A case of an adenoid cystic carcinoma of the minor salivary glands of then nasal cavity is reported. The tumour had spread locally and by perineural spread to the internal auditory mentus, causing facial nerve palsy.
The clinical applications of salivary cortisol measurements were evaluated by radioimmunoassay of time-matched saliva and plasma samples. Salivary cortisol levels of normal subjects exhibited a significant (p less than 0.001) diurnal variation with a mean (+/- SD) concentration of 8.7 +/- 4.8 nmol/L at 0800-1000 h and 2.4 +/- 1.1 nmol/l at 1500-1700 h. After an overnight dexamethasone suppression test, morning salivary cortisol levels decrease to 2.7 +/- 0.7 nmol/L (p less than 0.001 vs normal). An excellent correlation (r = 0.805) of cortisol measurements with time-matched saliva and plasma samples was obtained (y = 0.03x + 0.88, p less than 0.001, n = 91). Hypercortisolism was confirmed by raised salivary cortisols in only half of patients with elevated total plasma levels, thereby indicating that salivary cortisol measurements is a better index of adrenal status.
Twelve pleomorphic adenomas of minor salivary gland origin were examined for the distribution of S-100 protein, detected using the peroxidase-antiperoxidase (PAP) method. Strong S-100 protein immunoreactivity was noted in areas containing plasmacytoid cells, stellate and spindle cells against a myxochondroid or hyalinous stroma, and solid epithelial areas. Tubular and duct-like structures showed variable stainability. Stromal tissue and normal salivary glands were generally negative for S-100 protein. These findings were compared with those reported elsewhere.
The case of a minor salivary gland tumour, arising from the tongue, with nodal metastasis is presented. Biopsy of the tumour and fine-needle aspiration cytology of the neck swelling showed the presence of a clear cell carcinoma with evidence of nodal metastases. A commando operation was performed and the defect was reconstructed using a local tongue flap. The literature review indicated that the neoplasm was rare and its site of occurrence rather unusual.
The prevalence and cellular distribution of human herpesvirus 7 (HHV-7) in archival labial salivary glands was analysed for virus-specific DNA sequences by polymerase chain reaction (PCR) and in situ hybridization signals. In addition, the cellular expression of HHV-7-encoded protein was detected by immunohistochemical staining with a virus-specific monoclonal antibody. Eleven of 20 samples were positive for the HHV-7 DNA sequence by PCR. Eighteen of 20 tissues analysed by in situ hybridization showed signals in ductal, serous and mucous cells. Some nuclei of these cells and also the myoepithelial population were positive. In immunolocalization studies, all 20 salivary glands consistently showed HHV-7-expressed protein in the cytoplasm of ductal cuboidal and columnar cells. The protein was also found in the cytoplasm of mucous and serous acinar cells that were immunopositive for HHV-7. The observations are consistent with the suggestion that the labial salivary gland is a site for virus replication, potential persistence and a source of infective HHV-7 in saliva.
Human saliva contains a large number of proteins which can be separated using polyacrylamide gel electrophoresis (PAGE). In this study the protein profiles of whole saliva of diabetic and non-diabetic were compared. Considerable variations between individuals in the protein profiles were observed. The saliva from diabetic patients appeared to have more of proline-rich protein bands in the molecular weight region below 56 KOa. Further investigations using individual gland saliva should be carried out.
141 salivary gland lesions that were subjected to fine needle aspiration (FNA) cytology at the University Hospital, Kuala Lumpur, from January 1993 to October 2000 were reviewed with a view to assess the sensitivity and utility of cytological diagnosis in diseases of salivary glands. The highest number of cases was seen in the sixth decade of life. There was no gender preponderance in salivary gland neoplasms except in Warthin's tumours that occurred predominantly in males. The parotid gland was the most frequent salivary gland needled. Seven cases (5%) presented with bilateral salivary gland enlargement. Cytological study yielded a neoplastic diagnosis in 74.5% cases. Of the neoplastic lesions, 71.4% could be definitely designated as benign and 25.7% as clearly malignant. Pleomorphic adenoma and acinic cell carcinoma were the most common benign and malignant neoplasms diagnosed respectively. 53 cases had histological correlation; of these, 49 (92.5%) were neoplastic. The overall diagnostic accuracy of FNA cytological diagnosis in salivary gland lesions was found to be 73.6%.
Hyalinizing clear cell carcinoma is a low-grade neoplasm of the minor salivary gland composed exclusively of epithelial cells and not myoepithelial cells. It predominantly affects the oral cavity of adult females. It is microscopically characterized by hyalinizing stroma and clear cells, which are typically positive for cytokeratin markers and negative for S 100 and smooth muscle actin (SMA). Cystic degeneration can also be present. Pathologists should be aware of this new entity so as not to misdiagnose otherwise. To our knowledge, this is the first case report of its kind from Malaysia.
