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We report a case of a fibrous odontogenic lesion occurring in the maxilla of a man in his 60s. The patient presented with an asymptomatic radiolucent area related to the upper left premolar on radiography. Histological examination of the lesion obtained through an incisional biopsy revealed dense fibrous connective tissue containing small, rounded islands of odontogenic epithelium. The differential diagnoses included central odontogenic fibroma and sclerosing odontogenic carcinoma. Despite being completely different entities, the histological similarities between the two tumors raise diagnostic challenges, with fibrous connective tissue and odontogenic epithelium being the common features. Owing to the finding of unclear small or thin epithelial nests with a high nuclear-cytoplasmic ratio and despite its small size, the lesion was suspected of being malignant, and a maxillary resection was performed. Sections from the resected specimen displayed a small or tiny odontogenic epithelium with cellular atypia and invasion by epithelial cells in and around the nerve fasciculi; therefore, a final diagnosis of sclerosing odontogenic carcinoma was made. Nonetheless, the presence of an odontogenic epithelium in or around the nerve fascicles is not always an evidence of malignancy in the jaw. Caution should be exercised when differentiating invasive epithelia from epithelial residues to provide appropriate treatment.

This report aimed to introduce the new adjustable rotational skin flap for epicanthoplasty in combination with traditional epiblepharon repair by the modified Hotz procedure. This retrospective study involved 25 consecutive patients with superficial punctate keratitis secondary to epiblepharon complicated with epicanthal fold who underwent the combined surgery between 2019 and 2020. The mean patient age was 11.4 years in this study with a median follow-up was 8 months (range, 3-12 months). The rationale of the surgery was to release vertical tension of the eyelids by dissecting dense connective tissue beneath the epicanthal fold and to form a new medial canthus using a rotational skin flap supplied by the redundant the upper and/or lower eyelid skin excised during the epiblepharon repair. Postsurgical resolution of superficial punctate keratitis and patient satisfaction was achieved in all patients. Additionally, there were no complications, and no revisional surgery was required in all patients for a median 8 months follow-up period. Utilizing a rotational skin flap during epiblepharon repair is a useful adjunct during epicanthoplasty surgery. This modification is well tolerated and allows for intraoperative adjustment, whereas minimizing scarring and allowing for improved tissue relaxation.

A 130-week-old male Royal College of Surgeons rat kept as a non-treated animal in a long-term animal study presented with a mass in the hepatic portal region that adhered to a dilated common bile duct and the duodenum. Histopathologically, the solitary mass showed expansive growth with no apparent compression and continued to dilate the common bile duct, which had a hyperplastic epithelium with intestinal metaplasia. The mass mainly consisted of small to large dilated and/or tortuous ducts with abundant dense connective tissue and many inflammatory cells. The single-layer lining epithelium of the duct changed from cuboidal to columnar. Immunohistochemically, the lining cells were positive for cytokeratin 7, cytokeratin 19, and OV-6, which are bile duct markers. Based on the pathological characteristics, the rat was diagnosed as spontaneous cholangiofibrosis adjacent to a dilated common bile duct with intestinal metaplasia.

Summary. The aim of the study was to analyze the data of immunohistochemical studies of the lungs after a gunshot wound penetrating at different times. Materials and methods. Lung tissue removed from the wounded with an encapsulated foreign body or without a foreign body of fire origin in the period from 1 day to 10 months after injury was studied. Results and discussion. At 1 day after injury, pathological type IV collagen and transforming growth factor begin to accumulate in the damaged areas. On day 2 of the wound, there is a slight increase in the expression of TGF-β1 and Collagen IV, VEGF is practically not produced, the number of CD68 + macrophages increases. Day 10 was characterized by a progressive increase in the content of transforming growth factor in leukocytes, lymphocytes, fibroblasts, macrophages and collagen type IV in the surrounding wounds. Ten months after injury and surgery, the wound canal was a large area of dense connective tissue with single venous vessels, often without a muscular layer. Transforming growth factor showed pronounced expression in macrophages and vascular endothelium, while VEGF was manifested as a weak positive response in vascular endothelial cells and single macrophages. Type IV collagen remained between the fibers of dense fibrous tissue, which replaced the wound canal, and was also found in the walls of blood vessels, interalveolar membranes, fibroblasts of the adjacent lung parenchyma. Conclusions. 1. Traumatic disorders in the lung parenchyma in FPI in the first hours after injury are accompanied by the accumulation of CD68 + macrophages, which persist for 10 months after FPI and become the main producers of TGF-β1 and VEGF. 2. Transforming growth factor TGF-β1 and vascular-endothelial growth factor VEGF are found in large quantities in macrophages, leukocytes, lymphocytes, fibroblasts and vascular endothelium from the first day of trauma to the lung parenchyma; up to 10 days the expression of TGF-β1 becomes significant, while VEGF weakly marks capillary endotheliocytes, arterioles, single macrophages. This immunohistochemical picture explains the long healing period of FPI. 3. The content of pathological collagen type IV Collagen IV on the first day of gunshot wound is minimal, increases up to 10 days and is detected in the fields of fibrosis and dystelectasis of the lung parenchyma after 10 months. 4. Determination of IHC expression of CD68, TGF-β1, VEGF and Collagen IV in the first 10 days after FPI and in the subsequent stages of treatment of the wounded will help to predict the course of combat trauma and adjust the methods of treatment.

