Sialoadenitis aguda por administración de contraste yodado / Acute sialadenitis by iodine contrast medium administration

La sialoadenitis aguda es una reacción adversa muypoco frecuente a la administración de contraste yodado,que causa una inflamación autolimitada de las glándulassalivales. Su patogenia no está bien establecida, aunque la insuficiencia renal puede ser un factor de riesgo.El diagnóstico es inicialmente clínico, y debe realizarsediagnóstico diferencial con angioedema, infecciones y litiasis. Ningún tratamiento o profilaxis ha demostrado beneficio hasta el momento. Aunque tiene buen pronóstico,en algunos casos se han descrito complicaciones.Presentamos el caso de un varón de 68 años que presentó inflamación de las glándulas salivales submandibulares tras la realización de una tomografía computariza-da abdominal con administración de contraste yodado.Dado el uso creciente de contrastes yodados en pruebasde imagen y técnicas intervencionistas, es importante conocer posibles reacciones adversas como esta entidad.(AU)

Acute iodide sialadenitis is a rare adverse reactionto iodinated contrast that causes self-limited salivarygland swelling. Its pathogenesis is still unclear, althoughkidney failure may be a risk factor. The diagnosis isinitially clinical but angioedema, infections and lithiasis should be included in the differential diagnosis. Notreatment or prophylaxis was proven to be beneficial.Although its prognosis is benign, associated complications have been reported.We report a case of 68-year-old man with swelling ofthe submandibular salivary glands after the administration of iodine-based contrast media during an abdomi-nal computed tomography examination. Because of thewidespread use of iodinated contrast enhanced imaging and interventional techniques, clinicians should beaware of this issue.(AU)

Prognostic value of the immunohistochemical expression of vascular endothelial growth factors in malignant salivary gland neoplasms: a systematic review and meta-analysis / Valor pronóstico de la expresión inmunohistoquímica de vascular. Factores de crecimiento endotelial en neoplasias malignas de glándulas salivales: una revisión sistemática y un metanálisis

Background: The immunohistochemical expression of vascular endothelial growth factor is a prognostic markerin several cancer types. In salivary gland tumors, the association between vascular endothelial growth factor andprognosis remains unclear. The purpose of this study was to perform a systematic review and meta-analysis to as-sess whether the immunohistochemical expression of vascular endothelial growth factor in patients with salivarygland neoplasms presents prognostic value.Material and Methods: Immunohistochemical studies assessing the predictive value of vascular endothelialgrowth factor in salivary gland neoplasms were systematically reviewed using PubMed, Scopus, Embase, Co-chrane Library, and Web of Science databases. It was assessed any survival rates. The fixed-effect model withan adjusted hazard ratio (HR) and 95% confidence intervals (95% CI) as effect measures were performed in themeta-analysis. The Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the included stud-ies, and the evidence quality was assessed by the Grading of Recommendation, Assessment, Development, andEvaluation (GRADE) system.Results: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivarygland neoplasms was associated with shortened survival (HR=5.37, 95% CI: 2.67-10.83, P = 0.00001). In addition,the presence of vascular endothelial growth factor was tightly associated with tumor size, lymph node metastasis,clinical stage, perineural invasion, vascular invasion, poor local control of the disease, and recurrence.Conclusions: The immunohistochemical overexpression of vascular endothelial growth factor in patients withsalivary gland neoplasms has prognostic value and was associated with decreased survival time. However, moreprimary well-designed studies are necessary to increase the level of evidence.(AU)

Follistatin expressed in mechanically-damaged salivary glands of male mice induces proliferation of CD49f+ cells.

