| 1. |
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| 2. |
- Bjermo, Helena, et al.
(author)
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Lead, mercury, and cadmium in blood and their relation to diet among Swedish adults
- 2013
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In: Food and Chemical Toxicology. - : Elsevier BV. - 0278-6915. ; 57, s. 161-9
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Journal article (peer-reviewed)abstract
- The aim of the present study was to examine the body burden of lead (Pb), mercury (Hg), and cadmium (Cd) in blood among Swedish adults and the association between blood levels, diet and other lifestyle factors. The study was based on a subgroup (n = 273) of the national survey Riksmaten 2010-2011 (4-day food records and questionnaire). Lead, Hg, and Cd were measured in whole blood, and Cd additionally in urine, by mass or fluorescence spectrometry methods. The median values (5-95th percentiles) of the metals in blood were as follows: Pb: 13.4 (5.8-28.6) mu g/L, Hg: 1.13 (0.31-3.45) mu g/L, and Cd: 0.19 (0.09-1.08) mu g/L. All three metals increased with increasing age. Lead levels in blood were positively associated with intakes of game and alcohol, Hg was related to fish intake, and blood Cd related to smoking and low iron stores and to a low meat intake. Body burdens of the studied metals were generally below health based reference values, but several individuals had blood Pb levels above the reference point for possible nephrotoxic and developmental neurotoxic effects. As health effects cannot be excluded, individuals with high Pb exposure should aim at decreasing their body burden, both from food and from other exposure routes. (c) 2013 Elsevier Ltd. All rights reserved.
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| 3. |
- Blomstrand, Lena, et al.
(author)
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Telemedicine : a complement to traditional referrals in oral medicine
- 2012
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In: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 18:7, s. 549-553
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Journal article (peer-reviewed)abstract
- Introduction:Introducing telemedicine into clinical practice has not been without difficulties. Within the framework of the European Union project "Health Optimum," telemedicine consultations with specialists at the Department of Oral & Maxillofacial Surgery at Uppsala University Hospital (Uppsala, Sweden) have been offered to dentists in the public dental health service. The aim is to streamline the consultation process, improve/develop the skills of the participating dentists and dental hygienists, and save time and money for patients, healthcare authorities, and society.Subjects and Methods:Patient records are collected in a database for demonstration and discussion, and the system is also available for referrals. Both medical and dental photographs and x-rays are digitized in the same system. These can be viewed during telemedicine rounds and by the consultants at the hospital prior to a consultation. Secure, interactive conferencing software is used, which provides a quick, easy, and effective way to share video and data over the Internet. Both parties can demonstrate different parts of an image using a pointer or a drawing system. Conference phones are presently used for verbal communication.Results:Ten patients were discussed during telemedicine rounds (3 males and 7 females), all of whom would normally have been referred to a specialist. As a result of the telemedicine round, 2 were referred to a specialist, whereas diagnoses were made for the other 8, and treatment was suggested. The dental health clinic could thus provide treatment without the need for referral to a consultant.Conclusions:The telemedicine system described here allows patient care to be provided rapidly and more economically. Future plans include "live" rounds using a videocamera, providing the possibility to relay real-time information about the intraoral situation. A camera is being developed and should preferably be permanently installed chair side.
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| 4. |
- Hillbertz, Nicolette Salmon, et al.
(author)
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Viral and Molecular Aspects of Oral Cancer
- 2012
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 32:10, s. 4201-4212
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Research review (peer-reviewed)abstract
- Squamous cell carcinoma (SCC) is the most common epithelial malignancy in the oral cavity. SCCs and their variants constitute over 90% of oral malignancies, and the disease is associated with poor prognosis. OSCC is a complex malignancy where environmental factors, virus infections, and genetic alterations most likely interact, and thus give rise to the malignant condition. Herein, we review the available literature regarding high-risk factors such as alcohol and tobacco usage; discuss the roles of human papillomaviruses (HPV), the Epstein-Barr virus, and the human herpes simplex virus (HSV); and evaluate several candidate genes associated with the condition: p53, p16(INK4) and p21(WAF1/CIP1) survivin, B-cell lymphoma-2 (BCL-2), keratins, Fibroblast growth factor 3 (FGF3), FGF4, FGF19, Oral cancer overexpressed gene 1 (ORAOV1), and Cyclin D1 (CCND1).