Background: Varanus salvator is one of the reptiles being hunted by human beings for several purposes, including traditional medicine. The studies about reproductive biology aspects were limited. Aim: This study aimed to determine the morphology, histology, and histometry of V. salvator paryphasmata and hemibaculum based on Snout-Vent Length (SVL) as an indicator of sexual maturity. Methods: This study examined 18 pairs of hemipenis of V. salvator with SVL more and less than 40 cm in equal number. Paryphasmata and hemibaculum parts were observed visually and micro-sliced, then stained with Hematoxylin-Eosin (HE). The histological observation was conducted under a 40×, 100×, and 400× magnification of a light microscope. The histometry of the paryphasmata was examined using 13 Megapixels Coolpad and OptiLab Plus for microscopic pictures. The chondrocyte cell area was measured using the Optilab Plus and Image Raster three applications. Results: The sizes of glans of hemipenis, paryphasmata, and hemibaculum increased according to the increasing of SVL. The average paryphasmata row number, epidermis, and loose connective tissue thickness were not significantly different (p > 0.05). However, dense connective tissue was thicker (p < 0.05), which corresponds to SVL. Hemibaculum was composed of fibrous and hyaline cartilage characterized by chondrocyte cells. The SVL also affects (p < 0.05) the ossification of hyaline in hemipenis, while the chondrocyte cell area followed the equation −1.87E7 + 7.09E5* SVL. Conclusion: The SVL size of V. salvator affects the paryphasmata, hemibaculum, thickness of dense connective tissue of paryphasmata, and the area of chondrocyte cells.

During bone augmentation procedures, primary wound healing determines the bone augmentation result. After a crestal incision in the maxilla, the palatal flap might not be an adequate length to correctly couple to the vestibular flap and to seal the wound with horizontal mattress and single sutures. Due to the histologic structure made of dense connective tissue, the palatal flap eversion is impossible, negatively impacting the wound seal and primary healing. This case report describes the effectiveness and efficacy of an incision design to improve palatal flap management during bone augmentation procedures in the maxilla. Indeed, palatal flap verticalization is achieved. The incision line is proportionally shifted on the vestibular side, based on the defect anatomy, to obtain a palatal flap length extending at least 4 mm coronal to the bone graft level prior to wound closure. The described approach simplifies the optimal adaptation of the inner faces of the palatal and vestibular flaps, reducing the risk of nonprimary wound healing.

Tendons and ligaments are important structures in the musculoskeletal system. Ligaments connect various bones and provide stability in complex movements of joints in the knee. Tendon is made of dense connective tissue and transmits the force of contraction from muscle to bone. They are injured due to direct trauma in sports or roadside accidents. Tendon healing after repair is often poor due to the formation of fibro vascular scar tissues with low mechanical property. Regenerative techniques such as PRP (platelet-rich plasma), stem cells, scaffolds, gene therapy, cell sheets, and scaffolds help augment repair and regenerate tissue in this context. Therefore, it is of interest to document known data (repair process, tissue regeneration, mechanical strength, and clinical outcome) on applied regenerative medicine in tendon healing.

We previously reported on the thin membranous dense connective tissue around the esophagus in the upper mediastinum. This time, we histologically investigated the existence of similar structures in the middle and lower mediastinum, caudal to the bifurcation of the trachea. Semi-sequential transverse sections of the mediastinum were obtained from two cadavers. Hematoxylin and eosin staining and Elastica van Gieson staining were performed. In the middle mediastinum, the “visceral sheath” could not be observed completely around the esophagus. In the lower mediastinum, the thin membranous dense connective tissue was observed beneath the pericardium on the ventral side of the esophagus. On the dorsal side of the esophagus, two thin membranous dense connective tissues were similarly observed in two cadavers. One existed between the dorsal side of the esophagus and the three vessels (i.e., the descending aorta, the azygos vein and the thoracic duct) and was integrated with the thin membranous dense connective tissue of the ventral side of the esophagus at the bilateral side of the esophagus. This integrated dense connective tissue reached the left subpleural region and the adventitia of the aorta on the left side and the peripleural and pulmonary hilum on the right side. The other thin membranous dense connective tissue, which represents the “vascular sheath”, was observed between the descending aorta and the thoracic duct. These two thin membranous dense connective tissues, which are considered to represent the visceral sheath and vascular sheath, are thought to be available as optimal dissecting layers for radical esophagectomy.

Background The morbidities and complications reported in the reconstruction of large bony defects have inspired progression in the field of bioengineering, with a recent breakthrough for the use of decellularized skeletal muscle grafts (DSMG). Aim To assess the osteogenic potentials of seeded DSMG in vitro and to investigate bone regeneration in critical size defect in vivo. Materials and Methods Assessment of cell viability and characterization was carried out on seeded DSMG for different intervals in vitro. For in vivo experiments, histological analysis was performed for rat cranial defects for the following groups: (A) non-treated DSMG and (B) seeded DSMG after a period of 8 weeks. Results The in vitro experiment demonstrated the lack of cytotoxicity and inert properties of seeded DSMG; these facilitated the osteogenic differentiation and significant gene expressions, particularly of COL1A1, RUNX2, and OPN (1.9174 ± 0.11673, 1.1806 ± 0.02383, and 1.1802 ± 0.00775, respectively). In the in vivo experiment, superior results were detected in the seeded DSMG group which showed highly vascularized and cellular dense connective tissue with deposited bone matrix and multiple scattered islets of newly formed bone. Conclusion Our results demonstrated the promising aspects of DSMG; however, there is a lack of studies to support further implications.

