Gland Region Research Articles

Initial stages of development of the submandibular gland (human embryos at 5.5-8 weeks of development).

The aim of this study was to determine the main stages of submandibular salivary gland development during the embryonic period in humans. In addition, we studied submandibular salivary gland development in rats on embryonic days 14-16 and expression in the submandibular salivary gland region with the monoclonal antibody HNK-1. Serial sections from 25 human embryos with a greatest length ranging from 10 to 31mm (Carnegie stages 16-23; weeks 5.5-8 of development) and Wistar rats of embryonic days (E) 14-16 were analysed with light microscopy. Five stages of submandibular salivary gland development were identified. The prospective stage (1), between weeks 5.5 and early week 6, is characterized by a thickening of the epithelium of the medial paralingual groove in the floor of the mouth corresponding to the primordium of the submandibular salivary gland parenchyma. At this stage, the primordium of the parasympathetic ganglion lies below the lingual nerve. The primordium of the submandibular salivary gland parenchyma is observed in rats on E14 in the medial paralingual groove with mesenchymal cells, underlying the lingual nerve. These cells are HNK-1-positive, corresponding to the primordium of the parasympathetic ganglion. The bud stage (2), at the end of week 6 in humans and on E15 in rats, is characterized by the proliferation and invagination of the epithelial condensation, surrounded by an important condensation of the mesenchyme. The pseudoglandular stage (3) at week 6.5 is characterized by the beginning of the formation of lobes in the condensed mesenchyme. The canalicular stage (4), between week 7 and 7.5, is characterized by the appearance of a lumen in the proximal part of the submandibular duct. The innervation stage (5) occurs during week 8, with the innervation of the submandibular and interlobular ducts. Nervous branches arriving from the parasympathetic ganglion innervate the glandular parenchyma. Numerous blood vessels are observed nearby. Our results suggest that submandibular salivary gland development requires interactions among epithelium, mesenchyme, parasympathetic ganglion and blood vessels.

Potential Therapeutic Effects of Underground Parts of Kalanchoe gastonis-bonnieri on Benign Prostatic Hyperplasia.

Benign Prostatic Hyperplasia (BPH) affects mainly older men. It is estimated to affect 50% of 51-60-year-old men and 70% of 61-70-year-old men. BPH is a nonmalignant proliferation of epithelial and stromal cells of the prostate gland regions. Despite the use of conventional pharmacological therapy, herbal medicines are used in BPH therapy, and several mechanisms of action have been suggested based on their complex chemical composition. Considering the ethnomedicinal uses of Kalanchoe gastonis-bonnieri (KGB), we evaluated the inhibitory effects on the proliferation of stromal cells from primary benign prostatic hyperplasia (BPH) of four different aqueous extracts from this plant: underground parts from specimens in flower (T1 treatment), leaves from specimens in flower (T2 treatment), and flowers (T3 treatment) and leaves from specimens not in flower (T4 treatment). T1, T2, T3, and T4 treatments at 250 μg/ml for 72 hours inhibited BPH cells by 56.7%, 29.2%, 39.4%, and 13.5%, respectively, showing that the KGB underground parts extract (T1 treatment) was the most active. Our findings show that the extract of the KGB underground parts (150 and 250 μg/ml) stimulates important changes in the BPH cells, modulating crucial processes such as proliferation, viability, and apoptosis. HPLC-DAD-MS/MS analysis provided a tentative identification of glycosylated syringic acid derivatives, glycosylated forms of volatile compounds, and lignans in this extract. Finally, these results suggest that there is a potential therapeutic use for KGB in BPH, which could improve the clinical management of the disease.

Swelling of the submandibular gland region: Cystic or neoplastic entity?

A 43-year-old male patient reported with a swelling in the left submandibular region of 3–4 months’ duration. The soft fluctuant swelling was painless and cystic on palpation. The excised submandibular gland was submitted for histopathological examination, which showed the presence of a bluish, thin-walled cystic cavity containing gelatinous straw-colored fluid. H and E-stained sections showed thin cystic lining with papillary projections of salivary glandular cells and multiple cystic spaces. Immunohistochemistry was recommended to differentiate between acinic cell carcinoma of papillary-cystic variant and low-grade mucoepidermoid carcinoma.