Salivary glands (SGs) are very important for maintaining the physiological functions of the mouth. When SGs regenerate and repair from various damages, including mechanical, radiological, and immune diseases, acinar and granular duct cells originate from intercalated duct cells. However, the recovery is often insufficient because of SGs' limited self-repair function. Furthermore, the precise repair mechanism has been unclear. Here, we focused on CD49f, one of the putative stem cell markers, and characterized CD49f positive cells (CD49f+ cells) isolated from male murine SGs. CD49f+ cells possess self-renewal ability and express epithelial and pluripotent markers. Compared to CD49f negative cells, freshly isolated CD49f+ cells highly expressed inhibin beta A and beta B, which are components of activin that has anti-proliferative effects. Notably, an inhibitor of activin, follistatin was expressed in mechanically-damaged SGs, meanwhile no follistatin was expressed in normal SGs in vivo. Moreover, sub-cultured CD49f+ cells highly expressed both Follistatin and a series of proliferative genes, expressions of which were decreased by Follistatin siRNA. These findings indicated that the molecular interaction between activin and follistatin may induce CD49f+ cells proliferation in the regeneration and repair of mouse SGs.

Does Salivary Function Decrease in Proportion to Radioiodine Dose?

OBJECTIVES: This study was conducted to investigate the dose-response characteristics of radioiodine on salivary glands and to investigate the mechanism responsible for radioiodine-induced salivary glands toxicity. METHODS: Twenty-four mice were divided into six groups: 0, 0.05, 0.10, 0.20, 0.40, and 0.80 mCi/20 g mouse, administered orally. Mortalities were noted 12 months after radioiodine administration. Body weights, gland weights, salivary lag times, flow rates, and changes in 99m Tc pertechnetate were recorded. Histopathological changes and mRNA expressions were also evaluated, and immunohistochemical analysis and apoptotic assays were performed. RESULTS: Survival rates, body weights, gland weights, and flow rates decreased, and lag times increased on increasing radioiodine dose. Animals administered radioiodine showed acinar atrophy, striated duct dilations, and lymphocytic infiltration in glands and irregular destruction of epithelial surfaces of tongue. The uptake and excretion of 99m Tc pertechnetate were impaired by radioiodine. Immunohistochemical analysis showed that numbers of salivary epithelial, myoepithelial, and endothelial cells decreased and that numbers of ductal cells increased with radioiodine dose. Oxidative stress biomarker levels increased; reactive oxygen species scavenger levels decreased; and numbers of apoptotic cells increased in animals exposed to higher radioiodine doses. CONCLUSION: These dose-related, long-term effects on salivary gland should be taken into account when determining radioiodine doses. LEVEL OF EVIDENCE: NA Laryngoscope, 130:2173-2178, 2020.

Adipose-derived mesenchymal stem cells regenerate radioiodine-induced salivary gland damage in a murine model.

After radioiodine (RI) therapy, patients with thyroid cancer frequently suffer from painful salivary gland (SG) swelling, xerostomia, taste alterations, and oral infections. This study was aimed to determine whether adipose-derived mesenchymal stem cells (AdMSCs) might restore RI-induced SG dysfunction in a murine model. Forty -five mice were divided into three groups; a PBS sham group, a RI+ PBS sham group (0.01 mCi/g mouse, orally), and an RI+AdMSCs (1 × 105 cells/150 uL, intraglandular injection on experimental day 28) treated group. At 16 weeks after RI treatment, body weights, SG weight, salivary flow rates (SFRs), and salivary lag times were measured. Morphologic and histologic examinations and immunohistochemistry (IHC) were performed and the activities of amylase and EGF in saliva were also measured. Changes in salivary 99mTc pertechnetate excretion were followed by SPECT and TUNEL assays were performed. The body and SG weights were similar in the AdMSCs and sham groups. Hematoxylin and eosin staining revealed the AdMSCs group had more mucin-containing acini than the RI group. Furthermore, AdMSCs treatment resulted in tissue remodeling and elevated expressions of epithelial (AQP5) and endothelial (CD31) markers, and increased SFRs. The activities of amylase and EGF were higher in the AdMSCs group than in the RI treated group. 99mTc pertechnetate excretions were similar in the AdMSCs and sham group. Also, TUNEL positive apoptotic cell numbers were less in the AdMSCs group than in the RI group. Local delivery of AdMSCs might regenerate SG damage induced by RI.

Salivary glands require Aurora Kinase B for regeneration after transient innate immune-mediated injury.

