Search PubMed⌕ Search

Biomedical subjects

J A Svirsky

Publications and source records attributed to J A Svirsky.

At least 19 recordsLinked to original sources
PubMed1998

The effect of clinical information on the histopathologic diagnosis of oral epithelial dysplasia.

OBJECTIVES: The purpose of this study was to test the hypothesis that clinical information submitted with biopsy specimens helps pathologists be more consistent and accurate in diagnosing oral epithelial dysplasia. STUDY DESIGN: Each of six board-certified oral and maxillofacial pathologists examined the same set of 120 oral biopsies (involving diagnoses ranging from hyperkeratosis to severe epithelial dysplasia); they had examined these same biopsies in a previous study, but this time the clinical information was provided for each case. The examiner's diagnosis was compared to the sign-out diagnosis for each case. RESULTS: Rates of exact agreement with the sign-out diagnosis averaged 38.5%, and there was 85.4% agreement within one histologic grade. The rate of agreement in distinguishing epithelial dysplasia from no dysplasia was 71.4%. These results, when compared to those from a previous study in which the same examiners had evaluated the same slides but without clinical histories, represent a 2.5% to 20% decrease for exact agreement among the six pathologists, a 0% to 8.5% decrease for agreement within one histologic grade, and a 0% to 23.4% decrease for agreement regarding the presence or absence of epithelial dysplasia. CONCLUSIONS: When clinical information was used, accuracy and consistency among board-certified oral and maxillofacial pathologists in the diagnosis of oral epithelial dysplasia was not improved. In fact, there was a decrease in accuracy.

Biopsy↗
PubMed1998

The use of exfoliative cytology for the early diagnosis of oral cancers: is there a role for it in education and private practice?

BACKGROUND: Early detection of oral cancers is not easy, because oral precancerous lesions and early oral cancers can mimic many benign conditions in the mouth, leading to delays in diagnosis and treatment. There is a need to emphasize the early diagnosis of oral cancers in order to reduce the unacceptably high morbidity and mortality. METHODS: A survey regarding oral exfoliative cytology was completed by 132 dentists in Virginia who were randomly chosen from a mailing list. RESULTS: Less than half of the dentists (41.7%) had been taught how to obtain a cytologic smear, and only 26.0% knew the clinical indications for doing so. Only 9.2% of the dentists had ever obtained a cytologic smear in private practice. Of the 13 dentists in the survey who had done so, 12 had been trained in the technique. Interest in learning the cytologic technique and getting the needed supplies was indicated by 79.2% of the dentists. CONCLUSIONS: Diagnostic aids in the evaluation of oral mucosal lesions can serve an important role by identifying lesions that need to be biopsied in spite of a "benign" appearance. Exfoliative cytology, as well as vital staining, may aid in this goal. This has implications regarding undergraduate and postdoctoral education.

Cytodiagnosis↗
PubMed1995

Intraexaminer and interexaminer reliability in the diagnosis of oral epithelial dysplasia.

OBJECTIVES: Pathologists differ in their definition of "dysplasia." This study was done to test the hypothesis that experienced oral pathologists are consistent in diagnosing epithelial dysplasia. STUDY DESIGN: Six board-certified oral pathologists examined 120 oral biopsies exhibiting simple hyperkeratosis to severe dysplasia. No clinical information was given, and presence of dysplasia was judged by histomorphology. Examiners' diagnoses were compared with sign-out diagnoses for each case. Months later, each examiner viewed 60 relabeled slides from the original 120. Each diagnosis was compared with the diagnosis in the first round. RESULTS: Exact agreement with the sign-out diagnosis averaged 50.5% (within one histologic grade 90.4%). Examiners agreed exactly with their own diagnoses 50.8% of the time (within one histologic grade 92.4%). Agreement distinguishing dysplasia from no dysplasia compared with original sign-out diagnosis was 81.5%. Agreement with themselves distinguishing dysplasia from no dysplasia was 80.3%. CONCLUSIONS: Accurate reproducible agreement among experienced board-certified oral pathologists diagnosing oral epithelial dysplasia is difficult to achieve.

Diagnostic Errors↗
PubMed1994

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.

Journalism, Dental↗
PubMed1994

Adult rhabdomyoma. A light microscopic, ultrastructural, virologic, and immunologic analysis.

Adult rhabdomyoma is a rare benign tumor of skeletal muscle origin that frequently arises from musculature of the head and neck region. In this study we report five cases of adult rhabdomyoma. Light and electron microscopic examination revealed the typical cellular features as described by others. The results of immunophenotyping and quantitation of nucleolar organizer regions were consistent for a benign skeletal muscle tumor. Epstein-Barr virus and human papillomavirus genomic DNA could not be detected by in situ hybridization.

Actins↗
PubMed1994

Small cell carcinoma of the lung metastatic to the wall of a radicular cyst.

This case report details the unusual presentation of small cell carcinoma at the periapex of a maxillary left lateral incisor. The initial clinical presentation was that of a symptomatic, nonhealing, well-circumscribed radiolucency about the periapex of the tooth. The biopsy specimen submitted by the endodontist was diagnosed as small cell carcinoma. This report stresses the need for submission of all tissue removed from the oral cavity for histopathological examination.

