Assuntos
Doença de Charcot-Marie-Tooth/genética , Metionina tRNA Ligase/genética , Tirosina-tRNA Ligase/genética , Idade de Início , Sequência de Aminoácidos , Doença de Charcot-Marie-Tooth/epidemiologia , Feminino , Genes Dominantes , Variação Genética , Humanos , Masculino , Dados de Sequência Molecular , LinhagemRESUMO
BACKGROUND: Removal of tumours arising in the submandibular gland (SMG) usually involves excision of the entire gland. This prospective study evaluated the efficacy of gland-preserving surgery in patients with benign SMG tumours. METHODS: Twenty consecutive patients with pleomorphic adenomas in the SMG underwent local excision of tumours with limited tumour-free margins and preservation of the remnant glandular tissues. All patients had salivary scintigraphy before and 6 months after surgery, with ultrasonography 2 years after operation. Complications, operating time, salivary function and rates of tumour recurrence were evaluated. RESULTS: The mean operating time was 28 min, and no patient had neurological complications. After surgery, the function of the affected gland was equal to that of the unaffected gland. All patients had symmetrical facial contours without defects in the operated submandibular triangle. None of the patients had evidence of tumour recurrence on ultrasonographic examination and regular clinical examination at a median of 36 months after surgery. CONCLUSION: Gland-preserving surgery in patients with benign SMG tumours preserves salivation, and reduces surgical morbidity and operating time, with good cosmesis but without compromising local control.
Assuntos
Adenoma Pleomorfo/cirurgia , Neoplasias da Glândula Submandibular/cirurgia , Glândula Submandibular/cirurgia , Adulto , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Prospectivos , Saliva/metabolismo , Glândula Submandibular/metabolismoRESUMO
Acupuncture is useful in treating the nausea and vomiting related to chemotherapy, adult postoperative surgery pain and postoperative dental pain. We obtained single-photon emission computed tomography (SPECT) brain perfusion images of six patients with middle cerebral artery occlusion obtained before and after acupuncture and compared the changes in regional cerebral blood flow (rCBF) to those in normal control. Images were obtained before and after acupuncture at six traditional acupoints (LI 4, 10, 11, 15 and 16 and TE5) in the affected arm. The baseline image was subtracted from the postacupuncture image, to produce a subtraction image displaying only voxels with values >2 SD from the mean and those voxels were coregistered to the baseline SPECT or T2-weighted MRI. Similar images were obtained before and after acupuncture of eight normal volunteers. Statistical parametric mapping with a threshold of P =0.001 and a corrected P of 0.05 was performed for group comparison between postacupuncture and baseline SPECT. Focally increased CBF was seen in all patients especially in the hypoperfused zone surrounding the ischaemic lesion, the ipsilateral or contralateral sensorimotor area, or both. Normal subjects showed increased rCBF mainly in the parahippocampal gyrus, premotor area, frontal and temporal areas bilaterally and ipsilateral globus pallidus. Acupuncture stimulation after stroke patients appears to activate perilesional or use-dependent reorganised sites and might be a way of looking at brain reorganisation.