Introduction: Cystic lymphoid hyperplasia (CLH) is a common yet under recognised entity affecting the parotid gland in HIV infected patients. This is the largest global clinicopathological study of CLH to date consisting of 167 cases (85M, 82F). Aim: To define the clinical parameters, histology and immunopathological features of CLH with a view to elucidating the aetio-pathogenesis. Material and Methods: This retrospective study on archival cases of CLH included patient’s age, race, gender, nature of CLH, HIV status, CD4 counts and viral loads where available. Of the 167 confirmed cases of CLH, 109 cases were histologically reviewed and 25 cases were immunohistochemically analysed with CD3, CD20, CD4, CD8 and p24 using standard procedures. Ethics clearance (M080927 and M080850) was obtained. Results: CLH mainly affects the parotid gland with a male predominance. Submandibular gland (p = 0.27) and bilateral parotid involvement favours females (2:1). CLH affects females at a younger mean age in both the parotid and submandibular glands (36.5, 31 years) respectively compared to males (40.9, 42.4 years) (p = 0.0032). Intra-lymph nodal origin is favoured with 76.1% of cases occurring within entrapped salivary gland remnants. P24 staining reveals ~90% specificity in HIV associated CLH. Immunostaining showed a CD8:CD4 of ~1:1 except in selected cases where CD4 was decreased in the interfollicular areas. Conclusion: CLH is the preferred term to describe bilateral parotid enlargement in HIV infected patients. This study strongly supports origin of CLH following ductal ectasia of entrapped salivary gland inclusions within atypical lymphoid hyperplasia arising within lymph nodes in the context of an HIV setting. CLH should be classified as an orofacial lesion strongly associated with HIV and AIDS.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2009. / Härtill 6 uppsatser.

Thesis (doctoral)--Karolinska Institutet, Stockholm, 1982. / Extra t.p. with thesis statement inserted. Includes bibliographical references.

Previous epidemiological studies have shown that the diabetic population has a poor oral status compared to healthy subjects. While changes of the local microcirculation observed during diabetes can somehow explain periodontal pathologies this hypothesis does not stand for the carious decay. We propose the hypothesis that the increase of carious incidence might be linked to changes in the salivary composition, such as an increase of salivary glucose concentrations.The amount of glucose in saliva has been widely discussed in various scientific articles. Subsequently, we performed an initial study that allowed us to confirm that the concentration and excretion of glucose in the saliva were higher in diabetic patients compared to normal patients. In diabetic patients, the relative increase in salivary glucose concentration is even comparable to the rise of blood glucose.We conducted experimental studies in animals in order to investigate the presence and the level of expression of glucose transporters (GLUT1, GLUT2, GLUT4, SGLT1) in rat parotid glands. Through immunohistochemical labeling techniques, gene expression studies and protein expression studies, we demonstrated that GLUT1, GLUT4 and SGLT1 were found in rat parotid glands of normal and diabetic rats. Functional studies targeting the activity and the flux through those glucose transporters strengthened our hypothesis on the potential role of glucose transporter in salivary glucose.This original work introduce for the first time the hypothesis of a secretion mechanism of glucose by the salivary glands through GLUT1 & SGLT1 transporters, the first one being located on the apical and baso-lateral membranes of acinar cells, while the second one is located on the baso-lateral membrane. Secretion of glucose by the parotid gland is no longer at any doubt even though further studies must now specify the specific mechanisms. / Doctorat en Sciences dentaires / info:eu-repo/semantics/nonPublished

No / Post-operative facial palsy is the most important potential complication of parotid surgery for benign lesions. The published prevalence of facial weakness is up to 57 per cent for temporary weakness and up to 7 per cent for permanent weakness. We aimed to identify potential risk factors for post-operative facial palsy. Materials and methods: One hundred and fifty patients who had undergone parotid surgery for benign disease were retrospectively reviewed. Tumour factors (size, location and histopathology), patient factors (age and sex) and operative factors (operation, surgeon grade, surgeon specialty and use of intra-operative facial nerve monitoring) were all analysed for significant associations with post-operative facial palsy. Results and analysis: The overall incidence of facial palsy was 26.7 per cent for temporary weakness and 2.6 per cent for permanent weakness. The associations between facial palsy and all the above factors were analysed using Pearson's chi-square test and found to be non-significant. Conclusion: These outcomes compare favourably with the literature. No significant risk factors were identified, suggesting that atraumatic, meticulous surgical technique is still the most important factor affecting post-operative facial palsy.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2009. / Härtill 7 uppsatser.

