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Stomatological and mycological examinations of the workers at the fusion department of the RZWM "Silesia" showed a considerable intensification of paradontium diseases (about 80% of cases). Leukoplakia and candidiasis were the most common changes found on the mucous membrane in the oral cavity. Mycological investigations carried out on the Sabourand culture showed Candida albicans in 73,7% of cases.
The field of oral medicine is fundamental to the practice of general medicine as well as dentistry, oral surgery, and other special fields of medicine concerned with diseases of organs beneath the oral cavity. Disorders of the oral mucosa may reflect many dermal and internal diseases, and may focus the physician's diagnostic attention to systemic pathological conditions which otherwise could be misdiagnosed. As to their morphological appearance, however, the oral mucosa shows other forms of reactivity than the skin. When the dermal and oral manifestations of many skin diseases are compared the influence of distinct local factors on the intraoral clinical picture becomes evident. This comparative view, as well as the dermatologist's practical experience that many dermatoses either spread to, or even are restricted to the oral mucosa, may explain why most dermatologists are very interested in oral diagnosis. In this report, the interdisciplinary view and some aspects of clinical stomatology are stressed which are of actual interest in oral diagnosis and therapy. The following topics are dealt with: Diseases with aphthous lesions, Allergic reactions to drugs, Pemphigus and pemphigoid disorders, Oral infections by Candida albicans, Melkersson-Rosenthal syndrome, Lingual anomalies of different types, Leukoplakias.
Ten Candida albicans strains were tested for their adherence to buccal epithelial cells in vitro in the presence of synthetic antimycotic drugs as 5-fluorocytosine, clotrimazole and ketoconazole. The drugs when applied in therapeutic concentrations inhibited adherence stronger than when applied in subinhibitory concentrations although in both situations the inhibition was statistically significant in comparison to control experiments without these drugs (p less than 0.01). The highest inhibition of adherence was seen with 5-fluorocytosine and the weakest with clotrimazole. Out of imidazole derived drugs strong inhibition of adherence was achieved with ketoconazole.
The changes occurring in the oral mucosa, gingivae and periodontium of guinea pigs fed a vitamin C-deficient diet were determined by means of histological comparison with animals on a normal diet. The following results were obtained from the scorbutic guinea pigs: --detachment of the horny layer from the underlying epithelium, --bullous cells in the spinose and the granular layer, --formation of periodontal pockets, --reduction in number and disorientation of collagenous fibres of the periodontium associated with loosening of the molars.
Using the method of atomic absorption spectroscopy, platinum (DDP) concentrations were determined in tissue samples and plasma from 10 patients who suffered from a squamous cell carcinoma and were receiving cis-platinum. The drug was administered by a rapid infusion (60 mg/m2). Tissue samples and plasma were collected 5 h after infusion. Platinum concentrations found in squamous cells of the oral cavity varied from 3 to 20 micrograms/g with a median concentration of 7.5 micrograms/g. The corresponding plasma concentrations were 1.5-2.5 micrograms/ml. The data suggest that within 5 h after infusion an enrichment of cis-platinum takes place in human tissue.
BACKGROUND: Oral mucosa and periodontal lesions occurrence in Inflammatory Bowel Disease (IBD), Ulcerative Colitis (UC) and Crohn Disease (CD). METHODS: This study involved 100 patients examined for 5 years (1990/1995), with a clinical and histopathological diagnosis of CD (21 patients) and UC (79 patients). RESULTS: The analysis of the data obtained, from our sample, showed that 5 patients out of 100 presented aphtha minor lesions; in 3 cases the diagnosis was, respectively, of two neoformations of the genian mucosa--which turned out to be a papilloma and a fibroma--and a retro-commissural leukoplakia, degree OIN I. The 50% of our patients presented parodontal lesions, oral candidosis in 15 out of 67 patients who presented a whitish coating on the back of the tongue. CONCLUSIONS: The results of this investigation, lessen the importance of an association between IBD and oral diseases.
In a prospective study we examined the effect of preoperative chemotherapy with cisplatinum and 5-fluorouracil (5-FU) in 40 patients with advanced carcinoma of the oral cavity. Histopathologic grading, cell kinetics and immunohistochemical parameters of the mucosa were determined at two different locations. Prior to therapy, histologic dysplasias in the mucosa "close" to the tumor were observed in 75 percent of the patients. Dysplastic changes of the mucosa "far" from tumor were also found in more than one-third of the patients. Our results show that more advanced dysplasias improve only temporarily under the influence of preoperative systemic chemotherapy. Moreover, new dysplasias appearing during chemotherapy and persisting after its termination are probably induced. The results point to a possible carcinogenic potential of the combined chemotherapy schema used.
