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Simple Summary: In past populations, some individuals used their front teeth as tools for purposes other than eating, such as making tools or preparing food. These activities have an impact on both the visible part of the tooth (crown) through wear, as well as the part anchored deep in the gum (tooth root) by causing excessive production of a mineralized tissue called 'cementum'. Cementum surrounds the tooth root and forms throughout an individual's life. It records information about the individual's oral health, physiology, and chewing activities. Under certain conditions (e.g., significant mechanical stress or infection), cementum production becomes excessive and exceeds normal physiological limits, resulting in 'hypercementosis'. The present study aims to identify different patterns of cementum apposition and to propose probable causes. We examined a sample of 35 teeth (Sains-en-Gohelle, France, 7th–17th century) and identified four groups of cementum apposition: (i) impacted teeth that never erupted in the mouth, (ii) infected teeth, with caries or gum disease, (iii) hyperfunctional teeth subjected to high mechanical stress, and (iv) hypofunctional teeth that were not used in chewing due to the loss of opposing teeth. We conclude that hypercementosis could provide information on the life history of archeological specimens, even based on isolated teeth. The "teeth-as-tools" hypothesis posits that Neanderthals used their anterior teeth as a tool or a third hand for non-dietary purposes. These non- or para-masticatory activities (e.g., tool-making or food preparation prior to ingestion) have also been described in other past and extant human populations, and other Primates. Cementum is the mineralized tissue that covers the tooth root surface and anchors it to the alveolar bone. Under certain conditions (e.g., mechanical stress, infection), its production becomes excessive (i.e., beyond the physiological state) and is called 'hypercementosis'. Several studies in dental anthropology have established a correlation between the teeth-as-tools and hypercementosis. The present work aims to characterize the different patterns of cementum apposition on archeological teeth and discuss their supposed etiology. Using microtomography and confocal microscopy, the patterns of cementum apposition (i.e., thickness, location, and surface characteristics) were analyzed in 35 hypercementotic teeth (Sains-en-Gohelle, France; 7th–17th c. A.D.). Four groups were identified with distinct hypercementosis patterns: (1) impacted, (2) infected, (3) hypofunctional, and (4) hyperfunctional teeth. Characterizing hypercementosis can contribute to documenting the oral health status (paleopathology) and/or masticatory activity of individuals, even from isolated teeth. This has implications for the study of fossil hominins, particularly Neanderthals, known for their use of anterior teeth as tools and frequent and substantial occurrence of hypercementosis. [ABSTRACT FROM AUTHOR]

Background and Study Aims: The differential diagnosis of solid pancreatic masses by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently suboptimal in centers that are not equipped with rapid on-site evaluation. Needle-based confocal laser endomicroscopy (nCLE) enables real-time in vivo microscopic imaging during endoscopy. This study aimed to describe nCLE interpretation criteria for the characterization of pancreatic masses, with histopathological correlation, and to perform the first validation of these criteria.Patients and Methods: A total of 40 patients were evaluated by EUS-FNA combined with nCLE for the diagnosis of pancreatic masses. Final diagnosis was based on EUS-FNA histology and follow-up at 1 year. Five unblinded examiners defined nCLE criteria for adenocarcinoma, chronic pancreatitis, and neuroendocrine tumor (NET) using a set of video sequences from 14 patients with confirmed pathology (Step 1). These criteria were retrospectively validated by four independent, blinded examiners using sequences from 32 patients (Step 2).Results: nCLE criteria were described for adenocarcinoma (dark cell aggregates, irregular vessels with leakages of fluorescein), chronic pancreatitis (residual regular glandular pancreatic structures), and NET (black cell aggregates surrounded by vessels and fibrotic areas). These criteria correlated with the histological features of the corresponding lesions. In the validation review, a conclusive nCLE result was obtained in 75 % of cases (96 % correct). Statistical evaluation provided promising results, with high specificity, and negative and positive predictive values for all types of pancreatic masses.Conclusion: Considering the low negative predictive value of EUS-FNA, nCLE could help to rule out malignancy after a previous inconclusive EUS-FNA. Larger studies are required to confirm these findings and to establish the role of nCLE in the diagnosis of pancreatic masses.Trial Registration: ClinicalTrials.gov (NCT01563133). [ABSTRACT FROM AUTHOR]

Purpose Nephropathic cystinosis is a rare, autosomal‐recessive inherited disease, characterized by lysosomal accumulation of cystine crystals in almost all tissues. Aim: to describe an innovative in vivo confocal microscopy (IVCM) of crystals in the skin, the cornea and the conjunctiva as well as raman spectroscopy of the crystals in skin and cornea Methods A 36 year‐old women with advanced nephropatic cystinosis underwent penetrating keratoplasty for severe visual loss and chronic ulceration in her left eye. The only dermatology symptom was skin dryness. Cornea and skin was analysed with IVCM using the innovative multilaser (488, 658 and 785 nm) confocal microscope Vivascope 1500 and the handeld monolaser Vivascope 3000 (MAVIG GmbH). In order to obtain the chemical composition, ex vivo Raman spectroscopy (LabRAM ARAMIS,Horiba Jobin‐Yvon,France) was performed on corneal button retrieved during keratoplasty and on a skin sample, both immediately frozen in liquid nitrogen without adjuvant Results Multilaser and monolaser IVCM showed reflective crystals in the corneal epithelium, stroma, tarsal conjunctiva and forearm skin with the highest resolution obtained at 488nm. Ex vivo Raman spectra were obtained in skin and cornea Conclusion Combination of IVCM with Raman spectroscopy may improve the diagnosis and follow‐up for other metabolic diseases with skin and corneal thesaurismoses like amylosis, Wilson disease, Fabry disease or mucopolysaccharidosis [ABSTRACT FROM AUTHOR]