Large Salivary Glands Research Articles

A Clinicopathological Study of Parotid Gland Tumours

Abstract Background: The parotid gland is the largest salivary gland. Pleomorphic adenoma (PA) is the most common tumour found in the parotid gland. Most of the parotid tumours are painless and slow-growing. Ultrasound, computed tomography and magnetic resonance imaging are modalities of diagnosis. Fine-needle aspiration cytology (FNAC) is done in some cases, and its use is controversial. Aim: This clinicopathological study mainly aims at the demographic profile of the patient and clinical implications. Investigations were done and also evaluating the efficacy of FNAC in diagnosing parotid gland tumours. Materials and Methods: We conducted a prospective, hospital-based, observational study at our institution from December 2020 to June 2022. Forty patients who satisfied the inclusion and exclusion criteria were enrolled in the study. The study was analysed using SPSS version 25 developed by IBM. The categorical variables were presented as frequency and continuous data as mean, standard deviation (SD) and range with confidence interval. Categorical variables were compared using the Chi-square test; P <0.05 is considered significant. The sensitivity, specificity positive predictive value (PPV) and diagnostic accuracy of FNAC against the gold-standard histopathological examination (HPE) were worked out. The results are shown in tabular and graphical format. Results: The incidence of swelling was higher in males than females. Swelling was the most common clinical feature of the parotid gland. The duration of the disease ranges from ½to 48 months with an SD of 8.26 and a 95% confidence interval. One patient presented with facial nerve involvement and one patient presented with lymph node involvement. Five patients gave a history of surgery done in the past, which indicates recurrence, 10 (25%) patients were smokers and 1 (3%) patient had a history of previous radiation. Amongst the population of smokers, Warthin’s tumours were the most common (50%), PA (20%), oncocytic lipoadenoma, mucoepidermoid (MEP) carcinoma and myoepithelial (MyoEP) tumours having 10% incidence. The radiological findings were evaluated showing PA in 72.5% of cases, Warthin’s in 7.5%, neoplasm in 7.5% and non-specific cyst parotitis in 2.5% each. One patient image shows features of malignancy. FNAC says that 67.5% were PA, 20% were Warthin’s cyst and non-specific cyst, MEP and inflammation, but in one patient, FNAC was inconclusive. Most of the study population underwent superficial parotidectomy (32.5%); 30% of the study group underwent superficial conservative parotidectomy, but 27.5% of patients underwent total conservative parotidectomy. About 2.5% of the study group underwent extracapsular excision and enucleation. However, 2 (5%) patients were done with simple excision only. After surgery, out of 40, 38 patients had neuropraxia which recovered on follow-up. The most common tumour was PA (67.5%), and Warthin’s (22.5%) malignant tumours like MEP and MyoEP were 5% and 2.5%, respectively. Rare benign tumours like oncocytic lipoadenoma were the finding of HPE in FNAC that was inconclusive in this case. The incidence of malignant tumours was more common in males than in females, and it was more common in the age group of 21–40 years. MEP carcinoma was the most common malignant tumour. The efficacy of FNAC was identified in terms of sensitivity, specificity, negative predictive value (NPV), PPV and diagnostic accuracy. The sensitivity for benign tumours was 91.89% and that for malignant tumours was 33.33%. The specificity was 33.33% for benign tumours and 100% for malignant tumours respectively. The PPV was 94.44% for benign and 100% for malignant tumours. NPV was 25% and 94.87%, respectively. The diagnostic accuracy was 87.5% and 95%. Conclusion: Although FNAC has some pitfalls, the high sensitivity, specificity and accuracy in diagnosing malignant lesions as evident from this study indicate that FNAC is a reliable diagnostic method when correctly performed and interpreted by an experienced cytopathologist. Not all parotid lesions are lumps are malignant. Most of the masses are benign in nature. FNAC is a simple, safe, painless and cost-effective method for easy diagnosis.

