The myoepithelium of human major salivary glands revisited

BACKGROUND: Laminotomy as described by Réthi has proved useful in the treatment of laryngotracheal stenoses. Using this technique in children poses the question as to whether it interferes with the growth of the larynx and trachea. The aim of our study was to verify the influence of this operative procedure on the structure and function of the restored airway. PATIENTS: Fifteen children between the ages of 2 and 16 with severe laryngotracheal stenoses (Cotton Grade III and IV) underwent reconstruction with interposition of a piece of costal cartilage in the posterior cricoid plate. Indications for this procedure included the presence of severe circumferential subglottic stenosis in combination with stenosis of the posterior glottis (8 children) and complete atresia (4 children). RESULTS: In endoscopic follow-up examinations (2-12 years follow-up), complete epithelization with light stenosis in the subglottis was demonstrated in all cases. Airway ventilation tests showed a slight or moderate central obstruction in nearly all cases. No disturbance of growth of the larynx was noted. CONCLUSIONS: This technique is a safe and successful method for repairing severe subglottic stenoses in children. Although there are some structural and functional problems during the long term follow-up, this is not considered a significant disadvantage.     

Ultrasonographic biometry in salivary glands

Specifications about the size of healthy salivary glands are not available to date. Therefore, we determined the size of the submandibular and the parotid glands by ultrasonography in 50 subjects (25 men, 25 women, mean age 45 y, range 20-68) with no history of disease affecting the salivary glands. The subjects were equally distributed concerning gender and age. Body weight did not differ more than 20% from the ideal weight following Broca's formula (mean body weight 71 kg, range 46-95 kg). In the submandibular glands we found an anterior-posterior length of 35 mm +/- 5.7 mm, a paramandibular dimension to the depth of 14.3 mm +/- 2.9 mm and a dimension in frontal scanning of 33.7 mm +/- 5.4 mm. The parotid glands were measured 46.3 mm +/- 7.7 mm in the axis parallel to the mandibular ramus and 37.4 mm +/- 5.6 mm in the transversel axis. The dimension of the parotid parenchyma was measured with 7.4 mm +/- 1.7 mm lateral to the mandible and 22.8 mm +/- 3.6 mm dorsal to the mandible. No statistically significant difference to the 5%-level was found concerning gender. The dimension of the parotid glands correlated statistically significantly with body weight (p = 0.03). This correlation was not found in the dimension of the submandibular glands. Age did not correlate with the dimension of salivary glands. Results of the submandibular glands were compared with volume measurements of submandibular glands from cadavers.     

Immunohistochemical localization of transforming growth factor alpha in the major salivary glands of male and female rats

The three major salivary glands of normal male and female Fischer 344 rats of different ages were examined for the localization of epidermal growth factor (EGF) and transforming growth factor alpha (TGF alpha) by immunohistochemical staining. EGF was demonstrated only in the granulated convoluted tubule (GCT) cells of the submandibular gland, the results confirming the previous reports, and most abundantly in adult males and pregnant females. TGF alpha stain was localized in all three glands and was found throughout the entire duct system, excluding acinar cells. The myoepithelial cells of the sublingual gland were also reactive with the TGF alpha antibody. The specificity of the staining was confirmed by negative staining reaction with the absorbed antibody and by radio-immunoassay and Western blot methods. This is the first report describing the presence of TGF alpha in the rat salivary glands.     

Immunohistochemical study of inflammatory infiltrates in minor salivary glands in Sj?gren's syndrome and other autoimmune diseases

BACKGROUND: A study of the phenotype, activation and adhesive cells factors and cytokines in minor salivary glands in patients with primary Sj?gren's syndrome (pSS), secondary Sj?gren's syndrome (sSS) and autoimmune diseases (AD) without Sj?gren's syndrome. PATIENTS AND METHODS: We have studied the minor salivary glands in 30 patients with pSS, 30 patients with sSS, 19 patients with AD without SS and 18 controls, using immunohistochemical techniques to analyze the molecular expression of CD3, CD4, CD8, CD20, CD25, CD14, CD56, CD11a, CDw50 (ICAM-3), HLA-DR, IL-1, TNF-alpha and IFN-gamma in lymphocytic infiltration and epithelial cells. RESULTS: Phenotype features were similar in patients with pSS and sSS, except that CD20+ lymphocyte expression was significantly higher in the sSS group (p = 0.023). The patients affected by AD without SS had activated lymphocytes in minor salivary glands in a similar manner to patients affected by pSS and sSS. No significant differences were found in HLA-DR expression in epithelial cells. We found unusual CD25 expression in epithelial cells in patients with SS but not in patients with AD without SS. The differences between pSS and sSS are related to SS theoretical time development and to immunosuppressive treatments. CONCLUSIONS: The immunohistochemical pattern of minor salivary glands is similar in patients with pSS and sSS. Patients with AD are likely to develop immunological changes in minor salivary glands attributable to activated lymphocytes.     

