涎腺肌上皮肿瘤（附2例报告）

涎腺肌上皮肿瘤（附２例报告）浙江医科大学口腔病理教研室张岚，胡济安涎腺肌上皮瘤（Ｍｙｏｅｐｉｔｈｅｌｉｏｍａ）于１４４３年首先由Ｓｈｅｌｃｌｏｎ报告并命名。恶性者为恶性肌上皮瘤（Ｍａｌｉｇｎａｎｔｍｙｏｅｐｉｔｈｅｌｉｏｍａ）或肌上皮癌（Ｍｙｏｅｐｉ...     

腮腺非涎腺源性肿物21例临床诊治分析

目的：探讨腮腺非涎腺源性肿物的诊断和治疗特点。方法：回顾性分析21例腮腺非涎腺源性肿物的临床表现、病理类型和治疗方法。结果：21例腮腺非涎腺源性肿物中9例（43％）淋巴结疾病，包括淋巴瘤、转移癌和结核病，5例（24％）肉芽肿性病变，4例（19％）神经源性肿瘤，2例（10％）血管瘤。多数患者行腮腺浅叶或部分腮腺加肿物切除术，癌转移到腺体实质的患者需大块切除。结论：腮腺非涎腺源性肿物较少，且多数为淋巴结疾病，术前诊断比较困难。治疗首选部分腮腺或腮腺浅叶加肿物切除。     

涎腺导管癌9例报道及文献复习

目的：探讨涎腺导管癌临床病理学特征、治疗方法及预后。方法：结合我院近十年收治的9例涎腺导管癌病例,回顾国内详细记载涎腺导管癌病例报告,对其发病特点、临床表现、组织病理学特征、治疗方法和预后情况进行分析。结果：涎腺导管癌好发于老年人,以腮腺导管癌多见,临床上表现为质硬、界限不清肿块,常伴有神经侵犯症状。主要病理学特征是导管样细胞巢呈实质性、筛孔状和乳头状结构,中心有粉刺样坏死。治疗以手术扩大切除加颈淋巴清扫术为主,辅以术后放疗或化疗。术后易复发,颈淋巴结转移率高,常发生远处转移。结论：涎腺导管癌是一类较少见,且恶性程度很高的涎腺恶性肿瘤,预后较差,癌基因C-erbβ2和p53检测可能对判断早期局部复发、远处转移和生存率有所帮助。     

涎腺肌上皮瘤31例临床病理学分析

目的 分析涎腺肌上皮瘤(myoepithelioma,ME)临床病理学特点及生物学行为。方法 对1992年1月至2000年8月收治的31例患者进行回顾性分析。结果 ME主要发生于腮腺及腭部。临床上表现为无痛性缓慢生长的包块,无面瘫及破溃。光镜下呈实性、黏液性、网状或混合性生长方式。肿瘤细胞有梭形、浆细胞样、透明细胞样、上皮样型或混合型。4例肿瘤细胞生长活跃,在侵袭性生长的病例中可见轻度的细胞异型性、有丝分裂增加及包膜浸润。所有病例均采用手术切除。28例患者术后无复发。3例肿物复发或恶变为肌上皮癌。结论 ME是一类少见的肿瘤,具有独立的临床病理学特点,部分肿瘤侵袭性生长并具有潜在恶性的特点。     

涎腺原发恶性肌上皮瘤19例的病理诊断分析

目的 探讨涎腺多结节形态原发恶性肌上皮瘤的病理特征。方法 光镜观察19例涎腺多结节形态原发恶性肌上皮瘤的组织学、细胞学结构,其中11例做Calponin、平滑肌肌动蛋白(SMA)、S-100、神经胶质酸性蛋白(GFAP)、细胞角蛋白、增殖细胞核抗原(PCNA)的免疫组化检测,3例做超微结构观察。结果 肿瘤上皮巢呈多结节生长,中央常伴坏死,肿瘤侵袭周围组织,细胞有异形,肿瘤细胞主要为上皮样细胞型,有较多肿瘤性基质形成。肌上皮性标记及部分细胞角蛋白、PCNA标记阳性。电镜下见肿瘤细胞内有肌微丝。结论 免疫组化染色及超微结构观察均支持肿瘤为肌上皮来源及恶性特征。     

