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Computed tomographic (CT) appearances of 18 surgically proven parotid tumors were studied. Digital radiography (GE, ScoutView) was performed to select the desired gantry angulations and then plain CT and CT combined with sialography were performed. Plain CT clearly showed parotid tumors in nine of the patients. CT combined with sialography was more helpful than plain CT for delineating the tumors in the other patients who had either tumors in high-density parotid glands for tumors low density. CT allows more accurate evaluation of tumor location and extent in the parotid gland than any other method and helps distinguish malignant from benign lesions. The normal CT appearances of the parotid region are necessary for precise interpretation of CT images in this region.

Administration of bovine parathyroid hormone (PTH) preparations increased the phosphate concentration in the parotid saliva of sheep. Data on the site of action of PTH (1-84) were obtained by (a) equimolar infusions of PTH (1-84) and (1-34) directly into the arterial blood supply of the vascularly isolated parotid gland in anaesthetized sheep, (b) intravenous infusion of PTH (1-84) at a similar rate and (c) intra-arterial infusion of PTH (1-84) with complete drainage of the venous effluent from the gland during the infusion. Results showed substantial time- and dose-response identity of the two peptides, at 10(-9) to 4 X 10(-9) mol/l in arterial blood, in raising salivary phosphate concentration. The effect of PTH (1-84) was not due to recirculated fragments because the response was obtained when recirculation was prevented by complete venous drainage and little or no response occurred when the same infusion was given i.v.

The extratemporal course of the facial nerve must be completely understood if surgery is required for the removal of parotid and other tumors in the infratemporal space and skull base or if the nerve itself must be exposed when it has been severed. The key to mastering this surgery is to understand the anatomy of the parotid space and its relations to surrounding structures so that the facial nerve can be found during surgery and preserved intact. Tumor masses or scar tissue may distort normal structures and relations to adjacent structures; this must be kept in mind while operating in this complicated anatomic area.

A series of 17 parotid glands were obtained by radical parotidectomy. Between 1 and 11 lymph nodes were found in them. Superficial parotidectomy only leaves an average of 1 node in the deep parotid. There is a 1 in 4 chance of there being no nodes left. There were no nodes easily accessible immediately under the deep part of the parotid gland. There seems to be a discrepancy between the number of nodes found in a radical surgical specimen and serial sections of the area. This suggests a significant number may be left in the skin flap. The place of excision of this skin is discussed.

Under the descriptive term necrotizing sialometaplasia a lesion (infarct) is described in the minor salivary glands of the mouth, mucous glands in the nose and in the maxillary sinus. Identical changes are seen in the parotid gland after surgical treatment. In the German literature there is no report on necrotizing sialometaplasia or infarction of salivary gland. In this paper 6 infarcts of the parotid gland are reported. The pathohistologic picture is described, the proposed etiopathogenic factors are discussed. The diagnostic problems between the infarct of salivary glands and squamous carcinoma and low grade mucoepidermoid tumours were pointed out.

From a total of 323 adenolymphomas in the files of the British Salivary Gland Tumour Panel there were 20 cases (6.2%) which showed extensive necrosis, fibrosis and inflammation. The clinical and microscopical features of this distinctive subtype are described and it is suggested that infarction rather than infection is the more probable aetiological factor. In 40% of these infarcted adenolymphomas there was granuloma formation which mimicked tuberculosis or sarcoidosis and this possibility should be borne in mind when examining lesions in the parotid region.

Hypersalivation and facial skin hyperemia that simultaneously emerge in response to atropinization have been observed in patients who suffered trauma to the skull base combined with damage of the parasympathetic secretory and vasodilatory fibers in the greater and lesser petrosal nerves at the tip of the temporal bone pyramid. The study was facilitated by special vacuum capsules applied to both outlet ducts of the parotid glands. Hyperemia and hyperthermia of the face were evaluated visually, by thermometer readings, and color photography. The events described are distinct from those reported in the literature (i.e., paradoxical disturbances of facial and salivary gland innervation). This study analyzes the mechanism of initiation and the manifestations of this complex syndrome.