Imaging of the salivary glands

The most common conditions affecting the salivary glands are calculi, inflammation and tumours. Plain radiography may be useful, especially in showing calculi. Sialography is the examination of choice for inflammatory diseases, whereas ultrasonography, computed tomography and magnetic resonance imaging are particularly useful in evaluating masses in the salivary glands. Radionuclide studies are sometimes helpful in evaluating inflammatory or tumoral diseases. Each technique has its place, and the methods are often complementary. In this review article the authors present the techniques that they use in evaluating diseases of the salivary glands.     

Cellular localization of kallistatin and tissue kallikrein in human pancreas and salivary glands

We studied the effects of the new antioxidant drug U-83836E during splanchnic artery occlusion (SAO) shock in the rat. Serum tumor necrosis factor (TNF-alpha), white blood cell (WBC) count, mean arterial blood pressure (MAP), survival rate and the responsiveness to acetylcholine of aortic rings were investigated. SAO shock produced a marked increase in serum TNF-alpha (241.4 +/- 18.2 U/ml vs Not Detectable in basal), reduced MAP (51.4 +/- 4 mmHg vs 85.1 +/- 5 mmHg), survival time (80 +/- 10 min vs > 240 min), WBC count (2.8 +/- 0.4 x 10(3)/mm3 cells vs 11.7 +/- 0.9 x 10(3)/mm3 cells) and blunted the responsiveness to ACh of aortic rings (60 +/- 3% tension vs 23 +/- 4% tension). The analogue of vitamin E, U-84836E, administered at onset of reperfusion, lowered serum TNF-alpha (38.4 +/- 6.5 U/ml; p < 0.001), improved MAP (67.5 +/- 3.8 mmHg; p < 0.001), WBC count (8.9 +/- 0.6 x 10(3)/mm3; p < 0.001), and survival time (235 +/- 15 min; p < 0.001), and restored the responsiveness to ACh of aortic rings (32 +/- 3.7% tension; p < 0.001). These preliminary data suggest that this new compound could be a promising drug in shock therapy.     

Immunohistochemical localization of somatostatin receptors sst2A in human tumors

Human tumors frequently express somatostatin receptors. However, none of the receptor subtype proteins have been individually visualized in normal or neoplastic human tissues. Here, the distribution of the sst2A receptor was investigated using immunohistochemistry with the specific anti-peptide antibody R2-88 in 47 human tumors. All tumors selected for their abundance of sst2 mRNA and/or strong binding of the sst2-preferring ligand 125I-labeled Tyr3-octreotide were specifically immunostained with R2-88. Conversely, all tumors without somatostatin binding or expressing predominantly other somatostatin receptor subtype mRNAs (sst1 or sst3) were not specifically immunostained by R2-88. Specificity was shown in immunoblots, demonstrating receptor migration as a 70-kd broad band. In immunohistochemical and immunoblotting experiments, the abolition of staining after antibody blockade with antigen peptide was demonstrated. Immunostaining was identified in cryostat and in formalin-fixed, paraffin-embedded sections. Heat-induced epitope retrieval was necessary to visualize sst2A receptors in formalin-fixed sections. Moreover, because of occasional high nonspecific staining, the demonstration of complete abolition of immunostaining by treatment with antigen peptide was a prerequisite for the correct identification of sst2A-positive tumors. The sst2A receptors were clearly located at the membrane of the tumor cells. These results provide the first localization of a somatostatin receptor subtype in human tissues at the cellular level. The sst2A receptor identification and visualization in tumors with simple immunohistochemical methods in formalin-fixed, paraffin-embedded material will open new diagnostic opportunities for pathologists.     

Immunohistochemical localization of S100A1 and S100A6 in postnatally developing salivary glands of rats

S100 proteins are calcium-binding proteins of the EF-hand superfamily and are involved in the regulation of a number of cellular processes. The present study deals with the immunohistochemical expression of S100A1 and S10100A6 in the rat submandibular and sublingual glands during postnatal development from day 0 to 12 weeks. Expression of S100A1 was particularly concentrated in pillar and transition cells in the granular convoluted tubule (GCT) and in striated duct cells of the submandibular gland age 4 weeks to maturity. None or only weak staining for S100A1 was observed in the duct segment at 0-5 days. On the contrary, immunostaining of S100A6 was present in proacinar cells in undifferentiated submandibular gland at age 3 days to 2 weeks. S100A6 immunoreactivity in rat submandibular gland coexisted with chromogranin reactivity. It is possible that S100A6 regulates secretion of chromogranin in proacinar cells. Secretion of growth factors and biologically active peptides in the GCT are regulated by calcium signals, and S100A1 may be involved in the secretory mechanism of granular cells. S100A1 and S100A6 are potentially of great importance in secretory functions of granular cells and proacinar cells, as well as in rat salivary glands.     

