Knowledge of Oral Cancer Amongst Dental Patients Attending Public Clinics in South East Queensland, Australia

Patient knowledge of risk factors, signs and symptoms associated with oral cancers is crucial for increasing the likelihood of patient presentation for opportunistic screening and reducing delay in patient appraisal for early detection. This study aimed to assess the knowledge of oral cancer and to ascertain socio-demographic factors that influence knowledge amongst adult dental patients attending public clinics in Brisbane, Australia. A convenience sample of 213 adult dental patients who attended the Herston and Stafford public health clinics in Brisbane, Australia, between July and August 2019 participated in the self-administered questionnaire. Multivariate analyses were performed to identify predictors for oral cancer knowledge. Patients were well informed of smoking as a risk factor (n = 135; 84.4%), whereas only 53.8% (n = 82) of participants agreed that heavy alcohol consumption was a risk factor. A larger proportion of participants identified difficulty of moving the tongue (n = 79; 49.4%) and pain on swallowing (n = 72; 45.0%) compared to the proportion who identified fixed red patches (n = 61; 38.1%) and fixed white patches (n = 57; 35.6%) as a sign or symptom. Education level and gender were significant knowledge predictors for alcohol (p = 0.01), old age (p = 0.008) and family history (p = 0.004) as a risk factors for oral cancer. Those with a family history of cancer were more likely to identify a red patch (p = 0.02), bleeding gums (p = 0.001) and altered sensation (p = 0.023) as a sign or symptom of oral cancer. Overall, patient knowledge was greater for risk factors than for signs and symptoms for oral cancer. Symptoms associated with later stages of cancer were recognised by a greater proportion of patients compared to early stages of oral cancer. These results indicate the need for targeted public health initiatives to improve patient knowledge.

Human papillomavirus and oral disease - emerging evidence: a review

Human papillomavirus (HPV) infections have received considerable attention in recent years. Of the 120 or so known types of the virus, some cause a variety of benign wart-like lesions of the skin and genital and oral mucosae, whilst others are aetiologically associated with cervical and anogenital cancers. Recent epidemiologic evidence suggests that HPV may also be an independent risk factor for oropharyngeal cancer. In this context it has been suggested that HPV virus may modulate the process of carcinogenesis in some tobacco and alcohol induced oropharyngeal cancers and act as the primary oncogenic agent for inducing carcinogenesis among non-smokers. Dental practitioners have a major role in detecting all lesions of the oral mucosa caused, or possibly caused, by HPV. This paper briefly reviews the current state of knowledge of molecular and clinical aspects of HPV infections of the oral mucosa.

Squamous differentiation in a sarcomatoid chromophobe renal cell carcinoma: an unusual case report with review of the literature

We describe an extremely rare occurrence of a squamous differentiation in a sarcomatoid chromophobe renal cell carcinoma in a 45-year-old woman with nodal and lung metastasis at presentation. The tumor on histology showed all 3 components intimately admixed with each other, which to the best of our knowledge is the first such case to be reported in the literature. The renal pelvis was smooth walled and uninvolved. Kidney-specific cadherin was positive in the chromophobe renal cell carcinoma areas and negative in the sarcomatoid and squamous areas.

Histological spectrum of lymphoid follicles and aggregates in Helicobacter pylori gastritis

Seventy three patients of non ulcer dyspepsia underwent upper gastrointestinal endoscopy with biopsy from antrum and body of stomach. The tissue was stained with hematoxylin eosin and warthin starry stain. The severity of gastritis was correlated with the presence of Helicobacter pylori and lymphoid follicles and aggregates. The incidence of chronic atrophic gastritis and Helicobacter pylori were found to be 97% and 64.1% respectively. Lymphoid follicles and aggregates were seen in 32.9% of chronic atrophic gastritis. Severity of gastritis with activity correlates with Helicobacter pylori colonisation and the presence of lymphoid follicles and aggregates. We have found that there is no difference between presence of lymphoid follicles and aggregates in Helicobacter pylori positive and negative gastritis. The development of lymphoid follicles probably represents an immune response to the colonisation of gastric mucosa by Helicobacter pylori.

Role of Helicobacter pylori in gastric carcinoma

BACKGROUND

Helicobacter pylori infection has recently been incriminated in the pathogenesis of gastric carcinoma and chronic atrophic gastritis and intestinal metaplasia are considered to be precursors of this condition. Although the incidence of Helicobacter pylori infection in India is high that of gastric carcinoma is low. We, therefore, decided to examine the association between Helicobacter pylori, intestinal metaplasia and gastric carcinoma in a prospective study.

