Papers by Jasna Spicek-Macan
Collegium antropologicum, 2010
Mucoepidermoid carcinoma (MEC) accounts for approximately 30% of malignant salivary gland tumors ... more Mucoepidermoid carcinoma (MEC) accounts for approximately 30% of malignant salivary gland tumors and approximately 30% occur in minor salivary glands. The palate is the most frequent localization for those arising in minor glands. A 33-year-old male patient with MEC of the hard palate was treated as an acute odontogenic infection, which was not cured after tooth endodontic treatments, repeated incisions and antibiotics. On the hard palate ovoid, a hard painless mass, which had not extended over the middle palatal line, was observed. Partial maxillectomy was performed. A review of the literature was performed in order to provide a coherent overview on the differential diagnosis of palatal lesions. To the best of authors' knowledge, this is the first report in English literature describing palatal MEC misdiagnosed and treated as odontogenic infection. Considering the extensive list of MEC's differential diagnoses on the hard palate, acute odontogenic infection can now be added...
Croatian Medical Journal
Aim . To find ge netic al ter ations in PTC or other genes of the Shh /PTCH path way in tumorous ... more Aim . To find ge netic al ter ations in PTC or other genes of the Shh /PTCH path way in tumorous and non-tumorous sam ples from three fam i lies and to cor re late them with the vary ing ex pres sion of dis or ders in pre sented nevoid basal cell car ci noma syn drome (NBCCS) phe no types. Method . DNA was ex tracted from ar chi val par af fin-embedded tis sues, tu mor tis sue or pe riph eral b lood leu ko cytes, and the loss of heterozygosity (LOH) and sin gle strand conformational poly mor phism anal y sis was per fo rmed us ing PCR with primers for poly mor phic 9q22.3 mark ers (D9S196, D9S287, D9S180, D9S127); PTCH exons 3, 6, 8, 13, 15, 16; and smo ( smoothened ) exon 1. G-banding tecnique was used for cytogenetic anal y sis of the pe riph eral blood lym pho cytes. Re sults . We found a LOH for PTCH in sev eral cases and vari abil ity in smo in one case. In one case NBCCS could rea son ably be as cribed to hemizygous PTCH in ac ti va tion, while in other two fam i lies this typ i cal cor re la tion be tween the syn drome pheno type and the ob served ge netic al ter ations could not been es tab lished. Con clu sions . Fur ther anal y sis of rel a tively sparse cases of NBCCS is needed be fore the symp toms of the syn drome could be con vinc ingly ex plained by ge netic al ter ations in the Shh /PTCH sig nal ling path way. Key words: allelic loss; basal cell ne vus syn drome; Gorlin syn drome; LOH, loss of heterozigosity; sig nal pathways 534 Šitum et al: Patched (PTCH) Gene in Gorlin Syndrome Croatian Med J 1999;40:533-538 Šitum et al: Patched (PTCH) Gene in Gorlin Syndrome Croatian Med J 1999;40:533-538 Fig ure 3. Anal y sis of the sec ond fam ily with Gorlin syn drome. (a) Ped i gree of a Gorlin syn drome fam ily with chro mo some 9q22 haplotypes.
mukokele bile su u sublingvalnom prostoru, na obraznoj sluznici i u vestibulumu usne πupljine. Pr... more mukokele bile su u sublingvalnom prostoru, na obraznoj sluznici i u vestibulumu usne πupljine. Prema patohistoloπkom opisu zakljuËili smo da su 23 mukokele bile retencijskoga tipa, a dvije su bile ekstravazacijske promjene.
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Acta stomatologica Croatica
Only a successful cooperation of an oral surgeon and the pathologist can ensure a reliable diagno... more Only a successful cooperation of an oral surgeon and the pathologist can ensure a reliable diagnosis. The authors have analyzed operations performed during 1990 at outpatient clinic of the Department of Oral and Maxillofacial Surgery, University of Zagreb, School of Dentistry. Clinical appearance of the disease and clinical diagnosis sometimes enable us to recognize the real nature of the disease. The clinical diagnosis in correlation with the histological diagnosis can be either denied or improved. The aim of this investigation was to correlate the clinical and the histological diagnosis and to find out the number of improvement. Material most often sent for histological examination was an operated cyst. Although the removed tissues were analyzed under different clinical diagnoses, approximately 70% of the clinical diagnoses corresponded to the histopathological findings. In one case the clinical diagnosis of benign lesion--hyperkeratosis-- was after histopathological examination f...
