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Biomedical subjects

S A Hirsch

Publications and source records attributed to S A Hirsch.

27 records · Page 2Linked to original sources
PubMed1978

Gingival biopsy in thrombotic thrombocytopenic purpura.

Gingival biopsy has been advocated as a readily available, safe, rapid histologic confirmation of the clinical diagnosis of thrombotic thrombocytopenic purpura. Eighteen gingival biopsies from 16 patients with proven thrombotic thrombocytopenic purpura were reviewed. Seven (39%) showed characteristic histologic changes: [1] subendothelial hyalinelike deposits; [2] intraluminal deposits; [3] lack of inflammatory change in vessels and stroma. To assess specificity, gingival sections from 154 patients with oral pathology only and from 50 unselected autopsies were reviewed: 10% to 20% of biopsies from patients with oral pathology only (primarily inflammation) and three of 50 autopsy specimens showed occasional intraluminal deposits but no subendothelial deposits. In addition, other histologic features permitted them to be distinguished from thrombotic thrombocytopenic purpura. We conclude that gingival biopsy in thrombotic thrombocytopenic purpura, although helful in confirming the diagnosis, is less often positive than has been suggested. Biopsy of grossly inflamed gingiva should be avoided.

Biopsy↗
PubMed1977

A survey of 4,793 oral lesions with emphasis on neoplasia and premalignancy.

A survey was taken of a selected group of 4,793 oral lesions submitted to the oral pathology biopsy service between 1950 and 1970. About two thirds of all the specimens examined microscopically were classified as inflammatory, infectious, or reactive hyperplasia. Of the 12.6% of the sample classified as neoplasms, one of every five was malignant. Three of every four of the malignant neoplasms were microscopically diagnosed as squamous cell carcinomas. Benign neoplasms were most common in ages 40 to 60, whereas premalignancies and malignancies were most commonly discovered in the slightly older age group of 50 to 70. Although malignant neoplasms were found more often in men than women, there was a striking increase in the incidence of malignancies in women in the second ten-year period of the study. There were unexplainably few malignant neoplasms found in blacks. Patients should be taught to recognize the early signs of oral premalignancy and malignancy through the use of a simple method of self-examination at home. They should be discouraged from the frequent use of tobacco and alcohol, which have long been known to be predisposing factors in the production of oral squamous cell carcinomas.

Adult↗
PubMed1976

Arterial occlusion secondary to methylmethacrylate use.

We are reporting a new complication of the use of methylmethacrylate, namely occlusion of the iliac artery with embolization. We believe that the occlusion is related to trauma to the intima by the heat of polymerization created by methylmethacrylate, with resultant thrombosis. In view of the initial failure of embolectomy alone, we suggest direct attack on the involved artery with prosthetic replacement, and management of the distal embolus by embolectomy with Fogarty catheters.

Embolism↗