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [111]-126).

Thesis (Ph. D.)--University of Washington, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Dados da literatura mostram que a inervação simpática possui papel apenas na síntese e secreção das proteínas da saliva. Neste trabalho mostramos que após o tratamento crônico com reserpina, uma droga simpatolítica, houve alteração na síntese de diferentes proteínas em glândulas submandibulares e parótidas relacionadas com vários processos biológicos e a posterior administração de agonistas de adrenoceptores reverteu esses efeitos. Além disso, na glândula parótida, a estimulação da inervação simpática é importante para o processo de exocitose das proteínas secretadas. Esses resultados sugerem que a inervação simpática possui um importante papel para a funcionalidade das glândulas salivares de camundongos, isto é, mantendo estas glândulas em constante estado de ativação, regulando a síntese de diferentes proteínas dessas glândulas ou promovendo a exocitose de proteínas da saliva. Além disso, os resultados mostram que a inervação simpática atua de maneira diferente nas glândulas submandibulares e parótidas de camundongos. / Data in literature show that sympathetic outflow has a role only in stimulating synthesis and secretion of the saliva proteins in mammals. We show that after chronic treatment with reserpine, a sympatholytic drug, there were changes in the synthesis of different proteins in submandibular and parotid glands associated with various biological processes and subsequent administration of adrenoceptor agonists reversed these effects. Furthermore, in the parotid gland, stimulation of the sympathetic outflow is important to the process of exocytosis of secretory proteins. These results suggest that sympathetic outflow plays an important role for the functionality of the mouse salivary glands, namely, keeping these glands in a constant activated stage, regulating the synthesis of different proteins in these glands or promoting the exocytosis of saliva proteins. Furthermore, these results show that the sympathetic outflow acts differently in the mouse.

Dados da literatura mostram que a inervação simpática possui papel apenas na síntese e secreção das proteínas da saliva. Neste trabalho mostramos que após o tratamento crônico com reserpina, uma droga simpatolítica, houve alteração na síntese de diferentes proteínas em glândulas submandibulares e parótidas relacionadas com vários processos biológicos e a posterior administração de agonistas de adrenoceptores reverteu esses efeitos. Além disso, na glândula parótida, a estimulação da inervação simpática é importante para o processo de exocitose das proteínas secretadas. Esses resultados sugerem que a inervação simpática possui um importante papel para a funcionalidade das glândulas salivares de camundongos, isto é, mantendo estas glândulas em constante estado de ativação, regulando a síntese de diferentes proteínas dessas glândulas ou promovendo a exocitose de proteínas da saliva. Além disso, os resultados mostram que a inervação simpática atua de maneira diferente nas glândulas submandibulares e parótidas de camundongos. / Data in literature show that sympathetic outflow has a role only in stimulating synthesis and secretion of the saliva proteins in mammals. We show that after chronic treatment with reserpine, a sympatholytic drug, there were changes in the synthesis of different proteins in submandibular and parotid glands associated with various biological processes and subsequent administration of adrenoceptor agonists reversed these effects. Furthermore, in the parotid gland, stimulation of the sympathetic outflow is important to the process of exocytosis of secretory proteins. These results suggest that sympathetic outflow plays an important role for the functionality of the mouse salivary glands, namely, keeping these glands in a constant activated stage, regulating the synthesis of different proteins in these glands or promoting the exocytosis of saliva proteins. Furthermore, these results show that the sympathetic outflow acts differently in the mouse.