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| 5. |
- Hirsch, Jan-Michael, et al.
(author)
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Oral Cancer in Swedish Snuff Dippers
- 2012
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 32:8, s. 3327-3330
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Journal article (peer-reviewed)abstract
- Over recent decades there has been debate over whether or not Swedish snuff is carcinogenic in humans. Animal studies and molecular biological and experimental studies have shown the carcinogenic potential of Swedish snuff, but this has not been proved in prospective randomized studies. We present a case series of patients with oral squamous cell carcinomas diagnosed at the sites where the patients had used Swedish snuff for several years. Sixteen male patients were referred to and treated at Oral and Maxillofacial Surgery Departments and Ear, Nose and Throat clinics at seven different hospitals in Sweden. The mean age of the patients at the time of diagnosis was 72.9 years and the mean time of snuff use prior to cancer diagnosis was 42.9 years. This case series shows that Swedish snuff may not be a harmless alternative to smoking.
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| 6. |
- Jalouli, Jamshid, et al.
(author)
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Human Papilloma Virus, Herpes Simplex Virus and Epstein Barr Virus in Oral Squamous Cell Carcinoma from Eight Different Countries
- 2012
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 32:2, s. 571-580
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Journal article (peer-reviewed)abstract
- Oral squamous cell carcinoma (OSCC) is a major health problem in many parts of the world, and the major causative agents are thought to he the use of alcohol and tobacco. Oncogenic viruses have also been suggested to be involved in OSCC development. This study investigated the prevalence of human papillomaviruses (HPV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) in 155 OSCC from eight different countries from different ethnic groups, continents and with different socioeconomic backgrounds. 41 A total of OSCCs were diagnosed in the tongue (26%) and 23 in the floor of the mouth (15%); the other 91 OSCCs were diagnosed in other locations (59%). The patients were also investigated regarding the use of alcohol and smoking and smokeless tobacco habits. Tissue samples were obtained from formalin-fixed, paraffin-embedded samples of the OSCC. DNA was extracted and the viral genome was examined by single, nested and seminested PCR assays. Sequencing of double-stranded DNA from the PCR product was carried out. Following sequencing of the HPV-, HSV- and EBV-positive PCR products, 100% homology between the sampels was found. Of all the 155 OSCCs examined, 85 (55%) were positive for EBV, 54 (35%) for HPV and 24 (15%) for HSV. The highest prevalence of HPV was seen in Sudan (65%), while HSV (55%) and EBV (80%) were most prevalent in the UK. In 34% (52/155) of all the samples examined, co-infection by two (46/155=30%) or three (6/155=4%) virus specimens was detected. The most frequent double infection was HPV with EBV in 21% (32/155) of all OSCCs. There was a statistically significant higher proportion of samples with HSV (p=0.026) and EBV (p=0.015) in industrialized countries (Sweden, Norway, UK and USA) as compared to developing countries (Sudan, India, Sri Lanka and Yemen). Furthermore, there was a statistically significant higher co-infection of HSV and EBV in samples from industrialized countries (p=0.00031). No firm conclusions could be drawn regarding the relationship between alcohol, tobacco and virus infections. The significance of our findings must be put in relation to other risk factors and these observations warrant further studies to determine the possible role of viral infections and co-infections with HPV, EBV and HSV as risk markers for the development of OSCC.
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| 7. |
- Jalouli, Miranda M., et al.
