副腮腺肿瘤临床分析

目的　探讨副腮腺肿瘤的临床、影像、病理特点及治疗效果。方法　收集并分析我院经治的8例副腮腺肿瘤病例资料。结果　多形性腺瘤5例,基底细胞腺瘤、多 形性腺瘤恶变（高分化非特异性腺癌）、高分化鳞状细胞癌各1例。良性肿瘤病例的CT表现为肿块呈椭圆形、边界清楚、密度均匀;恶性肿瘤病例的CT表现为肿块形状不规则、境界不清、密度欠均匀。8例患者均行手术治疗,入路分别选择：1例面颊部直接切口,2例口内入路,5例标准腮腺肿瘤切除入路,鳞状细胞癌病例同时行选择性颈清扫术。2例恶性肿瘤患者术后辅以放疗。所有患者治疗后随访1～5年,无复发及转移。结论　副腮腺肿瘤CT表现具有一定的特征性,彻底切除是首选治疗,入路宜选用标准腮腺切除切口,恶性肿瘤术后辅以放疗,短期疗效较好。     

Malignant parotid gland tumors and facial nerve paralysis

Summary During the last three decades, 586 cases of parotid gland tumor have been extirpated in our clinic. The tumors were malignant in 170 cases and, of these, facial nerve paralysis was observed at first examination in 59 patients. This paper deals with the retrospective study of these cases and is chiefly concerned with the histological types and facial nerve paralysis.     

Cutaneous squamous cell carcinoma of the head and neck metastasizing to the parotid gland--a review of current recommendations

Cutaneous squamous cell carcinoma (SCC) of the head and neck may metastasize in up to 5% of patients, with the parotid lymph nodes the most frequent site for spread. Metastases frequently show delayed presentation after the primary cancer had been treated. The optimum treatment should be surgery followed by adjuvant radiotherapy, with an appropriate parotidectomy, and preservation of the facial nerve if not involved by tumor and treatment to the neck. In a clinically N0 neck, levels I to III should be cleared for facial primaries, levels II to III for anterior scalp and external ear primaries, and levels II to V for posterior scalp primaries. Approximate 5-year disease-specific survival (DSS) after treatment was 70% to 75%. Patients with immunosuppression, in particular transplant recipients, are at high risk of developing aggressive metastatic cutaneous SCC. Modifications of the staging systems have demonstrated the prognostic benefits of accurately staging parotid and/or neck nodal disease.     

Increased release of tissue plasminogen activator and its inhibitor in human parotid saliva upon stimulation

Parotid saliva from 12 healthy volunteers was collected prior to and after 5 and 25 min of stimulation at a constant flow rate of 0.25 or 1.0 ml min^-1. In the salivary samples the concentrations of tPA (tissue-type plasminogen activator), PAI-1 (plasminogen activator inhibitor type-1), albumin and total protein were determined and the activity of amylase, tPA and PAI assessed. Presence of both tPA and PAI-1 antigen was demonstrated in all samples, and in unstimulated saliva the ratio between the activator and its inhibitor was 1:7. Upon stimulation we found a significantly increased concentration of PAI-1, a less pronounced increase in tPA concentration, unchanged amylase and total protein levels and significantly decreased albumin concentration. tPA activity was significantly reduced after prolonged stimulation which had no effect on PAI activity. In stimulated saliva a significant positive correlation between concentration of tPA and PAI-1 was demonstrated. Stimulation with citric acid had no effect on output of albumin which is passively filtered from blood, whereas the increase in flow rate corresponded to the significantly increased secretion rate of total protein and amylase which is secreted by gland cells. The secretion pattern of tPA and PAI-1 differed significantly from that of albumin in showing markedly increased output rate during the stimulation period, and the relative increase in output of PAI-1 was significantly higher than that of amylase and total protein. Thus, the results from this study suggest an active release of both tPA and its main inhibitor PAI-1 into saliva.     