Severe, irreversible salivary gland disease and oral dryness is experienced by sufferers of Sjögren's syndrome and those treated with irradiation for head and neck cancer. Therefore, major efforts have been made in the last decade to unravel key molecular signals that can drive salivary gland (SG) regeneration and functional restoration. However, the earliest molecular determinants that accompany SG regeneration remain incompletely defined. The present study examined the initial mitogenic events marking the regenerative response of the murine submandibular gland (SMG), following innate immune-mediated injury. Local intraductal administration of the synthetic double stranded (ds) RNA polyinosinic-polycytidylic acid (poly (I:C)) widely, but transiently, depleted the acinar and progenitor cells, 24 hours post poly (I:C) introduction. While the progenitor and duct cells started to proliferate and expand at 72 hours, the Mist1-positve acinar cells did not re-appear until 96 hours post poly (I:C) injury. The cellular replenishment during regeneration involved significant upregulation of the cell cycle promoter Aurora kinase B (AURKB). AURKB, which is expressed in healthy proliferating and cancerous cells, is a serine/threonine protein kinase, well known to orchestrate key events in cell division and cytokinesis. However, the expression and role of AURKB in regeneration of post mitotic salivary gland cells has not been previously explored. In vivo inhibition of AURKB using the selective inhibitor Barasertib (AZD1152-HQPA) interfered with SMG recovery from the transient, but severe poly (I:C)-mediated injury and cellular depletion. AURKB deficiency during regeneration of the injured tissues: disrupted cell cycle progression, repressed renewal of Mist1-positive acinar cells and prevented recovery of salivary secretion. The knowledge gained in this study may be utilized in the development of therapeutic targets for irreversible salivary gland disease.

Synergistic effects of laminin-1 peptides, VEGF and FGF9 on salivary gland regeneration.

Hyposalivation is associated with radiation therapy, Sjögren's syndrome and/or aging, and is a significant clinical problem that decreases oral health and overall health in many patients and currently lacks effective treatment. Hence, methods to regenerate salivary glands and restore saliva secretion are urgently needed. To this end, this study describes the modification of fibrin hydrogels with a combination of laminin-1 peptides (YIGSR and A99) and human growth factors (vascular endothelial growth factor and fibroblast growth factor 9) to enhance regeneration in a salivary gland injury mouse model. Our results indicate that these fortified hydrogels enhanced angiogenesis and neurogenesis while promoting formation of acinar structures, thereby leading to enhanced saliva secretion. Such functional recovery indicates salivary gland regeneration and suggests that our technology may be useful in promoting gland regeneration and reversing hyposalivation in a clinical setting. STATEMENT OF SIGNIFICANCE: We engineered Fibrin Hydrogels (FH) to contain multiple regenerative cues including laminin-1 peptides (L1p) and growth factors (GFs). L1p and GF modified FH were used to induce salivary gland regeneration in a wounded mouse model. Treatment with L1p and GF modified FH promoted salivary epithelial tissue regeneration, vascularization, neurogenesis and healing as compared to L1p-FH or FH alone. Results indicate that L1p and GF modified FH can be used for future therapeutic applications.

Lesiones bucales y maxilofaciales en niños y adolescentes / Oral and maxillofacial lesions in children and adolescents

Introduction: Despite the vast literature reporting the prevalence of oral and maxillofacial diseases in the last decades, few studies have focused on lesions biopsied in the pediatric population. Objective: To determine the prevalence of oral and maxillofacial lesions that were biopsied in children and adolescents aged 0-19 years. Methods: Observational and descriptive study. We carried out a retrospective review of 862 reports of pathological examinations performed in an oral pathology laboratory of the northeast of Brazil, during the period from March 2001 to December 2009. The categories were neoplasms, hyperplastic/reactionary lesions, salivary gland lesions, bone lesions, healthy tissues and teeth, oral mucosal lesions, cystic lesions, odontogenic tumors, periapical inflammation, dental alteration and conclusive diagnosis. Results: The epidemiological profile of patients was characterized by females (53.24 percent), Caucasian (45.12 percent), with a mean age of 13.06 years. Salivary gland lesions were the category with the largest number of cases (182), and mucocele was the most prevalent histopathological diagnosis (18.44 percent), with an average size of 1.97 cm. Most cases were asymptomatic (70.88 percent). Conclusions: This study showed a predominance of lesions diagnosed as benign, the most prevalent lesions were associated with the salivary gland. Females were the most affected(AU)