癌基因c—erbB—2,抗癌基因p53在涎腺良恶性肌上皮瘤中 …

应用免疫组化方法牟４０例涎腺肌上皮瘤，肌上皮瘤细胞生长活跃，恶性肌上皮瘤进行了ｃ－ｅｒｂＢ－２，ｐ５３基因蛋白表达的研究，结果：ｃ－ｅｒｂＢ－２表达总的阳性率为４２．５％，其中ＭＥ为１６．７％，ＭＡＰ为３７．５％，ＭＭＥ为６０％，三者间有显著差异。     

涎腺导管癌临床病理分析

目的；分析、探讨涎腺导管癌。方法：本研究对6例涎腺导管癌进行临床病理分析。结果：其临床特点为：主要发生于腮腺，次为颌下腺，好发于老年男性，生长迅速，病程较短，易发生淋巴结转移，血行转移率高，易侵犯神经，患者预后差。组织学特点为：组织学表现与乳腺导管癌极为相似，并因此而得名。瘤细胞向导管内生长，形成乳头状，筛孔状，实性等多种结构，并可发生粉刺样坏死，瘤细胞也向导管外浸润生长，肿瘤向周围组织浸润生长是其显著特征。结论：涎腺导管癌高度恶性，预后较差，治疗方法以局部彻底扩大切除，根治性颈清为主，术后辅以放疗和化疗。     

涎腺转移癌7例报告

涎腺转移癌是原发于涎腺以外部位的癌瘤通过淋巴系统或血行转移到涎腺淋巴结或涎腺实质的癌瘤[1 ] 。国内文献罕见报道。本文报道 7例涎腺转移癌并结合文献资料 ,将涎腺转移癌的临床特点作初步的分析和探讨。1　临床资料作者收集 1990～ 2 0 0 0年中南大学湘雅医学院附属第二医院口腔科、耳鼻喉科收治的涎腺肿瘤 4 10例 ,其中涎腺转移癌 7例 ,均经病理切片证实。其详细临床资料见表 1。表 1　 7例涎腺转移癌临床资料病例 年龄(岁 ) 性别 原发部位 病理类型转移部位伴他处转移13 2男右中耳鳞癌右腮腺颈淋巴结2 3 5男左眉弓黑色素瘤恶变左腮腺…     

口咽小涎腺恶性肌上皮瘤（附病例报道）

涎腺恶性肌上皮瘤为一罕见的恶性肿瘤,好发于腮腺,可见于腭部小涎腺、颌下腺及小涎腺;早期无特征性临床表现,晚期可侵犯周围组织及神经,可出现颈部淋巴结转移,远处转移少见,但血行转移率较高;生物学行为呈易复发、低度恶性,预后差的特点。     

涎腺导管癌临床病理分析

目的 :分析、探讨涎腺导管癌。方法 :本研究对 6例涎腺导管癌进行临床病理分析。结果 :其临床特点为 :主要发生于腮腺 ,次为颌下腺 ,好发于老年男性 ,生长迅速 ,病程较短 ,易发生淋巴结转移 ,血行转移率高 ,易侵犯神经 ,患者预后差。组织学特点为 :组织学表现与乳腺导管癌极为相似 ,并因此而得名。瘤细胞向导管内生长 ,形成乳头状、筛孔状、实性等多种结构 ,并可发生粉刺样坏死 ,瘤细胞也向导管外浸润生长 ,肿瘤向周围组织浸润生长是其显著特征。结论 :涎腺导管癌高度恶性 ,预后较差 ,治疗方法以局部彻底扩大切除 ,根治性颈清为主 ,术后辅以放疗和化疗。     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

拔牙位点保存用复合温敏凝胶的构建及体外表征

目的:制备多壁碳纳米管/羟基磷灰石/壳聚糖复合温敏凝胶,探讨其作为拔牙位点保存材料的理化性能。方法:采用原位沉积方法制备多壁碳纳米管/羟基磷灰石(MWNT/ HA简称HAC)复合无机材料,将其分散至壳聚糖温敏凝胶中,制备壳聚糖/多壁碳纳米管/羟基磷灰石(CS /MWNT/HA简称CS/HAC)复合温敏凝胶,以成胶时间、孔径、孔隙率、机械强度及降解性能为指标优化配方设计,并表征复合温敏凝胶的微观形貌及理化性能。结果:以10 g/L的HAC作为补强成分加入到壳聚糖溶液中,能够在不影响成胶并保证一定孔隙率(84%)的前提下,提高材料的机械性能(抗压强度0.441 MPa),所获复合温敏凝胶具有适宜的临床操作时间(12 min),并具有可控的降解速率。结论:负载HAC的复合温敏凝胶具有良好的成型性,并具有较好的机械性能,在拔牙位点保存领域具有良好的应用前景。     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.