First measurements of spin-dependent double-differential cross sections and the Gerasimov-Drell-Hearn Integrand from 3He(γ,n)pp at incident photon energies of 12.8 and 14.7 MeV.

The first measurement of the three-body photodisintegration of longitudinally polarized (3)He with a circularly polarized γ-ray beam was carried out at the High Intensity γ-ray Source facility located at Triangle Universities Nuclear Laboratory. The spin-dependent double-differential cross sections and the contributions from the three-body photodisintegration to the (3)He Gerasimov-Drell-Hearn integrand are presented and compared with state-of-the-art three-body calculations at the incident photon energies of 12.8 and 14.7 MeV. The data reveal the importance of including the Coulomb interaction between protons in three-body calculations.

Advances in the biology of oral cancer.

The incidence of oral cancer remains high and is associated with many deaths in both Western and Asian countries. Several risk factors for the development of oral cancer are now well known, including smoking, drinking and consumption of smokeless tobacco products. Genetic predisposition to oral cancer has been found in certain cases but its components are not yet entirely clear. In accordance with the multi-step theory of carcinogenesis, the natural history of oral cancer seems to gradually evolve through transitional precursor lesions from normal epithelium to a full-blown metastatic phenotype. A number of genomic lesions accompany this transformation and a wealth of related results has appeared in recent literature and is being summarized here. Furthermore, several key genes have been implicated, especially well-known tumor suppressors like the cyclin-dependent kinase inhibitors, TP53 and RB1 and oncogenes like the cyclin family, EGFR and ras. Viral infections, particularly with oncogenic HPV subtypes and EBV, can have a tumorigenic effect on oral epithelia and their role is discussed, along with potential therapeutic interventions. A brief explanatory theoretical model of oral carcinogenesis is provided and potential avenues for further research are highlighted.

Factors associated with delay in the diagnosis of oral cancer.

Early detection and treatment improve the prognosis for oral cancer. Delays from the onset of symptoms to clinical diagnosis are common. Our aim is to identify factors associated with this delay. Between 1995 and 1998, we interviewed 105 consecutive patients with histologically confirmed oral cancer in Greece. If 21 or more days elapsed from the time the patient noticed major symptoms to a definitive diagnosis, we called it a delay (52% of cases). We used logistic and linear regression to estimate odds ratios of delayed diagnosis and to identify correlates of length of delay, respectively. Former smokers had a 4.3 times greater risk of delayed diagnosis compared with current smokers (95% confidence interval: 1.1-17.1). The length of delay was greater among single patients, non-smokers, or those with stage IV tumors. Clinicians should be advised that delay in the diagnosis of oral cancer occurs frequently, even in individuals who do not smoke heavily.

Paraneoplastic pemphigus: a review.

Paraneoplastic pemphigus (PNP) is a relatively recently described autoimmune disorder, distinguished from pemphigus vulgaris or foliaceus by specific clinical, histologic and immunologic criteria. In the present review, 18 cases of paraneoplastic pemphigus reported so far are discussed. The polymorphism, extent and persistence of skin and mucosal lesions are discussed while the problems of differential diagnosis and the significance of the associated neoplasms are also stressed. The underlying malignancy in the majority of the cases has been of lymphoid origin and has preceded the clinical presentation of pemphigus. All patients have had oral and cutaneous lesions. In 66.6% of the patients there was a poor response to therapy.

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa. A case report and review of the literature.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign uncommon entity whose aetiology and pathogenesis is under debate. Clinically, it is characterised by cutaneous papules or nodules. Cases of this entity reported in the oral mucosa are very rare. We describe such a case, discuss the problems of histological differential diagnosis between ALHE and other diseases of the region and review the literature.

Smoking and alcohol in the etiology of oral cancer: gender-specific risk profiles in the south of Greece.

Oral and pharyngeal cancer (OC) mortality is very low in Greece, especially among men, compared to other European countries. We conducted a case-control study of OC in Athens, and obtained information on tobacco, alcohol use and other potential risk factors and confounding variables for 110 incident cases and 115 hospital-based controls. We used multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tobacco smoking (pack years, P(trend)=0.01) and alcohol use (drinks/week, P(trend)=0.07) were independent risk factors, with a multiplicative effect for combined exposures (OR, 8.3; 95% CI, 2.4-29.1, for >28 alcohol drinks/week and >50 pack years of cigarette smoking). The type of alcoholic beverage also seemed important: drinking ouzo and tsipouro (liquors of high ethanol concentration) was associated with greater increased OC risk than drinking comparable amounts of wine, beer or dark spirits. While alcohol drinking is more common for male cases versus controls, few men reported regularly consuming large quantities of ethanol associated with highest risk of OC in other studies. This may partially explain the low rates of male OC mortality in Greece. Among the 38% of our cases who were women, however, neither smoking nor alcohol drinking frequencies were significantly elevated compared to controls, and so the etiology of OC risk in females requires further investigation.

Childhood cicatricial pemphigoid with exclusive gingival involvement.

A case of cicatricial pemphigoid in a 13-year-old boy presenting in the form of desquamative gingivitis is described. There are only 7 documented cases of childhood cicatricial pemphigoid reported in the literature.

Unpigmented intramucosal nevus of palate. An unusual clinical presentation.

A case of unpigmented intramucosal nevus occurring in the palatal mucosa is described. It presented as a nodule and was diagnosed clinically as fibroma. The correct diagnosis was established histologically and immunohistochemically; the importance of this lesion is that it should be considered in the differential diagnosis of oral soft-tissue tumors.

Benign cartilaginous tumor of the gingiva. A case report.