(author)
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Differential Expression of Apoptosis, Cell Cycle Regulation and Intermediate Filament Genes in Oral Squamous Cell Carcinomas Associated with Toombak Use in Sudan
- 2011
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 31:10, s. 3345-3351
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Journal article (peer-reviewed)abstract
- Previously we used microarray genomic hybridization technology to explore genome-wide profiles of chromosomal aberrations in samples of oral squamous cell carcinomas (OSCCs) and paired normal controls. Based on these findings, 9 genes related to apoptosis, cell cycle regulation and intermediate filament proteins were selected and their differential expression status was examined by real-time quantitative RT-PCR in 26 samples of Sudanese OSCCs and their matched normal controls. The findings were correlated with the habit of toombak use. The mRNA levels of Bcl2, keratin 1, keratin 13 and p53 were significantly lower and the level of survivin was significantly higher in the OSCC samples of the toombak users compared to their paired control samples. A significant down-regulation in keratin I and keratin 13 expression levels was found in the OSCC samples of the non-toombak users compared to their normal control samples. The differential expression of genes related to apoptosis, cell cycle regulation and types I and II keratin could be useful diagnostic markers and provide valuable information for the understanding of oral malignancy in relation to toombak use.
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| 8. |
- Jäwert, Fredrik, et al.
(author)
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Loss of 5-Hydroxymethylcytosine and TET2 in Oral Squamous Cell Carcinoma.
- 2013
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In: Anticancer research. - 1791-7530 .- 0250-7005. ; 33:10, s. 4325-8
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Journal article (peer-reviewed)abstract
- Aim: Epigenetic modifications, such as DNA methylation, are considered important in the regulation of target genes in cancer development. 5-Hydroxymethylcytosine (5hmC) was recently discovered to be related to the process of malignant transformation. The influence of DNA methylation in oral squamous cell carcinomas (OSCC) is not fully-understood. Therefore, the aim of the present study was to investigate the DNA methylation pattern in OSCC compared to healthy oral epithelium.
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| 9. |
- Lekerud, Ann-Kristin, et al.
(author)
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Treatment of sleep apnoea using a mandibular advancement splint : an open prospective study
- 2012
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In: In Vivo. - 0258-851X .- 1791-7549. ; 26:5, s. 841-845
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Journal article (peer-reviewed)abstract
- Obstructive sleep apnoea (OSA) may cause considerable disturbances, including the development of health problems. This study was performed in order to evaluate the results of treating OAS with a mandibular advancement splint (MAS), and to evaluate the effects of this treatment. This was a prospective open longitudinal study. Ninety patients were randomly selected and included in the study. All 90 patients received an MAS. Forty-eight patients concluded the study, whereas 27 dropped-out and 15 were excluded. The sleep pattern was monitored at home with portable equipment. There was a clear tendency towards a reduction in the apnoea/hypopnea index (AHI) and the oxygen desaturation index (ODI) between the two investigations. Furthermore, there was a tendency towards reduced sleep apnoea; ratings on the Epworth sleepiness scale were lower, indicating a reduction in daytime sleepiness. Treatment with MAS in our study reduced sleep apnoea and snoring, and lowered the values of the Epworth sleepiness scale, indicating a reduction in daytime sleepiness in the majority of the patients. Lifestyle factors are not believed to have affected the results.
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| 10. |
- Lunde, Mai Lill Suhr, et al.
(author)
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Gene expression analysis by cDNA microarray in oral cancers from two Western populations
- 2010
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 30:4, s. 1083-1091
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Journal article (peer-reviewed)abstract
- BACKGROUND: In this work, gene expression profile was examined in 19 cases of oral cancer (OC) obtained from patients from Sweden (n=8) and UK (n=11) and the findings were tested for correlation to patient's clinicopathological data. MATERIALS AND METHODS: Following total RNA extraction, cDNA synthesis, labeling with fluorescent dyes and hybridization to the 21 k human oligonucleotide microarrays, slides were scanned and images were subjected to Genepix and J-Express analysis. Results for selected genes were validated by quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). RESULTS: 42 genes were identified as being differentially expressed. These included 39 genes of known functions (such as fatty acid synthase (FASN), 5' nucleotidase, ecto (NT5E), high mobility group AT-hook (HMGA1), and v-fos FBJ murine osteosarcoma viral oncogene homolog (FOS)) and 3 novel genes; 26 (67%) of the 39 genes with known functions were previously reported in oral/head and neck tumors examined from other populations. Hierarchical clustering of the samples using the 42 genes demonstrated that samples mainly clustered in the same population. CONCLUSION: These results illustrate that microarrays can be used to identify distinct patterns of gene expression in different populations, but with no direct association to clinicopathological parameters. The fact that 67% of the 39 genes with known functions found in this work were previously reported in oral/head and neck tumors from other populations provides clear evidence that development of these tumors follows the same biological pathways irrespective of the source of the samples used.