OBJECTIVE. The purpose of this study was to determine the relationship between background parenchymal enhancement (BPE) on contrast-enhanced mammography (CEM) and breast tissue density, menstrual status, endocrine therapy, and risk factors for breast cancer and also to evaluate interreader agreement on classification of BPE on CEM. MATERIALS AND METHODS. Five subspecialty-trained breast radiologists independently and blindly graded tissue density (with fatty tissue and scattered fibroglandular tissue classified as nondense tissue and with heterogeneously dense and extremely dense classified as dense tissue) and BPE (with minimal or mild BPE categorized as low BPE and moderate or marked BPE categorized as high BPE) on CEM examinations performed from 2014 to 2018. Electronic medical charts were reviewed for information on menstrual status, endocrine therapy, history of breast surgery, and other risk factors for breast cancer. Comparisons were performed using the Kruskal-Wallis test, Mann-Whitney test, and Spearman rank correlation. Interreader agreement was estimated using the Fleiss kappa test. RESULTS. A total of 202 patients (mean [± SD] age, 54 ± 10 years; range, 25-84 years) underwent CEM. Tissue density was categorized as fatty in two patients (1%), scattered fibroglandular in 67 patients (33%), heterogeneously dense in 117 patients (58%), and extremely dense in 16 patients (8%). Among the 202 patients, BPE was minimal in 77 (38%), mild in 80 (40%), moderate in 31 (15%), and marked in 14 (7%). Dense breasts, younger age, premenopausal status, no history of endocrine therapy, and no history of breast cancer were significantly associated with high BPE. Among premenopausal patients, no association was found between BPE and time from last menstrual period to CEM. Overall interreader agreement on BPE was moderate (κ = 0.41; 95% CI, 0.40-0.42). Interreader agreement on tissue density was substantial (κ = 0.67; 95% CI, 0.66-0.69). CONCLUSION. Women with dense breasts, premenopausal status, and younger age are more likely to have greater BPE. Targeting CEM to the last menstrual period is not indicated.

A ventral midline surgical approach for fish celiotomy is commonly performed in veterinary clinical medicine and research, although the relevant ventral body wall anatomy of many fish species is not well documented. Histological evaluation of tissue samples from the ventral body wall of 12 fish species was performed to provide a reference for surgical approach and closure decisions. The width between muscle bundles running parallel to the long axis and total thickness of tissue layers varied among species. An appreciable space between longitudinal muscles of the ventral body wall and a lack of muscle, vessels and nerves on midline in all species examined supports recommendations of ventral midline incisions to spare important structures. Dense connective tissue consistent with an aponeurosis between musculature along the ventral body wall was not observed in any species evaluated. Connective tissue was concentrated within the dermis of all species evaluated, with an additional layer of collagen along the coelomic membrane in Russian sturgeon Acipenser gueldenstaedtii, koi Cyprinus carpio, goldfish Carassius auratus, black drum Pogonias cromis, black seabass Centropristis striata, tomtate Haemulon aurolineatum and scup Stenotomus caprinus. A sufficiently wide space on ventral midline for practical targeting during the surgical approach is present in A. gueldenstaedtii, C. carpio, striped bass Morone saxatilis, H. aurolineatum, P. cromis, rainbow trout Oncorhynchus mykiss and brown trout Salmo trutta. Sand perch Diplectrum formosum, C. auratus, S. caprinus, grey triggerfish Balistes capriscus and black sea bass Centropristis striata have a negligible space between longitudinal muscles on midline. The variation in ventral body wall structure observed in this study helps inform surgical decision making for celiotomy incision and closure in these species.

It is known that the extracellular matrix structure and composition changes with aging in many organs. Despite this, knowledge on how does the extracellular part of the ovary change with increasing age in women and how those changes might be related to women’s loss of fertility is still lacking. For this, we propose that recurrent injury and repair events on the outermost layers of the ovary due to ovulation are partly responsible for those changes women experience with aging. The histological analysis of the ovaries from 18 female-to-male transgender patients revealed that the ovarian tunica albuginea (TA) increases its thickness and density correlatively with increasing age of the patient (r = 0.52 and r = 0.55, P

Cell sheets from bone marrow mesenchymal stem cells (BMSC) have been widely used in the field of bone tissue engineering, although their source remains a challenging issue. In this study, adipose-derived stem cells (ADSC) were induced to differentiate into osteoblasts, and the incorporation of coral scaffolds with ADSC sheets for bone formation at an ectopic site was also investigated. First, ADSC isolated from inguinal adipose tissue of New Zealand rabbits were cultured for two weeks without passaging under osteogenic induction, and the microstructures of cell sheets were analysed by histological and scanning electron microscope (EM) observation. In addition, the activity of alkaline phosphatase (ALP) and alizarin red staining was also measured to detect their osteogenic ability. Subsequently, ADSC were proved to be able to proliferate well when seeded on the coral scaffolds. Next, coral scaffolds were wrapped in cell sheets to prepare sheet-coral complexes, which were implanted into subcutaneous pockets in nude mice. At eight weeks after implantation, gross examination, microcomputed tomography (MicroCT), and histological analysis were investigated to assess new bone formation. MicroCT scanning and histological analysis showed that there was more highly dense tissue formed in the complex group than control group (p=0.0004). These results indicated that osteoblastic ADSC sheets could be used to construct engineered bone and the incorporation of coral scaffolds with ADSC sheets significantly improved bone formation, providing a newly approach for bone tissue engineering.