The Spotted Lanternfly Contains High Concentrations of Plant Hormones in its Salivary Glands: Implications in Host Plant Interactions.

The spotted lanternfly (SLF), Lycorma delicatula is an invasive species in the United States that has emerged as a significant pest in vineyards. This polyphagous insect causes significant damage to grapevines and tree of heaven (TOH). SLF feeds voraciously on plant tissues using its piercing and sucking mouthparts through which it injects saliva and uptakes plant sap. Despite its impact, research on fundamental mechanisms mediating SLF interactions with their predominant hosts is limited. This study documents the morphology of salivary glands and quantifies plant hormones in salivary glands of SLF adults fed on grapevines and TOH using Liquid Chromatography-Mass Spectrometry (LC/MS). SLF adults have one pair of large salivary glands, ranging from 10 to 15mm in length that extend from the insect's head to the last sections of the abdomen. The salivary glands of SLF contain salicylic acid (89 ng/g), abscisic acid (6.5 ng/g), 12-oxo-phytodienoic acid (5.7 ng/g), indole-3-acetic acid (2 ng/g), jasmonic acid (0.6 ng/g), jasmonic acid isoleucine (0.037 ng/g), and the cytokinin ribosides trans-zeatin (0.6 ng/g) and cis-zeatin (0.1 ng/g). While the concentrations of these hormones were similar in insects fed on grapevines and TOH, abscisic acid was more abundant in insects fed on grapevines, and jasmonic acid isoleucine was only detected in insects fed on grape. These results are discussed in the context of the possible implications that these hormones may have on the regulation of plant defenses. This study contributes to our understanding of the composition of SLF saliva and its potential role in plant immunity.

MAJOR SALIVARY GLAND TUMORS: SINGLE INSTITUTION EXPERIENCE

IntroductionThe study analyses the occurrence and treatment outcomes of tumors of the major salivary glands in our patients.Material and methodsBetween 2019 and March 2023, a total of 182 salivary gland surgeries were conducted at our clinic. Of these, 111 were on females aged 18 to 76 years, and 71 on males aged 18 to 82 years. Diagnosis comprised a medical history, otolaryngological physical examination, ultrasonography (USG), fine-needle aspiration (FNA) biopsy of tumor, laboratory tests (CBC, CRP), and contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI).ResultsPredominantly (176 patients), benign tumors and neoplasms were found in the parotid salivary gland. Histopathology most commonly revealed pleomorphic adenoma (PA, 74 cases) and Warthin’s tumor (WT, 70 cases). Other benign tumors and neoplasms made up only 18% of cases. Malignant neoplasms were only identified in the parotid salivary gland in 3.3% of cases; these were diagnosed as epithelial-myoepithelial carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, mucoepidermoid carcinoma, and ductal carcinoma.ConclusionsIn our dataset, most patients with tumors of the major salivary glands were operated on at ages above 60 years. A low incidence of malignant tumors and a high incidence of WT of the large salivary glands were observed. The main postoperative complication was facial nerve paresis in 7.6% of cases.

Pleomorphic adenoma of the nasal cavity in a 21 – year – old patient – case report

Introduction and aim: Adenoma pleomorphum (multiform adenoma) is the most popular bening tumor, that originates from the salivary glands. Neoplasm develops mainly from large salivary glands and its occurrence in the nasal cavity is rare and falls mainly in the 3-6 decade of life. Only 1% of all pleomorphic adenomas develop in the nasal and sinus cavities. Despite being a benign tumor, malignant transformation can occur in 2-10% of cases. Description of the case: We report a case of a 21-year-old female ethnically Polish patient with nasal multiform adenoma with initial diagnosis, which indicated a polyp. The final diagnosis was based on the histopathological examination of the resected lesion. The tumor was removed by an endoscopic method with no tissue margins, which may increase the risk of recurrence. Conclusions: Our case demonstrates that despite pleomorphic adenomas typically occurs in the 3rd to 6th decade of life, clinical symptoms are nondistinctive with a polyp and nasal cavity is a very rare location there should be always be increased vigilance leading to choosing best diagnostic measures to form right diagnosis.

