Tissue Surface Area Research Articles

Amikacin in 30% poloxamer 407 is a versatile local therapy with method of application and outcome documented in 29 dogs.

To report the clinical use, adverse events, and outcomes after using amikacin in 30% poloxamer 407 (amikacin-P407) during open wound management or in a closed wound application in dogs. 29 client-owned dogs. Medical records from January 2017 to August 2023 from a single hospital were reviewed for dogs that received amikacin-P407 in an open or closed wound application. Information reviewed included signalment, nature of wound and/or surgical site infection (SSI), bacterial cultures, amikacin dose, gel volume, route of administration, estimated wound surface area, biochemistry parameters, urine casts, wound progression, and general clinical outcome. Amikacin-P407 was applied during open wound care (10 dogs), via injection (5 dogs), and at time of wound closure (13 dogs) and was used both in open and closed wound management (1 dog). Wounds were associated with SSIs in 18 of 30 sites. Multidrug resistance was noted in 21 of 30 preapplication cultures. Median amikacin dose was 14.5 mg/kg (range, 3 to 59.5 mg/kg), median total volume was 5.0 mL (range, 1 to 12 mL), and median tissue surface area was 6.6 cm2 (range, 1.6 to 36 cm2), for a local wound dose of 62.5 mg/cm2 (range, 6.9 to 214.3 mg/cm2). No short-term adverse local or systemic effects were noted in any wounds or dogs. No dehiscence was seen in 17 of 19 closed sites. The results of this case series suggested that Amikacin-P407 can be applied in a variety of ways with no adverse effects. Amikacin-P407 may be considered in open wound management or in a closed setting for infected wounds and SSIs.

Three-dimensional changes in the soft tissue chin after mandibular setback surgery in adult Japanese patients with skeletal class III malocclusion

ABSTRACT Purpose The purpose of the present study is to improve the quality of prediction of soft tissue morphology by clarifying the relationship between the amount of three-dimensional (3-D) changes of hard tissue and the morphological differences of the soft tissue chin before and after orthognathic surgery in skeletal class III malocclusion. Materials and methods Preoperative and six-month postoperative CT was used to analyze the changes in 26 adult Japanese skeletal class III patients. The mean age was 25.5 years. Lateral cephalograms were analyzed to evaluate the initial antero-posterior jaw relationship and the changes before and after treatment. Three-D masks and bone structures were reconstructed using 3-D modelling software, and the final chin models were defined for further analysis following voxel-based registration. Correlation and linear regression analyses were performed to clarify the relationship between the movement of the soft tissue chin and the underlying bone. Results The soft tissue chin volume and surface area significantly increased after surgery. The thickness of the chin significantly increased only at pogonion and menton after surgery. Furthermore, a statistically significant correlation between the movement of soft tissue chin and underlying bone was found. Consequently, the regression model predicted the changes in soft tissue chin from the movement of the underlying bone. Conclusion Three-D analysis of the soft tissue chin revealed a significant change in response to surgical orthodontic treatment in skeletal class III adult patients, and soft tissue chin movement could be predicted by using 3-D CT data when planning orthognathic treatment.

