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Biomedical subjects

A Langford

Publications and source records attributed to A Langford.

At least 37 records · Page 2Linked to original sources
PubMed1991

Guided bone regeneration next to osseointegrated implants in humans.

The purpose of this investigation was to evaluate the technique of guided tissue regeneration on a clinical and histologic level for generating new bone adjacent to osseointegrated implants. Cylindrical, press-fitted, titanium plasma flame-coated implants were modified by a disk screwed onto the implant. After implant insertion, the disk-implant assembly was covered by an expanded polytetrafluorethylene membrane. In one group, the space underneath the membrane was filled with hydroxylapatite granules; in the control group, no membrane was used. Clinical and histologic results demonstrate that the principle of guided tissue regeneration is applicable to osteogenesis in humans.

Adult↗
PubMed1991

Dental care of HIV positive patients at Berlin clinic.

During an exchange programme at the "Freie Universität Berlin" the authors worked on the department of Oral Surgery. Their work consisted of treating HIV positive patients. A report on their experiences is given.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Cytomegalovirus associated oral ulcerations in HIV-infected patients.

Oral ulcerations associated with disseminated cytomegalovirus (CMV) infection were observed in four patients with AIDS manifestations showing low CD4 counts. Virus cultures of urine and saliva samples were positive for CMV in all cases. The lesions were characterized by a punched-out appearance, non-indurated borders, low bleeding tendency and lack of inflammatory wall. Light microscopy revealed granulation tissue containing "owl's eye" like cells in all specimens. Presence of CMV was confirmed by immunohistochemistry and in situ hybridization. The ulcerations were infiltrated with T-lymphocytes of the helper, suppressor and cytotoxic subset, most were positive for HLA DR. Despite the local invasion with immunocytes and high serum titers of serum antibodies the patients experienced progressive CMV disease.

Adult↗
PubMed1990

[HIV-associated periodontal lesions].

During HIV infection different lesions may occur in the area of the gingiva and/or the periodontium. An increased frequency and severity of periodontal diseases has been observed. Different forms of Candida albicans infection have been clinically characterized as pseudomembranous, erythematous (atrophic) or hyperplastic form or as papillary variant. While infection with Candida albicans may occur frequently in other areas of the oral mucosa, candidiasis of the gingiva seems to be quite rare. Due to the underlying immunodeficiency, HIV-infected patients are prone to infection with and/or reactivation of different viruses, which may cause oral lesions as well. Recurrent progressive ulcerations may occur due to herpes simplex virus 1/2, while ulcerations with a punched-out appearance may result from disseminated CMV infection. Oral Kaposi's sarcoma may clinically present as bluish or red spots, which may increase into exophytic tumors during the progress of the disease.

Candidiasis, Oral↗
PubMed1990

[Guided bone tissue regeneration--a clinical and histological pilot study].

The aim of the present investigation was to study whether a technique based on the principle of guided tissue regeneration is able to generate new osseous tissue around osseointegrated implants in humans. 14 titanium implants (IMZ) were inserted in 4 patients. The fixtures were modified by hydroxyapatite (HA) or titanium discs measuring 3 mm in height, which were screwed onto the implants. The modified implants were inserted in such way, that the discs were above the level of the alveolar bone. 3 modalities of treatment were performed. In group I HA granules were placed on the bone around the disc-implant-constructions and completely covered by an ePTFE membrane in order to create a space for ingrowth of bone-derived cells. In group II the membrane alone was placed and in the control group HA granules alone were used. After complete closure of the flap and 2-4 months of healing, the membranes including the generated tissue and the discs were removed and processed for histological examination. Clinical results demonstrated that in group I hard tissue had formed underneath the membrane, which strongly adhered to alveolar bone. Histological examination revealed new formation of trabecular bone. When the membrane alone was used, the created space was almost completely reduced during healing and no significant tissue formation had occurred. The greatest clinical problem was flap dehiscence over the membrane. In the control group the HA granules and discs were encapsulated in connective tissue. Limited by the small number of sites, the study indicates that a membrane technique according to the principle of guided tissue regeneration promotes new bone formation around osseointegrated implants in humans.

Adult↗
PubMed1989

Oral hyperpigmentation in HIV-infected patients.

Six cases of oral hyperpigmentation in HIV-infected patients are reported. While in two patients the lesions could be related to systemic clofazimine or ketoconazole therapy, in the other patients the cause remained unknown. Clinically, the pigmentations were characterized by a sudden onset and the appearance of well-defined, brown-black macules in the buccal mucosa, the gingiva, the hard palate, or the lateral borders of the tongue. In one patient, longitudinal hyperpigmented striae were observed on all fingernails and toenails. Histologically, hyperpigmentations associated with systemic medication revealed accumulation of melanin in phagocytes and extracellularly within the connective tissue. In those lesions with unknown cause, melanin was restricted to keratinocytes of the basal cell layer or to extracellular foci in the lamina propria. The clinical and histologic findings, as well as differential diagnosis, are discussed.

Adult↗
PubMed1989

Regression of oral Kaposi's sarcoma in a case of AIDS on zidovudine (AZT).

A case with oral Kaposi's sarcoma (KS) is reported that regressed during therapy with Zidovudine (AZT) which was started 5 months after the first dermal and oral tumours were noted. After 6 months of treatment the absolute number of T-helper cells had increased from 54/microliters to 232/microliters and the ratio of T-helper to T-suppressor cells from 0.15 to 0.3. During the same time the lesions of KS on the gingiva, uvula and the body as well as the face disappeared. The lesion of KS on the hard palate regressed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Ultrastructural findings in clinically uninvolved oral mucosa of patients with HIV infection.

