Feasibility of endoscopic submandibular ganglion neurectomy for drooling

We performed endoscopic transoral neurectomy of the submandibular and sublingual glands to treat drooling. We bilaterally operated two adult cases with treatment‐resistant drooling. In these patients, conventional treatment had failed. Repeated botilinum toxin type A (BOTOX®, Abdi Ibrahim Pharmaceutical Company, Istanbul, Turkey) injections had been effective but were becoming less so. The patients benefited from surgery in that their saliva scores decreased. No issue emerged over 6 months of follow‐up. Endoscopic transoral neurectomy of the submandibular and sublingual glands reduces saliva production and allows management of drooling in treatment‐resistant patients. Laryngoscope , 127:1604–1607, 2017     

小鼠腹部照射后肾上腺皮质醇分泌含量变化及生物学效应

目的：探讨小鼠腹部照射后肾上腺皮质醇分泌含量和生物学效应的变化,为累及至肾上腺的腹部放射治疗的安全性提供参考依据。方法：将小鼠分为4组,每组小鼠各给一个剂量点照射,分别为0Gy,6Gy,9Gy和12Gy。运用放射免疫分析和组织化学法观察照射后第3d、7d、14d、30d小鼠血清皮质醇含量和肾上腺形态的变化。结果：小鼠腹部照射后血清皮质醇含量和肾上腺形态均发生变化,其表现为：照射后第3d皮质醇分泌增多,肾上腺髓质内毛细血管扩张充血;第7d皮质醇分泌较前下降,肾上腺皮质体积不同程度缩小;第14d出现皮质醇分泌下降到基础水平,肾上腺皮质球状带细胞的代偿性增生;第30d出现皮质醇分泌上升和肾上腺形态的恢复。结论：不同剂量腹部照射后皮质醇分泌量和肾上腺形态发生阶段性的适应性改变,这种改变可能为临床治疗肿瘤并同时保护肾上腺及其功能提供帮助。     

Novel phenotype of syndromic premature ovarian insufficiency associated with TP63 molecular defect

There is growing evidence that TP63 is associated with isolated as well as syndromic premature ovarian insufficiency (POI). We report two adolescent sisters diagnosed with undetectable ovaries, uterine hypoplasia, and mammary gland hypoplasia. A novel paternally inherited nonsense variant in TP63 [NM_003722.4 c.1927C > T,p.(Arg643*)] in exon 14 was identified by exome sequencing. One of the syndromes linked to TP63 is limb mammary syndrome (LMS), an autosomal dominant inherited disorder characterized by ectrodactyly, hypoplasia of mammary-gland and nipple, lacrimal duct stenosis, nail dysplasia, dental anomalies, cleft palate and/or cleft lip and absence of skin and hair defects. The TP63 variant segregated with symptoms of LMS in the family, however, no affected individual had limb defects. The phenotype reported here represents a novel syndromic phenotype associated with TP63. Reported cases with TP63 associated POI are reviewed.     

Role for protein kinase in Ca2+-dependent feedback modulation of divalent cation influx in internal-Ca2+-store-depleted rat parotid gland cells

 Divalent cation (Ca²⁺ and Mn²⁺) influx, stimulated by internal Ca²⁺ store depletion, into rat parotid acinar cells is inhibited by conditions which increase protein phosphorylation [T. Sakai and I.S. Ambudkar (1996) Am J Physiol 271:C284–C294]. The present study examines the involvement of this protein phosphorylation and Ca²⁺ in the store-dependent inactivation of divalent cation entry. Internal Ca²⁺ store depletion, achieved by incubation (30 min) of cells in nominally Ca²⁺-free medium containing either carbachol or thapsigargin, stimulated Ca²⁺, and Mn²⁺, influx into cells. In either case, inclusion of 1.5 mM Ca²⁺ for the last 5 min of incubation resulted in a decrease in Ca²⁺ (33–41%) and Mn²⁺ (50%) influx, which could not be accounted for by internal Ca²⁺ store refill. The inhibition was prevented when internal-store-depleted cells were treated (prior to incubation with Ca²⁺) with either staurosporine or K-252a, but not with H-7 or KN-93. Refilling of internal Ca²⁺ store(s) in carbachol-treated cells (incubation with Ca²⁺+atropine) induced complete inhibition of divalent cation influx, which was not prevented by treatment with protein kinase inhibitors. These data suggest the staurosporine-sensitive (and K-252a-sensitive) protein phosphorylation is not involved in Ca²⁺-store-refilling-dependent inactivation of Ca²⁺ influx but mediates a Ca²⁺-dependent feedback modulation of divalent cation influx in rat parotid gland acinar cells. Received: 24 July 1996 / Received after revision: 26 September 1996 / Accepted: 2 October 1996     