Effect of Guggulu Tiktakam Kashayam in Uterine Fibroid

The most common benign uterine tumours affecting women in reproductive and perimenopausal stages are fibroids or leiomyomas. There is strong evidence that estrogen and progesterone promote the growth of fibroids, despite the fact that their exact aetiology is still unclear. This is because fibroids seldom arise before menarche and retreat after menopause. The most prevalent reason for hysterectomy is fibroids. Menorrhagia, polymenorrhoea, metrorrhagia, intermenstrual bleeding, infertility, repeated abortions, pain and pressure feelings, abdominal lumps, and vaginal discharge are a few of the symptoms they exhibit clinically. In Ayurveda there is no exact correlation for uterine fibroid. Fibroids can be considered as Mamsa Grandhis, one among the Grandhis described by Charaka and Vagbhata. They increase the surface area of the endometrial tissue in the uterus when present, causing excessive bleeding, pressure feelings, dysmenorrhea, and even infertility. Vata-Kapha predominant Tridoshas have a role in the aetiology of the Granthi Roga, necessitating the use of Vata-kaphahara medicines. As Granthi can also be caused by Mandagni, in Granthi chikitsa we can make use of Dravyas that are Deepana pachana. According to Acharya Susrutha, Sopha Chikitsa is included in the Apakwa Granthi chikitsa. In Mamsa granthi chikitsa, Shothagna, Lekhana, Chedhana, and Vatanulomana dravyas may be utilised. Asrigdara chikitsa and Raktapitta chiktsa can be used to treat fibroids when heavy, prolonged menstrual cycles are present. A 38 year old lady was presented with complaints of heavy, prolonged bleeding during menstruation along with lower abdomen pain. On USG she was diagnosed with uterine fibroids. Guggulu tikitakam kashayam was given for 3 months and after follow up symptoms were evaluated. She was relieved from prolonged heavy bleeding during menstruation and lower abdomen pain. From this case report, it is evident that Guggulu tiktakam kashayam is effective in uterine fibroids

Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis

IntroductionWe propose a standardized protocol for measurement of nerve bundle density in endometriosis as a potential biomarker, including in deep endometriosis (DE), ovarian endometriomas (OMA) and superficial peritoneal endometriosis (SUP).MethodsThis was a prospective cohort of surgically excised endometriosis samples from Dec 1st 2013 and Dec 31st 2017 at a tertiary referral center for endometriosis in Vancouver, BC, Canada. Surgical data were available from linked patient registry. Protein gene product 9.5 (PGP9.5) was used to identify nerve bundles on immunohistochemistry. PGP9.5 nerve bundles were counted visually. To calculate nerve bundle density, PGP9.5 nerve bundle count was divided by the tissue surface area (total on the slide). All samples were assessed using NHS Elements software for semi-automated measurement of the tissue surface area. For a subset of samples, high power fields (HPFs) were also counted as manual measurement of the tissue surface area. Intraclass correlation was used to assess intra observer and inter observer reliability. Generalized linear mixed model (GLMM) with random intercepts only was conducted to assess differences in PGP9.5 nerve bundle density by endometriosis type (DE, OMA, SUP).ResultsIn total, 236 tissue samples out of 121 participants were available for analysis in the current study. Semi-automated surface area measurement could be performed in 94.5% of the samples and showed good correlation with manually counted HPFs (Spearman's rho = 0.781, p < 0.001). To assess intra observer reliability, 11 samples were assessed twice by the same observer; to assess inter observer reliability, 11 random samples were blindly assessed by two observers. Intra observer reliability and inter observer reliability for nerve bundle density were excellent: 0.979 and 0.985, respectively. PGP9.5 nerve bundle density varied among samples and no nerve bundles could be found in 24.6% of the samples. GLMM showed a significant difference in PGP9.5 nerve bundle density between the different endometriosis types (X2 = 87.6, P < 0.001 after adjusting for hormonal therapy, with higher density in DE and SUP in comparison to OMA).ConclusionA standardized protocol is presented to measure PGP9.5 nerve bundle density in endometriosis, which may serve as a biomarker reflecting local neurogenesis in the endometriosis microenvironment.

Biochemical and planimetric investigations of hydrophilic creams containing ceramides or dexpanthenol on the model of chemical burns

