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Biomedical subjects

M Gorsky

Publications and source records attributed to M Gorsky.

At least 37 records · Page 2Linked to original sources
PubMed1996

Clinical characteristics and treatment of patients with oral lichen planus in Israel.

Oral lichen planus (OLP) has a multiple-site involvement, with the buccal mucosa being the most prevalent. A possible relationship between OLP and the risk of malignancies in the involved site is documented. The characteristics of OLP have been studied in different populations; however, no similar studies have been conducted in any Jewish population. The purpose of this study was to evaluate the natural history of OLP in Israeli Jewish patients. Data were collected from 157 charts of patients with histologically confirmed OLP. No evidence suggesting a connection between OLP and diabetes, cardiovascular disease, smoking, alcohol use, or positive Candida culture was found. Skin involvement of lichen planus was found in one fifth of the patients. Symptomatic OLP was noted in half of the patients, mainly in those with the erosive form. In 65% of the patients with symptoms, improvement by more than 50% was shown within 2 weeks of steroid use. The transformation rate of 1.3% of OLP into malignancy was observed in the entire group. A constant follow-up for contributing symptoms and for early diagnosis of suspected transformed lesions is of utmost importance.

Adrenal Cortex Hormones↗
PubMed1995

Referral delay in diagnosis of oro/oropharyngeal cancer in Israel.

The delay, stage at diagnosis and referral pattern of 543 oro/oropharyngeal cancer patients in Israel were investigated. About two-thirds of the malignancies were diagnosed at early stages. In more than two-thirds there was a delay of at least 2 months from the onset of signs and symptoms up to diagnosis, with a non-significant relationship between stage and delay. A significant correlation (P = 0.002) was found between delay and malignancy site. A delay of more than 4 months was observed in 71% of the patients with lip cancer. Cancers of the lip, palate and buccal mucosa were more frequently diagnosed at early stages. A significant correlation (P = 0.001) was found between stage at diagnosis and referral source. Although 86% of the cancers were diagnosed by physicians, nearly half were already at an advanced stage; when the cancers were diagnosed by dentists, 81% of the remainder were at early stages. No significant relationship was found between the referral medical profession and site of diagnosis. No nasopharyngeal, oropharyngeal or laryngeal cancers were diagnosed by dentists.

Adolescent↗
PubMed1994

The prevalence of oral cancer in relation to the ethnic origin of Israeli Jews.

Smoking, alcohol, and familial background are considered major cofactors in the cause of oral cancer. The purpose of the present study was to determine the relationship between ethnic origin and oral cancer in the Israeli Jewish Population. Data were collected during the years 1970 to 1980 from 342 dental records of patients in Israeli hospitals. Results showed a male/female ratio of 2:1. Of 264 patients with clearly determined ethnic origin, 72% were Ashkenazi, 15% Sephardi, and 13% Eastern ethnic origin. The relative prevalence showed that the risk of the Ashkenazi group to develop oral cancer was at least twice as high as the other two ethnic groups. The increase in occurrence of oral cancer with age in each ethnic group was highly significant (p < 0.001). The most common type of malignancy was squamous cell carcinoma (95%) with 99% of this malignancy occurring in patients in their sixth and seventh decade. A significant (p < 0.02) relationship between site of involvement and ethnic origin was also noted. The tongue was the leading site in the Ashkenazi and Sephardi groups, whereas the lip and alveolar ridges were the most affected sites in the Eastern ethnic group.

Adult↗
PubMed1994

Pemphigus vulgaris in adolescence. A case presentation and review of the literature.

Pemphigus vulgaris, a chronic autoimmune vesiculobullous disease, affects people in their fifth or sixth decade of life. Involvement in adolescence is rare with only about 30 cases reported in the last 35 years. This article presents a case of adolescent pemphigus vulgaris in a 15-year-old girl with oral and skin lesions. The patient has been free of lesions with a maintenance dosage of 10 mg of prednisone every other day. The mean age of the 31 patients, including our patient, was 14 years. Skin involvement was reported in 87% of patients, oral involvement in 87%, and skin and oral lesions in 81% with oral lesions preceding skin lesions. Early diagnosis of adolescent pemphigus vulgaris is important to eliminate or reduce the severity of further intraoral or extraoral involvement. The term adolescent pemphigus vulgaris is suggested when the onset is between 12 and 18 years of age.

Adolescent↗
PubMed1994

Sucralfate suspension as a treatment of recurrent aphthous stomatitis.