The congenital basal cell adenoma of salivary glands Contribution to the differential diagnosis of congenital salivary gland tumours

Congenital epithelial tumours of the salivary glands are very rare. The Salivary Gland Registry maintained in the Department of Pathology, University of Hamburg, contains only three cases among a total of 6,646 salivary gland tumours from the years 1965–1994. The three cases were classified as congenital basal cell adenoma, two of the parotid gland and one of the submandibular gland. Histologically, the three adenomas were similar in structure to the adult counterpart of basal cell adenoma with solid, trabecular or tubular (duct-like) patterns. In some cystic spaces of the duct-like structures PAS- and Astra blue-positive substances were secreted. On immunocytochemistry, the luminal duct-like cells showed membranous expression of cytokeratins 3, 5, 6, 7, 13 and 19. In the isomorphic basaloid cells of the solid and trabecular cell nests few cells expressed cytokeratin. On the outside of the solid cell nests there were smaller elongated myoepithelial-like cells, which expressed cytokeratin 14 and vimentin. Cytokeratins 1, 2, 4 and 18 were not expressed. The pattern of expression reflects the different stages of maturity of the tumour cells and is related to the development of the salivary glands until the end of the 3rd embryonal month with an arrest of further cell differentiation. No acinic cells, invasive growth, recurrence or metastases were observed. The differential diagnosis includes other congenital salivary gland tumours, such as hybrid basal cell adenoma-adenoid cystic carcinoma, sialoblastoma or embryoma, carcinoma, hamartoma and teratoma.     

Canine invasive lobular carcinoma of the mammary gland: morphological and immunohistochemical characterizations of three cases

Invasive lobular carcinoma (ILC) represents 15% of invasive human breast tumours. This report describes the morphological and immunohistochemical features of three canine mammary tumours comparable with human ILC. These tumours were composed of a non-delimited proliferation of discrete cells infiltrating fibrous connective tissue. Multifocal in-situ carcinoma associated with invasive lesions was present. Invasive tumour cells and in-situ lesions expressed cytokeratin and CK34betaE12, but not E-cadherin. Based on these morphological and immunohistochemical characteristics, the tumours were classified as canine ILC.     

Estrogen and Insulin Replacement Therapy Modulates the Expression of Insulin‐Like Growth Factor‐I Receptors in the Salivary Glands of Diabetic Mice

Diabetes mellitus results in various complications, also compromising the salivary glands. Hormone levels and interactions with cellular receptors are altered, intensifying the damage caused by this disease. Hormone replacement therapy alone or combined with other treatments may reverse this damage, but doubts still exist regarding the efficacy of this procedure. The objective of this study was to evaluate the effect of estrogen replacement therapy combined with insulin treatment on salivary secretory cells and on the expression of insulin‐like growth factor (IGF)‐I receptors in salivary glands of spontaneously diabetic (NOD) mice. Twenty‐five mice were divided into five groups of five animals each: group I (NOD diabetic), group II (NOD diabetic treated with insulin), group III (NOD diabetic treated with estrogen), group IV (NOD diabetic treated with insulin and estrogen), and group V (control Balb/c mice). Group II received insulin, group III received estrogen, and group IV received insulin plus estrogen administered daily for 20 days. Groups I and V received saline for the same period of time to simulate treatment. Glucose and estrogen levels were monitored during treatment, and salivary gland samples were collected at the end of treatment for stereological analysis and immunofluorescence detection of IGF‐I receptors. Tissue restructuring and regulation of IGF‐I receptors expression were observed in animals submitted to estrogen replacement therapy plus insulin. Estrogen effectively promoted the recovery of salivary secretory cells, demonstrating that this hormone alone, and especially when combined with insulin, might be important for the reversal of hyperglycemia‐induced tissue injury. Anat Rec, 2011. © 2011 Wiley‐Liss, Inc.     