Introduction and aim. Chemical burns of the skin are common type of injuries both in private life and in industries. Local treatment of chemical burns using wound healing creams and ointments is predominant. Hydrophobic wound healing medicinal products dominate the Ukrainian pharmaceutical market but their hydrophobic base disturbs the healing process of skin. The aim of this work was biochemical and planimetric investigation of treatment efficacy of chemical burns with hydrophilic creams containing ceramides and dexpanthenol. Material and methods. The experiments were performed on 30 rats weighing 190–220 g. In a rat skin burn model, animals were exposed to 9% acetic acid solution. Treatment was initiated after wound appearance and included application of creams containing ceramides and dexpanthenol. The effectiveness of treatment was estimated using planimetric parameters, such as: surface area of necrotic tissue (S, mm 2 ) and cumulative reparative effect. Levels of the biochemical markers such as total protein, creatinine, C-reactive protein (CRP) and content of SH-groups were measured in the rats’ blood serum. Results. It was established that cream developed with ceramides and cream with dexpanthenol exhibits reparative properties at the level of 29 % and 4.5 %, respectively. Biochemical investigations demonstrated the treatment efficacy of creams containing ceramides and dexpanthenol. In terms of CRP level and content of SH-groups, the therapeutic action of cream with dexpanthenol was highly significant by a factor of 1.45 and 1.35, respectively in contrast to the cream with ceramides. Conclusion. Using the chemical burn model and results of planimetric and biochemical research it was found that cream with ceramides and cream with dexpanthenol exhibit wound-healing properties. In-depth study on the wound-healing mechanism of investigated creams with the aim of creating effective hydrophilic creams for use in burn treatment is prospective.

Clusterin is increased in morphologically normal cardiomyocytes in lymphocytic myocarditis.

Clusterin is increased in morphologically normal cardiomyocytes in lymphocytic myocarditis.

The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules.

The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs). From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022. The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications. Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

Quantitative analysis of tissue area of endoscopic ultrasound-guided liver biopsy specimens using 19-gauge fine-needle biopsy needle in patients with diffuse liver disease: A single-center retrospective study.

Endoscopic ultrasound-guided liver biopsy (EUS-LB) is a novel liver biopsy technique. We aimed to evaluate the efficacy and safety of EUS-LB in comparison with percutaneous liver biopsy (PLB). This retrospective study evaluated the safety and efficacy of EUS-LB using a 19-gauge fine needle biopsy (FNB) needle compared with PLB using a spring-loaded 16-gauge needle in patients with diffuse liver disease at our hospital from April 2017 to December 2020. The primary outcomes included the total hepatic tissue surface area and the total number of portal tracts. Secondary outcomes included the success and adverse event rates. Twenty patients each underwent EUS-LB and PLB. There was no statistical difference in the sum of liver tissue surface area (22 mm2 vs 22.6 mm2 , P= .910) and the total number of portal tracts (29 vs 25, P= .916). The success rate was 95% (19/20) for EUS-LB and 100% (20/20) for PLB (P= 1). There were two adverse events in the PLB group but none in the EUS-LB group (P= .487). Endoscopic ultrasound-guided liver biopsy using FNB has an optimal tissue yield and success rate and is safe compared to PLB. Thus, EUS-LB may be a new alternative to PLB.

Relationship between magnetic resonance imaging of intramuscular adipose tissue (IMAT) values and serum adipokines level among OBESE population

Background and Aims : Intramuscular adipose tissue (IMAT) is fat infiltrates between and/or within muscle fibres. To assess IMAT tissue surface area and examine the relationship between IMAT value with serum adipokines (leptin and adiponectin) among obese population.

Phosphatidylinositol transfer protein/planar cell polarity axis regulates neocortical morphogenesis by supporting interkinetic nuclear migration.

SUMMARYThe neocortex expands explosively during embryonic development. The earliest populations of neural stem cells (NSCs) form a thin pseudostratified epithelium whose contour determines that of the adult neocortex. Neocortical complexity is accompanied by disproportional expansion of the NSC layer in its tangential dimension to increase tissue surface area. How such disproportional expansion is controlled remains unknown. We demonstrate that a phosphatidylinositol transfer protein (PITP)/non-canonical Wnt planar cell polarity (ncPCP) signaling axis promotes tangential expansion of developing neocortex. PITP signaling supports trafficking of specific ncPCP receptors from the NSC Golgi system to potentiate actomyosin activity important for cell-cycle-dependent interkinetic nuclear migration (IKNM). In turn, IKNM promotes lateral dispersion of newborn NSCs and tangential growth of the cerebral wall. These findings clarify functional roles for IKNM in NSC biology and identify tissue dysmorphogenesis resulting from impaired IKNM as a factor in autism risk, developmental brain disabilities, and neural tube birth defects.

Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study.

