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Biomedical subjects

D Laufer

Publications and source records attributed to D Laufer.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Secondary bone grafting in cleft lip and palate].

Results of reconstruction of residual alveolar bone defects in 52 patients operated between 1990-1998 were evaluated clinically and radiographically in a retrospective study. Ages ranged between 9-37; 30 were males. The donor site of bone grafts in all was particulate cancellous marrow from the anterior iliac crest. 32 had unilateral clefts and 20 bilateral. Total cleft sites treated was 72. Best results were achieved when bone grafting was carried out prior to the eruption of the canine tooth. The cleft space was closed and oro-nasal fistulas were eliminated in 42 (80%). Success rates in unilateral and bilateral cases were significantly different.

Adolescent↗
PubMed2000

Osijek Health Center during the 1991-1992 war in Croatia.

To assess the effectiveness of health services in the city of Osijek during the 1991-1992 war in Croatia, we followed the changes in the utilization of health services, morbidity and mortality, and completion of a vaccination plan during the 2 years of the war. We used a retrospective analysis of data from the Osijek Health Center and the Osijek County Institute of Public Health. The organization of health care during the war followed the concept of integrated health care and the instructions of the Ministry of Health. Visits to primary health care physicians decreased considerably, with a concomitant increase in disease and mortality. The plan for mandatory vaccination was not completed because of the evacuation of preschool and school children. The war changed the mode of health care use, the disease and mortality structure, and the implementation of mandatory vaccination. However, timely education and preparation of the health services to the war situation resulted in an adequate provision of health care to the population.

Adult↗
PubMed1999

Early diagnosis and treatment monitoring roles of tumor markers Cyfra 21-1 and TPS in oral squamous cell carcinoma.

BACKGROUND: Mucosal oral squamous cell carcinoma (SCC) accounts for 3-5% of all reported cancers, with a 5-year survival rate of approximately 50%. Unfortunately, current detection means are of no value in diagnosing lesions early enough for cure, especially when they recur after resection. Postoperative radiotherapy and/or covering the resection site with reconstructive flaps (regional or free vascularized) often makes early diagnosis an impossible task. METHODS: The authors examined the detection and treatment monitoring capacity of two relatively new tumor markers in the serum of SCC patients, comparing their levels with those in patients with other oral/perioral malignancies or benign oral tumors and with disease free, posttreatment SCC patients and healthy controls. RESULTS: Values of sensitivity, specificity, and positive and negative prediction for Cyfra 21-1 were 96%, 87%, 93%, and 53%, respectively, whereas those for tissue polypeptide specific antigen (TPS) were 69%, 87%, 93%, and 54%, respectively. Approximately 2-3 weeks after resection of the SCC lesion, Cyfra 21-1 and TPS levels were reduced by 47% (P < or = 0.003) and 36% (P < or = 0.041), respectively. Cyfra 21-1 levels in SCC patients were significantly greater than those of healthy patients by 73% (P < or = 0.0001), patients with benign tumors by 74% (P < or = 0.0003), and patients in disease remission by 66% (P < or = 0.0002). Similarly, the TPS levels of SCC patients were significantly greater than those of healthy patients by 59% (P < or = 0.0005), patients with benign tumors by 55% (P < or = 0.0001), and patients in disease remission by 59% (P < or = 0.0001). In two patients, a second, new SCC lesion was diagnosed within the follow-up period, with increased tumor markers noted concomitantly with the diagnosis. CONCLUSIONS: The accumulated data point to the suitability of the clinical usage of these two markers, especially Cyfra 21-1, in the early detection of oral SCC lesions (primary, recurrent, or secondary) as well as for treatment monitoring. These results may open new avenues for the diagnosis and follow-up of these patients and hopefully improve their treatment outcome.

Adult↗
PubMed1999

[Ambulatory oral procedures in patients on low-dose aspirin].