METHODS

Fifty patients with carcinoma of the stomach and 50 with non-ulcer dyspepsia underwent upper gastro-intestinal endoscopy and had biopsies from the antrum, body and carcinomatous tissue. In 12 cases of gastric carcinoma, tissue was obtained from resected specimens at operation. The types of gastritis, intestinal metaplasia and presence of Helicobacter pylori were assessed by staining with haematoxylin and eosin, periodic acid-Schiff reagent with alcian blue and Warthin-Starry stains.

RESULTS

The incidence of chronic atrophic gastritis, intestinal metaplasia and Helicobacter pylori were 82%, 36% and 38% in patients with carcinoma and 86%, 4% and 68% in those with non-ulcer dyspepsia. Helicobacter pylori positivity was significantly higher (p < 0.05) and intestinal metaplasia significantly lower (p < 0.001) in patients with non-ulcer dyspepsia than in those with carcinoma. Of the 50 cases with carcinoma, 28 were of the intestinal and 22 of the diffuse type. The incidence of chronic atrophic gastritis, intestinal metaplasia and Helicobacter pylori in the intestinal type of carcinoma was 71%, 46% and 39% while in the diffuse type it was 32%, 23% and 36%. The incidence of Helicobacter pylori infection did not differ significantly in the two types of carcinoma.

CONCLUSIONS

We have found that although Helicobacter pylori infection and chronic atrophic gastritis are common in Indians, the incidence of intestinal metaplasia is low. Helicobacter pylori infection was equally common in both the intestinal and diffuse type of gastric carcinomas. Our findings, therefore, cast doubt on the role of Helicobacter pylori infection in gastric carcinogenesis.

Tuberculous abscess of the liver associated with HIV infection

Tuberculosis is an AIDS-defining illness in HIV-seropositive patients. Though disseminated tuberculosis is common in HIV-seropositive patients, hepatic involvement in the form of abscess formation is rare. We report such a patient.

Clinicopathologic study of fallopian tube closure after single transcervical insertion of quinacrine pellets

OBJECTIVE

To determine the effect on tubal closure of intrauterine quinacrine by dose and time from administration.

DESIGN AND PARTICIPANTS

Subjects included 33 women of reproductive age who were awaiting hysterectomy for nonmalignant conditions at a Bombay, India medical college. Ten women received 252 mg quinacrine as pellets using a modified Copper-T IUD inserter followed by hysterectomy within 6 weeks, and 23 women received 324 mg quinacrine followed by hysterectomy 6 to 20 weeks post-insertion. Hysterosalpingograms were done before insertion, prior to surgery and on the fresh surgical specimen. The uteri and tubes were subjected to histology studies, including grading of tubal damage. For study of dose, an additional 7 women receiving 100 mg quinacrine (and previously reported) were included.

MAIN OUTCOME MEASURE

Tubal closure rates by hysterosalpingogram and tubal histology.

RESULTS AND CONCLUSION

Tubal closures were directly related to quinacrine dose and length of insertion-hysterectomy interval. For the 252 mg quinacrine dose, 55.0% of intramural tubal segments and 5.9% of isthmic segments showed histologic evidence of closure. For the 324 mg dose, all intramural tubal segments and 58.8% of isthmic segments showed histologic evidence of closure. Clinical conditions, such as dysfunctional uterine bleeding, were associated with lower tubal closure rates. Multivariate discriminant analysis showed quinacrine dose to be more important than quinacrine-hysterectomy interval.

Fibrosing necrotic nodule of the liver

A fibrosing necrotic nodule of the liver is described in a 35 year old man suffering from malaria. This non-tumorous lesion is considered to be an entity of diverse pathogenesis.

Helicobacter pylori in normal gastric mucosa

Since the discovery of Helicobacter pylori (H. pylori) in 1983 several studies have established relationship of H. pylori with gastritis, duodenal ulcer disease and gastric carcinoma. H. pylori infection is widely prevalent and exposure occurs at younger age in our country. Several Western studies have shown prevalence of H. pylori in normal gastric mucosa to range from 0-25%. As similar information is not available from our country we estimated the prevalence of H. pylori in histologically normal gastric mucosa. Of the 50 asymptomatic volunteers studied, 33 showed histological evidence of gastritis and 28 of these were H. pylori. We conclude that histological gastritis is very common in young asymptomatic Indians and H. pylori infection is noticed in almost 25% subjects with histologically normal gastric mucosa.