DESIGN: A prospective randomized, double-blind, placebo-controlled, cross-over clinical trial. SETTING: A university hospital. SUBJECTS: Twenty-one patients with symptomatic recurrent aphthous stomatitis (RAS), unresponsive to conventional treatment were enrolled. They were divided into three groups. INTERVENTION: In a cross-over trial, the patients received an oral suspension of sucralfate, an antacid solution or a placebo for 2 years. RESULTS: After 2 years of follow-up, sucralfate was found to be superior to both placebo and antacid (P < 0.001) with regard to duration of pain, reduction of the healing period, response time to first treatment and duration of remission. CONCLUSION: Sucralfate suspension should be added to the armament of treatment modalities of RAS.

Administration, Buccal↗
PubMed1992

Clinical response to levamisole in thirty-nine patients with erythema multiforme. An open prospective study.

Patients with erythema multiforme (EM) often have chronic or recurring oral lesions that cause intense pain and interfere with a variety of functions including eating and speech. Previous studies suggest that levamisole restores to normal the function of phagocytes and T lymphocytes, and activates the inflammatory response. In our previous double-blind study 8 of 13 patients with EM had a decrease in severity and frequency of attacks. The purpose of this open prospective study was to evaluate short-term and long-term clinical efficacy of levamisole in patients with mucocutaneous EM. Thirty-nine patients with mucocutaneous EM seen in the Oral Medicine Clinic, School of Dentistry, University of California-San Francisco, comprised our study group. Levamisole was used alone in 17 patients or in combination with prednisone in 22 patients and was given as a single dose of 150 mg/day for 3 consecutive days. Thirty-one patients showed a complete response from levamisole (alone in 13 and in combination with prednisone in 18). Four showed a partial response of signs and symptoms, and four others had no benefits from levamisole whether alone or in combination. The most common side effects from levamisole were skin rash, tiredness, weakness, myalgia, taste change, and insomnia.

Adolescent↗
PubMed1992

Efficacy of etretinate (Tigason) in symptomatic oral lichen planus.

This study evaluated the maximum permitted dosage of etretinate (75 mg/day) as the first mode of systemic treatment of patients with symptomatic oral lichen planus. Six patients were treated and examined objectively and subjectively every 2 weeks for 2 months. At the end of the study 50% of patients reached an asymptomatic stage; improvement of clinical signs and symptoms was noted in all patients. However, on reevaluation 2 months after treatment was discontinued some clinical signs of recurrence were seen in all patients. Further follow-up for more than a year showed that the patients had reverted to the same frequency of recurrence as before the systemic use of etretinate.

Aged↗
PubMed1991

A prospective study of findings and management in 214 patients with oral lichen planus.

The findings in this prospective study of 214 patients with oral lichen planus were similar to those found in our 1985 evaluation of 570 patients with oral lichen planus. These two groups of patients with oral lichen planus patients constitute the largest series from one clinic. Oral lichen planus was found mainly in women and most commonly on the buccal mucosa. Spontaneous remissions were infrequent (6.5%), as were malignant transformations (2.3%) in a mean follow-up of 7.5 years. The erosive form of oral lichen planus was most common and was almost always associated with pain. Reproducibly successful management of this T-lymphocyte disease was obtained by selective use of systemic and/or topical corticosteroids. Oral lichen planus was not associated with any evident systemic disease, drug, smoking, or genetic predisposition. Although statistically Candida albicans does not appear to occur disproportionately in large samples of patients with oral lichen planus, in some of the Candida-positive patients, antifungal medications appeared to be useful.

Administration, Oral↗
PubMed1991

Clinical characteristics and management outcome in the burning mouth syndrome. An open study of 130 patients.

Clinical characteristics and treatment responses were studied in 130 patients with burning mouth syndrome (BMS). Most patients were postmenopausal women, and the tongue was the most frequently afflicted site. Although 39% of the patients complained of dry mouth, no causative factors were evident. Therefore BMS is assumed to be a functional disorder. This was at least partially confirmed because the most effective management was in response to mood-altering drugs. From our data BMS appears to be a chronic condition with variations in symptoms among patients and without a predictable endpoint.

Adult↗
PubMed1991

Physiologic pigmentation of the oral mucosa in Israeli children.

