Oral medicine case book 47: oral neurofibroma

A 29-year-old male patient presented at the Oral Medicine Clinic with the complaint of slow-growing growths on his tongue, causing discomfort. Extra-oral examination revealed several painless soft tissue nodules on his face (Figure 1 and 2), trunk (Figure 3), back (Figure 4) and arms. The patient reported that the lesions had appeared during childhood and had since increased in size and number. He was unaware of any family history of the disease. Intra-oral examination showed two soft tissue nodules on the midline of the dorsal surface of the tongue, 3,5cm and 0,5 cm in diameter respectively (Figure 5).Department of HE and Training approved lis

Oral Medicine Case Book 56: Oral Manifestations of aplastic anaemia

A 22-year old female patient was referred to the Oral Medicine Clinic from the Haematology Ward at Groote Schuur Hospital for evaluation of a painful oral ulcer, which had been present for three weeks. The patient reported that, six weeks ago, she had sought treatment from her own dentist for painful and bleeding gingivae. The dentist performed a scale and polish and prescribed a combination of amoxicillin and metronidazole, at normal adult doses, for seven days. The gingival bleeding had not resolved by the time she presented for her recall visit, two weeks later. The patient also reported the presence of 'small, purple spots' on her lower limbs and trunk.DHE

Oral medicine case book 49: plasmablastic lymphoma

A 25-year-old male patient presented at the Oral Medicine Clinic with a painful bleeding lesion on the palate causing him discomfort during speech, mastication, and sleep. The lesion started approximately five months earlier as a small growth that gradually increased in size. The patient was rather vague about his medical history and habits but he did reveal that he smoked two cigarettes per day as well as using cocaine, a habit for which he was receiving therapy, for drug-induced hallucinations, at a local psychiatric hospital. He was not aware of any other medical conditions or allergies. The extraoral examination revealed nothing of note, however, on intraoral examination a large and firm pedunculated exophytic soft tissue mass was seen on the hard palate. It covered a large portion of the hard palate extending from the back of the upper incisors posteriorly onto the anterior part of the soft palate and into the right vestibule. It extended laterally to the gingival margins of all the teeth in the first quadrant, resulting in an appearance of gingival hyperplasia. The growth had an erythematous appearance with surface patches of necrosis and other areas that easily bled on touch (Figure 1).Department of HE and Training approved lis

Oral Medicine Case Book 57: Orofacial granulomatosis

A 17-year old female presented at the Oral Medicine Clinic with the complaint of persistent swelling of the upper lip and anterior attached gingiva, causing her discomfort when eating and talking. The swelling started approximately ten months earlier. At the time she was seen by her physician who prescribed an antibiotic that gave mild symptomatic relief, but no clinical resolution. She was also seen by an oral hygienist on three occasions with no improvement of the gingival swelling. The patient also reported that she had been diagnosed with depression and type 2 diabetes approximately two years ago and was currently using Citalopram (a selective serotonin reuptake inhibitor) and Glucophage (metformin hydrochloride, an anti-hyperglycemic drug). Extra-oral examination revealed a firm, swollen and superficially cracked upper lip with a red granular appearance. No enlarged cervical lymph nodes could be palpated. Intra-orally, the anterior maxillary and mandibular gingivae were hyperplastic and erythematous, with a granular surface (Figures 1, 2 and 3). The differential diagnosis included contact allergy and granulomatous disease, including mycobacterial infection.DHE

Oral medicine case book 55: ondontogenic myxoma

A 20-year old female was referred from her local community health clinic to the Oral Medicine Clinic at Groote Schuur Hospital for a swelling that started out as a small and painless lesion. She had attended the local clinic approximately two months earlier when the growth increased in size, her teeth loosened and the lesion became symptomatic. At that time, her upper left molar teeth were extracted but, despite this, the lesion continued to enlarge.Department of HE and Training approved lis

Effect of Air- and Water-Filled Voids on Neutron Moisture Meter Measurements of Clay Soil

Air- and water-filled voids around neutron moisture meter (NMM) access tubes have been cited as sources of volumetric water content (θ) measurement error in cracking clay soils. The objectives of this study were to experimentally quantify this potential error stemming from (i) uncertainty in bulk density (ρ) sampling and (ii) the impact of air- and water-filled voids. Air- and water-filled voids were simulated using ∼0.6-cm (small) and ∼1.9-cm (large) annuli around access tubes. After NMM measurements were taken in a tightly installed access tube, either a small or large annulus was installed in the same borehole. Additional NMM measurements were taken with the annulus filled with air, and then water and ρ and θ were measured. The RMSE of the NMM calibration using all 11 installations was 0.02 m m. However, if two cores were used for calibration, the ratio of NMM-measured θ to in situ θ was significantly different ( < 0.05) from measured θ half the time (RMSE, 0.012–0.05 m m). Small air-filled voids created drier estimates of θ (bias, −0.039 m m; < 0.001), wherease small water-filled voids were not significantly different from the calibration. Air- and water-filled voids from larger annuli were significantly lower and higher ( < 0.001) than core-measured θ, with biases of −0.068 and 0.080 m m, respectively. Although this work does not correct NMM-predicted θ to matrix θ, it does bound NMM error under field conditions in a cracking clay soil