Discontinuation of long-term, low-dose aspirin prior to ambulatory oral surgical procedures was assessed in a blind, controlled prospective study. 50 patients on low-dose aspirin who needed dental extractions, periodontal surgery, or other ambulatory oral surgery were randomly divided into test and control groups. The control patients stopped taking aspirin a week before operation, but in the test group aspirin was continued. Before, during and after surgery bleeding time was tested. Although bleeding time was significantly longer when aspirin was continued, in both groups it was within normal limits. Intraoperative hemorrhage was more frequent in those taking aspirin. Hemostasis control posed no problem and there were no postoperative complications in either group. It is concluded that discontinuing low-dose aspirin prior to elective oral surgery is not justified.

Adult↗
PubMed1999

An experimental study of the isotopic enrichment in Ar, Kr, and Xe when trapped in water ice.

The isotopic enrichment of argon, krypton, and xenon, when trapped in water ice, was studied experimentally. The isotopes were found to be enriched according to their (m1/m2)1/2 ratio. These enrichment factors could be useful for comparison among the uncertain cosmic or solar isotopic ratios, the hopeful in situ cometary ratio, and those in Earth's atmosphere, in the context of cometary delivery of volatiles to Earth.

Argon↗
PubMed1999

Synchronous pleomorphic adenomas of the major salivary glands: a case report.

The presentation of multiple distinct tumors in major salivary glands is rare. Although the most common tumor with bilateral synchronous or metachronous development is the Warthin tumor, pleomorphic adenomas have been diagnosed simultaneously as well. We report the case of a female patient who was diagnosed with pleomorphic adenomas in the right parotid and submandibular glands, concomitant with sialolithiasis affecting the submandibular gland. This patient had been exposed to head and neck radiotherapy in childhood, which may have played a role in the development of her tumors. A review of the relevant literature is included.

Adenoma, Pleomorphic↗
PubMed1999

Clinical and radiographic features of eosinophilic granuloma in the jaws: review of 41 lesions treated by surgery and low-dose radiotherapy.

Eosinophilic granuloma within the jaws may radiographically mimic other benign odontogenic cysts and tumors, and different protocols have been suggested in the literature for treating eosinophilic granuloma of the jaws. Forty-one lesions of eosinophilic granuloma, diagnosed in 25 patients, were reviewed retrospectively, and data were collected regarding age, gender, ethnic origin, location, symptoms, clinical appearance, radiographic features, treatment, and recurrence. The lesions were found in youngsters (18.1 +/- 4.7 years of age), mostly in the posterior parts of the mandible, and the most common presenting symptom was pain (92%), often accompanied by swelling. Approximately one half of the lesions were radiographically well defined without ossification. All patients were treated by enucleation (with or without peripheral ostectomy) and radiotherapy; 7.3% lesions recurred during follow-up (9.3 +/- 4.6 years). In addition, the different treatments suggested in the literature for eosinophilic granuloma of the jaws were reviewed.

Adolescent↗
PubMed1999

Burkitt's lymphoma of the oral cavity in Israel.

The clinical presentation of Burkitt's lymphoma in the maxillofacial area is variable. The objective of this study is to review and analyse all cases of Burkitt's lymphoma with oral or maxillofacial involvement diagnosed in our department. A retrospective review of patients with Burkitt's lymphoma in the facial area between the years 1978 and 1997 was undertaken. The patients, 8 male and 5 female, were from 7 to 50 years old (mean 15.3 years). Six patients were Stage I and 7 were Stage II. Five had abdominal involvement and 2 lymph node involvement besides the maxillofacial presentation. Three tumours were in the mandible, 3 in both mandible and maxilla, 2 in the palate, and 5 in the maxilla alone. In 5 patients the tumour presented as a facial swelling, in 3 as an exophytic mass, in 2 as an ulcer, 1 case presented as a hyperplastic lesion, and 2 were periapical lesions. Complaints included pain (7), swelling (5), and sensory disturbance (2). EBV titres were positive in 4 patients. Abdominal involvement was only seen in patients under 12 years old. All patients were treated with chemotherapy, while adjuvant radiotherapy was indicated in 3 cases. Follow-up of 1-20 years revealed a 2-year survival rate of 61.5%. It seems that the Israeli disease is between that of the African and American types, when considering age distribution.

