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ENT surgeons may be the first specialists to encounter and diagnose patients with salivary gland disease. A new entity involving the salivary glands has recently been described of which ENT surgeons need to be aware: immunoglobulin G4 related chronic sclerosing sialadenitis.
Method:
A literature search of Medline, Embase and Cochrane Library databases was performed, using the search terms ‘IgG4’, ‘hyperIgG4 syndrome’ and ‘IgG4 related chronic sclerosing sialadenitis’.
Results:
Knowledge concerning immunoglobulin G4 related chronic sclerosing sialadenitis is rapidly increasing. This new entity is part of a fibro-inflammatory corticosteroid-responsive systemic disease (immunoglobulin G4 related disease) and has been described in almost every organ. Biopsy of the submandibular gland can be diagnostic. However, the diagnosis can easily be overlooked if: clinical suspicion is not high, one is unaware of the classical morphology and/or immunoglobulin G4 staining is not performed. This paper presents a summary of the current understanding of the disease and its management.
Conclusion:
ENT surgeons should be aware of this new disease entity. Patients with systemic disease should be managed under a multidisciplinary team, with input from clinicians who have an interest in such diseases (such as gastroenterologists and rheumatologists), and input from histopathologists and radiologists.
G4 alloys (Ti51Al47Re1W1Si0.2) are developed by Spark Plasma Sintering (SPS) with the aim to improve the creep resistance of SPS materials. The microstructure is analyzed by Scanning and Transmission Electron Microscopies (SEM and TEM). The mechanical properties at low and high temperatures are measured. The addition of heavy elements does not lead to an improvement of the mechanical strength.
Surface photometry in I, J, K of the oval disk galaxy M 94 (NGC 4736) reveal a weak central stellar bar of 0.7 kpc semi-major axis length, comprising ≈ 14% of the total light within 20″. By stellar kinematics the existence of a small spheroidal bulge with v/à ≈ 0.8 was discovered. The ionized gas (Hα) in this region shows global and local deviations from the stellar kinematics. Model calculations of closed orbits for the cold gas in the combined potential of bar, disk, and bulge predict large non-circular motions in equilibrium flow. However, these do not fit the observed gas kinematics; obviously hydrodynamical forces play a role in the central region of M 94.
Immunoglobulin G4 related disease is a recently described systemic syndrome. The head and neck region is the second most common site for presentation after the pancreas.
Methods
PubMed and the Cochrane Library were searched from 1995 to July 2017 for all the studies on immunoglobulin G4 related disease diagnosed in the head and neck compartment. Patient-specific data were extracted and basic statistical analysis was performed.
Results
Ninety-one patients were identified. Treatment was specified in 76 patients. Twenty patients received surgical treatment, eight of them in association with medical therapy. Fifty-six patients received medical treatment. The disease recurred in 25 per cent of patients treated with surgical treatment alone, in 3.6 per cent of patients treated with medical treatment alone and in 12.5 per cent of patients treated with both. All medical treatment protocols contained high-dose corticosteroids.
Conclusion
Early and correct diagnosis can avoid unnecessary surgical treatment, and glucocorticoid therapy can improve the long-term prognosis.
The estimation of diffusive transport of gases through tuffs is important in order to assess whether Yucca Mountain is an environmentally safe and acceptable repository for high-level radioactive waste. The purpose of this study is to provide effective diffusivity data which may be used to calculate the amount of diffusion of carbon dioxide through Yucca Mountain tuff layers to the environment. The effective diffusivity of carbon dioxide was measured for tuff samples from five different layers of the USW-G4 drillhole, which is located in the central part of the proposed repository horizon. The tuff samples studied are from the following layers and depths: Vapor Phase (83.6 m), Upper Lithophysal (130.1 m), Middle Nonlithophysal (224.5 m), Lower Lithophysal (243.9 m, 266.9 m, 297.3 m and 335.2 m), and Lower Nonlithophysal (356.3 m and 371.0 m). A steady-state, counter-diffusion method, using gas chromatographic analysis, was used to determine the effective diffusivity of carbon dioxide through tuff samples. Effective diffusivity increased with temperature between 25°C and 125°C for all layers. The effect of temperature on diffusivity correlated well using second-order polynomials. The porosity, specific surface area and mean pore radius were also determined. In general, diffusivity increased with porosity, specific surface area and mean pore radius, but did not correlate well. From the measured data , it appears that the diffusion takes place primarily in the combined Knudsen and bulk diffusion regimes.