First Case Report of Bilateral Parotid Lymphoepithelial Carcinoma.

The parotid is the largest salivary gland and is located anteriorly to the sternocleidomastoid muscle and laterally to the ramus of the mandible. Neoplasms in this gland are relatively rare, with 80% being benign and 20% malignant, primarily represented by mucoepidermoid carcinoma. In the head and neck region, lymphoepithelial carcinoma (LEC) accounts for 0.4% of malignant salivary gland tumors. A 35-year-old man with no previous comorbidities was admitted to a Head and Neck Surgery Specialty Service for a painless right cervical mass of uncertain growth. Extensive diagnostic investigation revealed involvement of the contralateral parotid, associated with systemic lymph node enlargement. Thus, adjuvant radiotherapy was decided by the treating team. This case confirms the heterogeneous features and distinctive behavior that the disease can present, as seen with bilateral parotid LEC.

Alternative surgical restoration of aesthetic defect during superficial parotidectomy – Case report

Tumors in the parotid gland, which is the largest salivary gland, could appear as a swelling in the cheek area or in the area in front of and below the earlobe. The majority are benign tumors. In all cases, removal of the tumor by parotidectomy is the main option. In the majority of these operations, postoperatively a defect remains in the lateral region of the face after the removal of the tumor. Many solutions have been proposed internationally to treatment this aesthetic defect. In this study, a proposal is presented to use part of the remaining parotid tissue, to restore the defect that appears after the removal of the tumor and the preparation of the facial nerve.

Post-radiation lesions of the salivary glands after radioiodine therapy: features of the clinical course

To date, thyroid diseases are one of the most common pathologies of the endocrine system and are an urgent medical and social problem. In order to treat and diagnose differentiated thyroid cancer, thyrotoxic goiter, and diffuse toxic goiter, radioiodine therapy is used in combination with other methods (surgery, hormone therapy). Lesions of the salivary glands that occur after radiotherapy are associated with the ability of large salivary glands to concentrate iodine in ductal cells. The accumulation of radioactive iodine I131 has an adverse radiation effect on the salivary glands, which leads to damage to the tissues of the glands of varying degrees of intensity.Background. Despite the large number of publications devoted to this problem, the clinical and laboratory characteristics of radioiodosialadenitis remain incomplete and often contradictory. In this regard, the study of this topic does not lose its relevance.Materials and methods. As a result of the examination of 45 patients after radiooderpia, with a clinical-radiological examination, a group of patients (n = 12), with a lack of a secret during visual examination and contrast of one or more salivary glands, is probably associated with irreversible changes in the salivary glands, was identified and described in this article.Results. Different combinations of damage to one or more salivary glands have been identified, reducing the level of quality of life of patients in this group of patients. When examining the salivary glands and conducting differential diagnostics, various combinations of examination methods must be used.Conclusions. The side effect of the effects of radioid therapy on the salivary glands is characterized by a wide spectrum of the involvement of the salivary glands up to a decrease in the functional activity and atrophy of the salivary glands, however, adverse consequences are not always dose-dependent. The results of the methods obtained do not exclude, but complement each other, which allows you to fully evaluate structural and functional changes in salivary glands. The negative effects of radionuclide therapy on the salivary glands affects the quality of life of patients.