Cytohistomorphology of prostatic lesions--by FNAC & scrape methods

A pilot study of transrectal fine needle aspiration biopsy was conducted in 44 patients, above the age of 50 years, who presented with features of obstructive uropathy during a one year period between August 1990 and April 1991. Histopathological study was carried out in 23 out of 44 patients, who underwent total prostatectomy or transurethral resection following the aspiration biopsy procedure. In 21 patients FNAB by the transrectal route could not be obtained because of technical difficulties; therefore intraoperative scrape cytology was studied prior to histopathology, of the fresh prostatic specimen. A good cytohistopathological correlation was obtained by both methods; an accuracy of 95.6% and 95.2% with FNAC and scrape respectively. A wide range of benign and malignant lesions were studied.

Congestive gastropathy: factors influencing development, endoscopic features, Helicobacter pylori infection, and microvessel changes

OBJECTIVES

To study 1) the factors influencing the development of congestive gastropathy (CG) in patients with portal hypertension (PHT), 2) the changes in gastric microvessels in patients with PHT with and without CG, and 3) to determine whether Helicobacter pylori plays any role in the pathogenesis of CG.

METHODS

One hundred eighteen patients with PHT (102 cirrhosis, 16 noncirrhotic portal fibrosis) were evaluated by videogastroscopic examination. Antral biopsy tissue was examined for microvessel changes, histological gastritis, and H. pylori infection in 85 of 118 patients and 45 controls. Portal venous pressure (PVP) was determined by hepatic venous pressure gradient in 17 patients with CG.

RESULTS

CG was present in 71 (60%) patients with PHT, of whom 41 (58%) had mild and 30 (42%) had severe CG. CG was observed with equal frequency in cirrhosis (63%) and noncirrhotic portal fibrosis (44%). The incidence of CG was higher in patients with severe liver disease, a past history of hemetemesis, in those with esophageal varices, and in those with gastric varices. Severe CG was commonly observed in patients with large size esophageal varices and in those with gastric varices. There was significant dilation of gastric mucosal vessels in patients with PHT, but in this regard there was no significant difference between patients with and without CG. The presence of H. pylori, histological gastritis, degree of PVP, or degree of capillary dilation did not influence the severity of CG.

CONCLUSIONS

CG occurs commonly in patients with PHT, especially those with severe liver disease, past history of hemetemesis, and esophagogastric varices. Patients with PHT have significant gastric microvessel changes. The severity of CG appears to be independent of PVP, capillary dilation, H. pylori infection, or histological gastritis.

Effect of inhaled terbutaline on platelet activity in bronchial asthma

Thirty five young subjects with long standing bronchial asthma were studied for the effects of terbutaline misthaler (500 micrograms) during acute asthma. Bronchodilators were omitted for a day before the test. Ten matched controls were also studied. In all subjects, basal IgE level (ELISA), pulmonary parameters (FVC, FEV, PEFR, FEF 25-75 and FEF 75-85) and platelet activity, (platelet clumping/150 WBC on smear, platelet adhesiveness, blood recalcification time and kaolin clotting time for platelet factor3) were compared. During acute asthma, the subjects displayed IgE levels > or = 500 IU/ml (n = 33), activation of clotting (n = 30) and eosinophilia > or = 450/cmm (n = 28). These changes were not seen in normal controls. Terbutaline resulted in a reversal of airway obstruction, mainly of small airways, while the platelet hyperactivity and blood hypercoagulability were rectified (P < 0.001). It is concluded that platelet activity increases in acute asthma and is corrected by inhaled terbutaline concomittant with the relief of bronchospasm.

Gastric metaplasia and Helicobacter pylori infection in intestinal tuberculosis

BACKGROUND

Gastric metaplasia occurs in intestinal epithelium of patients with Helicobacter pylori infection as well as intestinal tuberculosis, but the relationship between the three is not clear.

SETTING

Teaching hospital.

METHODS

Staining of intestinal sections from patients with ileocecal tuberculosis for H pylori and for metaplasia.

RESULTS

Twenty seven of 92 (29.3%) patients demonstrated gastric metaplasia (superficial epithelial and pyloric gland metaplasia) in resected specimens of ileum. Gastric metaplasia was of antral type in all 27 patients. Helicobacter pylori was present in 3 of 27 (11%) patients with gastric metaplasia and was absent in all 65 patients without metaplasia.