Misdiagnosed recurrent multiple Kimura's disease: A case report and review of the literature.

Kimura's disease (KD) is a rare condition, with only a few cases reported to date, mainly in Asian patients. We herein present the case of a 48-year-old man with KD who presented with recurrent masses in the right parotid gland and neck region over a 15-year period. The masses were not accompanied by pain, or significant functional or neurosensory dysfunction. The results of the laboratory tests revealed an increased eosinophil count and markedly elevated serum IgE levels. On magnetic resonance imaging examination, a widespread abnormal signal was detected in the area of the lesions; the contrast-enhanced scan revealed inhomogeneous enhancement, with partial involvement of the sternocleidomastoid muscle and the parotid gland. The patient underwent surgical resection of the right parotid and neck masses, and the postoperative pathological examination revealed eosinophilic hyperplastic lymphogranuloma, also referred to as KD. This presented case and review of the relevant literature aim to improve our understanding of KD in order to increase the accuracy of diagnosis, reduce the misdiagnosis rate and ensure proper treatment of this rare disease.

Relationships of endocrine cells to each other and to other cell types in the human gastric fundus and corpus.

Gastric endocrine cell hormones contribute to the control of the stomach and to signalling to the brain. In other gut regions, enteroendocrine cells (EECs) exhibit extensive patterns of colocalisation of hormones. In the current study, we characterise EECs in the human gastric fundus and corpus. We utilise immunohistochemistry to investigate EECs with antibodies to ghrelin, serotonin (5-HT), somatostatin, peptide YY (PYY), glucagon-like peptide 1, calbindin, gastrin and pancreastatin, the latter as a marker of enterochromaffin-like (ECL) cells. EECs were mainly located in regions of the gastric glands populated by parietal cells. Gastrin cells were absent and PYY cells were very rare. Except for about 25% of 5-HT cells being a subpopulation of ECL cells marked by pancreastatin, colocalisation of hormones in gastric EECs was infrequent. Ghrelin cells were distributed throughout the fundus and corpus; most were basally located in the glands, often very close to parietal cells and were closed cells i.e., not in contact with the lumen. A small proportion had long processes located close to the base of the mucosal epithelium. The 5-HT cells were of at least three types: small, round, closed cells; cells with multiple, often very long, processes; and a subgroup of ECL cells. Processes were in contact with their surrounding cells, including parietal cells. Mast cells had very weak or no 5-HT immunoreactivity. Somatostatin cells were a closed type with long processes. In conclusion, four major chemically defined EEC types occurred in the human oxyntic mucosa. Within each group were cells with distinct morphologies and relationships to other mucosal cells.

Rethinking origins of pineal meningiomas

Objective To investigate the clinical data and origin of pineal meningiomas, and to discuss the definite meaning of the term interpositum . Methods From January 2005 to December 2016, 21 cases of pineal region meningiomas underwent operations at Department of Neurosurgery, Nanfang Hospital, Southern Medical University and were enrolled into this retrospective study. Analysis was conducted on the clinical characteristics, imaging findings and surgical video data of those patients who were divided into 2 groups according to literature: falcotentorial meningioma group and velum interpositum meningioma group. Comparison was conducted between the 2 groups. Results Among 12 cases of falcotentorial meningiomas, 4 cases were originated from cerebral falx, 4 from cerebellar tentorium and 4 from straight sinus. Among 9 cases of velum interpositum meningiomas, 7 were originated from the cerebral arachnoidal envelope, 1 from the posterior cerebral vein and 1 from pineal surface. Postoperative pathological examination confirmed the diagnosis of meningioma in all cases. Among those, total resection was achieved in 16 cases and subtotal resection in 5. There were 3 cases of vertical movement limitation of the eyes, 7 cases of isotropic hemianopia, 1 case of hemiplegia, and 1 case of death. Conclusions The falcotentorial meningioma and primary pineal meningioma might be more appropriate for classification of origins of pineal meningiomas. The term interpositum may not be able to accurately reflect the origin of meningioma in the pineal gland region. During resection of pineal gland meningiomas, the protection of large veins and collateral circulation is of much significance. Key words: Meningioma; Pinealoma; Classification; Neurosurgical procedures