DEVELOPMENT OF PATHOLOGICAL CHANGES IN THE ORAL CAVITY ORGANS OF ANIMALS UNDER CONDITIONS OF POLYNEUROPATHIES OF DIFFERENT GENESIS

The aim of our research is to study the effect of polyneuropathy of different genesis on the development of pathological changes in the large salivary glands and periodontal tissues of animals. Methods. The study was conducted on 62 laboratory rats of both sexes. Toxic polyneuropathy was induced by paclitaxel injection, experimental type 1 diabetes mellitus was modeled by streptozocin injection, and alcoholic polyneuropathy was induced by chronic administration of increasing concentrations of ethanol. The development of polyneuropathy was confirmed by a change in the the pain sensitivity threshold (PST) using the Randall-Selitto tensoalgometric method. In the homogenate of oral cavity organs, total proteolytic and total antitryptic activity, catalase activity, content of TBARS, average mass molecules, oxidatively modified proteins, fucose and glycosaminoglycans (GAG), and amylase activity were determined. The level of total, protein-bound and non-protein sulfhydryl groups, activity of superoxide dismutase, glutathione peroxidase, glutathione transferase, glutathione reductase; content of reduced and oxidized glutathione, diene conjugates and Schiff bases were determined in blood serum. Results. We established the increasing of PST in animals that were simulated neuropathies of different genesis. All three types of polyneuropathies are accompanied by the development of carbonyl-oxidative stress in the soft tissues of the periodontium and large salivary glands of rats, which is evidenced by a probable increase in the content of oxidatively modified proteins and the content of TBARS, as well as average mass molecules compared to these indicators in intact animals . Under the conditions of modeling all three polyneuropathies, the protein-synthetic activity in the large salivary glands is suppressed, as evidenced by a decrease in the activity of α-amylase. Under conditions of experimental diabetic and toxic neuropathy in the salivary glands of animals, changes in the proteinase-inhibitor balance of the compensatory type are observed. We found that polyneuropathies of different genesis cause increased catabolism of biopolymers of the extracellular matrix of the periodontal connective tissue of rats, which confirms the increase in the content of GAG and fucose compared to these indicators in control animals. Conclusions. Under conditions of diabetic, toxic and alcoholic neuropathy, the amylolytic activity of the large salivary glands of animals is suppressed, the balance of the pro- and antioxidant system changes. When modeling peripheral polyneuropathy in animals by administration of paclitaxel, streptozocin, and ethanol, the development of periodontal syndrome is observed, the leading pathogenetic mechanisms of which are increased catabolism of connective tissue glycoconjugates and the development of oxidative stress and proteinase-inhibitor imbalance.

Primary squamous cell carcinoma of the parotid salivary gland: a clinical observation

Introduction. Malignant tumors of the salivary glands account for 3–5 % of all cases of head and neck cancer. Squamous cell carcinoma is the rarest histological variant of this pathology. It accounts for an average of 1.6 %. Among large salivary gland tumors, squamous cell carcinoma most often occurs in the parotid salivary gland.Aim. To present a clinical case of primary disseminated cancer of the parotid salivary gland with squamous cell structure.Clinical observation. A 70-year-old patient was under observation who was diagnosed with a primary squamous cell tumor of the parotid salivary gland with multiple metastases during a complex examination. He was sick for about 6 months when asymmetry of left half of the face appeared due to a painful neoplasm in the parotid salivary gland. Recently, the patient has noted increased tumor growth. Objective examination revealed peripheral paralysis of the facial nerve on the left. In the parotid-masticatory region on the left, with a transition to the zygomatic region, there is a dense painful immobile exophytic tumor with infiltration into soft tissues of the face and skin 6.5 × 5.0 cm in size with an ulcer in the center. Laterally, it reaches the tragus, and at the bottom-the angle of the lower jaw. In the submandibular region on the left, metastatic lymph nodes 2.5 × 2.0 cm in size are palpated. A biopsy was collected. Histological conclusion: non-keratinizing squamous cell carcinoma. Expression of the programmed death receptor ligand (PD-L1) in the tumor is negative. Mutations of genes Her2-neu and BRAF were not detected. According to medical imaging methods, multiple metastases were found in the lungs, liver, zygomatic bone and tumor growth in the maxillary sinus on the left. The diagnosis was established: cancer of the parotid salivary gland, stage IVC, cT4N1M1, with metastases to the liver, lungs and bones. Polychemotherapy was prescribed according to the scheme: 5-fluorouracil + cisplatin + cetuximab + bisphosphonates. After 3 cycles, a partial regression is obtained.Conclusion. The primary squamous cell carcinoma is prone to an aggressive course and has an unfavorable prognosis, especially in patients over 60 years of age with skin and facial nerve damage, as well as the presence of regional and distant metastases. Differential diagnosis is necessary to exclude the secondary nature of the tumor. The presented case is a rare example of primary squamous cell carcinoma of the parotid salivary gland with extensive metastatic lesion and regression of the pathological process after polychemotherapy in combination with targeted therapy.

