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Biomedical subjects

S Silverman

Publications and source records attributed to S Silverman.

At least 91 records · Page 5Linked to original sources
PubMed1994

A clinical trial of antioxidant supplements in the treatment of oral leukoplakia.

Seventy-nine patients with oral leukoplakia that was histologically verified as either hyperkeratosis or epithelial dysplasia with hyperkeratosis were enrolled in an antioxidant supplementation program for the treatment of the oral lesions. The patients received 30 mg of beta-carotene, 1000 mg of ascorbic acid, and 800 IU of alpha-tocopherol per day for 9 months. Clinical improvement of the oral lesion was noted in 55.7% of the patients and was more likely to occur in patients who reduced their use of alcohol or tobacco (p = 0.0056). Although risk-factor reduction was important, approximately half of the patients who did not alter their exposure to either alcohol or tobacco showed clinical improvement. The antioxidant supplementation significantly increased serum and tissue levels of beta-carotene, ascorbic acid, and alpha-tocopherol, but these changes did not correlate strongly with clinical improvement.

Adult↗
PubMed1994

A clinical trial of bethanechol in patients with xerostomia after radiation therapy. A pilot study.

The effects of bethanechol in the treatment of dry mouth were assessed in patients with xerostomia after radiation therapy to the head and neck. Bethanechol possesses muscarinic and nicotinic-cholinergic activity that likely accounts for its mode of action. Bethanechol (25 mg, three times daily) was not associated with significant side effects. Statistically significant increases in whole resting saliva (p = 0.003) and whole stimulated saliva (p = 0.001) were seen. In patients with pretreatment stimulated saliva volumes greater than resting saliva volumes, a positive response to subsequent use of the sialagogue was seen.

Bethanechol↗
PubMed1994

Oral cancer education and HIV-associated malignancies.

Interest and participation in "oral cancer" education courses has been disappointingly low, probably because of the sparsity and low impact of cases of oral cancer relative to clinical practice. Interest and participation increase as subject matter relevant to clinical practice is included to create innovative programs. Such subject matter has included more coverage of premalignant lesions (leukoplakia and erythroplakia), the role of vital staining (toluidine blue) to aid clinical judgment and biopsy, and utilization of lasers for control. A significant stimulus to encourage enrollment has been the incorporation of AIDS updating and HIV-associated malignancies, which adds identification, curiosity, and interest relative to a well-known and very current health care problem. The greater course participation presents the opportunity to emphasize the importance of oral cancer and clinician roles in prevention, early detection, and management.

Adult↗
PubMed1994

Oral cancer.

Oral cancer currently strikes about 31,000 Americans each year. Survival rates are approximately 50%. However, early detection followed by appropriate treatment can increase cure rates to about 80%, and greatly improves the quality of life by minimizing extensive, debilitating treatments. An early oral cancer can appear as an innocuous red or white change, an ulcer, or a lump, mimicking many benign lesions. Additionally, when the discomfort is minimal, professional consultation is often delayed, increasing the chance for local spread and regional metastases. Vital staining with toluidine blue and exfoliative cytological examination can aid early detection by accelerating the biopsy of lesions that cannot be classified adequately or made to disappear.

Carcinoma, Squamous Cell↗
PubMed1993

A review of the use of antioxidant supplements in the treatment of human oral leukoplakia.

Over the past twenty years, research into the role of antioxidants in the prevention of cancer has increased dramatically. The use of antioxidant supplements to treat oral leukoplakia has gained acceptance due to the success demonstrated in several clinical trials. This review discusses the role of antioxidants in the development of cancer and their possible use in the treatment of oral leukoplakia.

Animals↗
PubMed1993

Diagnostic imaging of exotic pets.

Radiographic, ultrasonographic, and computed tomographic (CT) imaging are important diagnostic modalities in exotic pets. The use of appropriate radiographic equipment, film-screen combinations, and radiographic projections enhances the information obtained from radiographs. Both normal findings and common radiographic abnormalities are discussed. The use of ultrasonography and CT scanning for exotic small mammals and reptiles is described.

Abdomen↗
PubMed1993

Differential orientations of the DNA-binding domain and carboxy-terminal dimerization interface regulate binding site selection by nuclear receptor heterodimers.

Retinoic acid, thyroid hormone, and vitamin D receptors preferentially activate target genes through response elements that consist of direct repeat arrangements of a core recognition motif of consensus sequence AGGTCA. We present evidence that the preference for direct repeat elements arises from two fundamental differences from steroid hormone receptors. First, retinoic acid, thyroid hormone, and vitamin D receptors are demonstrated to preferentially form heterodimers with the retinoid X receptors. These interactions are mediated by the carboxy-terminal dimerization interface, with heterodimer preference specified by actions of the DNA-binding domain. Second, the DNA-binding domains of heterodimeric receptors appear to be rotationally flexible with respect to the carboxy-terminal dimerization interface. Several independent lines of evidence suggest that, relative to the retinoid X and steroid hormone receptors, the DNA-binding domain of the thyroid hormone receptor is preferentially rotated by approximately 180 degrees with respect to its carboxy-terminal dimerization interface. As a result, solution interactions between the carboxy-terminal dimerization interfaces of the retinoid X and thyroid hormone receptors are predicted to lead to the preferential alignment of their respective DNA-binding domains in a direct repeat configuration. This alignment would position the retinoid X receptor over the upstream recognition motif of direct repeat response elements. Differential orientations of the DNA-binding domain, which contribute to the polarity of heterodimer binding, are regulated by a short sequence (the A box) that is located between the conserved DNA-binding and carboxy-terminal dimerization domains.