The effect mechanism of neurogen inflammation incited by local capsaicin irritation was examined by the authors in the oral soft tissue of rats subsequent to antihistamin pretreatment. Furthermore, with the aid of muscarin blocking receptor also the parasympathetic component of the vasodilatation was examined. On basis of their results it was established that the vein-wall-permeability and microcircular changes observed in the course of the neurogen inflammation of the oral soft tissue partly expanded by the histamin through the H1-receptors. The H2-receptors as well as the parasympathetic fibers do not become activated in the process.
Aphthous lesions in the oral mucosa (OM) were simulated in dog experiments by ligation of the common bile duct. In one of the experimental groups the beta-adrenoblocker propranolol was administered 30 min before surgery. Two hours after surgery the animals manifested changes in blood microcirculation of the OM. In animals treated with propranolol, the characteristics of blood microcirculation remained within normal. It is concluded that the development of aphthous lesions is preceded by functional disorders of blood microcirculation in the OM which are probably related to alterations in the neurovascular system.
Oral vaccination with live trivalent poliomyelitis in the liquid form in drops exerts a considerable influence on the IgA content in oral cavity secretes. After immunization with same vaccine in capsules no significant changes in IgA levels could be observed in oral cavity secretes for a 18-week observation period. A considerable increase in IgA level in oral secretes in children vaccinated with vaccine in capsules was observed after a 4th administration of the vaccine given orally in drops. Inrrespective of the method of vaccine administrations in the blood serum there was a considerable increase in the levels of immunoglobulins of all classes in the course of vaccination.
An influence of mannan++, its component methyl-D-mannopyranoside+ and N-acetylglucosamine on in vitro adhesion of Candida albicans strains to buccal mucosal epithelium was studied. These substances inhibited adhesion when added to adherence test in a concentration of 10 mg/ml and 25 mg/ml despite whether were added to the test incubation medium or when preincubated with fungi or epithelial cells. Preincubation of fungal cells and epithelial cells with mannan had no influence on attachment; preincubation of epithelial cells with methyl-D-mannopyranoside+ and N-acetylglucosamine decreased adherence significantly. On the other hand preincubation of fungal calls with methyl-D-mannopyranoside+ increased their adhesive properties, having no influence on adherence after preincubation of fungi with N-acetylglucosamine.
Examination of the leukoplakia simplex of the oral cavity localized on the buccal surface and in the bottom of the oral cavity was carried out in 11 cases using the method of stereological morphometry. It was established that: 1. Quantitative changes of the constituents of the cytoplasma coming into being during the process of the keratinization appear to be similar in both forms of the lokalization investigated; 2. these changes seem to be opposite to the process observed during the differentiation of the normal epithelium; 3. by comparing stereological, histopathological and clinical data a new form of leukoplakia simplex can be distinguished i.e. the indirect form of the metaplasia of the squamous epithelium. 4 Method of the stereological morphometry seesm to be suitable for the description of characteristic features of the keratinization.
UNLABELLED: OBJECTIVE OF INVESTIGATION: An unusual type of mucosal peeling appearing in 6 women and 1 man after use of a new toothpaste (Odol med 3 Samtweiss) is described. MATERIAL AND METHODS: The seven patients, aged 31 to 72 (average 53 years), were suffering from general sloughing of the oral mucosa. In all parts of the oral cavity including the gingiva propria a white leukoedema-like layer was found that peeled off spontaneously or could be lifted off easily using a forceps in flakes up to 1 cm2. There was no bleeding, but in two cases there were painful erosions. Specimens were examined histologically and cultured, especially for Candida species. RESULTS AND CONCLUSIONS: Histology of the removed membranes showed an epithelium composed of 2-15 layers without dysplasia or vesicles. Normal oral flora was found. All patients had begun using a new toothpaste 2-4 weeks before. When its use was discontinued, the lesions disappeared. Possible causes for the lesions (sodium lauryl sulphate, Sodium polyphosphates) are discussed.
