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SUMMARY Nomarski differential interference contrast microscopy of whole-mount preparations of frog gall bladders has been used for light microscopic measurement of epithelial cell luminal area. Measurements were performed: in buffer after fixation, and in cured Epon after step-by-step and after continuous dehydration and infiltration procedures. Sections cut perpendicularly to the luminal surface were used for the measurement of epithelial cell height. From these measurements epithelial cell mean volumes were calculated. The comparative measurements showed that a step procedure results in significantly smaller cellular dimensions than does a procedure of slow and continuous change of concentration of the preparative media, the difference in epithelial cell mean volume being about 40%. Electron microscopy of thin sections of continuously processed specimens showed superior ultrastructural preservation of cytoplasmic density and microplical arrangement compared to the step processed counterparts. The principle was successfully applied in processing for scanning electron microscopy of osmotically extremely fragile preparations of erythrocyte ghosts; similarly, formation of the luminal cobblestone appearance of gall bladder epithelium was prevented. The present studies support the view that at least part of the volume shrinkage through the procedures of embedding is caused by osmotic gradients set up in the tissue. [ABSTRACT FROM AUTHOR]

Background: The maxillary swing approach was introduced three decades ago in the head and neck field providing optimal surgical exposure for tumors in the nasopharyngeal and/or the retromaxillary space., Objectives: To report the clinical experience, patient surgical morbidity and survival outcomes following the introduction of the maxillary swing approach in Denmark., Material and Methods: A retrospective study including patients who underwent the maxillary swing approach from January 2012 - January 2020. Baseline and perioperative data, pathology, postoperative morbidity and survival outcomes were registered., Results: Sixteen patients were included of which 15 had a malignant tumor with different histology, while one patient had a benign tumor. Most commonly reported short-term morbidity were trismus, cheek hypoesthesia, nasopalatal fistula, lacrimation and nasal stenosis (<3 months postoperatively) improving markedly at 12 months follow-up. For patients with malignant tumors, the 5-year overall survival and recurrence-free survival rates were 60% and 66.7%, respectively., Conclusions and Significance: The maxillary swing approach was safely implemented by a multidisciplinary team at a high-volume centralized head and neck cancer center in Denmark. The procedure may be considered for salvage surgery of recurrent nasopharyngeal carcinomas and selected malignant and benign tumors located in the nasopharynx and/or retromaxillary space inaccessible by other surgical modalities.

Context and Overview: Chronic cluster headache (CCH) is a debilitating headache disorder with a significant impairment of the patients' lives. Within the past decade, various invasive neuromodulatory approaches have been proposed for the treatment of CCH refractory to standard preventive drug, but only very few randomized controlled studies exist in the field of neuromodulation for the treatment of drug-refractory headaches. Based on the prominent role of the cranial parasympathetic system in acute cluster headache attacks, high-frequency sphenopalatine ganglion (SPG) stimulation has been shown to abort ongoing attacks in some patients in a first small study. As preventive effects of SPG-stimulation have been suggested and the rate of long-term side effects was moderate, SPG stimulation appears to be a promising new treatment strategy., Aims and Conclusion: As SPG stimulation is effective in some patients and the first commercially available CE-marked SPG neurostimulator system has been introduced for cluster headache, patient selection and care should be standardized to ensure maximal efficacy and safety. As only limited data have been published on SPG stimulation, standards of care based on expert consensus are proposed to ensure homogeneous patient selection and treatment across international headache centres. Given that SPG stimulation is still a novel approach, all expert-based consensus on patient selection and standards of care should be re-reviewed when more long-term data are available., (© International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Objective: Visualising the molecular strands making up the glycocalyx in the lumen of small blood vessels has proved to be difficult using conventional transmission electron microscopy techniques. Images obtained from tissue stained in a variety of ways have revealed a regularity in the organisation of the proteoglycan components of the glycocalyx layer (fundamental spacing about 20 nm), but require a large sample number. Attempts to visualise the glycocalyx face-on (i.e. in a direction perpendicular to the endothelial cell layer in the lumen and directly applicable for permeability modelling) has had limited success (e.g. freeze fracture). A new approach is therefore needed., Methods: Here we demonstrate the effectiveness of using the relatively novel electron microscopy technique of 3D electron tomography on two differently stained glycocalyx preparations. A tannic acid staining method and a novel staining technique using Lanthanum Dysprosium Glycosamino Glycan adhesion (the LaDy GAGa method)., Results: 3D electron tomography reveals details of the architecture of the glycocalyx just above the endothelial cell layer. The LaDy GAGa method visually appears to show more complete coverage and more depth than the Tannic Acid staining method., Conclusion: The tomographic reconstructions show a potentially significant improvement in determining glycocalyx structure over standard transmission electron microscopy., (© 2012 John Wiley & Sons Ltd.)