Background High breast density increases breast cancer risk and lowers mammographic sensitivity. Supplemental MRI screening improves cancer detection but increases the number of false-positive screenings. Thus, methods to distinguish true-positive MRI screening results from false-positive ones are needed. Purpose To build prediction models based on clinical characteristics and MRI findings to reduce the rate of false-positive screening MRI findings in women with extremely dense breasts. Materials and Methods Clinical characteristics and MRI findings in Dutch breast cancer screening participants (age range, 50-75 years) with positive first-round MRI screening results (Breast Imaging Reporting and Data System 3, 4, or 5) after a normal screening mammography with extremely dense breasts (Volpara density category 4) were prospectively collected within the randomized controlled Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial from December 2011 through November 2015. In this secondary analysis, prediction models were built using multivariable logistic regression analysis to distinguish true-positive MRI screening findings from false-positive ones. Results Among 454 women (median age, 52 years; interquartile range, 50-57 years) with a positive MRI result in a first supplemental MRI screening round, 79 were diagnosed with breast cancer (true-positive findings), and 375 had false-positive MRI results. The full prediction model (area under the receiver operating characteristics curve [AUC], 0.88; 95% CI: 0.84, 0.92), based on all collected clinical characteristics and MRI findings, could have prevented 45.5% (95% CI: 39.6, 51.5) of false-positive recalls and 21.3% (95% CI: 15.7, 28.3) of benign biopsies without missing any cancers. The model solely based on readily available MRI findings and age had a comparable performance (AUC, 0.84; 95% CI: 0.79, 0.88; P = .15) and could have prevented 35.5% (95% CI: 30.4, 41.1) of false-positive MRI screening results and 13.0% (95% CI: 8.8, 18.6) of benign biopsies. Conclusion Prediction models based on clinical characteristics and MRI findings may be useful to reduce the false-positive first-round screening MRI rate and benign biopsy rate in women with extremely dense breasts. Clinical trial registration no. NCT01315015 © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Imbriaco in this issue.

The morphology of tongue in straw-coloured fruit bat from tropical forests was evaluated in relation to frugivorous diets and in comparison with other species that consumes other food types. Gross, stereomicroscopy, scanning electron microscope and histological methods were used. The tongue was relatively long with round tip, which closely fitted into oral cavity. Five types of mechanical papillae included crown-like and trifid filiform papillae. Also bulky, cone-shaped papillae and long conical papillae were identified. These mechanical types also showed variations in shape, size and number of processes of papillae. Transitional forms of these mechanical papillae were present. Fungiform papillae with taste pores were interposed amongst filiform types in apex and body; three ovoid-shaped vallate papillae were in triangular arrangement on root and displayed taste pores. Some bulky, cone-shaped papillae surrounded the vallate papillae. Histologically, mechanical filiform types showed highly keratinized stratified squamous epithelium and dense connective tissue core with secondary papillae. Taste buds appeared in fungiform and vallate papillae. Neutral and acidic secretions were identified in lingual glands of root. The presence of prominent filamentous processes of filiform papillae and conical papillae of the tongue in conjunction with gustatory papillae ensures adaptation to copious fruit diets. The gross morphometric and histometric parameters of the tongue did not differ remarkably from previous values obtained for some fruit bats with comparable weight. This investigation showed similarities with fruit bats such as large flying fox and Egyptian fruit bat and reflect common diet and feeding habits but varied from insectivorous and nectivorous bats.

The problem of anterior cruciate ligament (ACL) reconstruction of the knee joint remains relevant, despite of significant number of designed surgical techniques for its reconstruction. Repeated ruptures of the restored ACL are recorded in 3–15 % of cases. Objective: to determine the morphological features of the knee joint tissues rearrangement in rabbits after implantation of a polypropylene mesh (PM) into the capsule defect. Methods: the study was performed on 50 rabbits weighing (694 ± 27) g. A capsule defect was formed on the right knee joint between the patellar ligament and the medial collateral ligament. In the experimental group (25 rabbits), the defect was repaired using PM, in the control group (25) — the edges of the defect were tightened and sutured with vicryl. A modified Vanderbilt University scale was used to assess the scarring process. Morphological analysis was performed. Results: no significant clinical differences in the state of the operated knee joint in the postoperative period were found between the groups. In the control group, from the 7th day after the surgery, the formation of dense connective tissue (scar) was observed. In animals of the experimental group, against the background of the formation of connective tissue around the PM, a significant thickening of the capsule and ligaments was observed at the points of contact with it. In 21 days after PM implantation, 51–75 % of its area showed ingrowth of connective tissue, after 45 — 75–100 %. After 2 months after the surgery, the relative area of dense connective tissue in the experiment was (68.12 ± 2.74) % versus (51.68 ± 4.22) % in the control.Conclusions: implantation of PM into the area of the knee joint capsule defect of rabbits between the patellar ligament and the medial collateral led to the formation of a larger volume of dense connective tissue at the final follow-up period (2 months). Ingrowth of connective tissue between cells and fibers of PM promotes the formation of a tight connection with the surrounding tissues, thereby strengthening area of traumatic injury.