Expression of androgen receptors in astrocytoma

This study determines ash, K, Ca, Na, Mg, Fe, Cu, Pb, and Zn content in musts and wines of the DOC Tacoronte-Acentejo (Tenerife, Canary Islands) from two consecutive harvests. Samples were treated with HNO3 and H2O2. Na and K were determined by flame photometry and the remaining metals by air/acetilene flame atomic absorption spectrophotometry. Significant differences were observed in Na, Ca and Mg contents between both harvests, possibly due to climate conditions.     

Intraoral cancer of the minor salivary glands

The growth of the basal unit of the mandible was studied by plotting the position, relative to the median plane, of the oval, mandibular and mental foramina in immature and adult skulls of Man, chimpanzee and gorilla. In Man, the basal unit was found to grow out along a constant logarithmic spiral. In the apes, the basal unit grew along a constant logarithmic spiral, the amount of unfolding being greater in the gorilla than in the chimpanzee. It is argued that the mode of growth seen in the apes evolved, as these forms became more prognathous, because it requires less compensatory rotation of the mandible, while the mode seen in Man is probably closer to that which occurred in common ancestral form.     

Papillary tumours of the minor salivary glands

The clinical and histological features of oncocytic adenomatous hyperplasia, papillary adenoma, and papillary adenocarcinoma of the oral cavity are described, and the literature is reviewed. Histological features which may be of value in distinguishing between benign and malignant variants are described, and in view of the slow growth rate of most of these tumours, the importance of long-term follow-up is stressed.     

Papillary cystadenoma of the minor salivary glands

Papillary cystadenoma of the minor salivary glands is a rare benign tumor that clinically resembles a mucous cyst. We demonstrate its histologic features and differential diagnosis by a case report. Benign and malignant neoplasms of the minor salivary glands are not well acknowledged in the dermatologic literature, but should be considered in the differential diagnosis for mucous cysts.     

Ultrastructural localization of microliths in salivary glands of cat

Although microliths occur in normal human salivary glands and may be an aetiological factor of sialadenitis, little is known of their natural history. In an attempt to remedy this, we investigated a large archival collection of normal and experimental feline parotid, submandibular and sublingual salivary glands. In submandibular and sublingual glands, microliths were detected ultrastructurally in: all types of acinar secretory cells; myoepithelial cells; ductal cells; lumina; intercellular spaces; basement membrane; stroma; macrophages; multinuclear giant cells; and neutrophils. Microliths were not detected ultrastructurally in parotid glands. Microliths appear to form in acinar cells during autophagy and in stagnant secretory material in lumina. Microliths appear to be removed by secretion in the saliva, discharge from cells laterally and basally, and engulfment by macrophages. There appears to be a turnover of microliths, which possibly is upset by secretory inactivity with a resulting accumulation that leads to localized obstruction and sialadenitis.     

Immunohistochemical demonstration of myoepithelial cells in sweat gland carcinomas

Although myoepithelial cells are detectable in many benign sweat gland tumours, little is known about their role in sweat gland carcinomas. To specifically demonstrate myoepithelial cells, paraffin sections from 46 sweat gland carcinomas were stained, using a standard avidin-biotin-peroxidase complex method, with the monoclonal alpha-smooth muscle actin antibody 1A4. Myoepithelial cells were not found in adenoid cystic eccrine carcinoma (n = 2), malignant nodular hidradenoma (n = 2), porocarcinoma (n = 4), extramammary Paget's disease (n = 12), sclerosing sweat duct carcinoma (n = 4) or in adenosquamous-mucoepidermoid carcinoma (n = 1). In contrast, myoepithelial cells were demonstrated in two of eight apocrine adenocarcinomas, one of six mucinous eccrine carcinomas and two of seven eccrine adenocarcinomas. In all these tumours myoepithelial differentiation was found in peripheral cells of solid tumour islands, or in basal cells of tubular structures. However, in most areas of the tumours, myoepithelial layers were discontinuous. Cells in the centre of solid tumour nodules, and luminal cells of tubular structures, were negative for alpha-smooth muscle actin. In analogy to breast tumours, in which malignancy and invasiveness correlate with scattered or absent myoepithelial cells, we suggest that disrupted myoepithelial layers in sweat gland carcinomas may be interpreted as a loss of the invasion barrier.     