Utilization of 18FDG-PET-Based IMRT Planning to Spare the Most Metabolically Active Subvolume of Parotid Glands During Definitive Radiation Therapy for Head and Neck Cancer

To evaluate 18FDG-PET-based IMRT planning to reduce radiation dose to the most metabolically active regions of the parotid glands during radiation therapy for head and neck squamous cell carcinoma (HNSCC) with the goal of reducing xerostomia. A total of 20 patients with HNSCC (19 oropharynx; 1 nasopharynx) underwent 18FDG-PET and contrast-enhanced CT simulation for definitive radiation treatment planning. The original IMRT treatment plan used clinically was generated based on the pretreatment CT with volumetric-based dose constraints for each parotid gland. Prescription was 44 or 50 Gy (low risk PTV) and 70 Gy (high risk PTV) at 2 Gy/fraction. Patients were retrospectively replanned with added metabolically-based constraints for each parotid gland. SUV thresholding was performed in Eclipse to generate a contour encompassing the top one-third most metabolically active region of each parotid gland (SUV-High). SUV-High contours were transferred to the registered CT for the replanning. The original IMRT plans were re-optimized to reduce dose to SUV-High within each parotid while maintaining target coverage and meeting initial dose constraints for all other organs at risk. Median doses (Dmedian) to SUV-High and the entire gland for each parotid were calculated for the original and revised plans. Wilcoxon matched-pairs signed rank test (2-tailed, p<0.05) was performed to compare Dmedian in the initial vs. metabolically-based plan for each structure. SUV-High represented a median of 44% (IQR 38.9 – 52.4%) and 40.7% (IQR 21.7 – 54.8%) of the left and right parotid gland volumes, respectively. Median dose differed significantly between the metabolically-based (replan) and clinical (original) IMRT plans for the entire gland and SUV-High for each parotid (p < 0.0001). The table shows Dmedian from each plan, as well as relative percent change in Dmedian for the metabolically based plan relative to the original plan for each structure.Abstract 207; TableSUV-High, Left ParotidWhole Gland, Left ParotidSUV-High, Right ParotidWhole Gland, Right ParotidOriginal Median Dmedian (IQR), Gy14.3 (11.6, 25.8)16.3 (13.8, 22.3)18.3 (10, 27.6)18.8 (14.8, 22.7)Replan Median Dmedian (IQR), Gy13.7 (10.7, 21.5)15 (13.2, 20.1)15.5 (9.3, 24.4)16.8 (13.9, 19.6)Median % Change (IQR)-8.1% (-12.8, -3.9%)-4.6% (-10.2, 0.1%)-13.7% (-18, -7.1%)-6% (-11.8, -0.2) Open table in a new tab We have demonstrated that it is feasible to utilize 18FDG-PET information in IMRT planning to significantly reduce radiation dose to the most metabolically active sub-volume and whole gland for both parotids. Prospective evaluation is necessary to determine whether this approach can reduce late treatment-related xerostomia for head and neck cancer patients.

Multipotent peripheral glial cells generate neuroendocrine cells of the adrenal medulla

Current textbooks teach that adrenergic chromaffin cells of the adrenal medulla originate from a sympathoadrenal cell lineage of the neural crest nearby the dorsal aorta. Here, Furlan et al. demonstrate a novel origin of these neuroendocrine cells of the medulla arising predominantly from Schwamm cell precursors (SCP) of peripheral nerves. Previously it had been shown that SCPs serve as multipotent stem cells that can differentiate into various cell types, most importantly parasympathetic nerve cells. Using genetic cell fate tracing, SCP and nerve ablation, as well as chromaffin differentiation interference studies in mice, the authors show that most chromaffin cells of the adrenal medulla originated from SCP. They describe lineage segregation of chromaffin cells from sympathoblasts, and the specific gene program driving SCP into chromaffin cells via a defined bridge transition phase. Overall, the adrenal medulla seems to be formed in two steps. Organogenesis step one consists of expansion of the SCPs; step two, proliferation of the chromaffin cells. Peripheral nerves provide niches for progenitor cells and avenues for cell migration also important for neuroendocrine organ development. This new finding may have implications on the understanding of neuroblastoma and pheochromocytoma, which both mostly arise from the adrenal gland region.