Introducción: A pesar de la gran cantidad de literatura que informa sobre la prevalencia de enfermedades bucales y maxilofaciales en las últimas décadas, pocos estudios se concentraron en las lesiones biopsiadas en la población pediátrica. Objetivo: Determinar la prevalencia de las lesiones bucales y maxilofaciales que fueron biopsiadas en los niños y adolescentes de 0 a 19 años. Métodos: Estudio observacional y descriptivo. Se realizó una revisión retrospectiva de 862 informes de los exámenes patológicos realizados en un laboratorio de Patología Oral del nordeste de Brasil, durante el período comprendido entre marzo de 2001 y diciembre de 2009. Las categorías fueron: neoplasias, hiperplásicas / lesiones reactivas, lesiones de las glándulas salivales, lesiones óseas, tejidos y dientes sanos, lesiones de la mucosa bucal, lesiones quísticas, tumores odontogénicos, inflamación periapical, alteración dental y diagnóstico concluyente. Resultados: El perfil epidemiológico de los pacientes se caracterizó por las mujeres (53,24 por ciento), de raza caucásica (45,12 por ciento) con una edad media de 13,06 años. Lesiones de las glándulas salivales fueron la categoría con el mayor número de casos (182), y el mucocele fue el diagnóstico histopatológico más frecuente (18,44 por ciento), con un tamaño medio de 1,97 cm. La mayoría de los casos fueron asintomáticos (70,88 por ciento). Conclusiones: Este estudio mostró un predominio de las lesiones diagnosticadas como benignas. Las lesiones más frecuentes se relacionaron con la glándula salival. Las mujeres fueron las más afectadas(AU)

Lesiones bucales y maxilofaciales en niños y adolescentes / Oral and maxillofacial lesions in children and adolescents

Introduction: Despite the vast literature reporting the prevalence of oral and maxillofacial diseases in the last decades, few studies have focused on lesions biopsied in the pediatric population. Objective: To determine the prevalence of oral and maxillofacial lesions that were biopsied in children and adolescents aged 0-19 years. Methods: Observational and descriptive study. We carried out a retrospective review of 862 reports of pathological examinations performed in an oral pathology laboratory of the northeast of Brazil, during the period from March 2001 to December 2009. The categories were neoplasms, hyperplastic/reactionary lesions, salivary gland lesions, bone lesions, healthy tissues and teeth, oral mucosal lesions, cystic lesions, odontogenic tumors, periapical inflammation, dental alteration and conclusive diagnosis. Results: The epidemiological profile of patients was characterized by females (53.24 percent), Caucasian (45.12 percent), with a mean age of 13.06 years. Salivary gland lesions were the category with the largest number of cases (182), and mucocele was the most prevalent histopathological diagnosis (18.44 percent), with an average size of 1.97 cm. Most cases were asymptomatic (70.88 percent). Conclusions: This study showed a predominance of lesions diagnosed as benign, the most prevalent lesions were associated with the salivary gland. Females were the most affected(AU)

Introducción: A pesar de la gran cantidad de literatura que informa sobre la prevalencia de enfermedades bucales y maxilofaciales en las últimas décadas, pocos estudios se concentraron en las lesiones biopsiadas en la población pediátrica. Objetivo: Determinar la prevalencia de las lesiones bucales y maxilofaciales que fueron biopsiadas en los niños y adolescentes de 0 a 19 años. Métodos: Estudio observacional y descriptivo. Se realizó una revisión retrospectiva de 862 informes de los exámenes patológicos realizados en un laboratorio de Patología Oral del nordeste de Brasil, durante el período comprendido entre marzo de 2001 y diciembre de 2009. Las categorías fueron: neoplasias, hiperplásicas / lesiones reactivas, lesiones de las glándulas salivales, lesiones óseas, tejidos y dientes sanos, lesiones de la mucosa bucal, lesiones quísticas, tumores odontogénicos, inflamación periapical, alteración dental y diagnóstico concluyente. Resultados: El perfil epidemiológico de los pacientes se caracterizó por las mujeres (53,24 por ciento), de raza caucásica (45,12 por ciento) con una edad media de 13,06 años. Lesiones de las glándulas salivales fueron la categoría con el mayor número de casos (182), y el mucocele fue el diagnóstico histopatológico más frecuente (18,44 por ciento), con un tamaño medio de 1,97 cm. La mayoría de los casos fueron asintomáticos (70,88 por ciento). Conclusiones: Este estudio mostró un predominio de las lesiones diagnosticadas como benignas. Las lesiones más frecuentes se relacionaron con la glándula salival. Las mujeres fueron las más afectadas(AU)