Objective To report the clinical and MRI features, and histologic findings of thoracolumbar discal pseudocyst in dogs. Materials and methods The records of eight dogs with thoracolumbar discal cyst-like structures were retrospectively collected to record their clinical signs, MRI features and surgical and histologic findings. Results Eight dogs with surgically and histologically confirmed thoracolumbar discal pseudocysts were included in the case series. Six dogs presented with acute onset and two dogs presented with subacute onset of thoracolumbar myelopathy. MRI showed compressive thoracolumbar myelopathy due to a round to oval-shaped epidural mass lesion communicating with the intervertebral disc, iso/hypointense on T1WI and mostly hyperintense on T2WI, associated with a variable contrast-enhancing wall, compatible with a cyst-like structure. These structures were surgically visualised and removed through a mini-hemilaminectomy or hemilaminectomy and submitted for histologic investigation. One dog also underwent cytologic examination of the cystic content. Similar to that in humans, histology revealed a cyst-like nature with a wall consisting of dense fibrous connective tissue containing clusters of chondroid cells accompanied by groups of notochordal cells and occasional erythrocytes; however, a real epithelial lining was missing and the term pseudocyst seemed more appropriate. Clinical significance This report describes clinical signs, and MRI and histologic findings of discal pseudocysts in dogs with thoracolumbar myelopathy. Despite being rare, discal pseudocysts should be considered as a differential diagnosis in dogs with acute onset thoracolumbar myelopathy.

Introduction The thickness of connective tissue has been shown to be associated with pain (Stecco et al., 2014). However, the relationship between fascial thickness and gliding remains unclear. In addition, the influence between gliding and the motion rhythm and limb position isn't clear. Method A therapist moved patient's lower leg at one of two constant rhythms (40 or 60bpm). Gliding of both the vastus lateralis (VL) muscle and subcutaneous (SC) tissue were recorded during knee motion using ultrasonography. Particle image velocimetry analysis software was adapted to create the flow velocity from echo imaging. Gliding was calculated using a coefficient of correlation from each flow velocity. Myofascial thickness and SC were measured using Image-J. The ratios of the loose connective tissue (LCT) and dense connective tissue (DCT) thickness to the total myofascial thickness were calculated. Repeated-measures two-way ANOVA was used to compare the two motion rhythms and three positions, with stepwise multiple regression analysis to analyze the predictors that influenced the gliding coefficient at each rhythm. Results Repeated-measures two-way ANOVA showed that the effect of rhythm was statistically significant, but the effect of position was not. At a 40 bpm rhythm, stepwise multiple regression analysis selected SC thickness and DCT thickness as significant factors, while at a 60 bpm rhythm, SC thickness and DCT ratio were selected. Conclusion This study revealed that increased thickness of DCT of the myofascia and SC resulted in decreased gliding between the VL and SC, demonstrating that gliding is related to fascial thickness. Motion rhythm influences gliding between tissues.

Purpose To date, there are many theories about tear transport through the canaliculi of the draining lacrimal system into the lacrimal sac but only few with supportive data. It is certain that the function of the lacrimal part of orbicularis oculi muscle (Horner-Duverney's muscle) is indispensable for the transport of “used” tears. However, the muscle's exact structure and the mechanisms of its functions are as yet unclear. To obtain deeper insights we undertook the present study. Methods Upper and lower canaliculi (including the entrance into the lacrimal sac) from donor cadavers were dissected. Some of the specimens were prepared for scanning electron microscopy (SEM) to analyze the course of muscle fibers surrounding the canaliculi. Others were sectioned for enzyme- (EHC) and immunohistochemistry (IHC) to learn about the distribution of slow and fast reacting muscle fibers in Horner-Duverney's muscle as well as to analyze the distribution of different neurotransmitters to learn more about the innervation of Horner-Duverney's muscle. Four tear duct systems taken from body donors were cut out en bloc after formalin fixation, serially sectioned and reconstructed using a newly developed technology for 3D reconstruction of histological serial sections named HiD® (Chimaera GmbH, Germany). Patients that had undergone dacryocystorhinostomy (DCR) were video-analyzed endonasally during active blinking, focusing on viewing the temporal wall of the lacrimal sac movement where the canaliculi penetrated the lacrimal sac. Results SEM revealed that muscle fibers of Horner-Duverney's muscle surround the vertical parts of the upper and lower canaliculus in a scissor like pattern whereas they ran in parallel to the first two thirds of the horizontal parts surrounding the respective canaliculus. Here, the muscle fibers were embedded in dense connective tissue forming a unique network. At the nasal third, muscle fibers left the canaliculi and ran to the posterior part of the fascia of the lacrimal sac and the lacrimal bone. EHC revealed that Horner-Duverney's muscle contained nearly an equal distribution of type I and type IIb muscle fibers compared to the superior rectus muscle which contains more type I and the masseter and iliopsoas muscles with more type IIb muscle fibers. IHC indicated presence of trigeminal, catecholaminergic and cholinergic nerve endings. 3D reconstructions supported the SEM data. Endonasal video analysis of patients after DCR with a nasally open lacrimal sac revealed bulging of the temporal wall of the lacrimal sac during blinking. On the basis of these findings, a modified lacrimal pump theory is proposed. Conclusion The results support the hypothesis that contraction of Horner-Duverney's muscle leads to closure of the canaliculi in their first two thirds based on the special arrangement of muscle fibers and connective tissue fibers. This causes the tear fluid in the canaliculi to be pressed/transported towards the lacrimal sac. The medial third of the vertical portions of the canaliculi, the canaliculus communis and the intrasaccal portion of the canaliculus are compressed by the shortening and thickening of the Horner-Duverney muscle from dorsal, which leads to a compression of the canaliculi lumens in this part of the system, thereby pushing the lacrimal fluid further towards the lacrimal sac. The mix of fast contracting and fatigue resistant muscle fibers is ideally suited for the blink mechanism that is complexly regulated by the nervous system.

