Dennis G. Page

Actinic cheilitis: A review of 152 cases ☆ ☆☆

OBJECTIVE The purpose of this study was to determine whether any clinical or histopathologic variables are associated with the severity of epithelial change in lesions of actinic cheilitis. STUDY DESIGN A total of 152 acceptable cases of actinic cheilitis were identified from 66,067 cases accessioned from February 1989 to June 1998. For each case, the clinical information supplied by the submitting practitioner at the time of the biopsy and 8 histopathologic variables were evaluated. RESULTS The following 5 histopathologic variables were positively correlated with an increased degree of epithelial change: acanthosis, basophilic change within the connective tissue, the presence of inflammation within the connective tissue, perivascular inflammation, and thickness of the keratin layer. None of the clinical variables was associated with an increased degree of epithelial change. CONCLUSIONS The presence of any of the aforementioned histopathologic changes should prompt a close evaluation of the lesion for the presence of either epithelial dysplasia or carcinoma.

The clinical and histopathologic features of a series of 464 oral squamous cell papillomas

A clinical and histopathologic analysis of 464 oral squamous cell papillomas is presented. Data on age, sex, race, location, clinical appearance, duration, recurrence, and clinical diagnosis are reviewed. One hundred seventy-six of the 464 specimens were examined for hyperkeratosis, character and amount of inflammatory infiltrate, and evidence of cellular atypia. The trends seen in this study support claims made by previous authors regarding incidence and inflammatory involvement. The data support a slightly higher occurrence rate in males than in females and in white as opposed to black patients. Papillomas were most abundant on the palatal complex, dorsum and lateral tongue borders, and lower lips, respectively. Confusion of papilloma for fibroma in the clinical diagnosis was less common than expected. Recurrence rate and incidence of multiple papillomas were low. Histologic study revealed a tendency for hyperkeratotic lesions to arise from nonkeratinized oral sites. Cellular atypia was found, but it is still unclear whether these changes are preneoplastic or due to an increased growth rate.

Immunotoxicological Profile of Morphine Sulfate in B6C3F1 Female Mice

This study was undertaken to investigate a number of immune parameters which may be compromised with exposure to morphine sulfate. Mice were implanted subcutaneously with 8-, 25-, or 75-mg morphine sulfate pellets. Placebo pellets of identical makeup to the 75-mg morphine pellet (without morphine of course) were used as a control. Twenty-four hours after implantation of a 75-mg morphine pellet, blood levels reached a peak of 1610 ng/ml. Corticosterone increased in parallel with morphine and reached a peak level of 966 ng/ml 24 hr after implantation. The dose response of morphine to increase corticosterone, however, was flat. The weight of the lymphoid organs, spleen and thymus, and the liver were significantly reduced in the morphine-treated groups. Morphine treatment was associated with an increase in serum albumin, SGPT, BUN, and alkaline phosphatase indicative of hepatic damage. In contrast to increased serum proteins, the C3 component of complement was reduced in a dose-dependent manner. Leukocyte number in the peripheral blood was significantly reduced, while erythrocyte number and hematocrit were both increased. The number of B cells and T cells was decreased in morphine-treated animals. However, the percentage of T cells relative to B cells was increased. The primary IgM antibody response to the T-dependent antigen, sheep red blood cells, was decreased. Natural killer cell activity was reduced in response to morphine, as was the phagocytic capacity of Kupffer cells. Host-resistance models of Listeria monocytogenes or Streptococcus pneumoniae showed an increased resistance following administration of morphine. This increased host resistance, however, was not due to an increase in antimicrobial action of sera obtained from mice treated with morphine. The majority of morphines effects on the immune system exhibited a flat dose response, suggesting that these effects may be mediated secondarily through corticosterone.

Necrosis in benign salivary gland neoplasms. Not necessarily a sign of malignant transformation.

Necrosis that occurs in a salivary gland neoplasm is usually considered to be an ominous sign, suggesting malignant transformation, particularly in lesions that have had no prior manipulation such as fine-needle aspiration. We describe five pleomorphic adenomas and two canalicular adenomas of salivary gland origin that exhibited necrosis, yet were otherwise benign. All lesions displayed a distinctive histopathologic pattern characterized by a narrow rim of viable tumor tissue at the periphery of the neoplasm combined with a diffuse central region that demonstrated apparent ischemic necrosis. No invasion of adjacent normal tissue was identified, and no recurrence or metastasis has been seen with these lesions. Caution should be exercised in the evaluation of salivary gland neoplasms with central necrosis to avoid misdiagnosis of all such lesions as malignant.

