- Email: [email protected]
Salivary duct carcinoma
c J Oral Maxlllofac
t Surg
52 64%655,1994
Abstracts Classification and Diagnostic Criteria for Oral Lesions in HIV Infection. Williams DM. Axell T. Azul AM. et al. J Oral Pathol Med 22:289, 1993
Salivary Duct Carcinoma. Delgado JA. Cancer 72: 1503, I993
R. Vuitch
F, Saavedra
The prototype of neoplasms of ductal origin is mammary ductal carcinoma. Salivary duct carcinoma (SDC) can originate from either extralobular or intralobular ducts of the major salivary glands. SDC is currently classified as a highgrade malignancy because of its invasive growth pattern with early regional or distant metastases. In an attempt to identify clinical prognostic features, the authors reviewed 15 cases of SDC from Parkland Memorial Hospital, Zale Lipshy University. Hospital and St Paul’s Medical Center in Dallas, TX. The clmical features were: 1) ages ranged from 39 to 8 1 years (mean, 59 years). 2) the male to female ratio was 4: 1, 3) the predominant tumor site was the parotid gland ( I3 cases), one tumor was confined to Stensen’s duct, and another tumor was found in the minor salivary glands of the hard palate. All tumors were treated by either wide-local or radical surgical excisions. Nine patients received radiotherapy postsurgically: however, none received chemotherapy or hormone therapy. Mean tumor size was 3. I cm, usually multinodular and circumscribed. Ten tumors were primarily intraductal with a classic central comedo necrosis associated with a cribriform. solid, or micropapillary architecture. The myoepithelial cell was not involved in the neoplastic ductal differentiation. Five tumors were entirely infiltrative and SDC was found within three cases of pleomorphic adenoma. Perineural invasion of major and minor peripheral nerves was also prominent. Lymph node and visceral metastases characterized the primary tumors. Similar to the prototypic ductal carcinoma of the breast, periductal neovascularization may be a prognostic indicator for invasion and metastasis. The differential diagnosis should include low-grade and high-grade salivary gland malignant neoplasms. SDC is a clinically aggressive neoplasm that may account for those adenocarcinomas not otherwise specified as well as those carcinomas associated with pleomorphic adenoma.-S.L. PASION
This article outlines the consensus of the European Community Clearinghouse on Oral Problems related to human immunodeficiency virus (HIV) infections and the US Workshop on Oral Manifestation of HIV Infection for the classification of oral lesions in HIV-infected patients. Along with classification ofthe oral lesions they have also listed diagnostic criteria. based on presumptive and definitive criteria. Classification is divided into three groups: group I, lesions strongly associated with HIV infection: group 2. lesions less commonly associated with HIV infection: and group 3. lesions seen in HIV infection. Those lesions found in group I include specific forms of periodontal disease. Kaposi’s sarcoma. candidiasis, hairy leukoplakia, and non-Hodgkin’s lymphoma. It is hoped that this revised scheme will be applied to clinical and epidemiologic studies.-G.T. J~NFS Reprint requests to Professor Williams: Joint Department of Oral Pathology with The Institute of Dental Surgery. London Hospital Medical College. Turner Street, London El ZAD. England. Effects of Midazolam on Respiratory Muscles in Humans. Mollieux S. Dureuil B. Montravers P. et al. Anesth Analg 77:592. 1993 Midazolam used intravenously as a sedative agent for minor surgery or diagnostic procedures is a mild respiratory depressant and produces a marked increase in upper airway resistance. Nine men, aged 30 to 38. participated in this clinical trial in an attempt to quantitate the effects of midazolam on total pulmonary resistance (RTP) and intercostal, diaphragmatic. and abdominal muscle function. The subjects were prepared with the following equipment: pulse oximeter, electrocardiogram electrodes. two balloon catheters inserted through the same naris to measure pleural and gastric prcssures, a tightly fitting mask connected to a pneumotachograph to yield tidal volume (V, ). and intramuscular needle electrodes to monitor electromyographic activity of the muscles. Control measurements