Aged↗
PubMed1993

Oral melanotic macules. A review of 353 cases.

Clinical and histopathologic data were obtained on 353 cases of oral melanotic macules. The mean age at the time of diagnosis for all sites was 43.1 years. A significant predilection for females (p < 0.001) was noted and the most common location was the lower lip (33.0%). The mean size of the lesions was 6.8 mm. Brown was the most common color (64.9%), and most (66.0%) of the lesions were described as flat. Melanin was evident in both the basal cell layer and lamina propria in 93.5% of the cases.

Adult↗
PubMed1992

The prevalence of oral lesions in smokeless tobacco users and an evaluation of risk factors.

BACKGROUND: The widespread use of smokeless tobacco (ST) has prompted concern in regard to the development of oral lesions in long-term users. METHODS: For inclusion in the current study, a subject must have used an ST product, either snuff or chewing tobacco, for at least 6 months. The subjects were recruited by advertising, and none was referred for the evaluation of an oral lesion. The following were performed on all subjects: assessment of exposure to ST, cigarettes, and alcohol; examination of the oral cavity; a biopsy, if an oral lesion was found; and analysis of a blood sample for beta-carotene. The dietary intake of most of the subjects was analyzed. RESULTS: Of the 347 ST users, all of whom were white male subjects, 45 (13.0%) had an oral lesion. Thirty-five of the lesions were hyperkeratosis and 10 were epithelial dysplasia. CONCLUSIONS: Snuff exposure was associated significantly with the presence of an oral lesion (P < 0.0001). A decreased vitamin C intake also was found among the ST users with oral lesions (P < 0.01). The ST users with epithelial dysplasia, as compared with those with hyperkeratotic lesions, were slightly older, had a lower intake of vitamin C (P < 0.05), and were more likely to have used chewing tobacco than snuff.

Adult↗
PubMed1989

Dental management of patients after liver transplantation.

Liver transplantation over the past 10 years has become a nonexperimental therapy for patients with end-stage liver disease and offers hope to many for whom no treatment was previously available. As more patients undergo liver transplantation and survival rates continue to improve, the dental profession must adopt a protocol for dealing with these patients. With this in mind, a protocol for dental management of the patient who has had a liver transplant is presented. Two cases are presented to illustrate the importance of dental intervention.

Adult↗
PubMed1989

Rapidly enlarging gingival mass.

A case of small cell carcinoma metastatic to the mandible has been detailed. The lesion involved both hard and soft tissues and it was impossible to determine the site to which it first spread. Because of the histological similarity to the primary lung lesion and evidence of metastatic spread to other body organs, this lesion was considered to be metastatic rather than a primary tumor. The importance of accurate diagnosis was discussed, and treatment options were presented.

Carcinoma, Small Cell↗
PubMed1989

Intraosseous and extraosseous calcifying odontogenic cyst (Gorlin cyst).

This retrospective study of 15 central and five peripheral calcifying odontogenic cysts (COCs) was undertaken to compare the characteristics of these two lesions. The data reveal that the central COCs were more common than peripheral lesions by a 3:1 ratio and that they were usually diagnosed in the second decade of life, whereas the peripheral ones were usually noted after the age of 50. Seven of the 15 central COCs (47%) were associated with odontomas, and three (20%) with dentigerous cysts. Conservative enucleation or excision was the treatment of choice.

Adolescent↗
PubMed1989

Slow-growing, ulcerated mass of the left posterior hard palate.

The importance of a thorough oral and paraoral examination of all patients, with appropriate follow-up of abnormalities, cannot be overstated. The prognosis of any malignant lesion is improved if diagnosis and treatment are rendered early. This patient had an obvious lesion of the hard palate, 4 1/2 years before definitive diagnosis. When the lesion was first noted, prompt diagnostic evaluation may have discovered the malignant process. The lengthy delay in appropriate treatment for this patient has resulted in a potentially tragic outcome.

Aged↗
PubMed1987

Dermatitis artefacta of the paraoral region.

Factitial injuries constitute a group of lesions that relate only in the manner in which they are produced and have no particular physical appearance. The possibility of correctly diagnosing a factitial injury is difficult unless this unusual condition is considered in a differential diagnosis. In this article, a case report of factitial injury of the paraoral soft tissue in a 33-year-old white man is presented. A review of self-mutilation and of the psychological aspects of self-destructive behavior is also included.

Adult↗
PubMed1985

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.

Eye Neoplasms↗
PubMed1981

Lung malignancies metastatic to the oral cavity.

An analysis of intraoral metastatic lesions from lung cancers reported in the English-language literature was surveyed. Thirty-seven acceptable cases were found, and an additional case is presented. The average age of these cases was 54.0 years, with a marked male predilection. In a significant number of cases (48.6 percent) appearance of the intraoral metastases preceded discovery of the primary lesion. The mandible was the most common site of involvement (55.2 percent) and the symptoms were quite variable. Our results did not support a "seeding" hypothesis whereby sputum-borne cancer cells settle out in areas of traumatized tissue.

Carcinoma, Squamous Cell↗