Evaluation of Ultrasonography and Mammography in Diagnosis of Mammary Gland Tumor in Bitches: Based on Tumor Markers

Objective- This study refers to the role of ultrasonography in the diagnosis of mammary gland tumor in bitches as a complementary diagnostic method and its ultimate goal is to evaluate the results of mammography with the positive results of ultrasonography.Design- Prospective study.Animals- 12 German Shepherd bitches with swollen mass in the mammary gland region (group I) and 12 healthy German shepherd bitches without any swollen mass (group II-healthy group).Procedures- these bitches were evaluated by ultrasonography and assessment of axillary lymph nodes was performed simultaneously. Also, mammography was performed in these dogs and the results were reported by another radiologist. Finally, all suspected cases were referred for biopsy or surgery, and definite results were announced by the pathologist. In addition to, tumor markers such as carcino emberionic antigen (CEA) and cancer antigen 15.3 (CA 15.3) were detected in all samples (group I and group II).Results- Based on the results of the 12 cases of suspicious masses evaluated by ultrasonography, 9 cases of tumors (definitive diagnosis with pathological tests) and 3 cases of abscess were reported in the cases of group I. Moreover, tumor markers remarkably increased in the all sera samples of group I compared group II. The average diameter of the mass was 13 mm and the mean diameter of the lymph nodes was 5 mm. In mammography findings due to presence of dense mammary tissue, 18.3% of the cases had negative or only one asymmetric density and the remaining cases (81.7%) were positive. Conclusion and Clinical Relevance- Based on the results of this study, ultrasonography in diagnosis of mammary gland tumors especially in young bitches can be effective with high sensitivity.

Computerized tomography features and clinicopathological analysis of Kimura disease in head and neck.

The aim of the current study was to discuss and analyze computerized tomography (CT) features and clinicopathological characteristics of patients with Kimura disease in head and neck. CT and clinicopathological data of 12 patients with Kimura disease diagnosed between May 2011 and May 2015 were analyzed. The mean age was 43.9 years and the disease course varied from 1 week-20 years. The mean absolute value of eosinophil granulocytes was 1.95×109/l. Multiple nodules were detected in 4 patients with Kimura disease. Main symptoms included multiple enlarged lymph nodes in neck and submaxillary regions. CT imaging of nodular lesions revealed a clear boundary, with moderate to marked homogeneous enhancement. Diffuse mass lesions were observed in 6 patients with Kimura disease. Main symptoms included subcutaneous diffuse soft tissue mass in parotid gland and maxillofacial regions. CT imaging of diffuse mass revealed unclear boundaries, adjacent skin thickness and moderate heterogeneous enhancement. In some cases, the diffuse mass involved soft mass with unclear boundaries. Pathological symptoms of Kimura disease included infiltration of eosinophilia, lymphocytic proliferation, formation of lymphatic follicles and variable degrees of fibrosis and vascular proliferation. Diagnosis of Kimura disease in head and neck regions may be improved based on lesions with clear or unclear boundaries, homogeneous or heterogeneous enhancement, with or without lymphadenectasis and by the presence of peripheral blood eosinophilia. However, a final diagnosis relies on a pathological examination.

Sex Difference in the Morphology of Pineal Gland in Adults Based on Brain Magnetic Resonance Imaging.

We aimed to figure out the anatomical features of pineal gland region on magnetic resonance imaging (MRI) and to explore the sex difference in pineal gland-related parameters with increasing age. We measured the pineal gland on MRI images from 198 healthy adults (96 males and 102 females). Included subjects were divided into 4 age groups. After 3-dimensional reconstruction, the anatomic features of pineal gland and its distances to superior colliculus and splenium of corpus callosum were analyzed in each group. The prevalence of cystic pineal gland was calculated. Moreover, we calculated the volume of pineal gland (PGV) and explored the differences of PGV in males and females across different age groups. Linear regression analysis was performed to detect the relationship between age and pineal gland-related parameters. In 198 subjects, the mean length, width, and height of pineal gland were 7.58 ± 0.45 mm, 4.92 ± 0.40 mm, and 2.90 ± 0.20 mm. The distances between pineal gland and superior colliculus as well as splenium of corpus callosum were 3.96 ± 0.92 mm and 4.3 ± 1.89 mm, respectively. The PGV was 54.1 ± 7.02 mm. Significant sex differences were found in pineal gland length (P < 0.001), cranial cavity diameter (P < 0.001), pineal gland index (P < 0.001) and PGV values (P = 0.02). The prevalence of cystic pineal gland was 36.4% in total subjects, 41.7% in males and 32.4% in females. No linear relationship was found between age and pineal gland parameters. We measured the pineal gland morphology based on MRI images. Significant influences on pineal gland parameters were found in subjects with different sex, whereas no effect was observed from age.

