This document provides an outline on parotid gland tumors. It discusses the normal anatomy of the parotid gland and classification of parotid tumors. It also covers the important features and management of parotid gland tumors, types of parotidectomy surgery and their potential complications. Key topics include the most common benign and malignant tumors of the parotid gland, their incidence rates, histopathological features, staging systems and treatment approaches.
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. So here are slides containing information about salivary gland tumours with images.
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Oral squamous cell carcinoma is a malignant tumor that may occur anywhere within the oral cavity. It is locally invasive, infrequently metastasizes to ipsilateral regional lymph nodes, and rarely spreads to distant sites. Risk increases dramatically when alcohol use exceeds 6 oz of distilled liquor, 15 oz of wine, or 36 oz of beer/day. The combination of heavy smoking and alcohol abuse is estimated to raise the risk 100-fold in women and 38-fold in men.
Purpose:
The purpose of this webinar is to help participants learn how to prevent oral squamous cell carcinoma.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. OUTLINE
Normal anatomy
Classification of parotid gland tumors
Important features and management.
Parotidectomy and its Complications
Take home message
7. Gland Frequency % Malignant %
Parotid 65 25
Submandibular 10 40
Sublingual <1 90
Minor Glands 25 50
Incidence
8. INCIDENCE
Pleomorphic adenoma is most common
benign tumor in all major and minor
salivary glands.
Most common malignancy in Parotid is
Mucoepidermoid CA while in
Submandibular It’s Adenoid Cystic CA.
14. 1) Detailed history and
clinical examination
2) Ultrasonography
3) Radiology
4) FNAC
5) Incisional Biopsy
15. A sudden increase in size:
1. Infection
2. cystic degeneration
3. hemorrhage inside the mass
4. malignant transformation
MALIGNANT INDICATORS ARE:
1. Facial nerve paresis or paralysis.
2. Weakness or numbness of the tongue or
in distribution of branches of trigeminal
nerve
3. Pain
4. Fixation
5 Cervical adenopathy
18. Well circumscribed, encapsulated
incomplete infilterations
Is composed of glandular
epithelium and
myoepithelial cells with a
mesenchyme like
background.
22. IDENTIFICATION OF FACIAL
NERVE
Antegrade / Retrograde
Peripheral branch
Digastric muscle
Tragal pointer
(Conley)
Styloid process
Tympanomastoid
suture line
Mastoid process
23. Best treated with surgical excision
SUPERFICIAL LOBE; Superficial
parotidectomy saving facial nerve.
DEEP LOBE; Total parotidectomy.
95% cure rate.
5% malignant transformation.
24. Slowly growing, painless,
nodular mass
Firm or fluctuant
Tail of parotid
tendency to occur
bilaterally 5-7%
6th and 7th decade
> in males, associated
with smoking
26. Surgical removal is treatment of choice.
6-12% recurrence
Malignant Warthin tumors have been
reported but are rare..
27.
28. Is most common salivary malignancy.
Is most common in parotid gland usually
appears as asymptomatic swelling.
Pain/ facial nerve palsy occurs with Hi grade
tumor.
Peak age 2-7th decade
29. In minor Palate
Asymptomatic blue/ red color,
can be mistaken for mucocele
30. 1. Mucous
2. Squamous
3. Intermediate cells
1. Relative numbers of mucous,
squamous and intermediate cells
2. Amount of cyst formation
3. Degree of cytologic atypia
31.
32. – Mucus = squamous
– Fewer and smaller
cysts
– Increasing
pleomorphism
and mitotic figures
33. – Squamous > mucus
– Solid islands of
squamous
and intermediate cells
- inc. pleomorphism
and mitotic activity
– Mistaken for SCCA
34. Influenced by location, Grade and stage of
tumor.
PAROTID; Early stage subtotal
parotidectomy, saving facial nerve
Advanced tumors total parotidectomy,
sacrificing facial nerve .
35. Slow growing mass
Pain is common and important finding
In parotid tumors facial nerve paralysis may
develop
36. Clinical features
Smooth surfaced or ulcerated
Minor salivary gland 50-60%
Parotid 2-3%
Submandibular 12-17%
Middle aged adults
50-60%
40. is treatment of choice
is poorest for tumors arising
in maxillary sinus and submandibular gland
and for tumors with solid histopathologic
pattern.
occurs in aprox.35% cases
most frequently to lungs and bones.
42%
41. Cells show serous acinar
differentiation.
85% occur in parotid
9% minor salivary glands
2nd-7th decade
Females> males
85% 9%
42. Treatment And Prognosis
Best treated with surgical excision
Approx. 1/3rd of the patients have
recurrences
Metastasis develop in 10-15 % cases
43.
44. ; no clinical evidence of primary tumour
; Up to 2 cms diameter without
extraparenchymal extension
; 2 – 4 cms without extraparechymal extension
; > 4.0 cms and / or extraparenchymal
extension
;
a) Tumor invades adjacent st. skin, ear canal,
mandible, nerve
b) Invades skull base, pterygoid plates or
encases carotid artery
45. NX: Lymph nodes (LN) can’t be
assessed
N0: no nodal involvement
N1: metastasis in only one LN ipsilateral
to the tumor with up to 3 cm
N2a: LN of 3 to 6 cm, ipsilateral
N2b: multiple ipsilateral LNs
N2c: bilateral or contralateral LN’s
o N3: LN’s larger than 6 cm
47. STAGING
Stage I T1NoMo
Stage II T2NoMo
Stage III T3NoMo or
T1-3,N1Mo
Stage IVA T4aNo-1M0 or
T1-4aN2M0
Stage IVB T4bNxM0 or
TxN3M0
Stage IVC TxNxM1
48. Metastatic cervical L.A.P.
But there is controversy about
management of clinically negative neck
nodes
High-grade or large tumor occult
regional disease elective or
selective neck dissection
In low-grade malignancy the elective
neck disection not recommended
49. Microscopically positive margin
High grade including adenoid cystic
Involvement of skin, bone, nerve
LN spread
Large tumors requiring radical resection
Tumor spillage
Recurrence
50. INTRA-
OPERATIVE
EARLY POST OP LATE POST OP
Hemorrhage Nerve paralysis Facial sinkinesis
Nerve transaction Hemorrhage/
Hematoma
Numbness of ear
lobule
Incomplete tumor
resection
Infection Recurrent tumor
Capsule Rupture Flap necrosis Soft Tissue Defect
Cosmetic
Deformity
Frey’s syndrome
Salivary fistula
formation
53. Salivary gland tumors have diverse
pathology.
Principal treatment of salivary gland
tumors is surgical resection with safe
margins.
Used either as a single modality or in
conjunction with adjuvant radiotherapy.