeminal and facial nerves.

Perineural spread of squamous cell carcinomas in the orofacial region predominantly involves the trigeminal and facial nerves. Central spread, particularly along the trigeminal nerve, produces sensory impairment and involvement of other divisions through invasion of the gasserian ganglion, as illustrated in these case reports. Early diagnosis and medical referral is important because central invasion has a poor prognosis.

Aged↗

Trigeminal neuralgia.

Severe trigeminal neuralgia (TN) is probably the most excruciating pain experienced in the orofacial region. Apart from the primary idiopathic form (ITN), this lancinating pain may be secondary to a range of underlying organic diseases (STN). Diagnosis requires differentiation of these and elimination of other causes of orofacial pain.

Diagnosis, Differential↗