Efeito agudo da Transcutaneous Electric Nerve Stimulation (TENS) sobre a hipossalivação induzida pela radioterapia na região de cabeça e pescoço: um estudo preliminar

To verify the acute effect of electrostimulation on the salivary flow of patients with hyposalivation. Uncontrolled clinical trial evaluating 15 patients with hyposalivation induced by radiotherapy (RT) used for head and neck cancer treatment. Mean age of the patients was 56.8 ± 6.46 years. Males outnumbered females (73%). Transcutaneous Electrical Nerve Stimulation (TENS) was adjusted with 50Hz of frequency and 250μs of pulse width. Intensity was adjusted over a 20-minute period according to maximum tolerance. The electrodes were attached bilaterally on the region of the salivary glands. Evaluation of the salivary flow was performed through sialometry before and immediately after application of TENS. The most prevalent region for RT was the oropharynx (80.0% of cases). The mean dose used in RT was 64.6 ± 7.27 Gy. After TENS, salivary flow increased significantly (p = 0.0051) from 0.05 (0.00; 0.40) mL/min to 0.10 (0.07: 0.40) mL/min. The response to TENS was directly correlated with the intensity of the tolerated electric current (r = 0.553; p = 0.032) and the dose used in RT (r = -0.514; p = 0.050). TENS was able to increase the salivary flow rate of patients with RT-induced hyposalivation.

Immunohistochemical Biomarkers in Diagnosis of Hematolymphoid Neoplasms of Endocrine Organs.

The hematolymphoid infiltrations are challenging lesions in endocrine organs and tissues. The fourth edition of WHO classification of tumors of endocrine organs and the fourth edition of WHO classification of tumors of hematopoietic and lymphoid tissues are recently published. The updates in both fields include some new disease descriptions and prognostic markers. Our aim in this review article is to give practical diagnostic information about the most frequently seen hematolymphoid involvements of the pituitary gland, thyroid, and adrenal tissue. We designed the text in the order of organs and the contents according to the disease frequency. The pituitary gland and cellar region are the most frequently involved with Langerhans cell histiocytosis. Although it is very rare, Erdheim-Chester disease has recently been included in the classification and still needs more clear diagnostic definitions. Lymphoproliferative thyroid lesions and presentations create diagnostic problems for the pathologists. IGG4-related disease and its relation with thyroiditis is a new concept. There are many unknowns on pathobiology of the disease spectrum and discussion on defined diagnostic criteria of the IGG4-related thyroid diseases. The overlapping features of thyroiditis and primary thyroid lymphomas also create diagnostic difficulties. The frequently recognized primary hematolymphoid lesions of the endocrine organs may not be difficult to diagnose since they are expected lesions. The secondary involvement of hematolymphoid neoplasia may be more difficult to diagnose for an endocrine pathologist. In this review article, we aim to give brief description of the diseases and practical diagnostic approach by using optimum markers guided by the latest WHO classifications.

