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H Szpirglas

Publications and source records attributed to H Szpirglas.

At least 19 recordsLinked to original sources
PubMed1995

[Detection of oral cancers and current conception of precancerous conditions].

Detection and early diagnosis of oral cancers are conducted by general practitioners and dentists. Oral examination is particularly simple: it must be conducted methodically, helped with a good topographical knowledge. Oral examination allows to recognize cancers among tumorous oral lesions based on characteristic criteria. Precancerous lesions, like leucoplakias and lichen planus need a special attention; they must be treated to prevent cancers or strictly followed to catch up a possible worsening. The same physicians can help all along the treatment of oral cancers but their contribution is of major importance in prevention mostly against tobacco smoking.

Humans↗
PubMed1995

Alteration of cytokeratin expression in oral lichen planus.

The purpose of this investigation is to examine the possible biochemical and topographic cytokeratin alterations in lichen planus of oral mucosa. Biopsy samples of clinically normal buccal mucosa (n = 5), normal gingiva (n = 5), lichen planus from buccal mucosa (n = 5), and lichen planus from gingiva (n = 5) were obtained from patients of both sexes. Cytokeratin expression was determined by means of immunohistochemical labeling with use of a battery of monoclonal antibodies against cytokeratins and filaggrin and two-dimensional gel electrophoresis. In buccal mucosa, which is not keratinized cytokeratins 4 and 13 are expressed in the majority. In buccal mucosa lichen planus, the appearance of cytokeratins 1, 2, 10, and 11 coincides with a decrease in cytokeratins 4 and 13 and a moderate increase in cytokeratins 6, 16, 17, and 19. In normal gingiva, which is normally keratinized, the main cytokeratins are 1, 2, 10, and 11. In gingival lichen planus, a slight decrease in these cytokeratins and in cytokeratin 13 expression was noted. Finally, alterations in cytokeratins 5 and 14, explained by marked alterations of basal cells, were observed. The battery of antibodies used in this study, in correlation with two-dimensional gel electrophoresis, could represent useful diagnostic tools that enable the distinction between inflammatory keratosis and so-called quiescent lichen planus. Moreover, this work showed that cytokeratins 1, 2, 10, and 11 and filaggrin are sensitive tools that may help detect early relapse before clinical exacerbation. Finally, these biochemical techniques may be useful to follow the evolution of lichen planus under treatment.

Antibodies, Monoclonal↗
PubMed1994

[Topical tretinoin in the treatment of lichen planus and leukoplakia of the oral mucosa. A biochemical evaluation of the keratinization].

In earlier work, we demonstrated that 0.1 p. 100 topical tretinoin is clinically effective and well tolerated compared with placebo for the treatment of oral leukoplakia and oral keratosic or erythematous lichen planus. Here we aimed to complete this clinical protocol with histological and biochemical analyses comparing the biopsy specimens collected at inclusion and those collected after 4 months of treatment. Histological results were based on changes in keratinization observed between onset of treatment and 4 months treatment. Biochemical studies included the use of antibodies (anti-cytokeratins 10-11, anti-filaggrine) for the immunohistochemical evaluation of keratinization and 2-dimensional gel electrophoresis for measuring cytokeratins. In patients with lichen planus, histological changes during treatment showed that, in the 10 patients in the tretinoin group, keratinization disappeared in 6 and decreased significantly in 3. Immunohistochemistry revealed that cytokeratins 10-11 and filaggrin disappeared in 57 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the patients given placebo. Bidimensional gel electrophoresis showed that cytokeratins 1, 2, 10 and 11 disappeared only in the tretinoin group (60 p. 100 of the cases). In patients with leukoplakia, histological changes during treatment showed that, in the tretinoin group, keratinization disappeared in 5 cases and decreased in 5 others. Immunohistochemistry revealed that cytokeratins 10-11 disappeared in 30 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the placebo group. Bidimensional electrophoresis demonstrated that cytokeratins 1, 2, 10 and 11 disappeared in 43 p. 100 of the patients treated with tretinoin.

Administration, Topical↗
PubMed1994

[Topical tretinoin in the treatment of lichen planus and leukoplakia of the mouth mucosa. A clinical evaluation].

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.

Administration, Topical↗
PubMed1994

[Maxillary ameloblastoma. Apropos of a case and review of the literature].

Although ameloblastoma is one of the benign odontogenic tumors, the maxillary localisations often grow more infiltratively and show higher recurrency than the mandibular localisations. The authors report a case of ameloblastoma in maxillary sinus and sketch out the operative methods with a literature review.

Adult↗
PubMed1994

[Biopsy of the accessory salivary glands. 5 years' experience].

Biopsy of the minor salivary glands has become a routine examination ordered by physicians working in a wide range of disciplines in order to search for or eliminate the diagnosis of Gougerot Sjögren's disease or another systemic disease. We emphasize the need to use this examinations as a part of a complete work-up of the buccal cavity and the salivary glands. We reviewed our experience with 1,500 biopsies. The glands biopsied were normal in 56% of the cases and led to the diagnosis of Gougerot Sjögren's disease in 24%, chronic sialadenitis in 10% and diverse trophic problems in 5%. The clinical stage of Gougerot Sjögren's disease is usually proposed according to the Chisholm classification which we propose to compare with the Chomette classification. Finally, we described the technique of minor salivary gland biopsy.