were recorded after IO minutes of resting breathing followed by administration of midazolam 0. I mg/kg in 15 seconds. Trial measurements were taken at T5 (5 minutes after injection) and 7‘10 (10 minutes after injection). Final measurements were taken 2 minutes after a I-mg bolus of flumazenil. Midazolam produced a decrease in V, at T5 and T10 with a concomitant respirato? rate increase and a sixfold increase in R7,‘. A reduced ratlo between gastric pressure (SP,,,) and pleural pressure (1P,,) indicated a shift from diaphragmatic breathing to intercostal breathing. Flumazenil successfully reversed all respiratory effects of midazolam within 2 minutes after injection. This study demonstrated that an increase in total pulmonary resistance is associated with a depression in diaphragmatic breathing with a concomitant increase in intercostal muscle activity.-S.L. PAstoN
Reprint requests to Dr Delgado: Department of Pathology. University of Texas-Southwestern Medical Center. 5323 Harry Hines Blvd. Dallas, TX 75235-9072. Odontogenic Cyst Induction by Periapical Infection in Rats. Bando Y, Nagayama M. J Oral Pathol Med 23:323, 1993 Odontogenic cysts may represent the most common destructive lesions of the skeleton.. It has been noted that cysts occur more frequently in teeth succeeding infected primary teeth. This leads to the hypothesis that chronic inflammation and irritation to a developing dental sac may lead to an increased incidence of dentigerous cyst formation. This study tried to determine if infection, at the molar apices of rats predisposes the enamel epithelilim of the underlying incisors to develop dentigerous cysts. Eight-week-old male and female Sprague-Dawley rats were anesthetized intraperitonally and a one-half round bur was used to expose the pulp chambers. The pulpal tissue was removed with a barbed broach and the mesial and distal canals were instrumented with reamers. The roots of the first molars were intentionally overinstrumented by I to 2 mm. No attempt was made to keep a sterile
Reprint requests to Dr Dureuil: Dkpartement d’Anes-ThCsie et de RCanimation Chirugicale. Hopital Bichat. 46 rue Henri Huchard. 75018 Paris. France.
648
t Surg
52 64%655,1994
Abstracts Classification and Diagnostic Criteria for Oral Lesions in HIV Infection. Williams DM. Axell T. Azul AM. et al. J Oral Pathol Med 22:289, 1993
Salivary Duct Carcinoma. Delgado JA. Cancer 72: 1503, I993
R. Vuitch
F, Saavedra
The prototype of neoplasms of ductal origin is mammary ductal carcinoma. Salivary duct carcinoma (SDC) can originate from either extralobular or intralobular ducts of the major salivary glands. SDC is currently classified as a highgrade malignancy because of its invasive growth pattern with early regional or distant metastases. In an attempt to identify clinical prognostic features, the authors reviewed 15 cases of SDC from Parkland Memorial Hospital, Zale Lipshy University. Hospital and St Paul’s Medical Center in Dallas, TX. The clmical features were: 1) ages ranged from 39 to 8 1 years (mean, 59 years). 2) the male to female ratio was 4: 1, 3) the predominant tumor site was the parotid gland ( I3 cases), one tumor was confined to Stensen’s duct, and another tumor was found in the minor salivary glands of the hard palate. All tumors were treated by either wide-local or radical surgical excisions. Nine patients received radiotherapy postsurgically: however, none received chemotherapy or hormone therapy. Mean tumor size was 3. I cm, usually multinodular and circumscribed. Ten tumors were primarily intraductal with a classic central comedo necrosis associated with a cribriform. solid, or micropapillary architecture. The myoepithelial cell was not involved in the neoplastic ductal differentiation. Five tumors were entirely infiltrative and SDC was found within three cases of pleomorphic adenoma. Perineural invasion of major and minor peripheral nerves was also prominent. Lymph node and visceral metastases characterized the primary tumors. Similar to the prototypic ductal carcinoma of the breast, periductal neovascularization may be a prognostic indicator for invasion and metastasis. The differential diagnosis should include low-grade and high-grade salivary gland malignant neoplasms. SDC is a clinically aggressive neoplasm that may account for those adenocarcinomas not otherwise specified as well as those carcinomas associated with pleomorphic adenoma.-S.L. PASION