Salivary gland ultrasound or biopsy? : Comparison of methods based on case examples

Ultrasound examination of the salivary glands (SG) is aquick and noninvasive method to detect and semiquantitatively estimate typical changes in the large SG in Sjögren's syndrome (SS). The differential diagnosis of SS is difficult because several diseases and adverse effects of treatment have a similar clinical picture as SS with sicca syndrome and can even induce alterations in the SG (mimic diseases). Hence, for a long time an SG biopsy was regarded as the diagnostic procedure of choice, especially in SS‑A negative patients, whereas the significance of SD sonography is still controversially discussed. Comparison of typical and atypical changes for SS in the salivary glands in ultrasound and associated histological sections. This article describes six patient cases with antibody positive or negative SS with and without typical SS ultrasound patterns, SS-associated lymphoma, sarcoidosis and IgG4-associated disease. The findings of the sonographic examination of the parotid glands and the associated histology of the SD are explained and put into context. The SSA antibody positive patients with SS show atypical sonographic pattern with hypoechoic foci, especially if the disease has been present for along time. This pattern can help support the diagnosis of SS. The ultrasound patterns of the mimic diseases sometimes differ significantly from the typical patterns of pSS. The histological examination of the SG helps to corroborate the diagnosis but low histological focus scores, in particular, require acritical synopsis of the clinical, serological and imaging findings. Both salivary gland ultrasound and the histological examination of SG biopsies are justified in the diagnostics and differential diagnosis of SS and sicca syndrome.

Larval anatomy of the digestive and excretory systems of the pharyngeal bot fly, Pharyngomyia picta (Diptera: Oestridae).

Oestrid flies (Diptera: Oestridae) are obligate parasites of mammals during their larval stage and show anatomical adaptations for the infestation of host tissues. Unlike the species that parasitize domestic mammals, those oestrid species that infest wild mammal hosts remain poorly known. With the use of x-ray micro-computed tomography, we describe for the first time the anatomy of the digestive and excretory systems of the second and third larval instars of Pharyngomyia picta (Meigen), a parasite of cervids that, like other species within the subfamily Oestrinae, causes nasopharyngeal myiasis. Both larval instars of P. picta show a pair of remarkably large salivary glands arranged in a characteristic 'glandular band', a convoluted and thickly uniform midgut and a greatly enlarged distal region of the anterior pair of Malpighian tubules. These anatomical features also have been described in other species within the subfamily Oestrinae, whereas they differ from the observations in other oestrid subfamilies. We discuss the potential functional significance of the anatomy of the digestive and excretory systems of Oestrinae larvae as specific adaptations to parasitize the nasopharyngeal cavities of mammal hosts.

Morphofunctional characteristics of the parotid salivary glands of rabbits in postnatal ontogenesis

The rodent family unites a large number of animal species and is of interest to various areas scientific knowledge. Animal species from the rodent family are interesting because they occupy different ecological niches and are adapted to different conditions of existence. Many species of rodents feed exclusively on plant foods, but there are also omnivorous species whose dietary range includes insects, worms and other invertebrates, as well as bird eggs and small vertebrates. Examples include rats, guinea pigs, mice. As a result, the rodent family demonstrates biologically diverse group of species that are very different in appearance,with specific morphofunctional adaptations.Generally morphological and functional features of the large salivary glands in representatives of the rodent family in not currently studied.

