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Biomedical subjects

T J Fleming

Publications and source records attributed to T J Fleming.

36 records · Page 2Linked to original sources
PubMed1990

Salivary flow rates in patients with head and neck cancer 0.5 to 25 years after radiotherapy.

In this clinical study at the University of Texas M. D. Anderson Cancer Center, unstimulated and stimulated salivary flow rates were obtained from 47 patients with head and neck cancer who had received mantle, unilateral facial, or bilateral facial field radiotherapy from 0.5 to 25 years earlier. The magnitude of salivary flow rate reduction compared with a healthy control group was primarily related to the radiation dosage and the amount of salivary gland tissue included in the irradiated fields. Flow rates were lower for women in all groups, but these differences were not statistically significant.

Adult↗
PubMed1990

Oral complications associated with cancer therapy. An M. D. Anderson Cancer Center experience.

Oral complications associated with cancer therapy may not be inevitable. The intensity and duration can be prevented or alleviated by correcting existing oral-dental pathology and maintaining meticulous oral care. Microbial (bacterial, fungal and viral) assessment not only allows appropriate documentation of mucositis versus mucosal infection but directs therapeutic treatment.

Bacterial Infections↗
PubMed1990

Oral tissue changes of radiation-oncology and their management.

The cytologic effects of radiation therapy involve all tissues and most significantly bone within the treated area. Of greatest concern is the permanence of the compromised healing and resistance to infection of the irradiated tissues. Those dental procedures that do not cause tissue trauma are considered nonrisk. Any procedure that traumatizes previously irradiated tissues can exceed the healing potential of the compromised tissue and frequently results in an uncontrollable necrosis. The adequate utilization of hyperbaric oxygen therapy has been shown to be 95% effective in preventing osteoradionecrosis in postirradiated tissues.

Dental Care for Persons with Disabilities↗
PubMed1988

Preliminary observations on the effect of mantle field radiotherapy on salivary flow rates in patients with Hodgkin's disease.

Changes in stimulated and non-stimulated whole saliva flow rates were measured in 11 Hodgkin's disease patients who received therapeutic doses of radiation to a mantle field at the M. D. Anderson Hospital in Houston, Texas. Salivary flow rates were examined before, during, and after radiotherapy. Mean flow rate reductions of 54% for non-stimulated saliva and 55.7% for paraffin-stimulated saliva were observed post-radiotherapy. Flow rates had not returned to pre-irradiation levels in any of the patients who were observed for two to three months after completion of therapy. Results obtained from this preliminary study indicate that most patients who receive therapeutic doses of radiation to a mantle field experience a significant reduction in salivary output which is manifest during the period of treatment and persists for a period of at least two to three months post-radiotherapy.

Adult↗
PubMed1987

Prevalence of caries-associated microflora after radiotherapy in patients with cancer of the head and neck.

In this clinical study of irradiated head and neck cancer patients at M. D. Anderson Hospital, 68 adult xerostomic patients using different fluoride gels were evaluated for oral levels of Lactobacillus and Streptococcus mutans during the postradiotherapy period, which ranged from 2 months to 20 years. The fluoride groups were compared with a control group consisting of 21 cancer patients who were scheduled to undergo radiotherapy. Lactobacillus levels were significantly elevated in all postradiotherapy groups, irrespective of the type of fluoride gel used. S. mutans levels in the 0.4% SnF2 group were significantly lower than in the 1.0% NaF gel group. The low levels of S. mutans observed in the SnF2 group suggest that this agent may be exerting a downward selective pressure on the microorganism during the postradiotherapy period.

Adult↗
PubMed1987

Histological examination of experimental arthritis induced by gonococcal peptidoglycan.

