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J J Sciubba

Publications and source records attributed to J J Sciubba.

At least 19 recordsLinked to original sources
PubMed1999

Heterotopic oral gastrointestinal cyst: report of 2 cases and review of the literature.

Oral heterotopic gastrointestinal cyst is a rare entity occurring in infants and children and showing a predilection for males. The cyst usually appears as an asymptomatic swelling in the floor of the mouth. Difficulty in feeding, swallowing, respiration, and speech have been reported in approximately 30% of those affected. The tongue-in particular, its anterior aspectis involved in up to 60% of reported cases. The clinical, radiographic, and histopathologic features of cases of heterotopic gastrointestinal cyst involving the anterior tongue in a 2-year-old girl and the anterior floor of the mouth in a 2-month-old boy are presented, and theories of pathogenesis are discussed.

Child, Preschool↗
PubMed1999

Improving detection of precancerous and cancerous oral lesions. Computer-assisted analysis of the oral brush biopsy. U.S. Collaborative OralCDx Study Group.

BACKGROUND: A study group composed of researchers from across the United States undertook a study to evaluate the sensitivity and specificity of OralCDx (OralScan Laboratories Inc.), a computer-assisted method of analysis of the oral brush biopsy, in the detection of precancerous and cancerous lesions of the oral mucosa. METHODS: The study group conducted a multicenter double-blind study comparing results of OralCDx analysis with those of scalpel biopsy of suspicious oral lesions, as well as using OralCDx on oral lesions that appeared benign clinically. RESULTS: In 945 patients, OralCDx independently detected every case of histologically confirmed oral dysplasia and carcinoma (sensitivity = 100 percent, false-negative rate = 0 percent). Every OralCDx "positive" result was subsequently confirmed by histology as dysplasia or carcinoma. The specificity for the OralCDx "positive" result was 100 percent, while the specificity for the OralCDx "atypical" results was 92.9 percent. In 4.5 percent of clinically benign-appearing lesions that would not have received additional testing or attention other than clinical follow-up, OralCDx uncovered dysplasia or carcinoma (statistical sensitivity > 96 percent, P < .05, n = 131; statistical specificity for the OralCDx "positive" result > 97 percent and for the "atypical" result > 90 percent, P < .05, n = 196). CONCLUSIONS: The authors propose that this multicenter trial demonstrates that OralCDx is a highly accurate method of detecting oral precancerous and cancerous lesions. OralCDx can aid in confirming the nature of apparently benign oral lesions and, more significantly, revealing those that are precancerous and cancerous when they are not clinically suspected of being so. All OralCDx "atypical" and "positive" results should be referred for scalpel biopsy and histology to completely characterize the lesion. CLINICAL IMPLICATIONS: Given the difficulty in clinically differentiating premalignant and malignant lesions from benign lesions with a similar appearance, OralCDx appears to determine the significance of an oral lesion definitively and detect innocuous-appearing oral cancers at early, curable stages.

Adolescent↗
PubMed1996

Autoimmune aspects of pemphigus vulgaris and mucosal pemphigoid.

Oral mucosal lesions of ulcerative, desquamative, and bullous character are major problems for clinicians and patients alike. Underlying such processes is the autoimmune reaction manifesting as specific subsets of immunopathology. Responsible for the maintenance of mucosal integrity within the oral cavity are numerous adhesion proteins which operate at the cell-to-cell and cell-to-connective-tissue-matrix level. Two of the better-understood conditions characterized by altered or disordered levels of adherence are the pemphigus and the pemphigoid groups of lesions. Autoantibodies in pemphigus vulgaris specifically attack normal proteins within the desmosomal structure. Cellular adhesion is affected by steric interference by antibodies directed against antigens residing within the intercellular space or the desmosome itself. Such alterations ultimately result in cell-to-cell separation, with production of the acantholytic element characteristic of pemphigus vulgaris. Mucous membrane pemphigoid is characterized by a separation at the junction of the epithelium and connective tissue at the level of the basement membrane complex. Histologically, a split occurs in the sub-basilar region, with antibodies directed to the 230-kDa protein component of the hemidesmosome. Minor antigens residing within the basement membrane area include a 180-kDa element as well as other less commonly found proteins near the membrane complex. Manifestations of these illnesses are often severe. Management strategies of pemphigus vulgaris have changed over the recent past, with new modalities supplementing the traditional corticosteroid approach. Both conditions are usually lifelong, with the implications of management a major consideration.