This article outlines the consensus of the European Community Clearinghouse on Oral Problems related to human immunodeficiency virus (HIV) infections and the US Workshop on Oral Manifestation of HIV Infection for the classification of oral lesions in HIV-infected patients. Along with classification ofthe oral lesions they have also listed diagnostic criteria. based on presumptive and definitive criteria. Classification is divided into three groups: group I, lesions strongly associated with HIV infection: group 2. lesions less commonly associated with HIV infection: and group 3. lesions seen in HIV infection. Those lesions found in group I include specific forms of periodontal disease. Kaposi’s sarcoma. candidiasis, hairy leukoplakia, and non-Hodgkin’s lymphoma. It is hoped that this revised scheme will be applied to clinical and epidemiologic studies.-G.T. J~NFS Reprint requests to Professor Williams: Joint Department of Oral Pathology with The Institute of Dental Surgery. London Hospital Medical College. Turner Street, London El ZAD. England. Effects of Midazolam on Respiratory Muscles in Humans. Mollieux S. Dureuil B. Montravers P. et al. Anesth Analg 77:592. 1993 Midazolam used intravenously as a sedative agent for minor surgery or diagnostic procedures is a mild respiratory depressant and produces a marked increase in upper airway resistance. Nine men, aged 30 to 38. participated in this clinical trial in an attempt to quantitate the effects of midazolam on total pulmonary resistance (RTP) and intercostal, diaphragmatic. and abdominal muscle function. The subjects were prepared with the following equipment: pulse oximeter, electrocardiogram electrodes. two balloon catheters inserted through the same naris to measure pleural and gastric prcssures, a tightly fitting mask connected to a pneumotachograph to yield tidal volume (V, ). and intramuscular needle electrodes to monitor electromyographic activity of the muscles. Control measurements were recorded after IO minutes of resting breathing followed by administration of midazolam 0. I mg/kg in 15 seconds. Trial measurements were taken at T5 (5 minutes after injection) and 7‘10 (10 minutes after injection). Final measurements were taken 2 minutes after a I-mg bolus of flumazenil. Midazolam produced a decrease in V, at T5 and T10 with a concomitant respirato? rate increase and a sixfold increase in R7,‘. A reduced ratlo between gastric pressure (SP,,,) and pleural pressure (1P,,) indicated a shift from diaphragmatic breathing to intercostal breathing. Flumazenil successfully reversed all respiratory effects of midazolam within 2 minutes after injection. This study demonstrated that an increase in total pulmonary resistance is associated with a depression in diaphragmatic breathing with a concomitant increase in intercostal muscle activity.-S.L. PAstoN
Reprint requests to Dr Delgado: Department of Pathology. University of Texas-Southwestern Medical Center. 5323 Harry Hines Blvd. Dallas, TX 75235-9072. Odontogenic Cyst Induction by Periapical Infection in Rats. Bando Y, Nagayama M. J Oral Pathol Med 23:323, 1993 Odontogenic cysts may represent the most common destructive lesions of the skeleton.. It has been noted that cysts occur more frequently in teeth succeeding infected primary teeth. This leads to the hypothesis that chronic inflammation and irritation to a developing dental sac may lead to an increased incidence of dentigerous cyst formation. This study tried to determine if infection, at the molar apices of rats predisposes the enamel epithelilim of the underlying incisors to develop dentigerous cysts. Eight-week-old male and female Sprague-Dawley rats were anesthetized intraperitonally and a one-half round bur was used to expose the pulp chambers. The pulpal tissue was removed with a barbed broach and the mesial and distal canals were instrumented with reamers. The roots of the first molars were intentionally overinstrumented by I to 2 mm. No attempt was made to keep a sterile
Reprint requests to Dr Dureuil: Dkpartement d’Anes-ThCsie et de RCanimation Chirugicale. Hopital Bichat. 46 rue Henri Huchard. 75018 Paris. France.
648