Synchrotron- and focal plane array-based Fourier-transform infrared spectroscopy differentiates the basalis and functionalis epithelial endometrial regions and identifies putative stem cell regions of human endometrial glands

The cyclical process of regeneration of the endometrium suggests that it may contain a cell population that can provide daughter cells with high proliferative potential. These cell lineages are clinically significant as they may represent clonogenic cells that may also be involved in tumourigenesis as well as endometriotic lesion development. To determine whether the putative stem cell location within human uterine tissue can be derived using vibrational spectroscopy techniques, normal endometrial tissue was interrogated by two spectroscopic techniques. Paraffin-embedded uterine tissues containing endometrial glands were sectioned to 10-μm-thick parallel tissue sections and were floated onto BaF2 slides for synchrotron radiation-based Fourier-transform infrared (SR-FTIR) microspectroscopy and globar focal plane array-based FTIR spectroscopy. Different spectral characteristics were identified depending on the location of the glands examined. The resulting infrared spectra were subjected to multivariate analysis to determine associated biophysical differences along the length of longitudinal and crosscut gland sections. Comparison of the epithelial cellular layer of transverse gland sections revealed alterations indicating the presence of putative transient-amplifying-like cells in the basalis and mitotic cells in the functionalis. SR-FTIR microspectroscopy of the base of the endometrial glands identified the location where putative stem cells may reside at the same time pointing towards νsPO2− in DNA and RNA, nucleic acids and amide I and II vibrations as major discriminating factors. This study supports the view that vibration spectroscopy technologies are a powerful adjunct to our understanding of the stem cell biology of endometrial tissue.Graphical abstractᅟ

Use of low-level laser therapy on children aged 1 to 5 years with energy-protein malnutrition: A clinical trial.

Background:Episodes of malnutrition in early childhood can produces alterations in the salivary glands. The investigation of mechanisms that can reduce the impact of malnutrition on the defenses of the organism is of the utmost important and interest to public health. The aim of this study is to evaluate the effect of low-level laser on the saliva of children aged 1 to 5 years with energy-protein malnutrition.Methods:Mandatory inclusion criteria are diagnosis of malnutrition. The sample will consist of 50 men and women malnourished children aged 12 to 71 months. Saliva will be collected and the volume of saliva will be measured and the salivary flow rate will be determined (mL/min). Concentrations of salivary IgA in all samples will be measured using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Low-level laser (laser diode) will be administered in the region of the parotid glands bilaterally as well as in the regions of the submandibular and sublingual glands.Discussion:This study will be the first that investigate the effects of local laser therapy on the salivary glands of malnourished children.Trial registration:Clinical.trials.gov as NCT03355313, first received in 21 November 2017.

CD29 is highly expressed on epithelial, myoepithelial, and mesenchymal stromal cells of human salivary glands.

The phenotype of the cells present in the ductal region of salivary glands has been well characterized. However, it is imperative to identify novel biomarkers that can identify different cell types present in other glandular components for the development of therapeutic strategies and diagnostics of salivary gland disorders and malignancies. Our study aimed at the characterization of the expression and distribution of various cell surface markers, especially with a focus on CD29 in human fetal as well as adult glands. Paired human midgestation fetal and adult parotid, sublingual, and submandibular glands were collected. Phenotypic expression of various lineage-specific cell surface markers including CD29 was investigated in freshly collected glands. The findings were further corroborated by immunohistochemistry. Enriched expression of CD29 was found on acinar and ductal epithelial, mesenchymal stromal, and myoepithelial cells; CD29+ cells co-expressed epithelial (CD324, CD326, NKCC1, and CD44), mesenchymal (CD73, CD90, vimentin, and CD34), and myoepithelial (α-SMA) cell-specific progenitor markers in both fetal as well as adult salivary glands. CD29 is widely expressed in human salivary glands, and it could serve as a potential biomarker for devising novel cellular therapeutic and diagnostic strategies for salivary gland disorders and malignancies.

Ghrelin regulation of glucose metabolism

The a 28-amino acid peptide ghrelin was discovered in 1999 as a growth hormone (GH) releasing peptide. Soon after its discovery, ghrelin was found to increase body weight and adiposity by acting on the hypothalamic melanocortinergic system. Subsequently, ghrelin was found to exert a series of metabolic effects, overall testifying ghrelin a pleiotropic nature of broad pharmacological interest. Ghrelin acts through the growth hormone secretagogue-receptor (GHS-R), a seven transmembrane G protein-coupled receptor with high expression in the anterior pituitary, pancreatic islets, thyroid gland, heart and various regions of the brain. Among ghrelins numerous metabolic effects are the most prominent the stimulation of appetite via activation of orexigenic hypothalamic neurocircuits and the food-intake independent stimulation of lipogenesis, which both together lead to an increase in body weight and adiposity. Ghrelin effects beyond the regulation of appetite and GH secretion include the regulation of gut motility, sleep-wake rhythm, taste sensation, reward seeking behaviour, and the regulation of glucose metabolism. The latter received recently increasing recognition because pharmacological inhibition of ghrelin signaling might be of therapeutic value to improve insuin resistance and type 2 diabetes. In this review we highlight the multifaceted nature of ghrelin and summarize its glucoregulatory action and discuss the pharmacological value of ghrelin pathway inhibition for the treatment of glucose intolerance and type 2 diabetes.