Lijec̆nic̆ki vjesnik
The present study has been undertaken to compare the Q.E.D. test, a quantitative enzymatic method... more The present study has been undertaken to compare the Q.E.D. test, a quantitative enzymatic method for the determination of ethanol concentration in the saliva, and quantitative methods for determination of ethanol serum concentrations: UV alcohol dehydrogenase method and gas chromatography. The results of the study demonstrated a statistically significant correlation between the methods compared. We conclude that Q.E.D. test is an effective, rapid and safe method for specific quantitative determination of ethanol levels in the blood defined by ethanol concentrations in the saliva, especially in outpatient departments, initial emergency treatment as well as in differential diagnosis. Sometimes, an increased salivary viscosity caused by dehydration of an acutely drunken man as well as insufficient cooperation of the examinee may, however, aggravate the test performance. We propose the use of a test that measures ethanol concentration in the saliva up to 3.5 g/L in order to avoid repet...
Objective: The main objective of this study was to determine to what extent a detailed oral instr... more Objective: The main objective of this study was to determine to what extent a detailed oral instruction about treatment after surgical removal of a lower wisdom tooth affect postoperative quality of life (QoL). Method: The research on QoL after removal of a lower wisdom tooth was conducted with 108 patients. Depending on the type of information given to each respondent individually, the examinees were divided into two groups: a test group which was given detailed written and oral instructions, and a control group which received only written instructions about treatment after the surgery. In this research were examined the QoL using modified OHIP-14 criterion four, seven and thirty days after the operation depending on the type of information previously provided to the respondents. In order to reduce the dimensionality of the obtained data sets, as well as in order to explain the relationship between the examined variables that are interrelated we applied a principal component analys...
Croatian medical journal, 1999
To find genetic alterations in PTC or other genes of the Shh/PTCH pathway in tumorous and non- tu... more To find genetic alterations in PTC or other genes of the Shh/PTCH pathway in tumorous and non- tumorous samples from three families and to correlate them with the varying expression of disorders in presented nevoid basal cell carcinoma syndrome (NBCCS) phenotypes. DNA was extracted from archival paraffin-embedded tissues, tumor tissue or peripheral blood leukocytes, and the loss of heterozygosity (LOH) and single strand conformational polymorphism analysis was performed using PCR with primers for polymorphic 9q22.3 markers (D9S196, D9S287, D9S180, D9S127); PTCH exons 3, 6, 8, 13, 15, 16; and smo (smoothened) exon 1. G-banding tecnique was used for cytogenetic analysis of the peripheral blood lymphocytes. We found a LOH for PTCH in several cases and variability in smo in one case. In one case NBCCS could reasonably be ascribed to hemizygous PTCH inactivation, while in other two families this typical correlation between the syndrome phenotype and the observed genetic alterations could...
Chirurgia maxillofacialis & plastica, 1984
Chirurgia maxillofacialis & plastica, 1985
Chirurgia maxillofacialis & plastica, 1986
Large bone defects of the jaw have, so far, been filled with various types of bone implants, main... more Large bone defects of the jaw have, so far, been filled with various types of bone implants, mainly synthetic nonresporative aloplastic implants (hydroxilapatite). As we have data only for two types of resorptive xenogenic bone implants, the purpose of this investigation was to examine resorption and osteoinductive capability of OSTEOVIT as a material for filling bone defects after removing large cysts (more than 20 mm in diameter) and after apicectomy of the tooth, where more than 1/3 of the tooth has no strong bone bases. Osteovit is a collagen matrix of calf spongiose consisting of porous collagen purified of antigens, fats minerals, enzymes and all other noncollagen materials. Forty-one patients, 9 female and 32 male aged 15-54 years were included in the investigation Nineteen of them had a clinical diagnosis of OPC and 22 a clinical diagnosis of cysts radicularis. All patients had a indication for apicectomy indicating that they had bone defects larger than 20 mm in diameter or...
Acta clinica Croatica, 2013
The aim of this study was to determine the extent to which the intensity of postoperative pain in... more The aim of this study was to determine the extent to which the intensity of postoperative pain in the first seven days after lower wisdom tooth extraction is affected by operator experience, patient level of information and patient sex. Postoperative pain intensity after lower wisdom tooth extraction was assessed in 108 patients. Depending on the type of information given to each patient individually, the patients were divided into two groups: test group in which patients were provided with detailed standard written and verbal instructions and control group where patients only received detailed standard written instructions about treatment after surgery. Each of these two groups was divided into three subgroups depending on operator experience. Results of this study showed that the type of information irrespective of being given verbally or not had no effects on postoperative pain intensity, whereas operator experience and patient sex influenced postoperative pain intensity.
Journal of Cranio-Maxillofacial Surgery, 2011
Synovial sarcoma (SS) is a malignant mesenchymal tumour, predominantly found in the deep soft tis... more Synovial sarcoma (SS) is a malignant mesenchymal tumour, predominantly found in the deep soft tissues of lower extremities, whereas only 3% occur in the head and neck region. Primary synovial sarcoma of the parotid gland is exceptionally uncommon. This is a report of a 15-year-old boy with a synovial sarcoma arising in the parotid gland, and, to the best of our knowledge, this is the youngest patient on record. The patient was treated primarily surgically, followed by chemotherapy and radiotherapy. Two years after this multimodal therapy, the patient is without signs of loco-regional recurrence or distant metastases. This paper highlights the importance of a multidisciplinary approach in the diagnosis and treatment of this very rare entity.