Adolescent↗
PubMed1999

Generalized periodontal involvement in a young patient with systemic lupus erythematosus.

Inflammation is considered to be a leading cause of morbidity in systemic lupus erythematosus (SLE), yet inflammatory periodontal involvement is rarely encountered. A young lady suffering from active SLE accompanied by severe periodontal loss, manifested by gingival recession of all her teeth, was referred to our clinic for treatment. The association between periodontal involvement and connective tissue diseases is unclear, and the literature dealing with periodontal involvement in patients suffering from Sjogren's syndrome and rheumatoid arthritis is comprised of studies showing both normal and pathological periodontal status. We discuss the possible underlying mechanisms.

Adolescent↗
PubMed1999

The effect of smoking and periodontal treatment on salivary composition in patients with established periodontitis.

BACKGROUND: The purpose of this study was to evaluate the effect of smoking on the periodontal status and the salivary composition in subjects with established periodontitis before and after periodontal therapy. METHODS: Our study group included 26 healthy subjects, 12 smokers and 14 non-smokers with established periodontitis. Clinical measurements and non-stimulated whole saliva were obtained and analyzed at baseline and after scaling and root planing. Smokers presented at baseline with significantly greater probing depth (4.16+/-0.26) compared to non-smokers (3.52+/-0.32) which was statistically significant (P = 0.0268); likewise, baseline clinical attachment level was greater in smokers (4.49+/-0.31 compared to non-smokers 3.87+/-0.13; P = 0.0620). Mean plaque index was also greater in smokers compared to non-smokers (0.86 and 0.65, respectively; P = 0.0834). Baseline pretreatment sodium values were significantly greater in non-smokers (14.36 mEq/l compared to 9.31 mEq/l in smokers; P = 0.0662); likewise non-smokers exhibited 50% greater salivary calcium levels (6.04 mg/100 ml compared to 4.32 mg/100 ml in smokers; P = 0.0133). RESULTS: Post-treatment probing depth and clinical attachment level were not different between smokers and non-smokers; this in spite of significant difference in plaque index in smokers (0.35 compared to 0.13 in non-smokers; P = 0.0135). Post-treatment, smokers had reduced calcium concentration (3.58 mg/100 ml compared to 5.11 mg/100 ml in non-smokers; P = 0.0438). Treatment affected albumin level in smokers only, consequently non-smokers had significantly greater salivary albumin concentration (1.1 mg/100 ml compared to 0.38 mg/100 ml in smokers; P = 0.0274). CONCLUSIONS: Subjects with established periodontitis exhibited elevated concentrations of salivary electrolytes and proteins. Within this study group, smokers exhibited greater disease level but reduced sodium, calcium, and magnesium concentrations. Smokers responded favorably to treatment. The clinical improvement eliminated the differences in salivary composition.

Adult↗
PubMed1999

Surgically-assisted orthopedic protraction of the maxilla in cleft lip and palate patients.

Fourteen children, aged 8 to 13 years, with unilateral or bilateral cleft lip and palate, were treated by an incomplete Le Fort I osteotomy without down-fracturing the maxilla, followed by traction of the maxilla by face mask for twelve weeks. Our results revealed a mean maxillary forward movement of 7.2 mm after three weeks of traction, followed by a retention period of nine weeks for callus maturation. There was an associated minor downward movement of the maxilla that caused a slight increase in the lower facial height, which improved the facial esthetics of the patients. The advantages of this method are: i) it allows for early skeletal advancement of the maxilla with new bone formation in the osteotomy line, ii) there is no need for inter-maxillary fixation of young patients and no need for rigid fixation of the maxilla by miniplates that can damage teeth buds and roots at this age, and iii) it can be used in young patients to improve esthetic appearance, an important factor in the psychological development of adolescents.

Adolescent↗
PubMed1998

Protection against irradiation-induced damage to salivary glands by adrenergic agonist administration.