The aim was to examine the protein profiles of whole and parotid saliva using Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) and MALDI-TOF mass spectrometry. The banding patterns of proteins exhibited by the unstimulated whole saliva samples on the gel remained quite constant but the intensity of the protein bands were slightly different from one sample to another. Comparison of the protein profiles of unstimulated whole saliva and stimulated parotid saliva showed almost similar banding pattern. The exception is the presence of a pink protein band in the 65-67 kD region in the stimulated parotid saliva samples which was also observed in the unstimulated whole saliva sample contributed by a cerebral palsy patient. Analysis of the saliva samples using MALDI-TOF mass spectrometry also revealed that the stimulated parotid saliva samples exhibited some peaks that were in the same region as those for the unstimulated whole saliva sample of the cerebral palsy subject. This may imply that there is ineffective control of the parotid secretion in cerebral palsy subject under unstimulated condition. The SDS-PAGE and MALDI-TOF analyses may provide more information on the profiles of the salivary proteins which could be beneficial in the diagnosis of salivary gland dysfunction.
Cytomegalovirus (CMV) congenital infection is the major viral cause of well-documented birth defects in human. Because CMV is species-specific, the main obstacle to developing animal models for congenital infection is the difference in placental architecture, which preludes virus transmission across the placenta. The rat placenta, resembling histologically to that of human, could therefore facilitate the study of CMV congenital infection in human.
The present study described the kinetics of Rat cytomegalovirus (RCMV) infection in newborn rats by monitoring infectious virus and viral antigens in various organs, viral DNA in the blood (DNAemia) and antibody response. These parameters were evaluated quantitatively using double-antibody sandwich ELISA (DAS-ELISA), real-time PCR, indirect ELISA and virus infectivity assay. For the first time DAS-ELISA was used for detection of RCMV antigen directly from organ samples. The relationships between the presence of viral antigens in the infected organs and antibody levels were established by the Spearman's rank test. It was found that the virus was present in the blood, spleen, liver, lungs, and kidneys earlier than in the salivary glands. Furthermore, the early immunity of the newborn rats led to a delayed seroconversion. We suggested that the prolonged presence of the virus in salivary glands could augment the antibody response that conversely might be responsible for a reduction of viremia. This study expanded our understanding of RCMV pathogenesis leading to improved therapeutic and preventive treatment regimens particularly for the neonatal Human cytomegalovirus (HCMV) infections. Additionally, the detection procedures developed in this study such as DAS-ELISA and real-time PCR could serve as alternative techniques for rapid screening of large number of samples.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
A review of incident oral and maxillofacial biopsies in Kelantan from January 1994 to December 1998 was carried out to evaluate the scope of pathological lesions managed by the two main oral and maxillofacial units in this state. A total of 357 biopsy reports from incident cases of pathological lesions were reviewed. The biopsies were mainly from intra-oral sites (n=326, 91.3%). Females had more frequent oro-facial lesions compared with males (male:female ratio is 0.8:1). The Bumiputera ethnic group had the most number of biopsies (n=321; 90%). The three most commonly observed histopathological groups were the connective tissue hyperplasia (n=90; 25.2%), epithelial dysplasia and neoplasia (n=68; 19%) and salivary gland cysts/mucocele (n=56; 15.7%). The top five most frequent diagnoses were mucocele (n=56; 15.7%), squamous cell carcinoma (n=45; 12.6%), epulides (n=31; 8.7%), pyogenic granuloma (n=25; 7.0%) and fibroepithelial polyp (n=19; 5.3%). Oro-facial malignancies made up almost one-fifth of all diagnoses and squamous cell carcinoma was the most common sub-type. Lymphomas in the oro-facial region (n=8; 11.4%) were more common than basal cell carcinoma (n=7; 10%) and salivary gland malignancies (n=6; 8.5%). Epithelial jaw cysts consisted of 8.7% (n=31) of all diagnoses, where inflammatory types were more common than the developmental types. Odontogenic tumours consisted of 5.6% (n=20) of all diagnoses and ameloblastoma was the predominant type.
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
In this study, the effect of beverages (Coke TM, Sprite™, Ribena™, Chrysanthemum tea and mineral water) on the demineralisation of the enamel surface was investigated. Demineralisation was determined by the rate of calcium released from the enamel surface on exposure to the beverages. Calcium was determined using the EDTA titration method. The pH of these beverages was measured using a pH meter and found to be in the acidic range (2.43 to 5.79) while mineral water which served as a control has a pH of 7.00. Ii was found that the rate of calcium released from Coke™(0.76 J..lg/min) showed a significant mean difference from Sprite™ (0.38 J..lg/min), Chrysanthemum tea (0.10 J..lg/min) and mineral water (0.00 J..lg/min)at p< .05, but was however not significantly different from Ribena™. Likewise, Chrysanthemum tea and mineral water also showed statistically no significant mean difference in the released of calcium during the study period. The results obtained in this study indicated that beverages with low pH may pose detrimental effect on the enamel surface which could have clinical implication, especially in people with salivary gland dysfunction or low salivary flow.
Radiotherapy is an important treatment modality for head and neck tumours. One of its major drawbacks is post-treatment salivary gland hypofunction. This study was performed to objectively evaluate the salivary gland function in post-irradiated head and neck tumour patients.
Adenoid cystic carcinoma (ACC) is a rare malignant tumor that arises within secretary glands, most commonly the major and minor salivary glands. It has a tendency for a prolonged clinical course, perineural invasion, with local recurrences and distant metastases. The three recognized histopathologic pattern of ACC are cribriform, tubular, and solid with the cribriform being most common. Standard treatment for salivary gland ACC is surgery and postoperative radiotherapy. We report a case of ACC of palate in a 30-year-old female and review the literature.
Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204.