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Alterations of T cell subsets in patients with recurrent aphthous ulcers and behcets disease
M22
In Vivo Tumoricidal Activity of Hematoporphyrin Derivative. Joseph W. Wilkes, DMD, MD. Massachusetts General Hospital, 5 Fruit Street, Boston, MA 02114 This study examines the hamster buccal pouch as an animal model to test the in vivo tumoricidal activity of hematoporphyrin derivative (HPD) against implanted human oral squamous cell carcinoma. Human squamous carcinoma cells (American Tissue Culture, Certified Cell Line 138) were grown in monolayer cell culture with Wayland’s Medium. The cells were rinsed with Ca+ + and Mg+ + free Hank’s solution, released from the Basks with trypsin EDTA and spun down twice at 1,000 RPM for twenty minutes with an intervening wash with fresh medium. Next, 0.8 ml of fibrin solution and 0.8 ml of thrombin solution were added, the centrifuge tube shaken, and then incubated at 37” centigrade for 30 minutes. The resulting clot of tumor cells was sectioned into 0.5 mm pieces and implanted with a Perfecktum intravenous needle into the buccal pouch of 20 120 g Chinese Golden Hamsters, anesthetized with 1% nembutal and immunosuppressed with three preoperative doses of 60 g of cortisone. At seven days, the animals were anesthetized, the tumors measured and ten animals given 2.5 mg/kg of HPD by intra-peritoneal injection. Ten-animals received an identical volume of sterile saline by intraperitoneal injection as controls. The treated animals were re-anesthetized 48 hours after HPD administration and fluorescent light (0.73 mW/cm2) shown on the tumors for 30 minutes for photo-activation of the HPD. Seven days later, the buccal pouch tumors were measured in experimental and control groups. At 16 days after implantation, tumors in control animals measured a mean 4.2 mm (range, 2.2-5.3 mm) and treated animals a mean 1.4 mm (range, O-2.1 mm), P < 0.05. HPD and photo-activation retard tumor growth in this in vivo system for this oral squamous cell carcinoma line, but did not eliminate all tumors. The model seems a reasonable one for testing other squamous cell carcinoma lines. The Peripheral Ossifying Fibroma and the Peripheral Odontogenic Fibroma. Jeffrey N. Kenney, DDS. Box 556, MCV Station, Richmond, VA 23298-0001 (Kaugars GE, Campbell RL) The peripheral ossifying fibroma is a common reactive gingival lesion. Confusion exists in classifying this lesion as either peripheral ossifying fibroma or peripheral odontogenic Iibroma. It has been suggested that these are two distinct lesions, the former being the common reactive lesion, and the latter a rare extraosseous counterpart to the central odontogenic fibroma, but this has never been proven. The purpose of this study is to present data on a series of 413 lesions and to analyze the relationship between the two lesions. All gingival lesions diagnosed either as peripheral ossifying fibroma or those with a diagnosis indicating the presence of odontogenic epithelium were reviewed. From the 53,458 biopsies submitted to the Medical College of Virginia Oral Pathology Diagnostic Service from January 1, 1970 to December 31, 1986, 413 cases (0.77%) were selected. Data regarding age, race, sex, location, associated conditions, and recurrence were obtained from biopsy request forms, and each case was reviewed microscopically to separate it into one of two main histologic categories: 1) classic peripheral ossifying tibroma, with hypercellular connective tissue and various calcifications including bone, osteoid, and/or
dystrophic calcification, and 2) peripheral odontogenic fibroma, with prominent islands of odontogenic epithelium, less cellular fibrous connective tissue and no calcifications or with only dentin-like calcifications associated with the odontogenic epithelium. Of all the lesions, 96.9% (400) were histologic category (1). Variations in this category included the presence of small amounts of odontogenic epithelium (12%), and the presence of giant cells (3.8%). Only 3.1% of all lesions were category (2). Category (1) showed a predilection for females (65%) and for occurrence in younger patients (49.6% were between 10 and 30 years of age). A higher than expected incidence was noted in blacks (30.6%), since only 15.3% of all MCV biopsies are from black patients. The maxilla was involved in 55.9% of cases, while 44.1% were mandibular lesions. Anterior segments (between the canines) were most frequently involved (53.6%), while only 8.8% were from the mandibular molar region. The recurrence rate was 14.2%. In contrast, histologic category (2) displayed a predilection for males (61.5%) and most lesions occurred in the mandible (69%). Only 38.5% occurred