CONCLUSION

Gastric metaplasia (both superficial epithelial and pyloric gland) occurs in one-third of patients with ileocecal tuberculosis and such mucosa is poorly colonized by H pylori.

Is gastric metaplasia essential for duodenal ulcer?

Multiple biopsies were taken from the duodenum of 100 patients (46 active duodenal ulcer, 14 healed duodenal ulcer, 40 control subjects) to detect duodenitis, gastric metaplasia and Helicobacter pylori (Hp). Histamine-induced congo-red staining of the duodenal bulb was performed in additional 25 cases of active duodenal ulcer to determine the presence of functioning parietal cells in the duodenum. The incidence of duodenitis was 45% in control subjects and 76.7% in patients with duodenal ulcer (active or healed) (p < 0.01). Superficial gastric metaplasia was present in 2.5% of control subjects and 13.3% patients with duodenal ulcer (active or healed) (p > 0.05). Hp in the duodenum was detected in 10% of control subjects and 8.3% of patients with duodenal ulcer. Congo-red test was positive in two of 25 (8%) patients of active duodenal ulcer indicating "functioning" parietal cells in the duodenum. In Indian patients with duodenal ulcer, a low incidence of gastric metaplasia and Hp in the duodenum is observed in contrast to its high incidence in patients from Western countries.

Heterotopic gastric mucosa and Helicobacter pylori infection in Meckel's diverticulum in Indian subjects

Two of twenty nine (6.8%) patients who had undergone resection of Meckel's diverticulum demonstrated heterotopic gastric mucosa. In both these patients gastric mucosa was of antral type. Remaining 27 of 29 (93.2%) patients with Meckel's diverticulum had intestinal mucosa. 9 of 29 (31%) patients with Meckel's resected were symptomatic (8 bleeding, 1 perforation) and all 9 were negative for heterotopic gastric mucosa. Helicobacter pylori (H. pylori) was absent in both patients with intestinal mucosa. Antral biopsy from 13 partial gastrectomy specimens (surgery done for carcinoma stomach) were used as methodological controls and 7 of 13 (54%) showed H. pylori colonization. We conclude that (i) incidence of gastric mucosa is 6.8% in Meckel's diverticulum in our population, (ii) presence of heterotopic gastric mucosa is unlikely to be associated with complications of Meckel's diverticulum and (iii) heterotopic mucosa in Meckel's diverticulum is not commonly colonized by H. pylori.

Epidemiology of Helicobacter pylori: the Indian scenario

OBJECTIVE

To compare the age-related prevalence of Helicobacter pylori in populations from developing and developed nations to determine the possible mode of transmission.

METHODS

Endoscopic gastric biopsies (for biopsy urease test and histology) were obtained in 526 patients with dyspepsia and in 82 control subjects to determine H pylori prevalence.

RESULTS

H pylori prevalence in patients with dyspepsia and in control subjects was 65% and 46% respectively. Age-related prevalence in these two groups in the age groups 10-19 years, 20-29 years, 30-39 years, 40-49 years and > or = 50 years was 52%, 70%, 69%, 60% and 59%, and 44%, 55% 58%, 36% and 33% respectively.

CONCLUSION

Exposure to H pylori occurs early in India and is widespread, even in control subjects. The high prevalence of the organism in young Indian control subjects and the comparable prevalence of antibodies to H pylori and hepatitis A virus infection in different age groups both in developed and developing nations may suggest a feco-oral mode of transmission.

Multiple chylous cysts of abdomen causing intestinal obstruction

A case of multiple chylous cysts of the abdomen in a 35 years old female is presented here. The patient presented with signs and symptoms of acute intestinal obstruction. Exploratory laparotomy revealed few intestinal adhesions along with multiple small cysts containing blood stained gelatinous material in the abdominal cavity, some of which were excised alongwith lymph nodes. The abdomen was closed after a saline peritoneal lavage. Chylous nature of the cysts was confirmed on histopathology. The post-operative course was asymptomatic.

Primary malignant hemangioendothelioma of jejunum

Primary malignant hemangioendothelioma is a rare tumor. We report a patient with a malignant jejunal hemangioendothelioma which had metastasized to the regional lymph nodes and the liver.

Dental plaque: a permanent reservoir of Helicobacter pylori?