BackgroundTransbronchial forceps biopsy is the widely accepted modality for obtaining tissue specimens for the evaluation of unexplained lung parenchymal abnormalities. However, cryoprobe biopsy provides large specimen sizes and higher yield performance. Utilization of cryoprobe biopsy remains limited by its need to be performed under rigid bronchoscopy and subsequent required operator expertise. We evaluated whether a larger, 2.8 mm forceps could be utilized for parenchymal biopsies. A larger size would surrogate the cryoprobe’s large sample size and forceps mechanism to obviate the need for rigid bronchoscopy and its requirement for removing the sample en bloc.MethodsThis prospective, randomized controlled, single-blinded porcine study compared a 1.9 mm cryoprobe, a 2.4 mm cryoprobe, and a 2.8 mm forceps. Assessment of histopathologic quality, sample quality and surface area, attempts to retrieve specimen samples, fluoroscopy activation time, overall procedural time, and complications were compared.ResultsAlthough cryoprobe yielded larger specimens, there was no statistical difference amongst all tools with respect to alveolar tissue surface area. There was bleeding on all cryoprobe biopsies. No bleeding was observed with forceps. Out of 32 potential combinations of interventions for bleeding control, 18 (56.3%) were made. There was no significant difference in sample quality between all three modalities. There was one pneumothorax in the forceps arm.ConclusionsLarge forceps (LF) biopsy is a feasible technique while providing high diagnostic yield without the need for advanced therapeutic tools. Human studies are needed to further corroborate this technique.

Development of reconstructed intestinal micronucleus cytome (RICyt) assay in 3D human gut model for genotoxicity assessment\xa0of orally ingested substances

The micronucleus (MN) assay is widely used as part of a battery of tests applied to evaluate the genotoxic potential of chemicals, including new food additives and novel food ingredients. Micronucleus assays typically utilise homogenous in vitro cell lines which poorly recapitulate the physiology, biochemistry and genomic events in the gut, the site of first contact for ingested materials. Here we have adapted and validated the MN endpoint assay protocol for use with complex 3D reconstructed intestinal microtissues; we have named this new protocol the reconstructed intestine micronucleus cytome (RICyt) assay. Our data suggest the commercial 3D microtissues replicate the physiological, biochemical and genomic responses of native human small intestine to exogenous compounds. Tissues were shown to maintain log-phase proliferation throughout the period of exposure and expressed low background MN. Analysis using the RICyt assay protocol revealed the presence of diverse cell types and nuclear anomalies (cytome) in addition to MN, indicating evidence for comprehensive DNA damage and mode(s) of cell death reported by the assay. The assay correctly identified and discriminated direct-acting clastogen, aneugen and clastogen requiring exogenous metabolic activation, and a non-genotoxic chemical. We are confident that the genotoxic response in the 3D microtissues more closely resembles the native tissues due to the inherent tissue architecture, surface area, barrier effects and tissue matrix interactions. This proof-of-concept study highlights the RICyt MN cytome assay in 3D reconstructed intestinal microtissues is a promising tool for applications in predictive toxicology.

FEATURES OF THE CONNECTIVE TISSUE COMPONENT OF THE PALATINE TONSILS IN PATIENTS WITH RECURRENT TONSILLITIS.

The aim: To explore the morphological changes of palatine tonsil at the levels of the epithelial layer and connective tissue; to determine the relative area of the connective tissue component in the tonsillar tissue (fibrosis) in patients with recurrent tonsillitis compared to the control. Materials and methods: This study presents a morphological assessment of the palatine tonsils of 10 people. Tonsils' material with surrounding tissue was fixed in 10% formalin solution. The samples were dehydrated in increasing ethanol concentrations, cleared in xylol, impregnated with paraffin. Microscopy was then performed with samples stained beforehand. Results: In the samples of patients with recurrent tonsillitis pericapsular sclerosis was noted, along with thickening of interlobular septa and pronounced subepithelial fibrosis. A ratio of the dense connective tissue surface area to the total surface area of tonsil tissue was determined. The control group showed a statistically significant decrease in the degree of sclerosis of the tonsil stroma. Conclusions: Multiple changes were found in the tonsils of patients with recurrent tonsillitis at the level of the epithelial layer that manifested in structural alterations. Significant and irreversible changes were also observed in the connective stroma of the tonsil - pericapsular sclerosis, thickening of interlobular septa, and pronounced subepithelial fibrosis. A statistically significant increase in the relative surface area of the connective tissue component of the tonsil (fibrosis) by a factor of 1,26 was noted in patients with recurrent tonsillitis compared to the results of the control group of patients.