The exact location of the filtration barrier of the glomerular capillary wall, which consists of an endothelium, a basement membrane and a visceral epithelium, has not yet been determined. Apparent discrepancies between different investigators in the past could be explained if postmortem artifactual tissue changes, due to subnormal blood pressure or anoxia, have taken place in the endothelium before the tissue and tracers have been sufficiently fixed and immobilized by the fixative. To test this supposition, a new method of fixation, which includes a technique to maintain a physiological perfusion pressure and a fixative composed of an oxygen-carrying blood substitute fluid containing glutaraldehyde, was employed combined with contrast enhancement. New observations of the glomerular capillary wall revealed that filamentous plugs (about 90 nm in height) filled the capillary fenestrae and a filamentous surface coat about 60 nm thick covered the interfenestral domains of the endothelial cell. Based on these purely morphological data, we dare to suggest that the fenestral plugs are the primary site of the glomerular filtration barrier - albeit highly speculative, nevertheless a logical location - and consequently that the glomerular filtration process is a 'tangential-flow' as opposed to a 'dead-end' filtration process. A tangential-flow filtration would minimize 'clogging' and 'concentration polarization' in the 'filter'., (Copyright 2002 S. Karger AG, Basel)

A previous investigation indicated that the chief cells of the endolymphatic sac produce an endogenous inhibitor of sodium re-absorption in the kidneys, which has tentatively been named "saccin". In this study, the ultrastructure of the endolymphatic sac and in particular the chief cells is described, demonstrating that this organ fulfils the morphological criteria of a potential endocrine gland. Accordingly, the chief cells are shown to exhibit all the organelles and characteristics of cells that simultaneously synthesize, secrete, absorb and digest proteins.

Purpose: Production of reliable sections of fovea centralis of primate retina., Methods: Rhesus monkey eyes were processed using a new technique known to minimize artefacts and cell-shrinkage in other tissues. An in vivo vascular perfusion-fixation technique with an isotonic fixative followed by a process of slow infiltration with small increments in concentrations were used., Results: Tangential 1 microm thick serial-sections showed a very good morphology. An average cone-to-cone-center distance of 3.8 microm in the central part of the fovea centralis was found. A cone-to-cone-center distance of 2.2-2.6 microm is suggested in the literature., Conclusion: In spite of the limited study we believe that the new technique has resulted in less tissue shrinkage. Our results are discussed in relation to maximal possible resolution of the eye. Our calculations (for green light) support the idea that the structure of the fovea centralis and the refractive media of the eye are developed close to perfection.

The permeability of capillaries is usually explained with reference to "small pores," permeable to water and small solutes, and "large pores," permeable to proteins. Fenestrated capillaries are far more permeable to water and small solutes than nonfenestrated capillaries; moreover, the permeability is highest in the capillaries with the most fenestrae. This suggests that the small pores reside in the fenestral diaphragms; however, no such pores have been illustrated using electron microscopy. In an attempt to clarify this controversy, fenestrated capillaries in the small intestine, stomach, and kidney of the rat were reinvestigated by electron microscopy. A new method of vascular perfusion-fixation was employed, which included the use of glutaraldehyde dissolved in an oxygen-carrying blood substitute (fluorocarbon) and delivered by a peristaltic pump controlled by pressure feedback. The investigation disclosed a prominent endocapillary surface coat, about 50-100 nm thick, and the existence of bush-like filamentous sieve plugs in the fenestrae. Each filamentous plug was composed of 20-40 filaments, each filament measuring 300-400 nm in length and 5-10 nm in thickness. The filamentous plugs have tentatively been named fascinae fenestrae, because they resemble fascines and may also function as such.

To investigate the surface morphology of the endolymphatic duct epithelium, 8 rats were vascularly perfused with glutaraldehyde in a buffered and oxygenated blood substitute. Optimal preservation of the epithelium for scanning electron microscopy was attained by coating of the specimens with OsO4 and thiocarbohydrazide followed by a continuous dehydration procedure. Three types of cells were identified with the scanning electron microscope: A polygonal and oblong epithelial cell was observed in the largest number throughout the duct, whereas in the juxta-saccular half of the duct two additional types of epithelial cells were observed. The scanning electron microscopical observations are compared and discussed with reference to transmission electron microscopical observations of the endolymphatic duct.

Following intracardiac vascular perfusion fixation of 8 rats with glutaraldehyde in a buffered and oxygenated blood substitute, the vestibular aqueduct and endolymphatic duct were opened by microsurgery of the resulting 16 temporal bones. Optimum preservation of the epithelium for scanning electron microscopy was attained by coating of the specimens with osmium tetroxide and thiocarbohydrazide followed by a continuous dehydration procedure. This technique permitted, for the first time, an investigation of the surface morphology of the epithelial cells in the endolymphatic duct. Three types of cells were identified with the scanning electron microscope. A polygonal and oblong epithelial cell was observed in the largest number throughout the duct, and in the juxtasaccular half of the duct, two additional types of epithelial cells were observed. The scanning electron microscopic observations are compared and discussed with reference to previous transmission electron microscopic studies of the endolymphatic duct.

A method for preparing concentrated fibrinogen for use in autologous fibrin adhesive is described. The adhesive was used in seven patients with eight chronic leg ulcers. The ulcers were divided into two equal sections, and the adhesive was used to seal split-thickness skin grafts in one section, while no adhesive was used to seal the grafts in the other section of the ulcer. The strength of adhesion was measured 3 1/2 minutes after transplantation of a 1-cm2 test split-thickness skin graft. In the sealed grafts, the breaking strength varied from 12 to 26 gm. In the unsealed transplants, the strength was less than 5 gm. The take of the meshed split-thickness skin grafts was equal in the sealed and the unsealed areas, varying from 90 to 100 percent. Biopsies taken on day 7 showed a splitting between graft and recipient bed in half the unsealed grafts; none of the sealed grafts showed splitting, indicating a more stable graft in the sealed areas. Biopsies taken on day 21 showed no difference between sealed and unsealed grafts.