Amyloidosis↗
PubMed1994

[Histopathologic lesions of the accessory salivary glands in Gougerot-Sjögren syndrome: re-evaluation of the diagnostic criteria of Chisholm and Mason and of Chometter et al].

In a retrospective study, we used a series of 29 patients with Sjögren's Syndrome diagnosed according to the new European criteria (Cl. Vitali, S. Bombardieri, H. M. Moutsopoulos et al.) (8). (Arthritis Rheum 1993; 36:340-7). A labial biopsy technique allowed to classify these patients into the anatomical "scores" formerly related by Chisholm and Mason and Chomette et al. Referring to these criteria, only 45% of patients presented a characteristic histopathological pattern. If another complementary criterium, i.e. ductal tropism of lymphoid infiltrates, was added, that percentage remained low (50% only). Thus, these results would suggest the following considerations: the classical histopathological criteria do not seem sufficiently specific; other histological criteria such as ductal lesions previously noted by Leroy et al. must in addition be looked for; thus it would seem to be of considerable value to use in the future complementary quantitative studies by means of morphometric methods.

Diagnosis, Differential↗
PubMed1994

[Sarcoid granuloma of the accessory salivary glands. An anatomic study and anatomo-clinical correlations: apropos of 17 cases].

From 228 clinical files of cases with suspected sarcoidosis who had had a biopsy of the accessory salivary glands, 17 cases with both a final diagnosis of sarcoidosis and one or more tuberculoid granulomas. There were 12 women (mean age: 30 years) and 5 men (mean age: 28.5 years) including 3 of Caribbean or African descent. The histopathological examination was performed to determine: 1) the number of granulomas per biopsy, divided into 3 groups: group I, 1 granuloma (n = 1); group II, 2 to 5 granulomas, mean 3.5 (n = 6); group III more than 5 granulomas, mean 12.5 (n = 5); 2) the diffusion of the granulomas within the lobules: 17% of the lobules were involved in groups I and II vs 47% in group III; 3) the size of the granulomas "minimal" (barely identifiable in 3 of 6 patients in group I; rather easily identifiable in all the other patients; 4) the presence of "non-specific" lesions including lymphoid infiltration, epithelial changes. In addition correlations with other clinical parameters of severity and/or duration were evaluated including: involvement of the main salivary glands and/or non-secretory syndrome. The following conclusions were drawn: 1) lesions of the accessory salivary glands is a sign of sarcoid lesions outside the thorax since 16 of the 17 patients had extra-thoracic clinical, biological or anatomic manifestations; 2) there is not however any significant difference in clinical severity between the 3 anatomic "intensity" groups (number of follicules in the accessory salivary glands); 3) both cases of sarcoidosis of recent onset (< 3 months) with Loefgren's syndrome were in group I; 4) the intensity of the specific lesions in the accessory salivary glands was similar to that of the non-specific lesions and can be correlated with the intensity of the main salivary gland involvement, with or without a non-secretory syndrome.

Adult↗
PubMed1992

[Necrotizing sialometaplasia].

Necrotizing sialometaplasia is an infrequent, nonmalignant, self-limited condition involving the accessory salivary glands. Clinical and histologic features of necrotizing sialometaplasia may mistakenly suggest malignant disease. This fact emphasizes the importance of carefully correlating clinical and pathologic findings and of looking for histologic criteria indicative of nonmalignant disease. Three cases are discussed and the relevant literature is reviewed.

Adult↗
PubMed1992

[Apparently primary malignant cervical adenopathy].

Despite a thorough examination it is not always possible to detect the primary cancer responsible for malignant cervical adenopathy. In the vast majority of cases the metastases arise from an epidermoid carcinoma of the upper respiratory or digestive tract. A possible diagnostic, but also therapeutic procedure is exploratory cervicotomy with extemporaneous examination. The prognosis is poor, both locally (glandular involvement) and generally (metastatic spread).

Diagnosis, Differential↗
PubMed1990

Immunohistochemical study of oral lesions of lichen planus: diagnostic and pathophysiologic aspects.

The immunophenotype of lymphoid cells in the epithelium and lamina propria of the oral mucosa were examined in patients with lichen planus, nondysplastic leukoplakia, leukoplakia with lichen planus, and other unrelated lesions. In all groups T lymphocytes were predominant; however, the T4/T8 lymphocyte ratio was higher with lichen planus than with other groups. This may be of diagnostic value in the histologic evaluation of oral lesions not typical of lichen planus. Finally, a higher percentage of Langerhans cells were observed in lichen planus. An immunologic pathogenesis of lichen planus is proposed.

Adult↗
PubMed1990

[Malignant maxillofacial extra-nodal lymphoma].

64 patients with extra-nodal maxillo-facial NHL were seen between 1969 and 1989. These rare tumours (1 to 4% of stomatological tumours) tended to occur more often in men (60% of cases) between the ages of 40 and 70. Bony involvement was common (maxillary and mandibular involvement), though more rarely the salivary glands or mucosa were involved, presenting as a swelling with lysis of underlying bone. Highly malignant varieties (85% of cases) were most commonly encountered. The treatment remains medical, involving chemotherapy (C.H.O.P. or high dose methotrexate) and gives an actuarial survival rate of 50% at 3 years.

Adult↗