Twelve biopsies of clinically normal oral mucosa taken from HIV seropositive patients have been investigated by means of light- and electron microscopy. Vascular abnormalities were found in all biopsies, regardless of the clinical stage of the HIV infection. In particular slit-like vascular channels, sparseness of intercellular junctions and swollen, protruded endothelial cells with an increased quantity of Weibel-Palade bodies were noticed. These findings were similar to those described in lesions of early stage Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Ultrastructural findings in oral hyperpigmentation of HIV-infected patients.

Oral hyperpigmentation has been observed in six HIV-infected patients, in two of whom systemic medication (ketokonazole, clofazimine) was supposed to be etiologically involved. Histologically, pigment was found in epithelial basal cells and particularly in subepithelial connective tissue. Ultrastructurally, the presence of premature melanosomes in subepithelial keratinocytes was of interest. Stimulation of melanocytes during HIV infection may occur in association with immunopathologic changes in the oral mucosa.

Adult↗
PubMed1989

Oral hairy leukoplakia: observations in 95 cases and review of the literature.

Oral hairy leukoplakia (HL) was observed in 25.4% of 373 HIV-seropositive patients (n = 95). 87 were men of an average age of 37.1 yr, 8 were women (30.3 yr). 71.6% of the patients were male homosexuals. At initial diagnosis of HL the majority of cases was classified as CDC IVc1 (45.3%) and CDC II (22.1%). Average CD4/CD8 ratio (n = 19) was 0.24 with a range of 0.04-1.0. Thirty biopsies of HL revealed some of the histologic features thought to be characteristic. In only 20 of 30 biopsies EB-virus-specific-capsid antigen was detected. The problems of clinical and histological diagnosis of HL are discussed. Further strict criteria are necessary in order to define HL more distinctly.

Adult↗
PubMed1989

Do nurses consistently document incontinence?

1. Urinary incontinence is inconsistently documented on medical records of nursing home residents. 2. Documentation of urinary incontinence by professional nurses may be improved by changes in organizational factors such as staffing, policy implementation, and staff education. 3. Forms that employ cue words for eliminative status show more documentation of continence status than forms that have an open format. 4. Evaluation of changes in nursing practice in the nursing home setting can benefit from nursing studies that employ an organizational perspective.

Aged↗
PubMed1988

Immunohistochemical detection of HIV structural proteins and distribution of T-lymphocytes and Langerhans cells in the oral mucosa of HIV infected patients.

Seventeen biopsies taken from oral mucosa of HIV infected patients were analysed for the distribution of CD4+/CD8+ T-lymphocytes and Langerhans cells. The results were evaluated statistically. An increase in the absolute number of CD4+ and CD8+ cells in HIV infected patients without clinical symptoms, ARC or AIDS was seen in the connective tissue stroma when compared with normal oral mucosa from sero-negative patients. However, the ratio between CD4+/CD8+ cells was decreased due to the disproportionate increase of CD8+ cells. These findings did not show statistical correlation with the clinical status of the infection. In contrast to the increase in absolute number of CD4+/CD8+ cells the number of Langerhans cells was unchanged when compared with the control group. Using four different monoclonal antibodies against virus structural proteins (2 X anti p24, gp41, gp120) two of 26 patients showed labelled cells in consecutive sections in the same connective tissue areas. It was assumed that latently infected mononuclear cells invaded the oral mucosa together with uninfected cells of the cellular immune system.

AIDS-Related Complex↗
PubMed1988

Ultrastructural and immunohistochemical findings in oral hairy leukoplakia.

Three cases of HL from the lateral border of the tongue of male homosexual AIDS patients were investigated by thin section electron microscopy. Keratinocytes contained condensed chromatin in their pyknotic nuclei and a few organelles in the oedematous cytoplasm. Chromatin was in close association to the nuclear membrane and showed a punched-out appearance. Particles typical of the herpes virus group were abundant in the upper two thirds of the epithelium in all three cases. Virus particles were seen frequently in the nuclei of the ballooned keratinocytes, but rarely in cells containing Candida albicans. Viral nucleocapsids were observed budding at the inner nuclear membrane, thereby acquiring the prospective viral envelope. Complete, enveloped virions were found in the endoplasmic reticulum and in the extracellular space. These virions were identified immunohistochemically as Epstein-Barr virus (EBV) using two monoclonal antibodies directed against EBV capsid and membrane antigen, respectively. Candida albicans was observed in the stratum corneum and in the upper layer of the stratum spinosum. Special cytoplasmic tubular structures arranged in parallel bundles were found in koilocytotic cells in addition to characteristic membrane structures composed of undulating convoluted membranes. Epithelial basement membranes were always intact.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Forensic psychiatric assessments in the Northwest territories.

This paper is an analysis of the psychosocial and forensic factors leading to legal referrals to a northern mental health service. It was found, not surprisingly, that most criminal acts were associated with alcoholism, personality disorders, and low socioeconomic status. Young native males figured prominently in both violent and property crimes. Rape offenses and major psychopathology appeared to be more common among Inuit referrals. The influence of rapid culture change and psychosocial and biologic predisposition to the deleterious effects of alcohol were considered relevant criminogenic factors. It was also felt that the high Inuit referral rate might have been related to their willingness to accept consultation and discuss symptoms of mental illness.

Acculturation↗