The course of hindpaw arthropathy induced by single intradermal tail injections of sonicated, extensively-o-acetylated peptidoglycan (S-o-PG) from Neisseria gonorrhoeae was studied in male Lewis rats. Following a latent period of approximately 2 weeks, the hindpaw skin became inflamed and the ankles and hindfeet became swollen. Swelling was greatest at 32 days after injection, and decreased somewhat by day 40 to a level which remained well above normal. An aggressive, acute arthritis accompanied the swelling through day 24. The main features of the arthritis included the infiltration of periarticular tissues by many neutrophils, pannus formation, and the erosion of cartilage and subchondral bone. By day 32 the process had progressed and chronic inflammatory changes were becoming superimposed upon the acute changes. By day 40, chronic inflammatory changes predominated and fibrous ankylosis were established. In addition to the arthritis, deposition and absorption of bone occurred on surfaces unrelated to joints (e.g., the tibial shaft and plantar surface of the calcaneum), while tendons about the ankle developed adhesions following a severe tenosynovitis. This study supports the notion that cell-wall components may trigger severe arthropathy even in the absence of viable intraarticular gonococci.

Animals↗
PubMed1986

Arthropathic properties of gonococcal peptidoglycan fragments: implications for the pathogenesis of disseminated gonococcal disease.

We examined the arthropathic activity of purified peptidoglycan (PG) fragments derived from (i) lysozyme-resistant, extensively O-acetylated PG from Neisseria gonorrhoeae FA19 (O-PG), and (ii) lysozyme-sensitive, O-acetyl-deficient PG from N. gonorrhoeae RD5 (non-O-PG). Male Lewis rats were injected intradermally in the tail with 200 micrograms of PG emulsified in mineral oil and water (1:1) or with the oil and water emulsion alone (controls). Quantitation of hind paw size indicated that macromolecular PG of various chemical and physical forms induced paw swelling (P versus controls, less than 0.01) that was evident at about day 14 and that reached a maximum at about day 24. PG-mediated paw swelling was accompanied by intense synovitis with some cartilage and bone involvement. The minimal arthropathic dose of soluble macromolecular PG was 20 micrograms per rat. Of particular interest was that macromolecular O-PGs from strain FA19 caused considerably more extensive swelling than did either their RD5 non-O-PG counterparts or the homologous FA19 PG that had been de-O-acetylated by mild alkali treatment. This suggested that the persistence of hydrolase-resistant high-molecular-weight fragments, afforded by extensive O-acetylation, may be important for optimal expression of arthropathic activity. However, oligomeric PG was not an absolute requirement, since even low-molecular-weight fragments, including the anhydro-muramyl-containing disaccharide peptide monomer released by growing gonococci, were also arthritogenic. Experiments employing purified gonococcal lipopolysaccharide indicated that the arthropathic activity of PG preparations was not due to contaminating lipopolysaccharide. Based on the arthritogenicity of gonococcal PG in this model system, we suggest that PG may play a role in the pathogenesis of gonococcal arthritis, and that such an activity might be potentiated by the persistence of hydrolase-resistant O-PG.

Acetylation↗
PubMed1983

A tongue-shielding radiation stent.

This article describes a simple technique for fabricating stents to protect the lateral border of the tongue during therapeutic radiation therapy delivered to a unilateral region such as used in treating parotid or retromolar trigone lesions. The technique requires materials that are readily available and expertise that is possessed by all dentists. The use of radiation-protective stents markedly minimizes the treatment sequelae from therapeutic irradiation. The use of these protective stents is appreciated by patients and radiation therapists alike.

Acrylic Resins↗
PubMed1981

Angiosarcoma metastatic to the maxillary tuberosity gingiva.

A case of angiosarcoma metastatic to the maxillary gingiva is presented. A review of the literature and an epidemiologic survey of angiosarcoma cases since 1944 at the M. D. Anderson Hospital and Tumor Institute prove this to be an extremely rare occurrence. Generally, metastasis to the oral/perioral tissues occurs as a late sequela secondary to diffuse metastatic disease. In this case, however, two extensive metastatic tumor surveys determined that the only metastasis was to the oral site. The lesion clinically mimicked an inflammatory process. It is hoped that this presentation will reinforce aggressive pursuit of innocuous-appearing oral lesions when the patient has a history of malignant disease and will further encourage dental involvement in the oral/dental assessment and are of the cancer patient.

Bone Neoplasms↗