The aim of the study was to observe the relationship between the two reservoirs of Helicobacter pylori--that is, dental plaque and the stomach. With the Campylobacter-like organism (CLO) test, H. pylori was detected in dental plaque and in gastric antral and body mucosa in 98%, 67% and 70%, respectively, of 43 consecutive patients with dyspepsia. The rapidity of the CLO test indicates that the density of H. pylori is heaviest in dental plaque, less in the antrum, and least in the body mucosa of the stomach. Triple drug therapy (bismuth, tinidazole, and amoxycillin or doxycycline) was administered for 15 days to 24 patients. By the CLO test, H. pylori was eliminated from the gastric mucosa in all 24 patients but persisted in dental plaque in all of them. Our observations indicate that dental plaque is unaffected by triple drug therapy and is perhaps a permanent reservoir of H. pylori if local therapy also fails to eradicate the organism.

Mono and dual therapy for Helicobacter pylori associated gastritis

Sixty patients with Helicobacter Pylori positive non ulcer dyspepsia were randomly allocated to one of the following treatment groups: Group I--norfloxacin 400 mg bid for 10 days, Group II--amoxycillin 500 mg bid plus tinidazole 500 mg bid for 15 days, Group III--colloidal bismuth subcitrate (CBS) 240 mg bid for 4 weeks. H pylori elimination was achieved in 14%, 81%, and 62% in Groups I, II and III respectively. Eradication of H pylori was not observed in Groups I and II, but was achieved in 25% of patients in Group III. Antral gastritis improved in 69% in Group II and 50% in Group III. We conclude that norfloxacin is not effective in H pylori infection. A combination of amoxycillin and tinidazole is highly effective in H pylori elimination with improvement in associated gastritis, but H pylori eradication is not observed with this therapy. CBS is also effective in H pylori elimination though H pylori eradication is achieved in only 25%.

Diagnostic accuracy of biopsy urease tests for Helicobacter pylori infection in the gastric antrum and body

BACKGROUND

The biopsy urease test detects preformed urease in Helicobacter pylori and has excellent sensitivity and specificity for antral biopsies. Similar conclusions cannot be made for biopsies from the body of the stomach as data are scant.

METHODS

Endoscopy was performed and biopsies taken from the antrum and body ofthe stomach of 302 patients with dyspepsia to judge the diagnostic accuracy of Christensen's urea and campylobacter-like organism tests.

RESULTS

The sensitivity and specificity of Christensen's urea test (n=200) was 97% and 92% for the antrum, and 34% and 85% for the body respectively. The campylobacterlike organism test (n=102) had a 100% sensitivity and specificity for the antrum and a 97% sensitivity and 100% specificity for the body. It was also positive in 97% (31132) and 90% (27/30) of patients at 10 minutes and 30 minutes when the colonization was dense (grade 3), and 90% (27/30) positive at 1 to 3 hours when the density of the organisms was graded as 2. All tests positive at 24 hours (10/10) had densities of grades 1 and 2.

CONCLUSIONS

The Christensen's urea test has excellent sensitivity and specificity in the antrum, but its sensitivity in the body is poor because of a low density of organisms. The campylobacter-like organism test is more sensitive and specific than the Christensen's urea test, especially in the presence of low bacterial numbers and its rapidity correlates well with the density of organisms.

Primary malignant melanoma of esophagus

Primary esophageal melanoma is a rare tumor. A 35 year old male with primary malignant melanoma of the esophagus is reported. He presented with dysphagia and weight loss. At autopsy a fusiform polypoidal growth was seen in the middle third of the esophagus. Microscopic sections showed a malignant melanoma in an in situ as well as invasive form.

Leiomyosarcoma of mandible in a Sudanese female

Leiomyosarcomas are extremely rare in the oral region. A case of a malignant tumour of the smooth muscle of the mandible possibly originating from a pre-existent benign counterpart is reported and the literature briefly reviewed. The case presented suggested the possibility that leiomyosarcomas, whenever they originate as a result of malignant transformation in a leiomyoma, may grow to an enormous size and grow slowly.

Burkitt's lymphoma in the Sudan

Burkitt's lymphoma is the commonest of the jaw tumours affecting children in some parts of the tropical Africa. In the Sudan, the tumour appears to be relatively uncommon and our study showed only 7 cases during a 5-year period from December 1975 through to December 1980. The clinical features, aetiology, histopathology and the treatment of the tumour are discussed and the literature briefly reviewed.

