CT scan assessment in salivary gland lithiasis diagnosis.

INTRODUCTION: The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis. METHODS: Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated. RESULTS: A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%. DISCUSSION: According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.

[Calcifications of the parotid space. A review]. / Calcifications de la loge parotidienne. Mise au point.

INTRODUCTION: Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS: We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS: Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION: Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.

[Modified purse string suture to reduce the size of surgical defect]. / Réduction de la taille d'une perte de substance par une technique améliorée de suture en bourse.

INTRODUCTION: Skin carcinomas require excision with clear margins. In the head and neck region, these excisions most often result in round or oval defects. Due to the big size of the defect and limited tissue elasticity, it is not always possible to close these defects in the same operation. We describe a technique to minimize the size of the defect. TECHNICAL NOTE: It is an improved purse string suture technique. The purse string suture is realized with a circular continuous intradermal suture and is improved by three or four V-Y sutures, in order to reduce the skin defect. DISCUSSION: It is an easy, fast and effective technique for decreasing the size of the skin defect and for speeding up the healing.

Characterisation and expression of the biomineralising gene Lustrin A during shell formation of the European abalone Haliotis tuberculata.

The molluscan shell is a remarkable product of a highly coordinated biomineralisation process, and is composed of calcium carbonate most commonly in the form of calcite or aragonite. The exceptional mechanical properties of this biomaterial are imparted by the embedded organic matrix which is secreted by the underlying mantle tissue. While many shell-matrix proteins have already been identified within adult molluscan shell, their presence and role in the early developmental stages of larval shell formation are not well understood. In the European abalone Haliotis tuberculata, the shell first forms in the early trochophore larva and develops into a mineralised protoconch in the veliger. Following metamorphosis, the juvenile shell rapidly changes as it becomes flattened and develops a more complex crystallographic profile including an external granular layer and an internal nacreous layer. Amongst the matrix proteins involved in abalone shell formation, Lustrin A is thought to participate in the formation of the nacreous layer. Here we have identified a partial cDNA coding for the Lustrin A gene in H. tuberculata and have analysed its spatial and temporal expression during abalone development. RT-PCR experiments indicate that Lustrin A is first expressed in juvenile (post-metamorphosis) stages, suggesting that Lustrin A is a component of the juvenile shell, but not of the larval shell. We also detect Lustrin A mRNAs in non-nacre forming cells at the distal-most edge of the juvenile mantle as well as in the nacre-forming region of the mantle. Lustrin A was also expressed in 7-day-old post-larvae, prior to the formation of nacre. These results suggest that Lustrin A plays multiple roles in the shell-forming process and further highlight the dynamic ontogenic nature of molluscan shell formation.