Localization of androgen receptors in mouse thymus

Androgen receptors were found both in cytosol prepared from intact thymuses of the adult castrated B10. A male and in cytosol from thymuses of the castrated males that had been previously given whole-body irradiation with 6.0 Gy (60Co). Histologically, these thymuses were represented by the reticuloepithelial component, no lymphocytes were found in the cortex and small numbers of lymphocytes remained in the medulla. The 3H-dihydrotestosterone-receptor complex sedimented in the 4S region, as revealed by the 5-20% sucrose gradient centrifugation in buffer containing 0.4 M KC1. Free androgen and non-specifically bound androgen were removed by specific antibody coupled to CNBr-activated Sepharose-4B.     

Management of malignant tumors of the salivary glands

Results of treatment for patients with salivary gland carcinoma have improved in recent years, most likely due to earlier diagnosis and the use of more effective locoregional therapy. Salivary gland tumors are treated surgically, often in conjunction with postoperative radiation therapy when the tumor is malignant. Good results rest strongly on the performance of an adequate, en bloc initial resection. Radical neck dissection in indicated in patients with obvious cervical metastasis, and limited neck dissection may be appropriate in patients with clinically negative nodes in whom occult nodal involvement is likely. Postoperative radiation therapy should be administered when the tumor is high stage or high grade, the adequacy of the resection is in question, or the tumor has ominous pathologic features. Neutron beam therapy shows promise in controlling locoregional disease but requires further study. No single chemotherapeutic agent or combination regimen has produced consistent results. At present, chemotherapy is clearly indicated only for palliation in symptomatic patients with recurrent and/or unresectable cancers. Patients with salivary gland carcinomas must be followed for long periods, as recurrence may occur a decade or more following therapy. Distant metastasis appears to occur in approximately 20% of patients.     

Immunohistochemical localization of glucose transporters and insulin receptors in human fetal membranes at term

The localization has been investigated of the isoforms GLUT1, GLUT3 and GLUT4 of glucose transporter proteins as well as of insulin receptors. Fetal membranes (n = 10) were examined by immunohistochemical methods at the light and electron microscopic levels using mono- and polyclonal antibodies. In all amnion epithelial cells, GLUT1 and GLUT3 antibodies were bound to the apical membrane. Very rarely the GLUT1 antibody also immunostained the basolateral membrane and reacted weakly with the endomembrane system and membranes of the lateral cell protrusions. Fibroblasts reacted with the antibodies against GLUT1, GLUT4 and insulin receptor, whereas they were labelled only in one case with GLUT3 antibody. Cytotrophoblast cells were only stained with antibodies against GLUT1 and GLUT3. Antibodies against GLUT4 only reacted with fibroblasts in the membranes. On amnion epithelial cells, weak immunoreactivity with insulin receptor antibodies was detected only at the electron microscopic level. The data indicate: (1) GLUT1 is located on all cells of the amnion, whereas GLUT3 is present in detectable amounts only on amnion epithelial cells and cytotrophoblast; (2) GLUT1 and GLUT3 on amnion epithelial cells are predominantly located on the apical surface; (3) GLUT4 and insulin receptors are not regularly expressed. We suggest that amnion epithelial cells cover their basal glucose requirements from the amniotic fluid and not from the maternal circulation.     

Immunohistochemical demonstration of c-myc oncogene product in middle ear cholesteatoma

Oxygen consumption at intermittent mandatory ventilation (IMV) rates of 10 and 20 breaths per minute was evaluated to determine whether a higher IMV rate in mechanically ventilated premature infants with apnea and respiratory insufficiency would reduce metabolic expenditure. Ten studies were performed in seven infants, with three infants studied twice after a trial of failed elective extubation. The mean birth weight was 952 +/- 183 kg (SD), and the mean postnatal age was 12 +/- 8 days (SD). Mean oxygen consumption per kilogram of body weight was not significantly related to pulmonary resistance, dynamic lung compliance, or resistive work of breathing. Mean oxygen consumption was not altered at the different IMV rates. The oxygen consumption difference at the two IMV rates was not significantly related to dynamic lung compliance, resistance, or work of breathing. These results demonstrate that mechanically dependent premature infants without bronchopulmonary dysplasia do not have significant alteration in oxygen consumption with changes in IMV. This finding suggests that there is no potential metabolic energy balance benefit in use of moderately higher IMV rates to achieve improved growth rates in this population of infants.