Denture base adaptation, retention, and mechanical properties of BioHPP versus nano-alumina-modified polyamide resins.

Background. Continuous development of denture base materials has led to the introduction of innovative alternatives to polymethyl methacrylate. The present study aimed to evaluate the mechanical properties, adaptation, and retention of alumina nanoparticles (Al2O3 NPs) modified polyamide resin versus BioHPP (high-performance polymer) denture base materials. Methods. Four groups of specimens, one control (group I) (unmodified polyamide) and two groups (groups II and III) (2.5 and 5 wt% Al2O3 NP-modified polyamide, respectively) versus BioHPP specimen group (group IV), were tested for surface microhardness and flexural strength. Complete dentures fabricated from 5 wt% Al2O3 NP-modified polyamide resin and BioHPP were used to evaluate denture base adaptation and retention. Results. The higher concentration in the alumina NP-modified polyamide group (5 wt%) demonstrated significantly higher flexural strength values and insignificantly higher hardness values than the lower concentration (2.5 wt%). There was a significant increase in the BioHPP group in both flexural strength and surface hardness compared to all polyamide groups. A statistically insignificant difference was observed between the two denture base materials regarding mean misfit values of the calculated total tissue surface area and four of the total seven evaluated areas. Satisfactory and comparable retention values were observed for both denture base materials. Conclusion. BioHPP and Al2O3 NP-modified polyamide resin could be used as a promising alternative denture base material with good adaptation, retention, and mechanical properties.

The morphology of the subacromial and related shoulder bursae. An anatomical and histological study.

Shoulder bursae are essential for normal movement and are also implicated in the pathogenesis of shoulder pain and dysfunction. The subacromial bursa (SAB), within the subacromial space, is considered a primary source of shoulder pain. Several other bursae related to the subcoracoid space, including the coracobrachial (CBB), subcoracoid (SCB) and subtendinous bursa of subscapularis (SSB), are also clinically relevant. The detailed morphology and histological characteristics of these bursae are not well described. Sixteen embalmed cadaveric shoulders from eight individuals (five females, three males; mean age 78.6±7.9years) were investigated using macro-dissection and histological techniques to describe the locations, dimensions and attachments of the bursae, their relationship to surrounding structures and neurovascular supply. Bursal sections were stained with haematoxylin and eosin to examine the synovium and with antibodies against von Willebrand factor and neurofilament to identify blood vessels and neural structures respectively. Four separate bursae were related to the subacromial and subcoracoid spaces. The SAB was large, with a confluent subdeltoid portion in all except one specimen, which displayed a distinct subdeltoid bursa. The SAB roof attached to the lateral edge and deep surface of the acromion and coracoacromial ligament, and the subdeltoid fascia; its floor fused with the supraspinatus tendon and greater tubercle. The CBB (15/16specimens) was deep to the conjoint tendon of coracobrachialis and short head of biceps brachii and the tip of the coracoid process, while the inconstant SCB (5/16specimens) was deep to the coracoid process. Located deep to the subscapularis tendon, the SSB was a constant entity that commonly displayed a superior extension. Synovial tissue was predominantly areolar (SAB and SSB) or fibrous (CBB and SCB), with a higher proportion of areolar synovium in the bursal roofs compared to their floors. Blood vessels were consistently present in the subintima with a median density of 3% of the tissue surface area, being greatest in the SSB and SAB roofs (4.9% and 3.4% respectively) and least in the SAB floor (1.8%) and CBB roof and floor (both 1.6%). Nerve bundles and free nerve endings were identified in the subintima in approximately one-third of the samples, while encapsulated nerve endings were present in deeper tissue layers. The extensive expanse and attachments of the SAB support adoption of the term subacromial-subdeltoid bursa. Morphologically, the strong attachments of the bursal roofs and floors along with their free edges manifest as fixed and mobile portions, which enable movement in relation to surrounding structures. The presence of neurovascular structures demonstrates that these bursae potentially contribute blood supply to surrounding structures and are involved in mechanoreception. The anatomical details presented in this study clarify the morphology of the shoulder bursae, including histological findings that offer further insight into their potential function.