Autoantigens↗
PubMed1996

Opportunistic oral infections in the immunosuppressed patient: oral hairy leukoplakia and oral candidiasis.

Several opportunistic infections associated with immunosuppression are noted to occur secondary to an altered relationship between host and organism. In relation to diminished host immunologic defenses, associated commensal organisms may evolve to a pathogen state. Candidiasis, a common oral marker disease reflective of immunosuppression, results from dysfunction of complex cellular interactions keyed by depressed T-cell activity or function. Certain viral infections may also serve as probable markers of immunosuppression. One such infection is typified by the development of oral hairy leukoplakia, a condition highly correlated to HIV infection in most, but not all, patients. Detection of Epstein-Barr virus particles and subsequent molecular analytic verification of such and the absence of other potential viral candidates, such as papilloma and human immunodeficiency viruses, have led to a general acceptance of this virus as the cause of this condition.

AIDS-Related Opportunistic Infections↗
PubMed1995

Oral leukoplakia.

Leukoplakia has evolved as a clinico-pathologic concept over many years, with the current clinical designation being accepted worldwide. Reflective of the biology of leukoplakia is the concept of cellular atypia and epithelial dysplasia. Adding to a better understanding of leukoplakia in general has been the definition of relevant clinical subsets which, in some cases, includes etiology (snuff), while in other cases a verrucous clinical appearance will suggest a more aggressive anticipated behavior pattern. Tobacco usage, in many of its forms, remains the prime etiologic factor; however, other considerations also apply. More recently, the potential etiologic role of Candida albicans has been stressed, as well as its possible role in carcinogenesis. So-called oral hairy leukoplakia has been defined in relation to a possible Epstein-Barr viral infection, usually in the immunosuppressed patient. Other viruses, human papilloma virus in particular, have been implicated in leukoplakia, while genetic alterations involving tumor suppressor elements (p53) have also been investigated. Finally, the management of this common condition remains a variable and includes local, topical, and systemic therapies such as anti-oxidants, carotenoids, and retinoids.

Candidiasis, Oral↗
PubMed1994

Terminal duct carcinoma. Recognition of a low-grade salivary adenocarcinoma.

We describe six cases of terminal duct carcinoma of the minor salivary glands. All were localized to the oral cavity, without regional nodal or distant metastases. Histologically, five were originally mistaken for adenoid cystic carcinoma; one was interpreted as monomorphic adenoma with areas of adenoid cystic carcinoma. Treatment consisted of wide resection with or without radiation therapy, with no incidence of recurrence or metastasis. The characteristics of this recently described pathologic entity are reviewed. The less aggressive behavior of this tumor compared with adenoid cystic carcinoma should call for less radical therapy, with a favorable prognosis in most cases. Recognition of this tumor as a distinct clinical and pathologic entity is therefore important.

Adenocarcinoma↗
PubMed1994

Sjogren's syndrome: pathology, oral presentation, and dental management.

As one of the major autoimmune conditions involving the oral, head, and neck regions, Sjögren's syndrome has a significant level of dentally related pathology. As a result of salivary dysfunction, the teeth and mucosa may develop a wide array of changes. If these changes are not managed properly, major oral dysfunction can occur. An evaluation of salivary function, the management of xerostomia and its effects, dietary counseling, and an overall appreciation of the extraoral components of Sjögren's syndrome are presented. The dental component of comprehensive patient management is one of the most important aspects of this condition, with the dental practitioner being an essential part of the health-care team.

Humans↗
PubMed1993

Nodular amyloidosis.

An unusual intraoral form of amyloidosis, the nodular form, is discussed. Attention is directed to clinical, microscopic and immunohistochemical features. More specifically, the nodular form of this condition and the specific relationship in this patient to chronic hemodialysis and associated beta-2-microglobulin deposition is highlighted. An overview of other forms of amyloidosis is provided along with the chemical identity of each.

Aged↗
PubMed1992

Oral manifestations of HIV infection. Definitions, diagnostic criteria, and principles of therapy. The U.S.A. Oral AIDS Collaborative Group.

A set of definitions and diagnostic criteria for the more common oral features of human immunodeficiency virus infection were prepared as the result of a consensus reached by a group of dental and medical clinicians, epidemiologists, and other experts. These are intended for use in epidemiologic surveys, where the presumptive diagnoses are recommended, and in clinical care, pathogenesis and therapy studies, where the definitive diagnoses are appropriate.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Sjogren's syndrome.

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Diagnosis, Differential↗