ABSTRACT
BACKGROUND: Homeobox are a family of developmental genes involved in morphogenesis and cellular differentiation. Participation of homeobox within normal and malignant tissue has been recently discussed in the literature. OBJECTIVE: To analyze the presence of HOXB13 transcript expression in human minor salivary gland. MATERIAL AND METHODS: Ten-micrometer sections from frozen samples were evaluated employing non-radioactive in situ hybridization technique and HOXB13 mRNA probes. RESULTS: HOXB13 was found to be expressed in ducts and mucous acini but not in serous acini. CONCLUSIONS: RESULTS suggest that HOXB13 transcripts are differently expressed in normal mucous and serous acini, and it may possibly reflect a different role in salivary gland carcinogenesis.
Subject(s)
Homeodomain Proteins/biosynthesis , Salivary Glands, Minor/metabolism , Carcinoma, Squamous Cell/surgery , Female , Gene Expression , Genes, Homeobox/physiology , Humans , In Situ Hybridization , Male , Middle Aged , Mouth Mucosa/metabolism , RNA, Messenger/analysis , Reverse Transcriptase Polymerase Chain Reaction , Salivary Gland Neoplasms/surgery , Sequence Analysis, RNASubject(s)
Forearm , Head and Neck Neoplasms/surgery , Surgical Flaps , Adult , Aged , Child , Female , Humans , Male , Microsurgery , Middle AgedSubject(s)
Humans , Male , Female , Child , Adult , Middle Aged , Surgical Flaps , Forearm , Head and Neck Neoplasms/surgery , MicrosurgeryABSTRACT
BACKGROUND: Neck perforations by foreign bodies are uncommon. The surgical approach depends on the extension of visceral wounds and the development of cervical or mediastinal infection. PURPOSE: The objective of this paper is to report a neck perforation trauma by a piece of wire, with associated laryngeal and hypopharyngeal wounds and extensive cervico-mediastinal emphysema. Anatomic and clinical correlations are discussed, as well as the management of the case. MATERIAL AND METHODS: A 28-year-old male patient suffered a perforating trauma in his neck by a piece of wire. This foreign body was laid in the retropharyngeal space, at the level of the sixth cervical vertebra, after perforating the larynx and hypopharynx. There are no similar cases previously reported. The imaging tests are presented. Despite the potential severity of the lesions, the patient had a favorable outcome, and no surgical approach was necessary. CONCLUSIONS: This case illustrates, by the imaging tests, the complex anatomy of the cervical fasciae and deep neck spaces, and confirms the possibility of conservative management in a great number of laryngeal and hypopharyngeal traumatic lesions.
Subject(s)
Cervical Vertebrae/injuries , Foreign Bodies/complications , Wounds, Stab/complications , Adult , Cervical Vertebrae/diagnostic imaging , Foreign Bodies/diagnostic imaging , Foreign Bodies/therapy , Humans , Male , Tomography, X-Ray Computed , Wounds, Stab/diagnostic imaging , Wounds, Stab/therapyABSTRACT
As perfurações cervicais por corpos estranhos são incomuns. Sua abordagem cirúrgica depende do grau de lesão das vísceras cervicais e do desenvolvimento de sinais e sintomas de infecção cérvico-mediastinal. OBJETIVO: O presente artigo objetiva registrar a ocorrência de trauma perfurante cervical por fragmento de arame com lesão de laringe e hipofaringe dando origem a extenso enfisema cérvico-mediastinal. Correlações anátomo-clínicas e a conduta adotada são discutidas MATERIAL E MÉTODOS: O caso relatado é o de um indivíduo de 28 anos, do sexo masculino, vítima de ferimento perfurante na região cervical anterior por fragmento de arame. O corpo estranho assestou-se no espaço retrofaríngeo do doente, ao nível da 6a vértebra cervical, após perfurar a laringe e a hipofaringe. Não há caso semelhante relatado na literatura. A documentação radiológica do caso é apresentada. Apesar da potencial gravidade das lesões, o doente evoluiu bem e não necessitou de tratamento cirúrgico. CONCLUSÕES: O caso em questão, além de ilustrar, através dos exames de imagem, a complexa anatomia das fáscias e dos espaços cervicais profundos, demonstra a possibilidade da aplicação do tratamento conservador em grande parte das lesões traumáticas de laringe e hipofaringe.