Background A major challenge for any glaucoma implant is their ability to provide long-term intraocular pressure lowering efficacy. The formation of a low-permeability fibrous capsule around the device often leads to obstructed drainage channels, which may impair the drainage function of devices. These foreign body-related limitations point to the need to develop biologically inert biomaterials to improve performance in reaching long-term intraocular pressure reduction. The aim of this study was to evaluate in vivo (in rabbits) the ocular biocompatibility and tissue integration of a novel suprachoroidal microinvasive glaucoma implant, MINIject™ (iSTAR Medical, Wavre, Belgium). Results In two rabbit studies, no biocompatibility issue was induced by the suprachoroidal, ab-externo implantation of the MINIject™ device. Clinical evaluation throughout the 6 post-operative months between the sham and test groups were similar, suggesting most reactions were related to the ab-externo surgical technique used for rabbits, rather than the implant material itself. Histological analysis of ocular tissues at post-operative months 1, 3 and 6 revealed that the implant was well-tolerated and induced only minimal fibroplasia and thus minimal encapsulation around the implant. The microporous structure of the device became rapidly colonized by cells, mostly by macrophages through cell migration, which do not, by their nature, impede the flow of aqueous humor through the device. Time-course analysis showed that once established, pore colonization was stable over time. No fibrosis nor dense connective tissue development were observed within any implant at any time point. The presence of pore colonization may be the process by which encapsulation around the implant is minimized, thus preserving the permeability of the surrounding tissues. No degradation nor structural changes of the implant occurred during the course of both studies. Conclusions The novel MINIject™ microinvasive glaucoma implant was well-tolerated in ocular tissues of rabbits, with observance of biointegration, and no biocompatibility issues. Minimal fibrous encapsulation and stable cellular pore colonization provided evidence of preserved drainage properties over time, suggesting that the implant may produce a long-term ability to enhance aqueous outflow.

Purpose The palatopharyngeus is one of the longitudinal pharyngeal muscles which contributes to swallowing. It is reported that the palatopharyngeus has muscle bundles in various directions and with attachment sites, and each muscle bundle has a specific function. Although previous reports suggest that the palatopharyngeus is partly interlaced with some parts of the inferior constrictor, the precise relationship remains unclear. The purpose of this study was to examine the precise manner of the connection between the palatopharyngeus and inferior constrictor, and to examine the histological characteristics of this connection. Methods We examined 15 halves of nine heads from Japanese cadavers (average age: 76.1 years); 12 halves, macroscopically, and three halves, histologically. Results Our observation suggests that the palatopharyngeus spreads radially on the inner aspect of the pharyngeal wall. The most inferior portion of the palatopharyngeus extended to the inner surface of the cricopharyngeal part of the inferior constrictor. Histological analysis showed that the inferior end of the palatopharyngeus continued into the dense connective tissue located at the level of the cricoid cartilage. The dense connective tissue not only covered the inner surface of the inferior constrictor but also entered its muscle bundles and enveloped them. Conclusion Therefore, the palatopharyngeus interlaced the cricopharyngeal part of the inferior constrictor through the dense connective tissues. The findings of this study show that the palatopharyngeus may act on the upper esophageal sphincter directly and help in its opening with the aid of the pulling forces in the superolateral direction.

Posterior compartment of forearm and hand is among the most variable parts of the human body. During a routine dissection, we found two anatomical variants in the right forearm and hand of an 84-year-old male cadaver including the extensor indicis radialis and the extensor medii proprius associated with a fibromuscular slip. Histological analysis using hematoxylin and eosin staining revealed that this unusual fibromuscular slip associated with the extensor medii proprius was composed of dense connective tissue along with small amount of skeletal muscle fibers, and the innervation from the posterior interosseous nerve. Based on the existing literature, a fibromuscular slip associated with a hand extensor tendon on the dorsum of hand has never been reported. Further studies are needed to clarify the evolutionary origin of this structure, although it resembles to a certain extent the dorsometacarpales, a group of muscles that were once present in our mammalian ancestors.

One of the urgent problems of modern surgery continues to be the increasing number of patients with purulent-inflammatory and purulentnecrotic processes of soft tissues – about 60.0 % of patients in the structure of specialized hospitals of a surgical profile. This is due to the adaptation of microorganisms – pathogens of wound infection to existing means for treating wounds. In addition, the number of patients with diabetes mellitus increases annually, and as a result, the number of people suffering from diabetic foot syndrome. Thus, the relevance of developing new modern tools for the local treatment of purulent-necrotic processes of the skin and soft tissues is not reduced.Materials and methods.The material for the study was a highly porous biodegradable sponge (chitosan-collagen) in the ratio of chitosan: collagen 2: 1 with the inclusion of colloidal particles of metallic silver and chymotrypsin. The experiment was performed on 50 Wistar rats that simulated a purulent necrotic wound. During the treatment, the state of the wounds was visually evaluated, the morphological features of the course of the wound process were evaluated after animals were withdrawn from the experiment and the wound material was taken on days 1, 5, 10, 15 and 21, the sections were stained with hematoxylin-eosin and/or according to Van Gieson.Results.By visual assessment, by the 10th day it was noted that necrotic tissues underwent lysis, the wound defect was covered with a scab, swelling of the surrounding tissues was not noted, and on the 21st day of treatment the wound defect was covered with epithelium and had an area of about 3 mm2 with the initial - in 250 mm2. When describing micropreparations, it was noted that on the 10th day the exudation phase passed its peak and the activity of proliferation processes increased from the center of the wound to its periphery and from the granulation surface in depth. On the 15th day, the proliferative phase of inflammation was at its height, and on the 21st day, the proliferation phase was completed and the processes of remodeling of dense fibrous connective tissue began.Conclusion.Based on a visual assessment of the state of wounds and a morphological study, the effectiveness of a chitosan-collagen complex with silver nanoparticles and chymotrypsin was shown to be applied locally to a purulent necrotic wound in an experiment.