MRI-Derived Subcutaneous and Visceral Adipose Tissue Reference Values for Children Aged 6 to Under 18 Years.

The assessment of body composition in pediatric population is essential for proper nutritional support during hospitalization. However, currently available methods have limitations. This study aims to propose a novel approach for nutrition status assessment and introduce magnetic resonance imaging (MRI)-derived subcutaneous and visceral fat normative reference values. A total of 262 healthy subjects aged from 6 to 18 years underwent MRI examinations and anthropometric measurements. MRI images at the second lumbar vertebrae were used by two radiologists to perform the semi-automatic tissue segmentation. Based on obtained adipose tissue surface areas and body mass index (BMI) scores sex-specific standard percentile curves (3rd, 10th, 25th, 50th, 75th, 90th, 97th) and z-scores were constructed using LMS method. Additionally, 85th and 95th centiles of subcutaneous and visceral adipose tissue were proposed as equivalents of overweight and obesity. Bland-Altman plots revealed an excellent intra-observer reproducibility and inter-observer agreement. In conclusion, our findings demonstrate highly reproducible method and suggest that MRI-derived reference values can be implemented in clinical practice.

Mapping of Supramolecular Chirality in Insect Wings by Microscopic Vibrational Circular Dichroism Spectroscopy: Heterogeneity in Protein Distribution.

The supramolecular chirality of the hindwing of Anomala albopilosa (male) was investigated using a microscopic vibrational circular dichroism (VCD) system, denoted as MultiD-VCD. The source of intense infrared (IR) light for the system was a quantum cascade laser. Two-dimensional maps of IR and VCD spectra were taken by scanning the surface area (ca. 2 mm × 2 mm) of the insect hindwing tissue. The spectra ranged from 1500 to 1700 cm-1, and the maps have a spatial resolution of 100 μm. The distribution of proteins, including their supramolecular structures, was analyzed from the location-dependent spectral shape of the VCD bands assigned to amides I and II. The results revealed that the hindwing consists of segregated domains of proteins with different secondary structures: an α-helix (in one part of the membrane), a hybrid of α-helix and β-sheet (in another part of the membrane), and a coil (in a vein).

Early development of the cortical layers in the human brain.

The cortical plate (CP) first appears at seven postconceptional weeks (pcw), when it splits the preexisting preplate into two layers, the marginal zone and the presubplate (pSP). Although three-dimensional (3D) analysis using fetal magnetic resonance imaging and two-dimensional tissue observations have been reported, there have been no studies analyzing the early development of the layer structure corresponding to the pSP stage in 3D. Here, we reconstructed 3-D models of the brain with a focus on the cortical layers in pSP stage. To achieve this, we digitized serial tissue sections of embryos between CS20 and CS23 from the Kyoto Collection (n=7, approximately 7-8.5 pcw), and specimens at early fetal phase from the Blechschmidt Collection (n=2, approximately 9.5-12 pcw, crown rump length [CRL] 39 and 64mm). We observed tissue sections and 3D images and performed quantitative analysis of the thickness, surface area, and volume. Because the boundary between pSP and the intermediate zone (IZ) could not be distinguished in hematoxylin and eosin-stained sections, the two layers were analyzed together as a single layer in this study. The histology of the layers was observed from CS21 and became distinct at CS22. Subsequently, we observed the 3-D models; pSP-IZ was present in a midlateral region of the cerebral wall at CS21, and an expansion centered around this region was observed after CS22. We observed it over the entire cerebral hemisphere at early fetal phase (CRL 39mm). The thickness of pSP-IZ was visible in 3D and was greater in the midlateral region. At the end of the pSP stage (CRL 64mm), the thick region expanded to lateral, superior, and posterior regions around the primordium of the insula. While, the region near the basal ganglia was not included in the thickest 10% of the pSP-IZ area. Middle cerebral artery was found in the midlateral region of the cerebral wall, near the area where pSP-IZ was observed. Feature of layer structure growth was revealed by quantitative assessment as thickness, surface area, and volume. The maximum thickness value of pSP-IZ and CP increased significantly according to CRL, whereas the median value increased slightly. The layer structure appeared to grow and spread thin, rather than thickening during early development, which is characteristic during pSP stages. The surface area of the cerebral total tissue, CP, and pSP-IZ increased in proportion to the square of CRL. The surface area of CP and pSP-IZ approached that of the total tissue at the end of the pSP stage. Volume of each layer increased in proportion to the cube of CRL. pSP-IZ and CP constituted over 50% of the total tissue in volume at the end of the pSP stages. We could visualize the growth of pSP-IZ in 3D and quantify it during pSP stage. Our approach allowed us to observe the process of rapid expansion of pSP-IZ from the midlateral regions of the cerebral wall, which subsequently becomes the insula.