The diagnosis of oral pemphigus vulgaris (PV) without concomitant cutaneous manifestations is often complicated by difficulties in obtaining a biopsy specimen allowing histological examination and direct immunofluorescence (IF) microscopy. In this clinical study five of our patients with oral PV were investigated: biopsies were taken both from lesional oral mucous membranes and from unaffected gluteal skin for IF analysis. Identical IF results, with intercellular epidermal deposition of IgG in all and of C3 in two of the five cases, were obtained in lesional and nonlesional biopsies. Therefore, it is concluded that with current IF techniques examination of the normal skin is sufficient for the diagnosis of oral PV; thus, the often painful and difficult removal of biopsy specimens from within the affected oral cavity can be avoided. Further studies are needed to confirm the sensitivity of this method.
In vitro studies on epithelial cells suggest that cyclosporin (CsA) inhibits a pathway of production of IL-6, which is mediated by TNF alpha and E. coli. The aim of the present immunohistochemical study was therefore to evaluate the content and location of cytokines and cytokine receptors in the oral mucosa of 10 patients with CsA medication. Ten patients without immunosuppression served as controls. Specimens were procured during surgical treatment and processed by paraffin embedding and as cryosections. Expression of TNF alpha, IL-1 beta and IL-6-receptor was present both in the epithelial layer and the submucosal tissues, but did not differ very greatly between patients with CsA therapy and the controls. IL-6, however, displayed a positive reaction only in the control group, while it was invisible in the group of patients with CsA medication. The immunohistochemical findings of the present study suggest that there may be a lack of mucosal expression of IL-6 under CsA medication. With regard to the broad spectrum of possible effects of proinflammatory cytokines and their multiple interactions, the functional relevance of these findings merits further investigation.
Lichen planus of the buccal mucosa with its various clinical manifestations has proved to be much more resistant to general therapeutical means than the cutaneous lesions. Repeated infralesional (sub-mucosal) injections of triamcinolon-acetonid (Kenalon Volon in a 10 per cent suspension applied to 12 patients, 4 of them with erosive lesions, have revealed particular efficiency if given at 7 oder 14 day's intervals. After 2 to 6 injections, we could already observe positive results occurring faster with papular of reticular than with erosive forms of the disease. Slight relapses may occur after 4 to 6 months disappearing, however, after 1 to 2 injections. Provided that antiseptic measures are maintained, tamponade of the salivary orifices is applied and intravascular injection by aspiration control avoided, unexpected local and general sequelae will not occur. Most of the patients have been in ambulatory care.
A randomized study was conducted to evaluate the effect of tretinoin and patient tolerance to treatment with topical applications in series of 20 cases of smoking-related or traumatic oral keratoses leukoplakia and of 20 cases of lichen planus. In each group, patients applied the topical ointment containing tretinoin (10 patients) or placebo (10 patients) twice daily. Clinical outcome was evaluated on the basis of the surface area of the lesion, measured monthly during treatment, as compared with the area observed at treatment onset. After 4 months treatment, there was a significant decrease in the surface area of the lesion in the patients with lichen planus (p < 0.02): 94 p. 100 in the tretinoin group versus 21.4 p. 100 in the placebo group. In patients with leukoplakias, there was also a very significant reduction in the surface area of the lesion after 4 months of treatment (p < 0.001): 80 p. 100 in the tretinoin group and 16 p. 100 in the placebo group. Tolerance to treatment was generally good despite a few complaints of quite temporary burning sensation at application rapidly resolutive.
The work presents a new installation and a method for intravital investigation of microcirculation in man. The installation is a modification of the contact fluorescent microscope MLK-1 produced by the Leningrad Optico-Mechanical Amalgamation which consists of the introduction of a polarization light-dividing prism into the optical scheme of the microscope for examination of the object in polarized falling rays and of substitution of the illumination source of the microscope (lamp KLM9-75) for the xenon lamp DKSSh-120, working both in the standard and given impulse regimen. The latter opens opportunties for determination of the blood flow rate in capillaries. The determination principle is that the effect of bloodflow "stop" is observed in the case of "coincidence" of the bloodflow in the capillary and the lamp modulation rate. The mucouse membrane of the oral cavity (cheek) was used as the object for investigation. It has been shown that its microcirculatory bed in normality is represented by capillary loops in the shape of a hair-pin having the diameter of 2;92--7,74 mkm. Their amount in the view field fluctuates between 8 and 20. The average blood flow rate in the capillaries under study is 0,4 mm/sec.