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Frequency of oral manifestations in children infected with human immunodeficiency virus.

OBJECTIVE: The main objective of this study was to investigate the frequency of oral manifestations in children with acquired immunodeficiency syndrome. It also attempted to correlate the presence of lesions with the patient's degree of immunosuppression, as measured by the T4/T8 ratio. METHOD AND MATERIALS: Oral examinations were performed in 51 children with acquired immunodeficiency syndrome for a 2-year period. A questionnaire used in this investigation was based on the children's classification proposed by the Centers for Disease Control in 1987. The children's T4/T8 ratios were obtained from their medical files. RESULTS: Pseudomembranous candidiasis was the most common lesion, found in 21.57% of the children. Salivary gland disease was present in 19.61% of patients. Erythematous candidiasis was observed in 5.88%, and linear gingival erythema and oral hairy leukoplakia were both observed in 1.96% of children. Children with a T4/T8 ratio < 0.5 were more prone to development of pseudomembranous candidiasis. CONCLUSION: Pseudomembranous candidiasis was the most common type of oral lesion in human immunodeficiency virus-positive children with acquired immunodeficiency syndrome. There was a relationship between the frequency of oral manifestations and the patient's T4/T8 ratio.

AIDS-Related Opportunistic Infections↗

Deciphering novel targets in salivary gland pleomorphic adenoma by integrating plasma proteomics and parotid transcriptomics analyses.

BACKGROUND/PURPOSE: Pleomorphic adenoma (PA) is the most common salivary gland benign tumor, with its molecular drivers elusive due to a lack of experimental models. This study aimed to decipher novel targets in PA by systematically integrating plasma protein quantitative trait loci (pQTL)-based Mendelian randomization (MR) with multi-omics profiling of parotid gland tissues. MATERIALS AND METHODS: We performed two-sample MR using 5450 plasma pQTLs and genome-wide association study summary for benign or broader salivary gland diseases from FinnGen consortium. Bulk RNA-sequencing (RNA-seq) and single-cell RNA-seq (scRNA-seq) comparing PA to normal tissue were used for transcriptomic validation. Immunohistochemistry (IHC) was applied for protein-level validation in human PA, adenoid cystic carcinoma (ACC), and murine inflammatory lesions. RESULTS: MR identified 12 plasma proteins associated with benign salivary gland tumor risk. Transmembrane serine protease 6 (TMPRSS6) was the only protein significantly risk-increasing for both benign and broader salivary gland diseases. Strikingly, mitogen-activated protein kinase kinase 4 (MAP2K4) showed opposite MR effects between benign and all-lesion outcomes. Bulk RNA-seq showed limited concordance with MR findings, while scRNA-seq revealed a unique plastic epithelium and partially validated candidates at cellular resolution. Critically, IHC confirmed MAP2K4 protein overexpression specifically in human PA, but not in ACC or inflammatory lesions, while TMPRSS6 was downregulated in established pathologies despite its genetic risk association. CONCLUSION: By integrating plasma proteome-based causal inference with parotid tissue multi-omics, this study unveils MAP2K4 as a potential PA-specific driver. This integrative framework provides novel, context-specific targets for further functional investigation in salivary gland tumorigenesis.

Gene expression profiling↗

Management of occult metastatic disease from salivary gland neoplasms.

Evaluating salivary gland neoplasms is difficult because of the relatively low incidence of these lesions, their variable locations, and their multiple histologic cell types. Little has been reported on nodal metastases, whether manifest or occult, from these neoplasms. Ninety cases of salivary gland neoplasm are analyzed to provide a clearer understanding of the appropriate approach to occult salivary gland cervical metastases. Manifest regional metastases at the original presentation were absent in 72% (65/90). Few nodal metastases occurred after the primary tumor was controlled (2% [1/56]). Local recurrence (38% [34/90]) and distant metastases (25% [14/56]) were more common. Stage I and II disease was treated by surgical resection of the primary tumor alone; resection was combined with postoperative radiation therapy for stage III disease. Whenever the neck was entered for stage III disease, a conservative neck dissection was incorporated with the resection to reduce the postoperative irradiation field once the neck had been proved N, O histologically. Delayed nodal metastasis was treated by neck dissection alone.

Adenocarcinoma↗

Inflammatory and obstructive disorders of salivary glands.

Obstructive and inflammatory diseases of the salivary glands can have a congenital, traumatic, metabolic, or infectious-inflammatory cause. The acute inflammatory conditions include bacterial and viral infections, and the chronic conditions include sialoliths, strictures, chronic sialadenitis, sialectasis, and lymphoepithelial disease. The neoplastic disease can cause obstruction and/or infection and often make the diagnosis elusive. In addition to a working knowledge of possible etiology, one needs experience with clinical examination, salivary analysis, sialography, CT scans, MRI, and fine-needle aspiration and cytology in order successfully to evaluate and manage patients with these conditions.

Acute Disease↗

Xerostomia: diagnosis and management.

Xerostomia, or dry mouth, is a common complaint that may be caused by several conditions, which include side effects of a wide variety of drugs, such as antidepressants, therapeutic radiation to the head and neck, dehydration, diabetes, and diseases involving salivary glands, such as Sjögren's syndrome. The complaint of dry mouth may or may not be associated with decreased salivary gland function. Individuals with xerostomia complain of problems with eating, speaking, swallowing, and wearing dentures. Some people also complain of salivary gland enlargement or changes in taste. Lack of saliva may predispose one to oral infections, such as candidiasis, and increase the risk of dental caries. Management of the individual patient with xerostomia includes assessment of salivary gland function, replacement therapy, and prevention of caries and oral candidiasis. Early recognition and management of xerostomia may prevent devastating dental disease and help to improve the quality of life.