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| 11. |
- Ramadhan, Anwar, et al.
(author)
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A retrospective study of patients with mandibular fractures treated at a Swedish University Hospital 1999-2008
- 2014
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In: Annals of maxillofacial surgery. - : Medknow. - 2231-0746. ; 4:2, s. 178-181
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Journal article (peer-reviewed)abstract
- BACKGROUND:Fracture of the mandible is one of the most common fractures of the maxillofacial skeleton. However, the etiology, gender, and age distribution vary between different regions and countries, and the purpose of this study was to evaluate the current trend of patients with mandibular fractures at the Department of Oral and Maxillofacial Surgery, in Uppsala, Sweden.AIM:The aim of this retrospective study was to analyze patients with mandibular fractures treated in the University Hospital of Uppsala (the county capital of Uppland) Sweden during a 10-year period (1999-2008).MATERIALS AND METHODS:This study was designed as a retrospective study of patients admitted to the Department of Oral and Maxillofacial Surgery at Uppsala University Hospital, Sweden. The location of fractures was evaluated clinically by the surgeon and on the X-rays. We classified the data according to gender, age, etiology, day of the week, month of the year, fracture site, and method of treatment of the fractures.RESULTS:Records were collected from patient charts from 266 patients. One hundred eighty-seven patients (70%) with mandibular fractures were of male gender, and 132 patients (50%) were aged 16-30 years. Interpersonal violence constituted the most common etiological factor for mandibular fractures (24%), followed by falls (23%). Forty-nine percentages of the patients were treated surgically, and 51% were treated conservatively. There was an increase of the annual incidence of fractures toward the end of the period, even though not statistically significant.CONCLUSIONS:Mandibular fractures occurred primarily among younger men between 16- and 30-year-old. Condyle fractures were the most common fracture site and 50% of the patients required surgery. Summer months and weekends were the most common time of mandibular fractures.
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| 12. |
- Sand, Lars, et al.
(author)
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Local tolerance of a sublingual nicotine tablet, an open single-centre study.
- 2012
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In: In vivo (Athens, Greece). - 1791-7549 .- 0258-851X. ; 26:3, s. 463-8
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Journal article (peer-reviewed)abstract
- Nicotine replacement therapy (NRT) is now widely used in various forms of administration to aid cessation of tobacco use. In this smoking cessation programme, a new tablet formulation has been compared to and found bioequivalent to the existing one. The present trial was performed in order to investigate the local tolerance of the new sublingual tablet. The study was performed as a prospective follow-up study of 16 weeks' duration on smokers using the new tablet, Nicorette® Microtab, over a period of 12 weeks. Fifty smokers were included in the study and the oral mucosa was inspected and photographed at each visit. At 12 weeks, participants were asked for their consent to take a biopsy from the site of application. Compliance with tablet use was high, with participants using an average of 12 tablets/day throughout the 12 week treatment period. Adverse events related to treatment were mild and tolerable. The changes observed were classified as being induced by frictional stimuli, with no changes to the deeper layers of the epithelium, and no thickening of the basal layers of the epithelium. The new tablet was considered well tolerated during the course of this study, with a benign local effect on the mucous membrane that was consistent with lesions that are reversible in nature.
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| 13. |
- Sand, Lars, et al.
