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Fine-needle aspiration biopsy: efficacy in the diagnosis of head and neck sarcoidosis.

The authors report the usefulness of fine-needle aspiration biopsy to establish the diagnosis of sarcoidosis in patients with palpable disease in the head and neck areas. Aspiration biopsy proved to be a simple and quick method for establishing this diagnosis in the eight cases reported in this series. Interpretation of cytologic smears with identification of typical sarcoid-like granulomas proved to be quite easy. No complications occurred secondary to use of this technique.

Adult↗

Sonography and scintigraphy in the diagnosis of diseases of the major salivary glands.

This is a prospective study of 73 patients with diseases of the major salivary glands. The sonographic diagnosis could be confirmed by the course of the disease and/or the histologic result after operation in 67 (93%). In 29 patients, salivary gland scintigrams also were carried out. There was a tendency for signs of hypervascularization to be seen in patients with acute inflammation and reduction or loss of function in the presence of a chronic inflammation of the salivary glands. Scintigraphy did not provide diagnostic information on tumors of the salivary glands with regard to the type and location, with the exception of the Warthin's tumor. In selected cases it adds additional information, especially in functional therapy control.

Adenoma, Pleomorphic↗

Reversal of Sjogren's-like syndrome in non-obese diabetic mice.

BACKGROUND: Non-obese diabetic (NOD) mice exhibit autoimmune diabetes and Sjögren's-like syndrome. OBJECTIVE: To test whether a treatment that reverses end-stage diabetes in the NOD mouse would affect their Sjögren's-like syndrome. METHODS: NOD mice have a proteasome defect. Improperly selected naive T cells escape, but can be killed by reintroducing major histocompatibility complex class I self-peptides on matched normal splenocytes. The proteasome defect also impairs nuclear factor kB, a transcription factor in pathogenic memory T cells, increasing their susceptibility to tumour necrosis factor-induced apoptosis stimulated through complete Freund's adjuvant (CFA). The impact of this two-limb therapy (injections of matched normal splenocytes and CFA) on the autoimmune salivary gland disease of the NOD mice was studied. RESULTS: All NOD mice receiving the above treatment had a complete recovery of salivary flow and were protected from diabetes. Restoration of salivary flow could be the result of a combination of rescue and regeneration of the gland, as confirmed by immunohistochemical analysis. All untreated NOD mice showed a continuous decline in salivary flow, followed by hyperglycaemia and death. CONCLUSION: This study establishes that a brief intervention in NOD mice with Sjögren's-like syndrome can reverse salivary gland dysfunction.

Animals↗

Computed tomography of the major salivary glands.

Forty-eight patients with proven disease of the salivary glands were evaluated by computed tomography (CT). Twenty-seven patients had salivary gland neoplasm and all were identified by CT. Fifteen benign tumors appeared as discrete, sharply marginated, high-density masses embedded in an otherwise normal gland. All 15 were correctly identified as benign by CT. There were 12 malignant tumors; 10 were invasive and presented as poorly defined, relatively dense lesions which obliterated and/or transgressed adjacent fat and fascial planes. Two malignant tumors presented as discrete masses and were incorrectly considered to be benign by CT. Twenty-one patients with inflammatory disease of the salivary glands were studied. A variety of patterns were noted, the most common a relatively diffuse, irregular area of increased density in an enlarged gland. Salivary duct calculi, diffuse sialectasis, and enlarged lymph nodes were well demonstrated. Differentiation between focal and inflammatory disease and malignant neoplasm was difficult. Computed tomography may be augmented by coincident sialography, although it is seldom necessary.

Adolescent↗

The impact of gene therapy on dentistry: a revisiting after six years.

BACKGROUND: Gene therapy is an emerging field of biomedicine that has commanded considerable scientific and popular attention. The procedure involves the transfer of genes to patients for clinical benefit. Transferred genes can b e used for either reparative or pharmacological purposes. OVERVIEW: In 1995, the first author and a colleague described the potential impact of gene therapy on dentistry, on the basis of initial studies of gene transfer applications to salivary glands, keratinocytes and cancer cells. Their conclusion was that gene therapy would have a significant impact on the nature of dental practice within 20 years. In this article, the authors consider research progress since 1995 and reexamine the earlier conclusion. PRACTICE IMPLICATIONS: In the past six years, remarkable progress has been made in the field of gene therapy, including seven areas relevant to dental practice: bone repair, salivary glands, autoimmune disease, pain, DNA vaccinations, keratinocytes and cancer. While considerable problems remain, thus impeding the routine clinical use of gene transfer, gene therapy will have a pervasive and significant impact on areas of dental practice that are based in biological science. By 2015, this will translate into practitioners' having a wide range of novel biological treatment options for their patients.