Physiologic melanin pigmentation (racial pigmentation) of the oral mucosa varies in prevalence among different races and ethnic groups. The purpose of this study was to investigate the prevalence of physiologic pigmentation in Israeli Jewish children of different ethnic origins. A total of 1,300 children, 6 to 10 years of age, was examined. Physiologic pigmentation was found in 13.5% of the population studied. Children of Eastern origin showed a significantly higher prevalence of pigmentation compared with Ashkenazi and Sephardic groups. Because melanin pigmentation can be enhanced by mechanical and chemical stimulation (smoking), this study may serve as a baseline for investigation of melanin pigmentation in various ethnic groups.

Child↗
PubMed1990

Epidemiologic and demographic update in oral cancer: California and national data--1973 to 1985.

The number of new oral cancers diagnosed in the United States increases each year, with 31,000 cases reported in 1989. Unfortunately, in spite of advances in surgery, radiation, and chemotherapy, only about 50% of patients with oral cancer will survive their disease. During the past 12 years in which information is available, there have been no decided changes in age (mean 63), gender (males slightly outnumber females two to one), or sites (tongue most common). The lip is the only oral site showing an interval-decreased incidence. There is a slight trend toward an improvement in earlier detection; however, about two-thirds of all oral cancers are advanced (Stage III and IV) at the time of diagnosis.

Adolescent↗
PubMed1989

Oral erythema multiforme: clinical observations and treatment of 95 patients.

Erythema multiforme is a chronic, inflammatory mucocutaneous disease that can occur in both genders at any age. Although the cause remains obscure, a wide range of antigens and factors, including herpesvirus and other infections, has been suggested as triggering the disease. In the present study of 95 patients, we found that patients with oral involvement alone tend to predominate over those who have oral and lip, or oral, lip, and skin disease. There were also more women than men. Our study further confirmed that erythema multiforme cannot be characterized solely as a disease that is cyclical and self-limiting. The dramatic response to corticosteroids and to the immunoregulating agent levamisole, as well as the fact that patients with erythema multiforme are otherwise essentially healthy, suggests that erythema multiforme may be caused by a transient autoimmune defect, possibly triggered by multiple factors. Because 19 patients with oral candidiasis responded to antifungal therapy, a possible antigenic role for these organisms is suggested.

Adolescent↗
PubMed1988

Multifocal extraosseous eosinophilic granuloma of the head and neck.

Multifocal eosinophilic granuloma (Hand-Schüller-Christian disease) confined to soft tissues in the head and neck region is described in a man, 32 years of age. The lesions were detected at varying time intervals within a period of 14 months. They were located in the gingivae, the submaxillary salivary glands, the thyroid gland, and in the dermal lining of the external auditory meatus. Clinical, histologic, ultrastructural, and immunohistochemical findings are presented and discussed. Some of these findings go along with the tenet that the typical proliferating histiocyte in eosinophilic granuloma is a pathologic Langerhans' cell, or a close kindred to it.

Adult↗
PubMed1988

Lipid pigment (lipofuscin) in human perioral muscles with aging.

In a study of 80 perioral muscle specimens, lipid pigment (Lipofuscin) granules were present in 68.5% of the cases. The pigmented granules, which were stored at the nuclear poles, were PAS positive, stained black or brown with the Masson-Fontana procedure, black with Sudan black and strong purple-pink with Ziehl-Neelsen staining; yellow autofluorescence was emitted in ultraviolet light. The morphology, histochemical reactions and autofluorescence of the pigmented granules were characteristics of the endogenous lipid pigment--lipofuscin. Statistical analyses indicated a direct correlation between increase in quantity and distribution of the pigment and increase in age (p less than 0.0001), in both males and females. Accumulation of the pigment in the perioral muscles with aging was found to be similar to that in the myocardium and tongue muscles.

Aging↗
PubMed1988

The peripheral odontogenic keratocyst.

A case with a firm asymptomatic nodule of 1 cm diameter on the gingiva between the left upper cuspid and first bicuspid is presented. Radiographic examination did not reveal any pathology of the bone in that region. Histologic examination revealed a cyst wall lined by squamous stratified epithelium, characteristic to the lining of an odontogenic keratocyst. It is suggested that the term peripheral odontogenic keratocyst be used for the diagnosis of this lesion.

Adult↗
PubMed1987

Migratory stomatitis.

Migratory stomatitis is a unique oral condition with several descriptive names. The diagnosis is based on the clinical appearance and the history of the lesions. The etiology of this entity is still open to debate. A review of the literature and a clinical description of a study group consisting of seven additional cases, in which long-term follow-up was done, are presented. Migratory stomatitis is suggested as the most suitable term to describe accurately the nature and the behavior of this condition.

Adult↗