Early treatment response of a rare papillary tumor of the pineal region after primary proton-beam therapy using the raster-scanning technique at HIT.

Pineocytomas are rare intracranial tumors occurring in the pineal gland region. The curative therapy of choice is gross total resection, which cannot be performed in all patients because of the frequent eloquent location of these tumors. Percutaneous fractionated radiotherapy is an alternative treatment approach that may result in high local control rates. Nevertheless, our knowledge of this tumor entity is limited and based on retrospective case series only. We present a patient with a papillary tumor of the pineal region who was treated with highly conformal proton-beam therapy at the Heidelberg Ion Therapy Center (HIT) using the raster-scanning technique.

Twenty-Five Diagnoses on Midline Images of the Brain: From Fetus to Child to Adult.

Midsagittal images of the brain provide a wealth of anatomic information and may show abnormalities that are pathognomonic for particular diagnoses. Using an anatomy-based approach, the authors identify pertinent anatomic structures to serve as a checklist when evaluating these structures. Subregions evaluated include the corpus callosum, pituitary gland and sellar region, pineal gland and pineal region, brainstem, and cerebellum. The authors present 25 conditions with characteristic identifiable abnormalities at midsagittal imaging. Midsagittal views from multiple imaging modalities are shown, including computed tomography, ultrasonography, and magnetic resonance (MR) imaging. Standard MR imaging sequences are shown, as well as fetal MR and sagittal diffusion-weighted images. To demonstrate these conditions, fetal, neonatal, childhood, adolescent, and young adulthood images are reviewed. The differentiation of normal variants is guided by the understanding of anatomy and pathology. When a specific diagnosis is not possible, the authors present information to evaluate differential considerations and discuss when follow-up imaging may be indicated. The authors hope each case will clarify a pertinent differential diagnosis, appropriately guide patient management, and improve understanding of normal anatomy and identification of pathologic entities. It is in these hopes that the authors have presented a checklist of pertinent anatomy and pathologic entities that can build on existing search patterns. Improved confidence and accuracy in the evaluation of midsagittal images will benefit physicians and patients. ©RSNA, 2018.

Evaluation of Relationship between Exposure Parameters and Maxillofacial Bone Quality with Salivary Glands Absorbed Dose in Cone Beam Computed Tomography Imaging

The purpose of this study was to evaluate the protective effect of jaw bone on the dose of salivary glands and its relationship with radiation conditions. In this cross-sectional study, seven dried human skulls were used. In each mandible, six dosimeters were placed in six salivary gland regions numbered in visible light absorbent envelopes. Cone beam computed tomography (CBCT) images were taken from each mandible with a constant kV of 90 and mA varied from 6, 8, and 10. The absorbed dose was calculated using SOLAR 2A. The bone quality of each of the six areas was obtained using densitometry tool in On Demand software. Finally, the results were analyzed using Statistical Package for the Social Sciences (SPSS) software version 23 with covariance and Tukey tests (α = 0.05). The results of covariance analysis and Tukey test indicated that the sublingual salivary gland had the highest absorption dose. Meanwhile, the results of the analysis showed that the absorption rate of the glands increased by increasing the radiation conditions from 6 to 8 and increasing from 8 to 10 mA (p < 0.001). The results of Pearson analysis showed an inverse relationship between absorbed dose and bone quality (r = -0.327) (p < 0.001). The results of this study showed that the absorption rate of salivary glands will increase with increasing radiation conditions, while increasing the quality of mandibular bone, the absorption dose will decrease. The clinical significance is to reduce patient's absorbed dose in order to decrease the risk of mutation and cancer formation.