Swelling of the interstitial gel of the parotid salivary gland is modelled by means of perfusing its ducts under various hydrostatic pressure. Connection of this swelling with the size of the terminal secretory portions of the parotid salivary gland and with the size of the lumen in the periacinar blood capillaries is investigated by means of regression equations of the second degree. The size of the terminal portions decreases linearly, while the caliber of the blood capillaries demonstrates a parabolic dependence from the gel volume, when the interstitial gel is swelled. A conclusion is made that the swelled interstitial gel affects the terminal secretory portions of the gland by means of their simple mechanical compression, while the interconnection between the interstitial gel and the periacinar blood capillaries is of a more complicated character and cannot be understand without taking into account certain physico-chemical properties of the interstitial space and changes in intracapillary pressure.

In rats fed a diet lacking flavonoids (but which had supplementary vitamin C) definite fine structural alterations were found in blood capillaries and tissues. These fine structural alterations were quite different from those reported in C-avitaminosis and imply a different deficiency. They were largely prevented by feeding the benzopyrones, coumarin or coumarin plus troxerutin, thus pointing to the specificity of the lesions. This implies that, for the rat, benzopyrones are vitamins and that vitamin C and "vitamin P"-deficiency states are qute distinct. In "P-avitaminosis" the basic lesion is the opening of some blood capillary endothelial intercellular junctions. Unlike in C-avitaminosis, the endothelial cells are intact, without pale, grossly swollen cytoplasms.

Functional study on superficial temporal vessels. These vessels appear to have a board territory on--the horizontal part of the scalp--the superior lateral face--the anterior and superior half of the external ear The terminal part of these vessels and the rich anastomotic system is particularly studied. This system passes the middle line; the anastomoses are in the fascia superficilialis. Secondly there is a sub-dermal plexual formation which is in a parallel direction to the vessels. Practical consequences can be found--in neuro-surgery--in plastic-surgery--and in the new surgery of cutaneous transfer with micro-anastomoses of the vessels.

A rare case of a symptomatic venous anomaly of the parotid gland is described in a 14-year-old female patient who presented with Turkey Wattle sign. A definitive diagnosis of this disorder requires venographic studies. Surgical treatment was successful, with a follow-up of four years.

The blood vessels together with the parenchymal components of rat salivary glands were studied by scanning electron microscopy (SEM) after removal of stromal connective tissue by acid hydrolysis plus enzymatic digestion. The three-dimensional vascular architecture was also studied by SEM of vascular corrosion cats. Each cluster of 4-5 polymorphous acini is connected with the convoluted duct via an intercalated duct. The convoluted duct usually has a sigmoid course and drains to the intralobular striated duct (about 20 microns in diameter); this has a rather straight course before connecting with the interlobular excretory duct. Myoepithelial cells with radiating processes were observed on the stromal surface of the secretory acini. Pericytes with longitudinal and circular processes were also observed surrounding the stromal surface of capillaries. The acini and convoluted ducts are surrounded by plexuses of capillaries derived from terminal arterioles which run along the intralobular duct system. The sinusoidal capillary plexus enveloping the striated duct receives blood from capillaries surrounding the acini and convoluted ducts through portal venules. The interlobular excretory ducts are richly supplied by a subepithelial network of capillaries which receive blood directly from the interlobular artery and drain into the interlobular vein. Thus, the excretory duct circulation is separated from the intralobular circulation. No arterio-venous anastomoses were observed in the gland. However, veno-venous and arterio-arterial anastomoses were often seen along the excretory duct; such anastomoses may participate in controlling the direction of blood flow through the vascular plexus around the excretory duct. The well-developed subepithelial plexus of capillaries observed around this duct is appropriate for its known absorptive/secretory functions. The capillary network around the acini is densest in the parotid gland and sparsest in the sublingual gland. The subepithelial capillary network of the excretory ducts of the submaxillary gland is denser than those of the other two glands which had similar densities.