Stem cell properties of human clonal salivary gland stem cells are enhanced by three-dimensional priming culture in nanofibrous microwells.

BACKGROUND: Three-dimensional (3D) cultures recapitulate the microenvironment of tissue-resident stem cells and enable them to modulate their properties. We determined whether salivary gland-resident stem cells (SGSCs) are primed by a 3D spheroid culture prior to treating irradiation-induced salivary hypofunction using in-vitro coculture and in-vivo transplant models. METHODS: 3D spheroid-derived SGSCs (SGSCs3D) were obtained from 3D culture in microwells consisting of a nanofiber bottom and cell-repellent hydrogel walls, and were examined for salivary stem or epithelial gene/protein expression, differentiation potential, and paracrine secretory function compared with monolayer-cultured SGSCs (SGSCs2D) in vitro and in vivo. RESULTS: SGSCs3D expressed increased salivary stem cell markers (LGR5 and THY1) and pluripotency markers (POU5F1 and NANOG) compared with SGSCs2D. Also, SGSCs3D exhibited enhanced potential to differentiate into salivary epithelial cells upon differentiation induction and increased paracrine secretion as compared to SGSCs2D. Wnt signaling was activated by 3D spheroid formation in the microwells and suppression of the Wnt/ß-catenin pathway led to reduced stemness of SGSCs3D. Enhanced radioprotective properties of SGSCs3D against radiation-induced salivary hypofunction was confirmed by an organotypic 3D coculture and in-vivo transplantation experiments. CONCLUSION: The 3D spheroid culture of SGSCs in nanofibrous microwells promotes stem cell properties via activation of Wnt signaling. This may contribute to SGSC priming prior to regenerative therapy to restore salivary hypofunction after radiotherapy.

Cell extracts from spleen and adipose tissues restore function to irradiation-injured salivary glands.

A cell extract from whole bone marrow (BM), which we named "BM Soup," has the property to restore saliva secretion to irradiation (IR)-injured salivary glands (SGs). However, BM cell harvesting remains an invasive procedure for the donor. The main objective of this study was to test the therapeutic effect of "Cell Soups" obtained from alternate tissues, such as adipose-derived stromal cells (ADSCs) and spleen cells to repair SGs. BM Soup, Spleen Soup, ADSC Soup, or saline (vehicle control) was injected intravenously into mice with IR-injured SGs (13Gy). Results demonstrated that all three cell soups restored 65-70% of saliva secretion, protected acinar cells, blood vessels, and parasympathetic nerves, and increased cell proliferation. Although protein array assays identified more angiogenesis-related growth factors in ADSC Soup, the length of its therapeutic efficiency on saliva flow was less than that of the BM Soup and Spleen Soup. Another objective of this study was to compare "Fresh" versus "Cryopreserved (-80 °C)" BM Soup. It was found that the therapeutic effect of 12-month "Cryopreserved BM Soup" was comparable to that of "Fresh BM Soup" on the functional restoration of IR-injured SGs. In conclusion, both Spleen Soup and ADSC Soup can be used to mitigate IR-damaged SGs.

Epithelial disruptions, but not immune cell invasion, induced secretory dysfunction following innate immune activation in a novel model of acute salivary gland injury.