Benign cartilaginous tumors of the intraoral soft tissues are rare and are typically seen in the tongue, buccal mucosa, or soft palate. They comprise a diverse group of lesions that are usually defined as cartilaginous choristomas or chondromas. The case reported was located on the palatal maxillary gingiva of the first premolar of a 56-year-old white woman. It appeared as a small firm tumor covered by normal mucosa, with the underlying bone intact on radiographic examination. Histologic examination of the excised lesion revealed a circumscribed mass of cartilaginous tissue with occasional cells presenting atypical nuclear features. Two years after initial presentation, the patient is free of recurrence.

Oral hairy leukoplakia in a child with AIDS.

A case of a 9-year-old boy with AIDS and severe hairy leukoplakia on the tongue is reported. Clinically it appears as a bilateral whitish-grey, nonremovable lesion on the lateral margins of the tongue with characteristic vertical corrugations. The lesion failed to respond to topical and systemic antifungal treatment. In contrast, it completely disappeared after treatment with 600 mg acyclovir per day for 1 month. During the hairy leukoplakia development the CD4-lymphocytes count was 95/microL.

Oral histoplasmosis as an indicator of HIV infection.

Histoplasmosis as a serious opportunistic infection in association with AIDS has assumed considerable importance. We have gathered 20 case reports from the literature of oral histoplasmosis in HIV-infected patients. In some cases, oral lesions appear to be the primary or only manifestation of disease. We report one such case of oral histoplasmosis in a bisexual man who was seen with ulcerations on the palate and proved to be infected by HIV.

Oral manifestations of infectious diseases.

The oral manifestations of infectious diseases is a major topic since the prevalence rate has increased, and usually poses diagnostic and therapeutic dilemmas to the oral clinician. The clinical features of the most common and important oral infectious diseases are discussed.

Warty dyskeratoma of the oral mucosa.

A case of oral warty dyskeratoma is presented and the literature is reviewed in brief. While warty dyskeratoma of the oral mucosa is rare, it appears to exhibit a variability of clinical appearance and to have a special predilection for keratinised mucosae exposed to friction and mechanical stress.

[Risk of HIV infection among health care workers, dental team and household contacts]. / Poios einai o kindynos tychaias molynses me ton io HIV (AIDS): nosokomeiako prosopiko, odontiatroi, oikogeneiako periballon.

The transmission of HIV infection through contaminated blood and blood products is of a great concern to the medical and dental community and household contacts. The available data support the concept that the risk of causal nosocomial transmission of HIV following needlestick or mucous membranes injuries is extremely low (0.44%). On the other hand no dental professionals, not belonging to any AIDS-high risk group, have showed HIV-antibodies. However, recently one New York dentist, who treated high risk individuals and did not use barrier techniques was found to be HIV antibody positive. Despite of the fact that the risk of causal transmission of HIV is low, appropriate barrier techniques must be used to prevent such transmission. Various studies indicate that household contacts who are not sexual partner of patients with AIDS are at minimal or no risk for horizontal transmission of HIV-infection.

Oral pemphigus vulgaris: an immunofluorescent study of fifty-eight cases.

Oral mucosa biopsy specimens and sera from fifty-eight patients with pemphigus vulgaris limited to the oral cavity were studied by the direct and indirect immunofluorescence technique. Direct immunofluorescence demonstrated intercellular substance (ICS) deposition of IgG, either alone or in combination with C3, IgA, and IgM, in fifty-seven out of fifty-eight (98.3 per cent) oral mucosa biopsy specimens examined. At the time of initial evaluation circulating ICS antibodies were detected in twenty-eight out of fifty-eight patients (48.3 per cent) when a compound animal epithelial tissue was used as substrate. However, when normal human oral mucosa was used as substrate, circulating ICS antibodies were observed in fifty out of fifty-eight patients (86.2 per cent). It is concluded that direct and indirect immunofluorescence is a valuable diagnostic test in the early diagnosis of oral pemphigus vulgaris. In addition, normal human oral mucosa is a more appropriate substrate than animal epithelial tissue.

Immunopathology of oral mucosa in bullous pemphigoid.

The immunopathology of the oral mucosa was studied in twenty-nine patients with bullous pemphigoid. The 14 patients with simultaneous involvement of the skin and oral mucosa had positive oral mucosa biopsies by direct immunofluorescence, whereas 85.7 percent had positive skin biopsies. Of the fifteen patients with only skin lesions, 80 percent had positive oral mucosa biopsies by direct immunofluorescence, although the oral cavity was clinically free of disease. A total of 89.6 percent of the patients had positive oral mucosa biopsies, and an equal percentage had positive skin biopsies. IgG was present in the immune deposits in all positive biopsies, and in eight cases C'3 was detected as well. Circulating antibasement membrane zone antibodies were detected in 79.3 percent of the cases when a compound animal substrate was used and in 82.7 percent of the cases when healthy human oral mucosa was used as substrate.

Oral psoriasis: report of a case and review of the literature.

Psoriasis is a chronic inflammatory skin disease which very rarely affects the oral mucosa. In the present article, an interesting case of psoriasis with exclusive oral involvement is described. The patient's history, clinical, microscopic features, and HLA typing were consistent with a diagnosis of psoriasis. A review of the 68 reported cases of oral psoriasis is presented in table form.

Oral pemphigus vulgaris in a 6-year-old girl.

An extremely rare case of pemphigus vulgaris in a 6-year-old girl with prominent oral manifestations is presented. The disease was first noted at the age of 2 years, yet no diagnosis was made. Clinical, histopathologic, and immunologic criteria served to confirm the diagnosis. A review of the literature has revealed 22 well-documented cases of pemphigus vulgaris in children under the age of 17 years. It is concluded that although oral pemphigus vulgaris is rare in young persons, it must be included in the differential diagnosis in those cases that have a prolonged history of erosive or bullous lesions.