Antidepressive Agents↗

[The diameter of the Stenon and Wharton ducts. Significance for diagnosis and therapy].

In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy) of salivary gland disease, it is of importance to know the true dimensions of the secretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the sub-mandibular gland were examined histologically at different points of their anatomic course and their in vivo diameters were evaluated using a previously determined formalin-induced shrinking factor. The mean diameter of Stensen's duct at four different points along its length ranged between 0.5 mm and 1.4 mm, depending on the site. A narrowing at the middle of the duct was striking. In all preparations examined, the minimum width of the secretory duct was located at the ostium. In Wharton's duct the narrowest duct diameter was also identified at the ostium. The mean values for the duct diameters ranged between 0.5 mm and 1.5 mm. For diagnostic and therapeutic purposes, endoscopes, balloon catheters and stone-extraction baskets should conform as much as possible to physiological duct widths. A diameter of 1.2 mm should be considered the upper limit for duct instruments. Our findings also suggest that in the case of salivary stone lithotripsy the best results will be achieved when the maximum size of a stone fragment does not exceed 1.2 mm.

Aged↗

Fine needle aspiration biopsy in a diagnostic workup algorithm of salivary gland tumors.

The ultrasonic diagnosis of salivary gland diseases can give a more accurate information than clinical data alone. In diagnosis of the parotid gland diseases, it is necessary to differentiate clearly tumors from other diseases. When a tumor is suspected, its presence should be confirmed, and determined if it is solitary, multiple, unilateral or bilateral, intra or extraglandular, and benign or malignant. In the period of May 1998 to January 2001 ultrasound examinations were performed in 354 patients, FNAB with ultrasound control were performed in 152 patients with a mean age of 49.7 years. The ultrasound and cytologic findings were correlated with surgical and histologic findings. Results indicate that in patients with solid mass of the salivary gland, ultrasound examination confirmed the finding of salivary gland tumor in all patients (100%). In non-solid diseases of salivary glands the diagnostic accuracy was slightly lower. The use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution and improving clinical diagnosis. FNAB is a simple quick, accurate and virtually complications free investigative modality. The data on its ability to distinguish between lesions requiring surgery or not are encouraging.

Adult↗

Multiple mucous retention cysts of the oral mucosa.

While mucoceles of the oral mucosa are relatively common, multiple mucous retention cysts have not previously been reported. In this article two such cases, in which numerous minor salivary gland ducts had dilated to the point of cyst formation, are described. The number of individual cysts exceeded 100 in each case. Since it is clear that these cysts formed as a result of dilatation of salivary ducts, it would seem that either the ducts were blocked by altered secretion or there was an acquired or congenital weakness in their structure.

Aged↗

[Sialochemical studies of isolated secretions of the major salivary glands of the head].

The sialochemical parameters total protein, immunoglobulin A, lysozyme, amylase, sodium, potassium, calcium as well as flow rate were estimated in parotid saliva (PS) and submandibular saliva (SMS) in the course of differential diagnostics of salivary gland diseases. In addition to this the quantitative polyacrylamide gel electrophoresis based on 80 PS and 80 SMS normal secretions was performed. Sialochemistry was performed on parotid adenomas (29), carcinomas (9); sialadenosis (8); acute (8) and chronic (13) sialadenitis; dental caries (12 PS and 12 SMS); cystic fibrosis (21 PS and 12 SMS); diabetes mellitus (13 PS and 13 SMS); and hyperthyroilism (9 PS and 9 SMS). Our sialochemical analysis does not allow to distinguish between benign and malignant parotid neoplasms. The significant decrease of sodium in sialadenosis and increase of sodium and total protein in sialadenitis as well as interesting results in cystic fibrosis, diabetes mellitus and dental caries, are emphasised.

Adolescent↗

[Imaging protocol in salivary pathology].

Numerous techniques have been used for imaging salivary glands including standard radiography, scintigraphy, sialography, echography, computed tomography and finally NMI. These different techniques each have their own indications or complementary role. We therefore developed a protocol for using the different imaging techniques according to the different salivary pathologies encountered. This protocol is given as an examination flow chart to be used in light of clinical findings. A large number of images selected by P. Laudenbach illustrate the typical pathologies encountered. Special emphasis is placed on sialography, an important imaging technique, unfortunately somewhat neglected.

Acute Disease↗

Lymphomatoid granulomatosis of the lung, associated with a long history of benign lymphoepithelial lesions of the salivary glands and lymphoid interstitial pneumonitis. Report of a case.

A case of a man who had bilateral benign lymphoepithelial lesions of major salivary glands, subsequently had lymphoid interstitial pneumonitis at the age of 26 years, and progressed to lymphomatoid granulomatosis of the lung at the age of 42 years is reported, A labial gland biopsy was consistent with Sjögren's syndrome, which the patient was clinically suspected of having although his disease lacked many of the classic clinical features of that disorder. There was no evidence of malignant lymphoma of lymph nodes. Immunoglobulin distribances were minor, limited to slightly elevated IgG.

Adult↗

A simple cryosurgical method for treatment of oral mucous cysts.

A simple and easy cryosurgical method to treat intraoral mucous cysts is described. Twelve female and six male patients, with mucous cysts on the lower lip and the tip of the tongue, were treated by direct application of liquid nitrogen with a cotton swab. Each lesion was exposed to four or five cycles composed of freezings of 10-30 s and thawings of double the freezing times. No anesthesia was required. All lesions had disappeared completely 2-4 weeks after one or two treatment courses of cryosurgery. In all cases, neither scarring nor recurrence was noted during the 6 months to 5 years of follow-up.

Adolescent↗