Tissue response at the bone-implant interface in a hydroxylapatite augmented mandibular ridge

This case demonstrates that new bone formation can occur in human HA augmented mandibular ridges. However, patient age at the time of the procedure and the length of time the implant is in place may be determining factors in the degree of osteogenesis that occurs.

Nevus of Ota with associated palatal involvement

The nevus of Ota is a macular discoloration of the face which is most commonly found in the Japanese. The sclera is also often affected. The oral cavity is less commonly involved in the Japanese and is rarely affected in non-Orientals. The present case is only the seventh reported in a non-Oriental patient with clinical oral involvement and the first to illustrate the histopathologic features of an oral-lesion.

Adult smokeless tobacco use and age of onset.

To determine if an earlier age of onset is associated with greater levels of adult smokeless tobacco (SLT) use and to evaluate if this relationship differs by SLT type, 345 current adult SLT users were interviewed to obtain the age at first onset and current frequency of SLT use. The results indicated that more than twice as many SLT users began during adulthood than during preadolescence. Although preadolescent onset was associated with greater chewing tobacco use than adolescent onset, the greatest levels of both chewing tobacco and snuff use were associated with adult onset, suggesting an increased need for SLT prevention programs for young adults.

Characterization of the delayed hypersensitivity response to a protein antigen in the mouse. I: Kinetics of reactivity and sensitivity to classical immunosuppressants

Several parameters of the delayed hypersensitivity response (DHR) to a protein antigen, keyhole limpet hemocyanin (KLH), were investigated. Female B6C3F1 mice were sensitized with KLH suspended in either complete Freunds Adjuvant (CFA) or sterile saline. When the mice were sensitized twice, the magnitudes of these responses were equivalent as measured by a radioisotopic procedure reflecting the influx of monocytes. With only a single sensitization, there was a 37% decrease in the response of CFA-treated mice and a dramatic (82%) decrease in the response of saline-treated mice. Utilizing two sensitizing injections in male CD-1 mice, the kinetics of the responses were determined to be equivalent regardless of whether KLH was suspended in CFA or saline in that both responses were persistent for up to 5 weeks between the second sensitization and challenge. Ear thickness in CFA-treated mice was twice that of the saline-treated mice at 1, 3 and 5 weeks. This increased swelling was not due to an increase in the vascular permeability as measured by the extravasation of a radiolabelled protein. There was a marked increase in the total area of fibrin in both sensitized groups when compared to unsensitized mice; but no difference between the groups. The sensitivity of these responses to immunosuppressants was determined in male CD-1 mice exposed subchronically (14 day) to dexamethasone (DEX) and cytoxan (CTX). There was a marked increase in the suppression by DEX in mice sensitized to KLH in saline as compared to mice sensitized to KLH in CFA. In contrast, the sensitivity to suppression by cyclophosphamide was not affected by the presence of CFA.

Subchronic Toxicology of Diethystilbestrol in the Mouse

This study evaluated the subchronic (14-day) toxicity of selected (0.2, 1.0, and 4.0 mg/kg) daily subcutaneous injections of diethylstilbestrol (DES) in female (C57B1/6 X C3H)F1 mice. Parameters observed included body and organ weights, gross organ morphology, histopathology, clinical chemistry, and hepatic microsomal enzyme activities. The liver, bone marrow, and thymus are major target organs for DES. Liver enlargement, with associated histopathological changes consistent with mild hepatitis, centrolobular necrosis, and sinusoidal changes were observed. Supporting the histological changes were alterations in serum enzyme levels and microsomal enzyme activity. Bone marrow changes included decreases in the number of cells as well as the number of colony forming units per gram stem cells. Toxicity to the thymus was evidenced by decreased thymic weights and lymphocyte depletion. The hepatic and thymic effects were observed at the lowest (0.2 mg/kg) dose. Although all parameters were not assessed for recovery, those that were evaluated returned to control levels by thirty days after treatment.

Comparison of articles published in Oral Surgery Oral Medicine Oral Pathology in 1972 and 1992.

The articles published in the Oral Pathology section of Oral Surgery Oral Medicine Oral Pathology in 1972 and 1992 were analyzed and compared. A significant increase in the number of authors and the number of references per article was noted. There was also a significant increase in the number of articles that dealt with bacterial/viral/fungal diseases. A trend toward the origination of more articles from outside the United States was noted.