Infusion of bovine parathyroid hormone (bPTH) preparations into the arterial blood supply of the vascularly isolated parotid gland in anaesthetized sheep increases salivary phosphate concentration and gland blood flow rate with rapid onset and offset of action. These responses have been used as a bioassay for PTH and PTH analogues and for assessing the properties of an in-vitro inhibitory analogue [Nle-8, Nle-18, Tyr-34]bPTH-(3-34)amide. [Nle-8, Nle-18, Tyr-34]bPTH-(1-34)amide at 10(-9) to 10(-8) mol/l was four to five times more potent than bPTH(1-34) on both salivary phosphate and blood flow assays. Human PTH(1-34) was not significantly more potent than bPTH(1-34). The [Nle-8, Nle-18, Tyr-34]bPTH-(3-34)amide analogue had very slight agonist activity at 3 X 10(-7) mol/l and at a 100:1 ratio of analogue to PTH it completely inhibited the action of bPTH(1-34) on phosphate secretion and gland blood flow. It caused partial inhibition at 10:1 and had no evident effect at 1:1. These results differ from previous in-vitro results and indicate that the preparation may be valuable for evaluation of agonist and antagonist analogues of PTH. The vascularly isolated parotid gland of the sheep permits repeated random testing of analogues in a control-test-control sequence and the results indicate high sensitivity to PTH in a rapidly reactive in-vivo system with two responding parameters.

Chronic treatment of rats with isoproterenol (IPR) induces mitosis and differentiation of intercalated duct cells, and mitosis and hypertrophy of endothelial cells of the microvasculature in the parotid gland. Mitoses occurred in duct cells situated at or near the acinar-intercalated duct junction, and were most numerous after six IPR injections. These cells increased in size, contained numerous electron-lucent granules, and were incorporated into the hypertrophic acini. The granules contained branching filamentous or finely reticulated material, and did not react with histochemical stains for carbohydrate. Capillary and venule endothelial cell mitoses were frequently seen after four to six IPR injections. The endothelial cells increased in thickness, contained abundant cytoplasmic organelles, lacked fenestrations, and had few pinocytotic vesicles. These results demonstrate the extensive nature of the response to chronic IPR treatment, and are consistent with the concept that the intercalated ducts have an important role in salivary gland physiology.

The physiological saline was injected into the excretory duct of the cat parotid gland under the pressure of 30, 70 and 120 cm H2O. It was found with the aid of transmission electronic microscopy, morphometry and statistical analysis that the liquid injection into the gland produces compression of the blood capillaries weaving the acinus. The compression of the capillary tubes is shown by a significant reduction in space given to the lumen of the capillaries and their endothelial layer. The compression of the capillary tubes is combined with a two-fold lessening suggest that the additional blood volume entering the gland in response to its perfusion by the liquid does not reach the blood capillaries and is thrown off into the vein vessels through the shunt communications and that regulation of the blood volume getting into the cat parotid gland capillaries is likely to depend on the hydraulic and osmotic state in the interstitial space of glandular lobes.

1. The blood capillaries from the alveolar areas of the sheep's parotid gland drain into a sinusoidal portal venous system which is in close relation to the striated intralobular ducts.2. The alveoli of the gland are surrounded by a mesh of muscular processes of myoepithelial cells: there are no myoepithelial structures in relation to the ducts.3. In close relation to the alveoli are nerve fibres, some containing noradrenaline and some with cholinesterase at their cellular contact area. Stimulation of the cervical sympathetic trunk for 1-2 min (or intra-arterial injection of noradrenaline) causes expulsion from each gland of a regular amount of saliva without changing the long term appearance rate of saliva. Stimulation of the secretomotor nerve (or acetylcholine I.A.) causes an increase in saliva production.4. It is proposed that the saliva which appears due to sympathetic stimulation is expelled from the alveoli by contraction of the myoepithelial network and is little changed during its rapid transit through the duct system.5. The results indicate that the alveolar cells react to increasing aldosterone status by increasing concentration of K(+) in alveolar fluid with inverse change of Na(+) in alveolar secretion over a wide range of flow rates.6. No histological evidence of innervation of the intralobular striated ducts by sympathetic or secretomotor nerves was obtained.7. The secretory ducts appear to be the site of exchange of HCO(3) (-) and phosphate, Na(+) and K(+), and for enrichment of SCN(-) and I(-) in the alveolar fluid.8. During stimulation of the secretomotor nerve supply, the gland, whether in adrenally insufficient or in hyperaldosterone status, shows the initial transient of discharge of K(+) into saliva and blood and then maintains K(+) intake from plasma as near to output in saliva as does the gland in the replete animal with basal aldosterone status.