A therapeutic concept for the combined orthodontic surgical correction of angle Class II deformities with short‐face syndrome: Surgical lengthening of the lower face

In today's society not only facial esthetics have become important, but also the information on ways to correct adult orthodontic problems is readily available. Subsequently, increasing number of adults seek orthodontic treatment merely to change their facial appearance. In general, these adult patients exhibit such a severe skeletal deformity that it is noticeable even by non‐experts. The nature of these adult deformities is such that the only promising treatment is the combined orthodontic‐surgical approach. A stable and functional occlusion with a physiologic position for the condyle is the common goal of orthodontic treatment. In patients with skeletal deformities, however, improvement of facial esthetics takes paramount importance. They judge the success of treatment by extraoral appearance. Accordingly, the clinician must assess both the dental and facial appearance, and then inform the patient of different treatment possibilities. In this scenario, patient's input into the decision making process is critical for a mutually satisfactory result. This clinical report describes a concept of systematic approach to treatment of Class II deformities with skeletal deep bite and short lower face (short‐face syndrome). This approach emphasizes the soft tissue analysis.     

THE DIFFERENTIAL CONDITIONABILITY OF TWO COMPONENTS OF THE SKIN CONDUCTANCE RESPONSE

The dual effector basis of the skin conductance response (SCR) was investigated in an experiment in which responses from both the dorsal and palmar surfaces of the hand were classically conditioned using a delayed, discrimination conditioning paradigm. Orienting (OR), anticipatory (AR) and unconditional responses (UCR) were distinguished on the basis of latency. Both the anticipatory response and the response which occurred when the unconditional stimulus (UCS) was omitted (CR) were conditional. The magnitude of the response from the dorsal and palmar placements was similar for the ORs, UCRs, and CRs, but the palmar ARs were significantly greater than the dorsal. A conditioning index which took into account the magnitude of the UCR, revealed that the palmar AR differentiated between reinforced and non-reinforced conditional stimuli to a greater degree than the dorsal response. These results are consistent with the hypothesis that the epidermal component of the SCR, reflected in measurements from the dorsum of the hand, accompanies the alerting or orienting response of the organism, whereas the sweat gland component of the SCR, represented largely in measurements from palmar sites, is primarily associated with a defensive, anxiety-like response.     

Chlamydia trachomatis in Andrologic Patients – Direct and Indirect Detection

Background: Chlamydia trachomatis is considered to be the most common sexually transmitted disease in Germany. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands with consequences for male infertility. Patients and Methods: Within the framework of several prospective studies the association between sperm quality, male accessory gland function and infection with C. trachomatis was investigated in men of couples with unexplained infertility. Chlamydial infection was determined by serologic methods and by proof of Chlamydia-specific DNA. As a marker of infection the direct determination of granulocytes in the ejaculate or the measurement of the polymorphonuclear (PMN) elastase concentration was used. The male accessory gland function was evaluated using the markers fructose, citric acid and α-glucosidase in the seminal plasma. Results: Chlamydia-specific DNA in the ejaculate was present in between 3–5% of the subjects, which corresponds to it s prevalence in the normal population. Chlamydia IgA antibodies were demonstrated with a frequency of 38% in seminal plasma (n = 834) using a genus-specific test (rELISA). Using other species-specific tests (MIF, SeroCT, IgA pELISA and ImmunoComb), Chlamydia IgA antibodies were found at frequencies of between 8 and 22%. Conclusion: Only in a few individual cases was it possible to show a connection between reduced sperm quality, disturbed male accessory gland function and indication of infection with Chlamydia, bacteria or Ureaplasma. Received: May 23, 2000 · Revision accepted: December 20, 2000     

原发性醛固酮增多症的手术治疗

目的探讨原发性醛固酮增多症（PA）的手术适应证及疗效。方法分析26例不同类型PA的临床特点,18例行手术治疗,对手术病例的选取原则、手术方式及疗效进行评价。结果随访手术病例18例,随访期间2例APA和1例IHA仍有低血钾,其余15例（83.3%）血钾恢复正常。手术后不需再用降压药物12例,治愈率66.7%;血压明显改善者5例,缓解率27.8%;手术无效、血压未改善者1例（5.5%）。随访病例中,开放手术13例,腹腔镜手术5例,两组总有效率差异无显著意义。结论对过度分泌醛固酮的单侧肾上腺结节性病灶,均应手术切除;单个腺瘤型APA可行部分肾上腺切除;多发性APA或肾上腺增生应行肾上腺全切除。腹腔镜手术正成为治疗PA的新方法。     