PURPOSE: Irradiation [IR]-induced damage to major salivary glands is an entity first described at the beginning of our century, yet its underlying mechanism is still enigmatic. Exposure of the salivary glands to IR is often inevitable when delivering radiotherapy for malignancies of the head and neck region. Frequently, this results in rapidly developing, life-long severe xerostomia for which no adequate prevention or treatment is available. The purpose of this study was to examine the role of secretion granules in serous cells of the parotid (P) and submandibular (SM) glands as mediators in the IR-induced salivary damage. Functional parameters (flow rate and gland weight), and total body weight were examined at both early term (4 days) and extended term (2 months) post-IR in male Wistar rats exposed to 15 Gy of head and neck irradiation following stimulation for granule secretion (degranulation). METHODS AND MATERIALS: At 4 days, it was demonstrated that IR reduced P flow rate, P gland weight, total body weight, and submandibular/sublingual gland weight by 89, 33, 30, and 32% (p < 0.01), respectively, while SM flow rate was not altered significantly. At 2 months, these parameters were reduced by 59, 37, 31, and 37%, respectively, and the SM flow rate was reduced by 39% (p < 0.01). RESULTS: Pilocarpine, a muscarinsic agonist which, albeit its efficacy as a salivary watery secretion stimulator, causes only limited degranulation, did not protect significantly any of the reduced parameters at either term. In contrast, cyclocytidine, an adrenergic agonist that is a very potent salivary degranulating agent, protected the P against the weight loss at 4 days and 2 months, and against the flow rate reduction at 2 months. The P weight and flow rate were protected to the extent that their values were not significantly different than those of the nonirradiated controls. Cyclocytidine also partially protected against the body weight reduction at 2 months. Our results emphasize the importance of secretion granules as mediatory agents in IR-induced P damage, and more so at the extended term. The demonstrated protective role of adrenergic agonists against IR damage to the P may be of importance in the clinical setting.

Adrenergic Agonists↗
PubMed1998

Parotid gland dysfunction in a murine model of acute graft versus host disease [aGVHD].

BACKGROUND: The major salivary glands are target organs affected by acute graft versus host disease (aGVHD), resulting in severe xerostomia. METHODS: We evaluated the function of the major salivary glands in an animal model of aGVHD (B10.S-->SJL/J). For the induction of aGVHD, SJL/J mice were sublethally irradiated with 900 cGy and injected with 2 x 10(7) splenocytes. The SJL/J mice that received 900 cGy total-body irradiation (TBI) and nonirradiated mice served as controls. Major salivary gland function was evaluated in vivo at the peak of aGVHD (proven both clinically and histologically). The volume, flow rate, salivation lag phase, and composition of secreted saliva were evaluated following intraperitoneal (IP) administration of pilocarpine (5 mg/kg) by cannulation of the main parotid excretory duct with polyethylene tubing. RESULTS: We observed a significant decrease in the secreted saliva volume in the aGVHD mice, 12.4+/-1.7 microl/30 min, in comparison with 27.8+/-3.9 and 31.9+/-3.0 microl/30 min in the intact control and irradiated control mice, respectively (p < .001). Sialochemical evaluation revealed a significant decrease in total protein and a significant increase in potassium in the saliva secreted by the aGVHD mice, 2.6+/-0.4 mg/mL and 22.0+/-3.2 mEq/L, compared with 4.4+/-0.6 mg/mL and 14.9+/-2.0 mEq/L in the control mice, respectively (p < .05). A decrease in sodium concentration secreted by the aGVHD mice in comparison with the nonirradiated mice was statistically nonsignificant. Histopathologic evaluation of the parotid tissue of the aGVHD mice revealed massive infiltration of lymphocytes and almost total destruction of the normal parenchyma. CONCLUSIONS: We observed salivation hypofunction develop concomitantly with salivary tissue lymphocyte infiltration in an aGVHD animal model. We suggest that the lymphocytes and the secreted lymphokines are the cause of the salivary changes. This finding may provide an explanation for the severe oral changes and xerostomia observed in aGVHD patients.

Animals↗