in the anterior segments, while an increased incidence (38.5%) was observed in the mandibular molar area. The recurrence rate was 7.7%. In addition to the obvious histologic difference, the clinical data shows a significant difference (Fisher’s exact test, P = 0.05) between the two lesions in regard to their anatomic location. In the future, lesions should be classified as either peripheral ossifying fibroma or peripheral odontogenic fibroma to avoid possible confusion and to separate these distinct entities. Incidence of Oxygen Desaturation During Oral Surgery Outpatient Procedures. Charlotte S. White, DMD. University of Florida College of Dentistry, Department of Oral and Maxillofacial Surgery, Box J-416, Gainesville, FL 32610 (Dolwick MF, Gravenstein N, Paulus D) Local anesthesia alone, or some combination of local anesthesia with nitrous oxide analgesia, conscious or unconscious sedation are typically used during outpatient oral surgery procedures. The purpose of this study was to evaluate the frequency, severity, and duration of oxygen desaturation during these procedures; as well as the clinical pertinence of pulse oximetry. Methods: Sixty oral surgery outpatients were assigned to one of six treatment groups according to the type of anesthetic/sedation chosen by the oral surgeon (Table 7). The patients were monitored with an Ohmeda Biox 3700 pulse oximeter and an automatic blood pressure device. Baseline oxygen saturation, heart rate, and blood pressure were obtained. Pulse and oxygen saturation signals were continuously recorded on a two-channel strip chart recorder and blood pressures were recorded manually. All monitors and recording were managed by the Department of Anesthesia. Strip chart records were analyzed to determine frequency, duration and severity of desaturation episodes for all patients. Considering the correlation of SaO, to PaO,, desaturations greater than 5% were viewed as significant. Results: There were only four episodes of significant desaturation in patients who received supplemental O2 (n = 30), with a mean duration of 1.4 minutes. However, patients treated without supplemental O2 (n = 30) experienced 22 episodes of significant desaturation with a mean duration of 4.6 minutes. Nine of these episodes occurred in patients treated with local anesthesia alone. Our data show no appreciable difference in the incidence of significant desaturation between patients receiving
In Vivo Tumoricidal Activity of Hematoporphyrin Derivative. Joseph W. Wilkes, DMD, MD. Massachusetts General Hospital, 5 Fruit Street, Boston, MA 02114 This study examines the hamster buccal pouch as an animal model to test the in vivo tumoricidal activity of hematoporphyrin derivative (HPD) against implanted human oral squamous cell carcinoma. Human squamous carcinoma cells (American Tissue Culture, Certified Cell Line 138) were grown in monolayer cell culture with Wayland’s Medium. The cells were rinsed with Ca+ + and Mg+ + free Hank’s solution, released from the Basks with trypsin EDTA and spun down twice at 1,000 RPM for twenty minutes with an intervening wash with fresh medium. Next, 0.8 ml of fibrin solution and 0.8 ml of thrombin solution were added, the centrifuge tube shaken, and then incubated at 37” centigrade for 30 minutes. The resulting clot of tumor cells was sectioned into 0.5 mm pieces and implanted with a Perfecktum intravenous needle into the buccal pouch of 20 120 g Chinese Golden Hamsters, anesthetized with 1% nembutal and immunosuppressed with three preoperative doses of 60 g of cortisone. At seven days, the animals were anesthetized, the tumors measured and ten animals given 2.5 mg/kg of HPD by intra-peritoneal injection. Ten-animals received an identical volume of sterile saline by intraperitoneal injection as controls. The treated animals were re-anesthetized 48 hours after HPD administration and fluorescent light (0.73 mW/cm2) shown on the tumors for 30 minutes for photo-activation of the HPD. Seven days later, the buccal pouch tumors were measured in experimental and control groups. At 16 days after implantation, tumors in control animals measured a mean 4.2 mm (range, 2.2-5.3 mm) and treated animals a mean 1.4 mm (range, O-2.1 mm), P < 0.05. HPD and photo-activation retard tumor growth in this in vivo system for this oral squamous cell carcinoma line, but did not eliminate all tumors. The model seems a reasonable one for testing other squamous cell carcinoma lines. The Peripheral Ossifying Fibroma and the Peripheral Odontogenic Fibroma. Jeffrey N. Kenney, DDS. Box 556, MCV Station, Richmond, VA 23298-0001 (Kaugars GE, Campbell RL) The peripheral ossifying fibroma is a common reactive gingival lesion. Confusion exists in classifying