МЕТОДОЛОГИЯ ОБСЛЕДОВАНИЯ И УЛЬТРАЗВУКОВАЯ АНАТОМИЯ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ У ПАЦИЕНТОВ С КРАНИОФАЦИАЛЬНОЙ МИКРОСОМИЕЙ

The study presents findings of extended ultrasound examination of a maxillofacial area in 62 patients with craniofacial macrosomia. It was used to detect abnormalities in patients’ ultrasound anatomy and to apply a topographic anatomy option in order to advance the methodology of examination and planning for surgical procedures, namely auricle reconstruction. The following findings were detected throughout the ultrasound examination: 7 patients with a total aplasia of parotid salivary gland in a normal structure and size of salivary gland on the damaged side; all patients with a normal structure and size of submandibular salivary gland on the damaged side; and 25 patients with anatomic landmarks for auricle reconstruction using a carcass of costal cartilage autograft. An ultrasound examination of head and neck, particularly the temporal, parotid-masticatory and temporal areas on both sides, the masticatory and temporal muscles, the temporal fascia, the large salivary glands, the vessels of the temporal areas, is required for formation of unbiased assessment of the state of maxillofacial area in patients, as well as further systematization of results for detection of correlation with apparently healthy children. Based on an ultrasound examination of topographic anatomy of temporal area, a method for detection of optimal location for auricle reconstruction in patients with craniofacial macrosomia is found relevant and accessible.

The incidence of Frey syndrome and treatment with botulinum toxin in the Central Denmark Region.

Frey syndrome (FS) is a common complication to large salivary glands surgery. This study primarily aims to describe the incidence of FS among parotid surgery patients in the Central Denmark Region. The secondary aim is to describe predisposing characteristics to syndrome development and the effect of treatment with botulinum toxin (Botox) injection. This is a retrospective qualitative study spanning the years 2015-2020. Data on patients diagnosed with FS after parotid surgery with symptoms severe enough to require Botox was extracted from electronic patient records. Incidence of FS development was calculated using data from all parotid gland surgeries in the same period and region. The incidence of treatment-requiring FS was 2.6% (20/775), with an annual incidence ranging from 0.8% (1/125) in 2017 to 4.5% (5/112) in 2016. Difference in FS development for men and women was not statistically significant (p=.07), although it was significantly more common after total parotidectomy compared to superficial resection (p=.003), and after malignant compared to benign diagnosis (p=.01). Complications in the postoperative period arose for 30% of FS patients. Repeated treatment with Botox was necessary after 6-12 months and at a median interval of 11 months. Forty-five percent of patients received only one injection. The average dose per injection was 48.3 IU. This study revealed a rather low incidence of FS in the Central Denmark Region compared to current international literature. Total parotidectomy and malignant diagnosis predisposed to syndrome development. Botox injection had a wide-ranging effective duration but typically lasted for around 1 year. Level IV.

Ranula as an early symptom of Sjögren’s syndrome

Introduction and purpose: 
 Sjögren's syndrome is an autoimmune disease affecting exocrine glands, mainly salivary glands. A ranula is a type of retention cyst associated with salivary extravasation that develops within the large salivary glands. The most common reason of developing ranula is trauma of bottom of the oral cavity. Damaging the sublingual gland, due to changes in Sjögren’s syndrome, may lead to the development of ranula. The aim of this review is to analyze the possible impact of ranulas on early diagnosis of Sjögren's syndrome.
 Material and method:
 This review was based on articles collected in PubMed and published in the years 2003-2021 and books from 2009 and 2018. Articles were chosen using keywords such as "Sjögren's syndrome", "ranula", “mucocele” and "early diagnosis".
 Results:
 Ranulas are considered to be early clinical signs of Sjögren's syndrome. Undergoing diagnostic imaging in patients with ranulas allows to diagnose Sjögren's syndrome in early stage and implement appropriate therapy.
 Conclusion:
 Identification of ranula should suggest implementation of diagnostics of Sjögren's syndrome using imaging methods such as magnetic resonance imaging or ultrasonography. Early diagnosis of Sjögren's syndrome is crucial to start the adequate treatment and get better results. It is recommended to include imaging tests in the diagnostic criteria of adolescent and adult SS in order to facilitate the diagnosis at an earlier stage of the disease.

