Many third molar teeth are probably removed unnecessarily in Sandwell.
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Health Services Misuse↗
Biomedical subjects
V Lopes
Publications and source records attributed to V Lopes.
Proliferative verrucous leukoplakia: a report of ten cases.
A particularly aggressive form of oral leukoplakia that commences with a hyperkeratosis, spreads to become multifocal and verruciform in appearance, and later becomes malignant has been termed proliferative verrucous leukoplakia. Ten patients with persistent multifocal verruciform white patches were investigated. Lesions were often bilateral and affected predominantly mandibular alveolar and buccal mucosa. At first biopsy no lesion was graded higher than a verrucous hyperplasia, but subsequently all patients had squamous cell carcinoma, and two patients have died of their disease. Lesions were managed with surgery, carbon dioxide laser, and photodynamic therapy. The patients presented here confirm the existence of proliferative verrucous leukoplakia as a clinicopathologic entity. Careful examination of the whole mouth is essential when a hyperplastic white patch is seen to check for possible proliferative verrucous leukoplakia. Early aggressive treatment must then be started, and regular long-term review is crucial.
Aged↗
Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction.
A prospective investigation was undertaken of 522 patients undergoing third molar surgery. Data relating to indications for surgery and quality of care were collected on both pre- and post-operative proformas. This investigation showed that over half of the patients did not have clinically sound indications for surgery. The incidence of post-operative complications was approximately the same as other studies on third molar surgery. Patient satisfaction was at a high level, although this study revealed that a percentage of symptom-free patients undergoing third molar surgery sustained nerve damage some of which remains unreported. Clear and well defined indications for third molar surgery do exist and should be adhered to. Operating on patients without good reason involves unnecessary expenditure to purchasing authorities, cost to the patient in both time off work and post-operative complications and further, may result in potentially avoidable legal problems for practitioners. A reappraisal of the impacted third molar is indicated prior to committing the patient to surgery, such that the indications for surgery are compatible with current views on quality assurance, health service economics and medico-legal common sense.
Cost of Illness↗
Temporomandibular ganglion or synovial cyst? A case report and literature review.
A ganglion of the temporomandibular joint is a rare finding but it is important in the differential diagnosis of a preauricular swelling. This case report illustrates the usefulness of ultrasound in attempting to establish a preoperative diagnosis of a preauricular swelling. This article also illustrates the histologic techniques that may be used to distinguish a true ganglion from a synovial cyst or bursa.
Adult↗
The oral medicine clinic--what is its role?
The total number of new patients seen over a period of 12 months in an oral medicine department was 963. Of these 587 were seen by an oral physician, 168 by a liaison psychiatrist, 137 by an oral immunologist and 71 by a dermatologist with a special interest in diseases of the mouth. The broad categories of disease seen were: 364 with orofacial pain of non-dental origin; 263 with benign diseases of the oral mucosa; 149 with potentially malignant lesions, six with frank carcinomas; 100 with oral manifestations of a systemic disease; and 81 patients with conditions considered to be normal.
Dental Care↗
Homology between the HrpO protein of Pseudomonas solanacearum and bacterial proteins implicated in a signal peptide-independent secretion mechanism.
A region of approximately 22 kb of DNA defines the large hrp gene cluster of strain GMI1000 of Pseudomonas solanacearum. The majority of mutants that map to this region have lost the ability to induce disease symptoms on tomato plants and are no longer able to elicit a hypersensitive reaction (HR) on tobacco, a non-host plant. In this study we present the complementation analysis and nucleotide sequence of a 4772 bp region of this hrp gene cluster. Three complete open reading frames (ORFs) are predicted within this region. The corresponding putative proteins, HrpN, HrpO and HpaP, have predicted sizes of 357, 690 and 197 amino acids, respectively, and predicted molecular weights of 38,607, 73,990 and 21,959 dalton, respectively. HrpN and HrpO are both predicted to be hydrophobic proteins with potential membrane-spanning domains and HpaP is rich in proline residues. A mutation in hpaP (for hrp associated) does not affect the HR on tobacco or the disease on tomato plants. None of the proteins is predicted to have an N-terminal signal sequence, which would have indicated that the proteins are exported. Considerable sequence similarities were found between HrpO and eight known or predicted prokaryotic proteins: LcrD of Yersinia pestis and Y. enterocolitica, FlbF of Caulobacter crescentus, FlhA of Bacillus subtilis, MxiA and VirH of Shigella flexneri, InvA of Salmonella typhimurium and HrpC2 of Xanthomonas campestris pv. vesicatoria. These homologies suggest that certain hrp genes of phytopathogenic bacteria code for components of a secretory system, which is related to the systems for secretion of flagellar proteins, Ipa proteins of Shigella flexneri and the Yersinia Yop proteins. Furthermore, these homologous proteins have the common feature of being implicated in a distinct secretory mechanism, which does not require the cleavage of a signal peptide. The sequence similarity between HrpO and HrpC2 is particularly high (66% identity and 81% similarity) and the amino acid sequence comparison between these two proteins presented here reveals the first such sequence similarity to be shown between Hrp proteins of P. solanacearum and X. campestris. An efflux of plant electrolytes was found to be associated with the interactions between P. solanacearum and both tomato and tobacco leaves. This phenomenon may be part of the mechanism by which hrp gene products control and determine plant-bacterial interactions, since hrpO mutants induced levels of leakage which were significantly lower than those induced by the wild type on each plant.
Amino Acid Sequence↗
Immunohistochemical study of the heterogeneity of tenascin distribution within the oral mucosa of the mouse.
Immunohistochemical labelling of adult mouse oral mucosa revealed a heterogeneous distribution of the extracellular matrix glycoprotein, tenascin. In masticatory mucosa (palate and gingiva), tenascin was selectively localized to the tips of connective tissue papillae, whilst in lining mucosa (ventral tongue, buccal, labial and vestibular) it was more uniformly distributed in the basement membrane. Tenascin was restricted to the connective tissue of specialized papillary tips in the dorsal lingual mucosa. The heterogeneous distribution of tenascin may be linked to mechanical function, proliferative organization within the overlying epithelium or to continuing epithelial-mesenchymal interactions.
Animals↗
Mortality in adult ewes resulting from intestinal infestation with immature paramphistomes, complicated by severe fasciolasis.
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Animals↗
Prenatal diagnosis of tetrasomy 21.
Amniocentesis and prenatal diagnosis were done for late maternal age and an abnormality consistent with Tetrasomy 21 (47,XX, + t(21;21] was found in every cell examined of the initial amniotic fluid. Clinical examination revealed a fetus with many of the signs of Down Syndrome and pathological examination revealed gross abnormalities of the internal structures. Follow-up tissues showed mosaic Tetrasomy 21.
Adult↗