The important biological role of saliva in maintaining of the homeostasis of the oral cavity environment, preventing infection and tooth decay is widely accepted. Salivary glands insufficiency may violate the balance between health and disease. Clinical data indicated that the destruction, agenesis and aplasia of salivary gland commonly followed with hypo salivation, low salivary flow, which resulted in severe caries and periodontal disease. Salivary gland dysfunction also frequently found in preterm and low birth weight newborns. But the information about structural background of abnormal salivation in early childhood is still limited. A presence of any correlation between salivary glands structural development and intrauterine restrictions of fetal growth (IUGR) is unclear. The aim of present study was to determine morphological and morphometric peculiarities of human parotid gland in case of IUGR at late gestation. Material and methods: Parotid glands of twenty human fetuses 2022 weeks of gestation with diagnosed IUGR from late abortions material were compared with ten fetal glands in cases of induced abortions due to psychological reasons (control group). Tissue samples were immersionfixed in 10% buffered formalin solution, embedded in paraffin wax. Histological slides were stained routinely with hematoxylin & eosin, with Van Gieson's Stain. Microscopical examination was performed on magnification x 40 and x 100. Stereometric study by point count method at magnification x 40 allowed finding out volume fractions (VF) of glands parenchyma and stroma. VF of lobules components (glands wall, glands lumen, ducts wall, ducts lumen, vessels, intralobular connective tissue) were registered at magnification x100. Morphometry of the secretory portion of the parotid gland was conducted on the Zeiss microscope with the help of the AxioVision Rel.4.8 program. The mature (differentiated) end pieces were measured, including their area (in mkm2), width, height, perimeter (all in mkm). Similar measurements were done in the foci of immature secretory ends of a gland. Additionally the mean height of the epithelial cells layer within the mature secretory end pieces was measured. The differences were analyzed by methods of mathematical statistics using the software Microsoft Excel; data was compared with control measurements by Students ttest. Results: The results of present research have shown the delayed differentiation of fetal parotid glands parenchymal components in case of IUGR. The parenchymal VF did not reach control values. Furthermore, VF of lobules components was also decreased. Ducts lumens appeared to be significantly narrower than at physiological gestation. Interlobular and intralobular connective tissue stroma, in contrast to the controls, occupied vast areas, and their volume fraction was increased. Deficit of the parenchymal components of the gland was enhanced by slower maturation of glands. In cases with IUGR, differentiated glands occupied smaller area, with reduced width, height and perimeter. Epithelium lining the differentiated glands is characterized by significantly lower height compared to the control group. Delayed differentiation resulted in higher proportion of immature glands. Their area, width, height and perimeter increased. IUGR was also accompanied with a variety of pathological changes. Conclusion: Present evidences suggest that IUGR leads to impaired growth and maturation of the parotid gland. Structural immaturity and lack of differentiated parenchymal elements of the organ may form the basis of its secretory functions lesion. The finding tends to support the hypothesis that the mechanism behind the increased risk of dental pathology in preterm, low birth weight and retarded children is centred at structural and functional immaturity of salivary gland., Sergiy Morozov, Olga Reshetnikova, and Literatura
Cíl: Zhodnocení přesnosti a věrohodností MR vyšetření obličeje plodu při posuzování rozsahu rozštěpových vad rtu pomocí posouzení interpretační shody mezi několika vyhodnocujícími lékaři. Metoda: Zkoumanýsoubor zahrnuje jednak 23 MR vyšetření plodů gestačního stáří do 24. týdne s různě rozsáhlými rozštěpovými vadami rtu, které byly zachyceny pomocí UZ, a dále 17 standardizovaných vyšetření s normálním nálezem (celkově 40 vyšetření). Po anonymizaci obrazových dat proběhlo nezávislé posouzení MR nálezů třemi radiology a statistické zpracování (interobserver agreement study). Podle jednotného protokolu jsme hodnotili přítomnost rozštěpu a rozsah - postižení alveolárního výčnělku, pokračování/nepokračování na patro. Vyšetření byla prováděna pomocí přístroje Siemens Magnetom Symphony Maestro Class 1,5 T s použitím array cívek. Výsledky: Nejvyšší míru interpretační shody vykazuje metoda při hodnocení postižení alveolárního výčnělku - 94% (generalizovaná kappa 0,894, SE 0,106), u postižení rtu byla shoda 90 % (generalizovaná kappa 0,848, SE 0,083) a u postižení patra 86 % (generalizovaná kappa 0,711, SE 0,119) Závěr: MR vyšetření může být s úspěchem využito pro zpřesnění detailní zobrazovací diagnostiky cheilognatopalatoschízy u plodů textačního stáří do 24. týdne gravidity. Nejvyšší věrohodnost má při znázornění integrity alveolárního výčnělku horní čelisti, což představuje z klinického hlediska velmi cennou informaci., Aim: Assessing accurancy and credibility of MRI in the assessment of fetal facial cleft lip defects severity using interpretive agreement study between several specialists. Methods: Our study consists of 23 MRI examinations of fetusee in gestation age before 24 week with differently severe lip clefts, which were detected by ultrasound as well as other 17 examinations without face anomaly (whole group counts 40 cases). Datasets were anonymized and analyzed by 3 radiologists and statistical analysis was performed. According to standardised protocol presence of cleft and degree of severity was evalueted - alveolar ridge envolment, continuation or noncontinuation to pallate. The examinations were perfomed by Siemens Magnetom Symfony Masestro Class 1.5 T with use of array coils. Results: The best degree of interpretive agreement was in evaluation of alveolar ridge envolment - 94% (generalized kappa 0,894, SE 0,106), for isolated cleft lip it was 90% (generalized kappa 0,848, SE 0,083) and for defect of palatte 86% (generalized kappa 0,711, SE 0,119). Conclusion: MRI examination could be successfully used for more accurate imaging of cheilognathopalattoschisis of fetuses within the 24 gestation week of gravidity. The best credibility is for alveolar ridge defect detection, and this information is clinical very valuable., Zdeněk Bělobrádek, Jan Žižka, Ludovít Klzo, Eva Šimáková, Karel Hodík, Eva Čermáková, Pavel Eliáš, and Literatura