Autoimmune Diseases↗

[Sonography of the salivary glands].

358 sonographic studies of the salivary glands of 255 patients with proven diagnoses were evaluated retrospectively. Sonography proves to be highly valuable to differentiate between peri- and intraglandular lesions (98%). Superficial neoplasms can be delineated easily. A sharp margin of the tumour is not reliable to predict benignity, therefore biopsy should be performed in all neoplasms of the glands. Deep infiltrating processes require further evaluation by CT or MR. In cases with sialolithiasis the stones can be demonstrated in approx. 2/3 by ultrasound. Inflammatory diseases of the salivary glands have variant sonographic features. Acute infections usually have hypoechogenic parenchyma, chronic inflammations are more likely hyperechogenic.

Adenolymphoma↗

[A submandibular swelling: the salivary gland?].

Four patients, three men aged 32, 51 and 74 years, respectively, and a woman aged 34 years, presented with a submandibular swelling. In all four patients, the swelling was caused by submandibular salivary-gland disease. The first patient appeared to have chronic sialoadenitis due to sialolithiasis, in the second patient the diagnosis was sialoadenosis due to anorexia-boulimia, the third patient had a pleomorphic adenoma and the fourth had a malignant neoplasm of the floor of the mouth causing obstruction of the submandibular gland. A submandibular swelling may have many different causes. It is sometimes difficult to differentiate between enlargement of the submandibular gland and an enlarged lymph node. Intra-oral inspection and palpation may give valuable information about the origin of some submandibular swellings. Using a combination of history, examination and, when necessary, fine-needle aspiration and röntgenological examination, the diagnosis of submandibular lumps is usually straightforward.

Adenoma, Pleomorphic↗

Endoscopy: a minimally invasive procedure for diagnosis and treatment of diseases of the salivary glands. Six years of practical experience.

During a 6-year period we did a total of 72 videoendoscopies of the salivary glands and their associated ductal systems. This minimally invasive procedure is associated with little morbidity and discomfort. The main indication was sialolithiasis of the submandibular and parotid glands. Sialoendoscopy was used not only for diagnosis of radiolucent calculi but also for simultaneous removal of calculi. Sialoendoscopy was also of benefit in the diagnosis and treatment of other diseases of the salivary glands. Even patients with chronic sialadenitis could be helped with endoscopic dilatation of the causative sialostenosis, thereby enabling us to conserve the gland.

Adolescent↗

Differential responses of serum and salivary interleukin-6 to acute strenuous exercise.

Physical exercise is associated with elevation of serum levels of interleukin-6 (IL-6) because of its production in the muscles. The use of IL-6 measurements in saliva has been proposed in the field of immunopathology, mainly involving salivary gland disease. We evaluated the responses of serum and salivary IL-6 in two different groups of athletes submitted to different types of controlled strenuous exercise (spinning activity and maximal isokinetic test). Serum and salivary samples for IL-6 measurements, and serum samples for lactate and myoglobin determination before and after exercise, were obtained. Salivary IL-6 was measured by ELISA after dilution experiments and compared with results obtained by immunoradiometric assay. Spinning activity elicited significant increases in all the variables, and no correlation was found among the respective variations. A significant response to the isokinetic exercise was observed for serum IL-6, lactate and myoglobin only; no correlation was found between serum and salivary IL-6. Our study demonstrated that serum and salivary IL-6 responses to exercise are dissociated, possibly in relation to the lack of relationships between the systemic/muscular and the salivary routes of IL-6 production. Analytical issues that concern IL-6 measurement in saliva deserve attention, notably regarding the collection method used to absorb saliva. Concomitant monitoring of serum markers of inflammation, muscle metabolism and damage can provide information about muscle function properties and adaptations to physical effort in different types of athletes.

Adult↗

[PTYALISM].

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Humans↗