Von Recklinghausen's disease with a malignant meningeal, cerebral and optic nerve tumour and bilateral vagal schwannomas. Possible mesenchymal histogenesis on light and electron microscopy

The clinical, histopathologic and fine structural features of multiple unusual tumours detected in a 20-year-old patient with von Recklinghausen's disease, who died within a year of onset of symptoms of a rapidly expanding intracranial tumour, are described. The tumour was found to involve the falx cerebri, the basal leptomeninges and dura mater, both olfactory and optic nerves, both frontal lobes, the right temporal lobe and middle cerebral peduncle, both middle cerebellar peduncles, and with a metastasis in a cervical node. On light and electron microscopy this tumour appeared to be a fibroblastic meningeal sarcoma with giant cells, mitotic figures, a rich reticulin matrix throughout, and tumour cells full of rough ER but without any glial filaments. Also very unusual was the involvement of both vagus nerves in their cervical and intrathoracic portions, by a schwannomatous benign tumour and with a non-chromaffin paraganglioma at its termination in the oesophagus. One of the few cutaneous "neurofibromas" was also schwannian, containing tumour cells with a basement membrane on electron microscopy. Most, if not all, of these tumours appeared mesenchymal in origin, more aggressive in behaviour and carrying a graver prognosis in von Recklinghausen's disease.

Juvenile oral angiofibroma in a female

A case of oral angiofibroma in a 14-year-old girl is presented. Unlike in earlier reports, the patient was confirmed as female by gynecological examination and other specific examinations. The possibility of the origin of the angiofibroma from the Meckel's cartilage is postulated. Any exuberant, sessile growth with a tendency toward spontaneous bleeding should be viewed with suspicion in terms of angiofibroma. Lesions such as pyogenic granulomas, hemangiomas, myxomas, and fibromyxomas should be kept in mind while making a diagnosis of angiofibroma. A biopsy examination as a routine office procedure should not be done on benign-looking masses with tendencies to bleeding.

Hyperkeratosis palmoplantaris with periodontosis (Papillon-Lefevre syndrome): report of three cases, two occurring in siblings

Three cases of palmar-plantar hyperkeratosis with periodontosis, two cases of which occurred in siblings, are reported. The parents were unaffected, and parental consanguinity was present in all three cases. All essential features of the syndrome were present in these cases.

Chondroectodermal dysplasia (Ellis-van Creveld syndrome): report of two cases

Our two patients with chondroectodermal dysplasia had most of the classic manifestations of the syndrome. The simultaneous occurrence of partial anodontia and embedded supernumerary and second premolars in the mandible in one patient was interesting. The inverted impaction of the left maxillary lateral incisor is also a unique finding. The median fissure on the tongue may be an associated developmental anomaly of the syndrome.

The effect of ultra-violet radiation and restricted diet on rat labial mucosa

The combined effect of ultra-violet radiation and a restricted diet on oral mucosa was investigated using the labial mucosa of pigmented rats. Twenty-four rats were divided so that 12 experimental animals received 50% of the average daily diet of the remaining 12 normal controls. After 1 month, the epithelium of the restricted group had thinned to 2/3 of that of the controls. Nine rats from each group were then subjected to daily ultra-violet irradiation of the labial mucosa, three animals in each group remaining as unirradiated controls. After 1, 4 and 8 weeks irradiation, three experimental and one unirradiated control from each group were sacrificed. Microscopic examination showed that the thickness of the epithelium and the mitotic index increased in both normal and restricted animals at 4 weeks. The increase in thickness was maintained at 8 weeks, but the mitotic index declined in the deficient animals at this time. Evidence of epithelial dysplasia was seen in the normal animals at 4 weeks, and this increased at 8 weeks; such changes were rarely seen in the restricted animals. It thus appears that the extent of ultra-violet induced dysplasia may be related to the mitotic index, a lower mitotic index implying less dysplasia.

Tuberculous ulcer of the tongue: report of case

In the case presented, the patient sought treatment for a painful ulcer on the right lateral border of the tongue. In the absence of any other significant finding, the clinical features of the lesion suggested malignancy. Histopathologic examination of a biopsy specimen was an important aid in the diagnosis of tuberculosis. Pulmonary lesions were subsequently detected and the patient was treated accordingly. The ulcer on the tongue was believed to be secondary to the pulmonary tuberculosis.