Presence of a metallothionein-like protein in the bovine pineal gland

Summary The high concentration of zinc in the bovine pineal gland prompted us to investigate the existence of a zinc-binding protein in this organ. In this study, we report that the subcellular distribution of zinc in the bovine pineal gland is nonuniform, with the crude nuclear, mitochondrial, microsomal, and supernatant fractions having 0.264±0.038, 0.160±0.019, 0.130±0.016, and 0.287±0.010 g zinc/mg protein, respectively. Furthermore, gel filtration studies using Sephadex G-75 and a 105,000 g supernatant fraction revealed two zinc binding protein peaks that bind 1.7 and 3.7 g Zn⁺⁺/mg protein, respectively. Furthermore, purification of the protein peak with an elution volume (ve/vo) of 2.06 on anion exchange chromatography (DEAE-A 25) yielded a single protein peak which binds 10 g zinc/mg protein. The comparative high performance liquid Chromatographic (HPLC) profiles of the zinc-induced hepatic metallothionein isoform I (retention time=17.39 min) and of the bovine pineal metallothionein-like protein isoform I (retention time=17.49 min) are similar. Since zinc is a potent inhibitor of sulfhydryl-containing enzymes and receptor sites, we investigated the effects of zinc and found that it inhibited the binding of [³H]glutamate (IC 50=80 M) and of [³H]spiroperidol (IC 50=0.6 mM) to the pineal membranes. The results of these studies are interpreted to indicate that the bovine pineal gland possesses an active and dynamic zinc homeostatic mechanism, whose precise function(s) remain(s) to be delineated.     

A retrospective study of parotid gland tumors at a single institution

The aim of the present study was to analyze the clinical characteristics, surgical treatments and clinical outcome of patients with parotid gland tumors and to compare the results with those cited in the literature. A retrospective study was conducted in 140 patients (male, n=77; female, n=63) with parotid gland tumors who underwent parotidectomy at Hokuto Hospital Department of Otolaryngology-Head and Neck Surgery (Obihiro, Japan) between April 2007 and December 2021. Of the 140 patients enrolled, 118 (84.3%) patients had benign tumors, including 63 (45%) patients with pleomorphic adenomas and 43 (30.7%) patients with Warthin tumors, and 22 patients (15.7%) had parotid carcinoma. Comparison of the three groups of patients with parotid gland tumors indicated that pack years as an indicator of smoking status were significantly higher in patients with Warthin tumors than in those with parotid carcinomas (P=0.011) or pleomorphic adenoma (P<0.001). Fine-needle aspiration cytology (FNAC) was non-diagnostic for only 6 (4.3%) of 140 patients. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC by both conventional smear and liquid-based cytology (LBC) for parotid carcinomas were 70, 99, 93.3, 94.4 and 82.9%, respectively. Among the 22 patients with parotid carcinoma, extended total/total and superficial parotidectomy were performed in 10 (45%) and 11 (50%) cases, respectively. Total and selective neck dissection of the area from level II to I, II and III were performed in 6 (24%) and 7 (32%) patients, respectively. Postoperative radiotherapy (50 Gy) was performed in 15 (68%) patients. The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 51.5 and 76.4%, respectively. Univariate analysis revealed that age >65 years was significantly associated with poorer 5-year OS (P<0.001) and DFS (P<0.001). Multivariate analysis revealed that an age of more than 65 years combined with high-grade histologic malignancy was associated with worse DFS (P=0.02; hazard ratio, 3.628; 95% confidence interval, 1.283-9.514). In conclusion, the clinical characteristics and treatment outcomes of parotid gland tumors were consistent with the results of previous reports. Smoking may be closely related to the pathogenesis of Warthin tumors. LBC potentially provides improved accuracy in FNAC.