Morphometric Characteristics of the Parotid Glands in Immature Rats with Intestinal Dysbacteriosis

It is known that in some infectious diseases of the digestive system, the large salivary glands are also involved in the pathological process. In experimental modeling of dysbiosis in laboratory rats, increased adhesion of opportunistic microorganisms to intestinal epithelial cells was revealed. In connection with the above, the goal was to study the features of the morphological and functional differentiation of the major salivary glands in postnatal ontogenesis, as well as to find out the morphological criteria for their functional activity under the influence of intestinal dysbacteriosis.

Oral Health of Elderly People in Institutionalized Care and Three-Month Rehabilitation Programme in Southern Poland: A Case-Control Study

Demographic ageing is a global growing process and the quality of ageing is an important parameter in this process. The aim of the study was to analyse the distribution of remaining dentition in relation to oral hygiene indicators among elderly people remaining in institutional care and those who participated in a 3-month rehabilitation program, aimed at increasing time of independent functioning, in southern Poland. The patients underwent a questionnaire and clinical examination. An analysis of missing teeth was performed, plaque index, and gingival index were measured. Residents of the Municipal Health Centre for Older and Dependent People (n = 50) had a higher incidence of missing teeth in the maxilla (88.4%), mandible (77.6%), as well as in the maxilla and mandible combined (83%) than residents of the Daily Medical Care House (n = 30). The distribution of the remaining teeth, in both groups, corresponds to the outlets of the large salivary glands. The group of 53.8% of patients with dry mouth had PI scored 3. Residents with dry mouth were more likely to have plaque deposits and gingival inflammation. It is necessary to develop and implement an oral care program for patients with reduced saliva secretion, with a particular focus on dependents.

CHARACTERISTICS OF CHANGES IN QUALITATIVE PROPERTIES OF ORAL FLUID IN CHILDREN WITH CONGENITAL NONUNION OF THE PALATE

According to publications in scientific periodicals, children with congenital malformations of the development are increasingly born, including those with localization on the face, head and neck. Anatomical inferiority of tissues in the area of the slit defect of the palate creates the preconditions for the formation of pathological symptom complex, which contributes to the progression of inflammatory-dystrophic changes in the oral cavity.
 The aim of the study was to study the violations of the qualitative properties of oral fluid in children with congenital nonunion of the palate in the preoperative period.
 For an in-depth examination of 58 children who were under our supervision, a group of 25 patients aged from 4 to 6 years was formed. Of these, 14 had a unilateral cleft and 11 had a bilateral cleft.
 The substrate for the study was unstimulated fraction of oral fluid. The salivation rate was studied, the concentration of hydrogen ions in it, its optical density, viscosity, α-amylase activity, levels of medium weight molecules, sialic acids, total protein, oxyproline were determined. The degree of mineralizing potential was determined by magnesium, calcium and phosphorus.
 At the time of the examination in children with unilateral clefts, a decrease in the amount of oral fluid was found, which was expressed by a decrease in the secretory activity of the large and small salivary glands by 1,3 times. The concentration of ions is visible in it and the activity of α-amylase decreased by 1.3 times. The optical density and viscosity also increased by 1,3 times, the number of medium weight molecules, the level of sialic acid and total protein increased by 1.5 times, and oxyrolin by 1.6 times.
 The analysis of indexes that showed the mineralizing potential of oral fluid mineralizing potential of oral fluid allowed to determine the fact that in patients of this group it decreased by 1,7 times and this occurred against the background of a decrease in calcium and magnesium by 1,5, with an increase in phosphorus by 1.3 times. This imbalance led to falling in calcium-phosphorus ratio by 1,8 times.
 In children with congenital malformations of the palate there is a decrease in the functional activity of large and small salivary glands, reduced buffering capacity of oral fluid, which occurs against the background of falling mineralizing potential of oral fluid, imbalance of calcium, phosphorus and magnesium. This affects the calcium-phosphorus ratio, thus creating optimal conditions for demineralization of tooth hard tissues. Changes in physicochemical and biochemical properties of mixed saliva are determined, which is the basis for the prolongation and progression of pathological processes in the oral cavity that take place in them.
 The complex of treatment-and-prophylactic measures developed by us, aimed at improving the level of components of homeostasis of the oral cavity before surgery, is being tested for the future.