this lesion as either peripheral ossifying fibroma or peripheral odontogenic Iibroma. It has been suggested that these are two distinct lesions, the former being the common reactive lesion, and the latter a rare extraosseous counterpart to the central odontogenic fibroma, but this has never been proven. The purpose of this study is to present data on a series of 413 lesions and to analyze the relationship between the two lesions. All gingival lesions diagnosed either as peripheral ossifying fibroma or those with a diagnosis indicating the presence of odontogenic epithelium were reviewed. From the 53,458 biopsies submitted to the Medical College of Virginia Oral Pathology Diagnostic Service from January 1, 1970 to December 31, 1986, 413 cases (0.77%) were selected. Data regarding age, race, sex, location, associated conditions, and recurrence were obtained from biopsy request forms, and each case was reviewed microscopically to separate it into one of two main histologic categories: 1) classic peripheral ossifying tibroma, with hypercellular connective tissue and various calcifications including bone, osteoid, and/or
dystrophic calcification, and 2) peripheral odontogenic fibroma, with prominent islands of odontogenic epithelium, less cellular fibrous connective tissue and no calcifications or with only dentin-like calcifications associated with the odontogenic epithelium. Of all the lesions, 96.9% (400) were histologic category (1). Variations in this category included the presence of small amounts of odontogenic epithelium (12%), and the presence of giant cells (3.8%). Only 3.1% of all lesions were category (2). Category (1) showed a predilection for females (65%) and for occurrence in younger patients (49.6% were between 10 and 30 years of age). A higher than expected incidence was noted in blacks (30.6%), since only 15.3% of all MCV biopsies are from black patients. The maxilla was involved in 55.9% of cases, while 44.1% were mandibular lesions. Anterior segments (between the canines) were most frequently involved (53.6%), while only 8.8% were from the mandibular molar region. The recurrence rate was 14.2%. In contrast, histologic category (2) displayed a predilection for males (61.5%) and most lesions occurred in the mandible (69%). Only 38.5% occurred in the anterior segments, while an increased incidence (38.5%) was observed in the mandibular molar area. The recurrence rate was 7.7%. In addition to the obvious histologic difference, the clinical data shows a significant difference (Fisher’s exact test, P = 0.05) between the two lesions in regard to their anatomic location. In the future, lesions should be classified as either peripheral ossifying fibroma or peripheral odontogenic fibroma to avoid possible confusion and to separate these distinct entities. Incidence of Oxygen Desaturation During Oral Surgery Outpatient Procedures. Charlotte S. White, DMD. University of Florida College of Dentistry, Department of Oral and Maxillofacial Surgery, Box J-416, Gainesville, FL 32610 (Dolwick MF, Gravenstein N, Paulus D) Local anesthesia alone, or some combination of local anesthesia with nitrous oxide analgesia, conscious or unconscious sedation are typically used during outpatient oral surgery procedures. The purpose of this study was to evaluate the frequency, severity, and duration of oxygen desaturation during these procedures; as well as the clinical pertinence of pulse oximetry. Methods: Sixty oral surgery outpatients were assigned to one of six treatment groups according to the type of anesthetic/sedation chosen by the oral surgeon (Table 7). The patients were monitored with an Ohmeda Biox 3700 pulse oximeter and an automatic blood pressure device. Baseline oxygen saturation, heart rate, and blood pressure were obtained. Pulse and oxygen saturation signals were continuously recorded on a two-channel strip chart recorder and blood pressures were recorded manually. All monitors and recording were managed by the Department of Anesthesia. Strip chart records were analyzed to determine frequency, duration and severity of desaturation episodes for all patients. Considering the correlation of SaO, to PaO,, desaturations greater than 5% were viewed as significant. Results: There were only four episodes of significant desaturation in patients who received supplemental O2 (n = 30), with a mean duration of 1.4 minutes. However, patients treated without supplemental O2 (n = 30) experienced 22 episodes of significant desaturation with a mean duration of 4.6 minutes. Nine of these episodes occurred in patients treated with local anesthesia alone. Our data show no appreciable difference in the incidence of significant desaturation between patients receiving