Oral Diseases, 2014
To analyze the role of smoking, drinking, and their synergistic effect in the occurrence of poten... more To analyze the role of smoking, drinking, and their synergistic effect in the occurrence of potentially malignant oral disorders (PMOD). We examined three groups: 50 patients with lung cancer, 50 patients with liver cirrhosis, and 50 patients with clear medical history. Scores were developed for drinking, smoking, drinking & smoking, and PMOD. All four scores were the lowest in the control group. The lung cancer group showed the highest Smoking, Alcohol & Smoking and Lesions score, while the liver cirrhosis group had the Alcohol score the highest. Compared with the control group, lung cancer group is more likely to develop a PMOD than the liver cirrhosis group (OR = 12.31/OR = 6.71). Statistical significance between the groups was found in the Lesions score (χ(2) = 15.34; P = 0.001). The patients with lung cancer and liver cirrhosis represent a high-risk group for PMOD. Patients with lung cancer and liver cirrhosis have never, to our knowledge, been categorized as high-risk patients for PMOD. After diagnosed, patients with lung cancer and liver cirrhosis should have a routine oral cavity examination, as they present a high-risk group for PMOD and oral cancer.
British Journal of Oral and Maxillofacial Surgery, 2004
To evaluate the impact of oral health on the evolution of nosocomial infections and to document t... more To evaluate the impact of oral health on the evolution of nosocomial infections and to document the effects of oral antiseptic decontamination on oral health and on the rate of nosocomial infections in patients in a surgical intensive-care unit (ICU). A prospective, randomized, double-blind, placebo-controlled clinical trial. Surgical ICU in University Hospital Dubrava. The study included 60 nonedentulous patients consecutively admitted to the surgical ICU and requiring a minimum stay of three days. After randomization, the treatment group underwent antiseptic decontamination of dental plaque and the oral mucosa with chlorhexidine gel. The control group was treated with placebo gel. Dental status was assessed using a caries-absent-occluded (CAO) score, and the amount of plaque was assessed using a semi-quantitative score. Samples of dental plaque, oral mucosa and nasal and tracheal aspirates were collected for bacterial culture, and nosocomial infections were assessed. The plaque score significantly increased in the control group and decreased in the treated patients. Patients who developed a nosocomial infection had higher plaque scores on admission and during their ICU stay. The control group showed increased colonization by aerobic pathogens throughout their ICU stay and developed nosocomial infections (26.7%) significantly more often than the treated patients (6.7%); the control group also stayed longer in the ICU (5.1 +/- 1.6 vs. 6.8 +/- 3.5 days, P = 0.019). Furthermore, a trend in reduction of mortality was noted in the treated group (3.3% vs. 10%). Among surgical ICU patients, poor oral health had a significant positive correlation with bacterial colonization and the evolution of nosocomial infections. Oral decontamination with chlorhexidine significantly decreased oropharyngeal colonization, the incidence of nosocomial infections, length of ICU stay, and mortality in these patients.
Wiener klinische Wochenschrift, 2010
To evaluate the impact of oral health on the evolution of nosocomial infections and to document t... more To evaluate the impact of oral health on the evolution of nosocomial infections and to document the effects of oral antiseptic decontamination on oral health and on the rate of nosocomial infections in patients in a surgical intensive-care unit (ICU). A prospective, randomized, double-blind, placebo-controlled clinical trial. Surgical ICU in University Hospital Dubrava. The study included 60 nonedentulous patients consecutively admitted to the surgical ICU and requiring a minimum stay of three days. After randomization, the treatment group underwent antiseptic decontamination of dental plaque and the oral mucosa with chlorhexidine gel. The control group was treated with placebo gel. Dental status was assessed using a caries-absent-occluded (CAO) score, and the amount of plaque was assessed using a semi-quantitative score. Samples of dental plaque, oral mucosa and nasal and tracheal aspirates were collected for bacterial culture, and nosocomial infections were assessed. The plaque score significantly increased in the control group and decreased in the treated patients. Patients who developed a nosocomial infection had higher plaque scores on admission and during their ICU stay. The control group showed increased colonization by aerobic pathogens throughout their ICU stay and developed nosocomial infections (26.7%) significantly more often than the treated patients (6.7%); the control group also stayed longer in the ICU (5.1 +/- 1.6 vs. 6.8 +/- 3.5 days, P = 0.019). Furthermore, a trend in reduction of mortality was noted in the treated group (3.3% vs. 10%). Among surgical ICU patients, poor oral health had a significant positive correlation with bacterial colonization and the evolution of nosocomial infections. Oral decontamination with chlorhexidine significantly decreased oropharyngeal colonization, the incidence of nosocomial infections, length of ICU stay, and mortality in these patients.