Transcriptomic Mapping of Human Parotid Gland at Single-Cell Resolution

As the largest salivary gland in oral cavity, the parotid gland plays an important role in initial digesting and lubricating food. The abnormal secretory function of the parotid gland can lead to dental caries and oral mucosal inflammation. In recent years, single-cell RNA sequencing (scRNA-seq) has been used to explore the heterogeneity and diversity of cells in various organs and tissues. However, the transcription profile of the human parotid gland at single-cell resolution has not been reported yet. In this study, we constructed the cell atlas of human parotid gland using the 10× Genomics platform. Characteristic gene analysis identified the biological functions of serous acinar cell populations in secreting digestive enzymes and antibacterial proteins. We revealed the specificity and similarity of the parotid gland compared to other digestive glands through comparative analyses of other published scRNA-seq data sets. We also identified the cell-specific expression of hub genes for Sjögren syndrome in the human parotid gland by integrating the results of genome-wide association studies and bulk RNA-seq, which highlighted the importance of immune cell dysfunction in parotid Sjögren syndrome pathogenesis.

IgG4 immunoglobulin subclass and related pathological conditions or how to effectively imitate cancer disease.

IgG4 is the least represented subclass of human imunnoglobulines G (IgG) in serum and differs from other antibodies by its unique bio-logical properties. Although its function in the immune response is not entirely clear, it is mainly involved in the regulation of the immune response. It is formed as a result of chronic or strong antigenic stimulation; in such a case, it becomes a predominantly formed IgG subclass. IgG4 play a key role in the immune tolerance in allergies and tumors. The tolerogenic potential of IgG4 is used in the treatment of allergic diseases using the allergen immunotherapy; at the same time, it is also involved in inducing the immunological tolerance in the microenvironment of tumors, which promotes tumor progression. The increase of serum IgG4 is associated with relatively recently described groups of diseases. In addition to the IgG4-autoimmune diseases, it is mainly connected with IgG4-associated diseases (IgG4-RD) where various organs of the human body are affected by the formation of fibrous and sclerosing deposits in this group of the immune-mediated diseases, which leads to specific organ dysfunction. The most commonly affected organs include the pancreas and large salivary glands; moreover, the orbits and lacrimal glands, the biliary tract, the lungs, the kidneys, the retroperitoneum, the aorta, the meninges, and the thyroid gland may also be affected. It is not entirely clear whether these patients have a higher prevalence of cancer than the general population; however, there is also another relationship between IgG4 and cancer. IgG4-RD very often imitate advanced cancer in medical imaging techniques, so its existence should also be considered in the differential dia-gnosis of malignancies. The aim of this article is to draw attention of clinical oncologists to the issue of IgG4-associated diseases group which can mimic cancer condition in various organs in the human body. Therefore, it is necessary to bear them in mind in the differential dia-gnosis of malignant diseases.