Amino Acid Sequence↗
PubMed1993

Oral Kaposi's sarcoma: a 10-year retrospective histopathologic study.

Microscopic diagnosis of early Kaposi's sarcoma continues to be a challenge to the pathologist, as does the identification of bacillary angiomatosis (BA) which may have a similar appearance. 120 oral Kaposi's sarcoma (KS) biopsies submitted to the UCSF oral pathology service from 1981-1991 were reviewed in order to describe the clinical-pathologic spectrum of these lesions and to search for unrecognized cases of BA. Also, histopathologic features of oral KS were compared to 30 oral pyogenic granulomas, and immunohistochemical stains for endothelium-associated CD34 antigen were done. The diagnosis of KS was confirmed in all biopsies and no cases of BA were found. Histologically, the KS specimens exhibited numerous features that separated them from pyogenic granulomas, and could themselves be divided into two clinical-pathologic subtypes: small, well-delineated macular lesions (31), which were characterized by inconspicuous patches of spindle cells containing ill-defined vascular spaces; and larger, infiltrative nodular lesions (89), which were characterized by spindle cells lining vascular slits and bizarre-shaped vessels. Extravasated RBCs were evident in almost all KS lesions; hemosiderin deposits and hyaline globules were seen in half of each of the small and large lesions. Nuclear atypia was minimal and mitotic activity was slight. Lymphocytes in small lesions added to the difficulty of microscopic interpretation of these incipient lesions. CD34 was expressed on all spindle cells lining vascular spaces in larger lesions and on spindle cells of small, subtle lesions. We conclude that within the spectrum of lesions that are diagnosed as oral KS, two clinical-pathologic types can be identified: macular small spindle-cell lesions and nodular infiltrative vascular lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Head and neck malignancies associated with HIV infection.

Immunosuppressed persons are at greater risk of developing malignancies. In human immunodeficiency virus (HIV) immunosuppression the most common oral cancers are Kaposi's sarcoma and non-Hodgkin's lymphoma. Squamous cell carcinoma has also been reported to be associated with HIV disease. Kaposi's sarcoma is the most frequent neoplastic disease in acquired immunodeficiency syndrome and is by far the most common in the head and neck area. This article reviews the prevalence, clinical features, and management of these diseases in HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Dental student education in oncology: design and assessment of an undergraduate course.

Five-year survival rates of oral cancer patients remain poor. To better prepare undergraduate dental students to recognize this problem and contribute to solutions, a 24-hour lecture course in oral oncology was instituted. A pre-course quiz, daily quizzes, a midterm and a final examination were administered to assess student knowledge. The course covered all aspects of oral cancer from epidemiology and etiology, through diagnosis, treatment, and rehabilitation. Student oncology knowledge was assessed by analyzing the test results of two consecutive third-year dental classes. Overall, students adequately meet the course objectives, but assessment of specific topics reveal some deficits in particular areas. Evaluation of student knowledge provides valuable information to instructors for improving course content and student achievement.

Curriculum↗
PubMed1992

Reactivity of monoclonal antibodies 17.13 and 63.12 with 141 oral mucosal lesions.

We studied the reactivity of monoclonal antibodies (MAbs) 17.13 and 63.12 with normal and diseased human oral mucosa by means of the immunoperoxidase technique. The specimens included: 22 normal oral tissues, 20 benign tumors, 17 lichen planus, 23 focal keratosis and epithelial hyperplasias, 18 proliferative verrucous leukoplakias, 20 dysplasias, and 21 squamous cell carcinomas. In most cases of normal mucosa and benign lesions, MAb 17.13 stained basal epithelial cells only, whereas MAb 63.12 stained all cell layers above the basal cells. In the premalignant and malignant lesions MAb 17.13 stained above the basal cells and MAb 63.12 either stained areas not stained by MAb 17.13 or the staining was absent. Based on the different staining patterns observed, there appears to be a potential value of these new reagents in diagnostic histopathology regarding specimens with equivocal cellular morphology.

Antibodies, Monoclonal↗
PubMed1992

Precancerous lesions and oral cancer in the elderly.

Oral cancer is closely related to growing old, with over 95% of all cases occurring in individuals over age 40. In spite of advances in treatment, 5-year survival rates remain poor. Therefore, improvement in prevention and control of oral cancer is critically important. This can be accomplished through (1) reducing risks by avoiding tobacco and alcohol; (2) recognizing and treating premalignant lesions; and (3) early detection of developed oral cancers.

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↗