(author)
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p53 Codon 72 polymorphism in oral exfoliated cells in a Sudanese population
- 2012
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In: In Vivo. - 0258-851X .- 1791-7549. ; 26:1, s. 59-62
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Journal article (peer-reviewed)abstract
- Earlier studies have investigated the tumor suppressor gene p53 as a co-factor in the development of oral squamous cell carcinoma (OSCC). Our previous studies have indicated that chronic use of Sudanese snuff (toombak) and the presence of human papilloma virus (HPV) may be involved in the high prevalence of OSCC in Sudan. This study investigated the prevalence of p53 codon 72 polymorphism in brush biopsies obtained from a Sudanese population. A total of 174 individuals were included in the study; chronic toombak users (n=152) and non-users (n=22). DNA was extracted from all the samples and genotyped for the codon 72 polymorphism by polymerase chain reaction/restriction fragment length polymorphism. The Arg/Pro genotype was found in 53% of the 174 study participants, compared to 21% found with Arg/Arg and 26% found with Pro/Pro. Stratifying by toombak use, 28 (18%), 45 (29%) and 79 (52%) of the 152 samples from toombak users had Arg/Arg, Pro/Pro and Arg/Pro respectively, compared to 9 (41%), 0 (0%) and 13 (59%) found in the 22 samples from non users. The differences between the samples from toombak users and non users in Arg/Arg and Pro/Pro codon 72 polymorphism and HPV infection were statistically significant (p<0.05). Our study indicated that a high prevalence of the genotype Arg/Pro at the p53 codon 72 may contribute to susceptibility to OSCC, especially in combination with the use of carcinogenic tobacco-specific nitrosamine (TSNA)-rich toombak. Our observations warrant an in-depth study for understanding the role of p53 polymorphism in human oral cancers.
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| 14. |
- Sand, Lars, et al.
(author)
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Smokeless tobacco, viruses and oral cancer
- 2014
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In: Oral health and dental management. - 2247-2452. ; 13:2, s. 372-378
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Journal article (peer-reviewed)abstract
- Oral Squamous Cell Carcinoma (OSCC) is the most common epithelial malignancy in the oral cavity. OSCCs and their variants constitute over 90% of oral malignancies, and the disease is associated with poor prognosis. OSCC is a complex malignancy where environmental factors, viral infections, and genetic alterations most likely interact, and thus give rise to the malignant condition. The International Agency for Research on Cancer (IARC) in 2007 concluded: "there is sufficient evidence in humans to establish smokeless tobacco as carcinogenic, i.e. smokeless tobacco causes cancer of the oral cavity and pancreas". ST products contain a large array of carcinogens, although the number found is actually smaller than in cigarette smoke. Worldwide, ST products have many different names depending on the region where it is produced. However, there are two main types of ST, chewing tobacco and snuff. It is estimated that approximately 150 million people in the world use ST. Herein, we review available literature regarding smokeless tobacco and oral Carcinogenesis. We also discuss the role of viral infections in combination with ST in OSCC development.
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| 15. |
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| 16. |
- Sand, Lars, et al.
(author)
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Viruses and oral cancer. Is there a link?
- 2014
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In: Microbes and infection. - : Elsevier BV. - 1286-4579 .- 1769-714X. ; 16:5, s. 371-378
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Research review (peer-reviewed)abstract
- Oral squamous cell carcinoma (OSCC) is the most common malignant tumour of the oral cavity. The aetiology of epithelial cancer of the head and neck is considered to be a multifactorial, sequential process. DNA viruses are found in many different cancers and are also capable of transforming cells to a malignant phenotype. Human Papilloma Virus (HPV) has been proposed as risk factors in OSCC development and HPV type 16 is the most important subtype. Other oncogenic virus species i.e., Epstein-Barr Virus and Herpes Simplex Virus Type 1 have been proposed to be involved in oral carcinogenesis. However, no convincing evidence exist that they are an established risk factor in OSCC. Therefore more studies are needed in order to clarify the different aspects of virus involvement. Here, we review the existing literature on viral involvement in oral cancer.
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