An alternative method for preparation of tissue sections from the rat mammary gland

In toxicopathological studies of the rat mammary glands, the guidelines of the Registry of Industrial Toxicology and Animal Data (RITA) recommend transverse sections of the inguinal mammary gland. However, occasionally limited amounts of mammary gland tissue are found in transverse sections. We compared transverse sectioning with an alternative method comprising horizontal sections of the rat mammary glands. Normal cycling female Sprague Dawley rats were sacrificed in proestrous, estrous, metestrous and diestrous, and samples from all mammary glands were collected. Transverse sections were prepared from the left-sided glands, and horizontal sections were cut from the right-sided glands. Sections were stained with HE, and epithelial and myoepithelial cells were visualized by immunohistochemical staining of cytokeratin 18 and alpha smooth muscle actin, respectively. Area of the mammary fat pad, mammary epithelium and connective tissue were measured in randomly sampled vision fields from each section. Horizontal sections contained a significantly larger area of mammary fat pad as well as glandular and connective tissue. No differences in tissue densities of epithelial or myoepithelial cells or connective tissue were observed between transverse sections and horizontal sections. Interestingly, densities of epithelium and connective tissue varied between cranial and caudal glands as well as the phases of the estrous cycle. In conclusion, horizontal histological sections of the rat mammary gland provided significantly larger samples of mammary gland tissue with no difference in tissue composition compared to transverse sections, which are recommended in the RITA guidelines.     

Adrenal histoplasmosis: a diagnosis on fine needle aspiration cytology

Histoplasmosis is a fungal disease endemic in central and eastern states of United States, South America, Africa, and Asia. It may present as chronic pulmonary infection or in disseminated form of infection. The disseminated form of histoplasmosis frequently affects the adrenal gland and is more likely to affect immunocompromised patients as compared to immunocompetent individuals. There are very few cases of adrenal histoplasmosis diagnosed on fine needle aspiration cytology. In the present era when fine needle aspiration has become popular modality for diagnosis, adrenal fine needle aspiration is still a less commonly practiced technique. We report eight cases of adrenal histoplasmosis diagnosed on fine needle aspiration cytology in patients with bilateral adrenal masses. The present case series supports the role of fine needle aspiration cytology of adrenal gland infections where surgery can be prevented and a definitive diagnosis can be made on which treatment can be offered.     

Development of human minor salivary glands: expression of mucins according to stage of morphogenesis

The formation of salivary glands entails the proliferation of epithelial cells from the stomatodeum into the underlying ectomesenchyme, culminating in a complex network of ducts and acinar bulbs. The extent to which mucins regulate this process is unknown, but they appear to mediate luminal space formation and maturation. Our aim was to examine mucin expression patterns during the morphogenesis of human salivary glands. Mucin expression - MUC1, 2, 3, 4, 5AC, 5B, 6, and 16 - was analyzed in specimens of developing human salivary glands, obtained from fetuses at 4-24 weeks' gestation, and fully developed salivary glands by immunohistochemistry. Expression patterns were analyzed qualitatively according to the development stage of the salivary glands. Mucins 1, 3, 4, 5B, and 16 were expressed during salivary gland development - being stronger in all ductal segments by the final phases of branching morphogenesis and in mature glands. Acinar cells were negative for most mucins, including MUC1 in mature salivary glands. Mucins 2, 5AC, and 6 were not expressed. Mucins MUC1, 3, 4, 5B, and 16 are expressed in developing human salivary glands and in mature glands, suggesting important roles in the maturation and maintenance of the ductal network.