BACKGROUND: Salivary gland (SG) injurious agents are all translated into loss of salivation (xerostomia). An association has been established between activation of innate immunity and SG injury and dysfunction. However, it remains unclear how the secretory epithelia respond by halting saliva production. METHODS: C57BL/6 submandibular glands (SMGs) were acutely challenged using a single dose of the innate immune stimulant: polyinosinic-polycytidylic acid (poly (I:C)). Secretory capacity of the infected SMGs was substantiated by assessing the flow rate in response to pilocarpine stimulation. Depletion of the acute inflammatory cells was achieved by pre-treating mice with RB6-8C5 depletion antibody. Flow cytometry, histology and immunohistochemistry were conducted to verify the immune cell depletion. Epithelial expression of saliva-driving molecules: muscarinic 3 receptor (M3R), aquaporin 5 water channel (AQP5), Na-K-CL-Cotransporter 1 (NKCC1) and transmembrane member 16A (TMEM16A), was characterized using RT-qPCR and immunohistochemistry. Tight junction (TJ) protein; zonula occludens (ZO-1) and basement membrane (BM) protein; and laminin were assessed by immunohistochemistry. RESULTS: Innate immune challenge prompted dysfunction in the exocrine SGs. Dysregulated gene and protein expression of molecules that drive saliva secretion was substantiated. Aberrant expression of TJ and BM proteins followed innate immune activation. Hyposalivation in the current model was independent of myeloperoxidase (MPO)-positive, acute inflammatory cells. CONCLUSIONS: In this study, we developed a novel injury model of the SGs, featuring acute secretory dysfunction and immediate structural disruptions. Our results ruled out the injurious role of aggressively infiltrating inflammatory cells.

Optimal timing and frequency of bone marrow soup therapy for functional restoration of salivary glands injured by single-dose or fractionated irradiation.

Injections of bone marrow (BM) cell extract, known as 'BM soup', were previously reported to mitigate ionizing radiation (IR) injury to salivary glands (SGs). However, the optimal starting time and frequency to maintain BM soup therapeutic efficacy remains unknown. This study tested the optimal starting time and frequency of BM soup injections in mice radiated with either a single dose or a fractionated dose. First, BM soup treatment was started at 1, 3 or 7 weeks post-IR; positive (non-IR) and negative (IR) control mice received injections of saline (vehicle control). Second, BM soup-treated mice received injections at different frequencies (1, 2, 3 and 5 weekly injections). Third, a 'fractionated-dose radiation' model to injure mouse SGs was developed (5 Gy × 5 days) and compared with the single high dose radiation model. All mice (n = 65) were followed for 16 weeks post-IR. The results showed that starting injections of BM soup between 1 and 3 weeks mitigated the effect of IR-induced injury to SGs and improved the restoration of salivary function. Although the therapeutic effect of BM soup lessens after 8 weeks, it can be sustained by increasing the frequency of weekly injections. Moreover, both single-dose and fractionated-dose radiation models are efficient and comparable in inducing SG injury and BM soup treatments are effective in restoring salivary function in both radiation models. In conclusion, starting injections of BM soup within 3 weeks post-radiation, with 5 weekly injections, maintains 90-100% of saliva flow in radiated mice.

Identification of the active components in Bone Marrow Soup: a mitigator against irradiation-injury to salivary glands.

In separate studies, an extract of soluble intracellular contents from whole bone marrow cells, named "Bone Marrow (BM) Soup", was reported to either improve cardiac or salivary functions post-myocardial infarction or irradiation (IR), respectively. However, the active components in BM Soup are unknown. To demonstrate that proteins were the active ingredients, we devised a method using proteinase K followed by heating to deactivate proteins and for safe injections into mice. BM Soup and "deactivated BM Soup" were injected into mice that had their salivary glands injured with 15Gy IR. Control mice received either injections of saline or were not IR. Results at week 8 post-IR showed the 'deactivated BM Soup' was no better than injections of saline, while injections of native BM Soup restored saliva flow, protected salivary cells and blood vessels from IR-damage. Protein arrays detected several angiogenesis-related factors (CD26, FGF, HGF, MMP-8, MMP-9, OPN, PF4, SDF-1) and cytokines (IL-1ra, IL-16) in BM Soup. In conclusion, the native proteins (but not the nucleic acids, lipids or carbohydrates) were the therapeutic ingredients in BM Soup for functional salivary restoration following IR. This molecular therapy approach has clinical potential because it is theoretically less tumorigenic and immunogenic than cell therapies.