Pharyngeal spreading of peri-implant infections under antiresorptive/antiangiogenic therapy

ObjectivesTo assess the influence of antiresorptive/antiangiogenic therapy on the spreading of peri-implant infections in the pharyngeal region.Material and methodsThis analysis was based on tissue biopsies obtained from a total of twenty-five albino rats having either received (1) amino-bisphosphonate (Zoledronate) (Zo) (n=4), (2) RANKL inhibitor (Denosumab) (De) (n=4), (3) antiangiogenic medication (Bevacizumab) (Be) (n=4), (4) Zo+Be (n=3), (5) De+Be (n=5), or (6) no medication (Co) (n=5). Drug administration was repeated at 12 weeks. Chronic-type peri-implant infections were induced at titanium implants located in the upper jaws. The surface area (%) of infiltrated connective tissue (ICT) and CD68-positive cells was assessed within the lateral pharyngeal/retropharyngeal connective tissue zone.ResultsMean (±SD) and median ICT% values and CD68 counts were markedly highest in the De+Be (11.10±6.04; 11.81; 95% CI − 3.89; 26.11) and De (5.70±5.06; 6.19; 95% CI − 2.34; 13.75) groups, reaching statistical significance for De CD68 counts over the Co (0.18±0.25; 0.18; 95% CI −2.14; 2.51) group. In both De+Be and De groups, the ICTs were occasionally associated with an ulceration of the epithelial compartment.ConclusionsInduced peri-implant infections were not associated with any inflammatory lesions in pharyngeal tissues. While these findings were similar under Zo and Be medication, De and De+Be had a marked effect on ICT and CD68 values. The clinical relevance of these adverse findings needs further investigation.

Potential New Treatments for Kawasaki Disease, Its Variations, and Multisystem Inflammatory Syndrome.

The causation of Kawasaki disease has been a medical mystery for over 54 years. However, the causations of Kawasaki disease, its variations, and COVID-19-associated Multisystem Inflammatory Syndrome have been recently explained to involve high replication rate viral infections. In a subset of patients, the extensive antigen-antibody immune complexes that are not quickly cleared by phagocytosis will create a type III hypersensitivity immune reaction. The subsequent release of proteases and other enzymes and the expression or exposure of new immunogenic antigens due to protease attacks on basement membranes of epithelial cells or endothelial cells in blood vessels will induce new autoantibodies and cause Kawasaki disease, its variations, and COVID-19-related Multisystem Inflammatory Syndrome. There is now increasing evidence that a viral infection of a large surface area of tissue, such as the respiratory tract, gastrointestinal tract or blood vessels, and a resultant type III hypersensitivity immune reaction is the most plausible explanation for the causations of Kawasaki disease, its variations, and COVID-19-related Multisystem Inflammatory Syndrome. Furthermore, an improved understanding of these causations also suggests several potential new treatments which can be more effective.