Tonsilloliths are rare calcified structures that usually result from chronic inflammation of the ... more Tonsilloliths are rare calcified structures that usually result from chronic inflammation of the tonsils.
Concretions show differences in size, shape and colour. They are usually asymptomatic but can be associated
with halitosis, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. A patient
was referred because panoramic radiography performed by a general dentist revealed radiopaque shadows
over the ascending rami of the mandible, located bilaterally: a solitary structure on the higher portion of
the right side and two small structures on the left side. Paroxysmal attacks of orofacial pain and symptoms
such as dysphagia and swallowing pain on the left side distributed within the tonsillar fossa and pharynx
and the angle of the lower jaw were present. The computed tomography images revealed bilateral tonsilloliths.
Clinically, there was no sign of inflammation, and the patient’s past history revealed an
approximately 2-year history of dysphagia, swallowing pain and left-sided neck pain. At the request of the
patient, no surgical intervention was carried out. Glossopharyngeal neuralgia is a rare entity, and the aim of
this report was to indicate the importance of tonsilloliths as a cause of orofacial pain.
Oral Diseases, 2006
ABSTRACT Mucoepidermoid carcinoma (MEC) constituting less than 10% of all salivary gland tumors, ... more ABSTRACT Mucoepidermoid carcinoma (MEC) constituting less than 10% of all salivary gland tumors, account for approximately 30% of all malignant tumors, approximately 60% occur in the parotid and 30% in minor salivary glands. The palate is the most frequent localisation for those arising in minor salivary glands. Although the prognosis correlates with the histological grade, occasional low-grade tumors behave unexpectedly aggressive. Because of only moderately responsive to radiotherapy, initial wide local excision appears to be appropriate for low-grade, plus neck dissection if the neck nodes are clinically suspicious in intermediate-grade and for high-grade a neck dissection is combined with wide block excision. Differential diagnosis includes benign and malignant tumors of hard palate, mostly pleomorphic adenoma, polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma and squamous cell carcinoma. The chronic sialadenitis or mucocele as a histologically similar could be misdiagnosed with a low-grade MEC, but also necrotising sialometaplasia. Odontogenic cyst, lymphoma, plasmacytoma, Langerhans cell histiocytosis or metastatic carcinoma could also be included. We report a case of a 33-year-old male patient with a MEC of a hard palate treated as an acute odontogenic infection, which after tooth endodontic treatments, repeated incisions and antibiotics have not been cured. He had a toothache on 26 and tumor of a hard palate. Eight months after, the patient has been sent to our Department. The cytology diagnosis was MEC, low-grade malignant. Partial maxillectomy was performed. The diagnosis and the long-term unsuccessful treatment have warned that the diagnosis and consequently the treatment should have been revised.
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Papers by Jasna Spicek-Macan
Concretions show differences in size, shape and colour. They are usually asymptomatic but can be associated
with halitosis, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. A patient
was referred because panoramic radiography performed by a general dentist revealed radiopaque shadows
over the ascending rami of the mandible, located bilaterally: a solitary structure on the higher portion of
the right side and two small structures on the left side. Paroxysmal attacks of orofacial pain and symptoms
such as dysphagia and swallowing pain on the left side distributed within the tonsillar fossa and pharynx
and the angle of the lower jaw were present. The computed tomography images revealed bilateral tonsilloliths.
Clinically, there was no sign of inflammation, and the patient’s past history revealed an
approximately 2-year history of dysphagia, swallowing pain and left-sided neck pain. At the request of the
patient, no surgical intervention was carried out. Glossopharyngeal neuralgia is a rare entity, and the aim of
this report was to indicate the importance of tonsilloliths as a cause of orofacial pain.
Concretions show differences in size, shape and colour. They are usually asymptomatic but can be associated
with halitosis, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. A patient
was referred because panoramic radiography performed by a general dentist revealed radiopaque shadows
over the ascending rami of the mandible, located bilaterally: a solitary structure on the higher portion of
the right side and two small structures on the left side. Paroxysmal attacks of orofacial pain and symptoms
such as dysphagia and swallowing pain on the left side distributed within the tonsillar fossa and pharynx
and the angle of the lower jaw were present. The computed tomography images revealed bilateral tonsilloliths.
Clinically, there was no sign of inflammation, and the patient’s past history revealed an
approximately 2-year history of dysphagia, swallowing pain and left-sided neck pain. At the request of the
patient, no surgical intervention was carried out. Glossopharyngeal neuralgia is a rare entity, and the aim of
this report was to indicate the importance of tonsilloliths as a cause of orofacial pain.