[Features of pathology of the salivary glands in patients of older age groups].

The article presents the results of a clinical study on the features of age-related pathology of the salivary glands. 5329 records of patients who were hospitalized at the Department of maxillofacial surgery and dentistry in three years has been studied. We studied the frequency and reasons for referral to a specialized hospital for emergency or routine medical care in connection with the pathology of the salivary glands, the structure of diseases of the salivary glands. It is shown that people of elderly and senile age turn for specialized treatment in the Department of maxillofacial surgery and dentistry more than young and middle-aged people.

Afecciones quirúrgicas de las glándulas salivales mayores: algoritmo diagnóstico-terapéutico / Surgical conditions of the major salivary glands: diagnostic and therapeutic algorithm

El tratamiento de las afecciones quirúrgicas de las glándulas salivales mayores hasido una actividad cotidiana del Servicio de Maxilofacial desde su fundación en ladécada de los 60 hasta estos días. La intervención quirúrgica es el tratamiento deelección en la enfermedad tumoral, mientras que en los procesos litiásicos hansurgido otras técnicas no cruentas que han enriquecido el arsenal terapéutico.Conocido el comportamiento clínico y biológico de las afecciones tratadas se hadiseñado un protocolo de actuación con el algoritmo diagnóstico-terapéuticoindicado en cada caso para adoptar una conducta uniforme en el estudio y eltratamiento de estas enfermedades y para lograr una curación efectiva y definitiva(AU)

Human salivary gland stem cells ameliorate hyposalivation of radiation-damaged rat salivary glands.

Salivary function in mammals may be defective for various reasons, such as aging, Sjogren's syndrome or radiation therapy in head and neck cancer patients. Recently, tissue-specific stem cell therapy has attracted public attention as a next-generation therapeutic reagent. In the present study, we isolated tissue-specific stem cells from the human submandibular salivary gland (hSGSCs). To efficiently isolate and amplify hSGSCs in large amounts, we developed a culture system (lasting 4-5 weeks) without any selection. After five passages, we obtained adherent cells that expressed mesenchymal stem cell surface antigen markers, such as CD44, CD49f, CD90 and CD105, but not the hematopoietic stem cell markers, CD34 and CD45, and that were able to undergo adipogenic, osteogenic and chondrogenic differentiation. In addition, hSGSCs were differentiated into amylase-expressing cells by using a two-step differentiation method. Transplantation of hSGSCs to radiation-damaged rat salivary glands rescued hyposalivation and body weight loss, restored acinar and duct cell structure, and decreased the amount of apoptotic cells. These data suggest that the isolated hSGSCs, which may have characteristics of mesenchymal-like stem cells, could be used as a cell therapy agent for the damaged salivary gland.

Tratamento de rânula pela técnica de marsupialização: relato de caso clínico / Ranula treatment by marsupialization technique: clinical case report

As rânulas são fenômenos extensos de retençãode saliva que ocorrem no assoalho bucal, principalmentena região da glândula sublingual. Elaspodem causar a elevação da língua e interferircom a fala e a deglutição. O tratamento é cirúrgicopor meio da marsupialização da rânulaou da remoção definitiva da glândula sublingualenvolvida. A técnica da marsupialização é umaalternativa cirúrgica a ser considerada, visto queé um procedimento simples e pouco traumático,além de apresentar prognóstico favorávelquando bem indicado. O objetivo deste trabalhoé relatar um caso clínico de rânula tratadopela técnica de marsupialização, além de fazerconsiderações sobre as formas de tratamentodessa lesão glandular benigna.

The ranula phenomena are extensive retentionof saliva, which occur in the floor of the mouth,especially in the region of the sublingualgland. They can cause the elevation of the tongueand interfere with speech and swallowing.Treatment is by surgical marsupialization of theranula or permanent removal of the sublingualgland involved. The technique of marsupializationis a surgical alternative to be considered,since it is a simple and less traumatic, and presentsa favorable prognosis when properly indicated.The objective of this study is to reporta clinical case of ranula treated by marsupializationtechnique, in addition, to show considerationson how to treat this benign glandularlesion.