Tendon is a highly organized, dense connective tissue that has been demonstrated to have very little turnover. In spite of the low turnover, tendon can grow in response to loading, which may take place primarily at the periphery. Tendon injuries and recurrence of injuries are common in both humans and animals in sports. It is unclear why some areas of the tendon are more susceptible to such injuries and whether this is due to intrinsic regional differences in extracellular matrix (ECM) production or tissue turnover. This study aimed to compare populations of tenocytes derived from the tendon core and periphery. Tenocytes were isolated from equine superficial digital flexor tendons (SDFTs), and the proliferation capacity was determined. ECM production was characterized by immuno- and histological staining and by liquid chromatography-mass spectrometry-based proteomics. Core and periphery SDFT cultures exhibited comparable proliferation rates and had very similar proteome profiles, but showed biological variation in collagen type I deposition. In conclusion, the intrinsic properties of tenocytes from different regions of the tendon are very similar, and other factors in the tissue may contribute to how specific areas respond to loading or injury.

To investigate the association between mammographic density (MD) phenotypes and both clinicopathologic features of breast cancer (BC) and tumor location.MD was measured for 297 BC-affected females using qualitative (visual method) and quantitative (fully automated area-based method) approaches. Radiologists' description, visible external markers, and surgical scar were used to establish the location of tumors. Binary logistic regression models were used to assess the association between MD phenotypes and BC clinicopathologic features.Categorical and numerical MD measures showed no association with clinicopathologic features of BC (p 0.05). Participants with higher BI-RADS scores [(51-75% glandular) and ( 75% glandular)] (p 0.001), and percent density (PD) categories [PD (21-49%) and PD ≥ 50%] (p = 0.01) were more likely to have tumors emanating from dense areas. Additionally, tumors were commonly found in dense regions of the breast among patients with higher medians of PD (p = 0.001), dense area (DA) (p = 0.02), and lower medians of non-dense area (NDA) (p 0.001). Adjusted logistic regression models showed that high BI-RADS density ( 75% glandular) has an almost fivefold increased odds of tumors developing within dense areas (OR 4.99, 95% CI 0.93-25.9; p = 0.05. PD (OR 1.02, 95% CI 1-1.03, p = 0.002) and NDA (OR 0.99, 95% CI 0.991-0.997, p 0.001) had very small effect on tumor location. Compared to tumors within non-dense areas, tumors in dense areas tended to exhibit human epidermal growth factor receptor 2 positive (p = 0.05) and carcinoma in situ (p = 0.01) characteristics.MD shows no significant association with clinicopathologic features of BC. However, BC was more likely to originate from dense tissue, with tumors in dense regions having human epidermal growth receptor 2 positive and carcinoma in situ characteristics.

Objective: The aim of this case report is to describe the surgical removal of a mucocele and its histological analysis, in a child. Case Report: An 11-year-old female patient attended the Pediatric Dentistry clinic complaining of a lower lip lesion. During the anamnesis, the mother reported that the child had a habit of biting and sucking the spot frequently. Clinical examination showed the lesion was compatible with a mucocele. The proposed treatment was a complete enucleation of the lesion under local anesthesia. The incision and tissue divulsion were performed for maximum preservation of the mucosa, avoiding a possible recurrence. Total adjacent glands removal was also performed. The lesion was placed in 10% formaldehyde for histopathological analysis (H&E Staining), which showed dense connective tissue presenting chronic inflammatory infiltrate and extravasated mucin, presence of granulation tissue delimiting the area of extravasated mucin and presence of minor salivary glands. The patient was advised to quit the habit, and after seven days the sutures were removed. At the one-year follow-up there was no recurrence of the lesion. Conclusion: The proposed treatment proved to be effective without recurrence of the lesion.

Lipodermoids are abnormal epibulbar growths of the adipose tissue. A conjunctival lesion, the lipodermoid (dermolipoma) is usually located near the temporal fornix and is composed of adipose tissue and dense connective tissue. The overlying conjunctival epithelium is normal, and hair follicles are absent. Lipodermoids may be extensive, sometimes involving orbital tissue, lacrimal gland, and extraocular muscle. Surgical treatment is only indicated when the existing lipodermoid disturbs the patient either functionally or aesthetically. Purpose The main purpose of this study is to present our experience on the surgical treatment of lipodermoids in those cases when lipodermoids cause functional and aesthetic problem to the patient. Materials and Methods In our study we have included two cases of male gender, one with bilateral lipodermoid (in both eyes) while the other with a mono lateral lipodermoid (only in one eye). The treatment was surgical, where we carefully removed the lipodermoid lesion inside palpebral fissures, to fully preserve the bulbar conjunctiva and Tenon’s membrane during the removal of the conjunctival lipodermoid.Surgery was performed under local anesthesia (lidocaine 2% and adrenaline). The surgical area was set ready by using betadine 5%. Results In both cases there were neither intra-operative nor extra-operative complications and the results were positive.Also the functional and aesthetic problems were corrected. There was no recurrence encountered.Conclusions In conclusion, based on the results of this study, in the rare cases of lipodermoids where surgical treatment is necessary, it is very important to perform a careful surgical intervention, in order to prevent any intra-operative injuries of the lacrimal gland and the lateral and superior rectus muscles. In general the surgical treatment is a successful method on treating lipodermoids, in cases when they concern the patient both functionally and aesthetically.