Subject(s)
Humans , Male , Adult , Wounds, Stab , Cervical Vertebrae/injuries , Foreign Bodies , Wounds, Stab/therapy , Tomography, X-Ray Computed , Foreign Bodies/therapyABSTRACT
BACKGROUND: Several tumor factors are associated with papillary thyroid cancer. Most studies do not compare the expressions of these factors in the primary tumors and in their associated cervical metastasis. METHODS: Paraffin sections of 20 patients with papillary carcinoma of the thyroid gland with lymph node metastasis were studied. The presence and distribution of insulin-like growth factor I (IGF-I) and proliferating cell nuclear antigen (PCNA) was analyzed, through immunohistochemical technique, in both primaries and lymph node metastasis. The results were correlated with clinical-pathologic data (sex, age, size of primary, multicentricity, thyroid capsule invasion, lymphatic and blood vessels invasion, development of distant metastasis, and associated thyroid diseases). RESULTS: The qualitative analysis showed the reaction for IGF-I was present in more than 90% of the neoplastic cells in both primaries and lymph node metastasis. No correlation with the clinical-pathological features was observed. Regarding the PCNA, the mean percentage of nuclei stained showed no statistical difference between primaries and metastasis (p = 0.598). Except for age, clinicopathologic data had no influence on the mean percentage of nuclei stained. A correlation was verified between the percentage of cells stained by PCNA in primary tumors and the patients' age (p < 0. 01). CONCLUSIONS: The expressions of these tumor factors are equally intense for both primary and metastatic tissue in papillary thyroid cancer. Despite the small size of the sample, the expressions of IGF-I and PCNA could not be associated to clinical-pathologic features, except for the age. As patients over 40 years old had higher expression of PCNA, this marker may have prognostic significance for patients with papillary thyroid cancer.
Subject(s)
Carcinoma, Papillary/chemistry , Insulin-Like Growth Factor I/analysis , Proliferating Cell Nuclear Antigen/analysis , Thyroid Neoplasms/chemistry , Adolescent , Adult , Aged , Carcinoma, Papillary/secondary , Child , Female , Humans , Immunohistochemistry , Lymphatic Metastasis , Male , Middle Aged , Thyroid Neoplasms/pathologyABSTRACT
As infecçoes dos espaços cervicais profundos, embora raras, associam-se a alta morbi-mortalidade. A abordagem cirúrgica faz-se necessaria na maioria dos casos e se baseia no conhecimento da complexa anatomia das fascias cervicais e dos espaços cervicais profundos. Objetivo. Apresentar consideraçoes anatomicas de interese pratico sobre fascias e espaços do pescoço, sua conceituaçao e nomenclatura, relatando, a título de exemplo, quatro casos de infecçoes dos espaços cervicais profundos. Material e Método. Sao apresentados um caso de angina de Ludwig complicada com mediastinite, pericardite, pneumonia, empiema pleural, fístula esofagica e choque séptico, um caso de abscesso cervical espontâneo em paciente diabético, um caso de abscesso de loja submandibular e um caso de abscesso parafaríngeo iniciado após manipulaçao dentaria. Nos quatro casos, a documentaçao imagenológica é rica e, em dois deles, evidencia o comprometimento de mais e um espaço profundo do pescoço. Conclusoes. A literatura enfatiza morbidade e mortalidade elevadas, etiologia diversificada (infecçoes dentarias, uso de drogas endovenosas, infecçoes do trato aerodigestivo alto e outras), a necessidade de traqueostomia em cerca de 50 por cento dos casos e o emprego da terapêutica combinada (antibioticoterapia e abordagem cirúrgica do pescoço). Os métodos imagenológicos, como a tomografia computadorizada, sao imprescindíveis no estudo de infecçoes dos espaços profundos do pescoço, tanto para a avaliaçao do sítio e extensao da afecçao, como para o planejamento terapêutico.
Subject(s)
Adult , Female , Humans , Bacterial Infections/diagnosis , Abscess/microbiology , Fascia/anatomy & histology , Neck/anatomy & histology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Although rare, deep neck space infections are associated with high morbidity and mortality rates. The surgical approach is necessary in the majority of the cases, and the surgeon must know the complex anatomy of the cervical fasciae and deep neck spaces. PURPOSE: The anatomy of the cervical fasciae and deep neck spaces in reviewed. As an illustration, a series of deep neck space infections is presented. MATERIAL AND METHOD: Four clinical cases are reported: 1) a case of Ludwig's angina with several complications (mediastinitis, pericarditis, pneumonia, pleural effusion and empyema, esophageal fistula and septic shock), 2) a case of cervical abscess that appeared without apparent cause, in a young diabetic patient, 3) a case of abscess of the submandibular triangle, and 4) a case of parapharyngeal abscess that came forth after a dental treatment. Data from history taking, physical examination, X-rays, echography, CT scan and treatment and the follow-up are presented. The image tests were valuable and, in two of the cases, they demonstrated that more than one deep neck space were affected. CONCLUSIONS: The literature reinforces the high mortality and morbidity rates, the diversified etiology (dental infection, intravenous drug abuse, infections of the upper aerodigestive tract and others), and the tracheostomy indication made in about half of the cases. It stresses also the need for combined therapy (antibiotics and surgery). Evaluation with CT scan and other radiologic methods is indispensable to determine the site and extent of the process and to plan properly the treatment.