A 55-year-old man complained of sudden onset of severe neck pain. This was followed by prompt loss of consciousness and death. Autopsy revealed rupture of a saccular aneurysm, which was considered to have resulted from enlargement of the remaining ductal tissue, and was located on the medial aspect of the uppermost portion of the descending aorta. Dense blood extravasation was noted in the posterior mediastinum and extending to the strap muscles of the neck and larynx. Histological examination of the rupture site revealed disappearance of the medial elastic fibers and thickened intima covered with dense fibrous tissue. Spontaneous ductus arteriosus aneurysm in adults is a rare finding, but widespread use of imaging technologies has revealed that it develops more frequently than previously recognized. Fatal complications may occur even when the aneurysm is relatively small. Therefore, pathologists should be aware of this aneurysm as a potential cause of sudden death.

Background. Regeneration of bone defects remains a challenge for maxillofacial surgeons. The present study aimed to compare the effects of octacalcium phosphate (OCP) and the combination of octacalcium phosphate/gelatin (OCP/Gel) on mandibular bone regeneration in rats Methods. In the present study, 36 male Sprague-Dawley rats were used. The animals were randomly assigned to the following experimental groups: OCP (n=12), OCP/Gel (n=12), and the control group (n=12). Defects were created in the rat mandibles and filled with 10 mg of OCP and OCP/Gel disks in the experimental groups. In the control group, however, no substance was administered. Samples were taken on days 7, 14, 21 and 56, respectively, after the implantation. Sections (5 µ) were prepared and stained by H&E. The sections were studied, and the volume fraction of newly formed bone was measured by Dunnett's T3 test based on the significance level (P=0.05). Results. In the experimental groups, the new bone formation began from the margin of defects 7‒14 days after the implantation. During the healing process, the newly formed bone healed a larger area of the defects and grew structurally. In the control group, the defects were primarily filled with dense connective tissue, and only a small amount of new bone was formed. The present study showed a statistically significant difference in the volume of newly formed bone between the experimental groups and the control group (PConclusion. OCP/Gel composite can be beneficial in the healing process of mandibular bone defects.

Summary Loss of nuclear integrity correlates with increased DNA damage in different tissues. In a recent issue of Cell, Nader et al. reveal that nuclear envelope ruptures in dense tissue microenvironments cause TREX1-dependent DNA damage and promote the transition from in situ to invasive carcinomas.

Mouse and human teeth represent challenging organs for quick and efficient cell isolation for single-cell transcriptomic or other applications. The dental pulp tissue, rich in the extracellular matrix, requires a long and tedious dissociation process that is typically beyond the reasonable time for single-cell transcriptomics. For avoiding artificial changes in gene expression, the time elapsed from euthanizing an animal until the analysis of single cells needs to be minimized. This work presents a fast protocol enabling to obtain single-cell suspension from mouse and human teeth in an excellent quality suitable for scRNA-seq (single-cell RNA-sequencing). This protocol is based on accelerated tissue isolation steps, enzymatic digestion, and subsequent preparation of final single-cell suspension. This enables fast and gentle processing of tissues and allows using more animal or human samples for obtaining cell suspensions with high viability and minimal transcriptional changes. It is anticipated that this protocol might guide researchers interested in performing the scRNA-seq not only on the mouse or human teeth but also on other extracellular matrix-rich tissues, including cartilage, dense connective tissue, and dermis.

Tissue specimens taken from primary tumors or metastases contain important information for diagnosis and treatment of cancer patients. Multispectral imaging allows in situ visualization of heterogeneous cell subsets, such as lymphocytes, in tissue samples. Many image processing pipelines first segment cell boundaries and then measure marker expression to assign cell phenotypes. In dense tissue environments such as solid tumors, segmentation-based phenotyping can be inaccurate due to segmentation errors or overlapping cell boundaries. Here we introduce a machine learning pipeline design called ImmuNet that directly identifies the positions and phenotypes of immune cells without determining their exact boundaries. ImmuNet is easy to train: human annotators only need to click on immune cells and rank their expression of each marker; full annotation of tissue regions is not necessary. We demonstrate that ImmuNet is a suitable approach for immune cell detection and phenotyping in multiplex im-munohistochemistry: it compares favourably to segmentation-based methods, especially in dense tissues, and we externally validate ImmuNet results by comparing them to flow cytometric measurements from the same tissue. In summary, ImmuNet performs well on diverse tissue specimens, takes relatively little effort to train and implement, and is a simpler alternative to segmentation-based approaches when only cell positions and phenotypes, but not their shapes are required for downstream analyses. We hope that ImmuNet will help cancer researchers to analyze multichannel tissue images more easily and accurately.

A 65-year-old man with a chief complaint of rhinorrhea was referred to our hospital. A dental implant was placed 11 years prior to his referral, and prosthetic treatment was performed at the same dental clinic. X-ray imaging showed a migrated dental implant surrounded by dense tissue containing small radiopaque particles in the left maxillary sinus. The migrated dental implant and surrounding amorphous mass were removed under general anesthesia. Histopathological examination of the extracted object showed hyphae of Aspergillus and a thickened sinus membrane with infiltration of inflammatory cells. Therefore, we diagnosed the patient with maxillary sinus aspergillosis. Chemotherapeutic treatment with clarithromycin was performed after surgery; however, the symptoms persisted for a year. We consulted the department of otolaryngology, and endoscopic sinus surgery was performed. After surgery, the symptoms gradually subsided.